Altum, Validum, Velox No. 9 - English

Science in Motion

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The brain is like a muscle. When it is in use, we feel very good. Understanding is joyous -Carl Sagan

Basic notions of quantum physics tell us that the more accurate the measurement of the velocity of a subatomic particle, the less precise the measurement of its position, and vice versa. This is called the uncertainty principle. Such a foundation means that, so far, it is impossible to accurately forecast both values or to have complete knowledge of this reality. Now, without moving away from macroscopic organisms, similar events happen in everyday life. For example, in the early twentieth century, English and American scientists implemented mathematical models and spent hours analyzing thousands of soccer matches to determine predictability in the sport. Although it is true that it is increasingly predictable due to economic and social factors, according to these scientists, football is one of the most frequent sports in which a team with the worst record beats or surpasses an apparently superior one, thus breaking the rule of any theory and scientific study that seeks accuracy. So, to paraphrase Einstein, the outcome of every football game would be as if God rolled the dice before deciding the score; his unpredictability makes him exciting.

This type of circumstances, far from breaking scientific morality by finding limitations in our ability to measure and predictability of the world, makes scientists the torchbearers in our search for knowledge, being the ones who find the keys to overcoming our being and our environment and thereby reaching common goals. On this occasion, your journal Clinical Research Insider gathers among its pages various research and opinions of experts in the field to offer you a varied panorama of the relationship between science, sport, and health, who will help us ask questions such as are there insurmountable limits on our ability to perform an activity? or how science and technology can help us develop the maximum physical potential, human chemical and mental? Much of what makes us human is our sense of perfectionality, of wanting to surpass ourselves, continuously, and in reference to others. In this edition, we celebrate together with you, life in motion, scientific inquiry, and universal communication, because sport, as Jean Giraudoux would say, is the Esperanto of races.

Study tests how to assess knee muscle function

Explosive force is defined as the greatest muscle tension per unit of time, that is, the ability of the neuromuscular system to develop high degrees of strength in the shortest possible time. It is essential for the performance of athletes and the general population (regardless of age or physical activity performed) and is associated with speed and agility performance, balance control, and risk of falls.

Since knee extension strength is paramount for high athletic performance and a valuable factor to know about in young and even older adults with osteoarthritis, the research group that includes Dr. Ryota Akagi, from the School of Engineering and Systems Sciences, Shibaura Institute of Technology, evaluated the association of thigh PhA with maximal muscle strength, explosive muscle strength, contractile properties, and neuromuscular activity, to assess by bioimpedance which of the two measurements: whole-body PhA or thigh-only PhA, is a better predictor of knee extensor force.

The results of the study revealed that both the PhA of the whole body and the PhA of the thigh is associated with the muscle strength of the knee extensors, however, this association is due to the contractile properties of the muscles rather than to any neural aspect. This study is promising because of the implications for evaluating and monitoring muscle strength, both in athletes (who need to maintain muscle strength in the knee to perform better), and in older adults (in whom maintaining strong muscles represents greater independence to move), since bioimpedance can evaluate PhA quickly, non-invasively and the patient is not required to generate muscle strength during the test.

High jumping, running, sprinting, throwing, athletics, cycling, wrestling, gymnastics, speed skating, canoeing, and kayaking, are some of the sports that require speed, power, and explosive strength. Several studies have revealed that there is a correlation between explosive force and phase angle (PhA).

Source: Hirata, K., Ito, M., Nomura, Y., Yoshida, T., Yamada, Y., & Akagi, R. (2022). Can phase angle from bioelectrical impedance analysis associate with neuromuscular properties of the knee extensors?. FrontiersinPhysiology 1626.

Multidirectional Sports Shown to Prevent Stress Fractures in Young Athletes

Stress injuries or fractures are small breaks in the bone, where a thin fissure develops due to repetitive force, caused by overuse. They usually occur in the foot and femur, are predominant in women, and constitute 1 to 20% of all sports injuries. Those who practice one-way sports such as athletics have a high incidence of stress fractures, while in sports such as basketball or football they are not as frequent.

According to a study published by a research group at Indiana University, where division I and II college runners were examined, it was found that athletes who ran and had participated in multidirectional sports (basketball or soccer) when they were younger, had better bone structure and strength than those who only ran. They swam or rode bicycles throughout their physical career.

The findings of the study led by Dr. Stuart Warden support the recommendation to delay specialization in one-way athletes and choose to play multidirectional sports during their childhood and adolescence for at least two years, to achieve

Sources:

Warden, Stuart J.1,2,3; Sventeckis, Austin M.1; Surowiec, Rachel K.2,4; Fuchs, Robyn K.1,2. Enhanced Bone Size, Microarchitecture, and Strength in Female Runners with a History of Playing Multidirectional Sports. Medicine & Science in Sports & Exercise: August 6, 2022 - Volume - Issue - 10.1249/MSS.0000000000003016 doi: 10.1249/ MSS.0000000000003016

optimal bone health and build a more robust skeleton, all with the goal of potentially reducing the risk of suffering bone injuries from stress. Previous research by Dr. Warden and colleagues shows that as a person develops, both bone mass and size are equally important and that leading an athlete to specialization at a very early stage can compromise later professional performance, running the risk of not reaching competitive college levels. In addition to being highly exposed to injury. 1. 2. 3.

McSweeney, S. C., Grävare Silbernagel, K., Gruber, A. H., Heiderscheit, B. C., Krabak, B. J., Rauh, M. J., ... & Hollander, K. (2021). Adolescent running biomechanics-implications for injury prevention and rehabilitation. Frontiers in sports and active living, 230.

Tenforde AS, Sainani KL, Carter Sayres L, Milgrom C, Fredericson M. Participation in ball sports may represent a prehabilitation strategy to prevent future stress fractures and promote bone health in young athletes. PM R. 2015 Feb;7(2):222-5. doi: 10.1016/j. pmrj.2014.09.017. Epub 2014 Dec 9. PMID: 25499072.

Wendy López Romero,

Research and Development Analyst at Drox Health Science. PhD in Medical and Pharmaceutical Biotechnology, Master in Molecular Biology. More than six years of experience in molecular biology, Immunology, Biochemistry and Proteomic, as well as in the development and validation of medical devices.

Writing by PhD

Mejía

Algorithms are developed to identify potential highperformance swimmers

Talent identification systems in sports are based on physical, physiological, psychological, sociological, and genetic factors, without neglecting previous experience. These factors consider variables that are associated with sports performance; for example, for junior swimmers, performance can be mainly affected by leg length, shoulder width, and height, as established by researchers from the University of Minia, Egypt, through their study where they developed a system that uses two automated algorithms that allow image processing based on anthropometric measurements. In order to identify potential junior high-performance swimmers.

Claudia

Morales, Research and Development Analyst at Drox Health Science. PhD in Biosystematics, Ecology and Management of Natural and Agricultural Resources, with orientation in Biotic Products; Master in Environmental Sciences, with orientation in Environmental Technology.

Writing by PhD

In their study involved 15 children aged between 9 - 10 years, the system included the connection of a digital scale to a computer in order to establish the weight of the swimmer automatically; then the participants were photographed front and side considering specifications. The detection of body contour from photographs and mathematical equations continued; the algorithms used were Canny or Fuzzy; The images were initially to be converted to a binary image that considers two values for each pixel or to a grayscale image, respectively. The body silhouette is then extracted from the images, either from a Canny edge detector (Canny, 1986) or by fuzzy logic (Fuzzy); after this, points of the characteristics of the body are detected and finally, the automatic body measurements are obtained. The values of the body measurements obtained (8 measures: height, leg length, foot, arm, hand, shoulder width, hip, and chest) were compared with those of a database system of junior high-performance swimmers (144 swimmers under 14 years of age).

Only 4 junior swimmers presented the appropriate measures that are associated with high performance for this sport. The authors highlight the use of these algorithms for their low cost, easy use, reduction of error in manual taking measurements, and the possibility of being implemented in urban and rural areas. In addition, this system detects about 101 points of body characteristics that recognize 36 measurements (figure 1-B), but for this sport, only 8 measurements are required, so the proposed system can not only be used for the selection of potential swimmers, but for other types of sports. For more information, you can consult Moness, et al., 2021.

Source:

1. 2.

Moness, M., Loutfy, S. K., & Massoud,M. A. (2021). Selecting Promising Junior Swimmers in Egypt Using Automated Biometric Algorithms of Image Processing and Fuzzy Concepts. IEEE Access, vol. 9, pp. 89476-89496, doi: 10.1109/ACCESS.2021.3088409.

Canny, J. (1986). A computational approach to edge detection. IEEE Transactions on pattern analysis and machine intelligence, (6), 679-698.

Aerobic exercise helps in the progression of Parkinson’s disease patients

Worldwide, Parkinson’s disease presents 0.3% of the population, while in people over 80 years of age it is greater than 3%.

Parkinson’s disease is a progressive disorder, characterized clinically by the presence of bradykinesia (slowness of movement) and at least one cardinal motor feature, stiffness, or tremor at rest. The disease has an important impact on quality of life, as it is accompanied by non-motor symptoms such as sleep disorders, dementia, hallucinations, mood conditions, constipation, urogenital dysfunction, and loss or decrease of the sense of taste and pain, among others.

The treatment of the disease is based on dopamine substitution, as well as other non-dopaminergic ones, however, none is curative and the disease continues to be progressive, causing disability. Therefore, effective treatments for the management of the disease continue to be sought.

Recently, the prestigious scientific journal Annals of Neurology published promising results of a clinical trial of 130 patients diagnosed with Parkinson’s disease, in which they were assigned treatment with aerobic exercise with a stationary bicycle reaching 50 to 80% of their heart rate, or active control of stretching, flexibility and relaxation exercises. Subjects followed this program three times per week for 30 to 45 minutes per session, for 6 months. After the intervention, magnetic resonance imaging tests were performed.

Interestingly, the results showed that the group of patients who performed aerobic exercise, but not the one who performed active control exercises, showed an increase in sensorimotor functional connectivity, improving cognitive control, accompanied by improvements in physical fitness and a reduction in global brain atrophy.

These findings are extremely important in the community that suffers from the disease since, in addition to the benefits associated with exercise, it could be considered an adjuvant treatment that will result in a better quality of life and a slower progression of the disease.

Source:

1. 2.

Poewe, W., Seppi, K., Tanner, C. et al. Parkinson disease. NatRevDisPrimers 3, 17013 (2017). https://doi.org/10.1038/nrdp.2017.13

Johansson ME, et al. Aerobic Exercise Alters Brain Function and Structure in Parkinson’s Disease: A Randomized Controlled Trial. Ann Neurol 91(2):203-216 (2022). doi: 10.1002/ana.26291.

Exercise in overweight and obese adolescents is shown to improve their intelligence

Childhood overweight and obesity constitute more than 18% of the population, this is four times more than in the seventies. Evidence indicates that there is a relationship between the presence of obesity and academic performance. This means that in addition to the health problems that accompany the presence of obesity and overweight, as well as the social and psychological implications, school lag could also be a negative effect on children with obesity.

Part of the treatment for managing obesity and overweight is healthy eating and physical activity. The latter could also contribute to academic performance.

A recent randomized study conducted by researchers at the University of Granada, Spain, evaluated 109 children between the ages of 8 and 11 who were overweight or obese, in which half engaged in supervised physical activity for 90 minutes a week for 20 weeks. Before and after the interven-

tion, the researchers assessed intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance. As expected, the results showed an increase in cardiorespiratory physical performance in the intervention group, but interestingly, total intelligence and cognitive flexibility were found to improve significantly in the exercise group relative to control. In addition, there was a small positive effect on total academic performance. These findings were more significant in boys than girls.

This study contributes significantly to the information that supports the benefits of exercise, not only for managing overweight but for academic performance. It would be very interesting to observe results in children who are not overweight or obese.

1. Source: 2.

Ortega FB, et al. Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity The Active Brains Randomized Clinical Trial. JAMA Network Open. 2022;5(8):e2227893. doi:10.1001/jamanetworkopen.2022.27893

He J, etal.Is there a relationship between body mass index and academic achievement? A metaanalysis. PublicHealth.2019 Feb;167:111-124. doi: 10.1016/j.puhe.2018.11.002. Epub 2019 Jan 15. PMID: 30654313.

Writing by PhD

Carmen de la Rocha,

Director of Research and Development at Drox Health Science. PhD in Biotechnology, Master in Biochemical Engineering. More than eleven years of experience in clinical research and basic science. Member of the National System of Researchers, level I.

OPINION

CRACKS BECOMING

CEO DROX Health Science – Clinical Research Insider General Manager

Chemist-pharmacist Biologist from La Salle University, MBA from ITESO, postgraduate degree in Clinical Research from York College and Senior Management from IPADE InnovAD Program. Expert in drug research and development; entrepreneur, founder of several for-profit and non profit associations and developer of a private equity investment company.

Marco Cid

Every 4 years we witness the most important event on the planet, the FIFA World Cup, that this time takes place in Qatar. We will enjoy the stars of international football over a month and a half through games full of emotion and patriotism. We did not want to be left behind and to commemorate this great event, our cover alludes to the dedication to reaching the perfection of the human being, the most beautiful sport in the world.

We dedicate this edition to the intention of humans to overcome their physical and mental limitations, as it happens in these great events. Throughout time and in a constant fashion, the human being has sought physical improvement, overcoming the very limitations of the body or even our nature. It seems that we are about to reach the era where all this will be possible. It is believed that in the next 50 years humans will be able to double their physical power thanks to the advancement of medicine, biotechnology, nanotechnology, and personalized diagnosis.

The development and research of new exoskeletons will allow us to reach the next generation in prostheses and, even more, some new products are focused on increasing human productivity. Today, new electronic devices monitor our health constantly, generating accurate data in real-time. I firmly believe that this trend will continue, thus optimizing the way a disease is diagnosed and treated, solely based on the data generated day after day.

In addition to the development of sciences that enhance the physical capabilities of human beings, we cannot ignore the launching of new robots (Tesla and Boston Scientific) in international markets. We will face new ethical and scientific dilemmas; the days so announced by Isaac Asimov are closer than thought. New tasks and jobs will be delegated to robots, as happened with computers and much earlier with steam engines. We are about to witness the best years of the science of our modern era.

This is how a new panorama opens before our eyes, new opportunities are just around the corner; Our intention as a journal of scientific dissemination is to bring all these new developments and trends to our audience, clearly and effectively. Everything and more we can find within the pages of our magazine, I hope you enjoy it.

Dr. Emilio Luengo-Fernández

Heart, sport, risk, and freedom

Sport has been a form of competition since ancient times and sometimes it also contains an ethnic or religious component. It has even been related to certain social classes and popular traditions, but only recently has it been the subject of observation and health intervention. Recovering the idea of Olympism has marked a flex point. This change relates to professionalization and linked to it, the emergence of sport as a mass spectacle. Sport as a spectacle has been a seed to spread among the general non-professional public, the sport of risk or high physical demand.

Specialist in Cardiology. Director of the School of Sports Cardiology. Spanish Society of Sports Medicine, Zaragoza. 1. 2.

Sport has also begun to be considered a health value, as preventive and curative in a long series of diseases. Medicine increasingly effective and affordable to society has made health “trendy”, and sport has become a way of expressing it, inspired by the beneficial effects of physical exercise. Society applauds “sports fashion” and “sports health” and, meanwhile, medical science is interested in physical exercise. This medical interest has transcended the bone-muscle-joint component, also delving into the physiological fact of adaptation to effort and its consequences. At the end of the nineteenth century, Dr. Salomon-Eberhard Henschen of the Swedish University of Uppsala published the first article on the heart of the sportsman Schilauf und Schiwettlauf. Eine medizinische Sportstudie (in current German, the original in *1).

More recently, the work of Dr. Barry J. Maron draws attention to the relationship between certain heart diseases and sudden deaths of athletes (*2), which social media publish with a certain sense of scandal. Surprising that a “healthy” activity could “kill” presumably “healthy” individuals, especially if the athlete was famous. The Medical-Sports Examination (or Sports Pre-participation, RMD) emerges as a hinge between the health value of sport and the evaluation of diseases as a cause of risk when practicing it. In a way, the RMD is the bridge between the freedom to exercise and the limitation, in some emotional way, of a previous and periodic medical check-up. That well-being that comes from following a fashion, joining the flow, and at the same time feeling the protection of something that improves health is emotionally irreproachable. In the same way, it represents the balance that will level the risks and calm both the athlete and the authorities.

Finally, we must assume, both doctors and athletes, that physical exercise is a coin with heads and tails. It is common knowledge that it can cause injuries to bones, joints, and muscles, but it is less widely reported that it also has some medical consequences that we should not forget, such as immunity problems, certain anemias, overtraining or some cardiac arrhythmias (fortunately infrequently, although they should not be forgotten). So, sport is health, freedom, and life, but it also represents injury and risk. A human activity that satisfies, that protects, but that we must take in the right “dose” and with due precautions.

Sources:

(1) Henschen SE. Skidlauf und Skidwettlauf. Eine medizinische Sportsstudie. Mitt Med Klin Upsala 1899:2 (en alemán científico de aquella época).

(2) Maron BJ, Epstein SE, Roberts WC. Hypertrophic cardiomyopathy: a common cause of sudden death in the young competitive athlete. Eur Heart J . 1983;Suppl F:135

Sport as a source of ethics in human beings

As the famous sports psychologist Pierre Parlebas points out, sport must be understood above all as a motor situation subject to rules that define a competition. It could be counterpointed to its oldest Latin root – understood as deportare, which means to move or transport outside the walls of the city – that is, it is an activity and a moment of freedom, against compliance with a normativity.

Ethical practice has generated a problem throughout history; it has been and will continue to be tarnished, regardless of the sport in any of its disciplines, the level of competition, or the name of the competition, because not only the desire to win of the different athletes or participants intervenes but also the public and private sector participation in such practices in order to test regulated and unregulated drugs or to obtain better funding from sponsors, sometimes carried out for political purposes and overtones.

Examples and cases of unethical practices have become part of film productions, television series, and of course, matters aired in the Courts of different countries, having consequences of custodial sentences and disqualification of athletes (and with it the loss of their medals and recognitions) and, even, the disqualification of entire delegations in the Olympic Games.

These cases will continue to appear every day, as long as a sport from its most basic or amateur levels is seen with the purest eyes that Olympic sports poetry has made known to us, leaving aside economic interests, or, as long as it is insisted on demonstrating that a population is superior in physical and sports faculties than others. It is important to remember that sport and business are not in constant fight, however, the fight will be at the moment we forget that the latter delves into the integral development of people, that is, in their growth from the most intimate step to their development in this adventure called life.

In order for the athlete at any of the levels of practice to live the practice of ethics, he must be educated on three different topics, such as the body -body-, the mind -mind- and the soul/spirit -soul-, that is, the athlete seen as a person and not only as a practitioner of physical activity.

Master Manuel Vargas Almaraz

Law Degree, Master in Taxes; Bioethicist. Managing Partner of the firm Ragna Legal & Consulting Group.

Contact: https://www.linkedin.com/in/manuel-vargas-almaraz-961a7022a/

Interview with

Dr. José Manuel Celaya Velázquez, Medical Director of

Immunotherapy as the new paradigm in the treatment of cancer

According to UN reports, in 2021 there were more than 10 million deaths globally due to cancer (1). It is striking that, although this condition is treatable in all its types, in addition to being preventable and curable in most cases, cancer is still one of the leading causes of death in the world.

More than ten years ago and in this same context, the pharmaceutical Bristol Myers Squibb formed the International Immuno-Oncology Network (II-ON), one of the first global collaborations to unite industry and academia with the intention of promoting the scientific understanding of IoT (2).

In coherence with the work carried out by the pharmaceutical company, we find the collaboration of Dr. José Manuel Celaya Velázquez, Medical Director of Bristol Myers Squibb Mexico, whom we thank for granting this interview to talk a little more about new cancer treatments.

Regarding cancer, we have had a very important development and evolution, because we are pioneers in immunotherapy or immuno-oncology, as it is also known, which are a class of drugs that use the immune system itself to attack the tumor. Ten years ago, we managed to introduce the first immunotherapy to the Mexican market. Its development has been a great experience because during that time it has helped 30% of patients with the disease, even in the advanced/metastatic stage (which has spread to other parts of the body), to be alive in the long term.

Dear Dr. Celaya, could you tell us what are the transformational therapies you have developed for patients with serious diseases such as cancer?

Mexico

Although for some it could be a conservative figure, the number of patients who benefit from this type of treatment is significant, especially if one considers that, for example, in Mexico, every year more than 195 thousand people receive a diagnosis with this type of cancer.

There is also cell therapy called CAR-T (chimeric antigen receptor T cell therapies), which is a therapeutic innovation in which the patient has blood drawn by selecting their T lymphocytes (a type of white blood cell). Once these lymphocytes have been modified by the laboratory with a newly inserted receptor that identifies and destroys cancer cells, it is infused back into the person as a cellular drug.

Why is immunotherapy called the new paradigm in cancer treatment?

The concept of immunotherapy is very interesting, with it we are getting to what we see in science fiction movies, where the immune system itself is the one that attacks the tumor. We are returning the body to its natural state in such a way that it identifies which cells should not be there and eliminates them. Let’s talk first about what immunity is: it is the system that allows us to defend ourselves against what is not our own. Their main function is to destroy

invading agents: viruses, bacteria, fungi, and parasites. However, sometimes this becomes a lethal risk for its owner.

The intention of the immune system is to identify these cells when they are still a small number, or when they are still initiating a transformation and that they are not entirely malignant; It identifies them, attacks them,

and eliminates them, this is called immunoediting. It is a concept that we could say is recent, but now in oncology, it has been seen that it has a very important role.

Arthritis, lupus, type I diabetes, and fifty other autoimmune diseases are due to the patient’s immune system exceeding its functions and reac-ting against its own cells. And conversely, the immunodeficiencies that prevent us from infections and other diseases are due to the fact that the system has been pressing the brakes too much. Playing with this delicate balance, which we call immune checkpoints, is one of the most promising lines of research against cancer, which has made possible the development of so-called immunotherapies.

These are the result of research funded by Bristol Myers Squibb (BMS) in partnership with Dr. James P. Allison, executive director of the immunotherapy platform at the University of Texas MD Anderson Cancer Center, United States, and Dr. Tasuku Honjo, Kyoto University, Japan.

The work of both researchers focused on taking advantage of the immune system’s ability to identify and eliminate cancer cells, which is why they won the 2018 Nobel Prize in Physiology/ Medicine. His goal was to find a way to remove “the brakes” and “accelerate” a person’s own defense reactions. It is a new therapeutic reality that is proving useful in several types of tumors and from which a third of patients can benefit. In addition to having less toxicity, compared to traditional treatments, one of its main advantages lies in its very specific reaction according to the tumor being treated, unlike conventional therapies.

While surgery, radiation therapy, chemotherapy, or targeted therapies have been the mainstay of treatment for cancer diseases, long-term survival and good quality of life remain unattainable for many patients with advanced/metastatic disease.

For many common tumors, 5-year survival rates remain low, so there is a need not met with the current standard of care.

Recent findings with therapies that use the body’s immune system to fight cancer (immuno-oncology therapies) have fueled hope, for the first time, that long-term survival and quality of life are possible for people with many forms of advanced cancer. These conventional therapies use tools outside the body and act directly on the tumor. Instead, I-O takes advantage of the immune system itself and activates its natural mechanisms to produce T cells that attack tumor cells from within, that is, in the same way that the body fights against other infections and diseases.

Although immunotherapy has been a revolution, the most recent data indicate that we should no longer speak of an individual treatment scheme, but in combination with other therapeutic options to improve the health outcomes of patients, in addition to the fact that it has also been shown that early detection and good training to the clinical team that administers them is key in the prognosis of recovery and cure.

Today, for example, we know that dual immunotherapy plus chemotherapy is emerging as the first-line treatment in patients with non-small cell lung cancer (NSCLC) (3), the most common form of lung cancer and whose main risk factor is smoking (4). Unfortunately, these types of tumors are usually diagnosed late; therefore, their management focuses mainly on advanced or metastatic stages. This therapeutic regimen has demonstrated clinically significant progress in overall survival (period from initiation of treatment to the last check-up) (5) and progression-free survival (time where the condition does not worsen from treatment) (6). With a complex disease such as NSCLC, which currently affects more than 7,000 Mexicans (7), the availability of different treatment

options is critical for patients facing a difficult prognosis, hence access to innovative medicines is crucial. There are also several lines of research open in this field with different highly effective immunotherapeutic combinations that can change the way melanoma is treated in the future, especially in an advanced stage with or without mutations in a specific gene called BRAF, which occurs in 50% of cases (8); or, in inoperable metastatic tumors by inhibiting the LAG-3 and PD-1 proteins that prevent the immune system from achieving an energetic response. against cancer cells (9).

I believe that fortunately, a panorama of possibilities opens up for cancer patients. Today, chemotherapy is still considered a therapeutic option, because there are tumors that require that through toxic substances the size of the tumor is reduced so that there can be a good surgery or a faster response. There are also what we call target therapies, target therapies, or target therapies, which are therapies that specifically identify a marker of a certain tumor. Let’s say I develop lung cancer that has a mutation, what this targeted therapy does is directly attack that mutation. We call that therapy target (like the targets of the Olympic Games) because it is specifically aimed at that mutation, and if that tumor in the lung has no mutation, the drug that I am going to give it will not be of any use, then these therapies are for certain specific tumors.

Based on the medical advances seen so far, what do you consider to be the future of personalized oncology and what efforts does BMS make to better understand the biology of cancer?

What is the future we hope for? We expect combinations of these therapies, but for this, there must be a good complete diagnosis so that I can offer you the best therapeutic option. And I think we’re also going to see more development towards resistance to certain tumors because, unfortunately, we see that there are also tumors that are resistant and that express other proteins, other mutational variants that don’t allow them to respond to these types of therapies, even with combinations, and that’s where research is going to go, to identify which tumors are those that could develop resistance to treat them from the beginning.

Today, we continue to seek therapies at the forefront of scientific innovation. For example, through the use of precision and translational medicine, which combines disciplines, resources, knowledge, and techniques, we are trying to identify at-risk populations and select the appropriate treatment for each, based on the biology of their disease; even potentially before they begin to show symptoms. This avoids the frustration of trying multiple therapies before finding the one that offers the best results and of course, greatly reduces the associated costs for health systems, governments, and patients.

We suggest highlighting the importance of medical education in a hybrid format

Talk, for example, about the importance of events such as Synergy, which BMS recently held in Mérida, Yucatán, to update the medical community on the use of innovative medicines and therapeutic schemes for different types of cancer that affect Mexicans, including renal, gastrointes-

tinal, lung and melanoma tumors, and which also had the endorsement of the Mexican Council of Oncology, A.C, with nine points of recertification, which recognize the effort of health professionals.

2.Our Patient Support Program, which helps them improve the control of their health condition.

The prioritization of putting patients at the center of deverything we do reaffirms our commitment, and we will continue to foster and strengthen partnerships with key stakeholders, including governments, so that, through science and technology, we find joint solutions that contribute to improving the health of current and future generations.

• During the first month of the pandemic our R+D team could not access the institutions where the clinical trials were being carried out and this made us significantly change the way BMS operates.

• We decided to integrate the technology throughout the value chain.

• We strengthened our approach with medical professionals through digital tools and also changed our training programs to online modalities.

• Internally, we began to refine our data platforms and supply chains and offered all our employees the possibility to work remotely.

• The entire BMS team met this challenge with resilience, and we have learned to overcome crises as we grow and provide comprehensive solutions to our patients.

• Digitalization and collaborative work are definitely here to stay and will continue to be strategic pillars to continue promoting the company’s innovation.

In this era when modernization is indispensable for any industry, what technological processes has BMS medical implemented to improve its internal performance and R&D processes?

Do you conduct any medical education programs to assist health professionals in therapeutic decisions with their patients?

1.

INTERVIEW

We are proud to have a history of scientific excellence, helping to transform the health outcomes of patients with serious diseases such as cancer. We have a great commitment to the research of new innovative therapies, so in the last 5 years, in BMS Mexico we have invested more than 60 million dollars in R&D, a figure that we plan to continue maintaining.

Sources:

1. 2. 3. 4. 5. 6. 7. 8. 9.

Today, we have more than 50 clinical studies in various therapeutic areas: oncology, immunology, cardiovascular, hematology, and fibrosis, where more than 300 patients are participating in 80 different research sites of the institutional and private environment around the country, being one of the few companies that have R&D teams in IMSS facilities for 10 years.

Mexico is the subsidiary that leads the most important project in breast cancer research protocols; Of 10 authors of the protocol, 3 are Mexican researchers.

Editorial Clinical Research Insider

(2022), El cáncer afecta a todos igual, pero millones de personas mueren por la desigualdad de acceso al tratamiento. Retrieved September 19, 2022 from: https://news.un.org/ es/story/2022/02/1503572

(2020), Unidos para enfrentar el Cáncer. Retrieved September 19, 2022 from: https://www.bms.com/es/life-and-science/science/united-to-face-cancer.html

E-cancer. (2020). BMS anuncia la aprobación de la UE de la opción de tratamiento de primera línea para el cáncer de pulmón de células no pequeñas avanzado. August 31, 2022, from: Ecancer Medical Science Sitio web: https://ecancer.org/es/news/19042-bms-anuncia-la-aprobacion-de-la-ue-de-la-opcion-de-tratamiento-de-primera-linea-para-elcancer-de-pulmon-de-celulas-no-pequeas-avanzado.

Institutos Nacionales de Salud, Gobierno de Estados Unidos. (2022). Fumar es el factor de riesgo principal del cáncer de pulmón de células no pequeñas. August 31, 2022, from: Instituto Nacional del Cáncer Sitio web: https://www.cancer.gov/espanol/tipos/pulmon/paciente/tratamiento-pulmon-celulas-no-pequenas-pdq#_118

Clínica Universidad de Navarra, España. (2022). Diccionario médico: Supervivencia global. August 31, 2022, from: Universidad de Navarra Sitio web: https://www.cun.es/diccionariomedico/terminos/supervivencia-globa

Institutos Nacionales de Salud, Gobierno de Estados Unidos. (2022). Supervivencia sin progresión. August 31, 2022, from: Instituto Nacional del Cáncer Sitio web: https://www.cancer. gov/espanol/publicaciones/diccionarios/diccionario-cancer/def/supervivencia-sin-progresion

International Agency for Research on Cancer. (2021). México: Source Globocan 2020, Incidence, Mortality and Prevalence by cancer site. 3August 31, 2022, from: World Health Organization. Sitio web: https://gco.iarc.fr/today/data/factsheets/populations/484-mexico-fact-sheets.pdf.

Equipo de redactores y editores de la American Cancer Society (ACS). (2022). Medicamentos de terapia dirigida para el cáncer de piel tipo melanoma: Medicamentos que atacan a las células con cambios en el gen BRAF. August 31, 2022, from: ACS Sitio web: https://www.cancer.org/es/cancer/cancer-de-piel-tipo-melanoma/tratamiento/terapia-dirigida.html

Institutos Nacionales de Salud, Gobierno de Estados Unidos. (2022). La FDA aprobó Opdualag, la primera inmunoterapia dirigida a LAG-3. August 31, 2022, from: Instituto Nacional del Cáncer Sitio web: https://www.cancer.gov/espanol/noticias/temas-y-relatos-blog/2022/fda-aprueba-opdualag-melanoma-avanzado

Finally, Dr. Celaya, for your consideration, what are the achievements and advances that have had the greatest positive impact on the lives of your patients?

The benefit of music in physical activity

Physical activity adapted to age, at different stages of life, is necessary and essential to maintain health, not exclusively physical, but also mental. This was mentioned hundreds of years ago (in the second century AD) by the Roman poet Juvenal, with the expression “mens sana in corpore sano”, taken from his Satire X (line 356). But now, nineteen centuries later, science explains the underlying biochemical and neural mechanisms that underpin this claim.

Physical exercise improves the cardiovascular system, joints, and muscles, but surprisingly also contributes to improving cognitive functions such as attention and memory.

The repeated muscle contraction, due to movement, generates the muscle production of myokines, molecules formed by the union of different amino acids. Among these is the hormone irisin, discovered at Harvard Medical School (USA) in 2012, which is secreted by muscle tissue from the FNDC5 gene. This hormone favors the consumption of calories and energy expenditure, thus enhancing the consumption of fats. But it has other important properties since it is involved in the synthesis of proteins of “brain-derived neurotrophic factors” (BDNF). These neurotrophic factors contribute to promoting neurogenesis, synaptic plasticity, and the improvement of cognitive functions (learning and memory).

We could, then, consider which option to choose to improve cognitive functions: the practice of physical exercise or cognitive training with specific

instrumental tests? According to Professor Sandra Champan of the University of Dallas (Texas), after investigating and comparing the benefits achieved with both options, she concluded that physical exercise affected memory more, while the use of cognitive instrumental tests did so in abstract reasoning.

What if we add music to physical activity?

¿Obtendríamos alguna ventaja? Obviamente; la Would we gain any advantage? Obviously, the first and obvious advantage is that physical activity would be more enjoyable, and motivating and would require less effort, but others, even more important, can be cited. One of them, observed in experiments with mice, is that simple musical exposure produces an increase in the levels of BDNF proteins. And, in humans, according to researcher Elvira Brattico (2021), there is evidence that the same thing happens, even in a fetal state. Therefore, the practice of physical exercise with listening to music would activate with greater emphasis the generation of these proteins, further enhancing the cognitive improvements mentioned.

One of the researchers who has most studied and observed the effects of music on sports practice

has been Dr. Costa Karageorghis. In his book Inside Sport Psychology, he highlights that music is the legal doping of athletes, stating that sometimes it can increase the performance of the athlete by up to 15% and reduce the perception of effort by 10%.

During high-load microcycles when the need for motivation and enthusiasm is high, musicrelated interventions can help athletes achieve better results. Similarly, as an ergogenic aid, it can facilitate improved performance. At the end of the training, listening to sedative musical stimuli is possible to accelerate recovery and prevent complications related to the cardiovascular system.

Other studies focus on evaluating physiological changes in the presence of music. At the cardiovascular level, for example, alterations in heart rate and blood pressure are observed, as well as modifications in the release of the neurohormone norepinephrine that, among other functions, contributes to maintaining an adequate state of attention and action. Fast-tempo music increases these levels and decreases them if it is a slow-tempo.

Other advantages that listening to fast-tempo music while practicing physical exercise can bring are the synchronization of body movements and improved performance by maintaining a precise and constant rhythm and lower oxygen consumption. It is found that the synchronization of the movement with the musical tempo requires less oxygen, which indicates that the organism is working more efficiently: it does the same work with less effort.

By listening to slow-tempo music, especially when its speed (beats per minute, bpm) is below the heart rate or rate, contributes to a decrease in it (drag effect or entrainment) as well as blood pressure, thus facilitating rapid physiological recovery.

Music learning and motor coordination

others, due to the constant activation, it causes in neural networks of both cerebral hemispheres through the corpus callosum and cerebellum.

Several decades ago, a woman, musician and athlete pronounced this phrase: “Sport taught me to relax, the piano gave me strong biceps and the sense of movement and rhythm.” It is a littleknown true story, but worth mentioning.

One of the benefits of musical learning is the improvement in motor coordination. Among

These were the words of Micheline Ostermeyer (1922-2001), great-granddaughter of the famous writer Victor Hugo (1802-1885) and granddaughter of the composer Lucien Paroche (1881-1915). He started in music at the age of 4, graduating from the Paris Conservatory of Music. A lover of

Being accepted as a concert performer, when she was a renowned athlete, required her to give proof of this. And so she did: she offered a concert in which she performed three piano works, one after the other (Brahms’ Concerto in D minor, César Franck’s symphonic variations, and Liszt’s E flat concerto). A feat, a demonstration of strength and resistance, which assured her reputation as a concert performer. At the age of 28, she abandoned his sports career but continued to dedicate herself to music, offering the last concerts in France and Switzerland a few years before her death in 2001.

Music, art, science, language, communication, emotion… and so many other things, influence us integrally, in all our dimensions, even in those as intimate as biological and/or genetic, according to incipient and complex current research. Music and sport are, therefore, good allies, which with proper use, and at the same time entertaining, contribute to improving and enhancing our physical and mental health.

Brattico, E., Bonetti, L., Ferretti, G., Vuust, P., & Matrone, C. (2021). Putting Cells in Motion: Advantages of Endogenous Boosting of BDNF Production. Cells, 10, 183.

Jauset-Berrocal, J.A. (2020). Beneficios de hacer ejercicio físico para el cerebro (y la memoria). CuerpoMente. Recuperado de https://www.cuerpomente.com/salud-mental/beneficios-ejercicio-fisico-cerebro-memoria_6408, el 20 de octubre de 2022.

sports, she made her profession and managed to be a three-time Olympic champion at the London Olympics (1948): gold medals in the shot put and discus, and bronze in the high jump. And, to celebrate, he improvised a piano recital at the headquarters of the French team, performing the Hammerklavier sonata, considered Beethoven’s most demanding composition for piano.

Karageorghis, C., &Terry, P. (2011). Inside Sport Psychology. Australia: Human Kinetics. Pereira, A. C., Huddleston, D. E., Brickman, A. M., Sosunov, A. A., Hen, R., McKhann, G. M., ... & Small, S. A. (2007). An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus. Proceedings of the National Academy of Sciences, 104(13), 5638-5643. Ruiza, M., Fernández, T. & Tamaro, E. (2004). Biografía de Micheline Ostermeyer. En Biografías y Vidas. La enciclopedia biográfica en línea. Barcelona (España). Recuperado de https://www.biografiasyvidas.com/biografia/o/ostermeyer.htm, el 20 de octubre de 2020.

Jordi A. Jauset,

PhD

Doctor of Communication, engineer, and musician; Master of Business Administration and in Psychobiology and Cognitive Neuroscience; Scientific communicator. www.jordijauset.es

Courtesy photo: Linus Urpí

Projection of the top 10 pharmaceuticals in the world by 2026

(in billions of US dollars)

Drug name (launch year)

Humira (2003) 252.1

Keytruda (2015) 174.6

Lipitor (1997) 168.8

Enbrel (1998)

Remicade (1998)

Revlimid (2005)

Rituxan (1997) Advair (1988)

Epogen (1988)

125.8

150.8

123.5

117.6

116.3

115.2

Comirnaty (2020) 112.1

Lifetime sales from launch in billion U.S. dollars 2021 2026

Statistical courtesy: Matej Mikulic, Nov. 7, 2022; Statista.

Launched in 2003, Humira (also known as adalimumab, by its generic name) is currently the best-selling prescription drug in the world. Created by the American pharmaceutical company AbbVie, Humira is a drug indicated to treat pathologies such as arthritis, psoriasis, Crohn’s disease, and ulcerative colitis, among others, since it decreases the inflammation process associated with these diseases. It is expected that during the next few years it will accumulate around 54.2 billion dollars, totaling 252.1 billion dollars from its launch until the cut of 2026.

Humira 06. Revlimid 02. Keytruda

A thalidomide-like drug, Revlimid (lenalidomide) from the Celgene laboratory is used to treat myelodysplastic syndromes and certain anemias. It is a novel therapy based on immunomodulatory compounds. Since 2005, it has raised $89.9 million and expects to raise another $33.6 million for the year.

07. Rituxan 03. Lipitor

Also known as rituximab by its generic name, Rituxan is a genetically engineered monoclonal antibody. It is implemented as a treatment for certain types of non-Hodgkin lymphoma. Although their sales are declining, they are still expected to acquire 9.3 million dollars within the next four years.

The drug, called Keytruda (pembrolizumab) from the American pharmaceutical company MSD, was approved as a treatment for latestage melanoma; the consultancy Evaluate Pharma predicts that at some point it will unseat Humira in subsequent sales, as cancer support drugs will increase by 11% per year in the coming years until 2024.

CCreated by the Pfizer laboratory, Lipitor (atorvastatin) is a treatment against cardiovascular diseases, used specifically to drastically reduce cholesterol. For years it was the best-selling drug in the world and, although its patent expired in 2011, it is believed that it will get another 5.5 billion dollars in sales until 2026.

08. Advair 04. Enbrel

The drug Enbrel (etanercept), developed by Pfizer, is indicated to treat diseases such as rheumatoid, psoriatic, and juvenile idiopathic arthritis, among others, functioning as a powerful anti-inflammatory. From 1998 to the 2021 cutoff, it invoiced 124.7 billion dollars; it is expected to generate another $23.4 billion by 2026.

05. Remicade

Launched in 1998 by Janssen Biotech, Inc., Remicade (infliximab) is one of the so-called biologic treatments, typically used as an antiinflammatory when other drugs have failed. It has raised about 113.4 billion dollars and is expected to enter another 12.4 billion dollars.

Marketed since 1988 by GlaxoSmithKline, Advair (fluticasone and salmeterol) is used to treat shortness of breath, wheezing, shortness of breath, coughing, and chest tightness caused by asthma. It has billed $110.2 billion and expects another $6.1 billion by 2026.

09. Epogen

Epogen (epoetin alfa) works similarly to the human protein erythropoietin, which helps the body make more red blood cells, so it’s a prescription medicine used to treat anemia. Launched in 1988, it has grossed around $111.7 million through 2021.

10. Comirnaty

Comirnaty is a COVID-19 mRNA vaccine launched in 2020 by BioNTech/Pfizer; obtained Emergency Use Authorization from the FDA for use by persons 16 years of age or older. Due to the relevance caused by this disease, sales of more than 112.1 billion dollars are expected from its launch until the end of 2026.

*Projection taken based on sales from the date of its launch until the cut of 2021, as well as the needs of the market, and based on international consultants.

*All figures are referenced in U.S. dollars.

*Information update: October 2022.

Courtesy: Matej Mikulic statistic, Oct 7, 2022, retrieved from: https://www.statista.com/statistics/1089322/top-drugs-by-lifetime-salesglobally/

Editorial Clinical Research Insider

Federico

Higher, stronger, farther

A phrase known to many is the Olympic motto and represents the effort of the human being to be or achieve a better mark, without external comparisons and without more competition than oneself. It was never sought from the amateur origin of this type of sport anything beyond going higher, stronger, or further as a form of self-improvement. But throughout the development of the sport, the Olympic spirit was diluted in competition between peers and between countries.

It is also true that in sport, as in almost all human activity, technological and scientific development (in its area of competence) generates an advantage, sporting in this case, which is not less when the athletic difference in the disciplines is increasingly small. While there are many examples in this regard, I would like to share the story of one that I like punctually: the marathon and how it was scientifically worked to break the 2-hour barrier.

Today it is accepted to refer to it as the marathon or the marathon; the official distance is currently 42,195 meters, established since the London Olympics of 1908. Urban legend has it that the distance was adjusted so that the runners when leaving could be seen from the balcony of Windsor Palace, however, it was believed that such a distance was never going to be covered below 2 hours. Something that was impossible until it was simply done.

To do so requires not only an exceptional athlete and probably the best marathoner in history (Eliud Kipchoge), but also a set of unique scientific and technological advances, this being the point on which I want to concentrate on this note.

The first point I would like to comment on is the combination between the tread and the shoe. We all know that a part of the force of the stride is lost in response to the blow on the ground where we run, and finding a balance between rebounding, stability, and propulsion is key to being able to maintain proper momentum; Let all that energy be used to move the body forward and not be lost. The biomechanics of the tread, the choice of the center of gravity on the fly (that is, the position of the body during the race), and the stability of the footwear are the three factors that together define how to

Lerner

Director of Operations at LatinaBA, a regional CRO, and President of CAIC (Argentine Congress of Clinical Research). Dr. Lerner is responsible for leading international teams to conduct global clinical trials. He worked as a Latin American manager in global CRO and as a professor at different universities.

manufacture a propeller where kinetic energy is not lost. In short, the sneaker. This custom shoe with a specific and bespoke insole height for Eliud Kipchoge’s test is called Nike Air Zoom Alphafly and is estimated to have given him a total improvement of 30-40 seconds. It is not approved by the Olympic Committee, since it has 3 layers of rigid carbon fiber overlapped (up to two are accepted) in a thick foam and with a height of 4 cm (up to 3 are allowed.)

The second technological advance that I want to share briefly is the fight against wind and air friction. We have known for many years that the wings of airplanes and racing cars are evaluated in wind tunnels. This is what was studied to determine the formation of the athlete’s escorts during the test (the famous hares). All long-distance races employ a group of runners who launch themselves along with the competitors and help them maintain a specific pace for two-thirds of the race. This helps runners not lose energy to maintain a specific pace and concentrate until the end of the race. But they also function as a wind barrier and generate a specific inertia that “pushes” runners forward.

The configuration, rotation, and replacement of the hares were tested in wind tunnels and on animations by artificial intelligence showing a potential improvement of another few seconds. In total 41 different hares were used, but always 7 in a specific formation.

The third and last example that I want to share as a technological advance among others that were given to break the barrier of 2 hours (in addition to the specific circuit, the evaluation of the time and place by its weather conditions) is nutritional support. All of us who ever ran the 42 kilometers know the energy wear and tear that the test demands. Although it cannot be generalized, we can say that on average approximately 3500 calories are consumed by a man of about 80 kg who runs for about 4 hours. The reserves of freely available sugars do not cover this demand and supplementation

is required during competition. Not only do you run drinking water, and in this case, if you look closely, you can see that Kipchoge drinks a specific volume of liquid every so often time-distance. This nutrient and electrolyte solution was evaluated during workouts using a subcutaneous arm device that measures biomarkers such as glucose or lactic acid (he currently regularly uses an Abbott’s Libre Sense device). During the race, the drink-food was provided from a bicycle that moved at its pace so that the athlete did not waste time slowing down at the hydration points.

The mark obtained by all these things was not officially approved by the IAAF (it is now called World Athletics) for all these circumstances, but it is a clear example of the combination of the sportsmanship of an exceptional athlete and technological assistance. Without technological advances, without this athlete and the preparation of the team, it would not have been possible to achieve one of the few marks that were considered unattainable.

On October 12, 2019, in Prater Park, in the City of Vienna, on a special circuit, Eliud Kipochge forgot that the 2-hour mark was unbreakable and ran the marathon at 1:59:40 with a smile on his face. The mark is not approved (the time accepted today is 2:01:09 also by Eliud Kipchoge) but it is a clear example of how science and technology can improve sports performance.

Sports-related concussions

Sports-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. An estimated 3.8 million cases of concussion-related concussions are due to sports and recreational activities each year. In contact sports such as boxing, American football, ice hockey and rugby, this type of injury is common.

This issue has inspired films based on true stories such as Concussion (directed by Peter Landesman) and has now put the NFL’s concussion protocol under heavy scrutiny after quarterback Tua Tagovailoa’s second head and neck injury (Fig. 1) during the Miami Dolphins loss to the Cincinnati Bengals. As a result, the protocol update considers that it is forbidden for a player to return to the game if he is diagnosed with ataxia, an abnormality of balance/stability, motor coordination, or dysfunctional speech, very common in people who have a head injury.

Increased concussions can lead to subtle behavioral changes, early onset of memory disorders, dementia, or trigger chronic traumatic encephalopathy (Omalu, et al., 2005), which can only be confirmed after post-mortem evaluation. The current diagnosis of CRS begins with subjective clinical evaluations considering symptoms or neuropsychological tests, for example, using the Glasgow Coma Scale (GSC), although some of the lesions are not easily detectable even with routine brain scans such as computed tomography (CT) of the head. Multifaceted and complex presentation

of lesions can lead to ill-advised clinical reports and judgments.

There is currently great interest in identifying objective biomarkers that support the diagnosis of CRS. Some of the blood biomarkers that have been used to detect CRS are the ubiquitin carboxyterminal hydrolase L1 protein (UCH-L1) and the glial fibrillar acid protein (GFAP), which are synthesized and secreted from neurological cells to brain injury; these two proteins can be easily evaluated using the Banyan BTI (Brain Trauma Indicator) indicator approved by the FDA’s Advanced Devices Program that allows a Detection within a few hours after suffering a head injury. Other biomarkers that perform

CONCUSSIONS

Figure 1. Fencing posture of Tua Tagovailoa after suffering his second injury, associated with head trauma.

similar functions are calcium-binding B protein S100 (S100B) or total tau protein (p-tau), although many of them do not show minor concussions, which do not produce structural changes in the brain (Costandi, 2018). Other alternatives for detecting CRS have been the creation of patches, helmets, or portable devices such as BrainScope, however, specialists in sports medicine indicate that more effective CRS detection systems are still required and warn that children and adolescents are more likely to suffer concussions and may take longer to recover than adults.

Sources:

1. Omalu, B. I., DeKosky, S. T., Minster, R. L., Kamboh, M. I., Hamilton, R. L., & Wecht, C. H. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57(1), 128-134. 2. Costandi, Mo. 2018. FDA Okays First Concussion Blood Test but Some Experts Are Wary. https://www.scientificamerican.com/article/fda-okays-first-concussion-blood-test-but-some-experts-are-wary/

Courtesy: https://www.razon.com.mx/deportes/nfl-video-escalofriante-jugador-miami-conmociona-pleno-partido-500328

Claudia Mejía Morales, PhD Research and Development Analyst at Drox Health Science. Ph.D in Biosystematics, Ecology and Management of Natural and Agricultural Resources, with orientation in Biotic Products; Master in Environmental Sciences, with orientation in Environmental Technology.

Writing by

LFT. Paulina

Zarazúa Yáñez

Degree in Physiotherapy from the Autonomous University of Querétaro; Comprehensive Rehabilitation Center of Querétaro (CRIQ). Creator and founder of AVIS FISIOTERAPIA, an integral physiotherapy clinic.

Physical therapy is the science dedicated to preventing, recovering, conserving, and rehabilitating people of all ages. It provides treatment to restore patients’ bodily functions and thus reintegrate them into their activities of daily living, work, social, recreational, physical, and sports.

Physiotherapists provide a service to the population in which the maximum movement and functional capacity of the person is developed, maintained, and recovered when it is affected by an injury, disease, aging, disorder, or some external factor that damages their bodily function.

The physiotherapist comprehensively evaluates the patient, then diagnoses, prognoses, and carries out an intervention plan, gives treatment, and carries out an education program according to the evolution and diagnosis; It also determines the referral of the patient to another professional as an important part of multidisciplinary work.

The physiotherapy specialist uses different techniques to treat and thus maintain the well-being and health of the patient, among them are:

• Therapeutic exercise

• Manual therapy

• Physical agents (electricity, heat, cold, water, etc.).

Among the various specialties of physiotherapy is sports physiotherapy, which studies all factors, prevention, treatment, and approach of injuries related to athletes of any discipline.

The sports physiotherapist evaluates, attends, and designs a treatment to prevent, maintain and rehabilitate the athlete (amateur, health, elite or high performance). A professional who demonstrates advanced competencies in promoting safe participation in physical activity, providing counseling, and adapting rehabilitation and training interventions, for the purpose of preventing injury, restoring optimal functioning, and contributing to the improvement of athletic performance in athletes of all ages and abilities, while ensuring a high level of professional and ethical practice.

Competencies of patient management at the sports level:

-Injury

prevention:

The sports physiotherapist assesses the risks of injury associated with an athlete’s participation in a specific context of sport or physical activity, informing and training athletes and other professionals in a way that reduces the occurrence and recurrence of injuries.

-Acute intervention: Sports physiotherapists respond appropriately to acute injuries or illnesses in both training

and competitive settings, using prior communication with other professionals to identify and establish roles and responsibilities.

--Rehabilitation:

The sports physiotherapist uses clinical reasoning and therapeutic skills to assess and diagnose sports-related injuries and design, implement, evaluate, and modify evidence-based interventions that aim at a safe return to the athlete’s optimal level of performance in their specific sport or physical activity.

-Performance improvement:

LSports physiotherapists contribute to improving an athlete’s performance by evaluating their physical profile, advising, and intervening to optimize conditions for maximum performance in a specific sport, within a multidisciplinary team approach.

The objectives in this specialty are:

• Adapts the body to training

• Decrease recovery time

• Reduce-prevent the risk of injury

• Improve the quality of life

These objectives will depend on each patient, the type of injury, the severity, the sport performed, or simply the physical health objectives required by the athlete.

The treatment of sports injuries changes due to the demands on the patient’s body, which need to be integrated back into their activity with a full recovery. The physiotherapist in this specialty can also participate and collaborate for the development of training, as well as give advice together with the team of physical trainers-trainers. Treatment and recovery should be done in conjunction with sports doctors and psychologists.

The vast majority of injuries to be treated are musculoskeletal, for example: stress fractures, dislocations, muscle strains, ligament and tendon injuries, sprains in their different degrees, pre and post-surgical treatment, and contusions.

This specialty allows having better management of the athlete, in a multi and interdisciplinary way, from prevention so that the athlete performs his practice with the least possible risk so that he obtains a treatment according to all therapeutic techniques and his recovery is fast and so that the player returns to his activity without complications, optimally and fully functional. Scientific evidence tells us that sports physiotherapy is an extremely important field of action, in which the professional seeks the restoration of human body movement and rapid integration into physical exercise.

Reference: Pinzon, I. (2018). Perfil profesional del fisioterapeuta en actividad física, ejercicio físico y deporte. Revista Colombiana De Rehabilitación, 17 (2), 93-111. https://doi.org/10.30788/RevColReh.v17.n2.2018.325

Optimus, Tesla’s new humanoid robot

On September 30, at Tesla’s Artificial Intelligence Day in Silicon Valley, the latest generation of Optimus, the new robot prototype developed by the company of billionaire entrepreneur Elon Musk, was presented. Optimus will have a height of 173 cm high, weigh around 57 kilos, and reach speeds of up to 8 km/h. Such characteristics would allow you to load and transport objects up to 20 kg.

The way the robot will work will be through scopes, force transmission points, and electromechanical sensors distributed around the entire humanoid body, thereby ensuring movement and force in the arms and legs. Engineers involved in its development mention that the implementation of Optimus’ artificial intelligence does not start from

scratch, since they have been based on the technology previously implemented in Tesla vehicles.

The first activities that robots will have to test their effectiveness and, above all, their reliability, will be to serve as auxiliaries in the production chains of the brand’s own cars. However, the main objective of Optimus will be to assist in performing household tasks such as watering plants, loading, and transporting objects, as well as any activity that can be fulfilled through the advanced artificial intelligence of the product. In the same way, the entrepreneur is interested in his robot being useful in dangerous, repetitive, or boring activities for humans. In the same sense, without forgetting the safety laws of robotics, Optimus will have its

own third-party protection system, where the hardware can be deactivated even remotely, in case of representing a threat.

The business model articulated by Elon Musk is based on the mass production of androids so that their individual price is “less than a car”; each Optimus could cost about $20,000, he said. Based on this, the objective of this project is to become a mass product. As for its commercial launch, the date has not been set; the first concept image of the robot was presented in 2021, followed by the presentation of the development of its platform in February 2022. Although the android is currently in the development phase, its formal production and commercialization could begin until 2023.

Editorial Clinical Research Insider

Dr. Laura Maffei

Factors, reactions, and stress management

As Hans Seyle, the father of stress, who back in 1936 described the reaction to stress, said: “it is not the stressor who is to blame, but how we relate to him.”

And so, we have millions of stressors and millions of ways to react to them. Thus, no one is the same or affected in the same way by different situations that mobilize stress hormones, cortisol, and adrenaline from our adrenal gland to defend ourselves from this experience perceived as a threat of different intensity.

These two hormones prepare us to deal with the stressor causing a higher heart and respiratory rate; Muscle tension and blood pressure increase, peripheral arterioles close, skin becomes pale, and body temperature increases, but with the activation of the sweat glands, sweat tries to collaborate in reducing it and blood sugar increases to provide energy to carry out all this preparation of fight or flight of the... blocked transit as a mammoth used to be!

And the brain? Pure attention focused on the threat. When the threat is over, the hormones resume their normal cycle. The acute reaction that we must learn to recognize in ourselves when we are faced with a stressful stimulus. The first step towards stress

management to implement different strategies that help us so that hormones do not remain elevated for longer than necessary, that they are depleted and segregated inadequately.

That is where we move on to chronic stress and the picture is totally different. Blood pressure can be definitely increased, the heart rate goes to arrhythmia, and the skin has allergies... The immune system fails, and other diseases are derived from stress since our body is not prepared to face this permanent increase in cortisol and adrenaline and the entire system ends up misaligning.

So how to better manage our stress, if Seyle himself had struggled to manage his today, or at least much more than he did in 1935. However, at that time they faced other types of stressors, for example, diseases, cold, famines, fires, trench warfare, and other socalled absolute stressors, which endanger life.

Today we are also impacted by emotional, technological, and communicational stressors, etc. And to understand them better, Dr. Sonia Lupien, founder of the Centre for Human Stress Studies in Montreal, coined the acronym C.I.N.E. to understand what

Medical endocrinologist; Executive Medical Director in Applied Clinical Research, member of the Argentine Society of Endocrinology (SAEM-Department of Psychoneuroendocrinology) and the Endocrine Society; currently directs Maffei Medical Center in Buenos Aires, Argentina.

conditions the situations that generate the increase in stress hormones must have; the more conditions they meet, the more intense the stress reaction will be:

C: weak control

I: unpredictability

N: novelty

E: weak ego

To each one, their films within the C.I.N.E. affects them, and this is a crucial point also in the deconstruction of the way of facing everyday events: To which ingredient am I most sensitive? Is it the unpredictable that upsets me? or If I do not have total control of a situation I despair?

Simple things: I have already accepted that the day has 24 hours and not 36 so as not to feel overwhelmed? Did I organize myself to lower the unpredictability of the week? Am I being able to dose myself to make controlling situations easier? Do I participate more in decisions?

Analyzing each of these ingredients of the situations that alter us allows us to work emotionally on each of them to deepen strategies that accommodate each impact to a less toxic level.

Learning to breathe slowly and deeply sends the brain the signal that everything is fine and not that we are running in the middle of the jungle... Therefore, it can send to cut off the supply of stress hormones and thus allow greater relaxation. Physical activity levels blood sugar values and stimulates the secretion of substances that regulate cortisol, such as oxytocin. The latter is the hormone of hugging, of attachment. This is how cortisol isolates and peer company help lower stress, as well as community help, spirituality, and laughter! So, do not forget to laugh, even in front of the mirror, since it has the same therapeutic benefits.

In conclusion: up with the stress that allows us to accept challenges and get ahead, but beware of the film of each one, in their C.I.N.E. we must learn to regulate how to relate to each stressor.

Organ and tissue donation for transplant purposes.

Death as another dimension of life

Mexican scientist and entrepreneur noted for her studies on minimal hepatic encephalopathy, oxidative stress, quality of life and social cognition. A physician by profession, she completed her postgraduate studies at Texas A&M University. Certified by the Pan American Health Organization (PAHO) as a facilitator of MhGap (Action Program to bridge the gaps that exist in mental health care), she is currently a candidate to receive the degree of Doctor of Medicine from the UANL. CEO VICOMMA group.

Technical committee: Dr. Med. Homero Arturo Zapata Chavarría

While autumn is tinged with ochre, the leaves of the trees cover the ground and creak to accompany our march toward the end of 2022. In jasmine-scented cemeteries, entire families keep company to their dead beloved ones. They adorn the graves with marigold flowers, candles, fruits, sweet-made crafts, and the favorite foods of the deceased to whom this whole party is dedicated. This pagan religious cult is unique in the world, it is illuminated with wax, and it is only possible to live it in Mexico. There is a place where the mysticism of the day acquires a greater dimension, Tzintzuntzan, Michoacán, a small town that has flourished on the shores of Lake Patzcuaro,

the capital of the Purepecha empire. The streets full of bright and polished rocks and houses of red tiles are an invitation to this magical world, where the past comes alive. For the Tarascans, life comes to an end with death. The world of the dead was regarded as a place of delights. On the night of November 1st, canoes depart from the dock to sail to the island of Janitzio, a night that becomes unique in the memory of the spectators.

Wow, this night couldn’t have been more epic! In the Franciscan Convent, a local group premiered the staging of Hamlet.

Dr. Ana Villaseñor-Todd

“Am I a real boy?” Pinocchio asks The Blue Fairy, who replies, “No, Pinocchio. To make Geppetto’s wish come true will be entirely up to you.”

Yes! Shakespeare’s Hamlet, “a man of infinite human understanding”, is arguably the greatest dramatic character ever created, in the greatest play ever written. But is there really a method to Hamlet’s madness? And what is ‘madness’? Since the sixteenth century, medicine has been given increasing authority to determine the boundaries between sanity and disorder.

The same thing happens between the concepts of life and death. Developments in psychiatry can be influenced by culture and exert significant influence. The same thing is true of the concept of death. It is the culture that gives us a perception about the concept. For example, Drury Lane many decades ago gave us a mourning Hamlet, “this prince [Hamlet] of a reserved and cautious nature, arising from a melancholy stamped by the untimely death of his father and some consequent misfortunes.”¹

Hamlet transcended me many years ago, I was an inexperienced young doctor facing the miracle of the birth of a human being, and I was at the exact point where magic comes to life. In the general

hospital where I consolidated my medical training, my hands had already received the cry of cellular precision, as well as had already closed the eyelids of whoever lived their last breath. There I was, reflecting on death as another dimension of life. A few years have passed since then and I have taken up this idea again.

A few days ago, at the morning visit round, a patient that we will call “Maria” was recovering from a successful liver transplant. Emotionally she showed immense gratitude to her entire medical team, but especially to her donor. Maria inspired this article when she said, “I will give this liver all the love and care it deserves because it has given me a second chance to continue.”

In multicellular organisms, there is a constant effort to maintain a balance between the number of new cells that are generated through mitosis and the number of damaged or unrequired cells that are eliminated from the body. This constant renewal of cells is necessary for the development of life².

In the human being, what is the exact moment in which life is declared? Dr. José Alberto Villarreal-Rodriguez explains: “From the first perceived heartbeat of an embryo in utero, it is clear that a new life has been formed. Life is the force that creates and sustains this universe, we are part of it, and we move with it always. Human life is valuable for the simple fact that the human person himself is.”

There are two types of modes of cell death. One is the one that occurs as a result of a massive cellular injury known as necrosis, while many cells of the organism die through a more refined mechanism, called apoptosis. Cell death and neurodegenerative conditions have been linked to oxidative stress and the imbalance between free radical generation and antioxidant defenses. Multiple sclerosis, strokes, and neurodegenerative diseases have been associated with reactive oxygen and nitric oxide species⁴. The uncontrolled production of free radicals and the lack of antioxidants to neutralize them, damage molecules and alter cellular processes favoring cell death in a positive feedback mode. Martin Heidegger is right to define that “Death is the essential event in the human adventure.”

Clinical death corresponds to prolonged cardiac arrest that prevents oxygenation of the organism. Until 1950, any cardiac arrest meant death. But the invention of the ventilator in 1952, by Danish anesthesiologist Björn Ibsen, revolutionized this definition of death by allowing the implementation of resuscitation and intensive care. A few years later, in 1959, the neurologist Maurice Goulon and the infectologist Pierre Mollaret of the Claude-Bernard hospital in Paris, proposed the concept of “exceeded coma”, corresponding to the state of brain death. ³

This concept was resumed again in the Anglo-Saxon world in 1968, under the impulse of the committee of Harvard Medical School (HMS) in Boston, United States. In their opening statement, they wrote: “Our main goal is to define irreversible coma as a new criterion for death. There are 2 reasons why a definition is necessary, 1: the improvement in resuscitation and support measures has led to increased efforts to save those who are seriously injured. Sometimes these efforts are only partially successful, so the result is an individual whose heart is still beating but whose brain suffers irreversible damage. The burden is great for patients suffering a permanent loss of intellect, for their families, and for hospitals. 2: outdated criteria for the definition of death may lead to controversy in obtaining organs for transplantation.’’

The concept of brain death was developed, in part, to allow patients with devastating neurological injuries to be pronounced dead before cardiopulmonary arrest occurred. Brain death is essential to current practices of organ and tissue recovery for transplant purposes because it legitimizes the removal of organs from bodies that continue to have circulation and respiration, thus preventing ischemic organ injury. The Conference of Royal Medical Colleges and their Faculties in the United Kingdom published a statement on the diagnosis of brain death in 1976 where brain death was defined as the irreversible and complete loss of brain stem function.4,5 This statement provided guidelines that included a refinement of apnea testing and pointed to the brainstem as the center of brain function: without it, there is no life.

Understand that the story of a human being is over when we still hear that “Tum lub! Tum lub!” that once declared us that the beginning of life is complex.

The difficulties in determining brain death and making it understood by family members not only increase the costs of medical care but also hinder the process of organ and tissue transplantation, that is where this text makes sense. The “dead donor rule” requires that patients be pronounced dead prior to the removal of organs vital for transplantation6.

Brain injury from hemorrhage, trauma or other causes of anoxia is the common diagnosis in potential organ donors. It has been shown to be associated with significant hemodynamic, metabolic, and hormonal changes. These result in a progressive and profound systemic inflammatory response, which affects the function and viability of donor organs prior to recovery and transplantation8.

Time is a non-renewable resource, and it is in this context that the phrase makes sense. Once a patient is diagnosed with brain death,

a potential organ and tissue donor can be identified for transplant purposes. The period of donor management, after confirmation of death by neurological criteria and before organ recovery takes place, may offer an important opportunity to reduce organ injury and potentially initiate cell repair and regeneration.

In Mexico, three decades have passed since the first heart transplant and the scenario, as in the rest of the world, is characterized by a shortage of donations and transplants. Mortality remains high for patients on the organ transplant waiting list. A marked imbalance persists between the number of organs available and the recipients that need to be transplanted.

Today, thanks to the efforts of the National Transplant Center (CENATRA), in order to professionalize and standardize donation and transplantation activities, there are Hospital Coordinators for Organ and Tissue Donation for Transplant

purposes. Highly trained health professionals who perform precision clinical work, adequately inform family members if the patient diagnosed with brain death is a potential organ and tissue donor for transplant purposes, and also participate in the proper management of donors, this offers the opportunity to reduce organ damage to maximize the number of organs that can be offered, to respect the donor’s altruistic gift. It is not an easy task, the pillars of donor treatment include: correction of hypovolemia; maintenance of organ perfusion; timely treatment of diabetes insipidus; corticosteroid therapy, and pulmonary protective ventilation. But above all, the accompaniment and management of the grieving processes of the donor’s family7.

Death, like the birth of a human being, is an event with significance within society and culture. It is important to respect and attend to the loss of a family member or loved one with its psycho-affective consequences, its external manifestations, rituals, and the evolutionary psychological process following the loss. Grief is a common event after the death of a close person, but it is necessary to maintain vigilance over the people who live it in order to prevent pathological mourning. This moment of suffering can be transformed into

an altruistic manifestation through the donation of organs and tissues for transplant purposes.

Two decades ago, a 7-year-old boy named Nicholas Green was fatally shot while on vacation with his family in Italy. In an astonishing act of humanity, his parents immediately agreed to donate his organs to other adults and children awaiting a transplant. His altruistic decision received numerous praises from the media and contributed to a spectacular and sustained tripling of deceased organ donation rates throughout Italy, which continues to this day.

Nicholas Green is among the most famous deceased organ donors in history and is credited with rising organ donation rates in other European countries. In the U.S., however, rates of organ and tissue donation for transplantation by deceased people have increased only marginally. Current major campaigns target community members to become organ donor card holders.

In Mexico, there is a section in the driver’s license where we can express our consent to be organ donors. A signed organ donor card is neither necessary nor sufficient for donation. U.S. and Mexican law only allows the removal of organs from patients when consent has been documented, but organ retrieval usually does not take place if the family objects. Therefore, an organ donor card in practice only provides an opportunity to start a conversation: the final authorization is based on

the consent of the family. Deceased organ donors are recognized heroes, but only if their family manages to make a decision despite the tragedy.

Definitions of death have evolved from the intuitive to the pathophysiological and medico-legal. A poor understanding of the physiological nature of death and the methods for determining death has resulted in a bifurcated concept of death as cardiorespiratory arrest and brain death. It is necessary to promote a culture of donation prior to any tragic situation, starting with human dignity and respect for life and death.

In deceased donor organ and tissue transplantation, the interests of the donor as a person are paramount, and no interest of organ recipients or society at large can justify the denial of the rights and bodily integrity of the person who is a donor.

Events praising vital contributions from organ donors are widespread both locally and nationally, and public honors for surviving families are relatively rare. Donor

families remain invisible to the public. Large general hospitals could recognize surviving families of deceased organ donors, but they don’t. The mismatch in hospital recognition of organ donation versus time donation seems to indicate that large general hospitals are reluctant to prioritize the recognition of deceased donors.

Organ donor families are hardly mentioned in traditional organ and tissue donation campaigns for transplant purposes, perhaps because of society’s natural reluctance to talk about death. The culture of donation focuses primarily on grateful transplant recipients and how lives can be transformed. However, some community members may relate better to bereaved families who donate rather than receive.

These lines have been written in memory of our dear Elsa Maria MG and her beautiful family. And in gratitude to all the donors and their families who with this act of immense generosity have made possible the dream of many people to continue living, loving, and smiling.

D’Arcy MS. Cell death: a review of the major forms of apoptosis, necrosis and autophagy. Cell Biol Int. 2019 Jun;43(6):582-592. doi: 10.1002/cbin.11137. Epub 2019 Apr 25. PMID: 30958602.

Woodfine JD, Redelmeier DA. New thinking about honor and deceased organ donation. Am J Med. 2014 Sep;127(9):802-3. doi: 10.1016/j.amjmed.2014.05.021. Epub 2014 May 22. PMID: 24858064.

Radi E, Formichi P, Battisti C, Federico A. Apoptosis and oxidative stress in neurodegenerative diseases. J Alzheimers Dis. 2014;42 Suppl 3:S125-52. doi: 10.3233/JAD-132738. PMID: 25056458.

Spinello IM. Brain Death Determination. J Intensive Care Med. 2015 Sep;30(6):326-37. doi: 10.1177/0885066613511053. Epub 2013 Nov 12. PMID: 24227449.

Truog RD, Robinson WM. Role of brain death and the dead-donor rule in the ethics of organ transplantation. Crit Care Med. 2003 Sep;31(9):2391-6. doi: 10.1097/01.CCM.0000090869.19410.3C. PMID: 14501972.

Bera KD, Shah A, English MR, Harvey D, Ploeg RJ. Optimisation of the organ donor and effects on transplanted organs: a narrative review on current practice and future directions. Anaesthesia. 2020 Sep;75(9):1191-1204. doi: 10.1111/anae.15037. Epub 2020 May 19. PMID: 32430910.

Bera KD, Shah A, English MR, Harvey D, Ploeg RJ. Optimisation of the organ donor and effects on transplanted organs: a narrative review on current practice and future directions. Anaesthesia. 2020 Sep;75(9):1191-1204. doi: 10.1111/anae.15037. Epub 2020 May 19. PMID: 32430910.

Contribution of physical activity to physical and mental health

It is not unknown that the best medicine is the one that prevents, hence the importance of encouraging positive lifestyles to generate an adequate state of health. Strategies that improve quality of life and reduce the effects of disease and aging should also be chosen.

One of the chronic diseases with a multifactorial origin that most afflicts the Mexican population is obesity. Genetic factors intervene in it, but environmental and lifestyle factors such as a sedentary lifestyle, physical inactivity, as well as the intake of foods with high energy density and large portions influence a greater proportion. All of these are identified as risk factors associated with overweight and obesity.

They condition the development of metabolic syndrome, a group of disorders that includes increased blood pressure, glucose, insulin, cholesterol and/ or triglycerides, and body fat around the waist. This increases the risk of coronary heart disease, diabetes mellitus, high blood pressure, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer.

Hence, the practice of physical activity and sports promotes health by providing benefits such as increased muscle tone and mass, improved blood circulation, increases the amount of oxygen that the lungs can store, helps achieve and maintain a healthy weight, improves joint mobility, and increases flexibility to avoid injuries and prevent falls; it strengthens bones and helps prevent osteoporosis.

It also contributes to mental health because it helps increase the production of neurotransmitters such as epinephrine, norepinephrine, serotonin, and dopamine, which improve mood producing a feeling of well-being and immediate relaxation, in addition to positively influencing mental health by reducing anxiety, depression and helping to better cope with the stress of daily life.

All forms of activity or physical exercise are beneficial, the goal is to enjoy its practice and carry it out for at least 30 minutes a day with activities such as walking, climbing stairs instead of using the elevator, cycling, dancing, jogging, and incorporating strengthening exercises, flexibility and those that improve balance and prevent the risk of falls.

Since physical activity has been incorporated into daily life, it is important not to abandon the habit. We must remember that performing physical exercise and increasing physical activity in our lives is essential to improve health and reduce diseases, also promotes environmental protection, and becomes a long-term health investment.

In order to improve the quality of life, I propose the following physical activity plan:

1. TRY TO WALK FOR AT LEAST 30 MINUTES A DAY

Walking is easy to do and safe for your body because it is unlikely to cause injury compared to jogging or running. It is an aerobic exercise that does good to your heart and circulatory system. Walking in company can increase adherence to the habit and be a more enjoyable activity.

2.PERFORM STRETCHES AND PUSH-UPS

Stretching can be done at any time, while at work, in the car, or at school. It is important to stretch before and after doing some physical activity, but also when we get up, when being several hours in front of the computer or TV or when you feel tension in the arms, neck, or back.

3. DO STRENGTH EXERCISES

Carrying the bags from the supermarket and climbing stairs with them is a good method to develop muscle strength, also do sit-ups always take care of the posture, doing push-ups and extensions of the arms tilting the trunk, and resting the hands against the wall, in three batches or series of at least eight repetitions, with a minute of rest between each one.

Physical activity does not have an age limitation, this small program can be the motivator to start a more active and healthy life.

References:

1. 2.

Rodríguez-Romo, G., Barriopedro, M., Alonso Salazar, P. J., & Garrido-Muñoz M. (2015). Relaciones entre Actividad Física y Salud Mental en la Población Adulta de Madrid. Revista de Psicología del Deporte, 24(2),233-239.[fecha de Consulta 4 de Noviembre de 2022]. ISSN: 1132-239X. Recuperado de: https://www.redalyc.org/articulo. oa?id=235141413005

Fouilloux, C; Fouilloux-Morales, M; Tafoya, SA; Petra-Micu, I. (2021). Asociación entre actividad física y salud mental positiva en estudiantes de medicina en México: un estudio transversal. Cuadernos de Psicología del Deporte, 21(3), 1-15. [fecha de consulta 4 de noviembre de 2022]. ISSN edición impresa: 1578-8423 Recuperado de: https://www. redalyc.org/pdf/542/54250121006

Lorena

More than 12

Project Development Coordinator at FUNSALUD

years of experience in the development and implementation of health and wellness programs for international private companies and the public sector; CEO at +Salud

Guido

Myths and realities about the use of cannabis as an ally in sport

Dr. Mafer

Arboleda

Associate Director of Research at Santé Cannabis, a leading clinic specializing in the prescription of medical cannabis in Quebec, Canada. Anesthesiologist specialized in chronic pain and palliative care by UNAM and INCMNSZ. Medical surgeon from the Pontificia Universidad Javeriana, Bogotá. Clinical fellowship and postdoctoral studies in Supportive Care in Cancer and Medical Cannabis at McGill University, Montreal, Canada.

#DrMaferArboleda #MaferCannabisMD

● The benefits and safety of cannabis use and the improvement in athletes’ physical performance are not supported by good quality scientific studies, despite the anecdotal and empirical information that has been disseminated.

● Amid speculation of possible beneficial applications, the effects of cannabis and its two most abundant components, delta-9tetrahydrocannabinol (THC) and cannabidiol (CBD), remain uninvestigated in depth in the context of sports medicine.

● This limitation in clinical research is directly related to the prohibition of the cannabis plant and all existing regulatory barriers.

The Cannabis sativa plant is made up of more than 500 chemical compounds, including THC and CBD, which are the most abundant and studied cannabinoids in humans. These cannabinoids have their own characteristics and specific therapeutic effects. Thus, for example, low-dose THC has been shown to be useful for the control of chronic neuropathic pain, reduce nausea and vomiting secondary to chemotherapy and increase appetite in patients with HIV and cancer, among others. For its part, CBD has been shown to have anti-inflammatory, anxiolytic (low anxiety levels), neuroprotective properties, and an important control in seizures of patients with refractory epilepsies. But, in sports, what is known about the effects of cannabinoids? Dr. Mafer Arboleda, an expert in medicinal cannabis, clarifies it for us.

Currently, it is increasingly common to hear that cannabinoids serve to potentiate physical performance in athletes, recover injured muscles and tissues, improve anxiety and sleep quality of athletes, etc. Even the issue of cannabis in sports has generated significant controversy, to the point that the World Anti-Doping Agency (WADA), in 2018, decided to remove CBD from the list of prohibited substances1 for use in competitions. Not so for THC, where concentrations greater than 150 ng/ml in urine, continue to represent a violation of anti-doping rules. However, despite all this anecdotal and empirical information that has been disseminated, it has not yet been proven, nor is it supported by good quality clinical research, that the use of cannabinoids, both THC and CBD, improve athletic performance or has any beneficial effect on injured tissues in humans, even though historically it has been consumed by athletes frequently.

Despite the lack of clinical research supporting the use of cannabinoids in sport, the misconception, until now, that it improves athletic performance has led to an increase in their consumption to a large extent since the early 2000s. A systematic review of the literature found that out of 46,000 athletes of different ages and playing various sports, 23% had used some form of cannabis in the past year.2 This was generated by the idea of the possible benefits that cannabinoids can bring them in terms of sleep quality, anxiety and mood control, muscle relaxant effect, exercise recovery, pain control, recovery after a concussion, stress, euphoria, and improvement in muscle and joint inflammation.

Moreover, a survey conducted in 2019 showed that, of 1,161 participants, 26% reported current cannabis use and, of these, 63% reported exercising at least 5-7 times a week. More than 50% of these athletes reported having chronic pain. 3

How prevalent is cannabis use among athletes?

What is known about the effect of THC in the context of the athlete?

At the moment we know that the results of clinical research in humans do not support the benefits of consuming THC in sports, on the contrary, the few studies conducted (which were carried out more than 30 years ago), conclude that physical performance is hindered by reducing endurance, increasing heart and respiratory rate, reduce the ability to maintain physical effort and capacity and generate increased myocardial oxygen demand.4 Predominantly an ergolytic effect (detrimental effect on physical performance) and a higher degree of tachycardia, orthostatic hypotension, and accelerated fatigue are shown.

The methodology of many of these studies is limited and over the years there have been multiple changes in THC consumption. Today, much higher concentrations of THC are consumed (6-10 times more than 35-40 years ago), delivery methods have evolved and ways of measuring physical performance have also advanced.

An athlete who consumes THC before exercise can be harmed and endanger his/her health, and that of his/her peers and bystanders. Cannabis should not be considered an ergogenic substance (which refers to performance-enhancing substances), and doping control tests should take into account its social and health implication and not really the performance activity.

“The validity of THC’s effect on physical performance is still unknown, as huge gaps remain since human clinical research; studies are needed that use appropriate tools to objectively measure exercise capacity and performance in humans,” says Dr. Mafer Arboleda.

And about CBD in sports, what evidence do you have?

With regard to CBD, the results may be promising for athletes, since in preclinical studies (animal models, mainly) anti-inflammatory, neuroprotective and analgesic effects have been observed. However, this

should not yet be extrapolated to possible effects that benefit the athlete. “We still need to develop clinical studies in humans to show whether CBD really has these specific therapeutic effects for athletes,” explains Dr. Arboleda.

It is important to recognize that most of the therapeutic effects that have been proposed for CBD in sports medicine, such as improvement in sleep quality, anxiety, anti-inflammatory effect, etc., come from results of studies in animal models or from the effects of CBD in patients with specific pathologies such as social anxiety disorders, Parkinson’s disease, and post-traumatic stress disorder, among others,

The effect of CBD on the recovery of injured musculoskeletal tissues has also been proposed, but again, it is in studies conducted in animal models and cellular tissue. Clinical research is still required, with controlled and well-designed studies, to confirm these findings on the effects of CBD on athletes. It is worth emphasizing that studies that have included CBD to determine its effect on athletes have not used objective measurement scales that show the real impact of this cannabinoid on the symptoms to which improvement is attributed after administration, such as improvement of insomnia, for example. In fact, some of these studies that “go viral” have been carried out mainly with food supplements with doses greater than 150 mg of hemp-derived CBD, which does not correspond to real medical treatments and therapies used in clinical practice with cannabinoid-based medicines.

“While many results are promising for the effect CBD can have on athletes, it is critical to conduct the best possible quality clinical research that gives us truthfully, scientifically based answers,” concludes Dr. Mafer Arboleda.

Are cannabis products used among athletes safe?

with results that also remain controversial and conclusions where poverty is spoken of in the quality of the evidence.

Athletes seek to be an example of health and wellbeing; This is a consequence of physical work, good nutrition, rest, and mental work. Unfortunately, trends and “fashions” marked by marketing have opened new paths to achieve social, psychological, physical, or belonging goals, through the consumption of unauthorized, unproven, and low-quality substances, putting their own health and, in some cases, their professional careers at risk.

LET’S TALK ABOUT CANNABIS

It is very important to take into account the quality of the cannabis-derived products that are consumed, since in some countries (e.g., the United States of America) they are considered food supplements without strict quality control that demonstrates origin, components, and contaminants or even if the amount of CBD they contain really corresponds to that marked on the bottle label. As demonstrated in a study conducted in 20175, where 84 products were purchased online from 31 companies and the concentration of cannabinoids and contaminants was analyzed:

• 69% of the products had different levels of CBD than what was promoted on the label;

Sources:

1. 2. 3. 4. 5.

• And 21% contained THC (despite promoting and selling it as a CBD-only product), with some levels of THC potentially producing intoxication or cognitive compromise and being detected in anti-doping processes.

For all the above, it is essential to take care of the health of athletes and ethical and regulatory issues must be considered before recommending the use of cannabinoids in sports medicine.

World Anti-Doping Agency. (2021, enero). WORLD ANTI-DOPING CODE INTERNATIONAL STANDARD PROHIBITED LIST.

Docter S, Khan M, Gohal C, Ravi B, Bhandari M, Gandhi R, et al. Cannabis use and sport: a systematic review. SportsHealth . 2020;12:189–99.

Zeiger JS, Silvers WS, Fleegler EM, Zeiger RS. Cannabis use in active athletes: behaviors related to subjective effects. PLoS One. 2019;14:e0218998

Burr, Jamie & Cheung, Christian & Kasper, Andreas & Gillham, Scott & Close, Graeme. Cannabis And Athletic Performance. Sports Medicine. 2021; 51(Suppl 1):75-87. doi: 10.1007/s40279-021-01505-x

Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling accuracy of cannabidiol extracts sold online. JAMA. 2017;318:1708-1709.

Elizabeth Weeks-Rowe

Clinical research studies are regulated by governmental bodies, at the country level, to ensure patient safety, credible data, and Good Clinical Practice (GCP) standards are maintained. The investigational staff at institutions who execute each protocol are governed by institutional policy/training practices to likewise preserve trial integrity/patient safety. The Clinical Research Associates (CRA)s reviewing trial data at medical institutions must also have proficiency assessed to ensure quality monitoring standards that align with the rule of the respective organization and industry best practices. This is accomplished via the monitoring evaluation visit.

Monitoring evaluation visits are completed at predefined intervals specific to CRA experience, company standards and study needs. The monitoring evaluation

visit is the principal measure of CRA performance due to the autonomy of monitoring activity on site. The majority of CRAs assigned to investigational sites in a region work independently at said site, in conjunction with their “in house” colleagues, in performance of site management activities such as data analysis, regulatory review and investigational product (IP) accountability. Due to the independent practice (of the CRA profession), a trained assessor observing their monitoring conduct alongside them in “real time” is the most authentic measure of performance.

The process of monitoring evaluation is broken down into two primary components; the CRA sign off visit and the periodic evaluation visit of more experienced monitors. The sign off visit is completed on CRAs either new to the role or new to an organization, as the initial

Distinguished speaker and researcher with 22 years of clinical research experience, Elizabeth WeeksRowe has been a Certified Clinical Research Associate (CCRA) with the Association of Clinical Research Professionals (ACRP) since 2004. She is also a Clinical Research Fastrack staff trainer and works as a clinical operations manager for a large life sciences company. Passionate about training through creative and engaging communications, she has multiple Clinical Research Articles and Book updates.

confirmation of monitoring proficiency. The periodic evaluation satisfies institutional requirements for verification of continued proficiency.

The individuals conducting CRA evaluation visits (assessors) are either CRA managers, project managers or extremely experienced CRAs at the highest tier of employment within their organization. The CRA evaluation process is daunting for even the most seasoned clinical researcher, and fraught with stress (for the CRA) if the individual conducting the evaluation displays a detach-ed, inscrutable demeanor. Unfortunately, the process sometimes elicits critical review as opposed to constructive feedback. Some assessors feel the evaluation must result with some type of “finding” or else their scrutiny is in complete as opposed to the important realization that an evaluation that results in zero findings/proficiency confirmed is to be lauded and the CRA praised for their efforts. An error driven mindset displayed by an assessor undermines what should be a positive collaboration, where identified learning deficits are corrected, retraining includes supportive measures to address specific areas of improvement as well as re-evaluation of training materials/deployment to ensure optimal understanding, and an outcome that proves to the CRA that their success and comfort is the primary driver. When this is followed the CRA leaves the experience feeling supported, not dejected. Even if the CRA is not successfully signed off or proficiency reconfirmed, this will happen at another visit, with the above noted measures implemented for a successful outcome.

Transparency

The assessor must prepare appropriately for the evaluation visit with review of the protocol and study documents, that they understand study elements required for measure of CRA performance. CRA activity is unique, is influenced by study design, and investigational site model. Applying a blanket evaluation approach does a disservice to all participants and does not lend the perspective required for holistic analysis.

The assessor must communicate the parameters of the evaluation visit to include time, elements of review and overall visit expectations. The assessor should meet with the CRA ahead of the visit to discuss visit plan and preparation. This ensures unified understanding of participants.

Positivity

The assessor should open the dialogue of the evaluation process with positive demeanor, communication, and intent. The CRA evaluation process is multidimensional and encompasses all aspects of site management: communication, collaboration, protocol knowledge and monitoring principles (regulatory, data review and drug accountability) computers and technology application, and soft skills of empathy, responsiveness, engagement, and professionalism. It is not a black and white, “yes or no” verification process to a rote checklist that a robot could satisfy. A minimum requirement may be met in one category (computers/technology) while proficiency surpasses minimum expectation in another category (monitoring principles). A CRA not meeting full expectation in one category does not automatically fail the evaluation visit.

This initial deficiency may require further investigation with resolution as simple as spot correction (understand the deficit, provide further guidance, look for corrective action and continue). If the deficiency, however, demonstrates failure to understand/apply

A three-tiered approach to CRA assessment provides solid framework for a positive evaluation process: transparency, professionalism, and positivity.

research principles integral to patient safety/credible data, then the evaluation visit cannot be completed. This does not conclude the evaluation process nor terminate the training element. The assessor should set up a continuing education plan with the CRAs supervisor (if they are not the CRAs supervisor) to address learning needs and establish a secondary monitoring visit where the corrective action is evaluated to determine the CRAs ultimate proficiency. Even if the CRA does not successfully complete the evaluation visit, they should never depart the process feeling they have failed, and this hinges on the assessor’s narrative. Positive communication and affirmation will build an equitable perspective (understanding what was correct, and what can be corrected) as opposed to the CRA feeling like they failed. It is much easier to solidify a structure that is weakened as opposed to trying to rebuild a structure demolished by ignorance.

Professionalism

This is obvious and should be implemented from the beginning. At the site level, the assessor and CRA should make a point of thanking the investigational site for allowing the additional visit during the monitoring visit. This should especially include the study coordinator/data manager/support staff that are key to monitoring visit conduct. The assessor should extend appreciation to the CRA being evaluated for their participation in the process, for though the evaluation is required, it still adds an additional responsibility to the CRAs already busy monitoring visit. The assessor should ensure to complete their evaluation tasks without interrupting the flow of monitoring visit activities to the point the CRA is unable to focus or complete their required tasks. “Please” and “thank you,” and such courtesies should be extended to all individuals who impact

the process. The assessor should fit into the visit dynamic as opposed to creating an additional intimidating barrier.

The assessor should provide positive reinforcement/ guidance throughout the assessment process and should never leave the CRA hanging/wondering about the outcome. The assessor should strive to have a professional, candid discussion with the CRA about performance at the end of the visit or soon thereafter. It is decidedly unfair for the CRA to learn about retraining or performance reassessment needs from their line manager or supervisor; this should be initially communicated by the assessor whenever possible unless extreme circumstance or duress prohibit this.

Case study

A while I ago I was tasked to sign off an experienced CRA on site evaluation visits. She was newly assigned to a psychiatry study, and though extensively experienced with every monitoring visit type, she had never been assigned to a study during feasibility/start up phase and thus had no experience with direct conduct of site evaluation/ selection visits. We had a preliminary meeting where she demonstrated sufficient preparation for the visit, having gathered requisite information on site model and investigator background. She had reviewed the protocol, study design, informational slide deck and all questions required to solicit appropriate information from the site to confirm capabilities for study conduct. Though her preparation was extensive, she confessed nervousness over presenting to the investigational site as public speaking was not her forte. I advised her to practice the study presentation in front of a mirror, working on word pronunciations, timing, and presentational flow. I gave her small tips to ease nervousness; pause, breathing and maintaining eye contact. The day of the evaluation visit dawned, and as she was setting up the slide

presentation, I could see sweat beading on her brow and worry growing in her eyes. A couple of minutes before the investigational staff were due to arrive for the presentation, she informed me that she felt incredibly nervous and worried over the visit conduct and outcome.

I let her know that simply being nervous about the presentation and execution would not be a prohibitive reason for not being signed off, and that multiple elements influenced the dynamic and decision. This seemed to assuage her fears a bit. The presentation began, and though at times her anxiety caused her to speak rapidly, and look down, her knowledge of the protocol and her visit preparation carried her through to success. During the site question discussion, she started off a bit automatic and formal, but soon relaxed enough to engage in friendly banter that was critical to provision of information. Throughout the visit

I purposefully made eye contact and smiled in reassurance. At one point I gave her the “thumbs up” sign which made her smile and soften her style. The visit concluded successfully, and I let her know she was officially signed off for independent evaluation visit conduct. She thanked me for my support and for conducting a fully dimensional evaluation as opposed to a rigid assessment that would not serve the purpose of her success.

The process of monitoring evaluation is not to fulfil a rote checklist assessment of a CRA filling in every box of an automatic template. The purpose of monitoring assessment is a holistic evaluation of CRA strength and areas for improvement, that they fulfill the objectives of overall visit conduct while feeling supported, trained and part of a critical and successful collaboration.

Rapid quantification and identification of product impurities (nitrosamines)

The recent product impurity crisis has firmly put the spotlight on genotoxic impurities (GTI’s). Nitrosamines, or more correctly N-nitrosamines, refer to any molecule containing the nitroso functional group. These molecules are of concern because nitrosamine impurities are probable human carcinogens, signifying that long-term exposure above certain levels may increase the risk of cancer development. Although they are also present in some foods and drinking water supplies, their presence in medicines is nonetheless considered unacceptable.

The regulatory agencies, including the US FDA and the European Medicines Agency (EMA), have issued guidelines on the allowable limits of genotoxic impurities in pharmaceutical products. These limits are to ensure product safety, not just for the ones

frequently highlighted because of nitrosamines, but for all potentially contaminated drugs and processes in a company’s portfolio of active pharmaceutical ingredients (APIs).

The CHMP and CMDh extended the deadline for submitting variation applications for chemical medicines from 26 September 2022 to 1 October 2023 in July 2022.

Hardly a day goes by without mention of a newly emerging active pharmaceutical ingredient (API) nitrosamine, eg, nitrosamine propranolol. This has led to a great deal of pre-competitive data sharing. Many companies have initiated a Nitrites in Excipients database to facilitate risk assessment of drug products. The database categorises excipients thus: 1) excipients

show varying nitrite contents with pronounced batch-to-batch variance, 2) the nitrite impact is dependent on the amount of excipient in a product, 3) these excipients show low nitrite levels and low variability, resulting in an average value of 1 μg/g nitrite, and 4) different excipient vendors show pronounced differences in nitrite levels. A recent open-access publication discusses the generation of acceptable intakes for unknown API nitrosamines. The authors catalogued these complex nitrosamines based on common structural features, identifying 13

groups in total. Carcinogenicity data was then reviewed for structurally relevant nitrosamines and group-acceptable intakes were derived based on the most potent compound within each group. The authors indicated that the acceptable intakes of several of these API nitrosamine groups were found to be much higher than the corresponding simple nitrosamines, which results in a commensurately higher analytical LoQ.

In CENEBA BIOPROCESS a mexican analytical lab located in Jalisco, we have a validated method to Highly selective and sensitive method for quantitation of nitrosamines in pharmaceutical products, in compliant with FDA regulation limits and EMA, and recently stablish by FEUM 13va Ed. also in Mexico.

A rapid method for quantifying nitrosamine compounds with confirmation to the Analysis of genotoxic nitrosamines in active pharmaceutical ingredients, by HPLC-MS/MS.

Mauro Orozco Moreno

Communicologist and Historian from the University of Guadalajara. Since 2019 he is dedicated to journalism and content creation about video games, technology and geek culture on the internet. Co-founder of the page Operación Gamer; currently his content appears on his page Totherland on Facebook Gaming.

Technology that makes us stronger

There are characters in fiction that for decades made us think that the idea of a “superhuman” was the stuff of comics or some movie. Today many things that perhaps in the 60s, when Wilt Chamberlain broke all those records in the NBA, including the 100 points in a game or the record for most broken records (as redundant as it sounds, but broke 72 records), never imagined that 5 decades later someone with 1.75 meters tall was going to win three times the contest of nails on a board at 3.05 meters from the soil, as is the case with Nate Robinson.

Feats of this kind demonstrate how far sports have advanced, thanks to how much science, medicine, and technology are advancing. Facts such as Nate Robinson or the 36.9 km/h reached by Héctor Bellerín playing as a side of Arsenal in the Premier League, speak of how technology and science applied to sports have created authentic superhumans with physical capabilities that go beyond any talent. Many of us may not be high-performance athletes like those mentioned above, but there are many lovers of sports or exercise. It is possible that our ambition is not to reach the maximum speed of the Spanish full-back but to improve our performance to the maximum. Below I will present three examples of smart gadgets that can be useful to us. I’ll start with something basic like a dumbbell kit. The KSIX Smart your tech brand launched this smart weight equipment that can be synchronized to the

cell phone. Something that helps us improve our performance is being able to monitor our physical activity. These dumbbells, along with the app, not only help us keep track of our routines, but the application can make recommendations of when it is necessary to change the intensity or even helps us customize the routines, in addition to that we can find online some other routines designed by experts to perform with them. If what interests us is something more specific for football lovers, the following gadget will be interesting.

EM49 is an ideal electro-stimulator for when physical activity generates some muscle discomfort. With it, we can relieve pain, strengthen some areas or receive massages to relax, through very slight electrical stimuli that do not cause any discomfort and that barely manage to feel a slight tingling.

The Footbar Meteor is a band that fits the calf and will help us give us data statistics such as the force of hitting the ball, sprint speed, distance traveled, heart rate, jump capacity, and the number of passes, among many more. This article also has permission from FIFA to be used in competitions, not only for training.

Finally, I would like to present an article designed more for care than for performance. The Beurer

Sources: https://www.decathlon.co.uk/p/connector-sensor-footbar-meteor/_/R-p-X8662714

This is how technology helps us get the most out of sports. Without forgetting better-known items such as smartwatches, these are just some of the many recommendations on the market, because although we cannot become (yet) superhuman, some of this makes us better athletes who do not have the discipline of high-performance athletes; Fiction will have become reality.

Sources: https://beurer.com.mx/products/aparato-digital-tens-ems-de-beurer-em-49

Courtesy: https://thegadgetflow.com/blog/cool-ar-vr-gadgets-that-will-make-you-feel-like-youre-living-2050/

Source: https://luminopia.com/

Therapeutic digital viewer; watch TV to correct amblyopia

Recently the U.S. Food and Drug Administration (FDA) approved the market launch of Luminopia One This digital therapeutic device is transforming clinical practice because, through Artificial Intelligence (AI) algorithms, it can improve the eyesight of children between 4 and 7 years old who suffer from amblyopia, a condition listed as the leading cause of childhood vision loss, which occurs in approximately 3% of children and teenagers worldwide.

The success of the company Luminopia, which specializes in the development of digital therapies, focuses on the combination of medical treatment and fun, as children can choose from a collection of more than 700 hours of popular, attractive, and educational content while stimulating the teamwork of their eyes and their connection with the brain, all within a virtual reality (VR) headset. This audiovisual

material is modified in real-time through a patented and clinically proven algorithm. It is worth mentioning that this is the first FDA-approved digital therapy for children with amblyopia and, more broadly, the first for a neuro visual disorder. The official launch of Luminopia One is planned for the end of 2022.

Artistic holograms with unique value; device for projecting NFTs

The economy and the future are concepts widely linked by the uncertainty that both generate; however, a device was recently launched that links them again, this time under the premise of modernity and technology. The so-called Holocube, designed by the StarsLab team, is an electronic device that connects the economic metaverse with miniature works of art capitalized as unique assets, better known as NTFs (non-fungible tokens). The company has developed a collection called Planet NFT that combines spectacular visualizations inspired by planet designs using augmented reality (AR) and holographic visualization technology for the first time. So, what seems to be a small black box, is a device that projects intangible elements wonderfully through a glass cube with a futuristic design, adding eight corners with LED light applications to make it even more attractive.

The Planets is an artistic and educational collection of 9,999 planets; the dynamic is that anyone who buys and has a Planet NFT can redeem the physical device to store and display their digital assets. According to the developers, the idea of the Holocube is to allow owners to charge their NFTs from their phones and be able to display them in any place they want.

Although, in essence, NFTs are unique assets that cannot be modified or exchanged for another that has the same value, since no two NFTs are equivalent, users can transfer the right of exchange to the next holder if they decide to sell their NFT, which will be authenticated by blockchain technology.

Courtesy: https://www.behance.net/gallery/133898443/The-Holocube-NFT-display-device Source: https://thestarslab.com/

Editorial Clinical Research Insider

Recovering childhood through football

Orígenes

Romero Porras

Bachelor’s degree in History from the University of Guadalajara. Former Paralympic athlete (2006-2017). Interested in the relationship between art and history. Literary analyst.

Javier Marías, a writer whose recent death – at seventy years of age – has shocked thousands of readers, defined football as “the weekly recovery of childhood”. Many of us dream as children of sharing a goal with our heroes. We have witnessed great plays on the court, moments that we treasure all our lives. Then, growing up, it seems to us that the ball rolled better before our eyes when we were eleven than today at thirty. Capturing those moments is a virtue of literature.

In Al estilo Jalisco, Juan Pablo Villalobos explores the obsession with recovering that past that, being ungraspable, can only be achieved from daydreaming or madness. In a humorous key, the Jalisco author presents a story whose protagonist is, like Villalobos, a self-exile who landed in Brazil fishing for the memories of that selection led by Pelé that he fell in love with in the 1970 World Cup.

Villalobos, born in 1973, imagines himself in that Jalisco Stadium where he received the Brazilian stars and is dedicated to recreating the sparks of the genius of the verdeamarelha in the first part of the story; with so many elements belonging to reality, the reader seems to find himself in front of a wonderful chronicle, something not alien to the author’s bibliography. However, in the second

part, the comic protagonist blurs by his own hand attending to the economic needs of adulthood, thus demonstrating the theory of Javier Marías: the happiness that produces the memory of childhood lasts ninety minutes.

Going down to reality means, both for us and for the protagonist, facing what makes you uncomfortable. We are not who we wanted as children. To change our adult world, we are forced into a parody of children’s play. “There is nothing more serious than a child playing,” says soccer writer Juan Villoro. Jalisco style is the strange and unserious game of the adult who longs for his best years. There is, implicitly, a very fair celebration of what we call in Mexico “echar la cascarita” (to play a street soccer game) with friends, which only requires a spherical object.

The work has fun with memory. It is recognized, through the criminal turn of the protagonist, the impossibility of the exercise: we will not return to the past, but we can spend a nice moment remembering the days when we thought less and acted more.

Juan Pablo Villalobos, as a football lover, wonders what he would have done if he had been present in 1970 and we, readers, enjoy in the second part of the story that conjunction of the town of Lagos de

Moreno, childhood site for Villalobos himself, with the mischievous essence of the Mexican.

We are then, facing a short novel, which amuses the same that reflects on the antics of childhood or informs in great detail, to bring the youngest footballers closer to that consecrating World Cup for Pelé as a player and for Mexico as a sanctuary of the ball, because in this same territory, sixteen years later, Maradona would score the two most famous goals in history.

Published in Portuguese in 2014, when Brazil hosted the World Cup and Villalobos lived in Rio, Al estilo Jalisco can regain importance in four-year cycles for those who like to say “the football I watched is better than today’s.” To test the hypothesis, we must consider the Spanish translation in 2018, the year in which, according to Pollo Blanco, the publisher in charge of the Mexican publication, “Miguel Layún stepped on Neymar’s ankle in the knockout stages of the FIFA World Cup in Russia”.

Pollo Blanco and Villalobos celebrate the Mexican defeat, they are glad that at least the opponents did not leave immaculate. Contrary to the famous song, Al estilo Jalisco does not want to find oblivion but a memory.

George Wesley Bellows,

In 1900, the Lewis Law was implemented in New York, which prohibited boxing matches with prizes in the entire state; currently, boxing is one of the most profitable sports in the world, considered to be of a high level of complexity due to the convergence of scientific disciplines such as physics, chemistry and biomechanics, as well as psychology and the development of strategic thinking.

Editorial Clinical Research Insider

Henri Julien-Félix Rousseau, Lesjoueursdefootball

(The Football Players) (1908)

Oil on canvas. At the Solomon R. Guggenheim Museum, New York. Public domain.

In 1908, one of the most unusual and original painters of Paris at the end of the 18th century, Henri Rousseau, exhibited the painting The Football Players, motivated by one of the most innovative and modern sports in France in those years, rugby. That same year, the White City stadium was inaugurated for the London Olympic Games, where the first Olympic marathon in history was held.

The sports world never ceases to provide surprises, since for the Qatar 2022 World Cup, a city-island called Lusail was built from scratch, which will contain the stadium where the final of the tournament will be played, turning what was once a desert into one of the most modern cities in the country.

Editorial Clinical Research Insider

Hi guys, management has asked us to put together a physical exercise plan in the laboratory.

Exercise? What abummer

I like being fluffy.

It is for our own good, we spend so many hours sitting. Hmm… What if we take advantage of the fact that the football world cup has already started to motivate ourselves?

Great idea, Bobert!

Great, today we have our first session. Let's go to the company field

Okay, Dr. Marie, see you there.

Yes! Let's get ready.

Ugh, we stood up Dr. Marie.

Ok.

Historia y dibujo: Rick Ruiz-Dana

Bobert, research is the most important for any plan to succeed.