Título del artículo:

Strategies for Citizenship Training in Ibero-America: A Systematized Review

The purpose of this article is to analyze the relevance of the educational policies implemented for citizen training, and to identify the methods and strategies used for training in citizen competencies and alternative citizenship in Ibero-America. Therefore, a systematized review of the literature of the last five years (2017-2022) was carried out. The Newman and Gough (2020) methodology, PRISMA Statement (2020) for systematized reviews and the evaluation instruments (JBI) were applied. The databases Scopus, Redalyc, and Dialnet were searched, where 50 articles were selected according to the inclusion and exclusion criteria. Results show different positions and controversies about the relevance of the educational policies implemented for citizenship training, as well as divergences regarding pedagogical methods and strategies used for citizenship training. The percentage of studies found are the following: strategies for training in alternative citizenship 20%, education for global citizenship 14%, pedagogical methods and strategies for training in citizenship 48% and relevance of educational policies for training in citizenship 18%. Studies on alternative citizenships agree and open debates on new training strategies such as critical, gender, cyberspace, social justice, intercultural, decolonial, and techno-social pedagogies. It is concluded that, in the context of fragile democracies, as the ones studied, the emergence of complex social problems and technological transformations are generating new training strategies for alternative citizenships; however, changes, new educational policies, and the implementation of innovative pedagogies are still required.

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Revista de Investigacion Educativa

Título del artículo:

Effectiveness of an intervention to prevent child sexual abuse

Child sexual abuse prevention programs that focus on developing self-protective behaviors among children are highly significant as they address potential psychosocial impacts and the prevalence of sexual violence. There is also scientific evidence that supports their effectiveness. A quasi-experimental study was conducted with 57 sixth-grade students to evaluate an intervention that involved educational workshops on the topics of sexual and reproductive rights, self-awareness, boundary setting and identifying dangerous situations. The Prudence Test was employed to verify the intervention\'s effect. A significant difference was found between the different groups (U = 805.000, p < .001; rbis = 0.983) and between pre- and post-intervention measures (W = 1.500, p < .001, rbis = -0.992) within the experimental group. These findings confirm the effectiveness of the intervention.

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Revista Latinoamericana de Ciencias Sociales, Ninez y Juventud

Título del artículo:

Knowledge diffusion as a key element in smart governance

This study examines the critical role of knowledge diffusion in smart governance within complex and globalized contexts, emphasizing its importance in driving technological advancement and fostering an information-driven society. By integrating smart governance with knowledge diffusion, the research aims to identify strategies for building a more equitable and inclusive society. A narrative review of documents from 2015 to 2023 was conducted using Boolean operators across major databases, followed by a rigorous selection and analysis using a traceability matrix. The findings highlight the innovative culture of smart governance, showcasing successful integration of citizen participation, public value creation, open government, and interorganizational collaboration. The results demonstrate that effective knowledge diffusion is essential for establishing robust governance systems that contribute significantly to economic and social development. The study concludes that embedding knowledge diffusion within smart governance frameworks can drive substantial societal improvements, promoting greater equity and justice.

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Salud, Ciencia y Tecnologia

Título del artículo:

2024 Latin American Society of Hypertension guidelines on the management of arterial hypertension and related comorbidities in Latin America

Hypertension is responsible for more than two million deaths due to cardiovascular disease annually in Latin America (LATAM), of which one million occurs before 70 years of age. Hypertension is the main risk factor for cardiovascular morbidity and mortality, affecting between 20 and 40% of LATAM adults. Since the publication of the 2017 LASH hypertension guidelines, reports from different LATAM countries have confirmed the burden of hypertension on cardiovascular disease events and mortality in the region. Many studies in the region have reported and emphasized the dramatically insufficient blood pressure control. The extremely low rates of awareness, treatment, and control of hypertension, particularly in patients with metabolic disorders, is a recognized severe problem in LATAM. Earlier implementation of antihypertensive interventions and management of all cardiovascular risk factors is the recognized best strategy to improve the natural history of cardiovascular disease in LATAM. The 2024 LASH guidelines have been developed by a large group of experts from internal medicine, cardiology, nephrology, endocrinology, general medicine, geriatrics, pharmacology, and epidemiology of different countries of LATAM and Europe. A careful search for novel studies on hypertension and related diseases in LATAM, together with the new evidence that emerged since the 2017 LASH guidelines, support all statements and recommendations. This update aims to provide clear, concise, accessible, and useful recommendations for health professionals to improve awareness, treatment, and control of hypertension and associated cardiovascular risk factors in the region.

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Journal of Hypertension

Título del artículo:

A Novel Supraglottic Suction Device in Mechanically Ventilated Patients: A Randomized Controlled Trial

Objective: To evaluate the efficacy and safety of the SUPRAtube innovation device in preventing ventilator associated events and fluid accumulation in the supraglottic region in patients receiving mechanical ventilation (MV) through orotracheal tubes. Methods: Multicenter, controlled, randomized, parallel, open-label clinical trial with a 1:1 allocation ratio of MV patients compared the use of the SUPRAtube elastomeric device with standard care and aspiration techniques. A series of computer-random numbers and centralized allocation with sealed envelopes were used. Setting: Adult patients (n=108; mean age: 63 yrs, range: 19–85) hospitalized in intensive care units of two centers, the Cardiovascular Foundation of Colombia and the International Hospital of Colombia (Santander, Colombia), were included. All patients received MV through orotracheal tubes, were hemodynamically stable, had upper airway integrity according to fiberoptic bronchoscope findings, and had basic coagulation tests within acceptable risk criteria. Interventions: Comprehensive standard of care, including preventive strategies, medical therapy, positive pressure MV, and routine procedures for management of oropharyngeal and pulmonary secretions (humidification, patient mobilization, and airway suctioning), was compared with the standard of care plus continuous supraglottic suction with the new SUPRAtube device. Results: The study period reached five days before extubation (media 85±7 hours). The weight of the aspirated content was 415 g (P25;P75: 396;536) in the control group and 624 g (P25;P75: 469;824) in the SUPRAtube group (p<0.001), equivalent to a mean difference of 213 g (P25;P75: 55;569; +50%). The device did not induce adverse events. Conclusion: Continuous supraglottic aspiration using SUPRAtube is complementary, effective, safe, simple, and inexpensive and reduces the accumulation of oropharyngeal secretions in mechanically ventilated patients. The relevant clinical benefit in terms of preventing and improving tracheobronchitis earlier on was demonstrated by sequential fiberoptic bronchoscopy. Registration in Clinical Trials: The present study is registered at clinicaltrials.gov NCT03573609.

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Medical Devices: Evidence and Research

Título del artículo:

Homogeneity, dimensionality, convergent and nomological validity of the family APGAR among primary care users in Bucaramanga, Colombia

To conduct confirmatory factor analysis and examine the convergent and nomological validity of the family APGAR among primary care users in Bucaramanga, Colombia. Methods: A diagnostic technology study evaluated the performance of a health measurement scale without using a reference criterion, following the recommendations of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) statement. A total of 243 Primary Care users aged >18 years from Colombia participated in the study. Confirmatory Factor Analysis and convergent and nomological validity tests were performed by comparing the family APGAR scores with the PHQ-9, PHQ-2, and HADS-A scores. Results: Cronbach’s alpha coefficients were between 0.89 and 0.91, and McDonald’s omega coefficients between 0.89 and 0.91, with adequate correlations (>0.70) for the items. APGAR presented a single factor with excellent goodness-of-fit indicators: x2 = 7.90, df = 5, p =.16, RMSEA = 0.04, TLI = 0.99, CFI = 0.99, SRMR = 0.01, and normalized chi-square = 1.58. The analysis of the convergent validity of the APGAR with the HADS-A, PHQ-9, and PHQ-2 scales presented inverse and moderate correlations with adequate indicators of nomological validity with depressive symptomatology. Conclusion:The Family APGAR instrument shows robust unidimensional structure, adequate nomological validity, high internal consistency, and acceptable convergent validity.

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Journal of Family Social Work

Título del artículo:

Effect of two different types of exercise volumes on exercise capacity, physical activity, and quality of life in subjects undergoing percutaneous coronary intervention: a pilot study

Introduction. Phase II of cardiac rehabilitation includes 36 sessions of exercise over 12 weeks, an intervention format that seems to be based on historical practice and not scientific evidence. The objective was to evaluate the effect of two types of exercise volumes on exercise capacity, physical activity levels, and quality of life in subjects undergoing percutaneous coronary intervention. Methods. A randomized controlled clinical trial was performed in 17 subjects, who were randomly assigned into two groups. The first (n = 7) was trained for eight consecutive weeks, and the second (n = 10) for 12 weeks. The six-minute walk test, the International Physical Activity Questionnaire, and the SF-36 were applied before starting the cardiac rehabilitation program at 8 and 12 weeks. Results. No significant differences were found between the intervention groups. The rise in VO2 max was only significant in the 8-week group. Both groups improved their distance walked and sedentary behaviour. The 12-week intervention group had improved the quality of life, specifically in physical functioning, and the 8-week intervention group in the domains of social, physical, and emotional functioning. Additionally, the percentage of participants meeting physical activity recommendations was higher in the 12-week cardiac rehabilitation group. Conclusions. The implication for clinical practice is that the exercise traditionally used in cardiac rehabilitation shows early changes in exercise capacity and quality of life. The results of the levels of physical activity and sedentary behaviour improved after 12 weeks of rehabilitation without the presence of adverse events.

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Physiotherapy Quarterly

Título del artículo:

Self-Reported Prevalence of Chronic Non-Communicable Diseases Concerning Socioeconomic and Educational Factors: Analysis of the PURE-Ecuador Cohort

Background: The changing epidemiological landscape, marked by the increasing prominence of Non-Communicable Chronic Diseases (NCDs), underscores the need for studies that identify and analyze these conditions and their associated risk factors. This secondary analysis aims to describe the association between socioeconomic and educational characteristics and the prevalence of self-reported NCDs among participants in the PURE-Ecuador cohort in urban and rural populations of the Metropolitan District of Quito (MDQ), Ecuador. Methods: This secondary analysis is part of the Prospective Urban Rural Epidemiological (PURE) study. Data were collected from February to December 2018, including 2028 participants aged 35 to 70 years from different urban and rural areas of the MDQ. Data collection utilized standardized questionnaires administered in face-to-face interviews. Pearson’s chi-square tests and multivariate logistic regression were used to assess associations. Results: The self-reported prevalence of hypertension was 16.2%, rising to 32.7% in individuals over 60 years old. The prevalence of diabetes mellitus was 6.7%, coronary heart disease 1.3%, stroke 1.6%, heart failure 1.3%, COPD 0.4%, asthma 1.3%, and cancer 1.9%. Multimorbidity affected 5.9% of participants, with the highest rates in obese and older individuals (≥60 years). Adherence to medications was high for hypertension and diabetes mellitus but varied substantially between communities. Conclusions: The secondary analysis revealed significant disparities in the prevalence and management of NCDs in MDQ. The prevalence of self-reported NCDs in Quito, Ecuador, is significantly associated with age and body mass index (BMI). Older individuals, particularly those over 60 years, and obese participants demonstrated higher rates of NCDs and multimorbidity. While socioeconomic factors such as education and income showed some associations with NCD prevalence, these were less pronounced after adjusting for other variables. These findings highlight the importance of age-specific and obesity-focused interventions in addressing the burden of NCDs in this population.

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Global Heart

Título del artículo:

Team based strategy to control hypertension

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Revista de la Federacion Argentina de Cardiologia

Título del artículo:

Single-pill combination therapy is the standard of care for hypertension, but it is time for the next step: Implementation

The GMRx2 trial1 in adults with high blood pressure (BP) demonstrated that after 12 weeks, a low-dose single-pill combination of telmisartan, amlodipine, and indapamide significantly reduced BP levels compared to several dual combinations (telmisartan with amlodipine, telmisartan with indapamide, or amlodipine with indapamide). Adverse events did not differ between the groups. This novel therapeutic option could improve high BP control.

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Med

Título del artículo:

May Measurement Month 2022: Results from the global blood pressure screening campaign

Introduction Elevated blood pressure (BP) is the major contributor to mortality and disease burden worldwide. May Measurement Month (MMM) is a global BP screening campaign, which aims to raise awareness of BP measurement and provide evidence to inform and influence related health policy. Methods This cross-sectional survey included individuals aged≥18 years recruited through opportunistic sampling at sites in 60 countries during MMM 2022. Each participant had three sitting BP measurements and a questionnaire was completed including demographics, comorbidities and lifestyle factors. Hypertension was defined as a systolic BP≥140 mm Hg and/or a diastolic BP≥90 mm Hg (average of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to estimate BP readings where any participant\'s BP readings were missing. Linear mixed effects models were used to identify associations between participant characteristics and systolic or diastolic BP. Results Of the 715 518 participants surveyed (excluding 50 200 self-measured home BP screenees recruited via the ZOE Health Study app), 257 421 (36.0%) were identified as hypertensive, of whom 57.6% were aware and 49.3% were on antihypertensive medication. Of all participants with hypertension, 26.1% were controlled to <140/90 mm Hg and 12.0% to <130/80 mm Hg. Of those taking antihypertensive medication, 52.7% were taking only one drug class, 52.9% were controlled to <140/90 mm Hg and 24.4% to 130/80 mm Hg. In total, 190 314 (26.6% of total surveyed, 73.9% of hypertensives) participants screened were found to have untreated or inadequately treated hypertension. Only 27.6% of treated hypertensive participants were taking a statin. Substantial coexistence of diabetes, overweight and hypertension was apparent among participants. Conclusions MMM confirms a high global burden of hypertension with low rates of awareness, treatment and control. In the absence of systematic BP screening in many countries, the results from MMM underscore the continued need for BP screening to detect and thereby control raised BP.

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BMJ Global Health

Título del artículo:

Histopathological and histochemical alterations resulting from Phytophthora infestans infection in the potato plant Solanum tuberosum (Solanaceae)

Research on the histopathological and histochemical responses of the Phytophthora infestans/Solanum tuberosum pathosystem is limited in the scientific literature. The morpho-anatomy of the leaves and stems aligns with typical descriptions of most eudicot angiosperms. The cuticular patterns observed were not previously documented in specialized literature, and notable ultrastructural differences were found that varied by the genotype analyzed. The leaves are distinctly hypostomatic. Histopathologically, both the biotrophic and necrotrophic phases of the pathogen were observed, primarily affecting the primary tissues of the leaves and stems. All the infected genotypes exhibited an increase in the synthesis and accumulation of lignin, pectins, and polyphenols. In contrast, only the ESTRELLA and BETINA genotypes demonstrated synthesis and deposition of callose in response to the pathogen during sporulation. The histopathological and histochemical responses observed in this pathosystem are similar to those described in previous studies, even in other pathosystems. The pronounced differences in callose synthesis and accumulation are particularly noteworthy and may indicate a potential late resistance mechanism to the pathogen, which could be valuable for breeding programs aimed at developing varieties with enhanced resistance.

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Indian Phytopathology

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Ecthyma Gangrenosum of Fungal Origin: A Case Report

Introduction: Ecthyma gangrenosum (EG) is usually a dermatologic manifestation of a Pseudomonas aeruginosa infection in an immunocompromised individual but may sometimes be caused by other bacteria or fungi in an immunocompromised or nonimmunocompromised individual. Case Presentation: A 75-year-old woman with a history of high blood pressure and sequels of ischemic cerebral infarction presented with a 5-day history of general malaise, cough with yellow sputum, and respiratory distress. The patient had pale mucous membranes, temperature of 38.5°C, tachycardia, normal blood pressure, SaO2 of 85%, intercostal retractions, and severe bronchospasm upon hospital admission. No skin lesions were seen. The patient was admitted to the intensive care unit (ICU) because of her critical condition and was supported with invasive mechanical ventilation. Her blood count showed 8,100 leukocytes/mm3, neutrophils 79%, hemoglobin 10.1 g/dL, creatinine 1.1 mg/dL, and C-reactive protein 328 mg/dL. Arterial blood gases showed metabolic acidosis and moderate hypoxemia. The initial report of blood and urine cultures was negative for bacteria, and positive for influenza A H1N1. The patient was treated with oseltamivir and intravenous methylprednisolone for acute respiratory distress syndrome associated with the viral infection that occurred. Subsequently, violaceus macular and papular lesions appeared, which evolved into ulcerated lesions with erythematous border and necrotic center were seen in the anterior region of the chest and abdomen, from where Candida metapsilosis was isolated. EG was reported in this patient, who was also immunocompromised because of steroid use, had a prolonged stay in the ICU and received broad-spectrum antibiotics. Fungemia and urinary infection due to different fungi were also found. Conclusion: It is worth mentioning that EG can be caused by germs other than P. aeruginosa and fungal infections should not be ruled out.

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Case Reports in Dermatology

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Post-migration infection with SARS-CoV-2 in Venezuelan migrants: A laboratory-based epidemiological observational study

Background: Since 2015, over 6 million Venezuelans migrated to Colombia and neighboring countries. While most people adhered to lockdown measures, migrants kept moving during the COVID-19 pandemic. Method: To investigate the extent of migration-associated SARS-CoV-2 infections, we interviewed 1209 adult Venezuelan migrants upon arrival to Bucaramanga, Colombia, 200 km from the Colombian-Venezuelan border along the main migration route during April–September 2021, collected individual-level socio-economic and clinical data, sampled blood and saliva, and assessed SARS-CoV-2 infection by serological, molecular and phylogenetic tools. Results: SARS-CoV-2 RT-PCR positivity was 1.9 % (95 % Confidence Interval (CI), 1.2–2.9) without varying significantly over the study period (chi-square, p = 0.922) and significantly associated with stay in Colombia >14 days (p = 0.018; prevalence ratio 3.3, 95 % CI, 1.2–8.7). Pre-existing SARS-CoV-2-specific antibodies were neither significantly associated with preventing infection (Chi-square, p = 0.188), nor symptom development (Fisher, p = 0.246). Predominance and time of detection of SARS-CoV-2 Mu and Gamma variants in migrants in comparison to available genomic data suggested infection predominantly in Colombia. SARS-CoV-2 IgG-based seroprevalence was 34.2 % (95 % CI, 31.5–36.9). Detection of SARS-CoV-2-specific antibodies was significantly associated with previous contact with infected individuals (p = 0.002). Conclusions: SARS-CoV-2 infection occurred predominantly after immigration, potentially facilitated by densely populated border camps. Improved infrastructure and health care will prevent migration-associated spread of COVID-19 and other infectious diseases.

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Travel Medicine and Infectious Disease

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Assessing the built environment through photographs and its association with obesity in 21 countries: the PURE Study

Background: The built environment can influence human health, but the available evidence is modest and almost entirely from urban communities in high-income countries. Here we aimed to analyse built environment characteristics and their associations with obesity in urban and rural communities in 21 countries at different development levels participating in the Prospective Urban and Rural Epidemiology (PURE) Study. Methods: Photographs were acquired with a standardised approach. We used the previously validated Environmental Profile of a Community\'s Health photo instrument to evaluate photos for safety, walkability, neighbourhood beautification, and community disorder. An integrated built environment score (ie, a minimum of 0 and a maximum of 20) was used to summarise this evaluation across built environment domains. Associations between built environment characteristics, separately and combined in the integrated built environment score, and obesity (ie, a BMI >30kg/m2) were assessed using multilevel regression models, adjusting for individual, household, and community confounding factors. Attenuation in the associations due to walking was examined. Findings: Analyses include 143 338 participants from 530 communities. The mean integrated built environment score was higher in high-income countries (13·3, SD 2·8) compared with other regions (10·1, 2·5) and urban communities (11·2, 3·0). More than 60% of high-income country communities had pedestrian safety features (eg, crosswalks, sidewalks, and traffic signals). Urban communities outside high-income countries had higher rates of sidewalks (176 [84%] of 209) than rural communities (59 [28%] of 209). 15 (5%) of 290 urban communities had bike lanes. Litter and graffiti were present in 372 (70%) of 530 communities, and poorly maintained buildings were present in 103 (19%) of 530. The integrated built environment score was significantly associated with reduced obesity overall (relative risk [RR] 0·58, 95% CI 0·35–0·93; p=0·025) for high compared with low scores and for increasing trend (0·85, 0·78–0·91; p<0·0001). The trends were statistically significant in urban (0·85, 0·77–0·93; p=0·0007) and rural (0·87, 0·78–0·97; p=0·015) communities. Some built environment features were associated with a lower prevalence of obesity: community beautification RR 0·75 (95% CI 0·61–0·92; p=0·0066); bike lanes RR 0·58 (0·45–0·73; p<0·0001); pedestrian safety RR 0·75 (0·62–0·90; p=0·0018); and traffic signals RR 0·68 (0·52–0·89; p=0·0055). Community disorder was associated with a higher prevalence of obesity (RR 1·48, 95% CI 1·17–1·86; p=0·0010). Interpretation: Community built environment features recorded in photographs, including bike lanes, pedestrian safety measures, beautification, traffic density, and disorder, were related to obesity after adjusting for confounders, and stronger associations were found in urban than rural communities. The method presents a novel way of assessing the built environment\'s potential effect on health. Funding: Population Health Research Institute, Hamilton Health Sciences Research Institute, Heart and Stroke Foundation of Ontario, Canadian Institutes of Health Research\'s Strategy for Patient Oriented Research, Ontario Support Unit, Ontario Ministry of Health and Long-Term Care, AstraZeneca, Sanofi–Aventis, Boehringer Ingelheim, Servier, and GlaxoSmithKline.

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The Lancet Global Health

Título del artículo:

International review of blood donation screening for anti-HBc and occult hepatitis B virus infection

Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials and Methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

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Transfusion

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Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension

Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management. However, conventional home and ambulatory BP monitoring devices use the upper-arm cuff oscillometric method and only provide intermittent BP readings under static conditions or in a limited number of situations. New innovations include technologies for BP estimation based on processing of sensor signals supported by artificial intelligence tools, technologies for remote monitoring, reporting and storage of BP data, and technologies for BP data interpretation and patient interaction designed to improve hypertension management (\"digital therapeutics\"). The number and volume of data relating to new devices/technologies is increasing rapidly and will continue to grow. This International Society of Hypertension position paper describes the new devices/technologies, presents evidence relating to new BP measurement techniques and related indices, highlights standard for the validation of new devices/technologies, discusses the reliability and utility of novel BP monitoring devices, the association of these metrics with clinical outcomes, and the use of digital therapeutics. It also highlights the challenges and evidence gaps that need to be overcome before these new technologies can be considered as a user-friendly and accurate source of novel BP data to inform clinical hypertension management strategies.

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Journal of Hypertension

Título del artículo:

Green hydrogen demand in Cameroon\'s energy sectors by 2040

Cameroon possesses a significant endowment of solar energy, granting it exceptional potential for the generation of hydrogen through environmentally friendly means. However, the continued expansion of the nation\'s petroleum industry presents an obstacle to the domestic utilization of green hydrogen due to its present costliness for energy purposes. Nonetheless, the prospect of exporting green hydrogen to developed nations remains an intriguing proposition. Indeed, a pact concerning hydrogen was established between Australia and Cameroon in the year 2021, thus opening avenues for the export of green hydrogen to facilitate the decarbonization of national energy supplies in Australia and other industrialized nations. Presently, there are no documented large-scale projects within Cameroon dedicated to the electrolytic production of hydrogen. This study projects the potential hydrogen demand in the electricity and transportation sectors up to 2040. Electricity demand is expected to be as high as 8675 GWh in 2040, while gasoline and diesel demand are expected to reach 1.75 and 3.26 million cubic meters, respectively. Therefore, the total amount of hydrogen needed to power both the electricity and transportation sectors is estimated at 0.532 megatonnes. Even a relatively modest allocation, merely 5 %, of Cameroon\'s land for the production of hydrogen via solar-powered electricity generation could yield a surplus. This resultant quantity of hydrogen, estimated at a substantial 16.68 megatonnes, would likely be more than enough to satisfy the projected domestic needs for both electrical and transportation uses by the year 2040.

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Renewable and Sustainable Energy Reviews

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A very-low-calorie ketogenic diet normalises obesity-related enhanced levels of erythropoietin compared with a low-calorie diet or bariatric surgery

Purpose: Nutritional ketosis synergistically with body-weight loss induced by a very-low-calorie ketogenic diet (VLCKD) has proven to be effective in improving obesity-related pathophysiology. Recently, growing attention has been focused on the relation between erythropoietin (EPO) and obesity. Thus, this study aims to investigate whether nutritional ketosis and weight loss induced by a VLCKD modify the circulating levels of EPO in patients with obesity in comparison with the effect of low-calorie diet (LCD) or bariatric surgery (BS). Methods: EPO levels, iron status and body composition parameters were evaluated in 72 patients with overweight or obesity and 27 normal-weight subjects at baseline and after the three different weight-reduction therapies (VLCKD, LCD and BS) in 69 patients with excess body weight. β-hydroxybutyrate levels were also measured in the VLCKD group. The follow-up was established at 2–3 months and 4–6 months. Results: It was found that EPO levels were higher in morbid obesity and correlated with higher basal weight, fat mass (FM) and fat-free mass (FFM) in the overall sample. High baseline EPO levels were also correlated with higher impact on the course of weight loss and changes in FM and FFM induced by the three weight-loss interventions. Furthermore, the VLCKD induced a decrease in EPO levels coinciding with maximum ketosis, which was maintained over time, while statistically significant changes were not observed after LCD and BS. Conclusion: The obesity-related increased EPO levels are restored after VLCKD intervention at the time of maximum ketosis, suggesting a potential role of the nutritional ketosis induced by the VLCKD. Baseline EPO levels could be a biomarker of response to a weight-loss therapy. Graphical abstract: (Figure presented.)

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Journal of Endocrinological Investigation

Título del artículo:

Design and validation of educational material included in a health education strategy aimed at individuals with cardiovascular diseases implemented via WhatsApp

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. Cardiac rehabilitation programs (CRP) have demonstrated advantages for patients with CVD; however, few maintain their participation over time due to poor adherence, which could be impacted by the lack of structured education programs. Objectives: To design and validate educational material included in a health education strategy implemented via WhatsApp aimed at individuals with CVD who participate in a CRP. Materials and methods: Mixed methods study based on the research-creation process and developed in two stages: design and elaboration stage of the educational strategy and validation stage of the educational material, which included a technical validation (participation of 8 health professionals) and a target audience validation (participation of 6 patients with CVD users of a phase 2-CRP). This study followed the guidelines of the Pan American Health Organization for the elaboration and validation of educational material in health care. Results: The first version of the strategy included 26 educational pieces (17 images, 5 audios, and 4 videos), and 96.3% of them were rated as “use as is”. Considering the content and form suggestions made by the experts, the second version included 31 educational pieces (22 images, 5 audios, and 4 videos). Following the validation of the target audience, the final version of the material consisted of 30 pieces (21 images, 4 audios, and 5 videos). Conclusion: The present study allowed us to design and validate educational material targeted at CRP users which, through its patient-centered nature and easy dissemination via a widely used social network, becomes a tool that can help to improve adherence to these programs. This clinical trial was registered in the Australian New Zealand Clinical Trials Registry under code ACTRN12622001446752.

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Revista Facultad de Medicina

Título del artículo:

Campylobacter infection of young children in Colombia and its impact on the gastrointestinal environment

Campylobacter infections are a leading cause of bacterial-derived gastroenteritis worldwide with particularly profound impacts on pediatric patients in low- and middle-income countries. It remains unclear how Campylobacter impacts these hosts, though it is becoming increasingly evident that it is a multifactorial process that depends on the host immune response, the gastrointestinal microbiota, various bacterial factors, and host nutritional status. Since these factors likely vary between adult and pediatric patients in different regions of the world, it is important that studies define these attributes in well-characterized clinical cohorts in diverse settings. In this study, we analyzed the fecal microbiota and the metabolomic and micronutrient profiles of asymptomatic and symptomatic pediatric patients in Colombia who were either infected or uninfected with Campylobacter during a case-controlled study on acute diarrheal disease. Here, we report that the microbiome of Campylobacter-infected children only changed in their abundance of Campylobacter spp. despite the inclusion of children with or without diarrhea. In addition to increased Campylobacter, computational models were used to identify fecal metabolites that were associated with Campylobacter infection and found that glucose-6-phosphate and homovanillic acid were the strongest predictors of infection in these pediatric patients, which suggests that colonocyte metabolism is impacted during infection. Despite changes to the fecal metabolome, the concentrations of intestinal minerals and trace elements were not significantly impacted by Campylobacter infection but were elevated in uninfected children with diarrhea.

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mSphere

Título del artículo:

Differences in COVID-19 Vaccination and Experiences among Patients with Hypertension in Colombia and Jamaica during the COVID-19 Pandemic

During the COVID-19 pandemic, hypertensive patients had increased infection and healthcare disruption in many low- and middle-income countries (LMICs) with limited vaccine access. The objective of this report is to describe COVID-19 experiences and vaccination uptake among hypertensive patients in Colombia and Jamaica. A cross-sectional study of patients with hypertension was conducted in primary care clinics in both countries between 2021 and 2022. Trained interviewers used a telephone-administered questionnaire to assess COVID-19 experiences (infection, vaccination, and healthcare access). A total of 576 patients (68.5% female, mean age: 67.5 years) participated. Health service disruption affecting access to care was low (<10%). Compared to Jamaica, more participants from Colombia reported testing positive for COVID-19, having family members or friends testing positive, losing family members or friends due to COVID-19, and being vaccinated. In logistic regression models, adjusted for age, sex, education, and rural/urban clinic status, fear of COVID-19 (OR 2.7, 95% CI: 1.2–6.1) and residence in Colombia (OR 5.9, 95% CI: 2.4–14.6) were associated with higher vaccination uptake. Disparities in access to COVID-19 testing and diagnosis may have influenced these country differences including fear of COVID-19 and vaccine uptake. Other factors need to be better understood to prepare for future pandemic responses.

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International Journal of Environmental Research and Public Health

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Chronic Rheumatologic Disease in Chikungunya Virus Fever: Results from a Cohort Study Conducted in Piedecuesta, Colombia

This study aimed to determine the incidence of post-chikungunya chronic rheumatism (pCHIK-CR) and its impact on quality of life (QoL) and chronic fatigue in adults seven years after the 2014–2015 CHIKV outbreak in Piedecuesta, Colombia. We evaluated 78 adults (median age: 30 years, IQR: 21.0; women 60.3%) with confirmed CHIKV infection. In 2022, participants underwent a GALS examination and completed surveys on disability, stiffness, health status, and fatigue. A rheumatologist evaluated patients who reported arthralgia, morning stiffness, and abnormal GALS examination. Chronic fatigue was defined as fatigue persisting for over six months. Seven years after infection, 14.1% of participants were classified as pCHIK-CR cases, 41.0% as having non-inflammatory pain, likely degenerative (NIP-LD), and 44.9% without rheumatic disease (Wo-RM). Patients with pCHIK-CR and NIP-LD exhibited significantly worse QoL compared to Wo-RM cases. Chronic fatigue prevalence increased from 8.6% in Wo-RM patients to 25.0% in NIP-LD and 54.6% in pCHIK-CR cases. This study implemented a comprehensive clinical assessment to objectively estimate and characterize the incidence of chronic rheumatological disease attributed to CHIKV infection. One in seven cases with CHIKV infection develops pCHIK-CR, which impacts both QoL and chronic fatigue. This study contributes to understanding the burden of these arboviruses in the medium term.

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Tropical Medicine and Infectious Disease

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Enhancing the Cytotoxicity and Apoptotic Efficacy of Parasporin-2-Derived Variants (Mpp46Aa1) on Cancer Cell Lines

Parasporin PS2Aa1, recently renamed Mpp46Aa1, is an anti-cancer protein known for its selectivity against various human cancer cell lines. We genetically modified native PS2Aa1 to create a library of approximately 100 mutants. From this library, we selected promising mutants based on their half-maximal inhibitory concentration (IC50) and sequence variations. In this study, Variant 3–35, with the G257V substitution, demonstrated increased cytotoxicity and selectivity against the colon cancer cell line SW480. Conversely, Variant N65, featuring substitutions N92D, K175R, and S218G, yielded the most favorable results against the cancer cell lines SW-620, MOLT-4, and Jurkat. The caspase 3/7 and 9, Annexin V-Cy3 and 6-GFDA activities, and, most notably, mitochondrial membrane permeabilization assays confirmed the apoptotic marker elevation. These findings indicate that residues 92, 175, 218, and 257 may play a critical role in the cytotoxic activity and selectivity. We successfully obtained genetically improved variants with substitutions at these key amino acid positions. Additionally, we conducted molecular dynamic simulations to explore the potential interactions between PS2Aa1 and the CD59 GPI-anchored protein. The simulation results revealed that residues 57, 92, and 101 were consistently present, suggesting their possible significance in the interactions between parasporin and the CD59 protein.

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Toxins

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Low Levels of Complement Factor H in the First Trimester of Pregnancy Are Associated with Spontaneous Preterm Birth

Preterm birth (PTB) remains a significant public health concern, and prediction is an important objective, particularly in the early stages of pregnancy. Many studies have relied on cervical characteristics in the mid-trimester, with limited results. It is therefore crucial to identify novel biomarkers to enhance the ability to identify women at risk. The complement pathway is implicated in the process of placentation, and recent proteomics studies have highlighted the potential roles of some complement proteins in the pathophysiology of PTB. To determine the association between the occurrence of spontaneous preterm birth (sPTB) and the concentration of complement C3, factor B, and factor H in the blood of pregnant women during the first trimester. This prospective cohort study included women with singleton pregnancies, both with and without a history of sPTB, from two health institutions in Bucaramanga, Colombia. The outcome was sPTB before 37 weeks. A blood sample was obtained between 11 + 0 to 13 + 6 weeks. ELISA immunoassay was performed to quantify the levels of C3, factor B, and factor H. A total of 355 patients were analyzed, with a rate of sPTB of 7.6% (27/355). The median plasma concentration for C3, factor B, and factor H were 488.3 μg/mL, 352.6 μg/mL, and 413.2 μg/mL, respectively. The median concentration of factor H was found to be significantly lower in patients who delivered preterm compared to patients who delivered at term (382 μg/mL vs. 415 μg/mL; p = 0.034). This study identified a significant association between low first-trimester levels of factor H and sPTB before 37 weeks. These results provide relevant information about a new possible early biomarker for sPTB. However, the results must be confirmed in different settings, and the predictive value must be examined.

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International Journal of Molecular Sciences