Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics.

BackgroundPrimary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.MethodsA comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.AnalysisBaseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.ResultsTwo thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.ConclusionsThe two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.Trial registrationNCT02514889 , posted on 8/4/2015

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

SNAP II and SNAPPE II as Predictors of Neonatal Mortality in a Pediatric Intensive Care Unit: Does Postnatal Age Play a Role?

Introduction. In developing countries, a lack of decentralization of perinatal care leads to many high-risk births occurring in facilities that do not have NICU, leading to admission to a PICU. Objective. To assess SNAP II and SNAPPE II as predictors of neonatal death in the PICU. Methodology. A prospective study of newborns divided into 3 groups according to postnatal age: Group 1 (G1), of 0 to 6 days; Group 2 (G2) of 7 to 14 days; and Group 3 (G3), of 15 to 28 days. Variables analyzed were SNAP II, SNAPPE II, perinatal data, and known risk factors for death. The Hosmer-Lemeshow test and the receiver operating characteristics (ROC) curve were used with SPSS 17.0 for statistical analysis. An Alpha error <5% was considered significant. Results. We analyzed 290 newborns, including 192 from G1, 41 from G2, and 57 from G3. Mortality was similar in all 3 groups. Median SNAP II was higher in newborns that died in all 3 groups (P<0.05). The area under the ROC curve for SNAP II for G1 was 0.78 (CI 95% 0.70–0.86), for G2 0.66 (CI 95% 0.37–0.94), and for G3 0.74 (CI 95% 0.53–0.93). The area under the ROC curve for SNAPPE II for G1 was 0.76 (CI 95% 0.67–0.85), for G2 0.60 (CI 95% 0.30–0.90), and for G3 0.74 (CI 95% 0.52–0.95). Conclusions. SNAP II and SNAPPE II showed moderate discrimination in predicting mortality. The results are not strong enough to establish the correlation between the score and the risk of mortality

Starch and Cellulose Nanoparticles: Function and Surface Modifications for Biomedical application

In the last years, the use of polysaccharides in biomedical and biological application has received a significant great attention. Due to these materials derived from the biomass are cheap, non-toxic, renewable, biodegradable and compatible and could to produce materials capable to transfer to industrial scale. On the other hand, the use of nanoparticles represents the utmost materials of preference for engineer due to its excellent physiochemical properties. Starch and cellulose, are polysaccharides abundant, renewability, high strength stiffness, eco-friendliness and low cost, to be used in different biomedical applications. It is important to remark that the interaction cell-biomaterial is governed by the wettability, topography, chemistry, surface charge and/or the presence of hydrophobic and hydrophilic character. All of them also contribute to the biocompatibility and mechanical properties of the biomedical device. In order to improve these properties and reduce its limitations, modifications of these polysaccharides are needed, either physically or chemically. Physical modifications include the association with other nanomaterials or biopolymers yielding new nanohybrid materials for different applications. In contrast, chemical modifications include the substitution of the hydroxyl groups of the nanoparticle with other functional groups, (eterification, esterification, sulfonation, phosphorylation, amination), the variation of the distribution of functional groups (oxidation, cationization) or grafting side chains or crosslinking with small molecules or other polymers. This chapter summarizes the most relevance advances in the uses and potential applications of starch and cellulose nanoparticles and their derivatives in biomedicine. Their applications include, but are not limited to drug delivery devices, tissue engineering and antimicrobial activities.Fil: Repetto, Evangelina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Rodriguez Ramirez, Carlos Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Garcia, Nancy Lis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Manzano, Veronica Elena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: D'accorso, Norma Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; Argentin

El aprendizaje autónomo en educación superior. Revisión sistemática

Introduction: Higher education requires new learning scenarios, centered on flexible didactic strategies that allow student autonomy and contribute to their maturity in communicative-research competencies.Objective: Various investigations carried out regarding autonomous learning in higher education were analyzed. The research was important because it verified the relationship between autonomy and learning. Methods: Qualitative research, systematic review, followed the standards of the PRISMA Declaration; The information was obtained in the Scopus database, in the period 2018 - 2023 following the inclusion and exclusion criteria. For the analysis, 50 articles were selected (31 quantitative, 5 qualitative and 14 mixed). Results: They revealed that autonomous learning is the result of the union of individual or group work, self-motivation, solution strategies, responsibility, empowerment and autonomy on the part of the student together with freedom, empowerment, preparation of didactic material. of the teacher. Conclusion: most of the research emphasizes personal responsibility in the face of a situation and self-direction of learning; however, no study addresses the five dimensions of autonomous learning.Introducción: La educación superior requiere nuevos escenarios de aprendizaje, centrado en estrategias didácticas flexibles que permitan la autonomía del estudiante y que contribuyan en su madurez en las competencias de comunicativo-investigativo. Objetivo: Se analizó diversas investigaciones realizadas con respecto al aprendizaje autónomo en la educación superior. La investigación fue importante porque verificó la relación entre autonomía y aprendizaje. Métodos: Investigación cualitativa, de revisión sistemática, siguió las normas de la Declaración PRISMA; la información se obtuvo en la base de datos Scopus, en el período 2018 – 2023 siguiendo los criterios de inclusión y exclusión. Para el análisis se seleccionaron 50 artículos (31 cuantitativos, 5 cualitativos y 14 mixtos). Resultados: Revelaron que el aprendizaje autónomo es el resultado de la unión del trabajo individual o grupal, la automotivación, las estrategias de solución, la responsabilidad, el empoderamiento y la autonomía por parte del estudiante unido a la libertad, empoderamiento, preparación de material didáctico del docente. Conclusiones: la mayoría de las pesquisas hacen hincapié en la responsabilidad personal frente a una situación y la autodirección del aprendizaje; sin embargo, ningún estudio aborda las cinco dimensiones del aprendizaje autónomo

Randomized Comparative Effectiveness Trial of 2 Federally Recommended Strategies to Reduce Excess Body Fat in Overweight, Low-Income Patients: MyPlate.gov vs Calorie Counting

PurposeSince 2011, US authorities have supported the following 2 approaches to healthier body fat composition: the Centers for Disease Control and Prevention National Diabetes Prevention Program's calorie counting (CC) approach and the US Department of Agriculture's MyPlate (adherence to federal nutrition guidelines). The purpose of this study was to compare the effect of CC vs MyPlate approaches on satiety/satiation and on achieving healthier body fat composition among primary care patients.MethodsWe conducted a randomized controlled trial comparing the CC and MyPlate approaches from 2015 to 2017. The adult participants were overweight, of low income, and were mostly Latine (n = 261). For both approaches, community health workers conducted 2 home education visits, 2 group education sessions, and 7 telephone coaching calls over a period of 6 months. Satiation and satiety were the primary patient-centered outcome measures. Waist circumference and body weight were the primary anthropometric measures. Measures were assessed at baseline, 6 months, and 12 months.ResultsSatiation and satiety scores increased for both groups. Waist circumference was significantly decreased in both groups. MyPlate, but not CC, resulted in lower systolic blood pressure at 6 months but not at 12 months. Participants for both MyPlate and CC reported greater quality of life and emotional well-being and high satisfaction with their assigned weight-loss program. The most acculturated participants showed the greatest decreases in waist circumference.ConclusionsA MyPlate-based intervention might be a practical alternative to the more traditional CC approach to promoting satiety and facilitating decreases in central adiposity among low-income, mostly Latine primary care patients

Placental Trypanosoma cruzi infection is restricted by nitric oxide production by endothetial nitric oxide synthase isoform

Human placenta avoids Trypanosoma cruzi (T. cruzi) infection by differentmechanisms and the production of nitric oxide (NO) is one of them.Objective: To elucidate the importance of NO production in the parasiticload in placental tissue and the relevance of endothelial nitric oxide synthase(eNOS) isoform as a major NO producer.Methods: Placentas from caesarean delivery from clinically andserologically healthy women and Trypomastigotes of T. cruzi isolatedfrom a congenital case (named Lucky) were used. Placental villi explantswere co-cultured in RMPI 1640 for 24 h with or without(control) 1 x106 trypomastigotes of Lucky (TcII -VI strains). Cultureswere treated with NOS inhibitor NG-nitro-L-arginine methyl ester (LNAME)at 0.1 and 1 mM. Quantification of eNOS expression byimmunohistochemistry and Western blot, nitrite level in media supernatantwith Griess technique, and parasitic load by qPCR withTaqman probes were assayed.Results: Placental explants in the presence of T. cruzi showed a significantincrement of eNOS protein abundance (7.2 ± 0.94 fold, P<0.05) mainly at thesyncytiotrophoblast, bFil: Triquell, María Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Villa María; ArgentinaFil: Benizio, Evangelina Leticia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Villa María; ArgentinaFil: Moreira Espinoza, María José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Ramirez Gomez, Juan Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Mezzano, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Mazzudulli, G.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Piegari, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Schijman, Alejandro Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Díaz Luján, Cintia María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Villa María; ArgentinaFil: Fretes, Ricardo Emilio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de La Rioja. Departamento de Ciencias de la Salud y Educación. Instituto de Investigaciones en Ciencias de la Salud Humana; Argentin

Umbral densitométrico de densidad mineral ósea para considerar tratamiento en pacientes mujeres posmenopáusicas y hombres mayores de 50 años en tratamiento con glucocorticoids

Introduction and aim: T-score bone mineral density (BMD) thresholds may influence guidance for treatment in patients under glucocorticoid (GC) therapy. Different BMD thresholds have been described but there is no international consensus. The aim of this study was to find a threshold to help in treatment decision-making in the population under GC therapy. Methods: A working group representing three scientific societies from Argentina was convened. The first team was formed by specialists with expertise in glucocorticoid-induced osteoporosis (GIO) who voted according to summary of evidence. The second team was constituted by a methodology group who coordinated and supervised each stage. We conducted two systematic reviews to synthesize the evidence. The first included trials of drugs used in GIO to analyze the BMD cut-off used as inclusion criteria. In the second, we analyzed the evidence regarding the densitometric thresholds to discriminate between fractured and non-fractured patients under GC treatment. Results: In the first review, 31 articles were included for qualitative synthesis and more than 90% of the trials included patients regardless of their densitometric T-score or range of osteopenia. In the second review, 4 articles were included and more than 80% of the T-scores were in the range −1.6 to −2.0. The summary of findings was analyzed and put to a vote. Conclusions: With more than 80% agreement of the voting expert panel, a T-score ≤ −1.7 was considered the most appropriate for treatment in postmenopausal women and men over 50 years of age under GC therapy. This study could help in treatment decision-making in patients under GC therapy without fractures but other fracture risk factors should certainly be considered.Introducción y objetivo: Los umbrales del T-score de densidad mineral ósea (DMO) podrían influir en el tratamiento de pacientes bajo terapia con glucocorticoides (GC). Se han descrito diferentes umbrales, pero no existe un consenso internacional. El objetivo de este trabajo fue encontrar un umbral que ayude en la decisión terapéutica en la población bajo tratamiento con GC. Métodos: Se convocó un grupo de trabajo en representación de tres sociedades científicas de Argentina. El primer equipo estuvo formado por especialistas con experiencia en osteoporosis inducida por glucocorticoides (OIG), quienes estuvieron a cargo de la votación basada en la evidencia. El segundo equipo estuvo a cargo de la metodología coordinando y supervisando cada etapa. Realizamos dos revisiones sistemáticas: la primera incluyó ensayos de fármacos utilizados en OIG para analizar el T-score considerado como criterio de inclusión. En la segunda, analizamos la evidencia sobre umbrales densitométricos para la discriminación de pacientes fracturados y no fracturados bajo tratamiento con GC. Resultados: En la primera revisión se incluyeron 31 artículos donde se halló que más de 90% de los ensayos incluyeron pacientes independientemente del T-score o en el rango de osteopenia. En la segunda revisión se incluyeron cuatro artículos donde observamos que más de 80% de los valores de T-score se encontraban entre -1,6 y -2,0. Conclusiones: Con un acuerdo superior a 80% del panel de expertos, un T-score ≤ -1,7 se consideró el más adecuado para el tratamiento en mujeres posmenopáusicas y hombres mayores de 50 anos ˜ bajo tratamiento con GC. Este estudio podría ayudar en la decisión terapéutica en pacientes bajo tratamiento con GC sin fracturas, pero ciertamente deberían considerarse otros factores de riesgos de fracturas complementarios.Fil: Brance, María Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas; Argentina. Reumatología y Enfermedades Óseas; ArgentinaFil: Larroudé, María Silvia. Centro de Diagnostico Rossi;Fil: Somma, Luis Fernando. Consultorio de Reumatologia y Osteoporosis; ArgentinaFil: Giacoia, Evangelina. Hospital Nacional Profesor Alejandro Posadas.; ArgentinaFil: Diehl, María. Hospital Italiano; ArgentinaFil: Galich, Ana María. Hospital Italiano; ArgentinaFil: Ramirez Stieben, Luis Agustín. Hospital Privado de Rosario; ArgentinaFil: Maher, María Cielo. Instituto de Rehabilitación Psicofísica; ArgentinaFil: De La Vega, María. Ceim Investigaciones Médicas; ArgentinaFil: Ringer, Ariana. Provincia de Santa Fe. Ministerio de Salud y Medio Ambiente - Rosario. Hospital Provincial del Centenario; Argentina. Reumatología y Enfermedades Óseas; ArgentinaFil: Brun, Lucas Ricardo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas; Argentin

Short-Term Associations between Morbidity and Air Pollution in Metropolitan Area of Monterrey, Mexico

Short-term effects of air pollution on the number of hospital admissions in eight municipalities of the Metropolitan Area of Monterrey, Mexico, were assessed from 2016 to 2019 using a time-series approach. Air quality data were obtained from the Atmospheric Monitoring System of Nuevo Leon State (SIMA) which belongs to SINAICA (National System of Air Quality Information), providing validated data for this study. Epidemiological data were provided by SINAIS (National System of Health Information), considering admission by all causes and specific causes, gender and different age groups. Guadalupe had the highest mean concentrations for SO2, CO and O3; whereas Santa Catarina showed the highest NO2 concentrations. Escobedo and Garcia registered the highest levels for PM10. Only PM10 and O3 exceeded the permissible maximum values established in Mexican official standards. A basal Poisson model was constructed to assess the association between daily morbidity and air pollutants, from this, a second scenario in which daily mean concentrations of air pollutant criteria increase by 10% was considered. Most of pollutants and municipalities studied showed a great number of associations between an increase of 10% in their current concentrations and morbidity, especially for the age group between 5 and 59 years during cold months, excepting ozone which showed a strongest correlation during summer. Results were comparable to those reported by other authors around the world, however, in spite of relative risk index (RRI) values being low, they are of public concern. This study demonstrated that considering the nature of their activities, economically active population and students, they could be more vulnerable to air pollution effects. Results found in this study can be used by decision makers to develop public policies focused on protecting this specific group of the population in metropolitan areas in Mexico

Influence of Chloride Salinity on Cadmium uptake by Nicotiana tabacum in a Rhizofiltration System

A hydroponic trial was conducted to study the effect of chloride salinity in simulated effluent on Cd accumulation by tobacco. Leaf surface area (LSA) and root surface area (RSA) measurements were incorporated as possible determinants of Cd uptake rate by plants. Results showed that individual plant differences in Cd content were normalized when including RSA to express Cd uptake rates by plants but not including LSA. A biotic ligand model (BLM) fitted to predict Cd uptake, estimated active and almost linear uptake of the free Cd2+ ion by tobacco plants, while virtually no changes in the chloride complex (CdCl+) uptake were predicted, presumably due to a rapid saturation of the hypothetical root sorption sites at the concentrations used in this trial. Nicotiana tabacum var. K326 is evidenced to be a species potentially suitable for biological wastewater treatment using rhizofiltration at concentrations commonly found in salt-affected wastewater, with high Cd accumulation (185 to 280 mg/kgdm) regardless of water salinity and tolerance up to 80 mmol/L NaCl