Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review.

BACKGROUND: The interaction between modelers and policymakers is becoming more common due to the increase in computing speed seen in recent decades. The recent pandemic caused by the SARS-CoV-2 virus was no exception. Thus, this study aims to identify and assess epidemiological mathematical models of SARS-CoV-2 applied to real-world data, including immunization for coronavirus 2019 (COVID-19). METHODOLOGY: PubMed, JSTOR, medRxiv, LILACS, EconLit, and other databases were searched for studies employing epidemiological mathematical models of SARS-CoV-2 applied to real-world data. We summarized the information qualitatively, and each article included was assessed for bias risk using the Joanna Briggs Institute (JBI) and PROBAST checklist tool. The PROSPERO registration number is CRD42022344542. FINDINGS: In total, 5646 articles were retrieved, of which 411 were included. Most of the information was published in 2021. The countries with the highest number of studies were the United States, Canada, China, and the United Kingdom; no studies were found in low-income countries. The SEIR model (susceptible, exposed, infectious, and recovered) was the most frequently used approach, followed by agent-based modeling. Moreover, the most commonly used software were R, Matlab, and Python, with the most recurring health outcomes being death and recovery. According to the JBI assessment, 61.4% of articles were considered to have a low risk of bias. INTERPRETATION: The utilization of mathematical models increased following the onset of the SARS-CoV-2 pandemic. Stakeholders have begun to incorporate these analytical tools more extensively into public policy, enabling the construction of various scenarios for public health. This contribution adds value to informed decision-making. Therefore, understanding their advancements, strengths, and limitations is essential.

Estimation of Societal Values of Health States Preferences at the National Level for Low- and Middle-Income Countries.

OBJECTIVES: Social preference values of health states are a fundamental input for the preparation of studies in health economics. Several countries have undertaken studies to obtain these values. Our objective was to conduct a structured and systematic literature review of articles that calculates this set of representative values at the national level in low- and middle-income countries (LMICs). METHODS: In this systematic review, we searched the Embase, MEDLINE, Ovid, SciELO, and LILACS databases, among others, for studies published up to June 2022 that estimated nationally representative health states preferences values for LMICs. We summarized the information qualitatively and assessed the risk of bias in each article using the consensus-based standards for selecting health measurement instruments checklist tool. RESULTS: Of the 23 663 articles identified, 35 studies were eligible for inclusion. The studies were from 19 countries in Latin-American, Europe, Africa, and Asia. No studies were found for low-income countries. The most commonly applied generic instrument for measuring health-related quality of life was the 5-level version of EQ-5D and 3-level version of EQ-5D. Preference was given to face-to-face administration of these instruments. The sociodemographic variables with the most significant negative correlation versus utility were older adults, marital status (widowed or divorced), and low educational level and income. CONCLUSIONS: Worldwide, there have been few studies that have estimated, in a nationally representative manner, the social values of health states preferences in LMICs. We consider the local estimate of this set of societal values relevant for any society to improve decision making in allocating resources in health budgets.

NEUROD1 reinforces endocrine cell fate acquisition in pancreatic development.

NEUROD1 is a transcription factor that helps maintain a mature phenotype of pancreatic ß cells. Disruption of Neurod1 during pancreatic development causes severe neonatal diabetes; however, the exact role of NEUROD1 in the differentiation programs of endocrine cells is unknown. Here, we report a crucial role of the NEUROD1 regulatory network in endocrine lineage commitment and differentiation. Mechanistically, transcriptome and chromatin landscape analyses demonstrate that Neurod1 inactivation triggers a downregulation of endocrine differentiation transcription factors and upregulation of non-endocrine genes within the Neurod1-deficient endocrine cell population, disturbing endocrine identity acquisition. Neurod1 deficiency altered the H3K27me3 histone modification pattern in promoter regions of differentially expressed genes, which resulted in gene regulatory network changes in the differentiation pathway of endocrine cells, compromising endocrine cell potential, differentiation, and functional properties.

The flubbed body: Pathological body size representation in personal neglect.

Personal Neglect (PN) is a disorder in which patients fail to attend or explore the contralateral side of their body. An increasing number of studies have considered PN as a form of body representation disorder frequently observed following damage to parietal areas. The extent and the direction of the body misrepresentation is still unclear with recent studies suggesting a general reduction of contralesional hand size. However, little is known about the specificity of this representation and whether the misrepresentation also generalises to other body parts. We explored the features of the representation of the hands and face in a group of 9 right brain damaged patients with (PN+) and without PN (PN-), when compared to a healthy control group. For this, we used a body size estimation task with pictures, in which patients were required to choose the one that most closely matched the perceived size of their body part. We found that PN + patients showed a labile body representation for both hands and face, having a larger distorted representational range. Interestingly, in comparison with PN + patients and healthy controls, PN- patients also showed misrepresentation of the left contralesional hand which could be related to impaired motor performance of their upper limb. Our findings are discussed within a theoretical framework suggesting a reliance on multisensory integration (body representation, ownership, and motor influences) for an ordered representation of the size of the body.

ISL1 controls pancreatic alpha cell fate and beta cell maturation.

BACKGROUND: Glucose homeostasis is dependent on functional pancreatic α and ß cells. The mechanisms underlying the generation and maturation of these endocrine cells remain unclear. RESULTS: We unravel the molecular mode of action of ISL1 in controlling α cell fate and the formation of functional ß cells in the pancreas. By combining transgenic mouse models, transcriptomic and epigenomic profiling, we uncover that elimination of Isl1 results in a diabetic phenotype with a complete loss of α cells, disrupted pancreatic islet architecture, downregulation of key ß-cell regulators and maturation markers of ß cells, and an enrichment in an intermediate endocrine progenitor transcriptomic profile. CONCLUSIONS: Mechanistically, apart from the altered transcriptome of pancreatic endocrine cells, Isl1 elimination results in altered silencing H3K27me3 histone modifications in the promoter regions of genes that are essential for endocrine cell differentiation. Our results thus show that ISL1 transcriptionally and epigenetically controls α cell fate competence, and ß cell maturation, suggesting that ISL1 is a critical component for generating functional α and ß cells.

Selective effects of a brain tumor on the metric representation of the hand: a pre- versus post-surgery comparison.

Body representation disorders are complex, varied, striking, and very disabling in most cases. Deficits of body representation have been described after lesions to multimodal and sensorimotor cortical areas. A few studies have reported the effects of tumors on the representation of the body, but little is known about the changes after tumor resection. Moreover, the impact of brain lesions on the hand size representation has been investigated in few clinical cases. Hands are of special importance, as no other body part has the ability for movement and interaction with the environment that the hands have, and we use them for a multitude of daily activities. Studies with clinical population can add further knowledge into the way hands are represented. Here, we report a single case study of a patient (AM) who was an expert bodybuilder and underwent a surgery to remove a glioblastoma in the left posterior prefrontal and precentral cortex at the level of the hand's motor region. Pre- (20 days) and post- (4 months) surgery assessment did not show any motor or cognitive impairments. A hand localization task was used, before and after surgery (12 months), to measure possible changes of the metric representation of his right hand. Results showed a post-surgery modulation of the typically distorted hand representation, with an overall accuracy improvement, especially on width dimension. These findings support the direct involvement of sensorimotor areas in the implicit representation of the body size and its relevance on defining specific size representation dimensions.

Prevalence and associated factors of mental health outcomes among healthcare workers in Northern Colombia: A cross-sectional and multi-centre study.

Background: Mental health outcomes in Healthcare Workers (HCWs) has been few evaluated during COVID-19 pandemic in low-and middle-income countries. Our aim was carry-out a study to identify the prevalence of stress, anxiety, depressive symptoms in HCWs and associated factors to severe illness in a northern region in Colombia. Method: A cross-sectional, hospital-based survey was conducted to assess mental health outcomes in 1,149 HCWs in Colombia. The study used Perceived Stress Scale (PSS-10), 7-item Generalized Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) to evaluate stress, anxiety, and depression symptoms, respectively. Results: 682 HCWs completed the questionnaire. The 58,21% (397/682) were nurses, 31,23% were physicians (213/682), and 10,56% (72/682) were other health professionals. The proportion of HCWs with stress, anxiety, and depressive symptoms were 59,97%, 44,87%, and 23,02%, respectively. HCWs in emergency room and Intensive Care Units (ICU) have 2-3-fold increase risk to have severe symptoms of stress. Staff in ICU have 64% more likely to have severe anxiety symptoms, and 97% more likely to have severe depression symptoms. Limitations: Including HCWs only in the northern region in Colombia; a non-probabilistic sample, and a cross-sectional design to identify causality. Conclusion: A higher proportion on mental health outcomes has been reported in HCWs in Colombia. There are work areas related with severe mental symptoms such as ICU and emergency room. Hospitals and patient-care institutions in Latin-America needs consider the mental and physical health of HCWs during outbreaks and identify health staff at-risk to implementing support strategies to mitigate adverse mental outcomes.

Impact of antimicrobial stewardship programs on antibiotic consumption and antimicrobial resistance in four Colombian healthcare institutions.

BACKGROUND: Antimicrobial stewardship programs (ASPs) have become a fundamental pillar in optimizing antimicrobial usage, improving patient care, and reducing antimicrobial resistance (AMR). Herein we evaluated the impact of an ASP on antimicrobial consumption and AMR in Colombia. METHODS: We designed a retrospective observational study and measured trends in antibiotic consumption and AMR before and after the implementation of an ASP using interrupted time series analysis over a 4-year period (24 months before and 24 months after ASP implementation). RESULTS: ASPs were implemented according to the available resources in each of the institutions. Before ASP implementation, there was a trend toward an increase in the antibiotic consumption of all measured antimicrobials selected. Afterward, an overall decrease in antibiotic consumption was observed. The use of ertapenem and meropenem decreased in hospital wards, while a decrease in the use of ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, and vancomycin was observed in intensive care units. After ASP implementation, the trend toward an increase of oxacillin-resistant Staphylococcus aureus, ceftriaxone-resistant Escherichia coli, and meropenem-resistant Pseudomonas aeruginosa was reversed. CONCLUSIONS: In our study, we showed that ASPs are a key strategy in tackling the emerging threat of AMR and have a positive impact on antibiotic consumption and resistance.

Occipital encephalocele associated with Dandy-Walker malformation: a case-based review.

INTRODUCTION: Occipital encephalocele is a brain malformation that has been remotely associated with Dandy-Walker; only case reports and very small series have been published so far; therefore, their behavior and management are still under investigation. The goal of the present case-based review is to provide a summary of the state of the art in this association. METHODS AND RESULTS: The pertinent literature has been reviewed, and an exemplary case has been reported (an 11-month-old female with Dandy-Walker malformation and occipital encephalocele). So far, 33 cases have been described, with a mean age at surgery of 5, 1 day). The majority of the cases tend to present with hydrocephalus. There are no specific surgery approaches or global consensus about this association. The management possibly relies on surgery with shunt or encephalocele excision but without a dedicated protocol yet. CONCLUSIONS: The clinical research on occipital encephalocele in association with Dandy-Walker malformation is just at the beginning. New targets and wide-ranging clinical trials are needed to get an optimal management protocol.

The signing body: extensive sign language practice shapes the size of hands and face.

The representation of the metrics of the hands is distorted, but is susceptible to malleability due to expert dexterity (magicians) and long-term tool use (baseball players). However, it remains unclear whether modulation leads to a stable representation of the hand that is adopted in every circumstance, or whether the modulation is closely linked to the spatial context where the expertise occurs. To this aim, a group of 10 experienced Sign Language (SL) interpreters were recruited to study the selective influence of expertise and space localisation in the metric representation of hands. Experiment 1 explored differences in hands' size representation between the SL interpreters and 10 age-matched controls in near-reaching (Condition 1) and far-reaching space (Condition 2), using the localisation task. SL interpreters presented reduced hand size in near-reaching condition, with characteristic underestimation of finger lengths, and reduced overestimation of hands and wrists widths in comparison with controls. This difference was lost in far-reaching space, confirming the effect of expertise on hand representations is closely linked to the spatial context where an action is performed. As SL interpreters are also experts in the use of their face with communication purposes, the effects of expertise in the metrics of the face were also studied (Experiment 2). SL interpreters were more accurate than controls, with overall reduction of width overestimation. Overall, expertise modifies the representation of relevant body parts in a specific and context-dependent manner. Hence, different representations of the same body part can coexist simultaneously.

Bloodstream Infections With Candida auris Among Children in Colombia: Clinical Characteristics and Outcomes of 34 Cases.

BACKGROUND: Candida auris is an emerging multidrug-resistant yeast that can cause invasive infections and healthcare-associated outbreaks. Here, we describe 34 cases of pediatric C. auris bloodstream infections (BSIs) identified during July 2014-October 2017 in 2 hospitals in Colombia. METHODS: We conducted a retrospective review of microbiology records for possible C. auris cases in 2 hospitals in Barranquilla and Cartagena. BSIs that occurred in patients aged <18 years confirmed as C. auris were included in this analysis. RESULTS: We identified 34 children with C. auris BSIs. Twenty-two (65%) patients were male, 21% were aged <28 days, 47% were aged 29-365 days, and 32% were aged >1 year. Underlying conditions included preterm birth (26%), being malnourished (59%), cancer (12%), solid-organ transplant (3%), and renal disease (3%). Eighty-two percent had a central venous catheter (CVC), 82% were on respiratory support, 56% received total parenteral nutrition (TPN), 15% had a surgical procedure, and 9% received hemodialysis. Preinfection inpatient stay was 22 days (interquartile range, 19-33 days), and in-hospital mortality was 41%. CONCLUSIONS: Candida auris affects children with a variety of medical conditions including prematurity and malignancy, as well as children with CVCs and those who receive TPN. Mortality was high, with nearly half of patients dying before discharge. However, unlike most other Candida species, C. auris can be transmitted in healthcare settings, as suggested by the close clustering of cases in time at each of the hospitals.Candida auris is an emerging multidrug-resistant yeast that can cause invasive infections and healthcare-associated outbreaks. This report describes 34 cases of pediatric C. auris bloodstream infections, identified in two hospitals in Colombia, South America.

Felicidad y Salud: evidencias científicas. Revisión bibliográfica / Happiness and Health: scientific evidence. Bibliographic review

OBJETIVO: Comprobar la relación entre felicidad y salud. Material y MÉTODOS: Se encontraron un total de 863 artículos que fueron seleccionados inicialmente. Se procedió a la revisión de los resúmenes de esta selección y se verificó el tema de búsqueda y la duplicación de artículos. Se seleccionaron inicialmente 37 artículos y de estos se excluyeron 18 por no cumplir los criterios de inclusión o porque no se pudo obtener acceso al texto completo. Finalmente se incluyeron en la investigación 19 artículos para ser revisados a profundidad. RESULTADOS:19 artículos seleccionados. CONCLUSIONES: podemos señalar que mayores niveles de bienestar y felicidad influyen de forma positiva en la salud de las personas, disminuyendo el riesgo cardiovascular, los estados inflamatorios, incluso retrasando el envejecimiento celular. Investigaciones posteriores deberán profundizar en su análisis a fin de solventar algunas limitaciones presentes en los artículos revisados

OBJECTIVE: To check the relationship between happiness and health. MATERIAL AND METHODS: A total of 863 articles were found that were initially selected. The abstracts of this selection were reviewed and the search topic and duplication of articles were verified. 37 articles were initially selected and 18 of these were excluded because they did not meet the inclusion criteria or because the full text could not be accessed. Finally, 19 articles were included in the investigation to be reviewed in depth. RESULTS:19 selected articles. CONCLUSIONS: We can point out that higher levels of well-being and happiness positively influence people's health, decreasing cardiovascular risk, inflammatory states, even delaying cellular aging. Subsequent investigations should deepen their analysis in order to overcome some limitations present in the articles reviewed

The downsized hand in personal neglect.

Introduction: Personal neglect (PN) refers to a form of hemi-inattention toward the contralesional body space and it usually occurs following a right brain lesion. Recent studies suggest that PN indicates a disorder of body representation. Specifically, patients with PN show difficulties in identifying differences between left and right hands and have an altered visuospatial body map, which is associated with disrupted mental body representations. However, the metric representation of the body, and in particular the hands, has not been systematically addressed in patients showing this form of neglect. Method: In the present study, we have investigated this representation by testing the perceived hands' width of 11 hemiplegic patients with right hemisphere cerebral lesions (5 with PN) and 12 healthy controls on a judgment of passability task. Patients and controls were asked to imagine inserting their hand (left and right) through a series of vertical apertures of different sizes and to judge whether their hand could fit through. Due to the heterogeneity of the data, both parametric and non-parametric approaches were used. Furthermore, additional single-case analyses were conducted. Results: Study findings showed that patients with PN showed a significant underestimation of the left hand compared with their right hand. In contrast, whilst the right hand was equally distorted in both patients' groups, the hemiplegic patients with no evidence of PN tended to perceive the affected hand as larger than their ipsilesional one. Conclusions: In line with the literature, our findings confirm an underlying distorted body representation following right brain damage. However, for the first time, we report both a quantitative and qualitative difference in impact of hemiplegia and PN on body representation of the contralesional body space.

Type and Consequences of Short-Term Complications in Colon Cancer Surgery, Focusing on the Oldest Old.

BACKGROUND: While the proportion of colon cancer occurring in older patients is expected to increase, these patients may have more complications that may lead to serious consequences. The aim of this study was assess postoperative complications and their short-term consequences in colon cancer surgery according to age. PATIENTS AND METHODS: Patients undergoing surgery for primary invasive colon cancer in 22 centers between June 2010 and December 2012 were included. Presurgical and surgical variables were analyzed, and in-hospital major postoperative complications and its most serious consequence (no relevant, transfusion, reintervention, admission to the intensive care unit, or death) were estimated according to age group. Chi-square tests were used to analyze the possible associations between variables and age groups. RESULTS: Data from 1976 patients, mean (range) age 68 (24-97) years, 62% men, were analyzed; 52.2% were aged > 69 years and 17.7% were aged > 79 years. The complication rate was 25.3%, reaching 30.9% in those aged ≥ 80 years. Older age was associated with a higher rate of postoperative infections during the hospital stay. The most common surgical complication in patients aged > 85 years was dehiscence of the anastomosis (11.5%). About 5% of patients with major complications died in the hospital (11.1% of those aged 80-84 years and 14.3% aged > 85 years). Among patients aged > 85 years, 38.1% required transfusions. CONCLUSION: Older patients should receive appropriate functional preparation before the intervention, and when the risks of the intervention outweigh the potential benefits, a nonsurgical approach may be preferable.

¿Asma profesional o agravada por el trabajo? / Occupational asthma or work-exacerbated asthma?

En los últimos años se viene observando un aumento de la prevalencia de asma siendo la exposición laboral uno de los factores condicionantes. Se llama asma laboral al que es inducido por la exposición a una sustancia en el lugar de trabajo y asma agravada por el trabajo a la que existe previamente y se exacerba en el trabajo. Para realizar un diagnóstico correcto es necesario una alta sospecha y relacionar temporalmente los síntomas y el trabajo. Un diagnóstico incorrecto produce consecuencias socio-económicas para el paciente. En el Real Decreto 1299/2006 de 10 noviembre (modificado el 4 de mayo de 2018) se establecen criterios para su clasificación y registro. Ante un proceso alérgico debe contemplarse la etiología laboral y los médicos del trabajo de los servicios de prevención de riesgos laborales hospitalarios pueden actuar como consultores para orientar y manejar estos casos. En este caso que se presenta se estableció una asociación entre la exposición laboral y el asma sufrido por la paciente, lo cual llevó, mediante una serie de procesos, a establecer su patología como enfermedad profesional

Currently there is an increase in the prevalence of asthma and it seems that occupational exposure is one of the factors contributing to this increase. "Occupational asthma" refers to new onset asthma induced by exposure to a substance in the workplace, whereas "work-aggravated asthma" refers to pre-existing asthma that is then exacerbated in the workplace. A correct diagnosis requires a high index of suspicion and establishing a temporal relationship between symptoms and work. An in-correct diagnosis can lead to important socioeconomic consequences for the worker. In Spain, Royal Order 1299/2006 on 10 November (amended on May 4, 2018) establishes the criteria for its classification and official recognition. In the context of an allergic process, an occupational etiology should be considered and occupational physicians in an occupational health service can serve as consultants to guide and manage these cases. In this case report we established an association between an occupational exposure and asthma in a worker which led to a series of steps resulting in its acceptance as an occupational disease

[Occupational Asthma or Work-exacerbated asthma?] / ¿Asma profesional o agravada por el trabajo?

Currently there is an increase in the prevalence of asthma and it seems that occupational exposure is one of the factors contributing to this increase. "Occupational asthma" refers to new onset asthma induced by exposure to a substance in the workplace, whereas "workaggravated asthma" refers to pre-existing asthma that is then exacerbated in the workplace. A correct diagnosis requires a high index of suspicion and establishing a temporal relationship between symptoms and work. An incorrect diagnosis can lead to important socioeconomic consequences for the worker. In Spain, Royal Order 1299/2006 on 10 November (amended on May 4, 2018) establishes the criteria for its classification and official recognition. In the context of an allergic process, an occupational etiology should be considered and occupational physicians in an occupational healht service can serve as consultants to guide and manage these cases. In this case report we established an association between an occupational exposure and asthma in a worker which led to a series of steps resulting in its acceptance as an occupational disease.

En los últimos años se viene observando un aumento de la prevalencia de asma siendo la exposición laboral uno de los factores condicionantes. Se llama asma laboral al que es inducido por la exposición a una sustancia en el lugar de trabajo y asma agravada por el trabajo a la que existe previamente y se exacerba en el trabajo. Para realizar un diagnóstico correcto es necesario una alta sospecha y relacionar temporalmente los síntomas y el trabajo. Un diagnóstico incorrecto produce consecuencias socio-económicas para el paciente. En el Real Decreto 1299/2006 de 10 noviembre (modificado el 4 de mayo de 2018) se establecen criterios para su clasificación y registro. Ante un proceso alérgico debe contemplarse la etiología laboral y los médicos del trabajo de los servicios de prevención de riesgos laborales hospitalarios pueden actuar como consultores para orientar y manejar estos casos. En este caso que se presenta se estableció una asociación entre la exposición laboral y el asma sufrido por la paciente, lo cual llevó, mediante una serie de procesos, a establecer su patología como enfermedad profesional.

The magic hand: Plasticity of mental hand representation.

Internal spatial body configurations are crucial to successfully interact with the environment and to experience our body as a three-dimensional volumetric entity. These representations are highly malleable and are modulated by a multitude of afferent and motor information. Despite some studies reporting the impact of sensory and motor modulation on body representations, the long-term relationship between sensory information and mental representation of own body parts is still unclear. We investigated hand representation in a group of expert sleight-of-hand magicians and in a group of age-matched adults naïve to magic (controls). Participants were asked to localise landmarks of their fingers when their hand position was congruent with the mental representation (Experiment 1) and when proprioceptive information was "misleading" (Experiment 2). Magicians outperformed controls in both experiments, suggesting that extensive training in sleight of hand has a profound effect in refining hand representation. Moreover, the impact of training seems to have a high body-part specificity, with a maximum impact for those body sections used more prominently during the training. Interestingly, it seems that sleight-of-hand training can lead to a specific improvement of hand mental representation, which relies less on proprioceptive information.

My true face: Unmasking one's own face representation.

Face recognition has been the focus of multiple studies, but little is still known on how we represent the structure of one's own face. Most of the studies have focused on the topic of visual and haptic face recognition, but the metric representation of different features of one's own face is relatively unknown. We investigated the metric representation of the face in young adults by developing a proprioceptive pointing task to locate face landmarks in the first-person perspective. Our data revealed a large overestimation of width for all face features which resembles, in part, the size in somatosensory cortical representation. In contrast, face length was compartmentalised in two different regions: upper (underestimated) and bottom (overestimated); indicating size differences possibly due to functionality. We also identified shifts of the location judgments, with all face areas perceived closer to the body than they really were, due to a potential influence of the self-frame of reference. More importantly, the representation of the face appeared asymmetrical, with an overrepresentation of right side of the face, due to the influence of lateralization biases for strong right-handers. We suggest that these effects may be due to functionality influences and experience that affect the construction of face structural representation, going beyond the parallel of the somatosensory homunculus.