ABSTRACT This article aims to bridge the gap between drug development and lifestyle modification strategies for dementia prevention. First, it focuses on three lessons from drug development to inform lifestyle changes: dementia treatment-resistance, the importance of maximizing therapeutic dose, and obtaining actionable feedback from drug trials. Moreover, epidemiology reveals a mismatch between promising associations and later interventions, the specificity of different dementias, and the ethics of health promotion. The article will argue that lifestyle choices for dementia risk should be understood through the lens of a life philosophy rather than a testable scientific hypothesis. This philosophy known by "DOSE" has four components: Diet — Other life priorities — Stimulation — Exercise. Striking the balance between a healthy lifestyle and non-health priorities is a fundamentally personal question and challenge, particularly in resource-limited contexts. Finally, individual behaviors are only the tip of the iceberg of modifiable dementia risk, inviting collective action to ensure equitable prevention. prevention First changes treatmentresistance, treatmentresistance treatment resistance, resistance treatment-resistance dose trials Moreover interventions dementias promotion hypothesis DOSE "DOSE components Exercise nonhealth non challenge resourcelimited resource limited contexts Finally

RESUMO Este artigo visa preencher a lacuna entre o desenvolvimento de medicamentos e as estratégias de modificação do estilo de vida para a prevenção da demência. Em primeiro lugar, ele se concentra em três lições do desenvolvimento de medicamentos para informar as mudanças no estilo de vida: resistência ao tratamento da demência, a importância de maximizar a dose terapêutica e a obtenção de informações acionáveis a partir de testes de medicamentos. Além disso, a epidemiologia revela um desacordo entre associações promissoras e intervenções posteriores, a especificidade de diferentes demências e a ética da promoção da saúde. O artigo argumentará que as escolhas de estilo de vida para o risco de demência devem ser entendidas pelas lentes de uma filosofia de vida em vez de uma hipótese científica testável. Essa filosofia conhecida como "DOSE" tem quatro componentes: Dieta — Outras prioridades da vida — Estimulação — Exercício. Alcançar o equilíbrio entre um estilo de vida saudável e as prioridades não relacionadas à saúde é uma questão e um desafio fundamentalmente pessoais, principalmente em contextos de recursos limitados. Finalmente, os comportamentos individuais são apenas a ponta do iceberg do risco de demência modificável, o que exige uma ação coletiva para garantir uma prevenção equitativa. lugar disso posteriores testável DOSE "DOSE componentes Exercício pessoais limitados Finalmente modificável equitativa

Abstract Since the COVID-19 pandemic, several countries have developed digital health applications to assist prevention and population care policies. But they use personal and sensitive data and may rely on inadequate infrastructure for data storage, safeguarding and protection. We present ten criteria that digital health applications must meet to guarantee the protection of the right to privacy, freedom, equality and confidentiality of every human being. Appropriate forms of governance must be established that involve all stakeholders in their use to ensure transparency and accountability in the processes of knowledge generation and transfer in the health sector.

Resumen Desde la pandemia por COVID-19, varios países han desarrollado aplicaciones digitales en salud para ayudar a las políticas de prevención y cuidado de la población. Pero utilizan datos personales y sensibles y pueden depender de una infraestructura inadecuada para el almacenamiento, el resguardo y la protección de los datos. Presentamos diez criterios que deben cumplir las aplicaciones digitales en salud para garantizar la protección del derecho a la intimidad, libertad, privacidad, igualdad y confidencialidad de todo ser humano. Deben establecerse formas adecuadas de gobernanza que impliquen a todas las partes interesadas en su uso para garantizar la transparencia y la responsabilidad en los procesos de generación y transferencia de conocimientos en el sector sanitario.

Resum Des de la pandèmia per COVID-19, diversos països han desenvolupat aplicacions digitals en salut per a ajudar a les polítiques de prevenció i cura de la població. Però utilitzen dades personals i sensibles i poden dependre d'una infraestructura inadequada per a l'emmagatzematge, el resguard i la protecció de les dades. Presentem deu criteris que han de complir les aplicacions digitals en salut per a garantir la protecció del dret a la intimitat, llibertat, privacitat, igualtat i confidencialitat de tot ésser humà. Han d'establir-se formes adequades de governança que impliquin a totes les parts interessades en el seu ús per a garantir la transparència i la responsabilitat en els processos de generació i transferència de coneixements en el sector sanitari.

ABSTRACT Loxoscelism occurs when the dermonecrotic venom produced by spiders of the genus Loxosceles, known as “violin spiders,” enters a person’s organism through their bite. In Mexico there is an underreporting of loxoscelism cases due to the absence of laboratory tests for its diagnosis and the complexity of the clinical picture. The aim of this paper is to describe a case of cutaneous loxoscelism caused by the bite of Loxosceles yucatana in a resident of Yucatan, Mexico. Cutaneous loxoscelism is the most frequent and less severe type. This case was diagnosed by means of the symptomatology registered in the medical records, the initial lesion, and the identification of L. yucatana spiders. This study represents the first description of a case of cutaneous loxoscelism with favorable outcome in Yucatan.

RESUMEN El loxoscelismo es ocasionado cuando el veneno dermonecrótico producido por las arañas del género Loxosceles, conocidas como «arañas violinistas», ingresa al organismo de una persona a través de su mordida. En México ocurre un subregistro de los casos de loxoscelismo por la ausencia de pruebas de laboratorio para su diagnóstico y la dificultad del cuadro clínico. El objetivo de este trabajo es describir un caso de loxoscelismo cutáneo ocasionado por mordedura de Loxosceles yucatana en un residente de Yucatán, México. El loxoscelismo cutáneo es el tipo más frecuente y menos severo. El presente caso se diagnosticó por medio de la sintomatología registrada en la historia clínica, la lesión inicial y la identificación de arañas L. yucatana. Este trabajo representa la primera descripción de un caso de loxoscelismo cutáneo con resolución favorable en Yucatán.

Resumo Cycnoches haagii é uma orquídea epífita alvo de muitos coletores, mas nenhuma referência foi encontrada na literatura sobre sua biologia reprodutiva. Assim, o objetivo deste estudo foi obter informações preliminares sobre os tipos de polinização e sua influência na viabilidade das sementes desta orquídea nativa do Cerrado brasileiro, a fim de viabilizar futuros programas de multiplicação e preservação. Foram realizadas polinizações entre flores da mesma planta (geitonogamia) ou plantas diferentes (xenogamia). As sementes obtidas das cápsulas foram semeadas em meio B&G, com concentração total e parcial de sais. Sementes de geitonogamia resultaram em 25% dos protocormos albinos e consequentemente em plântulas albinas. Este fenômeno não ocorreu em sementes oriundas de polinização xenogâmica. A análise de pigmentos mostrou que mesmo as plântulas albinas apresentaram clorofilas e carotenoides, porém em concentrações significativamente menores, 16% e 37% respectivamente, em relação às plântulas pigmentadas. A polinização geitonogâmica deve ser evitada em programas de propagação da orquídea C. haagii devido à origem de plântulas albinas. Além disso, a polinização xenogâmica mostrou-se um método muito interessante para a obtenção de mudas com fenótipo albino, material vegetal muito intrigante para futuras investigações.

Abstract Cycnoches haagii Barb. Rodr. is an epiphytic orchid very targeted by collectors, but no reference was found in the literature about its reproductive biology. Thus, the purpose of this study was to obtain initial information regarding pollination types and its influence on seed viability of this native orchid of the Brazilian Cerrado, in order to enable future propagation and preservation programs. Pollination among flowers of the same plant (geitonogamy) or different plants (xenogamy) were carried out. Seeds extracted from the capsules were sown in B&G medium, with full and half strength. Seeds from geitonogamic resulted in 25% of albino protocorms and consequently in albino seedlings. This phenomenon did not occur in seedlings derived from xenogamic pollination. Pigment analysis showed that even the albino seedlings presented chlorophylls and carotenoids, however, in significantly minor concentrations, 16% and 37% respectively, in relation to green seedlings. Geitonogamic and xenogamic pollinations resulted in C. haagii viable seeds with high germination percentage (90%) under in vitro conditions. The germination of seeds from xenogamic pollination resulted in chlorophyll or normal seedlings only, and can be recommended at conservation programs. On the other hand, although geitonogamic pollination should be avoided at conservation programs of this orchid species as it leads to albino seedlings, it showed a very interesting system to obtain seedlings with this phenotype, an interesting plant material to future investigation.

Resumo Annonaceae é a família de maior riqueza na ordem Magnoliales, com distribuição pantropical, inclui 109 gêneros e 2.440 espécies. É subdivida em quatro subfamílias, Anaxagoreoideae, Ambavioideae, Annonoideae e Malmeoideae. Esta última compreende oito tribos, incluindo Malmeeae, a única tribo de Malmeoideae representante no Brasil, com 13 gêneros e 73 espécies. A Amazônia é o centro de diversidade da tribo, com oito gêneros restritos a este bioma, e cinco gêneros com ampla distribuição. O presente estudo buscou caracterizar as espécies de Malmeeae que ocorrem no estado de Rondônia. Foram identificadas e caracterizadas 17 espécies pertencentes a oito gêneros: Oxandra com cinco espécies, Bocageopsis com três, Onychopetalum, Pseudoxandra e Unonopsis com duas, e Cremastosperma, Ephedrantus e Klarobelia com uma espécie cada. Bocageopsis mattogrossensis e Pseudoxandra lucida são citadas pela primeira vez para o estado. São fornecidas uma chave de identificação para as espécies, descrições morfológicas, distribuição geográfica e comentários.

Abstract Annonaceae is the most species-rich family in the order Magnoliales and has a pantropical distribution, includes 109 genera and 2,440 species. It is subdivided into four subfamilies, Anaxagoreoideae, Ambavioideae, Annonoideae and Malmeoideae. The latter comprises eight tribes, including the Malmeeae, the only tribe of Malmeoideae represented in Brazil, with 13 genera and 73 species. The Amazon is the center of diversity of the tribe, with eight genera restricted to this biome, the other five genera having broader distributions. The present study sought to characterize the species of Malmeeae that occur in the state of Rondônia. Seventeen species belonging to eight genera were identified and characterized: Oxandra with five species, Bocageopsis with three, Onychopetalum, Pseudoxandra and Unonopsis with two, and Cremastosperma, Ephedranthus and Klarobelia with one species each. Bocageopsis mattogrossensis and Pseudoxandra lucida are recorded for the state for the first time. A key to the species, morphological descriptions, geographical distribution and comments are provided.

Abstract: One of the main problems in aquaculture lies in the stress to which the species in cultivation can be subjected, therefore the development of alternative techniques such a mixed culture are beneficial to minimize stress and improve the industry. Tegula atra is a gastropod that lives in subtidal and intertidal, with local economic importance and due its herbivorous behavior, we hypothesized that T. atra may be valuable in controlling macroalgae growth in culture tanks by mixed culture. Grazing percentage, respiratory behavior and excretion of nitrogen wastes, were measured in three size classes of T. atra, which were maintained in mixed culture together with the economically relevant Chilean flounder. While the largest specimens of T. atra (Class 3) were the most efficient in terms of algae consumption, the other classes were less effective and did not show significant differences in each other within a 24-hour period. Smaller and larger size classes organisms (Class 1 and Class 3), consumed the greatest amount of oxygen within a period of 120 min. Finally, smallest organisms (Class 1) emitted the greatest nitrogen wastes, in a period of 120 min. As the grazing ability was higher in larger specimens (Class 3), they could be the ideal candidates for polyculture. However, medium-sized specimens (Class 2) may be the most suitable, due its low O₂ consumption and lower excretion of NH3, producing less negative effect on water quality. Future studies should evaluate the potential negative impacts of T. atra on the physiology of its cohabitants.

Resumen: Uno de los principales problemas en la acuicultura es el estrés al que se pueden ver sometidas las especies en cultivo, por esto el desarrollo de técnicas alternativas para minimizar el estrés son de gran ayuda. Tegula atra es un gastrópodo que habita en el submareal e intermareal, con importancia económica local y debido a su conducta herbívora, se planteó la hipótesis que esta especie puede ser útil en el control del crecimiento de macroalgas en los estanques, mediante cultivo mixto. En el presente estudio, se midió el porcentaje de ramoneo, la conducta respiratoria y excreción de desechos nitrogenados de tres clases de talla de T. atra, las cuales se mantuvieron en estanques con Paralichthys adspersus. Los ejemplares de mayor talla de T. atra (Clase 3) fueron los más eficientes en términos de consumo de algas, dentro de un período de 24 horas. Los organismos pertenecientes a las clases de tallas pequeñas y grandes (Clase 1 y Clase 3), consumieron mayor cantidad de oxígeno dentro de un periodo de 120 min. Finalmente, los organismos de menor talla (Clase 1) fueron los que emitieron la mayor cantidad de desechos nitrogenados, en un período de 120 min. Dado que, la capacidad ramoneadora fue mayor en los ejemplares de talla superior (Clase 3), éstos podrían ser los candidatos ideales para el policultivo, sin embargo, al considerar la respirometría, los animales de talla media (Clase 2), serían óptimos, por su bajo consumo de O₂ y menor excreción de NH3, generando un menor impacto negativo en la calidad del agua. Futuros estudios debieran evaluar los posibles impactos negativos a nivel fisiológico que pueda tener la presencia de T. atra, sobre sus cohabitantes.

Most pituitary adenomas are sporadic, but 3-5% can occur in a family and hereditary context. This is the case of multiple endocrine neoplasia type 1 (MEN1), Carney complex (CNC) and familial isolated pituitary adenomas (FIPA). FIPA is an infrequent condition that occurs in a family context, not associated with MEN type1 or CNC. FIPA kindred can be homogeneous (all adenomas affected in the family having the same tumor phenotype) or heterogeneous (different tumor phenotypes in the affected members). We describe a Congolese family in which two sisters and a cousin were diagnosed with a prolactinoma (homogenous FIPA) at the ages of 29, 32 and 40 years, respectively. The patients presented with macroadenomas at the time of diagnosis, non-invasive tumors and good biological response to cabergoline treatment (maximum dose of 1.5 mg/weekly). Of these two sisters, one went through a pregnancy without complications. Because no MEN1 and CNC clinical and biochemical features were detected during the 12-year follow-up, these genes were not investigated. The genetic analysis of the aryl hydrocarbon receptor interacting protein (AIP) was normal. As nearly 80% of patients with FIPA do not have a mutation in the AIP gene, future studies in these families are required to identify other affected genes involved in their physiopathology.

La mayoría de los adenomas hipofisarios son esporádicos, pero un 3-5% puede ocurrir en un contexto familiar y hereditario. Este es el caso de la neoplasia endocrina múltiple de tipo 1 (NEM1), complejo de Carney (CNC) y adenomas hipofisarios aislados familiares (FIPA). El FIPA es una condición infrecuente, que ocurre en un contexto familiar, no asociada a NEM t ipo1 ni CNC. Los FIPA pueden ser homogéneos (todos los adenomas tienen el mismo fenotipo) o heterogéneos (diferente fenotipo tumoral). Describimos una familia congolesa en la que dos hermanas y una prima fueron diagnosticadas a los 29, 32 y 40 años, respectivamente, con un prolactinoma (FIPA homogéneo). Las pacientes presentaron macroadenomas no invasivos al momento del diagnóstico, con buena respuesta biológica y tumoral al tratamiento con cabergolina hasta una dosis máxima de 1.5 mg/semanal. De las dos hermanas, una cursó un embarazo sin complicaciones. Durante el seguimiento de 12 años, ninguna de ellas presentó elementos clínicos o biológicos compatibles con NEM1 o CNC, por lo que dichos genes no se estudiaron. El análisis genético en dos de las pacientes permitió descartar la posibilidad de una mutación germinal del gen aryl hydrocarbon receptor interacting protein (AIP). Se considera que el 80% de los pacientes con FIPA no presentan mutación del gen AIP, por lo que se requieren futuros estudios en este tipo de familias, para poder determinar otros genes afectados involucrados en su fisiopatología.

ABSTRACT Emphysematous gastritis (EG) is a rare and potentially lethal process caused by invasive, gas-producing bacteria leading to inflammation and gas dissection of the stomach. The most common etiologic agents are Clostridium infections, but other organisms, including enterobacteria, staphylococcus, and fungi have also been identified. We report the first case of EG due to Sarcina ventriculi in a solid organ transplant recipient, who presented with epigastric pain and vomiting. The patient had a history of type 1 diabetes mellitus (DM) with recurrent episodes of ketoacidosis and systemic diabetic complications, including severe gastroparesis. CT scan studies demonstrated EG with venous air, and endoscopy showed severe gastritis and ulcerations. In the gastric biopsies, abundant Sarcina ventriculi were noted in areas of mucosal/submucosal necrosis. Antibiotic treatment was instituted at admission, and subsequent endoscopy demonstrated the disappearance of Sarcina, with some improvement of the gastric inflammation; however, the patient developed septic shock with multiorgan failure and expired. This case highlights the need to consider other infectious etiologies in transplant patients, in addition to the well-known opportunistic infections.

ABSTRACT Introduction: Bacteria of the Rickettsia genus are causal agents of the rickettsial diseases, zoonoses transmitted by ectoparasites. In Yucatan, in inhabitants from Bolmay an outbreak occurred; however, the probable vector was not identified. Objective: To analyze the Rickettsia spp. presence in ticks infesting domestic dogs from Bolmay. Material and methods: We used 105 vials with up to eight ticks. Total DNA from the ectoparasites was extracted, after the identification of the life stages, sex, gender, and species. Two PCR to isolate fragments of the htrA (17-kDa) and rOmpB genes belonging to Rickettsia spp., were performed. The positive products were sequenced and analyzed using the BLAST tool and the Megablast algorithm. Results: 291 ticks of the genera Amblyomma (55.7%, 162/291), Rhipicephalus (34%, 99/291), and Ixodes (10.3%, 30/291), and the species Rhipicephalus sanguineus sensu lato, Ixodes affinis, and Amblyomma mixtum, were used. The PCR positivity was 11.4% (12/105) for the genera Amblyomma (66.7%, 8/12), Rhipicephalus (25%, 3/12), and Ixodes (8.3%, 1/12), and the species A. mixtum, Rh. sanguineus s. l., and I. affinis. Rickettsial DNA in nymph, larva, adult, males, and females, were identified. Each BLAST analysis showed an identity and coverage of 96% with several Rickettsia spp. sequences, such as Rickettsia typhi, Rickettsia felis and Rickettsia prowazekii, so it was not possible to determine the infecting species. Conclusion: Ticks infesting dogs from Bolmay are probably involved in the transmission cycle of Rickettsia spp. The first molecular evidence of Rickettsia spp. in I. affinis ticks from Yucatan, Mexico, is presented.

RESUMEN Introducción: Las bacterias del género Rickettsia son agentes causales de las rickettsiosis, enfermedades zoonóticas transmitidas por ectoparásitos. En Yucatán, ocurrió un brote en habitantes de Bolmay, Valladolid; sin embargo, no se identificó el probable artrópodo vector. Objetivo: Analizar la presencia de Rickettsia spp. en garrapatas que infestan perros domésticos de Bolmay. Material y métodos: Se trabajaron 105 viales con hasta ocho garrapatas. Se extrajo ADN de los ectoparásitos, posterior a la identificación del estadio de desarrollo vital, sexo, género y especie. Se realizaron dos PCR para aislar fragmentos de los genes htrA (17-kDa) y rOmpB, pertenecientes a Rickettsia spp. Los productos positivos fueron secuenciados y analizados con la herramienta BLAST y el algoritmo Megablast. Resultados: Se utilizaron 291 garrapatas de los géneros Amblyomma (55.7%, 162/291), Rhipicephalus (34%, 99/291) e Ixodes (10.3%, 30/291), y las especies Rhipicephalus sanguineus sensu lato, Ixodes affinis y Amblyomma mixtum. La positividad por PCR fue de 11.4% (12/105) para los géneros Amblyomma (66.7%, 8/12), Rhipicephalus (25%, 3/12) e Ixodes (8.3%, 1/12), y las especies A. mixtum, Rh. sanguineus s. l. e I. affinis. Se identificó ADN rickettsial en ninfas, larvas, adultos, machos y hembras. Cada análisis BLAST arrojó un 96% de cobertura e identidad con varias secuencias de Rickettsia spp. como Rickettsia typhi, Rickettsia felis y Rickettsia prowazekii, por lo que no fue posible determinar la especie infectante. Conclusión: Las garrapatas que infestan perros de Bolmay, probablemente están involucrados en el ciclo de transmisión de Rickettsia spp. Se presenta la primera evidencia molecular de Rickettsia spp. en garrapatas I. affinis de Yucatán, México.