Short-term associations between fine particulate air pollution and cardiovascular and respiratory mortality in 337 cities in Latin America.

Ambient air pollution is a health concern in Latin America given its large urban population exposed to levels above recommended guidelines. Yet no studies have examined the mortality impact of air pollutants in the region across a wide range of cities. We assessed whether short-term levels of fine particulate matter (PM2.5) from modeled estimates, are associated with cardiovascular and respiratory mortality among adults in 337 cities from 9 Latin American countries. We compiled mortality, PM2.5 and temperature data for the period 2009-2015. For each city, we evaluated the association between monthly changes in PM2.5 and cardiovascular and respiratory mortality for sex and age subgroups using Poisson models, adjusted for seasonality, long-term trend, and temperature. To accommodate possibly different associations of mortality with PM2.5 by age, we included interaction terms between changes in PM2.5 and age in the models. We combined the city-specific estimates using a random effects meta-regression to obtain mortality relative risks for each sex and age group. We analyzed 3,026,861 and 1,222,623 cardiovascular and respiratory deaths, respectively, from a study population that represents 41 % of the total population of Latin America. We observed that a 10 µg/m3 increase in monthly PM2.5 is associated with an increase of 1.3 % (95 % confidence interval [CI], 0.4 to 2.2) in cardiovascular mortality and a 0.9 % increase (95 % CI -0.6 to 2.4) in respiratory mortality. Increases in mortality risk ranged between -0.5 % to 3.0 % across 6 sex-age groups, were larger in men, and demonstrated stronger associations with cardiovascular mortality as age increased. Socioeconomic, environmental and health contexts in Latin America are different than those present in higher income cities from which most evidence on air pollution impacts is drawn. Locally generated evidence constitutes a powerful instrument to engage civil society and help drive actions to mitigate and control ambient air pollution.

Ambient fine particulate matter in Latin American cities: Levels, population exposure, and associated urban factors.

BACKGROUND: Exposure to particulate matter (PM2.5) is a major risk factor for morbidity and mortality. Yet few studies have examined patterns of population exposure and investigated the predictors of PM2.5 across the rapidly growing cities in lower- and middle-income countries. OBJECTIVES: Characterize PM2.5 levels, describe patterns of population exposure, and investigate urban factors as predictors of PM2.5 levels. METHODS: We used data from the Salud Urbana en America Latina/Urban Health in Latin America (SALURBAL) study, a multi-country assessment of the determinants of urban health in Latin America, to characterize PM2.5 levels in 366 cities comprising over 100,000 residents using satellite-derived estimates. Factors related to urban form and transportation were explored. RESULTS: We found that about 172 million or 58% of the population studied lived in areas with air pollution levels above the defined WHO-AQG of 10 µg/m3 annual average. We also found that larger cities, cities with higher GDP, higher motorization rate and higher congestion tended to have higher PM2.5. In contrast cities with higher population density had lower levels of PM2.5. In addition, at the sub-city level, higher intersection density was associated with higher PM2.5 and more green space was associated with lower PM2.5. When all exposures were examined adjusted for each other, higher city per capita GDP and higher sub-city intersection density remained associated with higher PM2.5 levels, while higher city population density remained associated with lower levels. The presence of mass transit was also associated with lower PM2.5 after adjustment. The motorization rate also remained associated with PM2.5 and its inclusion attenuated the effect of population density. DISCUSSION: These results show that PM2.5 exposures remain a major health risk in Latin American cities and suggest that urban planning and transportation policies could have a major impact on ambient levels.

Survey data on the impact of COVID-19 on parental engagement across 23 countries.

This data article describes the dataset of the International COVID-19 Impact on Parental Engagement Study (ICIPES). ICIPES is a collaborative effort of more than 20 institutions to investigate the ways in which, parents and caregivers built capacity engaged with children's learning during the period of social distancing arising from global COVID-19 pandemic. A series of data were collected using an online survey conducted in 23 countries and had a total sample of 4,658 parents/caregivers. The description of the data contained in this article is divided into two main parts. The first part is a descriptive analysis of all the items included in the survey and was performed using tables and figures. The second part refers to the construction of scales. Three scales were constructed and included in the dataset: 'parental acceptance and confidence in the use of technology', 'parental engagement in children's learning' and 'socioeconomic status'. The scales were created using Confirmatory Factor Analysis (CFA) and Multi-Group Confirmatory Analysis (MG-CFA) and were adopted to evaluate their cross-cultural comparability (i.e., measurement invariance) across countries and within sub-groups. This dataset will be relevant for researchers in different fields, particularly for those interested in international comparative education.

Convalescent Plasma in COVID-19. Mortality-Safety First Results of the Prospective Multicenter FALP 001-2020 Trial

BackgroundThe use of convalescent plasma (CP) to treat COVID-19 has shown promising results; however, its effectiveness remains uncertain. The purpose of this study was to determine the safety and mortality of CP among patients hospitalized with COVID-19. Study Design and MethodsThis multicenter, open-label, uncontrolled clinical trial is currently being conducted at nine hospitals in Chile. Patients hospitalized due to COVID-19 who were still within 14 days since symptom onset were classified into four groups: Patients with cancer and severe COVID-19. Patients with cancer and non-severe COVID-19. Patients with severe COVID-19 and patients with non-severe COVID-19 only. The intervention involved two 200-cc. CP transfusions with anti-SARS-CoV-2 IgG titers [≥] 1:320 collected from COVID-19-recovered donors. Results192 patients hospitalized for COVID-19 received CP transfusions. At the first transfusion, 90.6% fulfilled the criteria for severity, and 41.1% required mechanical ventilation. 11.5% of the patients had cancer. Overall 7-day and 30-day mortality since the first CP transfusion was 5.7% and 16.1% respectively. There were no differences at either time point in mortality between the four groups. Patients on mechanical ventilation when receiving CP had higher mortality rates than those who were not (22.8% vs. 11.5%; p = 0.037). Overall 30-day mortality was higher in patients over 65 than in younger patients (p = 0.019). Severe adverse events were reported in four patients (2.1%) with an overall transfusion-related lung injury rate of 1.56%. No CP-related deaths occurred. DiscussionCP is safe when used in patients with COVID-19 even when also presenting severity criteria or risk factors. Our mortality rate is comparable to reports from larger studies. Controlled clinical trials are required to determine efficacy. RegistrationNCT04384588

Survey for antibody to hantaviruses in Tamaulipas, Mexico.

Wild rodents (n=248) were trapped in two ecologically distinct sites at El Cielo Biosphere Reserve in the state of Tamaulipas, Mexico, during the summer of 2003. Samples from 199 individuals were tested for Hantavirus antibodies by an indirect enzyme-linked immunosorbent assay (ELISA). Hantavirus antibodies to recombinant Sin Nombre virus nucleocapsid protein were found in seven rodents (3.5%) of a single species, Peromyscus levipes. Antibody-positive rodents were found only in the Cloud Forest site, which had lower rodent species diversity than the Tropical Subdecidous Forest site. Although the identity of the virus in P. levipes remains to be determined, our study provides further evidence that Hantavirus antibody-positive individuals are prevalent in the rodent fauna of Mexico. This is the first survey for Hantavirus antibodies in the rodent fauna of Tamaulipas and the first report of P. levipes as a potential host for a Hantavirus.

Bioelectrical parameters of the whole human body obtained through bioelectrical impedance analysis.

Knowledge of electrical properties of body tissues across the frequency spectrum is useful for tissue characterization. The bioelectric impedance analysis method, operating from 1 to 250 kHz (multi-frequency), was used in 23 normal male human subjects between the ages of 21 and 52 years, for estimation of their bioelectrical parameters. Amplitude of the output current was set to 800 microA(RMS). The experimental data showed that bioelectric parameters were highly dependent on frequency and the presence of a threshold frequency around 4 kHz. In order to explain the unusual features observed in our experimental data, the human body was simulated through the Cole-Fricke-Cole model (RC circuit) and the Extended Cole-Fricke-Cole model (RLC circuit). The simulated data showed that the Extended Cole-Fricke-Cole model had a higher accuracy than the traditional Cole-Fricke-Cole model. These results suggest that the unusual features could be due to the possible existence of inductive effects in biological cells and body tissues and that the inductive parameter and the threshold frequency could be used for characterizing the healthy tissues as well as the traditional bioelectric parameters.