Genomic consequences of dietary diversification and parallel evolution due to nectarivory in leaf-nosed bats.

BACKGROUND: The New World leaf-nosed bats (Phyllostomids) exhibit a diverse spectrum of feeding habits and innovations in their nutrient acquisition and foraging mechanisms. However, the genomic signatures associated with their distinct diets are unknown. RESULTS: We conducted a genomic comparative analysis to study the evolutionary dynamics related to dietary diversification and specialization. We sequenced, assembled, and annotated the genomes of five Phyllostomid species: one insect feeder (Macrotus waterhousii), one fruit feeder (Artibeus jamaicensis), and three nectar feeders from the Glossophaginae subfamily (Leptonycteris yerbabuenae, Leptonycteris nivalis, and Musonycteris harrisoni), also including the previously sequenced vampire Desmodus rotundus. Our phylogenomic analysis based on 22,388 gene families displayed differences in expansion and contraction events across the Phyllostomid lineages. Independently of diet, genes relevant for feeding strategies and food intake experienced multiple expansions and signatures of positive selection. We also found adaptation signatures associated with specialized diets: the vampire exhibited traits associated with a blood diet (i.e., coagulation mechanisms), whereas the nectarivore clade shares a group of positively selected genes involved in sugar, lipid, and iron metabolism. Interestingly, in fruit-nectar-feeding Phyllostomid and Pteropodids bats, we detected positive selection in two genes: AACS and ALKBH7, which are crucial in sugar and fat metabolism. Moreover, in these two proteins we found parallel amino acid substitutions in conserved positions exclusive to the tribe Glossophagini and to Pteropodids. CONCLUSIONS: Our findings illuminate the genomic and molecular shifts associated with the evolution of nectarivory and shed light on how nectar-feeding bats can avoid the adverse effects of diets with high glucose content.

The SARS-CoV-2 (COVID-19) coronavirus pandemic: current situation and implications for Mexico.

The Coronavirus pandemic (COVID-19) is one of the most devastating in this century. It originated in China in December 2019 caused by the SARS-Cov-2 virus, and in less than a month it had been classified as an "International Public Health Emergency". To date there are nearly 3 million people infected and more than 250,000 deaths caused by the disease worldwide. Initially it affects the respiratory tract with atypical pneumonia and in severe cases it produces systemic inflammation with cytokine storm that can cause rapid deterioration with circulatory and respiratory failure, coagulopathy and a lethality rate of approximately 7%. In Mexico, the first case was detected in February 2020, and to date there are 26,616 confirmed cases and 2,961 deaths throughout the country. The low number of diagnostic tests conducted in our country clearly underestimates the real incidence and impact of the disease. The most affected groups are those with risk factors such as age over 60, presence of hypertension, diabetes or cardiovascular disease. Of the confirmed cases, 15% are healthcare workers. There is no specific treatment or vaccine yet, so it is important to have hygiene, social isolation and personal protection measures. Health, social and economic consequences could have great impact in the near future.

La pandemia del Coronavirus (COVID-19) es una de las más devastadoras de este siglo. Originada en China en diciembre de 2019 y causada por el virus SARS-CoV-2, en menos de 1 mes ya había sido catalogada como "Emergencia de Salud Pública de Alcance Internacional". A la fecha hay cerca de 3 millones de personas con infección confirmada y ha provocado más de 250,000 fallecimientos en el mundo. Inicialmente afecta las vías respiratorias con neumonías atípica y en casos graves provoca inflamación sistémica con liberación de citoquinas que pueden provocar un rápido deterioro, insuficiencia circulatoria, respiratoria y alteraciones de coagulación con una letalidad cercana al 7%. En México, el primer caso se detectó en febrero del 2020, y a la fecha de esta publicación se cuenta con 29,616 casos confirmados y 2,961 fallecimientos en toda la extensión de país. La baja tasa de muestreo diagnóstico en nuestro país claramente subestima la incidencia e impacto de esta enfermedad. Los grupos mas afectados son aquéllos con factores de riesgo como lo son la edad mayor a 60 años, hipertensión, diabetes o historia de enfermedad cardiovascular. De los casos confirmados, 15% son trabajadores del sector salud. No existe hasta ahora un tratamiento específico o vacuna, de tal manera que es importante contar con las medidas de higiene, aislamiento social y protección personal. Las consecuencias en salud, sociales y económicas podrían ser de gran impacto en los tiempos por venir.

Will environmental changes in temperature affect the course of COVID-19?

While the outbreak has reached every region of the world, it is undeniable that countries in the southern hemisphere seem to be less affected, where cases have been reported, these have been imported and travel related. We analyzed the climate temperature from various regions according to their current ongoing human-to-human transmission status. We studied 3 groups; Group 1, 10 provinces from China with majority of COVID-19 cases; Group 2, areas where continuous horizontal transmission outside of China had been reported; and group 3, areas where imported cases had been detected and no horizontal transmission had been documented after at least seven days since the first case was reported. The regions without ongoing human-to-human transmission showed significantly higher temperatures when compared to China and countries with ongoing human-to-human transmission, with over an 11-degree difference. The average rainfall during the study period was significantly higher in those regions without OHHT when compared to the Chinese provinces with ongoing human-to-human transmission and the regions with active transmission of SARS-CoV-2. Our findings show statistically significant differences between regions with ongoing human-to-human transmission of COVID-19 cases compared to those regions without horizontal transmission. This phenomenon could have implications in the behavior of the ongoing COVID-19 outbreak in the following months.

A Fast and Accurate Method to Identify and Quantify Enzymes in Brush-Border Membranes: In Situ Hydrolysis Followed by Nano LC-MS/MS.

A simple method for the identification of brush-border membrane α-glucosidases is described. The proteins were first solubilized and separated in a gel under native, non-denaturing, conditions. The gel was then incubated in substrate solutions (maltose or sucrose), and the product (glucose) exposed in situ by the oxidation of o-dianisidine, which yields a brown-orange color. Nano-liquid chromatography coupled to mass spectrometry analyses of proteins (nano LC-MS/MS) present in the colored bands excised from the gels, was used to confirm the presence of the enzymes. The stain is inexpensive and the procedure permits testing several substrates in the same gel. Once enzymes are identified, their abundance, relative to that of other proteins in the brush border, can be semi-quantified using nano LC-MS/MS.

Marijuana Use and Its Associations With Pain, Opioid Dose, and HIV Viral Suppression Among Persons Living With HIV on Chronic Opioid Therapy.

BACKGROUND: Medical marijuana is legal in 29 US states and the District of Columbia: both HIV and chronic pain are "approved conditions" for receipt. Chronic pain is common among people living with HIV (PLWH). We anticipate PLWH will question their providers about medical marijuana for chronic pain. We examined marijuana use and its associations with pain, opioid dose, and HIV viral suppression among PLWH receiving chronic opioid therapy. METHODS: PLWH prescribed chronic opioid therapy were recruited into the Targeting Effective Analgesia in Clinics for HIV cohort. The main exposure variable was any past 12-month marijuana use. The primary outcomes were (1) opioid misuse (≥9 on the Current Opioid Misuse Measure) and (2) opioid dose (morphine equivalent daily dose). HIV viral load (VL) suppression (<200 copies/µL) and pain severity and interference using the Brief Pain Inventory were exploratory outcomes. RESULTS: Participants (n = 166) were men (65%), Black (72%), and had an undetectable VL (89%). We found no significant association between current marijuana use and opioid misuse, opioid dose, or pain. Current marijuana use was associated with 3.03 times the odds of having a detectable VL (95% odds ratio: 1.11-8.31, P = 0.03) while controlling for depressive symptoms and other substance use. DISCUSSION: We did not detect an association between marijuana use and opioid misuse behaviors, opioid dose, or pain. In an exploratory analysis, current marijuana use was associated with 3× greater odds of having a detectable VL. This study provides insights into potential consequences of marijuana use among PLWH with chronic pain.

Isotopic niches support the resource breadth hypothesis.

Because a broad spectrum of resource use allows species to persist in a wide range of habitat types, and thus permits them to occupy large geographical areas, and because broadly distributed species have access to more diverse resource bases, the resource breadth hypothesis posits that the diversity of resources used by organisms should be positively related with the extent of their geographic ranges. We investigated isotopic niche width in a small radiation of South American birds in the genus Cinclodes. We analysed feathers of 12 species of Cinclodes to test the isotopic version of the resource breadth hypothesis and to examine the correlation between isotopic niche breadth and morphology. We found a positive correlation between the widths of hydrogen and oxygen isotopic niches (which estimate breadth of elevational range) and widths of the carbon and nitrogen isotopic niches (which estimates the diversity of resources consumed, and hence of habitats used). We also found a positive correlation between broad isotopic niches and wing morphology. Our study not only supports the resource breadth hypothesis but it also highlights the usefulness of stable isotope analyses as tools in the exploration of ecological niches. It is an example of a macroecological application of stable isotopes. It also illustrates the importance of scientific collections in ecological studies.

CD4 Counts at Entry to HIV Care in Mexico for Patients under the "Universal Antiretroviral Treatment Program for the Uninsured Population," 2007-2014.

In Mexico, public health services have provided universal access to antiretroviral therapy (ART) since 2004. For individuals receiving HIV care in public healthcare facilities, the data are limited regarding CD4 T-lymphocyte counts (CD4e) at the time of entry into care. Relevant population-based estimates of CD4e are needed to inform strategies to maximize the impact of Mexico's national ART program, and may be applicable to other countries implementing universal HIV treatment programs. For this study, we retrospectively analyzed the CD4e of persons living with HIV and receiving care at state public health facilities from 2007 to 2014, comparing CD4e by demographic characteristics and the marginalization index of the state where treatment was provided, and assessing trends in CD4e over time. Our sample included 66,947 individuals who entered into HIV care between 2007 and 2014, of whom 79% were male. During the study period, the male-to-female ratio increased from 3.0 to 4.3, reflecting the country's HIV epidemic; the median age at entry decreased from 34 years to 32 years. Overall, 48.6% of individuals entered care with a CD4≤200 cells/µl, ranging from 42.2% in states with a very low marginalization index to 52.8% in states with a high marginalization index, and from 38.9% among individuals aged 18-29 to 56.5% among those older than 50. The adjusted geometric mean (95% confidence interval) CD4e increased among males from 135 (131,142) cells/µl in 2007 to 148 (143,155) cells/µl in 2014 (p-value<0.0001); no change was observed among women, with a geometric mean of 178 (171,186) and 171 (165,183) in 2007 and 2014, respectively. There have been important gains in access to HIV care and treatment; however, late entry into care remains an important barrier in achieving optimal outcomes of ART in Mexico. The geographic, socioeconomic, and demographic differences observed reflect important inequities in timely access to HIV prevention, care, and treatment services, and highlight the need to develop contextual and culturally appropriate prevention and HIV testing strategies and linkage programs.

Estimating the Impact of Earlier ART Initiation and Increased Testing Coverage on HIV Transmission among Men Who Have Sex with Men in Mexico using a Mathematical Model.

OBJECTIVE: To estimate the impact of late ART initiation on HIV transmission among men who have sex with men (MSM) in Mexico. METHODS: An HIV transmission model was built to estimate the number of infections transmitted by HIV-infected men who have sex with men (MSM-HIV+) MSM-HIV+ in the short and long term. Sexual risk behavior data were estimated from a nationwide study of MSM. CD4+ counts at ART initiation from a representative national cohort were used to estimate time since infection. Number of MSM-HIV+ on treatment and suppressed were estimated from surveillance and government reports. Status quo scenario (SQ), and scenarios of early ART initiation and increased HIV testing were modeled. RESULTS: We estimated 14239 new HIV infections per year from MSM-HIV+ in Mexico. In SQ, MSM take an average 7.4 years since infection to initiate treatment with a median CD4+ count of 148 cells/mm3(25th-75th percentiles 52-266). In SQ, 68% of MSM-HIV+ are not aware of their HIV status and transmit 78% of new infections. Increasing the CD4+ count at ART initiation to 350 cells/mm3 shortened the time since infection to 2.8 years. Increasing HIV testing to cover 80% of undiagnosed MSM resulted in a reduction of 70% in new infections in 20 years. Initiating ART at 500 cells/mm3 and increasing HIV testing the reduction would be of 75% in 20 years. CONCLUSION: A substantial number of new HIV infections in Mexico are transmitted by undiagnosed and untreated MSM-HIV+. An aggressive increase in HIV testing coverage and initiating ART at a CD4 count of 500 cells/mm3 in this population would significantly benefit individuals and decrease the number of new HIV infections in Mexico.

The HIV care continuum in Latin America: challenges and opportunities.

Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test and treat approach might decrease HIV transmission at the population level, but to do so the HIV continuum of care, from diagnosis to viral suppression, should be optimised. Access to ART has improved greatly in Latin America, and about 600,000 people are on treatment. However, health-care systems are deficient in different stages of the HIV continuum of care, and in some cases only a small proportion of individuals achieve the desired outcome of virological suppression. At present, data for most Latin American countries are not sufficient to build reliable metrics. Available data and estimates show that many people living with HIV in Latin America are unaware of their status, are diagnosed late, and enter into care late. Stigma, administrative barriers, and economic limitations seem to be important determinants of late diagnosis and failure to be linked to and retained in care. Policy makers need reliable data to optimise the HIV care continuum and improve individual-based and population-based outcomes of ART in Latin America.

HIV and noncommunicable diseases (NCDs) in Latin America: a call for an integrated and comprehensive response.

The life expectancy of people living with HIV has dramatically improved with the much increased access to antiretroviral therapy. Consequently, a larger number of people living with HIV are living longer and facing the increased burden of noncommunicable diseases (NCDs). NCDs and HIV infection share common epidemiologic and sociodemographic characteristics that influence their outcomes, which may be difficult to address in the relatively weak health systems of the region. Data on the prevalence and interactions of NCDs and HIV in Latin American countries remain very limited, which hinders their governments' ability to make informed decisions about health care policies. Therefore, there is an urgent need to develop a research agenda that will be the basis for an integrated and comprehensive health care approach to HIV and NCD comorbidities in Latin America.

Correlation between sleep disorder screening and executive dysfunction in children with attention deficit-hyperactivity disorder.

OBJECTIVE: To compare frequency of sleep disorders (SD) and executive dysfunction (ED) in children with attention deficit-hyperactivity disorder (ADHD) and a control group. METHOD: We studied 156 children with ADHD with a mean age of 8.5 years, and a control group with 111 children with a mean age of 8.3 years. We utilized the Pediatric Sleep Questionnaire (PSQ) to screen SD and the working memory measurement from the Wechsler intelligence scale for children (WISC-IV) to screen ED. RESULTS: We did not observe an increased frequency of SD in children with ADHD compared with the controls. However, we did identify ED in children with ADHD; additionally a significant correlation was observed between the type of ADHD and SD and among ED, WISC-IV measurements, and type of SD in children with ADHD. CONCLUSION: An increase of SD frequency in children with ADHD was not observed, but we did identify ED in children with ADHD. Additionally, a correlation among ADHD types, SD, ED, and WISC-IV measurements was observed in children with ADHD.

The isotopic composition and insect content of diet predict tissue isotopic values in a South American passerine assemblage.

We analyzed the carbon and nitrogen isotopic values of the muscle, liver, and crop contents ("diet") of 132 individuals of 16 species of Chilean birds. The nitrogen content of diet was tightly correlated with the fraction of gut contents represented by insects relative to plant material. The carbon and nitrogen isotopic values of diet, liver, and muscle were all linearly correlated, implying high temporal consistency in the isotopic value of the diet of these birds. However, δ(15)N was not significantly related with the percentage of insects in diet. These results cast doubt on the applicability of the use of (15)N enrichment to diagnose trophic level in, at least some, terrestrial ecosystems. However, the residuals of the relationship relating the isotopic value of bird tissues with those of their diet were weakly negatively correlated with insect intake. We hypothesize that this negative correlation stems from the higher quality of protein found in insects relative to that of plant materials. Finally, our data corroborated a perplexing and controversial negative relationship between tissue to diet isotopic discrimination and the isotopic value of diet. We suggest that this relationship is an example of the commonly observed regression to the mean effect that plagues many scientific studies.

Low quality of life scores in school children with attention deficit-hyperactivity disorder related to anxiety.

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is an alteration that begins early in infancy and whose cardinal symptoms are inattention, hyperactivity and impulsivity. There are few studies for specific tests to measure Quality of Life (QoL) in children with ADHD. METHODS: We evaluated QoL of 120 children from 7-12 years of age with ADHD and of a group of 98 healthy control children. To measure QoL, we utilized the Questionnaire of Quality of Life for Children in Pictures (AutoQuestionnaire Qualité de Vie Enfant Imagé, AUQUEI). We evaluated anxiety in children by the Children´s Manifest Anxiety Scale-Revisited (CMAS-R). We compared results among groups and employed the calculation of correlation between the AUQUEI questionnaire and the CMAS-R scale. RESULTS: The total average of the AUQUEI questionnaire in children with ADHD was 45.2, while in the control group it was 54.3 (p<0.05). We also observed significant differences between the control group and groups of children with ADHD in the CMAS-R scale. We found significant correlations between AUQUEI questionnaire and CMAS-R scale. CONCLUSION: The main result was to the disclosure that low QoL scores in ADHD children was anxiety-related.

Identification of attention-deficit-hyperactivity disorder and conduct disorder in Mexican children by the scale for evaluation of deficit of attention and hyperactivity.

The objective was weighing the usefulness of a Spanish-language Scale for the evaluation of deficit of attention and hyperactivity (EDAH) to identify children with attention deficit-hyperactivity disorder (AD-HD) and conduct disorder (CD) in a sample of school-aged children. We studied 132 children from a government-run public elementary school previously selected by teachers as having learning and attention disorders. We screened children of the sample with parents' and teachers' EDAH and Diagnostic and Statistical Manual of Mental Disorders-IV edition Text Revision (DSM-IV-TR) questionnaires, and performed an interdisciplinary clinical examination for the final diagnosis. We found 81 children with AD-HD and 51 children without AD-HD. AD-HD was classified as follows: AD-HD-combined (-C), n=32; AD-HD-inattentive (-I), n=17 and AD-HD-hyperactive (-H), n=32. Cronbach's alpha calculation for the EDAH parents' questionnaire was 0.76, and for teachers, 0.80. Sensitivity of the teachers' EDAH questionnaire was 0.94, and specificity, 0.91. Sensitivity of the parents' EDAH questionnaire was 0.91, while specificity was 0.87. The data of EDAH parents' and teachers' questionnaires have a concordance of 93.1% and 80%, respectively. The correlation of scores among parents' and teachers' EDAH scales was significant. The correlation between results from parents' and teachers' DSM-IV-TR and EDAH questionnaires was also significant. Our results partially support the use of EDAH questionnaires for AD-HD and CD screening in Spanish-speaking populations.

Ventilación asistida por presión vs. ventilación mandatoria intermitente sincronizada: efectos hemodinámicos en pacientes críticos / Pressure support ventilation vs. synchronized intermittent mandatory ventilation hemodynamic effects on critically ill patients

Introducción: en los últimos años han aparecido varias publicaciones acerca de los efectos hemodinámicos de la ventilación asistida por presión (VAP). Ningún estudio ha comparado los efectos fisiológicos de la VAP con los de la ventilación mandatoria intermitente sincronizada (VMIS) en el mismo paciente. Objetivo: establecer si existe diferencia en los efectos hemodinámicos de la VAP y de la VMIS en cuidado intensivo. Diseño: experimento clínico cruzado (aleatorizado-controlado). Pacientes y métodos: de junio de 1993 a mayo de 1995, 31 pacientes ingresaron al estudio. Fueron sometidos a ventilación mecánica por ventilación asistida (VAC) o VMIS de manera no premeditada, durante la fase de estabilización. Antes del destete del ventilador, aleatoriamente, se asignaron a VAP o VMIS por 2 horas, tomándose medidas hemodinámicas. Luego permanecieron en VAC 1 hora y seguidamente se sometieron por 2 horas al método contrario al usado en las primeras 2. Se mantuvo VC de 10 cc/kg, FIO2 de 40% y PEEP de 4. Las variables estudiadas fueron frecuencia cardíaca, frecuencia respiratoria, tensión arterial, diuresis, presión ven osa central, presión capilar pulmonar, índice cardíaco, aporte de O2, consumo de oxígeno, resistencias vasculares sistémicas y pulmonares, SaO2, SvO2 y distensibilidad. Los resultados obtenidos son presentados en 2 subgrupos según la enfermedad: Grupo 1: respuesta inflamatoria sistémica (SDRIS) y Grupo 11: falla cardíaca severa. El análisis estadístico fue hecho con promedios, desviación estándar y prueba T de student. Resultados: no hubo diferencias significativas entre los 31 pacientes. Tampoco al dividirlos en SDRIS y falla cardíaca, salvo que estos últimos pacientes tuvieron mejor índice cardíaco con VAP que con VMIS. Ventilatoriamente fue evidente una mejor distensibilidad en todos los grupos con VAP. Conclusión: la VAP puede considerarse como método de elección para pacientes con falla cardíaca severa que requieran ventilación mecánica.

Effectiveness of highly active antiretroviral therapy (HAART) among HIV-infected patients in Mexico.

The National Government HAART Program (NGP) for the provision of HAART to uninsured HIV-infected persons in Mexico began in 2001. The objective was to describe the virologic outcome of patients enrolled in the NGP in a large HIV treatment center in Mexico City. HIV-infected persons, naive or < or =6 months on HAART, who entered the NGP from 2001 to 2005 were included. Patients with virological suppression were compared to those with virologic failure (VF) during follow-up. Of 377 patients enrolled, 191 where eligible for analysis. The median age was 35.9 (18-75 years) and 85% were male. The median baseline CD4(+) T cell count was 183 cells/mm(3); 63.9% had <200 cells/mm(3) and/or an AIDS-defining event. During follow-up (median: 17.77 months), 55 patients (28.7%) changed their first regimen: 8.3% because of VF and the remaining due to toxicity. The probability of VF at 48 months was 20%. VF was associated with age <30 years (p = 0.003, RR 4.7, IC 95% 1.5-14.4). The use of NNRTI was associated with lower risk of VF (p = 0.042, RR 0.3, IC 95% 0.12-0.99). Nadir CD4(+) and AIDS-defining at baseline were not associated with VF. Implementation of NGP for HAART access in a specialized care setting in Mexico resulted in an excellent virologic response. Younger age was a significant risk factor for VF.

Pandemic influenza as 21st century urban public health crisis.

The percentage of the world's population living in urban areas will increase from 50% in 2008 to 70% (4.9 billion) in 2025. Crowded urban areas in developing and industrialized countries are uniquely vulnerable to public health crises and face daunting challenges in surveillance, response, and public communication. The revised International Health Regulations require all countries to have core surveillance and response capacity by 2012. Innovative approaches are needed because traditional local-level strategies may not be easily scalable upward to meet the needs of huge, densely populated cities, especially in developing countries. The responses of Mexico City and New York City to the initial appearance of influenza A pandemic (H1N1) 2009 virus during spring 2009 illustrate some of the new challenges and creative response strategies that will increasingly be needed in cities worldwide.