Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella pneumoniae Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis.

BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) on antimicrobial use (AU) and resistance has not been well evaluated in South America. These data are critical to inform national policies and clinical care. METHODS: At a tertiary hospital in Santiago, Chile, between 2018 and 2022, subdivided into pre- (3/2018-2/2020) and post-COVID-19 onset (3/2020-2/2022), we evaluated intravenous AU and frequency of carbapenem-resistant Enterobacterales (CRE). We grouped monthly AU (defined daily doses [DDD]/1000 patient-days) into broad-spectrum ß-lactams, carbapenems, and colistin and used interrupted time-series analysis to compare AU during pre- and post-pandemic onset. We studied the frequency of carbapenemase-producing (CP) CRE and performed whole-genome sequencing analyses of all carbapenem-resistant (CR) Klebsiella pneumoniae (CRKpn) isolates collected during the study period. RESULTS: Compared with pre-pandemic, AU (DDD/1000 patient-days) significantly increased after the pandemic onset, from 78.1 to 142.5 (P < .001), 50.9 to 110.1 (P < .001), and 4.1 to 13.3 (P < .001) for broad-spectrum ß-lactams, carbapenems, and colistin, respectively. The frequency of CP-CRE increased from 12.8% pre-COVID-19 to 51.9% after pandemic onset (P < .001). The most frequent CRE species in both periods was CRKpn (79.5% and 76.5%, respectively). The expansion of CP-CRE harboring blaNDM was particularly noticeable, increasing from 40% (n = 4/10) before to 73.6% (n = 39/53) after pandemic onset (P < .001). Our phylogenomic analyses revealed the emergence of two distinct genomic lineages of CP-CRKpn: ST45, harboring blaNDM, and ST1161, which carried blaKPC. CONCLUSIONS: AU and the frequency of CP-CRE increased after COVID-19 onset. The increase in CP-CRKpn was driven by the emergence of novel genomic lineages. Our observations highlight the need to strengthen infection prevention and control and antimicrobial stewardship efforts.

Assessing the utility of marine filter feeders for environmental DNA (eDNA) biodiversity monitoring.

Aquatic environmental DNA (eDNA) surveys are transforming how marine ecosystems are monitored. The time-consuming preprocessing step of active filtration, however, remains a bottleneck. Hence, new approaches that eliminate the need for active filtration are required. Filter-feeding invertebrates have been proven to collect eDNA, but side-by-side comparative studies to investigate the similarity between aquatic and filter-feeder eDNA signals are essential. Here, we investigated the differences among four eDNA sources (water; bivalve gill-tissue; sponges; and ethanol in which filter-feeding organisms were stored) along a vertically stratified transect in Doubtful Sound, New Zealand using three metabarcoding primer sets targeting fish and vertebrates. Combined, eDNA sources detected 59 vertebrates, while concurrent diver surveys observed eight fish species. There were no significant differences in alpha and beta diversity between water and sponge eDNA and both sources were highly correlated. Vertebrate eDNA was successfully extracted from the ethanol in which sponges were stored, although a reduced number of species were detected. Bivalve gill-tissue dissections, on the other hand, failed to reliably detect eDNA. Overall, our results show that vertebrate eDNA signals obtained from water samples and marine sponges are highly concordant. The strong similarity in eDNA signals demonstrates the potential of marine sponges as an additional tool for eDNA-based marine biodiversity surveys, by enabling the incorporation of larger sample numbers in eDNA surveys, reducing plastic waste, simplifying sample collection, and as a cost-efficient alternative. However, we note the importance to not detrimentally impact marine communities by, for example, nonlethal subsampling, specimen cloning, or using bycatch specimens.

Creación del primer biorrepositorio nacional de bacterias multirresistentes disponible para el estudio de la resistencia bacteriana en Chile

La disponibilidad de cepas bacteriana para el estudio de la resistencia bacteriana es clave para los avances en la investigación básica y clínica respecto del tema. Existen pocos biorrepositorios o bancos de bacterias con mecanismos de resistencia conocidos, aisladas de infecciones clínicamente significativas. Una revisión de la literatura revela que sólo en los Estados Unidos de América existe un biobanco de aislados resistentes disponibles para estudios. En esta publicación se cuenta cómo se creó el primer biorrepositorio de bacterias resistentes en Chile asociados a la Red de Laboratorios MICROB-R, con la participación de 11 centros distribuidos a lo largo del país, que a la fecha cuenta con más de 3.500 aislados bacterianos estudiados fenotípica y genotípicamente, disponibles para la comunidad científica chilena.

The availability of bacterial strains for the study of bacterial resistance is key to advances in basic and clinical research. There are few biobanks of bacteria with known resistance mechanisms, isolated from clinically significant infections. A review of the literature reveals that only in the United States of America is there a biobank of resistant isolates. This publication shows the creation of the first biorepository of resistant bacteria Chile associated with the MICROB-R Laboratory Network, with the participation of 11 centers distributed throughout the country, which to date has more than 3,500 bacterial isolates studied phenotypically and genotypically, available to the Chilean scientific community.

Meal timing across the day modulates daily energy intake in adult patients with type 2 diabetes.

BACKGROUND/OBJECTIVES: We assessed the association between the timing of meals across the day with diet composition and metabolic parameters in patients with type-2 diabetes (T2D). SUBJECTS/METHODS: Eighty adults (55.2 ± 6.8 years, 45% males) patients with T2D (without insulin therapy) were included. Three non-consecutive dietary records assessed food intake. The onset time of each consumed meal/beverage was identified and assigned to one of three periods of the day: Period 1 (P1, 06:00-11:59 h), Period 2 (P2, 12:00-17:59 h), and Period 3 (P3, 18:00-00:30 h). RESULTS: Energy intake in P1 was lower compared to P2 and P3 (22.8 ± 7.9%, 37.5 ± 9.6%, and 39.7 ± 9.9%, respectively, P < 0.001). The same pattern was found for both total protein and fat intake, but carbohydrate intake was similar among periods. Patients with greater daily energy intake (as % of total energy) in P3 showed increased total food consumption, total energy, protein, and fat intake (all P < 0.05). The opposite pattern was observed in patients with greater daily energy intake in P1 (all P < 0.05). Regression analysis showed that daily energy intake was significantly reduced when a higher proportion of carbohydrates was eaten in P1 (vs. P3, P < 0.04). CONCLUSION: Increased energy intake late during the day is related to increased total food and daily energy intake in patients with T2D. A greater proportion of total carbohydrates eaten early during the day relates to lower total energy intake. Our results suggest that earlier food intake may be a nutritional tool for dietary and metabolic control in these patients.

Real-World Performance of Susceptibility Testing for Ceftolozane/Tazobactam against Non-Carbapenemase-Producing Carbapenem-Resistant Pseudomonas aeruginosa.

Ceftolozane/tazbactam (C/T) is a potent anti-pseudomonal agent that has clinical utility against infections caused by non-carbapenemase, producing-carbapenem-resistant Pseudomonas aeruginosa (non-CP-CR-PA). Accurate, precise, and reliable antimicrobial susceptibility testing (AST) is crucial to guide clinical decisions. However, studies assessing the performance of different AST methods against non-CP-CR-PA (the main clinical niche for C/T), are lacking. Here, we evaluated performance of gradient strips (Etest and MIC test strip [MTS], and disk diffusion [DD]) using CLSI breakpoints. Additionally, we assessed the performance of DD using EUCAST breakpoints. For all susceptibility tests, we used a collection of 97 non-CP-CR-PA clinical isolates recovered from 11 Chilean hospitals. Both gradient strips and DD had acceptable performance when using CLSI breakpoints, yielding a categorical agreement (CA) of >90% and 92%, respectively. In contrast, DD using EUCAST breakpoints performed suboptimally (CA 81%). MTS yielded a higher essential agreement (EA, >90%) than Etest (84%). Importantly, the performance of all methods varied significantly when the isolates were stratified by their degree of susceptibility to other anti-pseudomonal ß-lactams. All methods had 100% CA when testing isolates that were pan-susceptible to all ß-lactams (Pan-ß-S). However, the CA markedly decreased when testing isolates resistant to all ß-lactams (Pan-ß-R). Indeed, the CA was 81% for Etest (six errors), 78% for MTS (seven errors), and 78% and 56% for DD when using CLSI (seven errors) or EUCAST breakpoints (14 errors), respectively. Our results suggest that all manual AST methods have strikingly decreased performance in the context of Pan-ß-R P. aeruginosa with potentially major clinical implications.

Stuttering intervention in children: an integrative literature review / Intervención de la tartamudez en niños: una revisión integrativa de la literatura

ABSTRACT Purpose: to describe intervention methodologies implemented in recent years in stuttering children. Methods: a search was performed for empirical articles on interventions in stuttering children aged 2.5 to 7 years. The search was carried out in Embase, WOS, Pubmed, and Scopus, considering articles published between January 2014 and June 2020. Literature Review: 11 articles were selected out of the 1,099 retrieved. Different approaches were observed, of which the Lidcombe program showed the most evidence. Most studies were conducted on English-speaking children and participants were assessed regarding linguistic and non-linguistic aspects. All studies considered parental involvement in the intervention. No investigation took measurements for more than 24 months. Individual interventions predominated. Conclusion: good therapeutic results were found in all reviewed interventions. Research comparing two types of treatments did not find one to be superior to the other.

RESUMEN Objetivo: describir las metodologías de intervención implementadas durante los últimos años en niños con tartamudez Métodos: se realizó la búsqueda de artículos empíricos de tratamiento en niños con tartamudez entre los 2.5 a 7 años. Se consideraron artículos publicados entre enero del año 2014 a junio del año 2020. La búsqueda se realizó en las bases de datos Embase, WOS, Pubmed y Scopus. Junto a lo anterior se realizó un análisis de las referencias de los artículos seleccionados. Revisión de la Literatura: se seleccionaron 11 artículos de 1.099 revisados. Se observaron distintas propuestas de intervención de las cuales el Programa Lidcombe es el que mayor evidencia presenta. La mayoría de las investigaciones fueron realizadas en hablantes de lengua inglesa. Los participantes son evaluados tanto en aspectos lingüísticos como no lingüísticos. Todos consideraron la participación de los padres en la intervención. No hubo investigaciones con mediciones a más de 24 meses. Predomina la modalidad de intervención individual. Conclusión: se evidencian buenos resultados terapéuticos en todas las intervenciones revisadas. En las investigaciones que compararon dos tipos de tratamiento no se observó la superioridad de uno por sobre otro.

CRISPR/Cas13-Based Platforms for a Potential Next-Generation Diagnosis of Colorectal Cancer through Exosomes Micro-RNA Detection: A Review.

Colorectal cancer (CRC) is the third most prevalent cancer with the second highest mortality rate worldwide. CRC is a heterogenous disease with multiple risk factors associated, including obesity, smoking, and use of alcohol. Of total CRC cases, 60% are diagnosed in late stages, where survival can drop to about 10%. CRC screening programs are based primarily on colonoscopy, yet this approach is invasive and has low patient adherence. Therefore, there is a strong incentive for developing molecular-based methods that are minimally invasive and have higher patient adherence. Recent reports have highlighted the importance of extracellular vesicles (EVs), specifically exosomes, as intercellular communication vehicles with a broad cargo, including micro-RNAs (miRNAs). These have been syndicated as robust candidates for diagnosis, primarily for their known activities in cancer cells, including immunoevasion, tumor progression, and angiogenesis, whereas miRNAs are dysregulated by cancer cells and delivered by cancer-derived exosomes (CEx). Quantitative polymerase chain reaction (qPCR) has shown good results detecting specific cancer-derived exosome micro-RNAs (CEx-miRNAs) associated with CRC, but qPCR also has several challenges, including portability and sensitivity/specificity issues regarding experiment design and sample quality. CRISPR/Cas-based platforms have been presented as cost-effective, ultrasensitive, specific, and robust clinical detection tools in the presence of potential inhibitors and capable of delivering quantitative and qualitative real-time data for enhanced decision-making to healthcare teams. Thereby, CRISPR/Cas13-based technologies have become a potential strategy for early CRC diagnosis detecting CEx-miRNAs. Moreover, CRISPR/Cas13-based platforms' ease of use, scalability, and portability also showcase them as a potential point-of-care (POC) technology for CRC early diagnosis. This study presents two potential CRISPR/Cas13-based methodologies with a proposed panel consisting of four CEx-miRNAs, including miR-126, miR-1290, miR-23a, and miR-940, to streamline novel applications which may deliver a potential early diagnosis and prognosis of CRC.

Zinc absorption and zinc status are reduced after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women with severe obesity studied prospectively over 24 postoperative months.

BACKGROUND: Roux-en-Y gastric bypass (RYGBP) is known to reduce zinc absorption; the effects of vertical sleeve gastrectomy (SG) and its long-term implications on zinc absorption have not yet been studied. OBJECTIVE: The aim was to evaluate the effects of SG and RYGBP on zinc absorption and zinc status in premenopausal women with severe obesity up to 24 mo after surgery. METHODS: Twenty-six premenopausal women undergoing SG [BMI (in kg/m2): 37.3 ± 3.2] and 32 undergoing RYGBP (BMI: 42.0 ± 4.2) were studied. A series of anthropometric, dietary, and zinc status parameters (plasma and hair zinc), and the size of the exchangeable zinc pool (EZP), as well as percentage zinc absorption from a standardized dose using a stable isotope methodology were evaluated in the patients before the surgical procedure and at 12 and 24 mo after SG or RYGBP. SG patients received 15 mg and RYGBP received 25 mg of supplemental Zn/d. RESULTS: In premenopausal women, zinc absorption was decreased by 71.9% and 52.0% in SG and RYGBP, respectively, 24 mo postsurgery, compared with initial values. According to 2-factor repeated-measures ANOVA, time effect was significant (P = <0.0001), but not time × group interaction (P = 0.470). Plasma zinc below the cutoff point of 70 µg/dL increased from 0 to 15.4% and 38.1% in SG and RYGBP, respectively. Mean EZP was significantly reduced 24 mo after surgery, although no time × group interactions were observed. Hair zinc did not change across time or between groups. CONCLUSIONS: Both SG and RYGBP have profound effects on zinc absorption capacity, which are not compensated for after 24 mo. Although zinc absorption reduction was similar in both types of surgeries, plasma zinc was more affected in RYGBP than SG, despite greater zinc supplementation in RYGBP.This trial was registered at http://www.isrctn.com as ISRCTN31937503.

Prunus Hexokinase 3 genes alter primary C-metabolism and promote drought and salt stress tolerance in Arabidopsis transgenic plants.

Hexokinases (HXKs) and fructokinases (FRKs) are the only two families of enzymes in plants that have been identified as able to phosphorylate Glucose (Glc) and Fructose (Fru). Glc can only be phosphorylated in plants by HXKs, while Fru can be phosphorylated by either HXKs or FRKs. The various subcellular localizations of HXKs in plants indicate that they are involved in diverse functions, including anther dehiscence and pollen germination, stomatal closure in response to sugar levels, stomatal aperture and reducing transpiration. Its association with modulating programmed cell death, and responses to oxidative stress and pathogen infection (abiotic and biotic stresses) also have been reported. To extend our understanding about the function of HXK-like genes in the response of Prunus rootstocks to abiotic stress, we performed a detailed bioinformatic and functional analysis of hexokinase 3-like genes (HXK3s) from two Prunus rootstock genotypes, 'M.2624' (Prunus cerasifera Ehrh × P. munsoniana W.Wight & Hedrick) and 'M.F12/1' (P. avium L.), which are tolerant and sensitive to hypoxia stress, respectively. A previous large-scale transcriptome sequencing of roots of these rootstocks, showed that this HXK3-like gene that was highly induced in the tolerant genotype under hypoxia conditions. In silico analysis of gene promoters from M.2624 and M.F12/1 genotypes revealed regulatory elements that could explain differential transcriptional profiles of HXK3 genes. Subcellular localization was determinates by both bioinformatic prediction and expression of their protein fused to the green fluorescent protein (GFP) in protoplasts and transgenic plants of Arabidopsis. Both approaches showed that they are expressed in plastids. Metabolomics analysis of Arabidopsis plants ectopically expressing Prunus HXK3 genes revealed that content of several metabolites including phosphorylated sugars (G6P), starch and some metabolites associated with the TCA cycle were affected. These transgenic Arabidopsis plants showed improved tolerance to salt and drought stress under growth chamber conditions. Our results suggest that Prunus HXK3 is a potential candidate for enhancing tolerance to salt and drought stresses in stone fruit trees and other plants.

Evaluación de la composicion corporal antes y después de la reducción de peso con baipás gastrico en Y de Roux. ¿Son confiables las mediciones de la bioimpedanciometría? / Body composition assessment before and after weight loss following a Roux-en-Y gastric bypass. Are bioimpedanciometry estimations reliable?

INTRODUCCIÓN: en pacientes con obesidad severa y mórbida se ha observado que la evaluación por bioimpedanciometría (BIA) genera una subestimación de la masa grasa (MG) y del peso perdido como MG después de la cirugía bariátrica, sobreestimándose la pérdida de masa libre de grasa (MLG) y la masa muscular. OBJETIVO: evaluar la confiabilidad de la BIA para estimar el agua corporal total (ACT), la MLG, la MG y sus cambios después de 6 meses de un baipás gástrico en Y de Roux (BPGYR) en pacientes con obesidad severa y mórbida. MÉTODOS: 36 adultos con indicación de BPGYR se estudiaron prospectivamente. Se midió el ACT por deuterio (D) y se calcularon la MLG y MG. Con BIA de doble frecuencia (5 y 200 kHz) (Bodystat Dualscan(R)) se estimaron la MG, la MLG, el ACT, el agua extracelular (AEC), el agua intracelular (AIC) y la relación AEC/AIC. RESULTADOS: antes del BPGYR, la BIA sobreestimó el ACT en 2,6 ± 4,3 L (p = 0,002) y la MLG en 3,5 ± 5,7 kg (p = 0,002), y subestimó el %MG en 2,98 ± 4,7% (p = 0,002). La relación AEC/AIC mostró una correlación positiva con la sobreestimación de la MLG por BIA (r = 0,49; p = 0,002). Después de la cirugía, las diferencias entre BIA y D no fueron significativas y el error de estimación de la MLG no se correlacionó con la relación AEC/AIC. CONCLUSIONES: la BIA genera una subestimación de la MG como la reportada, la cual se atenúa después de la reducción de peso, subestimando el peso perdido como MG y sobreestimando la pérdida de MLG. Futuras investigaciones podrán evaluar si estos errores se reproducen con otros equipos de BIA

INTRODUCTION: in patients with severe and morbid obesity it has been observed that bioimpedance (BIA) assessment generates an underestimation of fat mass (FM) and weight loss as FM after bariatric surgery, overestimating the loss of fat-free mass (FFM) and muscle mass. OBJECTIVE: to evaluate the reliability of bioelectrical impedance analysis (BIA) to estimate total body water (TBW), fat-free mass (FFM), fat mass (FM), and its changes after 6 months of a Roux-en-Y gastric bypass (RYGBP), in patients with severe and morbid obesity. METHODS: thirty-six patients approved for RYGBP were prospectively studied. TBW was measured by deuterium (D), and FM and FFM were calculated. A dual-frequency BIA device (5 and 200 kHz) (Bodystat Dualscan(R)) was used to estimate FM, FFM, TBW, extracellular water (ECW), intracellular water (ICW), and ECW/ICW ratio. RESULTS: before RYGBP, BIA overestimated TBW by 2.6 ± 4.3 L (p = 0.002) and FFM by 3.5 ± 5.7 kg (p = 0.002), and underestimated FM% by 2.98 ± 4.7% (p = 0.002). The ECW/ICW ratio showed a significant and positive correlation with the difference BIA-D for FFM (r = 0.49; p = 0.002). After surgery, the differences between BIA and D were not significant, and the estimation error of FFM did not correlate with the ECW/ICW ratio. CONCLUSIONS: BIA generates an underestimation of FM as reported in patients with severe and morbid obesity, which is attenuated after weight reduction, underestimating weight loss as FM and overestimating FFM loss. Future research may assess whether these errors are reproduced by other BIA devices

La suplementación con zinc reduce la concentración de ácidos grasos libres en pacientes con diabetes tipo 2

RESUMEN Elevadas concentraciones de ácidos grasos libres (AGL) han sido asociadas con la patogénesis de resistencia a la insulina y diabetes tipo 2 (DT2), por lo que la regulación de la lipólisis resulta prioritaria en estos pacientes. El zinc mediante sus acciones insulinomiméticas e inducción de fosfodiesterasas podría regular la liberación de AGL desde el tejido adiposo. El objetivo de esta investigación fue evaluar en pacientes con DT2 el efecto de 24 meses de suplementación con zinc sobre las concentraciones séricas de AGL en ayuno. Para este propósito: se realizó la determinación de AGL en ayuno por colorimetría enzimática, zinc plasmático por espectrofotometría de absorción atómica, y parámetros bioquímicos y antropométricos de interés en 60 pacientes con DT2 que fueron asignados aleatoriamente para recibir suplementación con 30 mg/día de zinc (n= 30) o placebo (n= 30) por 24 meses. El grupo zinc presentó menor concentración sérica de AGL al mes 24 (p = 0,034). El cambio en el índice de masa corporal, el sexo y la suplementación con zinc contribuyeron significativamente como predictores de la concentración sérica de AGL al mes 24 (R= 0,493, R2= 0,243, p= 0,001). Conclusión: la suplementación con 30 mg/día de zinc en pacientes con DT2 tuvo un efecto significativo en reducir la concentración sérica de AGL en ayuno tras 24 meses de tratamiento. Estos resultados apoyan los beneficios del zinc como coadyuvante en el tratamiento de DT2.

ABSTRACT High concentrations of free fatty acids (FFA) have been associated with the pathogenesis of insulin resistance and type 2 diabetes (T2D), making lipolysis regulation a priority in these patients. Through its insulin-mimetic actions and phosphodiesterase induction, zinc could regulate FFA release from adipose tissue. The objective of this research was to evaluate the effect of 24 months of zinc supplementation on fasting serum FFA concentrations in patients with T2D. For this purpose: fasting FFA by enzymatic colorimetric, plasma zinc by atomic absorption spectrophotometry, and biochemical and anthropometric parameter of interest were determined in 60 T2D patients who were randomly assigned to 30 mg/day of zinc supplementation (n= 30) or placebo (n= 30) for 24 months. The zinc group had lower serum FFA concentration at month 24 (p= 0.034). Body mass index change, gender, and zinc supplementation contributed significantly as predictors of serum FFA concentration at month 24 (R= 0.493, R2= 0.243, p= 0.001). Conclusion: Supplementation with 30 mg/day of zinc in patients with T2D had a significant effect in reducing serum fasting FFA concentration after 24 months of treatment. These results support the benefits of zinc as coadjutant in T2D treatment.

Preventive effectiveness of varicella vaccine in healthy unexposed patients. / Efectividad preventiva de la vacuna varicela en pacientes sanos no expuestos.

INTRODUCTION: Chickenpox is an infectious disease caused by varicella-zoster virus. Varicella vaccine is conventionally used for its prevention, and its administration seeks to reduce the onset of the disease and complications associated. However, there is still controversy about its effectiveness. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified two systematic reviews including 16 studies overall, of which three were randomized trials. We concluded that the varicella vaccine decreases the risk of contracting the disease in the long term and probably reduces the risk of developing the disease in the short term in healthy unexposed patients. Nevertheless, the vaccination increases the occurrence of local reactions 48 hours after its administration and probably increases the presence of fever and chickenpox-like rash.

INTRODUCCIÓN: La varicela es una enfermedad infectocontagiosa producida por el virus varicela-zóster. Para su prevención, convencionalmente se utiliza la vacuna varicela, cuya administración busca disminuir la aparición de enfermedad y sus complicaciones. Sin embargo, aún existe controversia sobre la efectividad. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Se identificaron dos revisiones sistemáticas que en conjunto incluyeron 16 estudios primarios, de los cuales, tres corresponden a ensayos aleatorizados. Concluimos que la vacunación contra la varicela disminuye el riesgo de contraer la enfermedad a largo plazo en pacientes sanos sin exposición previa y que probablemente disminuye el riesgo de contraer la enfermedad a corto plazo. Sin embargo, aumenta la reacción local 48 horas posterior a su administración y probablemente aumenta la aparición de fiebre y varicela-like rash.

Efectividad preventiva de la vacuna varicela en pacientes sanos no expuestos / Preventive effectiveness of varicella vaccine in healthy unexposed patients

INTRODUCCIÓN: La varicela es una enfermedad infectocontagiosa producida por el virus varicela-zóster. Para su prevención, convencionalmente se utiliza la vacuna varicela, cuya administración busca disminuir la aparición de enfermedad y sus complicaciones. Sin embargo, aún existe controversia sobre la efectividad. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Se identificaron dos revisiones sistemáticas que en conjunto incluyeron 16 estudios primarios, de los cuales, tres corresponden a ensayos aleatorizados. Concluimos que la vacunación contra la varicela disminuye el riesgo de contraer la enfermedad a largo plazo en pacientes sanos sin exposición previa y que probablemente disminuye el riesgo de contraer la enfermedad a corto plazo. Sin embargo, aumenta la reacción local 48 horas posterior a su administración y probablemente aumenta la aparición de fiebre y varicela-like rash.

INTRODUCTION: Chickenpox is an infectious disease caused by varicella-zoster virus. Varicella vaccine is conventionally used for its prevention, and its administration seeks to reduce the onset of the disease and complications associated. However, there is still controversy about its effectiveness. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified two systematic reviews including 16 studies overall, of which three were randomized trials. We concluded that the varicella vaccine decreases the risk of contracting the disease in the long term and probably reduces the risk of developing the disease in the short term in healthy unexposed patients. Nevertheless, the vaccination increases the occurrence of local reactions 48 hours after its administration and probably increases the presence of fever and chickenpox-like rash.

Fatty acid desaturation in red blood cell membranes of patients with type 2 diabetes is improved by zinc supplementation.

BACKGROUND/OBJECTIVE: Membrane flexibility can be a determining factor in pathophysiological mechanisms of type 2 diabetes (T2D). As a cofactor of delta-5 desaturase (D5D) and delta-6 desaturase (D6D), and gene expression regulator, zinc may play a role modulating membrane flexibility by increasing membrane polyunsaturated fatty acids (PUFA) abundance. The objective of this study was to evaluate the effect of a 24-month zinc supplementation (30 mg elemental zinc) on membrane fatty acid composition in patients with T2D. SUBJECTS/METHODS: Sixty patients with T2D were evaluated. Thirty were randomly assigned to the zinc supplemented group and thirty to the placebo group. Fatty acid composition in red blood cell (RBC) membranes was determined by gas chromatography. Expression of gene encoding for D5D (FADS1), and D6D (FADS2) were evaluated in peripheral blood mononuclear cells by real-time polymerase chain reaction. RESULTS: After 24 months of supplementation, a greater abundance of docosapentaenoic acid (C22:5 n-3), arachidonic acid (C20:4 n-6), adrenic acid (C22:4 n-6), and total n-6 PUFA was found (p = 0.001, p = 0.007, p = 0.033, p = 0.048, respectively). The unsaturated fatty acids/saturated fatty acids ratio, and unsaturation index was increased in the zinc supplemented group at month 24 (p = 0.003 and p  = 0.000, respectively). FADS1 gene was upregulated in the zinc group in relation to placebo at month 12 (p = 0.020). CONCLUSIONS: Supplementation with 30 mg/d elemental zinc during 24 months in patients with T2D had an effect on the composition of RBC membranes increasing PUFA abundance and in turn, improving membrane flexibility. This effect may be mediated by induction of D5D gene expression.

Comparative transcriptomic analysis reveals novel roles of transcription factors and hormones during the flowering induction and floral bud differentiation in sweet cherry trees (Prunus avium L. cv. Bing).

In sweet cherry trees, flowering is commercially important because the flowers, after fertilization, will generate the fruits. In P. avium, the flowering induction and flower organogensis are the first developmental steps towards flower formation and they occur within specialized organs known as floral buds during the summer, nine months before blooming. During this period the number of floral buds per tree and the bud fruitfulness (number of flowers per bud) are stablished affecting the potential yield of orchards and the plant architecture. The floral bud development is sensitive to any type of stress and the hotter and drier summers will interfere with this process and are calling for new adapted cultivars. A better understanding of the underlying molecular and hormonal mechanisms would be of help, but unlike the model plant Arabidopsis, very little is known about floral induction in sweet cherry. To explore the molecular mechanism of floral bud differentiation, high-throughput RNA sequencing was used to detect differences in the gene expression of P. avium floral buds at five differentiation stages. We found 2,982 differentially expressed genes during floral bud development. We identified genes associated with floral initiation or floral organ identity that appear to be useful biomarkers of floral development and several transcription factor families (ERF, MYB, bHLH, MADS-box and NAC gene family) with novel potential roles during floral transition in this species. We analyzed in deep the MADS-box gene family and we shed light about their key role during floral bud and organs development in P. avium. Furthermore, the hormonal-related signatures in the gene regulatory networks and the dynamic changes of absicic acid, zeatin and indolacetic acid contents in buds suggest an important role for these hormones during floral bud differentiation in sweet cherry. These data provide a rich source of novel informacion for functional and evolutionary studies about floral bud development in sweet cherry and new tools for biotechnology and breeding.

Determination of subtypes of Blastocystis sp. in Chilean patients with and without inflammatory bowel syndrome, A preliminary report.

BACKGROUND & METHODS: Blastocystis sp. is one of the most prevalent unicellular eukaryote of the human large intestine in Chile and worldwide. It is classified in subtypes (STs), where using the polymorphic sequences of its 18S rRNA genes currently recognizes 22. STs 1-9 and ST12 have been reported in humans. It has been hypothesized that different STs of Blastocystis sp. differentially affect the clinical severity of the digestive disease in Irritable Bowel Syndrome (IBS) patients, but more studies ar4e needed to establish this statement. To contribute in the elucidation of the potential relationship between Blastocystis sp. subtypes and IBS severity, 37 IBS patient fecal samples were collected at hospitals in Santiago (Chile) and were screened for the presence of vacuolated forms of Blastocystis sp. by using conventional microscopy. Positive samples were submitted to PCR and sequencing for determining STs. The same procedure was performed in fecal samples from five non-IBS Blastocystis sp. carriers for preliminary comparative purpose. RESULTS AND DISCUSSION: Four out of the 37 samples from the IBS patients were found positive for Blastocystis sp. (10.81%) by using microscopy. The presence of this microorganism in these four samples were confirmed by PCR and sequencing. Subtypes and their respective closest match alleles were searched and the ST1, ST2 and ST4 subtypes were found in these patients. ST4 subtype is scarcely detected in South America countries, being reported previously only in Colombia and Brazil. In this ST4 subtype we determined the allele 42 which is the most frequent allele observed in human Blastocystis isolates. In the non-IBS individuals' carriers, three subtypes were found: ST1, ST2 and ST3, even belonging to the same family group. Closest match alleles: 2, 12 and 34 here detected were also commonly reported globally. Instead of the small number of IBS patients studied here, the frequency of blastocystosis detected (10.81%) was lower than the prevalence of Blastocystis sp. infections described for the Chilean general population (30.4%). In Chile, clear correlation of Blastocystis sp. subtypes and IBS severity is still lacking with this study but it may lead and contribute to a better understanding of its pathogenicity and worldwide epidemiology.

Valores profesionales de enfermería en el posmodernismo: una revisión sistemática / Valores profissionais de enfermagem no posmodernismo: uma revisão sistemática / Professional values of nursing in the postmodernism: a systematic revision

Resumen: La sociedad postmoderna basada en un modelo neoliberal cuestiona el fuerte componente valórico característico del cuidado profesional de enfermería. Ante esta situación surge la interrogante: ¿Cómo se enfrenta la formación valórica en los estudiantes de enfermería y cómo se viven estos en la práctica del cuidado? Objetivo: Analizar qué se ha investigado en los últimos diez años sobre la formación ética en estudiantes de enfermería y en la práctica valórica de estos profesionales en una sociedad postmoderna. Metodología: Revisión sistemática mixta de carácter narrativo que considero los últimos diez años (2008-2018), incluye 76 artículos de los cuales se seleccionaron 48 para su análisis. Se revisaron las bases de datos: ProQuest, ProQuest education Database, ProQuest Religión Database, Ebsco, Cuiden, Dialnet plus, Latindex, Scielo, SCOPUS y Google académico. Conclusiones: El postmodernismo trastoca los valores profesionales, tanto en la práctica del cuidado como en la formación de los futuros profesionales, por ello se requiere fortalecer y adecuar los valores tradicionales entre la academia y la clínica, centrando la formación en el profesor como modelo de la práctica profesional.

Resumo: A sociedade pósmoderna baseada em um modelo neoliberal questiona o forte componente de valor característico do cuidado profissional de enfermagem. Diante desta situação surge a pregunta: Como se enfrente a formação de valores nos estudantes de enfermagem e como isto é vivido na prática do cuidado? Objetivo: Analisar o que se investigou nos últimos dez anos sobre a formação ética nos estudantes de enfermagem e na prática de valor destes profissionais em uma sociedade pósmoderna. Metodologia: revisão sistemática mista de caráter narrativo que considere os últimos dez anos (2008-2018), incluindo 76 artigos dos quais se selecionaram 48 para análise. Foram revisadas as bases de dados: ProQuest, ProQuest education Database, ProQuest Religión Database, Ebsco, Cuiden, Dialnet plus, Latindex, Scielo, SCOPUS e Google acadêmico. Conclusões: O postmodernismo transtorna os valores profissionais, tanto na prática do cuidado como na formação dos futuros profissionais, por isso se requer fortalecer e adequar os valores tradicionais entre a academia e a clínica, centrando a formação no professor como modelo da prática profissional

Abstract: The postmodern society based on a neoliberal model questions the strong value component characteristic of professional nursing care. Faced with this situation, the question arises: How is valuation training faced by nursing students and how are these students living in the practice of care? Objective: To analyze what has been researched in the last ten years about the ethical formation in nursing students and the value practice of these professionals in a postmodern society. Methodology: Mixed systematic review of a narrative nature that I consider the last ten years (2008-2018), includes 76 articles, of which 48 were selected for analysis. The databases were revised: ProQuest, ProQuest education Database, ProQuest Religion Database, Ebsco, Cuiden, Dialnet plus, Latindex, Scielo, SCOPUS and Google academic. Conclusions: Postmodernism upsets professional values, both in the practice of care and in the training of future professionals, for this reason it is necessary to strengthen and adapt the traditional values between the academy and the clinic, focusing the training on the teacher as a model of professional practice.

Draft genome sequence data of maqui (Aristotelia chilensis) and identification of SSR markers.

Maqui (Aristotelia chilensis [Molina] Stunz) is a small dioecious tree, belonging to the Elaeocarpaceae family. Maqui fruit has high levels of antioxidant activity, which are due to elevated anthocyanin and polyphenol content. Here we describe a draft genome sequence data of maqui (A. chilensis). The genomic sequence datasets were obtained using Illumina NextSeq platform. Nucleotide sequences of raw reads and the assembled draft genome are available at NCBI's Sequence Read Archive as BioProject PRJNA544858. Also, a total of 210067 microsatellite or simple sequence repeat (SSR) markers were identified.

Dataset of genome identification and characterization of microsatellite markers loci in Atriplex atacamensis and Atriplex deserticola.

In this work, we partially sequenced genomes of two Atriplex species (A. deserticola Phil. and A. atacamensis Phil.), using Illumina technology (Hiseq 2500 paired-end system) and de novo assembly strategy. Raw data of A. deserticola and A. atacamensis are available from NCBI-Bioproject, PRJNA495747 and PRJNA495763 accessions, respectively. A total of 127086 and 134984 microsatellite or simple sequence repeat (SSR) markers were identified within A. deserticola and A. atacamensis genomic DNA, respectively. In addition, predicted putative genes in A. deserticola and A. atacamensis sequences are also presented in this article.