Native Arbuscular Mycorrhizal Fungi Promote Plukenetia volubilis Growth and Decrease the Infection Levels of Meloidogyne incognita.

The use of arbuscular mycorrhizal fungi (AMF) offers promising benefits to agriculture in the Amazon regions, where soils are characteristically acidic and nutrient-poor. The purpose of this research was to investigate the potential effects of two recently described species of AMF (Nanoglomus plukenetiae and Rhizoglomus variabile) native to the Peruvian Amazon for improving the plant growth of Plukenetia volubilis (inka nut or sacha inchi) and protecting the roots against soil pathogens. Two assays were simultaneously conducted under greenhouse conditions in Peru. The first focused on evaluating the biofertilizer effect of AMF inoculation, while the second examined the bioprotective effect against the root knot nematode, Meloidogyne incognita. Overall, the results showed that AMF inoculation of P. volubilis seedlings positively improved their development, particularly their biomass, height, and the leaf nutrient contents. When seedlings were exposed to M. incognita, plant growth was also noticeably higher for AMF-inoculated plants than those without AMF inoculation. Nematode reproduction was significantly suppressed by the presence of AMF, in particular R. variabile, and especially when inoculated prior to nematode exposure. The dual AMF inoculation did not necessarily lead to improved crop growth but notably improved P and K leaf contents. The findings provide strong justification for the development of products based on AMF as agro-inputs to catalyze nutrient use and uptake and protect crops against pests and diseases, especially those that are locally adapted to local crops and cropping conditions.

Discapacidad y calidad de vida después de un accidente de tránsito en Medellín y su área metropolitana. Estudio de cohorte

Objetivo: Comparar al año, el funcionamiento, calidad de vida (cv), dolor y depresión entre adultos menores y mayores de 60 años que tuvieron lesiones moderadas y graves en accidentes de tránsito ocurridos en Medellín y su área metropolitana. Metodología: Análisis secundario de dos cohortes de pacientes con lesiones moderadas y graves ocurridas en Medellín y su área metropolitana en 2009-2010 y 2015-2016. Se hizo evaluación para el funcionamiento, la cv, depresión y el dolor, con instrumentos validados para ello. Las diferencias entre las cohortes 12 meses después del accidente se compararon con t-Student. Se hizo un análisis de regresión lineal múltiple para determinar los factores explicativos de discapacidad y cv. Resultados: Se incluyeron 837 pacientes, de los cuales el 84,8 % completó el seguimiento. La motocicleta fue el principal vehículo involucrado (86,1 y 60,7 %). Se observó mejor funcionamiento en mayores de 60 años en cuidado personal, y mayor compromiso en las actividades de la vida diaria, laborales y funcionamiento global. La cv fue significativamente mejor en menores, en desempeño emocional, desempeño físico y función física. En el análisis multivariado, el mayor compromiso en el funcionamiento fue explicado por ser mujer, tener más edad, lesión más grave, mayor dolor y depresión. La mejor cv fue explicada por ser hombre, menos edad, menor gravedad de la lesión, dolor y síntomas depresivos. Conclusiones: La edad, el sexo, la gravedad de la lesión, el dolor y la depresión explican la discapacidad y las dimensiones de la cv 12 meses después del accidente de tránsito.

Objective: To compare functioning, quality of life (QoL), pain, and depression at one year between adults under and over 60 years of age who had moderate and severe injuries in traffic accidents in Medellin and its metropolitan area. Methodology: Secondary analysis of two cohorts of patients with moderate and severe injuries that occurred in Medellín and its metropolitan area in 2009-2010 and 2015-2016. They were evaluated at baseline and 12 months with functioning (who-das ii), QoL (sf-36), pain (vas), and depression (phq-9). The differences between cohorts 12 months after the accident were compared with t-Student test. A multiple linear regression analysis was done to determine factors related to disability and QoL. Results: 837 patients were included, 84,8% completed the follow-up. The motorcycle was the main vehicle involved (86,1% vs. 60,7). Better functioning was observed in people over 60 years of age in personal care, and greater commitment in activities of daily living, work and global functioning. QoL was significantly better in minors, in emotional performance, physical performance and physical function. In the multivariate analysis, the greater compromise in functioning was explained by being female, older, more severe injury, greater pain, and depression. The best QoL was explained by being male, younger, less severe injury, pain, and depressive symptoms. Conclusions: Age, sex, injury severity, pain, and depression explain disability and QoL dimensions 12 months after the traffic accident.

Objetivo: Comparar a funcionalidade, qualidade de vida (QV), dor e depressão entre adultos com menos e mais de 60 anos de idade que sofreram lesões moderadas e graves em acidentes de trânsito ocorridos em Medellín e sua região metropolitana. Metodologia: Análise secundária de duas coortes de pacientes com lesões moderadas e graves que ocorreram em Medellín e sua área metropolitana em 2009-2010 e 2015-2016. Foi feita avaliação funcional, cv, depressão e dor, com instrumentos validados para isso. As diferenças entre as coortes 12 meses após o acidente foram comparadas com o teste t de Student. Uma análise de regressão linear múltipla foi realizada para determinar os fatores explicativos para deficiência e cv. Resultados: foram incluídos 837 pacientes, dos quais 84,8% completaram o seguimento. A motocicleta foi o principal veículo envolvido (86,1 e 60,7%). Melhor funcionamento foi observado em pessoas com mais de 60 anos nos cuidados pessoais e maior comprometimento nas atividades de vida diária, trabalho e funcionamento global. A QV foi significativamente melhor nos menores, no desempenho emocional, no desempenho físico e na função física. Na análise multivariada, o maior comprometimento funcional foi explicado por ser mulher, ser mais velho, lesão mais grave, maior dor e depressão. A melhor QV foi explicada por ser homem, menor idade, menor gravidade da lesão, dor e sintomas depressivos. Conclusões: Idade, sexo, gravidade da lesão, dor e depressão explicam as dimensões de incapacidade e QV 12 meses após o acidente de trânsito.

A modified CALGB 10403 in adolescents and young adults with acute lymphoblastic leukemia in Central America.

Mexico and Central America have a high incidence of acute lymphoblastic leukemia (ALL) in adolescents and young adults. Historically, this patient group has been treated using adult-based regimens, which entails a high rate of treatment-related mortality and a poor overall survival (OS). The use of the CALGB 10403, a pediatric-inspired regimen, has been proven effective in this patient subgroup. Nonetheless, low- and middle-income countries (LMICs) may present limited access to standard care treatments implemented elsewhere, warranting the need for further research to improve outcomes among vulnerable populations. In this study, we present the outcomes in terms of safety and effectiveness of using a modified CALGB 10403 regimen to reflect drug and resource availability in LMICs. Modifications included the use of Escherichia coli asparaginase,6-mercaptopurine instead of thioguanine and the use of rituximab among patients with CD20+. A total of 95 patients with a median age of 23 (range, 14-49) years treated with this modified scheme were prospectively assessed at 5 centers in Mexico and 1 in Guatemala. Among these, 87.8% achieved a complete response after induction. During follow-up, 28.3% of patients relapsed. Two-year OS rate was 72.1%. Factors associated with worse OS included hyperleukocytosis (hazard ratio [HR], 4.28; 95% confidence interval [CI], 1.81-10.10) and postinduction minimal residual disease (HR, 4.67; 95% CI, 1.75-12.44). Most patients presented hepatotoxicity (51.6% and 53.7% during induction and consolidation, respectively), and the treatment-related mortality was 9.5%. Overall, results highlight that implementing a modified CALGB 10403 regimen in Central America is feasible, and it is associated with improvements in clinical outcomes and a manageable safety profile.

Beta Diversity of Arbuscular Mycorrhizal Communities Increases in Time after Crop Establishment of Peruvian Sacha Inchi (Plukenetia volubilis).

(1) Background: Beta diversity, i.e., the variance in species compositions across communities, has been pointed out as a main factor for explaining ecosystem functioning. However, few studies have directly tested the effect of crop establishment on beta diversity. We studied beta diversity patterns of arbuscular mycorrhizal (AM) fungal communities associated to sacha inchi (Plukenetia volubilis) after crop establishment. (2) Methods: We molecularly characterized the AM fungal communities associated to roots of sacha inchi in plots after different times of crop establishment, from less than one year to older than three. We analyzed the patterns of alpha, beta, and phylogenetic diversity, and the sources of variation of AM fungal community composition. (3) Results: Beta diversity increased in the older plots, but no temporal effect in alpha or phylogenetic diversity was found. The AM fungal community composition was driven by environmental factors (altitude and soil conditions). A part of this variation could be attributed to differences between sampled locations (expressed as geographic coordinates). Crop age, in turn, affected the composition with no interactions with the environmental conditions or spatial location. (4) Conclusions: These results point out towards a certain recovery of the soil microbiota after sacha inchi establishment. This fact could be attributed to the low-impact management associated to this tropical crop.

Leucemia promielocítica aguda durante el embarazo: reporte de 17 casos de un país en desarrollo / Acute promyelocytic leukemia during pregnancy: report of 17 cases from a developing country

Resumen OBJETIVO: Recopilar casos atendidos en centros oncológicos de México y reportar los tratamientos exitosos, con respuestas completas y las complicaciones del embarazo. MATERIALES Y MÉTODOS: Estudio retrospectivo de serie de casos que incluyó a pacientes con leucemia promielocítica aguda asociada con el embarazo atendidas en diferentes hospitales de la zona metropolitana de la Ciudad de México entre 1999 y 2021. RESULTADOS: Se identificaron 17 pacientes con leucemia promielocítica aguda asociada con el embarazo, con mediana de edad de 23 años (14-40 años); 7 correspondieron a madres menores de 20 años. En relación con su entorno social 9 tenían baja escolaridad, 12 se dedicaban al hogar y 13 tenían una pareja al momento de la concepción. Por último, 11 eran originarias de una zona urbana. Las pacientes atendidas entre 1999-2010 se trataron con interferón plus citarabina (7 de 17) o mediante soporte transfusional y esteroide (2 de 17), en 8 de los 17 casos el tratamiento se inició con tretinoína en combinación con quimioterapia (daunorrubicina) como tratamiento de inducción. CONCLUSIONES: El tratamiento de pacientes embarazadas y con leucemia promielocítica aguda representa un reto debido al riesgo trombótico y hemorrágico. Si bien la adición de tretinoína ha modificado el pronóstico de las pacientes con esta leucemia, su indicación a las embarazadas sigue siendo motivo de controversia, sobre todo por el riesgo de teratogenicidad.

Abstract OBJECTIVE: To collect cases attended in oncology centers in Mexico and to report successful treatments, with complete responses and complications around gestation. MATERIALS AND METHODS: Retrospective case series study including patients with pregnancy-associated acute promyelocytic leukemia attended in different hospitals in the metropolitan area of Mexico City between 1999 and 2021. RESULTS: Seventeen patients with pregnancy-associated acute promyelocytic leukemia were identified, with a median age of 23 years (14-40 years); 7 corresponded to mothers younger than 20 years. In relation to their social environment, 9 had low schooling, 12 were homebased and 13 had a partner at the time of conception. Finally, 11 were originally from an urban area. Patients seen between 1999-2010 were treated with interferon plus cytarabine (7 of 17) or by transfusion support and steroid (2 of 17), in 8 of the 17 cases treatment was initiated with tretinoin in combination with chemotherapy (daunorubicin) as induction therapy. CONCLUSIONS: Treatment of pregnant patients and patients with acute promyelocytic leukemia represents a challenge due to thrombotic and hemorrhagic risk. Although the addition of tretinoin has modified the prognosis of patients with this leukemia, its indication in pregnant women remains controversial, especially because of the risk of teratogenicity.

New Insights into the Phosphorus Acquisition Capacity of Chilean Lowland Quinoa Roots Grown under Low Phosphorus Availability.

Reducing phosphate fertilizer inputs while increasing food nutritional quality has been posited as a major challenge to decrease human undernourishment and ensure food security. In this context, quinoa has emerged as a promising crop due to its ability to tolerate different stress conditions and grow in marginal soils with low nutrient content, in addition to the exceptional nutritional quality of its grains. However, there is scarce information about the phosphorus acquisition capacity of quinoa roots. This work aimed to provide new insights into P acquisition and functional root traits, such as root biomass, rhizosphere pH, carboxylate exudation, and acid phosphatase activity of thirty quinoa genotypes grown under P limiting conditions (7 mg P kg-1). Significant genotypic variation was observed among genotypes, with average P accumulation ranging from 1.2 to 11.8 mg. The shoot biomass production varied more than 14 times among genotypes and was correlated with the P accumulation on shoots (r = 0.91). Despite showing high variability in root traits, only root biomass production highly correlated with P acquisition (r = 0.77), suggesting that root growth/morphology rather than the measured biochemical activity possesses a critical role in the P nutrition of quinoa.

Consenso de leucemia mieloide aguda en México / Mexican consensus in acute myeloid leukemia in Mexico

resumen está disponible en el texto completo

Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

Diagnostic concordance of pathological methods and reports of hematopathologists compared to local nonspecialized pathologists in the diagnosis of lymphoma in Mexico.

OBJECTIVES: To assess the concordance between lymphoma diagnoses made via tissue biopsy by local pathologists and also to assess the after review of these specimens by more specialized hematopathologists. METHODS: A prospective, non-interventional and multicenter study was conducted at seven sites in Mexico from January 2017 to October 2017. Eligible biopsies were sampled from patients with a previous diagnosis of lymphoma on lymph node biopsy or a diagnosis of extranodal lymphoma, with adequate amount and tissue preservation for the review analysis. The biopsy tissues reviewed by local pathologists were also reviewed by hematopathologists participating in the study. The concordance in diagnosis results was classified into three categories: diagnostic agreement, minor discrepancy and major discrepancy. RESULTS: Out of 111 samples received, 105 samples met the eligibility criteria and were included for full analysis. The median patient age (range) was 54 (16-94) years. A diagnostic agreement was observed in 23 (21.9%) biopsies, minor discrepancies were observed in 32 (30.5%) biopsies and major discrepancies were observed in 50 (47.6%) biopsies. Diagnostic concordance varied across the seven study sites; the rate of major discrepancies ranged from 0% to 100% and the rate of diagnostic agreement ranged from 0% to 81.8%. Out of the 105 reviewed biopsies, a total of 89 cases were diagnosed as lymphoma by hematopathologists. CONCLUSIONS: This study showed that major discrepancies were observed following the review by hematopathologists compared with that of the local pathologist's initial diagnosis in nearly one-half cases. In addition, there was a wide variation in the percentage of diagnostic agreements and discrepancies among different study sites.

Molecular Analysis of Streptomycin Resistance Genes in Clinical Strains of Mycobacterium tuberculosis and Biocomputational Analysis of the MtGidB L101F Variant.

Globally, tuberculosis (TB) remains a prevalent threat to public health. In 2019, TB affected 10 million people and caused 1.4 million deaths. The major challenge for controlling this infectious disease is the emergence and spread of drug-resistant Mycobacterium tuberculosis, the causative agent of TB. The antibiotic streptomycin is not a current first-line anti-TB drug. However, WHO recommends its use in patients infected with a streptomycin-sensitive strain. Several mutations in the M. tuberculosisrpsL, rrs and gidB genes have proved association with streptomycin resistance. In this study, we performed a molecular analysis of these genes in clinical isolates to determine the prevalence of known or novel mutations. Here, we describe the genetic analysis outcome. Furthermore, a biocomputational analysis of the MtGidB L101F variant, the product of a novel mutation detected in gidB during molecular analysis, is also reported as a theoretical approach to study the apparent genotype-phenotype association.

Variational determination of ground and excited-state two-electron reduced density matrices in the doubly occupied configuration space: A dispersion operator approach.

This work implements a variational determination of the elements of two-electron reduced density matrices corresponding to the ground and excited states of N-electron interacting systems based on the dispersion operator technique. The procedure extends the previously reported proposal [Nakata et al., J. Chem. Phys. 125, 244109 (2006)] to two-particle interaction Hamiltonians and N-representability conditions for the two-, three-, and four-particle reduced density matrices in the doubly occupied configuration interaction space. The treatment has been applied to describe electronic spectra using two benchmark exactly solvable pairing models: reduced Bardeen-Cooper-Schrieffer and Richardson-Gaudin-Kitaev Hamiltonians. The dispersion operator combined with N-representability conditions up to the four-particle reduced density matrices provides excellent results.

Kidney transplantation outcomes in lupus nephritis: A 37-year single-center experience from Latin America.

OBJECTIVE: We assessed patient and graft outcomes and prognostic factors in kidney transplantation in patients with end-stage kidney disease (ESKD) secondary to lupus nephritis (LN) undergoing kidney transplantation from August 1977 to December 2014 in a Latin American single center. METHODS: The primary endpoint was patient survival, and the secondary endpoints were death-censored graft survival for the first renal transplant and the rate of recurrent LN (RLN). Kaplan-Meier method was used for survival analysis. Factors predicting patient and death-censored graft survivals were examined by Cox proportional-hazards regression analyses. RESULTS: 185 patients were retrospectively evaluated. Patient survival rates were 88% at one year, 82% at three years, 78% at five years, and 67% at ten years. Death-censored graft survival for the first renal transplant was 93% at one year, 89% at three years, 87% at five years, and 80% at ten years. RLN was diagnosed in 2 patients (1.08%), but no graft was lost because of RLN. Thirty-nine (21.1%) patients died, and 65 (35.1%) patients experienced graft loss during the follow-up. By multivariable analyses, older recipient age and 1-month posttransplantation eGFR <45 ml/min/1.73m2 were associated with lower patient survival and an increased risk of graft loss, while induction immunosuppressive therapy exerted a protective effect on patients' survival. In the subgroup of patients in whom disease activity was measured at the time of transplantation, a higher SLEDAI score was also associated with lower patient survival and an increased risk of graft loss. CONCLUSION: In a mostly Mestizo population, kidney transplantation is an excellent therapeutic alternative in LN patients with ESKD. Older recipient age, an eGFR <45 ml/min/1.73m2 at one month posttransplantation, and disease activity at the time of transplantation are predictive of a lower patient and death-censored graft survival, while induction immunosuppressive therapy has a protective effect on patient survival. RLN is rare and does not influence the risk of graft loss.

Acute Promyelocytic Leukemia: A Long-Term Retrospective Study in Mexico.

BACKGROUND: The present retrospective study reviewed acute promyelocytic leukemia (APL) cases recorded in Mexico between January 2007 and January 2017. The primary objective of the study was to evaluate overall survival (OS) in Mexican patients with APL. Secondary objective was to evaluate the impact of induction treatment with different anthracyclines on OS, event-free survival (EFS) and complications in this patient population. METHODS: The medical charts of patients referred to medical institutions in Mexico from January 2007 through January 2017 for the treatment of suspected APL were reviewed retrospectively. Patients aged 15 - 75 years, in whom the diagnosis of APL was confirmed, who had an Eastern Cooperative Group performance status of 0 - 2, and who were eligible for combined treatment with intensive chemotherapy and all-trans retinoic acid (ATRA), were included in the study. Study participants received induction and consolidation treatment with ATRA plus either daunorubicin or idarubicin, followed by 2 years of single-agent ATRA as maintenance therapy. Patients who were unable to pay for ATRA treatment received anthracycline-based induction and consolidation, with methotrexate plus mercaptopurine as maintenance therapy. RESULTS: A total of 360 patients from 21 public and private hospitals were included in the study. The median age of the population was 37 years, and 51% were male. Of the 360 patients, 205 (57%) vs. 155 (43%) received daunorubicin vs. idarubicin as induction treatment for APL. ATRA was administered to 201 (98%) patients in the daunorubicin group vs. 138 (89%) in the idarubicin group (P = 0.001), and was initiated at diagnosis in 92% vs. 73% of recipients, respectively (P = 0.0001). At 150 months, OS and EFS for the entire population were 84% and 79%, respectively. Both OS (90% vs. 76%, P = 0.003) and EFS (85% vs. 72%, P = 0.001) were significantly prolonged in daunorubicin vs. idarubicin recipients. Rates of complications were similar in the two groups. CONCLUSIONS: As arsenic trioxide (ATO) is not currently available in Mexico, anthracycline plus ATRA is the mainstay of treatment for APL here. Our results confirm the efficacy of this strategy, with high OS and EFS rates being observed 12.5 years after diagnosis.

Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries.

PURPOSE: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION: These results highlight the collateral damage of COVID-19 in oncology patients.

Embarazo y COVID-19. Consideraciones en la práctica de la hematología / Pregnancy and COVID-19. Considerations in the practice of Hematology

Resumen La enfermedad por coronavirus 2019 (COVID-19) en una población vulnerable, como es el caso de la mujer embarazada, feto y recién nacido, obliga a establecer estrategias efectivas y seguras centradas en la seguridad del binomio madre-hijo. El objetivo del presente reporte es presentar los resultados de la revisión de las fuentes de información secundaria (metaanálisis y revisión sistemática) del estado del arte en el avance del conocimiento de la COVID-19 durante el embarazo. En diferentes reportes se ha insistido en que la mortalidad materna por COVID-19 es baja. Sin embargo, la razón de mortalidad materna (RMM) aumentó de 30.9 a 45.5 defunciones por cada 100,000 nacimientos, es decir, mostró un incremento del 36.32% respecto a la misma semana del 2019. Pero el tema no se limita a la COVID-19, el aumento en la RMM es del 24.% para hemorragia materna, del 20% para la enfermedad hipertensiva y del 28.5% para sepsis puerperal. Sin embargo, por su naturaleza de condición inédita y el comportamiento particular de la COVID-19 durante el periodo perinatal, la generación de nuevos datos, su integración a información accesible y su análisis clínico epidemiológico inevitablemente proporcionarán nuevas evidencias que deberán integrarse a la gestión y práctica clínica. No existe un comportamiento hematológico característico o de las complicaciones trombóticas o hemorrágicas de la paciente con COVID-19, son características clínicas similares a las que se presenta en sus pares sin embarazo. El aumento global en todas las causas de mortalidad materna no son exclusivas de la COVID-19, lo que expone las deficiencias del sistema de salud en términos de atención primaria de la salud, vigilancia prenatal y planificación familiar, entre otros programas más; adicional al impacto de la COVID-19. Es una necesidad imperiosa el rediseño de las políticas públicas en términos de atención primaria para la salud a toda la población, en particular para las mujeres embarazadas.

Abstract Coronavirus disease 2019 (COVID-19) in a vulnerable population, such as the pregnant woman, fetus, and newborn, requires an establishment of effective and safe strategies focused on the safety of the mother-child binomial. The objective of this report is to present the results of the review of secondary information sources (meta-analysis and systematic review), of the state of the art in the advancement of knowledge of the disease due to COVID-19 during pregnancy. Different reports have insisted that maternal mortality from COVID-19 is low. However, the maternal mortality ratio (MMR) increased from 30.9 to 45.5 deaths per 100,000 births, that is, it showed an increase of 36.32% compared to the same week of 2019. Due to its unprecedented condition and the particular behavior of the COVID-19 disease during the perinatal period, the generation of new data, its integration into accessible information and its epidemiological clinical analysis will inevitably provide new evidence that must be integrated into clinical management and practice. But the issue is not limited to COVID-19, the increase in MMR is 24% for maternal obstetric hemorrhage, 20% for hypertensive disease, and 28.5% for puerperal sepsis. There is no characteristic hematological behavior and the appearance of thrombotic or hemorrhagic complications in the patient with COVID-19, without clinical characteristics similar to those seen in her non-pregnant peers. The global increase in all causes of maternal mortality are not exclusive to COVID-19, which exposes the deficiencies of the health system in terms of primary health care, prenatal surveillance, family planning, among other programs; additional to the impact of COVID-19. The redesign of public policies in terms of primary health care for the entire population is an urgent need, particularly for pregnant women.

Delayed vs Immediate Cord Clamping Changes Oxygen Saturation and Heart Rate Patterns in the First Minutes after Birth.

OBJECTIVE: To build arterial oxygen saturation (SpO2) and heart rate (HR) percentiles for the first 10 minutes after birth in term infants born after an uneventful gestation, vaginal delivery, and delayed cord clamping (DCC) for ≥60 seconds, and to compare our results with previous ones constructed after immediate cord clamping. STUDY DESIGN: Preductal SpO2, HR, and timing of DCC immediately after complete fetal body expulsion were recorded. The pulse-oximeter was adjusted in the right wrist/hand and set at maximal intensity and measurements performed every 2 seconds. RESULTS: A total of 282 term newborn infants were included. The definitive data set comprised of 70 257 SpO2 and 79 746 HR measurements. Median and IQR of SpO2 (%) at 1, 5, and 10 minutes after birth were 77 (68-85), 94 (90-96), and 96 (93-98), respectively. HR (beats per minute) median and IQR at 1, 5, and 10 minutes after birth were 148 (84-170), 155 (143-167), and 151 (142-161), respectively. We found significantly higher SpO2 for the 10th, 50th, and 90th percentiles compared with the previous reference ranges for the first 5 minutes and HR for the first 1-2 minutes after birth. CONCLUSIONS: Spontaneously breathing term newborn infants born by vaginal delivery who underwent DCC ≥60 seconds achieved higher SpO2 and HR in the first 5 minutes after birth compared with term neonates born under the same conditions but with immediate cord clamping. Further studies in neonates undergoing cesarean delivery are under way.

Acute Myeloid Leukemia in Mexico: The Specific Challenges of a Developing Country. Results From a Multicenter National Registry.

BACKGROUND: In the past decades, long-term survival outcomes for younger patients with acute myeloid leukemia (AML) have improved. Nonetheless, developing nations might be lagging behind, highlighting the need to assess real-world outcomes in such regions. METHODS: We performed a multicenter retrospective study, which included patients with AML diagnosed between January 2013 and December 2017 from 13 centers in Mexico. RESULTS: A total of 525 patients with AML met the inclusion criteria and were included in the study. Median age for the entire cohort was 47 years. The patients were classified according to cytogenetic risk: favorable 16.0%, intermediate 55.6%, and unfavorable 28.4%. Most patients received intensive chemotherapy (80.2%), and among these 74.1% underwent a 7 + 3 induction regimen. A complete remission was achieved in 71.3% of patients. Induction-related mortality occurred in 17.8% and we identify the following as independent risk factors: >60 years (odds ratio [OR] 2.09 [1.09-4.02]), Eastern Cooperative Oncology Group >2 (OR 4.82 [2.46-9.43]), prior solid tumor (OR 3.8 [1.24-11.59]) and active infection (OR 1.82 [1.06-3.12]). Further, allogeneic hematopoietic stem-cell transplantation (AlloHSCT) was performed in 8.2% in CR1. The 3-year overall survival (OS) was 34.8%. In a multivariate analysis, several factors were independently associated with a worse OS, including secondary AML (hazard ratio [HR] 2.14 [1.15-4.01]) and unfavorable cytogenetic risk (HR 1.81 [1.16-2.82]), whereas maintenance therapy (HR 0.53 [0.32-0.86]) and AlloHSCT (HR 0.40 [0.17-0.94]) were associated with better OS. CONCLUSIONS: This is the first multicenter report analyzing AML survival in Mexico. Challenges in this setting include a high induction-related mortality and low AlloHSCT rate, which should be addressed to improve outcomes.

Ethyl (3S)-3-[(3aR,5R,6S,6aR)-6-hy-droxy-2,2-di-methyl-tetra-hydro-furo[4,5-d][1,3]dioxol-5-yl]-3-{(3S)-3-[(3aR,5R,6S,6aR)-6-hy-droxy-2,2-di-methyl-tetra-hydro-furo[4,5-d][1,3]dioxol-5-yl]-5-oxoisoxazolidin-2-yl}propano-ate chloro-form monosolvate.

The title compound, C22H33NO12·CHCl3, was obtained as a product of a double aza-Michael addition of hydroxyl-amine on a Chiron with a known absolute configuration. The enanti-opure compound crystallized as a chloro-form solvate, in space group P1, and diffraction data were collected at room temperature with Ag Kα radiation. The Flack parameter refined to x = -0.01 (16); however, the Flack and Watkin 2AD plot clearly shows that differences between Friedel opposites (the D component of the plot) do not carry any reliable information about resonant scattering of Cl atoms, and are rather dominated by random and systematic errors. The RD factor calculated using 1941 acentric Friedel pairs is RD = 0.995. On the other hand, the 2A component of the plot, related to average intensities of Friedel pairs, shows that data are of good quality (RA = 0.069). This example illustrates that while using Ag Kα radiation (λ = 0.56083 Å), scatterers heavier than Cl should be present in a chiral crystal in order to determine confidently the absolute structure of the crystal.

Variational reduced density matrix method in the doubly occupied configuration interaction space using three-particle N-representability conditions.

Ground-state energies and two-particle reduced density matrices (2-RDMs) corresponding to N-particle systems are computed variationally within the doubly occupied configuration interaction (DOCI) space by constraining the 2-RDM to satisfy a complete set of three-particle N-representability conditions known as three-positivity conditions. These conditions are derived and implemented in the variational calculation of the 2-RDM with standard semidefinite programming algorithms. Ground state energies and 2-RDMs are computed for N2, CO, CN-, and NO+ molecules at both equilibrium and nonequilibrium geometries as well as for pairing models at different repulsive interaction strengths. The results from the full three-positivity conditions are compared with those from the exact DOCI method and with approximated 2-RDM variational ones obtained within two-positivity and two-positivity plus a subset of three-positivity conditions, as recently reported [D. R. Alcoba et al., J. Chem. Phys. 148, 024105 (2018) and A. Rubio-García et al., J. Chem. Theory Comput. 14, 4183 (2018)]. The accuracy of these numerical determinations and their low computational cost demonstrate the usefulness of the three-particle variational constraints within the DOCI framework.

Phosphorus Acquisition Efficiency Related to Root Traits: Is Mycorrhizal Symbiosis a Key Factor to Wheat and Barley Cropping?

Wheat (Triticum aestivum L.) and barley (Hordeum vulgare L.) are major crops cultivated around the world, thus playing a crucial role on human diet. Remarkably, the growing human population requires a significant increase in agricultural production in order to feed everybody. In this context, phosphorus (P) management is a key factor as it is component of organic molecules such as nucleic acids, ATP and phospholipids, and it is the most abundant macronutrient in biomass after nitrogen (N), although being one of the scarcest elements in the lithosphere. In general, P fertilization has low efficiency, as only a fraction of the applied P is acquired by roots, leaving a substantial amount to be accumulated in soil as not readily available P. Breeding for P-efficient cultivars is a relatively low cost alternative and can be done through two mechanisms: i) improving P use efficiency (PUE), and/or ii) P acquisition efficiency (PAE). PUE is related to the internal allocation/mobilization of P, and is usually represented by the amount of P accumulated per biomass. PAE relies on roots ability to acquire P from the soil, and is commonly expressed as the relative difference of P acquired under low and high P availability conditions. In this review, plant adaptations related to improved PAE are described, with emphasis on arbuscular mycorrhizal (AM) symbiosis, which is generally accepted to enhance plant P acquisition. A state of the art (1980-2018) of AM growth responses and P uptake in wheat and barley is made to discuss about the commonly accepted growth promoting effect and P increased uptake by AM fungi and the contrasting evidence about the generally accepted lack of positive responses in both plant species. Finally, the mechanisms by which AM symbiosis can affect wheat and barley PAE are discussed, highlighting the importance of considering AM functional diversity on future studies and the necessity to improve PAE definition by considering the carbon trading between all the directly related PAE traits and its return to the host plant.

DNA Extraction with DNAzol and LAMP, Performed in a Heating Block as a Simple Procedure for Detection of Mycobacterium tuberculosis in Sputum Specimens.

Tuberculosis (TB) remains as a major public health issue in developing countries. Accurate detection is essential for the proper management of patients with active disease. Here, we present a simple DNAzol-LAMP (loop-mediated isothermal amplification) procedure for the detection of Mycobacterium tuberculosis in sputum specimens. Twenty smear-positive sputum samples were analyzed as follows: (i) Genetic material was extracted by a standard DNAzol protocol, and (ii) mycobacterial DNA was detected by a typical TB-specific loop-mediated isothermal amplification method. Results and diagnostic test performance attests to the suitability of the proposed procedure.