Care Pathway at a Cancer Center for the Administration of Radiometabolic Therapy with 177Lu-PSMA in Patients with Metastatic Castration-resistant Prostate Cancer.

Objectives: To present a clinical care model for the administration of 177Lu-labeled prostate-specific membrane antigen (PSMA) in radiometabolic therapy for metastatic castration-resistant prostate cancer (mCRPC) at the National Cancer Institute (NCI) of Bogotá, Colombia. Methods: A care model was designed for patients with mCRPC based on the VISION study, a prospective, phase III, multicenter, open-label, randomized study in patients with positive 68Ga-PSMA positron emission tomography/computed tomography who had progressed to taxane and androgen therapy, to receive 177Lu-PSMA-617 combined with the best standard of care vs. the best standard of care alone. The care pathway provided to patients was developed by the Nuclear Medicine Group of the NCI and is the result of adjustments and improvements in the care process and the updating of the literature. Results: A systematic and efficient care model was formalized and implemented for the administration of 177Lu-PSMA therapy in patients with mCRPC who had previously been treated with at least one androgen receptor pathway inhibitor and one or two taxane regimens, with evidence of disease progression. Conclusion: An optimized process of care based on the determinants of clinical outcomes was developed for patients who received this type of radiometabolic therapy.

Prevalencia y determinantes de la infección por virus de papiloma humano en mujeres jóvenes de Guanacaste y Puntarenas, Costa Rica, 2004-2005.

OBJETIVO: Estimar la prevalencia e identificar determinantes de la infección por el virus del papiloma humano (VPH) en mujeres jóvenes (18-25 años). Material y métodos. Se analizaron datos de 5 871 mujeres sexualmente activas a quienes se les realizó una entrevista y toma de muestras cervicouterinas para detección de VPH y citología durante la visita de reclutamiento del Ensayo de Vacunación contra VPH16/18 en Costa Rica. Se calculó la prevalencia total para cualquier tipo de VPH y tipos oncogénicos, no oncogénicos y específicos, con intervalos de confianza al 95% (IC95%). Se utilizó regresión logística múltiple paso-a-paso para identificar determinantes asociados con la infección. RESULTADOS: La prevalencia total de VPH fue 50.0% (IC95% 48.8,51.3) y por tipos oncogénicos fue 33.8% (IC95% 32.6,35.0). El VPH-16 fue el tipo más prevalente (8.3%, IC95% 7.6,9.0). Los determinantes asociados con un alto riesgo de infección prevalente por VPH oncogénicos fueron no estar casada/unión libre, >1 compañero sexual, infección concomitante por Chlamydia trachomatis, y entre aquéllas con un único compañero sexual en su vida, un compañero con antecedente de múltiples compañeras sexuales. Conclusión. Se confirma la asociación de las infecciones por VPH oncogénicos con el comportamiento sexual de la mujer y se destacan los comportamientos del compañero sexual.

Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study.

PURPOSE: The RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19. PARTICIPANTS: From November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts. Participants were interviewed and blood and saliva collected for antibodies and PCR tests. Participants will be followed for 2 years to assess antibody response and infection incidence. FINDINGS TO DATE: Recruitment included 3860 individuals: 1150 COVID-19 cases, 1999 population controls and 719 household contacts from 304 index cases. The age and regional distribution of cases was as planned, including four age strata, 30% rural and 70% urban. The control cohort had similar sex, age and regional distribution as the cases according to the study design. Among the 1999 controls recruited, 6.8% reported at enrolment having had COVID-19 and an additional 12.5% had antibodies against SARS-CoV-2. Compliance with visits and specimens has been close to 70% during the first 18 months of follow-up. During the study, national vaccination was implemented and nearly 90% of our cohort participants were vaccinated during follow-up. FUTURE PLANS: RESPIRA will enable multiple analyses, including population prevalence of infection, clinical, behavioural, immunological and genetic risk factors for SARS-CoV-2 acquisition and severity, and determinants of household transmission. We are conducting retrospective and prospective assessment of antibody levels, their determinants and their protective efficacy after infection and vaccination, the impact of long-COVID and a series of ancillary studies. Follow-up continues with bimonthly saliva collection for PCR testing and biannual blood collection for immune response analyses. Follow-up will be completed in early 2024. TRIAL REGISTRATION NUMBER: NCT04537338.

Six-probe scintillator dosimeter for treatment verification in HDR-brachytherapy.

BACKGROUND: In vivo dosimetry (IVD) is gaining interest for treatment delivery verification in HDR-brachytherapy. Time resolved methods, including source tracking, have the ability both to detect treatment errors in real time and to minimize experimental uncertainties. Multiprobe IVD architectures holds promise for simultaneous dose determinations at the targeted tumor and surrounding healthy tissues while enhancing measurement accuracy. However, most of the multiprobe dosimeters developed so far either suffer from compactness issues or rely on complex data post-treatment. PURPOSE: We introduce a novel concept of a compact multiprobe scintillator detector and demonstrate its applicability in HDR-brachytherapy. Our fabricated seven-fiber probing system is sufficiently narrow to be inserted in a brachytherapy needle or in a catheter. METHODS: Our multiprobe detection system results from the parallel implementation of six miniaturized inorganic Gd2 O2 S:Tb scintillator detectors at the end of a bundle of seven fibers, one fiber is kept bare to assess the stem effect. The resulting system, which is narrower than 320 microns, is tested with a MicroSelectron 9.14 Ci Ir-192 HDR afterloader, in a water phantom. The detection signals from all six probes are simultaneously read with a sCMOS camera (at a rate of 0.06 s). The camera is coupled to a chromatic filter to cancel Cerenkov signal induced within the fibers upon exposure. By implementing an aperiodic array of six scintillating cells along the bundle axis, we first determine the range of inter-probe spacings leading to optimal source tracking accuracy (first tracking method). Then, three different source tracking algorithms involving all the scintillating probes are tested and compared. In each of these four methods, dwell positions are assessed from dose measurements and compared to the treatment plan. Dwell time is also determined and compared to the treatment plan. RESULTS: The optimum inter-probe spacing for an accurate source tracking ranges from 15 to 35 mm. The optimum detection algorithm consists of adding the readout signals from all detector probes. In that case, the error to the planned dwell positions is of 0.01 ± 0.14 mm and 0.02 ± 0.29 mm at spacings between the source and detector axes of 5.5 and 40 mm, respectively. Using this approach, the average deviations to the expected dwell time are of - 0.006 ± 0.009 $-0.006\,\pm \,0.009$ s and - 0.008 ± 0.058 $-0.008\, \pm 0.058$ s, at spacings between source and probe axes of 5.5 and 20 mm, respectively. CONCLUSIONS: Our six-probe Gd2 O2 S:Tb dosimeter coupled to a sCMOS camera can perform time-resolved treatment verification in HDR brachytherapy. This detection system of high spatial and temporal resolutions (0.25 mm and 0.06 s, respectively) provides a precise information on the treatment delivery via a dwell time and position verification of unmatched accuracy.

Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica.

INTRODUCTION: Variability in household secondary attack rates and transmission risks factors of SARS-CoV-2 remain poorly understood. METHODS: We conducted a household transmission study of SARS-CoV-2 in Costa Rica, with SARS-CoV-2 index cases selected from a larger prospective cohort study and their household contacts were enrolled. A total of 719 household contacts of 304 household index cases were enrolled from November 21, 2020, through July 31, 2021. Blood specimens were collected from contacts within 30-60 days of index case diagnosis; and serum was tested for presence of spike and nucleocapsid SARS-CoV-2 IgG antibodies. Evidence of SARS-CoV-2 prior infections among household contacts was defined based on the presence of both spike and nucleocapsid antibodies. We fitted a chain binomial model to the serologic data, to account for exogenous community infection risk and potential multi-generational transmissions within the household. RESULTS: Overall seroprevalence was 53% (95% confidence interval (CI) 48-58%) among household contacts. The estimated household secondary attack rate is 34% (95% CI 5-75%). Mask wearing by the index case is associated with the household transmission risk reduction by 67% (adjusted odds ratio = 0.33 with 95% CI: 0.09-0.75) and not sharing bedroom with the index case is associated with the risk reduction of household transmission by 78% (adjusted odds ratio = 0.22 with 95% CI 0.10-0.41). The estimated distribution of household secondary attack rates is highly heterogeneous across index cases, with 30% of index cases being the source for 80% of secondary cases. CONCLUSIONS: Modeling analysis suggests that behavioral factors are important drivers of the observed SARS-CoV-2 transmission heterogeneity within the household.

When living in the same house with known SARS-CoV-2 cases, household members may change their behavior and adopt preventive measures to reduce the spread of SARS-CoV-2. To understand how behavioral factors affect SARS-CoV-2 spreading in household settings, we focused on household members of individuals with laboratory-confirmed SARS-CoV-2 infections and followed the way SARS-CoV-2 spread within the household, by looking at who had antibodies against the virus, which means they were infected. We also asked participants detailed questions about their behavior and applied mathematical modeling to evaluate its impact on SARS-CoV-2 transmission. We found that mask-wearing by the SARS-CoV-2 cases, and avoiding sharing a bedroom with the infected individuals, reduces SARS-CoV-2 transmission. However, caring for SARS-CoV-2 cases, and prolonged interaction with infected individuals facilitate SARS-CoV-2 spreading. Our study helps inform what behaviors can help reduce SARS-CoV-2 transmission within a household.

Efficiency and Safety of CyberKnife Robotic Radiosurgery in the Multimodal Management of Patients with Acromegaly.

OBJECTIVE: To analyze, in a cohort of acromegalic patients, the results of the efficiency and safety of radiosurgery (CyberKnife), as well as the prognostic factors associated with disease remission. MATERIAL AND METHODS: Observational, retrospective, longitudinal, and analytical study that included acromegalic patients with persistent biochemical activity after initial medical-surgical treatment, who received treatment with CyberKnife radiosurgery. GH and IGF-1 levels at baseline after one year and at the end of follow-up were evaluated. RESULTS: 57 patients were included, with a median follow-up of four years (IQR, 2-7.2 years). The biochemical remission rate was 45.6%, 33.33% achieved biochemical control, and 12.28% attained biochemical cure at the end of follow-up. A progressive and statistically significant decrease was observed in the comparison of the concentrations of IGF-1, IFG-1 x ULN, and baseline GH at one year and at the end of follow-up. Both cavernous sinus invasion and elevated baseline IGF-1 x ULN concentrations were associated with an increased risk of biochemical non-remission. CONCLUSION: Radiosurgery (CyberKnife) is a safe and effective technique in the adjuvant treatment of GH-producing tumors. Elevated levels of IGF x ULN before radiosurgery and invasion of the cavernous sinus by the tumor could be predictors of biochemical non-remission of acromegaly.

Hydroxy proline and gamma-aminobutyric acid: markers of susceptibility to vine decline disease caused by the fungus Monosporascus cannonballus in melons (Cucumis melo L.).

Background: Vine decline disease caused by the fungus Monosporascus cannonballus, is a threat to melon production (Cucumis melo L.) worldwide. Nonetheless, little is known about the metabolites produced during the host pathogen interaction. Thus, the objective of this study was to measure quantities of amino acids produced over time during such an interaction. Methods: Two melon genotypes named TAM-Uvalde (susceptible) and USDA PI 124104 (resistant) were grown and inoculated with M. cannonballus. The metabolites previously stated were measured before inoculation (0 hours) and 24, 48 and 72 hours after inoculation, using high performance liquid chromatography analysis. Results: The production of some amino acids during the interaction of the resistant and susceptible melon genotypes with the fungus M. cannonballus was different regarding quantities over time. Interestingly, hydroxy proline was always up-regulated in higher quantities in response to pathogen infection in the genotype TAM-Uvalde. Also, the up-regulation in higher quantities of gamma-aminobutyric acid in the genotype TAM-Uvalde 48 and 72 hours after inoculation, suggests more penetration of the pathogen in its roots. Hence, taken together, hydroxy proline and gamma-aminobutyric acid levels could be used as markers of susceptibility to vine decline disease caused by M. cannonballus, which could be useful in developing resistant varieties.

Strengthening primary health care in low- and middle-income countries: furthering structural changes in the post-pandemic era.

Strengthening primary health care (PHC) is the most cost-effective approach in low- and middle-income countries (LMICs) to achieve sustainable universal health coverage (UHC), protect against health shocks, and promote health and wellbeing for all people. It has been 45 years since PHC was put on the global agenda followed by multiple efforts to advocate for more funding and improved performance of PHC. Yet, investment in PHC is still insufficient and overall performance of PHC systems is weak in LMICs, resulting in increased vulnerability and poor health outcomes especially among marginalized populations. As countries recover from the COVID-19 pandemic, which exposed the fragility of PHC platforms, it is imperative to go beyond advocacy for PHC investments and make systemic changes to strengthen PHC as the foundation of resilient and equitable health systems. We propose five gamechangers to facilitate structural changes for strengthening PHC through a focused health systems approach: (i) integration of client-centered health services at PHC level; (ii) digitization of PHC services; (iii) efficiency gains invested in essential health services; (iv) strengthening management practices for PHC at district and facility levels; and (v) advancing community engagement for PHC. To be successful, the implementation of the gamechangers must be contextualized and focus on achieving sustainable health outcomes, and therefore use implementation approaches that link essential health services to health outcomes. Through this way countries will maximize the possibility of achieving UHC and attaining the ambitious health targets of the Sustainable Development Goals (SDGs) by 2030.

Habitação, saúde e meio ambiente em conflito no Distrito Federal: a Vila Santa Luzia em perspectiva / Housing, health and environmental conflicts in Brazil: Vila Santa Luzia in perspective

Resumo Neste artigo discute-se as correlações entre habitação, meio ambiente e saúde na comunidade da Vila Santa Luzia, no Distrito Federal. O objetivo geral do trabalho é conhecer as percepções, interpretações e representações da amostra de um grupo de moradores e líderes comunitários acerca das referidas vinculações. Em termos teóricos, o projeto fundamentou-se no enfoque da promoção da saúde e habitação saudável. Metodologicamente, os dados foram coletados com a técnica da entrevista. O principal resultado alcançado sugere que existe disposição entre as partes para alcançar uma resolução satisfatória, razoável e republicana ao conflito em questão. A conclusão do texto assinala que a experiência socioambiental e sanitária da Vila Santa Luzia é relevante e significativa, quer em termos empíricos, quer em termos analíticos (políticas públicas).

Abstract The article discusses the correlations between housing, environment and health in the Vila Santa Luzia community, Federal District, Brazil. It purports to investigate the perceptions, interpretations and representations of residents and community leaders about such correlations based on health promotion and healthy housing theoretical framework. Data were collected by means of interviews. Results point to a willingness between the parties to reach a satisfactory, reasonable and republican resolution for the conflict in question. In conclusion, the socio-environmental and health experience of Vila Santa Luzia is relevant and significant, both in empirical and analytical (public policies) terms.

Limited Humoral and Specific T-Cell Responses After SARS-CoV-2 Vaccination in PWH With Poor Immune Reconstitution.

BACKGROUND: We analyzed humoral and cellular immune responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in people with human immunodeficiency virus (HIV; PWH) who had CD4+ T-cell counts <200/µL (HIV<200 group). METHODS: This prospective cohort study included 58 PWH in the HIV<200 group, 36 with CD4+ T-cell counts >500/µL (HIV>500 group), and 33 HIV-1-negative controls (control group). Antibodies against the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) and the receptor-binding domain (anti-RBD IgG) were quantified before and 4 weeks after the first and the second doses of BNT162b2 or mRNA-1273 (at week 8). Viral neutralization activity and T-cell responses were also determined. RESULTS: At week 8, anti-S/anti-RBD IgG responses increased in all groups (P < .001). Median (interquartile range) anti-S and anti-RBD IgG levels at week 8 were 153.6 (26.4-654.9) and 171.9 (61.8-425.8) binding antibody units (BAU)/mL, respectively, in the HIV<200 group, compared with 245.6 (145-824) and 555.8 (166.4-1751) BAU/mL in the HIV>500 group and 274.7 (193.7-680.4) and 281.6 (181-831.8) BAU/mL in controls (P < .05). Neutralizing capacity and specific T-cell immune responses were absent or reduced in 33% of those in the HIV<200 group, compared with 3.7% in the HIV>500 group (P < .01). CONCLUSIONS: One-third of PWH with CD4+ T-cell counts <200/µL show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2, and no vaccine-induced T cells after receiving coronavirus disease 2019 mRNA vaccines.

Characterization of a miniaturized scintillator detector for time-resolved treatment monitoring in HDR-brachytherapy.

Purpose.HDR brachytherapy combines steep dose gradients in space and time, thereby requiring detectors of high spatial and temporal resolution to perform accurate treatment monitoring. We demonstrate a miniaturized fiber-integrated scintillator detector (MSD) of unmatched compactness which fulfills these conditions.Methods.The MSD consists of a 0.28 mm large and 0.43 mm long detection cell (Gd2O2S:Tb) coupled to a 110 micron outer diameter silica optical fiber. The fiber probe is tested in a phantom using a MicroSelectron 9.1 Ci Ir-192 HDR afterloader. The detection signal is acquired at a rate of 0.08 s with a standard sCMOS camera coupled to a chromatic filter (to cancel spurious Cerenkov signal). The dwell position and time monitoring are analyzed over prostate treatment sequences with dwell times spanning from 0.1 to 11 s. The dose rate at the probe position is both evaluated from a direct measurement and by reconstruction from the measured dwell position using the AAPM TG-43 formalism.Results.A total number of 1384 dwell positions are analyzed. In average, the measured dwell positions differ by 0.023 ± 0.077 mm from planned values over a 6-54 mm source-probe distance range. The standard deviation of the measured dwell positions is below 0.8 mm. 94% of the 966 dwell positions occurring at a source-probe inter-catheter spacing below 20 mm are successfully identified, with a 100% detection rate for dwell times exceeding 0.5 s. The average deviation to the planned dwell times is of 0.005 ± 0.060 s. The instant dose retrieval from dwell position monitoring leads to a relative mismatch to planned values of 0.14% ± 0.7%.Conclusion.A miniaturized Gd2O2S:Tb detector coupled to a standard sCMOS camera can be used for time-resolved treatment monitoring in HDR Brachytherapy.

Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica.

Variability in household secondary attack rates (SAR) and transmission risks factors of SARS-CoV-2 remain poorly understood. To characterize SARS-CoV-2 transmission in a household setting, we conducted a household serologic study of SARS-CoV-2 in Costa Rica, with SARS-CoV-2 index cases selected from a larger prospective cohort study and their household contacts were enrolled. A total of 719 household contacts of 304 household index cases were enrolled from November 21, 2020, through July 31, 2021. Demographic, clinical, and behavioral information was collected from the index cases and their household contacts. Blood specimens were collected from contacts within 30-60 days of index case diagnosis; and serum was tested for presence of spike and nucleocapsid SARS-CoV-2 IgG antibodies. Evidence of SARS-CoV-2 prior infections among household contacts was defined based on the presence of both spike and nucleocapsid antibodies. To avoid making strong assumptions that the index case was the sole source of infections among household contacts, we fitted a chain binomial model to the serologic data, which allowed us to account for exogenous community infection risk as well as potential multi-generational transmissions within the household. Overall seroprevalence was 53% (95% confidence interval (CI) 48% - 58%) among household contacts The estimated household secondary attack rate (SAR) was 32% (95% CI 5% - 74%) and the average community infection risk was 19% (95% CI 14% - 26%). Mask wearing by the index case was associated with the household transmission risk reduction by 67% (adjusted odds ratio = 0.33 with 95% CI: 0.09-0.75) and sleeping in a separate bedroom from the index case reduced the risk of household transmission by 78% (adjusted odds ratio = 0.22 with 95% CI 0.10-0.41). The estimated distribution of household secondary attack rates was highly heterogeneous across index cases, with 30% of index cases being the source for 80% of secondary cases. Modeling analysis suggests behavioral factors were important drivers of the observed SARS-CoV-2 transmission heterogeneity within the household.

The prognostic importance of the angiotensin II/angiotensin-(1-7) ratio in patients with SARS-CoV-2 infection.

BACKGROUND: Information about angiotensin II (Ang II), angiotensin-converting enzyme 2 (ACE2), and Ang-(1-7) levels in patients with COVID-19 is scarce. OBJECTIVE: To characterize the Ang II-ACE2-Ang-(1-7) axis in patients with SARS-CoV-2 infection to understand its role in pathogenesis and prognosis. METHODS: Patients greater than 18 years diagnosed with COVID-19, based on clinical findings and positive RT-PCR test, who required hospitalization and treatment were included. We compared Ang II, aldosterone, Ang-(1-7), and Ang-(1-9) concentrations and ACE2 concentration and activity between COVID-19 patients and historic controls. We compared baseline demographics, laboratory results (enzyme, peptide, and inflammatory marker levels), and outcome (patients who survived versus those who died). RESULTS: Serum from 74 patients [age: 58 (48-67.2) years; 68% men] with moderate (20%) or severe (80%) COVID-19 were analyzed. During 13 (10-21) days of hospitalization, 25 patients died from COVID-19 and 49 patients survived. Compared with controls, Ang II concentration was higher and Ang-(1-7) concentration was lower, despite significantly higher ACE2 activity in patients. Ang II concentration was higher and Ang-(1-7) concentration was lower in patients who died. The Ang II/Ang-(1-7) ratio was significantly higher in patients who died. In multivariate analysis, Ang II/Ang-(1-7) ratio greater than 3.45 (OR = 5.87) and lymphocyte count ⩽0.65 × 103/µl (OR = 8.43) were independent predictors of mortality from COVID-19. CONCLUSION: In patients with severe SARS-CoV-2 infection, imbalance in the Ang II-ACE2-Ang-(1-7) axis may reflect deleterious effects of Ang II and may indicate a worse outcome.

Identification and Characterization of Potato Zebra Chip Resistance Among Wild Solanum Species.

Potato zebra chip (ZC) disease, associated with the uncultured phloem-limited bacterium, Candidatus Liberibacter solanacearum (CLso), is transmitted by the potato psyllid Bactericera cockerelli. Potato ZC disease poses a significant threat to potato production worldwide. Current management practices mainly rely on the control of the psyllid to limit the spread of CLso. The present study investigated new sources of ZC resistance among wild Solanum species. A taxonomically diverse collection of tuber-bearing Solanum species was screened; one ZC-resistant accession and three ZC-tolerant accessions were identified among the 52 screened accessions. Further characterization of the resistant accession showed that the resistance was primarily associated with antibiosis effects due to differences in leaf trichome density and morphology of the wild accession, which could limit the psyllid feeding and oviposition. This germplasm offers a good resource for further understanding ZC and psyllid resistance mechanisms, contributing to potato breeding efforts to develop ZC resistance cultivars. Alternatively, it could be used as a potential trap crop to manage psyllid and control ZC disease.

Elevated Levels of Soluble CD147 are Associated with Hyperinflammation and Disease Severity in COVID-19: A Proof-of-Concept Clinical Study.

To evaluate soluble CD147 levels in COVID-19 and identify whether these are associated with hyperinflammation and disease severity. One-hundred and nine COVID-19 patients and 72 healthy blood donors were studied. Levels of CD147, matrix metalloproteases (MMP) and inflammatory markers were measured on hospital arrival, while the need for mechanical ventilation and the occurrence of death during hospitalization were recorded. CD147 levels were higher in COVID-19 (1.6, 1.0-2.3 vs 1.3, 1.0-1.6 ng/ml; P = 0.003) than controls. MMP-2 (9.2, 4.5-12.9 vs 4.2, 3.7-4.6 ng/ml; P < 0.001), MMP-3 (1.1, 0.9-1.3 vs 0.9, 0.7-1.0 ng/ml; P < 0.001) and MMP-9 (0.9, 0.5-1.2 vs 0.4, 0.2-0.6 ng/ml; P < 0.001) were also higher in COVID-19, while MMP-1 (0.6, 0-1.4 vs 0.6, 0.3-0.7 ng/ml; P = 0.711) was not different. Significant correlations were found between CD147 and MMP-2 (ρ = 0.34), MMP-3 (ρ = 0.21), interleukin 6 (ρ = 0.21), and the neutrophil/lymphocyte ratio (ρ = 0.26). Furthermore, CD147 levels were higher in patients who required mechanical ventilation (1.8, 1.4-2.4 vs 1.2, 0.8-1.9 ng/ml; P < 0.001) and in those who ultimately died (1.9, 1.4-2.7 vs 1.4, 0.9-1.9 ng/ml; P = 0.009). CD147 is elevated in COVID-19 and appears to contribute to hyperinflammation and disease severity.

Genome-wide association study and genomic prediction of white rust resistance in USDA GRIN spinach germplasm.

White rust, caused by Albugo occidentalis, is one of the major yield-limiting diseases of spinach (Spinacia oleracea) in some major commercial production areas, particularly in southern Texas in the United States. The use of host resistance is the most economical and environment-friendly approach to managing white rust in spinach production. The objectives of this study were to conduct a genome-wide associating study (GWAS), to identify single nucleotide polymorphism (SNP) markers associated with white rust resistance in spinach, and to perform genomic prediction (GP) to estimate the prediction accuracy (PA). A GWAS panel of 346 USDA (US Dept. of Agriculture) germplasm accessions was phenotyped for white rust resistance under field conditions and GWAS was performed using 13 235 whole-genome resequencing (WGR) generated SNPs. Nine SNPs, chr2_53 049 132, chr3_58 479 501, chr3_95 114 909, chr4_9 176 069, chr4_17 807 168, chr4_83 938 338, chr4_87 601 768, chr6_1 877 096, and chr6_31 287 118, located on chromosomes 2, 3, 4, and 6 were associated with white rust resistance in this GWAS panel. Four scenarios were tested for PA using Pearson's correlation coefficient (r) between the genomic estimation breeding value (GEBV) and the observed values: (1) different ratios between the training set and testing set (fold), (2) different GP models, (3) different SNP numbers in three different SNP sets, and (4) the use of GWAS-derived significant SNP markers. The results indicated that a 2- to 10-fold difference in the various GP models had similar, although not identical, averaged r values in each SNP set; using GWAS-derived significant SNP markers would increase PA with a high r-value up to 0.84. The SNP markers and the high PA can provide valuable information for breeders to improve spinach by marker-assisted selection (MAS) and genomic selection (GS).

Efecto del ejercicio en la memoria de adultos mayores con sobrepeso u obesidad: Revisión sistemática / Effect of exercise on the memory of overweight or obese older adults: Systematic review

RESUMEN La obesidad y el sobrepeso en adultos mayores se asocia con un mayor riesgo de enfermedades cognitivas, lo que contribuye a la disminución del rendimiento funcional. El objetivo de esta revisión es analizar el efecto del ejercicio en la memoria de adultos mayores con obesidad o sobrepeso. La metodología utiliza las palabras MESH: Población = envejecido, sobrepeso, obesidad; Intervención = ejercicio; Comparación = grupo control; Resultado = memoria; Diseño: ensayo clínico aleatorio. Buscando hasta diciembre de 2021 en: PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE Y MEDLINE. Se identifican 6.832 artículos. Se analizan cinco estudios, con 214 participantes. El índice de masa corporal medio es 28,6 ± 1,1 kg/m2 y el Mini mental medio inicial es 23,6 ± 2,1 puntos. La intervención con ejercicio es de doce a veintiséis semanas. En el modelo de efectos aleatorios el ejercicio mejora el Mini mental medio en MD = 2,6 puntos (1,7 a 3,4) p < 0,01. Heterogeneidad (87,7 %). El ejercicio mejora la función cognitiva (memoria) en adultos mayores con sobrepeso u obesidad.

ABSTRACT Obesity and overweight in older adults are associated with an increased risk of cognitive diseases, contributing to decreased functional performance. The objective of this review is to analyze the effect of exercise on memory in older adults with obesity or overweight. The methodology uses the words MESH: Population = aged, overweight, obesity; Intervention = exercise; Comparison = control groups; Result = Memory; Design: randomized controlled trial. Searching until December 2021 in PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE, and MEDLINE. Six thousand eight hundred thirty-two items are identified. We analyzed five studies with 214 participants. The mean body mass index is 28.6 ± 1.1 kg/m2, and the initial average Mini mental is 23.6 ± 2.1 points. The intervention with exercise is from twelve to twenty-six weeks. In the random-effects model, exercise improves the mean Mini Mental by MD = 2.6 points (1.7 to 3.4) p < 0.01. Heterogeneity (87.7 %). Exercise improves cognitive function (memory) in older adults who are overweight or obese.

Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile. / Seroprevalencia y estimación del impacto de la infección por SARS-CoV-2 en personas mayores residentes en centros de larga estadía en Chile.

Introduction: Older adults are at a higher risk of severe illness and death from COVID-19. This vulnerability increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pandemic on these establishments in lowand middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. Methods: A cross-sectional design with 2099 residents in three regions of Chile was carried out between September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correlation analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. Results: The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confidence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults residing in long-term care facilities and the cumulative incidence by municipalities. Conclusions: The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environment is directly related to COVID-19 infection. Morbidity and mortality monitoring systems should be implemented promptly to establish prevention and control measures.

Introducción: Las personas mayores tienen más riesgo de enfermar gravemente y fallecer por COVID-19. Esta vulnerabilidad aumenta en quienes viven en establecimientos de larga estadía, debido a hacinamiento, mayor dependencia física y contacto con los trabajadores. La evidencia sobre el impacto de la pandemia de estos establecimientos en países de medianos y bajos ingresos ha sido escasa. El objetivo es determinar la seroprevalencia de la infección por SARS-CoV-2 en personas mayores que residen en establecimientos de larga estadía. Así como estimar el impacto global de la infección después de la primera ola de la pandemia. Métodos: Diseño transversal con 2099 residentes en tres regiones de Chile, realizado entre septiembre y noviembre 2020. Anticuerpos fueron medidos con test rápido contra SARS-CoV-2. Se estimó el impacto de la infección con los residentes seropositivos, los residentes con antecedentes de reacción en cadena de la polimerasa de transcripción inversa positiva, y residentes que murieron por COVID-19. Análisis bivariado entre el resultado serológico y región, sexo, edad, antecedentes de COVID-19 y dependencia física fueron realizados. Además, realizamos un análisis de correlación entre la seroprevalencia de los centros por municipio y la tasa acumulada de casos confirmados. Resultados: La seroprevalencia de anticuerpos en las tres regiones fue 14,7% (intervalo de confianza del 95%: 13,2 a 16,3%). El impacto real de la infección se estimó en 46,4% y la tasa de letalidad en 19,6%. La seroprevalencia de los residentes de los centros por comuna se correlacionó positiva y significativamente con la frecuencia de la enfermedad a nivel comunal. Conclusiones: Seroprevalencia superior a la de la población general, observándose un alto impacto de la infección por COVID-19 al final de la primera ola de la pandemia. El lugar en el que se encuentran los establecimientos está directamente relacionado con la tasa de seroprevalencia en ellos. Sistemas de vigilancia epidemiológica deben aplicarse con prontitud para establecer medidas de prevención y control.

Seroprevalencia y estimación del impacto de la infección por SARS-CoV-2 en personas mayores residentes en centros de larga estadía en Chile / Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile

INTRODUCTION: Older adults are at a higher risk of severe illness and death from COVID-19. This vulnerability increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pandemic on these establishments in lowand middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. METHODS: A cross-sectional design with 2099 residents in three regions of Chile was carried out between September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correlation analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. RESULTS: The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confidence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults residing in long-term care facilities and the cumulative incidence by municipalities. CONCLUSIONS: The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environment is directly related to COVID-19 infection. Morbidity and mortality monitoring systems should be implemented promptly to establish prevention and control measures.

INTRODUCCIÓN: Las personas mayores tienen más riesgo de enfermar gravemente y fallecer por COVID-19. Esta vulnerabilidad aumenta en quienes viven en establecimientos de larga estadía, debido a hacinamiento, mayor dependencia física y contacto con los trabajadores. La evidencia sobre el impacto de la pandemia de estos establecimientos en países de medianos y bajos ingresos ha sido escasa. El objetivo es determinar la seroprevalencia de la infección por SARS-CoV-2 en personas mayores que residen en establecimientos de larga estadía. Así como estimar el impacto global de la infección después de la primera ola de la pandemia. MÉTODOS: Diseño transversal con 2099 residentes en tres regiones de Chile, realizado entre septiembre y noviembre 2020. Anticuerpos fueron medidos con test rápido contra SARS-CoV-2. Se estimó el impacto de la infección con los residentes seropositivos, los residentes con antecedentes de reacción en cadena de la polimerasa de transcripción inversa positiva, y residentes que murieron por COVID-19. Análisis bivariado entre el resultado serológico y región, sexo, edad, antecedentes de COVID-19 y dependencia física fueron realizados. Además, realizamos un análisis de correlación entre la seroprevalencia de los centros por municipio y la tasa acumulada de casos confirmados. RESULTADOS: La seroprevalencia de anticuerpos en las tres regiones fue 14,7% (intervalo de confianza del 95%: 13,2 a 16,3%). El impacto real de la infección se estimó en 46,4% y la tasa de letalidad en 19,6%. La seroprevalencia de los residentes de los centros por comuna se correlacionó positiva y significativamente con la frecuencia de la enfermedad a nivel comunal. CONCLUSIONES: Seroprevalencia superior a la de la población general, observándose un alto impacto de la infección por COVID-19 al final de la primera ola de la pandemia. El lugar en el que se encuentran los establecimientos está directamente relacionado con la tasa de seroprevalencia en ellos. Sistemas de vigilancia epidemiológica deben aplicarse con prontitud para establecer medidas de prevención y control.