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MATCH (Motivating Adolescents with Technology to CHOOSE Health) is an online, interdisciplinary wellness program targeted at improving adolescent nutrition that teachers can easily incorporate into existing curricula. The shift from childhood to adolescence is characterized by rapid increases in autonomy of nutritional intake. Given that dietary habits established in adolescence often persist into adulthood, effective nutrition education programs during this period are of particular relevance. Although there are a vast number of existing nutrition education programs aimed at adolescents, we explain why MATCH and similar programs should be expanded across the United States to improve adolescent health outcomes including obesity prevention. [ABSTRACT FROM AUTHOR]

Food insecurity in the United States is a public health crisis and particularly impacts individuals in rural areas.1 Efforts to improve food access, including pilot programs to increase online ordering, have reduced food insecurity and improved diet quality for participants enrolled in supplemental nutrition programs.3,4 We discuss the nutritional and economic benefits of public and private partnerships that enhance the supplemental nutrition programs of the United States Department of Agriculture Food and Nutrition Service (eg, Special Supplemental Nutrition Program for Women, Infants, and Children; Supplemental Nutrition Assistance Program), and propose the expansion of technology and transportation resources through public and private partnerships to better address rural food insecurity. [ABSTRACT FROM AUTHOR]

NdFeAsO films have been grown by a two-step method. First, precursor films that contain a mixture of Nd and Fe oxides were grown by metal–organic chemical vapor deposition. Afterward, the arsenic is incorporated during annealing of these precursor films in the presence of a \NdFeAsO0.75 \F0.25 pellet. The X-ray diffraction and the scanning electron microscopy show that the formation of the quaternary NdFeAsO phase is prevented by the stability of the rare-earth oxides and rare-earth oxyfluorides and that it is synthesized only if the annealing temperature is higher than 1050 ^\circ\C. Although the pellet creates a reaction atmosphere to synthesize the superconducting phase, the fluorine is not incorporated into the quaternary NdFeAsO phase. [ABSTRACT FROM PUBLISHER]

Abstract: The endocytic pathway followed by dengue virus to infect the mosquito cells C6/36 HT was analyzed. Using DIL-labeled virions and real-time imaging it was determined that viral entry into C6/36 HT takes approximately 5 to 7 min. Pretreatment of C6/36 HT cells with sucrose and bafilomycin A, but not filipin, inhibited dengue virus infection up to 80%. Furthermore, the overexpression of dominant-negative mutants of Eps15, a molecule required for the formation of clathrin-coated vesicles, reduced dengue infection up to 50%, indicating that dengue virus entry is through clathrin-mediated endocytosis and is pH-dependent. By double-immunofluorescence assays, DIL-labeled particles were colocalized with early endosomes at 5 min and with lysosomes mainly at 30 min post-infection. Finally, disruption of the microtubule and microfilaments by nocodazole and by cytochalasin D reduced viral infection by more than 80%. Taken together these results indicate that dengue virions enter into C6/36 HT cells by clathrin-mediated endocytosis, using the endosomal pathway from early endosomes to acidic lysosomes before viral RNA is released into the cytoplasm. [Copyright &y& Elsevier]

A subgroup of patients with neurocardiogenic syncope and negative electrophysiologic studies and adenosine tests (in 5 of 6 cases), who developed symptomatic paroxysmal atrioventricular block in the natural, ambulatory state, had positive tilt tests without advanced block. Lack of concordance between electrocardiographic changes may have reflected differential effects of the autonomic nervous system in the sinus and atrioventricular nodes, occurring in diverse circumstances and less likely because of the protocol used for tilt testing. [ABSTRACT FROM AUTHOR]

Introduction: Transcatheter leadless pacing systems have recently emerged as a safe and effective alternative in the treatment of patients who require right ventricular pacing therapy. There is little information about the feasibility and safety of leadless pacemaker implantation under treatment with anticoagulant agents. Methods: We studied 60 consecutive patients who, according to their prior anticoagulation regimen, underwent implantation of leadless pacemaker system. The procedures were performed under warfarin with target INR 2 to 3, a novel oral anticoagulant agent (apixiban or rivaroxaban) or no anticoagulation. Enoxaparin was not used. Thromboembolic and bleeding complications were assessed the day of the procedure, the next day and one month after the procedure, time during which anticoagulation was maintained. Results: A total of sixty (60) patients were included in this study. Patients did not differ in age, gender, procedure time, thrombotic or hemorrhagic complications (Table). There were no thrombotic complications. There was one groin bleeding in the non-anticoagulation group that required observation Conclusions: Implantation of leadless pacemakers systems under uninterrupted anticoagulation is efficient and does not appear to result in an increased incidence of bleeding or thromboembolic complications. Further study of this strategy is necessary. [ABSTRACT FROM AUTHOR]

Introduction: Zika pandemic remains a formidable challenge to medicine and has been considered the worst outbreak of the century. There are only a few reports of cardiovascular manifestation of Zika. Objective: This study sought to describe Zika myocarditis manifesting with coexisting acute atrial and ventricular arrhythmias and pruriginous " itchy" rash. Methods: We enrolled 16 cases that developed acute Zika myocarditis within one week of disease onset in a prospective observational multicenter study. Clinical and laboratory evaluation including Zika confirmation, ECG, echocardiogram, Holter, coronary arteriography (2) and cardiac MRI were performed. Results: Of the 16 patients, 10 (63%) were female with a mean age of 52 ± 15, 10 (63%) developed simultaneously acute atrial and ventricular arrhythmias and itchy rash. The new arrhythmias included atrial fibrillation in 7 patients, non-sustained atrial tachycardia in 10 cases, ventricular tachycardia in 5 patients, complex ventricular arrhythmias in 10 cases. Two patients died suddenly within the first week of the disease. Acute heart failure was present in 7 cases, 6 with low ejection fraction. Conclusion: Zika myocarditis can be lethal and severe, manifesting with coexisting acute atrial and ventricular arrhythmias and itchy rash. Physicians should be aware of this combination and complication. [ABSTRACT FROM AUTHOR]

Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV) block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up. [ABSTRACT FROM AUTHOR]

The US Food and Drug Administration is considering an update of a front-of-pack voluntary “healthy” designation that received little use or attention by the food industry. Effective communication to consumers is crucial in promoting healthy diet and lifestyle patterns. In the current food landscape, it is difficult for consumers to determine what foods are healthy. Furthermore, the healthy definition should fit the current science based on the Dietary Guidelines for Americans. We present an argument for required front-of-pack labeling, rooted squarely in the Dietary Guidelines. [ABSTRACT FROM AUTHOR]

Background: Chagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is actually challenging. Thus, the aim of this work was to determine the Th1/Th17 (IL-6, IL-2, TNF, IL-17 and IFN-γ) and Th2 (IL-4 and IL-10) serum profile in Venezuelan Chagasic patients stratified according amiodarone treatment, hypertension and arrhythmias.Methods: Sera from 38 chagasic patients were analyzed to determine the level of cytokines by Multiplexed Bead-Based Immunoassays. ANOVA test was applied to determine differences for each group. Additionally, a Linear Discriminant Analysis (LDA) was applied to observe the accuracy of different cytokines to discriminate between the groups.Results: The levels of several cytokines were significantly higher in the high-risk of sudden death and untreated group. LDA showed that IL-2, IFN-γ and IL-10 were the best cytokines for discriminating between high-risk of sudden death and untreated patients versus low-risk of sudden death, treated and control groups.Conclusions: High IL-2 levels seem to identify patients with high-risk of sudden death and seems adequate as treatment efficacy marker. To our knowledge, this is the first report about the anti-inflammatory role of the amiodarone in Chagas disease, suggesting an inmunomodulatory effect that may be exploited as coadjutant therapy in chronic Chagas disease. [ABSTRACT FROM AUTHOR]

The burden of cardiovascular diseases is sharply rising in low- and middle-income countries (LMICs). Along with the increasing rates of cardiovascular risk factors in these regions, there is a growing recognition of the contribution of neglected tropical diseases and other infections. Several cardiac implications of these infections have been reported but have not yet been validated by robust population data. This is in part due to limited access to health care and insufficient data collection infrastructure in many LMICs. Therefore, the true impact of these infections on the cardiovascular system may be underestimated, because of both underdiagnosis and underreporting bias. There is an urgent need to thoroughly delineate the cardiac impact of these conditions with elevated prevalence in LMICs and to propose strategies to reduce the negative consequences of these diseases in health systems with limited resources. [Display omitted] • Tropical infections can adversely affect the cardiovascular system in multiple ways, and their impact may be underestimated. • Better understanding of the cardiovascular effects of tropical infectious diseases can facilitate development of preventive, diagnostic, and therapeutic strategies. • Collaboration between public and non-governmental sectors is crucial to reducing the detrimental impact of tropical infectious diseases. [ABSTRACT FROM AUTHOR]

As one of the neglected tropical diseases, leishmaniasis is defined as a parasitic communicable disease that is most prevalent in tropical and subtropical regions, affecting especially populations living in poverty. It has a profound negative impact on developing economies. It represents a group of heterogeneous syndromes with a wide spectrum of severity ranging from self-resolving cutaneous injuries to disseminated visceral compromise. Visceral leishmaniasis represents its most severe form, can affect almost all organs, and can have fatal consequences, especially in immunosuppressed patients. Cardiac involvement seems to be rare but has not been deeply studied. Consequently, there are no clear recommendations for the screening of cardiac manifestations in these patients. However, cardiovascular complications could be potentially lethal. In addition, there are valuable reports on the potential cardiotoxicity caused by drugs used in the treatment of this condition, so knowledge of its side effects could have important implications. This article is a part of the "Neglected Tropical Diseases and other Infectious Diseases affecting the Heart" project (the NET-Heart Project); its purpose is to review all the information available regarding cardiac implications of this disease and its treatment and to add knowledge to this field of study, focusing on the barriers for diagnosis and treatment, and how to adopt strategies to overcome them. [ABSTRACT FROM AUTHOR]

As one of the tropical diseases, malaria is endemic in developing countries. Severe malaria, mainly caused by the Plasmodium falciparum parasite, can result in life-threatening complications. Traditionally, cardiac involvement has not been included as a frequent cause of morbidity and mortality. This could be due to under-reporting or underdiagnosing. Specific cardiovascular (CV) complications include electrocardiogram abnormalities, myocarditis, pericarditis, pericardial effusion, ischemic disease, and heart failure. According to the data analyzed, CV manifestations can lead to severe consequences. Possible theories related to the pathophysiological mechanisms related to CV compromise include an imbalanced pro-inflammatory cytokine response and/or erythrocyte sequestration by increased cytoadherence to endothelium. Although there is a paucity of data regarding cardiac manifestations of malaria, an algorithm for appropriate use of diagnostic tools to assess cardiac involvement has been developed in this paper. Furthermore, it is important to note that typical antimalarial treatment regimens can have fatal cardiac side-effects. [ABSTRACT FROM AUTHOR]

Introduction: Neglected tropical diseases are a group of communicable diseases that occur in tropical and subtropical conditions and are closely related to poverty and inadequate sanitation conditions. Among these entities, chikungunya remains one of the most widely spread diseases. Although the main symptoms are related to a febrile syndrome, cardiovascular (CV) involvement has been reported, with short- and long-term implications. As part of the "Neglected Tropical Diseases and other Infectious Diseases involving the Heart" (NET-Heart) Project, the aim of this review is to compile all the information available regarding CV involvement of this disease, to help healthcare providers gain knowledge in this field, and contribute to improving early diagnosis, treatment, and prevention strategies. Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in conducting and reporting this systematic review. The search was conducted using MEDLINE/PubMed, SciELO, and LILACS databases to identify any relevant studies or reviews detailing an association between chikungunya and cardiac involvement published from January 1972 to May 31, 2020. Results: Despite its mechanism not being fully understood, CV involvement has been described as the most frequent atypical presentation of chikungunya (54.2%). Myocarditis is the most prevalent CV complication. Different rhythm disturbances have been reported in 52% of cases, whereas heart failure was reported in 15% of cases, pericarditis in 5%, and acute myocardial infarction in 2%. Overall estimated CV mortality is 10%, although in patients with other comorbidities, it may increase up to 20%. In the proper clinical setting, the presence of fever, polyarthralgia, and new-onset arrhythmia suggests chikungunya virus-related myocarditis. Conclusion: Although most cases are rarely fatal, CV involvement in chikungunya infection remains the most frequent atypical presentation of this disease and may have severe manifestations. Timely diagnosis and appropriate management are necessary to improve patient outcomes. [ABSTRACT FROM AUTHOR]

This study examined the association of self-rated health with physical function and emotional well-being, while controlling for differences in sex, age and anthropometry. Subjects were participants in a multicentre study originated by the International Union of Nutritional Sciences (IUNS). A total of 151 elderly Guatemalan subjects were examined using a questionnaire which included information on self-rated health, activities of daily living, well-being, and a common battery of anthropometric variables. Adjusted odds ratios (OR) obtained with polytomous logistic regression showed that subjects with the highest score on the well-being index compared with those with the lowest were 1.67 times more likely (P-value <0.001, confidence interval (C.I.) = 1.31-2.14) to rate themselves in 'good' health versus 'fair' and 'poor' health. Subjects with the highest score versus those with the lowest on the mobility index were 1.15 times more likely (P-value <0.05, (C.I.) = 1.00-1.32) to rate themselves in 'good' health versus the other health ratings. These are the first results to examine the relationship of self-rated health to physical function and emotional well-being of elderly, free-living Guatemalans. [ABSTRACT FROM AUTHOR]