The potential importance of the built-environment microbiome and its impact on human health.

There is increasing evidence that interactions between microbes and their hosts not only play a role in determining health and disease but also in emotions, thought, and behavior. Built environments greatly influence microbiome exposures because of their built-in highly specific microbiomes coproduced with myriad metaorganisms including humans, pets, plants, rodents, and insects. Seemingly static built structures host complex ecologies of microorganisms that are only starting to be mapped. These microbial ecologies of built environments are directly and interdependently affected by social, spatial, and technological norms. Advances in technology have made these organisms visible and forced the scientific community and architects to rethink gene-environment and microbe interactions respectively. Thus, built environment design must consider the microbiome, and research involving host-microbiome interaction must consider the built-environment. This paradigm shift becomes increasingly important as evidence grows that contemporary built environments are steadily reducing the microbial diversity essential for human health, well-being, and resilience while accelerating the symptoms of human chronic diseases including environmental allergies, and other more life-altering diseases. New models of design are required to balance maximizing exposure to microbial diversity while minimizing exposure to human-associated diseases. Sustained trans-disciplinary research across time (evolutionary, historical, and generational) and space (cultural and geographical) is needed to develop experimental design protocols that address multigenerational multispecies health and health equity in built environments.

Dynamic vagal-mediated connectivity of cortical and subcortical central autonomic hubs predicts chronotropic response to submaximal exercise in healthy adults.

BACKGROUND: Despite accumulation of a substantial body of literature supporting the role of exercise on frontal lobe functioning, relatively less is understood of the interconnectivity of ventromedial prefrontal cortical (vmPFC) regions that underpin cardio-autonomic regulation predict cardiac chronotropic competence (CC) in response to sub-maximal exercise. METHODS: Eligibility of 161 adults (mean age = 48.6, SD = 18.3, 68% female) was based upon completion of resting state brain scan and sub-maximal bike test. Sliding window analysis of the resting state signal was conducted over 45-s windows, with 50% overlap, to assess how changes in photoplethysmography-derived HRV relate to vmPFC functional connectivity with the whole brain. CC was assessed based upon heart rate (HR) changes during submaximal exercise (HR change /HRmax (206-0.88 × age) - HRrest). RESULTS: During states of elevated HRV the vmPFC showed greater rsFC with an 83-voxel region of the hypothalamus (p < 0.001, uncorrected). Beta estimates of vmPFC connectivity extracted from a 6-mm sphere around this region emerged as the strongest predictor of CC (b = 0.283, p <.001) than age, BMI, and resting HRV F(8,144) = 6.30, p <.001. CONCLUSION: Extensive glutamatergic innervation of the hypothalamus by the vmPFC allows for top-down control of the hypothalamus and its various autonomic efferents which facilitate chronotropic response during sub-maximal exercise.

The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome.

The COVID-19 pandemic has the potential to affect the human microbiome in infected and uninfected individuals, having a substantial impact on human health over the long term. This pandemic intersects with a decades-long decline in microbial diversity and ancestral microbes due to hygiene, antibiotics, and urban living (the hygiene hypothesis). High-risk groups succumbing to COVID-19 include those with preexisting conditions, such as diabetes and obesity, which are also associated with microbiome abnormalities. Current pandemic control measures and practices will have broad, uneven, and potentially long-term effects for the human microbiome across the planet, given the implementation of physical separation, extensive hygiene, travel barriers, and other measures that influence overall microbial loss and inability for reinoculation. Although much remains uncertain or unknown about the virus and its consequences, implementing pandemic control practices could significantly affect the microbiome. In this Perspective, we explore many facets of COVID-19-induced societal changes and their possible effects on the microbiome, and discuss current and future challenges regarding the interplay between this pandemic and the microbiome. Recent recognition of the microbiome's influence on human health makes it critical to consider both how the microbiome, shaped by biosocial processes, affects susceptibility to the coronavirus and, conversely, how COVID-19 disease and prevention measures may affect the microbiome. This knowledge may prove key in prevention and treatment, and long-term biological and social outcomes of this pandemic.

Precision Medicine for Blood Glutamate Grabbing in Ischemic Stroke.

Glutamate grabbers, such as glutamate oxaloacetate transaminase (GOT), have been proposed to prevent excitotoxicity secondary to high glutamate levels in stroke patients. However, the efficacy of blood glutamate grabbing by GOT could be dependent on the extent and severity of the disruption of the blood-brain barrier (BBB). Our purpose was to analyze the relationship between GOT and glutamate concentration with the patient's functional status differentially according to BBB serum markers (soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and leukoaraiosis based on neuroimaging). This retrospective observational study includes 906 ischemic stroke patients. We studied the presence of leukoaraiosis and the serum levels of glutamate, GOT, and sTWEAK in blood samples. Functional outcome was assessed using the modified Rankin Scale (mRS) at 3 months. A significant negative correlation between GOT and glutamate levels at admission was shown in those patients with sTWEAK levels > 2900 pg/mL (Pearson's correlation coefficient: -0.249; p < 0.0001). This correlation was also observed in patients with and without leukoaraiosis (Pearson's correlation coefficients: -0.299; p < 0.001 vs. -0.116; p = 0.024). The logistic regression model confirmed the association of higher levels of GOT with lower odds of poor outcome at 3 months when sTWEAK levels were >2900 pg/mL (OR: 0.41; CI 95%: 0.28-0.68; p < 0.0001) or with leukoaraiosis (OR: 0.75; CI 95%: 0.69-0.82; p < 0.0001). GOT levels are associated with glutamate levels and functional outcomes at 3 months, but only in those patients with leukoaraiosis and elevated sTWEAK levels. Consequently, therapies targeting glutamate grabbing might be more effective in patients with BBB dysfunction.

The validity of learning potential for predicting educational adjustment in preschoolers with Down syndrome: A longitudinal study.

Learning Potential tests aim to assess cognitive functioning using mediation strategies by observing subsequent changes in learning patterns. In this study, this methodology was applied with the Preschool Learning Potential and Abilities Scale and two additional tests, the Kaufman Brief Intelligence Test and the Battery of Aptitudes for School Learning I, to a total of 58 children with Down Syndrome, at four and six years of age. The results demonstrate improvements in general intelligence, learning potential, and school aptitudes between the two timepoints. There was a significant, positive relationship between the variables measured in the different tests, as well as on the predictive variables of school aptitudes, in these children at six years of age. There is evidence that supports the use of this dynamic evaluation methodology, opening new fields of action in child evaluation processes.

Usnea aurantiaco-atra (Jacq) Bory: Metabolites and Biological Activities.

BACKGROUND: Lichens are complex symbiotic associations between a fungus and an alga or cyanobacterium. Due to their great adaptability to the environment, they have managed to colonize many terrestrial habitats, presenting a worldwide distribution from the poles to the tropical regions and from the plains to the highest mountains. In the flora of the Antarctic region, lichens stand out due to their variety and development and are a potential source of new bioactive compounds. METHODS: A phytochemical study of the Antarctic lichen Usnea aurantiaco-atra (Jacq) Bory was conducted with the intention of determining the most important metabolites. In addition, the cytotoxic and antioxidant activities of its extracts were determined. RESULTS: Cytotoxicity studies revealed that the hexane extract contains usnic acid as a majority metabolite, in addition to linoleic acid, ergosterols and terpenes, and demonstrates cytotoxic activity against an A375 melanoma cell line. On the other hand, the presence of total phenols in the extracts did not influence their antioxidant activity. CONCLUSIONS: U. aurantiaco-atra contains mainly usnic acid, although there are terpenes and ergosta compounds that could be responsible for its cytotoxic activity. The presence of phenols did not confer antioxidant properties.

Serum levels of VCAM-1 are associated with survival in patients treated with nivolumab for NSCLC.

BACKGROUND: High circulating levels of cellular adhesion molecules (CAMs) in non-small cell lung cancer (NSCLC) have been supposed to act as a negative prognostic factor. Here, we explored the predictive role of pre-treatment levels of CAMs in previously treated patients receiving nivolumab for NSCLC. MATERIALS AND METHODS: Seventy one patients with advanced NSCLC, treated with nivolumab at the dose of 3 mg/kg every 14 days, were enrolled. Maximum follow-up time was 3 years. Serum levels of Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intracellular Adhesion Molecule-1 (ICAM-1) were measured at baseline and before each nivolumab administration. Endpoints of the study were a composite outcome of survival ≥2 years or absence of disease progression at the end of the follow-up, and the overall survival. RESULTS: Composite outcome and overall survival were positively associated with VCAM-1 baseline levels and with the reduction of VCAM-1 during the treatment. After adjustment for potential confounders, the change in VCAM-1 serum levels during the treatment was an independent predictor of overall survival. CONCLUSIONS: High baseline serum levels of VCAM-1 are associated with a longer survival in patients treated with nivolumab as second line treatment for NSCLC. Surviving patients experience also a significant reduction in CAMs expression during the treatment. Hence, CAMs might be promising prognostic factors in patients with NSCLC underoing immunotherapy.

Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus infection and COVID-19: a retrospective cohort study.

BACKGROUND: Unlike SARS-CoV and MERS-C0V, SARS-CoV-2 has the potential to become a recurrent seasonal infection; hence, it is essential to compare the clinical spectrum of COVID-19 to the existent endemic coronaviruses. We conducted a retrospective cohort study of hospitalized patients with seasonal coronavirus (sCoV) infection and COVID-19 to compare their clinical characteristics and outcomes. METHODS: A total of 190 patients hospitalized with any documented respiratory tract infection and a positive respiratory viral panel for sCoV from January 1, 2011, to March 31, 2020, were included. Those patients were compared with 190 hospitalized adult patients with molecularly confirmed symptomatic COVID-19 admitted from March 1, 2020, to May 25, 2020. RESULTS: Among 190 patients with sCoV infection, the Human Coronavirus-OC93 was the most common coronavirus with 47.4% of the cases. When comparing demographics and baseline characteristics, both groups were of similar age (sCoV: 74 years vs. COVID-19: 69 years) and presented similar proportions of two or more comorbidities (sCoV: 85.8% vs. COVID-19: 81.6%). More patients with COVID-19 presented with severe disease (78.4% vs. 67.9%), sepsis (36.3% vs. 20.5%), and developed ARDS (15.8% vs. 2.6%) compared to patients with sCoV infection. Patients with COVID-19 had an almost fourfold increased risk of in-hospital death than patients with sCoV infection (OR 3.86, CI 1.99-7.49; p < .001). CONCLUSION: Hospitalized patients with COVID-19 had similar demographics and baseline characteristics to hospitalized patients with sCoV infection; however, patients with COVID-19 presented with higher disease severity, had a higher case-fatality rate, and increased risk of death than patients with sCoV. Clinical findings alone may not help confirm or exclude the diagnosis of COVID-19 during high acute respiratory illness seasons. The respiratory multiplex panel by PCR that includes SARS-CoV-2 in conjunction with local epidemiological data may be a valuable tool to assist clinicians with management decisions.

Environmental pollutant exposure associated with altered early-life gut microbiome: Results from a birth cohort study.

Emerging evidence shows that the gut microbiota interacts with environmental pollutants, but the effect of early exposure on the neonatal microbiome remains unknown. We investigated the association between maternal exposure to environmental pollutants and changes in early-life gut microbiome development. We surveyed 16S rRNA gene on meconium and fecal samples (at 1, 3, and 6 months) from the Brazilian birth cohort, and associated with levels of metals, perfluoroalkyl chemicals (PFAS), and pesticides in maternal and umbilical cord blood. The results indicate that the magnitude of the microbiome changes associated with increasing pollutant exposure was bigger in cesarean-section (CS) born and CS-born-preterm babies, in relation to vaginally (VG) delivered infants. Breastfeeding was associated with a stronger pollutant-associated effect on the infant feces, suggesting that the exposure source could be maternal milk. Differences in microbiome effects associated with maternal or cord blood pollutant concentrations suggest that fetal exposure time - intrauterine or perinatal - may matter. Finally, despite the high developmental microbiota variability, specific microbionts were consistently affected across all pollutants, with taxa clusters found in samples from infants exposed to the highest toxicant exposure. The results evidence that perinatal exposure to environmental pollutants is associated with alterations in gut microbiome development which may have health significance.

The Family-Centred Practices Scale: Psychometric properties of the Spanish version for use with families with children with Down syndrome receiving early childhood intervention.

BACKGROUND: The Family-Centred Practices Scale (FCPS) assesses the degree to which staff in early childhood intervention and development centres use this therapeutic approach. However, there is no adaptation of this scale to families of children with Down syndrome, which is one of the most prevalent intellectual disabilities in early intervention. OBJECTIVES: To validate and analyse the psychometric properties of the FCPS in Spanish parents with children with Down syndrome receiving early childhood intervention. METHODS: Descriptive analyses, exploratory factor analysis (n = 131), confirmatory factor analysis (n = 126) and scale reliability analyses were performed. In addition, the invariance of the scale by parents' age and gender was assessed, and a longitudinal analysis of the scores was performed. RESULTS: A new scale was obtained with a two-factor structure, similar to the original version, but with fewer items. Goodness-of-fit indices were excellent (root mean square error of approximation [RMSEA] [95% confidence interval {CI}] = 0.02 [0.01; 0.04]; comparative fit index [CFI] = 0.98; Tucker-Lewis index [TLI] = 0.97; root mean residual [RMR] = 0.02; goodness-of-fit index [GFI] = 0.91; adjusted GFI [AGFI] = 0.90). However, the measure was not gender invariant. Additionally, internal consistency of the two dimensions showed high values in this sample, and comparing the means between the two measurement time points (initial and at about 6 months) showed no differences; the test was powerful but had a very small effect size. CONCLUSIONS: The psychometric properties of this FCPS are adequate, and it uses fewer items, which makes it faster to apply and gives it better clinical applicability. This new version of the scale is a valid, reliable tool for evaluating family-centred practices in Spanish families with children with Down syndrome.

Measurement invariance in gender and age of the Herth Hope Index to the general spanish population across the lifespan.

The Herth Hope Index (HHI) is used to measure hope. Assessing the psychometric properties of HHI in Spanish population, exploring its structural validity, the different functionalities of the items and the invariability of this measure according to the gender and age of the population. Confirmatory factor analysis was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. A new scale was obtained with the structure of one factor with 9 items. Goodness-of-fit indices were excellent. The internal consistency of the one dimension proved high values. The configural invariance on gender shows that both men and women understand the new HHI items, also, this research also shows that there is no scalar invariance across age groups, revealing good levels of adjustment of the item. The Spanish version of the HHI proved to be a valid, reliable instrument to assess the hope in Spanish population.

Variables protecting mental health in the Spanish population affected by the COVID-19 pandemic.

The pandemic produced by COVID-19 can lead the population to suffer serious psychological disorders. However, there are several psychosocial variables that can enhance resilient outcomes in adverse situations. The aim would be to establish the level of resilience of the general Spanish population exposed to a traumatic situation by the COVID-19 in order to identify which protective factors predict resilient outcomes. 1227 homebound people (863-70.3% women), aged 18-73 years (M = 28.10; SD = 12.88) reported on sociodemographic and psychological variables such as optimism, hope, self-efficacy and post-traumatic growth. Having a higher academic level (ß = .47; CI (95%) = .11-.34; p < .01), being autonomous (ß = .29; CI (95%) = 0.1-.09; p < .01), along with self-efficacy (ß = .42; CI (95%) = .71-92; p < .01) and to a lesser extent optimism (ß = .31; CI (95%) = .63-.84; p < .01) would be the predictive variables of a resilient outcome. A high level of statistical power (1-ß = 1) and effect size (f2 = 19.2) is observed. The Spanish population exposed to confinement presents high levels of resilience, but no relevant post-traumatic growth has taken place. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-020-01132-1.

Do psychological strengths protect college students confined by COVID-19 to emotional distress? The role of gender.

The COVID-19 pandemic represents a stressful situation for the university population due to the important changes in the development of their studies and in their living conditions. However, the impact of factors related to the family unit (living with COVID-19 positive patients and living with Essential Services Workers-ESW) and other protective psychosocial factors that could produce resilient or psychopathological results (anxiety and depression) in this population has not been sufficiently assessed, differentiating them by gender. The results obtained show that both variables related to the family unit and psychosocial protective variables explain 28.6% of the variance in general distress in the total sample (R2 = 0.286; F(3,250) =34,717; p < .001). However, models of regression of distress and anxiety levels differ between men and women, but not in terms of mood alteration. Women facing circumstances reminiscent of mandatory pandemic containment have moderately higher levels of resilience than men (tCDRISC(125) = 2.218; p < .05; tGSE(125) = 2.415; p < .05; tCDRISC(125) = 0.146; p = .884; tGSE(125) = 0.315; p = .756). The results are discussed from the perspective of gender differences, taking into account the contribution of sociodemographic factors that increase remembrance of the stressor/trauma and the coping styles of the participants.

Novel Emerging Molecular Targets in Non-Small Cell Lung Cancer.

In the scenario of systemic treatment for advanced non-small cell lung cancer (NSCLC) patients, one of the most relevant breakthroughs is represented by targeted therapies. Throughout the last years, inhibitors of the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), c-Ros oncogene 1 (ROS1), and V-raf murine sarcoma viral oncogene homolog B (BRAF) have been approved and are currently used in clinical practice. However, other promising molecular drivers are rapidly emerging as therapeutic targets. This review aims to cover the molecular alterations with a potential clinical impact in NSCLC, including amplifications or mutations of the mesenchymal-epithelial transition factor (MET), fusions of rearranged during transfection (RET), rearrangements of the neurotrophic tyrosine kinase (NTRK) genes, mutations of the Kirsten rat sarcoma viral oncogene (KRAS) and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA), as well as amplifications or mutations of human epidermal growth factor receptor 2 (HER2). Additionally, we summarized the current status of targeted agents under investigation for such alterations. This revision of the current literature on emerging molecular targets is needed as the evolving knowledge on novel actionable oncogenic drivers and targeted agents is expected to increase the proportion of patients who will benefit from tailored therapeutic approaches.

Adaptation and Psychometric Properties in Spanish of the Herth Hope Index in People Who have Attempted Suicide.

Suicide is a major global public health problem. The most predictive behavior of completed suicide is prior suicide attempt. However, studies focused on risk factors have to date proved unsuccessful in reducing death by suicide rates. To adapt a hope assessment tool to a Spanish clinical population having carried out a suicide attempt, to evaluate whether hope modulates the resilience level following discharge from the emergency department. The sample comprised 682 people (62.4% female) aged between 18 and 77 years (M = 39; SD = 19.1) with previous suicide attempts who were administered the Herth Hope Index, the Beck Hopelessness Scale, and the 14-item Resilience Scale. The HHI in Spanish (IEH) showed a high internal consistency (α = .97), a two-dimensional structure that explains 73% of the variance with high goodness-of-fit indices (GFI = .91; CFI = .89; RMSEA = .08), and divergent validity of -.77 with hopelessness. Significant hope-related differences by resilience level were also observed. Hope modulates resilience to suicide attempts and a new scale adapted to the Spanish clinical population is offered. This short tool is easy to use in emergency department settings and predicts the level of potential vulnerability to more serious future repeated attempts.

Psychometric properties of the Emotional Quotient Inventory: Youth Version-EQ-i:YV in Spanish adolescents with Down syndrome.

BACKGROUND: The people with Down syndrome who are now adolescents can face a self-report questionnaire with guarantees of being answered with validity to evaluate areas of development that traditionally have not been able to be evaluated. This is the case of emotional intelligence, measured in this research with the Emotional Quotient Inventory: Youth Version-EQ-i:YV. AIMS: To validate and analyse the scale's psychometric properties in adolescents with Down syndrome. METHODS: A two-stage cross-sectional investigation was conducted. The inventory consists of 60 items that measure 5 dimensions. The test was administered to 644 adolescents with Down syndrome. We carried out exploratory and confirmatory factor analyses. OUTCOMES: The 5-factor structure of the test was confirmed. The internal consistency of four dimensions and the EQ-i:YV's total calculated score yielded high values. CONCLUSIONS: This new version of the EQ-i:YV represents a valid and reliable tool to assess emotional intelligence in Spanish adolescents with Down syndrome.

The COVID-19 Fear Scale (FCV-19S): Psychometric properties and invariance of the measure in the Spanish version.

The emergence of COVID-19 worldwide has had serious consequences for physical and psychological health. Spain is one of the countries that has been most-seriously affected by the pandemic. This study aims to evaluate the psycho- metric properties of the Spanish version of the COVID-19 fear scale (FCV-19S), assessing its structural validity, differential item functioning, and measurement invariance by gender and age.

A Retrospective Study of Coinfection of SARS-CoV-2 and Streptococcus pneumoniae in 11 Hospitalized Patients with Severe COVID-19 Pneumonia at a Single Center.

BACKGROUND A lethal synergism between the influenza virus and Streptococcus pneumoniae has been identified. However, bacterial coinfection is considered relatively infrequent in hospitalized patients with COVID-19, and the co-prevalence of Streptococcus pneumoniae is low. MATERIAL AND METHODS We retrospectively analyzed the clinical characteristics and outcomes of patients subsequently admitted to AMITA Health Saint Francis Hospital between March 1 and June 30, 2020, with documented SARS-CoV-2 and S. pneumoniae coinfection. RESULTS We identified 11 patients with S. pneumoniae coinfection. The median age was 77 years (interquartile range [IQR], 74-82 years), 45.5% (5/11) were males, 54.5% (6/11) were white, and 90.9% (10/11) were long-term care facility (LTCF) residents. The median length of stay was 7 days (IQR, 6-8 days). Among 11 patients, 4 were discharged in stable condition and 7 had died, resulting in an inpatient mortality rate of 64%. CONCLUSIONS At our center, 11 patients with COVID-19 pneumonia who had confirmed infection with SARS-CoV-2 were diagnosed with Streptococcus pneumoniae infection while in hospital. All patients had pneumonia confirmed on imaging and a nonspecific increase in markers of inflammation. The in-hospital mortality rate of 64% (7 patients) was higher in this group than in previous reports. This study highlights the importance of monitoring bacterial coinfection in patients with viral lung infection due to SARS-CoV-2.

Adaptation of the Screen for Child Anxiety Related Emotional Disorders in Spanish with Nonspecific Intellectual Disability.

Anxiety continues to be one of the most frequent disorders with typically developing children and youth. However, people with intellectual disability (ID) lack validated diagnostic tests backed by sufficient methodological rigor. Analyze the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in this clinical population, specifically in children and young Spanish with Nonspecific Intellectual Disability. Descriptive statistics and item analysis (N = 542), exploratory factorial analysis (n = 245) and confirmatory (n = 297) and scale reliability analyses were performed and evaluated the internal consistency with various indices (Cronbach's alpha and omega) and the stability of the measurement (test-retest) of the resulting scale with better goodness-of-adjustment indices. A new scale called SCARED-DI was obtained in this clinical sample with three factors and a smaller number of items (22), offering important goodness-of-fit indices (RMSEA [95% CI] 03[0.01; .04]; CFI = 0.99; TLI = 0.98; GFI = 0.88; AGFI = 0.89) and high internal consistency (α = 0.91; ω = 0.93) and adequate measurement stability (rxx = 0.92). The importance of validating psychopathological anxiety tests for children and youth with ID in order to build good mental health is discussed, emphasizing the need to provide easy, short-duration tests on both cognitive and emotional aspects in this clinical sub-population. In addition, the results are assessed in terms of future research and practical implications. This new version of SCARED-ID represents a valid and reliable tool to evaluate the anxiety in people with intellectual disabilities.