Activos de salud, calidad de vida y morbimortalidad de la población en Asturias.

INTRODUCCIÓN: n promoción de la salud se ha detectado en los últimos años un incremento de investigaciones con enfoques teóricos basados en activos de salud. Pese a los estudios identificados, no se dispone de suficiente evidencia sobre los efectos que diferentes tipos de activos pueden tener en la calidad de vida y en la morbimortalidad de la población. OBJETIVO: analizar la relación entre los activos de salud disponibles con indicadores de morbilidad, mortalidad y calidad de vida de la población asturiana en el año 2018. METODOLOGÍA: diseño ecológico a partir de datos agregados municipales procedentes de los 78 municipios de Asturias (1.034.960 habitantes). Tras aplicar la definición de activos de salud como aquellas variables que pudieran redundar en una mejora de la salud y del bienestar de los individuos y de las comunidades, se seleccionaron 19 variables de activos agrupados en cuatro categorías: individuales, socioeconómicas, comunitarias e infraestructura. Una vez controladas las variables relacionadas con las características demográficas de la población, se analizó la asociación de los activos con las tasas de morbimortalidad y de calidad de vida. Se desarrollaron 5 modelos predictivos a partir de modelos de regresión lineal múltiple para las variables dependientes: calidad de vida, enfermedades crónicas, mortalidad por todas las causas, mortalidad por enfermedades cardiovasculares (ECV) y por cáncer. RESULTADOS: la disponibilidad de recursos sanitarios (beta = 0.474), coberturas sociales (beta = 0.305) y redes de apoyo social (beta = 0.225) constituyen los activos de salud con mayor peso explicativo en los resultados de salud de la población asturiana. Las variables incluidas en los modelos predictivos de calidad de vida (R2 = 0.650) y de mortalidad por ECV (R2 = 0.544) son las que mostraron una mayor capacidad explicativa. CONCLUSIONES: la inversión en recursos sociosanitarios y la mejora de redes de apoyo social impulsados desde el ámbito de la salud pública pueden producir importantes mejoras en la salud de la población asturiana.

Immunomodulatory and Antitumoral Activity of Gold Nanoparticles Synthesized by Red Algae Aqueous Extracts.

This study reports on the green and cost-efficient synthesis of gold nanoparticles from three different red algae extracts. The nanoparticles synthesized were fully characterized by UV-Vis spectroscopy, HRTEM, and Z-potential. Relevant components occurring in the extracts, such as polysaccharides or phenolic content, were assessed by analytical techniques such as spectrophotometric assays and liquid chromatography. Finally, the antioxidant, antitumoral, and anti-inflammatory potential of both the extracts and the gold nanoparticles synthesized were analyzed in order to determine a possible synergistic effect on the nanoparticles. The results obtained confirmed the obtainment of gold nanoparticles with significant potential as immunotherapeutic agents. The therapeutic potential of these nanoparticles could be higher than that of inert gold nanoparticles loaded with bioactive molecules since the former would allow for higher accumulation into the targeted tissue.

Efficient extraction of carrageenans from Chondrus crispus for the green synthesis of gold nanoparticles and formulation of printable hydrogels.

The integral utilization of sustainable resources with versatile, efficient and cleaner processes is encouraged. Hydrothermal treatment with subcritical water is a chemical free, tunable and rapid technology providing enhanced yield compared to conventional extraction and was explored for the benign by design extraction and depolymerization of carrageenan from Chondrus crispus. Up to 90% of the seaweed was solubilized operating under nonisothermal regime during heating up to 200 °C and 75.5% crude carrageenan yield was attained at 140 °C. Crude carrageenan could not be precipitated by ethanol from the extracts produced at 180 °C and higher temperatures, but ultrafiltration (100 kDa) of the extract obtained at 160 °C provided comparable recovery yields and similar rheological features to those of the ethanol precipitated product. Operation at 140 °C was preferred based on the higher recovery yield of the biopolymer and the whole extract was suitable for the green synthesis of polycrystalline decahedral quasi-spherical gold nanoparticles with a mean size distribution of 8.4 nm and Z potential value of -40.2 mV. Alternatively, the crude carrageen fraction was used for the formulation of printable biopolymer based gels with suitable mechanical properties, including a relevant gel strength enhancement (about 10-fold) when compared with conventional procedures.

Gold Nanoparticles Synthesized by an Aqueous Extract of Codium tomentosum as Potential Antitumoral Enhancers of Gemcitabine.

Cancer still poses a global threat, since a lot of tumors remain untreatable despite all the available chemotherapeutic drugs, whose side effects, it must also be noted, still raise concerns. The antitumoral properties of marine seaweeds make them a potential source of new, less toxic, and more active antitumoral agents. Furthermore, these natural extracts can be combined with nanotechnology to increase their efficacy and improve targeting. In this work, a Codium tomentosum (CT) aqueous extract was employed for the green synthesis of gold nanoparticles (Au@CT). The complete characterization of Au@CT was performed by UV-Vis spectroscopy, Fourier transform infrared (FTIR) spectroscopy, Zeta potential, electron microscopy, X-ray powder diffraction (XRD), high-performance steric exclusion chromatography (HPSEC), and by the determination of their antioxidant capacity. The antiproliferative activity of Au@CT was then tested in hepatic (HEPG-2) and pancreatic (BxPC-3) cell lines. Their potential capacity as enhancers of gemcitabine, a drug frequently used to treat both types of tumors, was also tested. The activity of Au@CT was compared to the activity of the CT extract alone. A synergistic effect with gemcitabine was proven for HEPG-2. Our results showed that gold nanoparticles synthesized from seaweed extracts with antitumoral activity could be a good gemcitabine enhancer.

Incidence of enterovirus in patients with acute gastroenteritis.

Enteroviruses (EV) have been linked to lymphocytic meningitis and exanthems, but they may also be involved in acute gastroenteritis (AGE), a condition whose aetiological agent often remains unidentified. In this work 1214 samples from individuals with AGE were studied with the aim of establishing the incidence of EV. The samples were collected between September and December in three different years and subjected to real-time genomic amplification in order to determine the viral load (VL). Of the 1214 samples studied, infection by a single virus was found in 328 cases (27%) and coinfection in 69 (5.7%). While adenoviruses (AdV) were the most frequent (14.8% of total), EV were present in 126 (10.4%) of the individuals tested. Of the 126 EV-positive samples, this virus was found as a single infection and coinfection in 76 (6.3%) and 50 (4.1%) cases, respectively. VL for EV was 5.58±1.51 log copies/ml (range 3.73-9.69) in the former and 6.27±1.75 (range 3.73-10.5) (p=0.02) in the latter. EV were identified in 97 children under 5 (16.9%) and in 29 (4.5%) patients over 5. Patients less than 5 years showed a higher VL that those more than 5 years age [6.08±1.57 (range 3.82-9.69) vs. 5.07±1.53 (range 3.73-10.58); (p=0.002)]. There was a high incidence of EV in AGE patients, and they were more frequent in those under 5, where they were found to replicate more efficiently. These results therefore indicate that testing for EV should be included in the diagnosis of AGE.

Eco-friendly extraction of Mastocarpus stellatus carrageenan for the synthesis of gold nanoparticles with improved biological activity.

Carrageenan was extracted from Mastocarpus stellatus using hot water extraction under atmospheric and pressurized conditions. The influence of heating temperature during a non-isothermal heating profile up to temperatures in the range 70-190 °C was studied to evaluate the extraction yields and properties of the carrageenan fraction. Under the selected conditions (130 °C), extracted carrageenan (CMs) was used for the green synthesis of gold nanoparticles (AuNPs). After the optimization of the reaction conditions, the synthesized gold nanoparticles (Au@CMs) were characterized by UV-Vis spectroscopy, Z potential measurements, electron microscopy, and X-ray diffraction analysis, which confirmed the formation of spherical, polycrystalline, and negatively charged nanoparticles with a mean diameter of 14.3 ± 2.1 nm. The study conducted by scanning transmission electron microscopy, energy dispersive X-ray analysis and mapping confirmed the presence of carrageenan stabilizing AuNPs. Finally, Fourier transformed infrared spectroscopy was performed to analyze the functional groups of CMs involved in the reduction and stabilization of AuNPs. The selective cytotoxicity and the antioxidant activity of the Au@CMs were evaluated in different cell lines and compared to the CMs. Au@CMs showed an improved antioxidant capacity in cells under oxidative stress and the induction of apoptosis in a monocytic cell line, while no antitumor effect was observed in a lung endothelial cell line.

Saccorhiza polyschides used to synthesize gold and silver nanoparticles with enhanced antiproliferative and immunostimulant activity.

Over the last years, there has been an increasing trend towards the use of environmentally friendly processes to synthesize nanomaterials. In the case of nanomedicine, the use of bionanofactories with associated biological properties, such as seaweed, has emerged as a promising field of work due to the possibility they open for both the preservation of those properties in the nanomaterials synthesized and/or the reduction of their toxicity. In the present study, gold (Au@SP) and silver (Ag@SP) nanoparticles were synthesized using an aqueous extract of Saccorhiza polyschides (SP). Several techniques showed that the nanoparticles formed were spherical and stable, with mean diameters of 14 ± 2 nm for Au@SP and 15 ± 3 nm for Ag@SP. The composition of the biomolecules in the extract and the nanoparticles were also analyzed. The analyses performed indicate that the extract acts as a protective medium, with the particles embedded in it preventing aggregation and coalescence. Au@SP and Ag@SP showed superior immunostimulant and antiproliferative activity on immune and tumor cells, respectively, to that of the SP extract. Moreover, the nanoparticles were able to modulate the release of reactive oxygen species depending on the concentration. Hence, both nanoparticles have a significant therapeutic potential for the treatment of cancer or in immunostimulant therapy.

Evaluation of the Antioxidant Capacities of Antarctic Macroalgae and Their Use for Nanoparticles Production.

Macroalgae are sources of bioactive compounds that are interesting from both a chemical and a medical point of view. Although their use in biomedicine has increased significantly in recent years, tests conducted to date have been mostly related to species from temperate latitudes, with the potential application of Antarctic biodiversity being minor. The wide variety of algae species present on Antarctic coastal areas can be a source of new antioxidants. Bearing this in mind, the brown macroalgae Desmarestia antarctica (DA) and the red Iridaea cordata (IC) were selected for the preparation of aqueous extracts with the aim of analyzing their antioxidant activity. This analysis was performed by determining reducing power, total phenolic content, and 2,2-diphenyl-1-picrylhydrazyl free radical scavenging activity. Furthermore, both extracts were employed to synthesize gold and silver nanoparticles. The nanomaterials were fully characterized by means of UV-Visible spectroscopy, transmission electron microscopy, Z potential measurements, and Fourier transform infrared spectroscopy, which confirmed the formation of stable, spherical nanoparticles with mean diameters of 13.7 ± 3.1 and 17.5 ± 3.7 nm for Ag@DA and Ag@IC and 12.6 ± 1.9 and 12.3 ± 1.6 nm for Au@DA and Au@IC. Antioxidant assays were performed after the synthesis of the nanomaterials to evaluate their possible synergistic effect with the extracts. The results suggest that polysaccharides and proteins may play a key role in the process of reduction and stabilization. Finally, for the sake of comparison, the results obtained for the Antarctic macroalgae Desmarestia menziesii and Palmaria decipiens have also been considered in the present work.

A novel single nucleotide polymorphism assay for the detection of N501Y SARS-CoV-2 variants.

The N501Y mutation in SARS-CoV-2 variants found in several strains from the UK, South Africa and Brazil has been linked to increased transmission. In order to discriminate N501Y variants quickly, a single nucleotide polymorphism (SNP) discrimination assay was designed and validated. It was then deployed prospectively in 757 nasopharyngeal swabs. Validation of the novel variant discrimination assay corroborated the results in all validation panel samples (n = 63) through sequencing. This novel variant discrimination assay was then deployed prospectively in 757 clinical nasopharyngeal swabs during the last week of January 2021. N501Y was found in 206 (27.4 %) of the samples: 94 (28.2 %) men and 112 (26.85 %) women (p = 0.73). The patients in whom it was identified had a mean age of 47.8 ± 25.8 (0-96) years, similar to that of patients without this variant: 51.7 ± 25.9 (0-104) years (p = 0.06). 501Y variant was confirmed in 34 samples by sequence method and 501 N wild type was confirmed in 67. This method is sensitive, specific, and simple to apply in any microbiology lab.

Immunostimulant and biocompatible gold and silver nanoparticles synthesized using the Ulva intestinalis L. aqueous extract.

This is the first study to report on the biocompatible and immunogenic properties of one-pot synthesised gold and silver nanoparticles (Au@UI and Ag@UI) using the macroalgae Ulva intestinalis (UI). The UI aqueous extract, Au@UI, and Ag@UI were obtained under sterile conditions and fully characterized by UV-vis spectroscopy, TEM, HRTEM, STEM and FTIR spectroscopy. Moreover, for the first time, the composition of carbohydrates in the UI extract has been reported along with the changes observed after nanoparticle synthesis by size exclusion chromatography, in order to investigate their possible role in the biosynthetic process. This study suggested that the polysaccharide fraction of the extract is involved in the formation and stabilization of the nanoparticles. The potential toxicity of the samples was evaluated using different cell lines and the hemocompatibility was tested in mouse erythrocytes. In addition, ROS production, complement activation and cytokine release were evaluated to determine the immunogenicity. The results showed that Au@UI and Ag@UI exhibit good biocompatibility and hemocompatibility, with the exception of Ag@UI nanoparticles at high concentration, which were hemolytic. The samples induced ROS release and complement activation, two key mechanisms in innate immunity. The samples also induced the release of cytokines from Th1 and Th2 profiles, and other cytokines implicated in the activation of the immune system. Au@UI and Ag@UI were biocompatible and preserved the immunostimulant properties of the UI extract. Hence, Au@UI and Ag@UI could be useful as adjuvants in vaccine development and promote a balanced Th1 and Th2 immune response mediated by ROS production, cytokine release and complement activation.

Macroalgae to nanoparticles: Study of Ulva lactuca L. role in biosynthesis of gold and silver nanoparticles and of their cytotoxicity on colon cancer cell lines.

Marine bio-resources are being widely studied as an invaluable source of compounds with therapeutic applicability. In particular, macroalgae contain an extended variety of bioactive compounds with different structures and promising biological applications. In this work, Ulva lactuca L. (hereafter UL) was utilyzed for the synthesis of gold and silver nanoparticles. Full characterization by UV-Vis spectroscopy, TEM, HRTEM and STEM miscroscopies, Z Potential and FTIR spectroscopy was performed. The first time in the scientific literature, the composition of carbohydrates of UL extract and their changes observed after nanoparticles synthesis were explored in order to investigate their possible role in the biosynthetic process. The reducing power, total phenolic content and DPPH scavenging activity of UL extract, Au@UL and Ag@UL nanoparticles were determined. The effects of UL extract, Au@UL and Ag@UL were tested in vitro on the colon cancer cell lines HT-29 and Caco-2, on normal primary neonatal dermal fibroblast cell line PCS-201-010, as well as on normal colon cell line CCD-112CoN. Lastly, the apoptotic activity and cellular uptake evaluation was determined for Au@UL and Ag@UL.

Prognostic value of Ki-67 according to age in patients with triple-negative breast cancer

Purpose: The prognostic value of Ki-67 in triple-negative breast cancer (TNBC) is yet unclear because the cut-off points employed differ widely and its predictive effect may vary according to age. The purpose of this study was to analyze the role of Ki-67 among patients with TNBC, and determine the optimal Ki-67 cut-off point to demonstrate its prognostic relevance associated with patient age and treatment strategy. Methods/patients: 201 consecutive patients treated for primary TNBC from 1999 to 2014 were analyzed. Clinicopathological characteristics and outcomes were compared between patients treated with neoadjuvant or adjuvant chemotherapy. We used time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) to evaluate the discriminative ability of Ki-67 at 3 and 5 years of follow-up. A Ki-67 cut-off point that maximized sensibility and specificity was established. Interaction effect between age and Ki-67 on disease-free survival (DFS) and overall survival (OS) was evaluated by stratified analysis. Results: According to the coordinates of the ROC curves, the best cut-off point for Ki-67 was 60% (high/low). In the whole group, there was not a statistically significant association between Ki-67 and OS and DFS, using a cut-off point of 60%. In multivariate analysis (COX proportional hazards regression), for DFS high Ki-67 (> 60%) was a poor prognostic factor in patients > 40 years old and a better prognostic factor among the patients < 40 years old. Conclusion: Prognostic value of Ki-67 in TNBC, using a cut-off point of 60%, may vary depending on age

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Prognostic value of Ki-67 according to age in patients with triple-negative breast cancer.

PURPOSE: The prognostic value of Ki-67 in triple-negative breast cancer (TNBC) is yet unclear because the cut-off points employed differ widely and its predictive effect may vary according to age. The purpose of this study was to analyze the role of Ki-67 among patients with TNBC, and determine the optimal Ki-67 cut-off point to demonstrate its prognostic relevance associated with patient age and treatment strategy. METHODS/PATIENTS: 201 consecutive patients treated for primary TNBC from 1999 to 2014 were analyzed. Clinicopathological characteristics and outcomes were compared between patients treated with neoadjuvant or adjuvant chemotherapy. We used time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) to evaluate the discriminative ability of Ki-67 at 3 and 5 years of follow-up. A Ki-67 cut-off point that maximized sensibility and specificity was established. Interaction effect between age and Ki-67 on disease-free survival (DFS) and overall survival (OS) was evaluated by stratified analysis. RESULTS: According to the coordinates of the ROC curves, the best cut-off point for Ki-67 was 60% (high/low). In the whole group, there was not a statistically significant association between Ki-67 and OS and DFS, using a cut-off point of 60%. In multivariate analysis (COX proportional hazards regression), for DFS high Ki-67 (> 60%) was a poor prognostic factor in patients > 40 years old and a better prognostic factor among the patients < 40 years old. CONCLUSION: Prognostic value of Ki-67 in TNBC, using a cut-off point of 60%, may vary depending on age.

Correction to: Fraction of high-grade cervical intraepithelial lesions attributable to genotypes targeted by a nonavalent HPV vaccine in Galicia, Spain.

After publication of the article [1], it was brought to our attention that the author E. López-Díez is missing their second affiliation. The author would also like to indicate an affiliation to "Universidade de Vigo, Pontevedra, Spain".

Harnessing the wine dregs: An approach towards a more sustainable synthesis of gold and silver nanoparticles.

In recent years, the management of food waste processing has emerged as a major concern. One such type of food waste, grape pomace, has been shown to be a great source of bioactive compounds which might be used for more environmentally - friendly processes for the synthesis of nanomaterials. In this study, grape pomace of Vitis vinifera has been used for the obtainment of an aqueous extract. Firstly, the reducing activity, total phenolic content and DPPH scavenging activity of the aqueous extract were determined. Then, the aqueous extract was used for the synthesis of gold and silver nanoparticles. The formation of spherical and stable nanoparticles with mean diameters of 35.3±5.2nm for Au@GP and 42.9±6.4nm for Ag@GP was confirmed by UV-vis spectroscopy and transmission electron microscopy. Furthermore, the functional group of biomolecules present in grape pomace extract, Au@GP and Ag@GP, were characterized by Fourier transform infrared spectroscopy prior to and after the synthesis, in order to obtain information about the biomolecules involved in the reducing and stabilization process. This study is the first to deal with the use of Vitis vinifera grape pomace in obtaining gold and silver nanoparticles through an eco-friendly, quick, one-pot synthetic route.

Fraction of high-grade cervical intraepithelial lesions attributable to genotypes targeted by a nonavalent HPV vaccine in Galicia, Spain.

BACKGROUND: Human papillomavirus (HPV) bivalent and quadrivalent vaccines have been widely implemented in worldwide organized immunization programs. A nonavalent HPV vaccine is now available in several countries. The objective was to describe the fraction of squamous non-invasive high-grade cervical intraepithelial lesions attributable to genotypes targeted by bi-quadrivalent vaccines and by nonavalent vaccine according to age and diagnosis in women living in the city of Vigo (Galicia, Spain). METHODS: Cervical scrapings (2009-2014) of women with histological diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2, n = 145) and grade 3-carcinoma in situ (CIN3-CIS, n = 244) were tested with Linear Array HPV Genotyping test (Roche diagnostics, Mannheim, Germany). Hierarchical estimation of the fraction attributable to HPV 16/18 or HPV 31/33/45/52/58 detected alone or in combination was calculated. Absolute additional fraction attributable to genotypes targeted by nonavalent vaccine compared to genotypes targeted by bi-quadrivalent vaccines was calculated as the increment of attributable cases with respect to all studied cases. Age group 1, 2 and 3 included women 18 to 34, 35-44 and ≥45 years old, respectively. EPIDAT 3.1 was used. RESULTS: Fraction attributable to genotypes targeted by bi-quadrivalent vaccines was 59% CIN2 vs. 69% CIN3-CIS (p < 0.001). It was 63/51/50% of CIN2 and 78/66/45% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by nonavalent vaccine was 86% CIN2 and 86% CIN3-CIS. It was 87/91/75% of CIN2 and 90/86/76% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by these vaccines tended to decrease as age increased (p-trend <0.05). Globally, absolute additional attributable fraction was 16%, 26% and 29% in age group 1, 2 and 3, respectively (p < 0.005). CONCLUSIONS: Absolute additional fraction of CIN2 and CIN3-CIS attributable to genotypes targeted by nonavalent vaccine was observed in women of any age, especially in those over 35 years old.

Green synthesis of gold nanoparticles using brown algae Cystoseira baccata: Its activity in colon cancer cells.

This study is the first dealt with the use of brown macroalgae Cystoseira baccata (CB) extracts in obtaining gold nanoparticles (Au@CB) through an eco-friendly, fast, one-pot synthetic route. The formation of spherical, stable, polycrystalline nanoparticles with mean diameter of 8.4±2.2nm was demonstrated by UV-vis spectroscopy, TEM, HRTEM, STEM and zeta potential measurements. The extract appears to act as a protective agent where the particles are embedded, keeping them separated, avoiding aggregation and coalescence. The EELS and EDS analyses confirmed the elemental composition of the extract and nanoparticles. Moreover, the functional group of biomolecules present in CB and Au@CB were characterized by FTIR. The effects of CB extract and Au@CB were tested in vitro on the colon cancer cell lines HT-29 and Caco-2, as well as on normal primary neonatal dermal fibroblast cell line PCS-201-010. Results show a stronger cytotoxic effect against HT-29 than that on Caco-2; interestingly, a lack of toxicity on PCS-201-010 was obtained. Finally, the apoptotic activity was determined; Au@CB is able to induce apoptosis activation by the extrinsic and mitochondrial pathway in our CRC in vitro model. These encouraging results suggest that Au@CB has a significant potential for the treatment of colon rectal cancer.