Costa Rican consumer perceptions of gene-editing.

Costa Rica's rice production, a large determinant of the country's food security, is being negatively impacted by frequently increasing periods of intense drought. Costa Rican scientists have applied CRISPR/Cas9 to develop drought resistant rice varieties they believe the country's rice producers could benefit from. However, would Costa Ricans consume gene edited rice or products derived from this crop? A three-part, 26-question survey administered in-person to 1096 Costa Ricans uncovers their attitudes, knowledge, and perceptions of gene editing technology and crops. Multiple regressions were built where the independent variables were age, gender, education level, and subjective economic situation. No statistically significant relationships were found in the regression coefficients. Moreover, the k-means procedure (cluster analysis) was used to categorize respondents according to their attitudes on the consumption of gene-edited foods: negative, neutral, and positive. Results show that overall, Costa Rican consumers are open to the application of gene editing in agriculture and would consider consuming products derived from the application of the technology. They are also open to gene editing technology being used to address human and animal health issues. However, Costa Rican consumers are not open to gene editing being used to "design" human traits. This study adds evidence to the emerging literature on the acceptance of gene-edited food. It also highlights the importance of informing societies of just how vulnerable agriculture, and therefore food security, is to the increasingly adverse effects of climate change.

Concordancia entre cinco criterios de síndrome metabólico en adolescentes de una zona altoandina del Perú / Concordance between five criteria of metabolic syndrome in teenagers from a Peruvian high andes region

RESUMEN Objetivo. Determinar la concordancia entre cinco criterios diagnósticos de síndrome metabólico (SM) entre adolescentes residentes de una zona altoandina del Perú. Materiales y métodos. Se realizó un estudio transversal con datos secundarios de un estudio de intervención en dos escuelas públicas en el año 2019. Participaron 397 adolescentes que residen en la ciudad de Cajamarca ubicada en la región andina del Perú. Se aplicaron cinco criterios diagnósticos: Third Adult Treatment Panel (ATP-III) modificados por Cook, de la Federación Internacional de Diabetes (IDF), de la American Heart Association (AHA), de Ferranti, y de la Organización Mundial de Salud (OMS). Se estimaron las prevalencias puntuales y de intervalo con los cinco criterios. Se estimó el coeficiente de concordancia de Kappa con su respectivo intervalo de confianza al 95% (IC 95%). Resultados. El criterio de Ferranti identificó un 17,1% (IC 95%: 13,4 a 20,8) de adolescentes con SM, seguido del criterio de la ATP-III con 4,3% (IC 95%: 2,3 a 6,3); los demás criterios identificaron una menor frecuencia. La mejor concordancia fue encontrada entre los criterios de la AHA y la ATP-III (k = 0,905), los criterios de la OMS e IDF tuvieron un coeficiente de 0,628. Los cinco criterios coincidieron en clasificar como SM a seis adolescentes (1,5%). Conclusiones. Los criterios de la AHA y la ATP-III modificados por Cook tuvieron una concordancia casi perfecta, que se mantuvo en ambos sexos. Los criterios ATP-III, de Ferranti, IDF, AHA y OMS concuerdan en menos del 2% en identificar SM en el mismo grupo de adolescentes.

ABSTRACT Objective. To determine the concordance between five diagnostic criteria for metabolic syndrome (MS) among teenagers from a Peruvian high Andes region. Materials and methods. A cross-sectional study was carried out with secondary data from an intervention study in two public schools in 2019. We included 397 teenagers who lived in the city of Cajamarca, in the Andean region of Peru. We applied the criteria from the Adult Treatment Panel III (ATP-III) modified by Cook, the International Diabetes Federation (IDF), the American Heart Association (AHA), Ferranti, and the World Health Organization (WHO). The point prevalence and interval prevalence were estimated with the five criteria. The Kappa concordance coefficient with an 95% confidence interval (95%CI) was estimated. Results. The Ferranti criterion identified 17.1% (95%CI: 13.4 to 20.8) of teenagers with MS, followed by the ATP-III criterion with 4.3% (95%CI: 2.3 to 6.3); the other criteria identified a lower frequency. The best concordance was found between the AHA and ATP-III criteria (k = 0.905); the WHO and IDF criteria had a coefficient of 0.628. The five criteria coincided in classifying six adolescents (1.5%) as MS. Conclusions. The AHA and ATP-III criteria modified by Cook had almost perfect concordance, which was also found for both sexes. The ATP-III, Ferranti, IDF, AHA and WHO criteria agree in less than 2% when identifying MS in the same group of adolescents.

Concordance between five criteria of metabolic syndrome in teenagers from a Peruvian high andes region. / Concordancia entre cinco criterios de síndrome metabólico en adolescentes de una zona altoandina del Perú.

OBJECTIVE.: Motivation for the study. There are several criteria for metabolic syndrome in adolescents, each reporting different prevalence rates and not necessarily coinciding with each other. Main findings. We studied school children from the city of Cajamarca at 2750 meters above sea level. The five criteria for metabolic syndrome coincided in six of the 397 (1.5%) adolescents. The criteria generated prevalence rates ranging from 3.0% to 17.1%. The criteria with near perfect concordance were those from the American Heart Association criteria and those modified by Cook. Implications. The diagnosis of metabolic syndrome in adolescents is complex, even more so among those residing at high altitudes. . To determine the concordance between five diagnostic criteria for metabolic syndrome (MS) among teenagers from a Peruvian high Andes region. MATERIALS AND METHODS.: A cross-sectional study was carried out with secondary data from an intervention study in two public schools in 2019. We included 397 teenagers who lived in the city of Cajamarca, in the Andean region of Peru. We applied the criteria from the Adult Treatment Panel III (ATP-III) modified by Cook, the International Diabetes Federation (IDF), the American Heart Association (AHA), Ferranti, and the World Health Organization (WHO). The point prevalence and interval prevalence were estimated with the five criteria. The Kappa concordance coefficient with an 95% confidence interval (95%CI) was estimated. RESULTS.: The Ferranti criterion identified 17.1% (95%CI: 13.4 to 20.8) of teenagers with MS, followed by the ATP-III criterion with 4.3% (95%CI: 2.3 to 6.3); the other criteria identified a lower frequency. The best concordance was found between the AHA and ATP-III criteria (k = 0.905); the WHO and IDF criteria had a coefficient of 0.628. The five criteria coincided in classifying six adolescents (1.5%) as MS. CONCLUSIONS.: The AHA and ATP-III criteria modified by Cook had almost perfect concordance, which was also found for both sexes. The ATP-III, Ferranti, IDF, AHA and WHO criteria agree in less than 2% when identifying MS in the same group of adolescents.

OBJETIVO.: Determinar la concordancia entre cinco criterios diagnósticos de síndrome metabólico (SM) entre adolescentes residentes de una zona altoandina del Perú. MATERIALES Y MÉTODOS.: Se realizó un estudio transversal con datos secundarios de un estudio de intervención en dos escuelas públicas en el año 2019. Participaron 397 adolescentes que residen en la ciudad de Cajamarca ubicada en la región andina del Perú. Se aplicaron cinco criterios diagnósticos: Third Adult Treatment Panel (ATP-III) modificados por Cook, de la Federación Internacional de Diabetes (IDF), de la American Heart Association (AHA), de Ferranti, y de la Organización Mundial de Salud (OMS). Se estimaron las prevalencias puntuales y de intervalo con los cinco criterios. Se estimó el coeficiente de concordancia de Kappa con su respectivo intervalo de confianza al 95% (IC 95%). RESULTADOS.: El criterio de Ferranti identificó un 17,1% (IC 95%: 13,4 a 20,8) de adolescentes con SM, seguido del criterio de la ATP-III con 4,3% (IC 95%: 2,3 a 6,3); los demás criterios identificaron una menor frecuencia. La mejor concordancia fue encontrada entre los criterios de la AHA y la ATP-III (k = 0,905), los criterios de la OMS e IDF tuvieron un coeficiente de 0,628. Los cinco criterios coincidieron en clasificar como SM a seis adolescentes (1,5%). CONCLUSIONES.: Los criterios de la AHA y la ATP-III modificados por Cook tuvieron una concordancia casi perfecta, que se mantuvo en ambos sexos. Los criterios ATP-III, de Ferranti, IDF, AHA y OMS concuerdan en menos del 2% en identificar SM en el mismo grupo de adolescentes.

Economic surplus implications of Mexico's decision to phaseout genetically modified maize imports.

The Mexican government has decided to ban imports of genetically modified (GM) maize, to rely on agroecology for maize production to satisfy domestic yellow maize requirements. No economic impact assessment of this policy decision was made public, and the implications of this decision for users of yellow maize and consumers are significant. This article measures the economic surplus generated from Mexican GM yellow maize imports and domestic conventional yellow maize production over the last 20 years, and projects the economic surplus generated over five years from adopting agroecology for yellow maize production. We explore three likely scenarios and find that in all of them, yellow maize processors lose almost twice as much economic surplus as producers. In the most conservative loss estimate (Scenario 1), the surplus loss in five years is equivalent to 35% of the economic surplus generated over the last 21 years from GM maize imports and domestic Mexican conventional production. In all simulated Scenarios, between 2024 and 2025 the price of a metric ton of yellow maize will increase 81percent because of the change in production systems (from conventional to agroecology). These financial losses will ultimately factor into the prices consumers pay for poultry and red meat products, resulting in higher domestic retail food prices.

Expert opinions on the regulation of plant genome editing.

Global food security is largely affected by factors such as environmental (e.g. drought, flooding), social (e.g. gender inequality), socio-economic (e.g. overpopulation, poverty) and health (e.g. diseases). In response, extensive public and private investment in agricultural research has focused on increasing yields of staple food crops and developing new traits for crop improvement. New breeding techniques pioneered by genome editing have gained substantial traction within the last decade, revolutionizing the plant breeding field. Both industry and academia have been investing and working to optimize the potentials of gene editing and to bring derived crops to market. The spectrum of cutting-edge genome editing tools along with their technical differences has led to a growing international regulatory, ethical and societal divide. This article is a summary of a multi-year survey project exploring how experts view the risks of new breeding techniques, including genome editing and their related regulatory requirements. Surveyed experts opine that emerging biotechnologies offer great promise to address social and climate challenges, yet they admit that the market growth of genome-edited crops will be limited by an ambiguous regulatory environment shaped by societal uncertainty.

Genetically modified maize impacts in Honduras: production and social issues.

Maize production is one of the most important activities for the Honduran economy, both in terms of area cultivated and food security provided. This article reports the results of a survey undertaken to gauge knowledge, perceptions, opinions, and attitudes of Honduran farmers towards genetically modified (GM) maize. Data were collected from 32 maize producers in 2018-19, of both conventional and GM, in five different departments (regions) of Honduras. Results show that over 75% of interviewed farmers have significant knowledge of basic biotechnology concepts and GM maize. Overall, producers have a positive opinion about GM maize because yields are higher than conventional maize, and adopting farmers have higher incomes. A significant finding was the reduction in the number of necessary pesticide applications, 84% of interviewees who used GM maize did not apply any pesticides. Farmers indicate the two main reasons for using GM maize are higher incomes (48%) and ease of use of the crop (33%). Overall, GM maize impacts in Honduras could be greater if the federal government took on a more proactive role in knowledge dissemination and facilitation of credit access.

How should we regulate products of new breeding techniques? Opinion of surveyed experts in plant biotechnology.

The adoption of genome editing depends among others, on a clear and navigable regulatory framework that renders consistent decisions. Some countries like the United States decided to deregulate specific transgene-free genome edited products that could be created through traditional breeding and are not considered to be plant pests, while others are still challenged to fit emerging technologies in their regulatory system. Here we poll international experts in plant biotechnology on what approach should nations agree upon to accommodate current and future new breeding technologies and derived products. A key finding is product-based models or dual-product/process systems are viewed as potential appropriate frameworks to regulate outcomes of genome editing. As regulation of novel products of biotechnology is expected to impact research and trade, we test the impact of experts' worldviews on these issues. Results show that region influences worldviews of trade but not of agricultural innovation. In contrast, there was no effect of experts' worldviews on how products of novel biotechnologies should be regulated.

Ex-ante impact assessment of GM maize adoption in El Salvador.

Bacillus thuringiensis (Bt) white maize was field tested in El Salvador in 2009. Results showed sufficient pest abatement, eliminating the need for insecticide applications, and an average yield increase of 18% above that of the most widely cultivated conventional hybrid. This article presents an ex ante economic impact assessment of Bt maize adoption in El Salvador. Ten-year economic surplus projections show a considerable welfare gain for the overall economy, with consumers being the principal beneficiaries. Trade implications of adopting Bt maize are analyzed and appropriate alternatives to possible market shutdowns are explored. Results obtained in this study could compliment the agronomic evaluation of Bt maize and become part of the Salvadoran government decision process on Bt maize adoption.

Benefits of genome-edited crops: expert opinion.

Innovation in agriculture is pervasive. However, in spite of the success stories of twentieth century plant breeding, the twenty-first century has ushered in a set of challenges that solutions from the past century are unlikely to address. However, sustained research and the amalgamation of a number of disciplines has resulted in new breeding techniques (NBTs), such as genome editing, which offer the promise of new opportunities to resolve some of the issues. Here we present the results of an expert survey on the added potential benefits of genome-edited crops compared to those developed through genetic modification (GM) and conventional breeding. Overall, survey results reveal a consensus among experts on the enhanced agronomic performance and product quality of genome-edited crops over alternatives. The majority of experts indicated that the regulations for health and safety, followed by export markets, consumers, and the media play a major role in determining where and how NBTs, including genome editing, will be developed and used in agriculture. Further research is needed to gauge expert opinion after the Court of Justice of the European Union ruling establishing that site-specific mutagenic breeding technologies are to be regulated in the same fashion as GM crops, regardless of whether foreign DNA is present in the final variety.

Relationship between the QTc interval at hospital admission and the severity of the underlying ischaemia in low and intermediate risk people studied for acute chest pain.

BACKGROUND: The corrected QT interval (QTc) is prolonged in the setting of acute coronary artery disease. However, very little data are available concerning the relationship between the QTc obtained soon after an episode of acute chest pain (ACHP) and the magnitude and severity of the myocardial ischaemia objectified in subsequent stress tests (STS). METHODS: This was a prospective and observational study in which we investigated the relationship between the QTc determined on the hospital admission electrocardiogram (AQTc) using Bazett's formula and the results of the STS performed subsequently in 206 patients consecutively admitted to the Emergency Department for ACHP without persistent ST-elevation. RESULTS: The mean AQTc was 456+/-60 ms. There were 88 (42%) individuals with a moderately or severely abnormal STS. The AQTc was longer in the patients with a moderately or severely abnormal STS: 490+/-52 versus 430+/-56 (p<0.001) and was correlated with the probability of the patient having a moderately or severely abnormal STS (c=0.84; p<0.001). The best cut-off point was 450 ms (sensitivity, specificity and negative predictive value: 81, 77 and 84 %). Patients with AQTc>or=450 had a higher frequency of moderately or severely abnormal STS (73 versus 16%; OR: 2.9; 95% CI: 2.1-4.1; p<0.001). After adjusting for age, sex, cardiac risk factors, cardiac history, QRS duration, ST-depression, troponin I release and pre-STS medical treatment, AQTc>or=450 remained as an independent predictor (OR: 12; 95% CI: 6-24; p<0.001). CONCLUSIONS: In patients studied for ACHP, the QTc on the hospital admission electrocardiogram correlates with the underlying myocardial ischaemia. AQTc>or=450 ms selects a group of people at risk of presenting a moderately or severely abnormal STS, regardless of ST abnormalities and troponin release.

Short- and long-term prognostic value of the corrected QT interval in the non-ST-elevation acute coronary syndrome.

BACKGROUND AND PURPOSE: Myocardial ischemia prolongs the QTc interval. Very little data exists about its prognostic implications in the non-ST-elevation acute coronary syndromes (NST-ACS). METHODS: This is and observational and prospective study in which we evaluated the prognostic implications of the QTc obtained at admission (AQTc) in the short- and long-term of the NST-ACS. The median of the follow-up was 17 months. RESULTS: AQTc correlated adequately with the incidence of adverse events in the short- and long-term (P < .001), with the best cut-off point in 450 milliseconds. Patients with AQTc > or =450 presented higher frequency of in-hospital death: 8.8% vs 1.2%; P = .001, and MACE (death, recurrent ischemia, or urgent coronary revascularization): 72% vs 25%; P < .001. In a Cox regression analysis, we found 3 independent predictors of cardiovascular death after discharge: AQTc > or =450 (14.7% vs 2.1%; P < .0001), age >65 years and left ventricular ejection fraction <40%. Coronary revascularization reduced the risk of posthospitalary cardiovascular death in AQTc > or =450 milliseconds (5% vs 24%; P < .0001) but had no significant effect in AQTc<450 milliseconds. CONCLUSION: These findings provide a new evidence supporting the prognostic value of the AQTc in predicting unfavorable events in the short- and long-term of the NST-ACS.

[Hypoxemia and stroke in a patient with a pacemaker]. / Cianosis y accidente cerebrovascular en una paciente con marcapasos.

We report a woman with a VVI pacemaker and a history of stroke and severe hypoxemia due to a right-to-left shunt. Anomalous blood flow was through a patent foramen oval, and was related directly with severe tricuspid regurgitation because the ventricular pacemaker electro de was adhered to the tricuspid valve. She was treated successfully with surgery. We review the role of patent foramen ovale from a clinical point of view, and current therapeutic options.

[Long-term prognostic value of troponin I in patients admitted to a coronary unit for unstable angina]. / Valor pronóstico de la troponina I en los pacientes ingresados en una unidad coronaria por angina inestable.

INTRODUCTION AND OBJECTIVES: Troponin I (TnI) is a useful marker of myocardial damage for the diagnosis and prognosis of acute coronary syndrome. The purpose of this study was to analyze the long-term prognostic value of the peak TnI concentration obtained within 48 h of admission to the coronary unit for unstable angina. METHODS: The study included 149 consecutive patients. Serial determinations were made of the MB fraction of creatine kinase (CK-MB) and TnI. Patients without CK-MB elevation were classified into two groups depending on the presence of high (n = 58) or normal (n = 91) troponin I values. We prospectively analyzed the clinical and evolutive factors related to the probability of death, new acute coronary event, or coronary revascularization at one-year of follow-up. RESULTS: There were no differences in the clinical characteristics between groups, except that patients in the group with high TnI values were older (69 vs. 64 years, p = 0.01). At one year of follow-up there were no differences in the incidence of new acute coronary events or coronary revascularization procedures; however there was a higher mortality in the group with high TnI (13 vs. 4%; p = 0.01). The independent predictors of mortality were prior myocardial infarction (RR = 3), elevated troponin I (RR = 3.2), left ventricular ejection fraction < 35% (RR = 10), and age > 70 years (RR = 15). CONCLUSIONS: In patients with unstable angina a high troponin I value in the first 48 h of admission was associated with a higher mortality rate at one-year of follow-up.

Valor pronóstico tardío de la troponina I en los pacientes ingresados en una unidad coronaria por angina inestable / Long-term prognostic value of troponin i in patients admitted to a coronary unit for unstable angina

Introducción y objetivos. La troponina I (TnI) es un marcador de daño miocárdico utilizado en la estratificación pronóstica del síndrome coronario agudo. El objetivo del estudio fue analizar el valor pronóstico tardío del nivel máximo de TnI obtenido en las 48 h tras el ingreso en una unidad coronaria por angina inestable. Métodos. Se incluyó a 149 pacientes consecutivos. Se realizaron determinaciones seriadas de la fracción MB de la creatincinasa (CK-MB) y TnI. Los pacientes sin elevación de la CK-MB fueron clasificados en dos grupos, en función de la presencia de TnI elevada (n = 58) o normal (n = 91). Se analizaron prospectivamente los factores clínicos y evolutivos relacionados con la probabilidad de muerte, nuevo episodio agudo coronario o revascularización coronaria tras un año de seguimiento. Resultados. No se observaron diferencias entre los dos grupos en relación con las características clínicas, salvo la edad, que fue mayor en el grupo con TnI elevada (69 frente a 64 años; p = 0,01). Tras un año de seguimiento no se apreciaron diferencias en la incidencia de nuevos acontecimientos coronarios agudos ni en la revascularización; sin embargo, la mortalidad fue mayor en el grupo con TnI elevada (el 13 frente al 4 per cent; p = 0,01).Los predictores independientes de mortalidad fueron el infarto previo (riesgo relativo [RR] = 3), TnI elevada (RR = 3,2), fracción de eyección 70 años (RR = 15).Conclusiones. En la angina inestable, un valor elevado de TnI dentro de las primeras 48 h del ingreso se asocia con un aumento de la mortalidad al año de seguimiento (AU)