Assessing refrigerated preservation performance using Listeria predictive microbiology models and temperature data: Refrigerator performance indicator and time-temperature equivalent.

Time-temperature data for queso fresco (QF) cheese varieties stored in a residential refrigerator operating at 5°C and a predictive microbiology secondary model for Listeria monocytogenes in QF were used to estimate a refrigerator performance indicator (RPI) of microbial preservation. RPI values were used to assess how compressor technology (single [SS] and variable speed [VS]), ambient temperature (21.1°C [LT] and 32.2°C [HT]), and refrigerator load (22.5 kg regular load and 39 kg higher load) affected preservation performance. All deterministic and probabilistic RPI estimations slightly exceeded the desirable 1.0 value, i.e., the variable temperatures for the QF kept in the refrigerator were worse than keeping it constantly at the temperature recommended by food safety agencies for QF. Furthermore, the mean comparison of estimates of the time-temperature equivalent indicator previously developed by French researchers showed similar behavior to those observed for RPI. Finally, statistical analysis showed that Tambient was the factor with the highest impact on refrigerator performance because of its impact on the sample temperature increase during door openings and when exposed to ambient temperature during product use. This highlights the need to reduce the time for product temperature recovery by improving the compressor operation logic. Also important are consumer behavior changes such as a reduction in product exposure to ambient temperature and in the door opening duration and frequency. PRACTICAL APPLICATION: This study demonstrated how a quantitative tool (RPI) can assess refrigerator preservation performance. Although the findings presented can be applied to any cold chain segment, the data used was collected for its weakest link, the domestic refrigerator. Surveys show that 77% of them operate above the recommended 4°C. The RPI methodology is ready for use by refrigerator designers to assess performance improvements possible by modifications of the compressor operation logic. Moreover, it can be integrated into smart-hubs monitoring the frequency and duration of refrigerator door openings to inform consumers when their habits are compromising the preservation performance of the refrigerator.

Case report: Comprehensive follow-up of a Colombian family carrying a novel MEN1 variant linked to a rare ACTH-producing pancreatic neuroendocrine carcinoma.

Background: Multiple Endocrine Neoplasia type 1 (MEN1) is an autosomal dominant disorder marked by pathogenic variants in the MEN1 tumor suppressor gene, leading to tumors in the parathyroid glands, pancreas, and pituitary. The occurrence of ACTH-producing pancreatic neuroendocrine carcinoma is exceedingly rare in MEN1. Case presentation: This report details a Colombian family harboring a novel MEN1 variant identified through genetic screening initiated by the index case. Affected family members exhibited primary hyperparathyroidism (PHPT) symptoms from their 20s to 50s. Uniquely, the index case developed an ACTH-secreting pancreatic neuroendocrine carcinoma, a rarity in MEN1 syndromes. Proactive screening enabled the early detection of pituitary neuroendocrine tumors (PitNETs) as microadenomas in two carriers, with subsequent surgical or pharmacological intervention based on the clinical presentation. Conclusion: Our findings underscore the significance of cascade screening in facilitating the early diagnosis and individualized treatment of MEN1, contributing to better patient outcomes. Additionally, this study brings to light a novel presentation of ACTH-producing pancreatic neuroendocrine carcinoma within the MEN1 spectrum, expanding our understanding of the disease's manifestations.

Dynamics of multisystem inflammatory syndrome in children associated to COVID-19 in Chile: Epidemiologic trends during pandemic, before and after children vaccination.

BACKGROUND: Multisystem inflammatory syndrome associated to Covid-19 (MIS-C) is one of the most severe outcomes of SARS-CoV-2 in children. Covid-19 vaccines were successfully implemented in Chile for the pediatric population since 2021, using both mRNA and inactivated platforms. Effectiveness against MIS-C has been reported for mRNA vaccines. The aim of this study was to describe the epidemiologic trend of MIS-C in Chile during Covid-19 pandemic, both before and after the availability of vaccination for children. MATERIALS AND METHODS: Analytic study of MIS-C cases from April 2020 to December 2022. Epidemiological data, SARS-CoV-2 variants and vaccination uptake information were obtained from the Epidemiology Department-Ministry of Health, Institute of Public Health and the National Immunization Program, respectively. RESULTS: 496 cases of MIS-C were reported, 58 % males. Median age was 5 years and most frequent age-cohorts were 6-11 and 0-2 years old with a 33 % each. After the introduction of the Covid-19 vaccine, most cases occurred in children aged 0-2 years. Incidence rates were 3.8, 5.4 and 1.7 per 100,000 inhabitants in 2020, 2021 and 2022, respectively. 97 % of cases (481) occurred in unvaccinated subjects. On those previously vaccinated (15), all but one case occurred in children receiving the inactivated vaccine. No association among circulating variants and incidence was observed. Incidence rate reduction (IRR) comparison between 2020 and 2021-2022 periods was 0.72 (CI 95 % 0.65-0.81, p < 0.05) overall; 0.86 for 0-2 years (CI 95 %:0.71-1; p = 0.12); 0.88 for 3-5 years (CI 95 %:0.69-1.11; p = 0.28); 0.61 for 6-11 years (CI 95 %: 0.50-0.75; p < 0.05); and 0.64 for 12-17 years (CI 95 %:0.47-0.89; p < 0.05), consistent with vaccination uptake during the studied period: 63 % for 3-5 years, 91 % for 6-11 years, and 99 % for 12-17 years. CONCLUSIONS: A decline of MIS-C incidence and a shift to younger, unvaccinated population overtime was observed. IRR decreased in age-cohorts which achieved high vaccination rates.

[Normative values for handgrip strength in Colombian older adults: Estimation by quantile regression]. / Valores normativos para la fuerza prensil manual en adultos mayores colombianos estimados mediante regresión cuantílica.

INTRODUCTION: Handgrip strength is a robust indicator of the biological health of elderly. OBJECTIVE: The purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. METHODS: A cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. RESULTS: Absolute handgrip strength values were considerably higher in men (P50 60-64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60-65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. CONCLUSIONS: The estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.

Performance of machine-learning approach for prediction of pre-eclampsia in a middle-income country.

OBJECTIVE: Pre-eclampsia (PE) is a serious complication of pregnancy associated with maternal and fetal morbidity and mortality. As current prediction models have limitations and may not be applicable in resource-limited settings, we aimed to develop a machine-learning (ML) algorithm that offers a potential solution for developing accurate and efficient first-trimester prediction of PE. METHODS: We conducted a prospective cohort study in Mexico City, Mexico to develop a first-trimester prediction model for preterm PE (pPE) using ML. Maternal characteristics and locally derived multiples of the median (MoM) values for mean arterial pressure, uterine artery pulsatility index and serum placental growth factor were used for variable selection. The dataset was split into training, validation and test sets. An elastic-net method was employed for predictor selection, and model performance was evaluated using area under the receiver-operating-characteristics curve (AUC) and detection rates (DR) at 10% false-positive rates (FPR). RESULTS: The final analysis included 3050 pregnant women, of whom 124 (4.07%) developed PE. The ML model showed good performance, with AUCs of 0.897, 0.963 and 0.778 for pPE, early-onset PE (ePE) and any type of PE (all-PE), respectively. The DRs at 10% FPR were 76.5%, 88.2% and 50.1% for pPE, ePE and all-PE, respectively. CONCLUSIONS: Our ML model demonstrated high accuracy in predicting pPE and ePE using first-trimester maternal characteristics and locally derived MoM. The model may provide an efficient and accessible tool for early prediction of PE, facilitating timely intervention and improved maternal and fetal outcome. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Eficiencia de un enfoque de aprendizaje automático para la predicción de la preeclampsia en un país de ingresos medios OBJETIVO: La preeclampsia (PE) es una complicación grave del embarazo asociada a morbilidad y mortalidad materna y del feto. Dado que los modelos de predicción actuales tienen limitaciones y pueden no ser aplicables en situaciones con recursos limitados, se propuso desarrollar un algoritmo de aprendizaje automático (AA) que ofrezca una solución con potencial para desarrollar una predicción precisa y eficiente de la PE en el primer trimestre. MÉTODOS: Se realizó un estudio de cohorte prospectivo en Ciudad de México para desarrollar un modelo de predicción de la PE pretérmino (PEp) en el primer trimestre utilizando AA. Para la selección de variables se utilizaron las características maternas y los múltiplos de la mediana (MdM) obtenidos localmente para la presión arterial media, el índice de pulsatilidad de la arteria uterina y el factor de crecimiento placentario sérico. El conjunto de datos se dividió en subconjuntos de datos de entrenamiento, de validación y de test estadístico. Se empleó un método de red elástica para la selección de predictores, y el rendimiento del modelo se evaluó mediante el área bajo la curva de características operativas del receptor (ABC) y las tasas de detección (TD) con tasas de falsos positivos (TFP) del 10%. RESULTADOS: El análisis final incluyó a 3050 mujeres embarazadas, de las cuales 124 (4,07%) desarrollaron PE. El modelo de AA mostró una buena eficiencia, con un ABC de 0,897, 0,963 y 0,778 para la PEp, la PE de aparición temprana (PEat) y cualquier tipo de PE (todas las PE), respectivamente. Las TD con TFP del 10% fueron del 76,5%, 88,2% y 50,1% para la PEp, PEat y todas las PE, respectivamente. CONCLUSIONES: Nuestro modelo de AA demostró una alta precisión en la predicción de la PEp y la PEat utilizando características maternas del primer trimestre y MdM calculados localmente. El modelo puede proporcionar una herramienta eficiente y accesible para la predicción temprana de la PE, facilitando la intervención oportuna y la mejora de los resultados maternos y del feto.

Feather's Composition of South Polar Skua (Stercorarius maccormicki) Using WDXRF.

This study investigated the feathers' composition of South polar skua (Stercorarius maccormicki) using WDXRF, evaluating the concentration of essential and non-essential elements in the feathers, and dividing it into rachis and barb parts. We collected South polar skuas feathers from Hennequin Point, King George Island, South Shetland, Antarctic Peninsula in January of 2013. Our results show that 18 elements were observed in the composition of the feathers, with a different concentration between the rachis and barbs, qualitatively and quantitatively. Only 3 elements observed were classified as non-essentials but still mostly elements do not have a function described in the literature to the feathers. According to our knowledge, this is the first study that uses this technique to evaluate the concentration of different elements in the feathers. The findings of this study highlight the use of alternative techniques to biomonitoring elements in the ecosystem and bring baseline information for future studies.

Exploring the CO2 photocatalytic evolution onto the CuO (1 1 0) surface: A combined theoretical and experimental study.

A combined theoretical and experimental study was performed to elucidate the photocatalytic potential of tenorite, CuO (1 1 0) and to assess the evolution pathway of carbon dioxide (CO2) evolution pathway. The calculations were performed with density functional theory (DFT) at a DFT + U + J0 and spin polarized level. The CuO was experimentally synthesized and characterized with structural and optical methodologies. The band structure and density of states revealed the rise of band gaps at 1.24 and 1.03 eV with direct and indirect band gap nature, respectively. These values are in accordance with the experimental evidence at 1.28 and 0.96 eV; respectively, which were obtained by UV-Vis DRS. Such a behavior could be related to enhanced photocatalytic activity among copper oxide materials. Experimental evidence such as SEM images and work function measurements were also performed to evaluate the oxide. The redox potential suggests a catalytic character of tenorite (1 1 0) for the CO2 transformation through aldehydes (methanal) intermediate formation. Furthermore, a route through methylene glycol CH2(OH)2 was also explored with the theoretical methodology. The reaction path exhibits an immediate reduction of Image 1 into a •OH radical and an [OH]- anion, in the first step. This •OH radical attacks a double bond (C = O) of Image 2 to form bicarbonate ([Image 3]-) and subsequently, carbonic acid (Image 4). The carbonic acid reacts with other •OH radical to finally form orthocarbonic acid (Image 5).

The relationship between loneliness and healthy aging indicators in Brazil (ELSI-Brazil) and England (ELSA): sex differences.

OBJECTIVES: This study aimed to estimate five harmonized healthy aging indicators covering functional ability and intrinsic capacity among older women and men from Brazil and England and evaluate their association with loneliness. STUDY DESIGN: This was a cross-sectional study. METHODS: We used two nationally representative samples of men and women aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) wave 2 (2019-2021; n = 6929) and the English Longitudinal Study of Aging wave 9 (2018-2019; n = 5902). Healthy aging included five separate indicators (getting dressed, taking medication, managing money, cognitive function, and handgrip strength). Loneliness was measured by the 3-item University of California Loneliness Scale. Logistic regression models stratified by sex and country were performed. RESULTS: Overall, age-adjusted healthy aging indicators were worse in Brazil compared with England for both men and women. Considering functional ability, loneliness was negatively associated with all indicators (ranging from odds ratio [OR] = 0.26, [95% confidence interval (CI) 0.13-0.52] in English men regarding the ability to take medication to OR = 0.49 [95% CI 0.27-0.89] in Brazilian women regarding the ability to manage money). Considering intrinsic capacity, loneliness was negatively associated with a higher cognitive function (OR = 0.72; 95% CI 0.55-0.95 in English women) and a higher handgrip strength (OR = 0.61; 95% CI 0.45-0.83 in Brazilian women). Lonely women demonstrated lower odds of a higher number of healthy aging indicators than men in both countries. CONCLUSIONS: Country-specific social environments should be targeted by public policies to decrease loneliness and promote healthy aging later in life.

Time until modification of antiparkinsonian therapy in a group of patients from Colombia. / Tiempo hasta la modificación de la terapia antiparkinsoniana en un grupo de pacientes de Colombia.

INTRODUCTION: The aim was to determine the time elapsed between the start of treatment with antiparkinsonian agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson's disease from Colombia. PATIENTS AND METHODS: Retrospective cohort study that collected information about the treatment of patients with Parkinson's disease who started drug therapy between June, 2011 and December, 2013; a five-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. RESULTS: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinsonian agents. After five years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% confidence interval: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to another drug. In the multivariate analysis, male sex, age over 65 years, and the start of amantadine were identified as factors that increased the likelihood of therapy modification. The use of bromocriptine, biperiden, and monotherapy as an initial treatment were associated with a reduction in this likelihood. CONCLUSIONS: After five years of treatment, 63.5% of the patients with Parkinson's disease required modifications to their therapy, with a mean time of three years. Male sex, age over 65 years, and receiving initial therapy with amantadine affected the likelihood of switching therapy in these patients in Colombia.

TITLE: Tiempo hasta la modificación de la terapia antiparkinsoniana en un grupo de pacientes de Colombia.Introducción. Se buscó determinar el tiempo transcurrido desde el inicio del tratamiento con fármacos antiparkinsonianos hasta la modificación en la terapia y establecer sus factores relacionados en un grupo de pacientes con enfermedad de Parkinson de Colombia. Pacientes y métodos. Estudio de cohorte retrospectiva que recolectó información sobre el tratamiento de pacientes con enfermedad de Parkinson que iniciaron terapia farmacológica entre junio de 2011 y diciembre de 2013; se realizó seguimiento a cinco años. Se generaron análisis de sobrevida para el tiempo trascurrido hasta la modificación de la terapia y se determinaron los factores relacionados con estos cambios utilizando modelos de regresión de Cox. Resultados. Un total de 3.224 pacientes (51,8%, hombres), con edad media de 73,1 ± 13,5 años, iniciaron tratamiento con fármacos antiparkinsonianos. Después de cinco años, 2.046 pacientes (63,5%) tuvieron modificaciones en la terapia farmacológica, con un promedio de tiempo de 36,4 meses (intervalo de confianza al 95%: 35,7-37,1). Un total de 1.216 pacientes (37,8%) requirió adición de otro principio activo, mientras que 830 (25,7%) tuvieron un cambio por otro medicamento. En el análisis multivariado, el sexo masculino, la edad mayor de 65 años y el inicio de amantadina se identificaron como factores que aumentaron la probabilidad de modificar la terapia. El uso de bromocriptina y biperideno, y la monoterapia como tratamiento inicial redujeron dicho riesgo. Conclusión. Después de cinco años de tratamiento, el 63,5% de los pacientes con enfermedad de Parkinson requirió modificaciones de la terapia, con un tiempo promedio de tres años. El sexo masculino, la edad mayor de 65 años y recibir terapia inicial con amantadina afectaron a la probabilidad de cambio de terapia en estos pacientes en Colombia.

Guillain-Barré syndrome outbreak in Tapachula temporally associated with the Zika virus introduction in Southern Mexico.

The Guillain-Barré syndrome (GBS) has been previously associated with Zika virus infection. We analysed the data from all the patients with GBS diagnosis that were admitted to a referral hospital, in Tapachula City during the period from January 2013 to August 2016, comparing the incidence of GBS according to the temporality of the Zika outbreak in Southern Mexico. Additionally, we described the clinical and epidemiological characteristics of the GBS patients admitted before or after the Zika outbreak. We observed a sharp increase in the number of patients hospitalised due to GBS from the time the first confirmed Zika cases appeared in Mexico. Clinically we observed GBS cases before zika outbreak had more frequently history of respiratory/gastrointestinal symptoms and GBS during zika outbreak had significantly more frequently recent history of rash/conjunctivitis. Although we cannot affirm that the increased cases of GBS have a specific aetiologic association with Zika, our results suggest that this observed outbreak of in Tapachula, might have been associated to the emerging Zika epidemic, locally and suggests that rare complications associated with acute infections (such as GBS) might be useful in the surveillance systems for emerging infections.

[Food insecurity levels and associated characteristics in pregnant women in Colombia in 2015]. / Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015.

INTRODUCTION: Food insecurity is the inability of households to acquire safe, nutritionally adequate food that meets physiological needs for leading a healthy and active life. OBJECTIVE: To describe the levels of food insecurity and associated factors in pregnant women in Colombia. METHODOLOGY: Cross-sectional-analytical study; is a secondary analysis of the 2015 Nutritional Situation Survey of Colombia. 1393 pregnant women between 12 and 48 years old were examined. Food insecurity was assessed using the Latin American and Caribbean Food Security Scale. Sociodemographic, anthropometric and micronutrient characteristics were evaluated. The description of food insecurity distribution was made for each of the selected variables, through absolute and percentage frequencies. To estimate the association between the different variables and food insecurity, we used multivariate Poisson regression models. RESULTS: 60.4% (CI95% 55.6%-64,7%) of pregnant women resided in homes with some degree of food insecurity; severe: 9.4% (CI95% 7.4%-11.9%), moderate: 17.6% (CI95% 13.5%-22.8%) and light: 33.2% (CI95% 28.9%-37.8%); we found that Black/Mulatto/Afro-descendant pregnant women (PR 1.22 CI95% 1.01-1.47), belong to quartile 1 of wealth (PR 2.23 CI95% 1.41-3.68), and residing in the región Atlántica (PR 1.34 CI95% 1.08-1.67), was associated with some food insecurity level. CONCLUSION: A high proportion of pregnant women living in households with some food insecurity level. The pregnant women of low socioeconomic levels and those belonging to the black/mulatto/Afro-descendant ethnic group showed to be the main characteristics associated with residing in households with some degree of food insecurity.

Temperature effects on the conductance, spin-valley polarization and tunneling magnetoresistance of single magnetic silicene junctions.

Magnetic silicene junctions are versatile structures with spin-valley polarization and magnetoresistive capabilities. Here, we investigate the temperature effects on the transport properties of single magnetic silicene junctions. We use the transfer matrix method and the Landauer-Büttiker formalism to calculate the transmittance, conductance, spin-valley polarization and tunneling magnetoresistance. We studied the case for T = 0 K, finding the specific parameters where the spin-valley polarization and the tunneling magnetoresistance reach optimized values. Regarding the temperature effects, we find that its impact is not the same on the different transport properties. In the case of the conductance, depending on the spin-valley configuration the resonant peaks disappear at different temperatures. The spin polarization persists at a considerable value up to T=80 K, contrary to the valley polarization which is more susceptible to the temperature effects. In addition, a stepwise spin-valley polarization can be achieved at low temperature. The tunneling magnetoresistance is attenuated considerably as the temperature rises, decreasing more than two orders of magnitude after T=20 K. These findings indicate that in order to preserve the spin-valley polarization and magnetoresistive capabilities of magnetic silicene junctions is fundamental to modulate the temperature adequately.

Predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis: 5-year experience in a tertiary care hospital.

INTRODUCTION AND OBJECTIVES: Emphysematous pyelonephritis is a life-threatening infection of the kidney and surrounding tissues associated with a high mortality rate. The aim of this study was to determine predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis, and to propose a therapeutic algorithm based on current literature and our experience. METHODS: A retrospective study was done including patients with emphysematous pyelonephritis in a single center in the north of Mexico from 2011 to 2016. Demographic, clinical, microbiological and biochemical parameters, therapeutic management, and outcomes were assessed. Factors associated with admission to intensive care unit and mortality were determined. Comparison was assessed using X2 test for categorical variables, and T-test for numerical variables. Univariate and multivariate logistic regression analyses were performed. Statistical significance was set at P < .05. RESULTS: A total of 63 patients were included, of which 55 (87.3%) were females, with a mean age of 55.5 ±â€¯12.2 years. The most common comorbidities were diabetes and hypertension. Escherichia coli was the most common isolated microorganism (51.7%) and extended-spectrum beta-lactamase-producing agents were reported in 31.7%. Conservative therapy was provided to 38.7%, double J stent 42.9%, open/percutaneous drainage 12.7%, and nephrectomy 25.3%. Overall mortality and intensive care admission were 20.6% and 36.5%, respectively. In the multivariate analysis, hemodynamic instability (P = .005), qSOFA ≥ 2 (P = .003), hypoalbuminemia (P = .02), and early nephrectomy (P = .002) were associated with intensive care admission. Huang scale 4 (P = .006) and early nephrectomy (P = .001) were associated to mortality. CONCLUSIONS: Emphysematous pyelonephritis is a life-threatening disease and evidence of management is based in small case series due to the low incidence of this condition. Hemodynamic instability, hypoalbuminemia, qSOFA ≥ 2, Huang scale ≥3, and early nephrectomy are associated with poor prognosis.

Prevalence of SARS-CoV-2 infection in Baja California, Mexico: Findings from a community-based survey in February 2021 in the Mexico-United States border.

Between March 2020 and February 2021, the state of Baja California, Mexico, which borders the United States, registered 46,118 confirmed cases of COVID-19 with a mortality rate of 238.2 deaths per 100,000 residents. Given limited access to testing, the population prevalence of SARS-CoV-2 infection is unknown. The objective of this study is to estimate the seroprevalence and real time polymerase chain reaction (RT-PCR) prevalence of SARS-CoV-2 infection in the three most populous cities of Baja California prior to scale-up of a national COVID-19 vaccination campaign. Probabilistic three-stage clustered sampling was used to conduct a population-based household survey of residents five years and older in the three cities. RT-PCR testing was performed on nasopharyngeal swabs and SARS-CoV-2 seropositivity was determined by IgG antibody testing using fingerstick blood samples. An interviewer-administered questionnaire assessed participants' knowledge, attitudes, and preventive practices regarding COVID-19. In total, 1,126 individuals (unweighted sample) were surveyed across the three cities. Overall prevalence of SARS-CoV-2 infection by RT-PCR was 7.8% (95% CI 5.5-11.0) and IgG seroprevalence was 21.1% (95% CI 17.4-25.2). There was no association between border crossing in the past 6 months and SARS-CoV-2 prevalence (unadjusted OR 0.40, 95%CI 0.12-1.30). While face mask use and frequent hand washing were common among participants, quarantine or social isolation at home to prevent infection was not. Regarding vaccination willingness, 30.4% (95% CI 24.4-3 7.1) of participants said they were very unlikely to get vaccinated. Given the high prevalence of active SARS-CoV-2 infection in Baja California at the end of the first year of the pandemic, combined with its low seroprevalence and the considerable proportion of vaccine hesitancy, this important area along the Mexico-United States border faces major challenges in terms of health literacy and vaccine uptake, which need to be further explored, along with its implications for border restrictions in future epidemics.

Time after a peak-pesticide use period and neurobehavior among ecuadorian children and adolescents: The ESPINA study.

BACKGROUND: Limited evidence exists regarding transient neurobehavioral alterations associated with episodic pesticide exposures or agricultural pesticide spray periods. We previously observed that children examined soon after a pesticide spray period (the Mother's Day flower harvest [MDH]) had lower neurobehavioral performance than children examined later. The present study builds on our previous work by incorporating longitudinal analyses from childhood through adolescence. METHODS: We examined participants in agricultural communities in Ecuador (ESPINA study) during three periods: July-August 2008 (N = 313, 4-9-year-olds); April 2016 (N = 330, 11-17-year-olds); July-October 2016 (N = 535, 11-17-year-olds). Participants were examined primarily during a period of low floricultural production. Neurobehavior was assessed using the NEPSY-II (domains: Attention/Inhibitory Control, Language, Memory/Learning, Visuospatial Processing, and Social Perception). Linear regression and generalized linear mixed models were used to examine cross-sectional and longitudinal associations between examination date (days) after the MDH and neurobehavioral outcomes, adjusting for demographic, anthropometric, and socio-economic variables. RESULTS: Participants were examined between 63 and 171 days after the MDH. Mean neurobehavioral domain scores ranged from 1.0 to 17.0 (SDrange = 2.1-3.1) in 2008 and 1.0 to 15.5 (SDrange = 2.0-2.3) in 2016. In cross-sectional analyses (2016 only; N = 523), we found significant or borderline positive associations between time after the MDH and Attention/Inhibitory Control (difference/10 days [ß] = 0.22 points [95% CI = 0.03, 0.41]) and Language (ß = 0.16 points [95% CI = -0.03, 0.34]). We also observed positive, longitudinal associations (2008-2016) with Attention/Inhibitory Control (ß = 0.19 points [95% CI = 0.04, 0.34]) through 112 days after the harvest and Visuospatial Processing (ß = 3.56, ß-quadratic = -0.19 [95% CI: -0.29, -0.09]) through 92 days. CONCLUSIONS: Children examined sooner after the harvest had lower neurobehavioral performance compared to children examined later, suggesting that peak pesticide spray seasons may transiently affect neurobehavior followed by recovery during low pesticide-use periods. Reduction of pesticide exposure potential for children during peak pesticide-use periods is advised.

Increased levels of soluble fms-like tyrosine kinase-1 are associated with adverse outcome in pregnant women with COVID-19.

OBJECTIVE: In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy. METHODS: This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis. RESULTS: Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia. CONCLUSION: sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed SARS-CoV-2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico.

OBJECTIVE: Mortality in pregnancy due to coronavirus disease 2019 (COVID-19) is a current health priority in developing countries. Identification of clinical and sociodemographic risk factors related to mortality in pregnant women with COVID-19 could guide public policy and encourage such women to accept vaccination. We aimed to evaluate the association of comorbidities and socioeconomic determinants with COVID-19-related mortality and severe disease in pregnant women in Mexico. METHODS: This is an ongoing nationwide prospective cohort study that includes all pregnant women with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Mexican National Registry of Coronavirus. The primary outcome was maternal death due to COVID-19. The association of comorbidities and socioeconomic characteristics with maternal death was explored using a log-binomial regression model adjusted for possible confounders. RESULTS: There were 176 (1.35%) maternal deaths due to COVID-19 among 13 062 consecutive SARS-CoV-2-positive pregnant women. Maternal age, as a continuous (adjusted relative risk (aRR), 1.08 (95% CI, 1.05-1.10)) or categorical variable, was associated with maternal death due to COVID-19; women aged 35-39 years (aRR, 3.16 (95% CI, 2.34-4.26)) or 40 years or older (aRR, 4.07 (95% CI, 2.65-6.25)) had a higher risk for mortality, as compared with those aged < 35 years. Other clinical risk factors associated with maternal mortality were pre-existing diabetes (aRR, 2.66 (95% CI, 1.65-4.27)), chronic hypertension (aRR, 1.75 (95% CI, 1.02-3.00)) and obesity (aRR, 2.15 (95% CI, 1.46-3.17)). Very high social vulnerability (aRR, 1.88 (95% CI, 1.26-2.80)) and high social vulnerability (aRR, 1.49 (95% CI, 1.04-2.13)) were associated with an increased risk of maternal mortality, while very low social vulnerability was associated with a reduced risk (aRR, 0.47 (95% CI, 0.30-0.73)). Being poor or extremely poor were also risk factors for maternal mortality (aRR, 1.53 (95% CI, 1.09-2.15) and aRR, 1.83 (95% CI, 1.32-2.53), respectively). CONCLUSION: This study, which comprises the largest prospective consecutive cohort of pregnant women with COVID-19 to date, has confirmed that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Impact of Cadmium Mediated by Tobacco Use in Musculoskeletal Diseases.

Tobacco use has a negative impact on health due to its relationship with the development of high-mortality diseases, such as pulmonary cancer. However, the effect of cadmium (Cd), present in tobacco smoke, on the development of joint diseases has been scarcely studied. The objective of this review is to discuss the evidence regarding the mechanisms by which Cd exposure, through tobacco smoke, may lead to the development of osteoarthritis (OA), osteoporosis (OP), and rheumatoid arthritis (RA). There's evidence suggesting a string association between moderate to severe OA development and tobacco use, and that a higher blood concentration of Cd can trigger oxidative stress (OS) and inflammation, favoring cartilage loss. At the bone level, the Cd that is inhaled through tobacco smoke affects bone mineral density, resulting in OP mediated by a decrease in the antioxidant enzymes, which favors the bone resorption process. In RA, tobacco use promotes the citrullination process through Cd exposure and increases OS and inflammation. Understanding how tobacco use can increase the damage at the articular level mediated by a toxic metal, i.e., Cd, is important. Finally, we propose prevention, control, and treatment strategies for frequently disabling diseases, such as OA, OP, and RA to reduce its prevalence in the population.