Prioritizing Colombian plant genetic resources for investment in research using indicators about the geographic origin, vulnerability status, economic benefits, and food security importance.

Germplasm banks are the most significant repository for plant genetic resources for food and agriculture (PGRFA) worldwide. Despite their strategic importance, national germplasm banks of tropical megadiverse developing countries such as Colombia have extremely limited funds. Therefore, making strategic decisions about research investment is essential. Here, we designed a data-driven approach to build an index that sorts Colombian PGRFA into three groups: high, medium, or low priority, based on four pillars of information from open-access databases and aligned with the sustainable goals of no poverty and zero hunger: Geographic origin, vulnerability status, economic benefits, and food security importance. We analyzed 345 PGRFA using the index, separating them into two groups, 275 already conserved in the Colombian germplasm bank (BGVCOL group) and 70 not currently conserved in the BGVCOL (NCB group). We used fuzzy logic to classify each PGRFA by each pillar and integrate it to obtain a priority index. Missing data for native crops were frequent in the BGVCOL group. Therefore we adopted an imputation strategy to fill the gaps and calculated the uncertainty. After applying the index, PGRFA with higher priority were 24 (8.72%) from the BGVCOL (i.e., 15 potatoes, three tomatoes, two tree tomatoes, pineapple, cocoa, papaya, and yacon) and one from NCB (i.e., coffee). We concluded that this methodology successfully prioritized PGRFA in Colombia and shows the big holes of knowledge for future research and alternatives to improve this index. The versatility of this methodology could be helpful in other genebanks with budget limitations for research investment. Supplementary Information: The online version contains supplementary material available at 10.1007/s10531-023-02599-7.

[Validation of a brief screening test to assess functional capacity in Chilean older people]. / Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile.

BACKGROUND: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. AIM: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. MATERIAL AND METHODS: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. RESULTS: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha's coefficient and from correlations between the new instrument and key variables. CONCLUSIONS: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile / Validation of a brief screening test to assess functional capacity in Chilean older people

Background: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. Aim: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. Material and Methods: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. Results: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha s coefficient and from correlations between the new instrument and key variables. Conclusions: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

Reflexiones sobre calidad de vida, dignidad y envejecimiento / Thoughts about qua lity of life, dignity and aging

El problema del envejecimiento ha preocupado al hombre desde el principio de su existencia, y en la actualidad se ha acentuado su interés por las implicancias éticas, los cambios sociales y económicos significativos de la población que contribuyen a la modificación del perfil demográfico de un país. Estas condicionantes demográficas se traducen en nuevos escenarios, en los cuales la inequidad, asimetría y exclusión social son factores que influyen en las condiciones de vida del adulto mayor que envejece a pasos acelerados y que plantea principales desafíos, aspiraciones y oportunidades. En consecuencia, las sociedades que envejecen deberían priorizar su preocupación en la dinámica demográfica en función de la percepción de la satisfacción personal, bienestar, calidad y dignidad de vida de sus mayores. El presente trabajo analiza aspectos cruciales del envejecimiento en un intento de una mejor comprensión del proceso de envejecimiento en sí mismo, las condiciones personales, familiares, sociales y ambientales que promueven una vejez digna y en calidad. Destaca que los cambios en las políticas sociales para mejorar la cantidad, calidad y dignidad de vida no son dictados por el avance de los conocimientos científicos, sino por decisiones políticas que reflejan el pensamiento y las necesidades sentidas por la sociedad donde se produce.

The problem of aging has preoccupied man since the beginning of its existence and now has increased its interest in the ethical implications, the social and economic changes significant population contributing to the change in the demographics of a country. These conditions translate into new demographic scenarios, in which inequality, asymmetry and social exclusion are factors that influence the lives of the elderly to age at an accelerated pace and poses major challenges, aspirations and opportunities. Consequently, aging societies should prioritize its concerns on population dynamics based on the perception of personal satisfaction, well being, quality of life and dignity of their elders. This paper analizes key aspects of aging in an attempt to better understand the aging process itself, the personal conditions familiar, social and environmental factors that promote a dignified old age and quality. Stresses that the changes in social policies to improve the quantity, quality and dignity of life are not dictated by the advance of scientific knowledge, but by political decisions that reflect the thought and the felt needs of the society in which it occurs.

Effectiveness and cost of replacing a calcineurin inhibitor with sirolimus to slow the course of chronic kidney disease in renal allografts.

Renal grafts suffer a progressive decrease in glomerular filtration rate (GFR) because of several factors including calcineurin inhibitor (CNI) nephrotoxicity. Switching CNIs to sirolimus may improve this adverse prognosis. We performed a prospective, open-label clinical trial among 18 kidney transplant patients with more than 12 months of evolution (range, 385-1826 days), showing progressive GFR decreases and biopsies with interstitial fibrosis and tubular atrophy (IFTA). Immunosuppressive treatment included cyclosporine, ketoconazole, and steroids associated with azathioprine or mycophenolate mofetil. After signing an Institutional Review Board-approved written consent, cyclosporine was switched to sirolimus seeking to achieve a trough blood sirolimus concentration of 6-15 ng/mL. Wilcoxon and Student's t-tests were used to compare the values in the annual periods before and after the switch. GFR was estimated by the Modification of Diet in Renal Disease formula. There were no acute rejection episodes. Estimated GFR on the day of the switch was 38.0 +/- 12.1 mL/min. After CNI switch, the slope of the estimated GFR significantly improved from -6.5 +/- 9.2 to 8.1 +/- 14.0 mL/min/year (P < .01). The estimated GFR 1 year after the switch was 47.2 +/- 16.9 mL/min (P = .003 vs baseline). Total expenditures increased. The ratio of post-switch versus baseline total expenditures was 1.93 (95% confidence interval, 1.54-2.31) and the ratio of sirolimus to CNI cost was 2.16 (95% confidence interval, 1.53-2.78). Switching from CNI to sirolimus for kidney transplants with decreasing GFR and a biopsy with IFTA changes, suggesting progressive graft nephropathy, almost doubled total expenses. It is necessary to conduct trials using clinical end points to definitively validate this therapeutic intervention.

Cost-benefit analysis for the use of Haemophilus influenzae type b conjugate vaccine in Santiago, Chile.

Cost-benefit analyses can be integral to the evaluation of interventions in developing countries. The authors compare the potential benefits to the Chilean Ministry of Health, in terms of treatment costs averted, by prevention of Haemophilus influenzae type b (HIB) invasive disease, with the costs of adding HIB conjugate vaccine to the diphtheria-tetanus-pertussis (DTP) immunization routinely administered to infants. In their basecase model, over a 10-year period (1991-2000), vaccination against HIB will prevent 1,229 cases of HIB invasive disease, including 713 cases of meningitis, 107 of whom would suffer severe, long-term sequelae, and between 29 and 116 deaths. Assuming a cost of US$1 for a full three-dose regimen of vaccine, the benefit/cost ratio of 1.66, with a net discounted savings of over $403,225, illustrates that HIB vaccine can be cost-beneficial. Sensitivity analyses which alter each of the variables in the analysis indicate that if the true incidence of HIB disease is twice the published rate, then three doses of vaccine remains cost-beneficial at US#3.

PIP: Health practitioners reviewed the clinical records of all 6-60 month old children who were treated for meningitis caused by Haemophilus influenzae type b (HIB) in 1989-1990 at Roberto del Rio Children's Hospital in Santiago, Chile, to estimate costs for all phases of meningitis treatment (ambulatory visits, hospitalization, and follow-up). They also estimated annual HIB incidence. They determined the cost of adding HIB conjugate vaccine to the DTP vaccine. They assumed a cost of US$1 for a full 3-dose regimen of vaccine. They then conducted a cost benefit analysis of the use of HIB conjugate vaccine to prevent invasive HIB disease in Santiago. The National Health Service had to pay an average of US$1301/case of HIB meningitis and US$887/case of HIB invasive disease other than meningitis, including pre- and post-hospitalization costs and adjustment for frequency of sequelae. Several factors indicated that the estimates were actually underestimates. For example, the researchers did not take into account herd immunity and the fact that sequelae often do not appear until the children are older. The addition of the HIB conjugate vaccine to the immunization program would prevent at least 1229-3111 cases of HIB invasive disease, disabling sequelae, and deaths during a 10-year period. Further, it would save the National Health Service more than US$403,225. The benefit/cost ratio was 1.66. The researchers changed each of the variables in the cost benefit analysis. These sensitivity analyses revealed that if the true incidence of HIB disease were 2 times greater than the based on reported data, the 3 doses of HIB conjugate vaccine would still have a cost benefit of US$3. These results indicated that adding HIB conjugate vaccine would exert a considerable public health and cost benefit. Cost benefit analyses of vaccines would also prove useful to decision-makers in other developing countries.

Nutritional status assessment of HIV-positive drug addicts.

Since human immunodeficiency virus (HIV) is known to lead to modifications of immune function and interrelationships among malnutrition, anergy and drug addiction have been shown, the aim of this work was to assess the nutritional status of 36 male heroin addicts under a period of detoxication (3 months). They were divided into two groups: (1) HIV negative (n = 20) and (2) HIV positive (n = 16); heights, weights and serum albumin concentration were measured and immune function was tested, using delayed hypersensitivity skin tests containing 7 antigens. No significant differences in anthropometric measurements were found between both groups, but anthropometric improvement was shown in every patient after the detoxication period. Serum albumin, often used as a classical index of malnutrition, remained within the normal values in both groups. The whole response to skin tests was depressed in both groups and no significant differences were shown between them. Therefore, these results might suggest that in spite of the apparent anthropometric recovery and the normal values of albumin, a subclinical malnutrition was indicated by the depressed immune function, which was more noticeable in the HIV-positive group.