A humanized mouse that mounts mature class-switched, hypermutated and neutralizing antibody responses.

Humanized mice are limited in terms of modeling human immunity, particularly with regards to antibody responses. Here we constructed a humanized (THX) mouse by grafting non-γ-irradiated, genetically myeloablated KitW-41J mutant immunodeficient pups with human cord blood CD34+ cells, followed by 17ß-estradiol conditioning to promote immune cell differentiation. THX mice reconstitute a human lymphoid and myeloid immune system, including marginal zone B cells, germinal center B cells, follicular helper T cells and neutrophils, and develop well-formed lymph nodes and intestinal lymphoid tissue, including Peyer's patches, and human thymic epithelial cells. These mice have diverse human B cell and T cell antigen receptor repertoires and can mount mature T cell-dependent and T cell-independent antibody responses, entailing somatic hypermutation, class-switch recombination, and plasma cell and memory B cell differentiation. Upon flagellin or a Pfizer-BioNTech coronavirus disease 2019 (COVID-19) mRNA vaccination, THX mice mount neutralizing antibody responses to Salmonella or severe acute respiratory syndrome coronavirus 2 Spike S1 receptor-binding domain, with blood incretion of human cytokines, including APRIL, BAFF, TGF-ß, IL-4 and IFN-γ, all at physiological levels. These mice can also develop lupus autoimmunity after pristane injection. By leveraging estrogen activity to support human immune cell differentiation and maturation of antibody responses, THX mice provide a platform to study the human immune system and to develop human vaccines and therapeutics.

Victimization, polyvictimization, and depression symptoms among immigrants and native children and youth in Chile.

BACKGROUND: Migration exposes children and youth to vulnerabilities, including uprooting, lack of protection, limited access to services, and violence. Previous studies have shown that victimization experiences impact the mental health of migrant children, including depression, anxiety, and post-traumatic stress disorder. This study aims to examine the co-occurrence of multiple forms of maltreatment (polyvictimization) among migrant and Chilean children and youth and its association with depressive symptoms, addressing a research gap in Latin America. METHODS: Secondary data from the National Polyvictimization Survey (NPS) conducted by the Chilean Ministry of the Interior were analyzed. Measures assessing polyvictimization and depressive symptoms were administered to a sample of 1362 participants, with equal group sizes for migrants and Chilean-born individuals. Data analysis included descriptive statistics, group comparisons, correlation analyses, and multiple regression analyses. RESULTS: The study revealed marked differences in experiences of conventional crime victimization and polyvictimization between migrant and Chilean-born participants, with migrants facing slightly higher incidences. Correlational analysis indicated variable strengths of association between victimization types and depressive symptoms across groups, with Chilean-born individuals showing stronger correlations for certain victimization forms. Multiple regression analysis highlighted gender, polyvictimization, child maltreatment, internet victimization, sexual victimization, and peer/sibling victimization as significant predictors of depressive symptoms across the sample. Notably, an interaction was observed between child maltreatment and migrant status, indicating a mitigated impact of maltreatment on depressive symptoms among migrant adolescents. This suggests the potential for unique resilience or coping mechanisms in this group. CONCLUSIONS: This study elucidates the varied victimization experiences of migrant children and youth in Chile, with a notable emphasis on the mitigating effect of migrant status on the relationship between child maltreatment and depressive symptoms. It highlights the resilience and potential adaptive strategies of migrant minors facing adversity. The findings underscore the necessity of developing support and intervention strategies that recognize the specific needs and strengths of migrant children and youth, advocating for policies that protect and empower this vulnerable demographic amidst new environmental challenges.

The effects of Facebook and Instagram on the 2020 election: A deactivation experiment.

We study the effect of Facebook and Instagram access on political beliefs, attitudes, and behavior by randomizing a subset of 19,857 Facebook users and 15,585 Instagram users to deactivate their accounts for 6 wk before the 2020 U.S. election. We report four key findings. First, both Facebook and Instagram deactivation reduced an index of political participation (driven mainly by reduced participation online). Second, Facebook deactivation had no significant effect on an index of knowledge, but secondary analyses suggest that it reduced knowledge of general news while possibly also decreasing belief in misinformation circulating online. Third, Facebook deactivation may have reduced self-reported net votes for Trump, though this effect does not meet our preregistered significance threshold. Finally, the effects of both Facebook and Instagram deactivation on affective and issue polarization, perceived legitimacy of the election, candidate favorability, and voter turnout were all precisely estimated and close to zero.

Association between lipid profile and clinical outcomes in COVID-19 patients.

High-density lipoprotein cholesterol (HDL-c) removes cholesterol, an essential component in lipid rafts, and this cholesterol removal can regulate protein attachment to lipid rafts, modulating their functionality in the immune cell response. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can alter the lipid profile, there is little information on the role of HDL-c and other lipids in prognostic of the coronavirus disease 2019 (COVID-19) in Mexican population. This study aims to evaluate the predictive value of HDL-c and lipid profile on severity and survival of 102 patients infected with SARS-CoV-2 during the COVID-19 first wave. Our findings, derived from univariate and multivariate Cox proportional hazards regression models, highlighted age and hypertension as significant predictors of survival (HR = 1.04, p = 0.012; HR = 2.78, p = 0.027), while gender, diabetes, and obesity showed no significant impact. Triglycerides and HDL-c levels notably influenced mortality, with elevated triglycerides and lower HDL-c associated with higher mortality risk (p = 0.032). This study underscores the importance of lipid profiles alongside traditional risk factors in assessing COVID-19 risk and outcomes. It contributes to the understanding of COVID-19 patient management and emphasizes the need for further investigation into the role of dyslipidemia in influencing COVID-19 prognosis, potentially aiding in refined risk stratification and therapeutic strategies.

Fistula of the mitral-aortic intervalvular fibrosa in a patient with bacterial endocarditis: a case report and systematic literature review.

BACKGROUND: A fistulous tract in the mitro-aortic intervalvular fibrosa (MAIVF) is a rare entity, which presents as a complication of endocarditis or surgical trauma. Generally, it is associated to a pseudoaneurysm of the MAIVF (p-MAIVF) or aortic abscesses. MAIVF fistulas could potentially lead to devastating complications and a high mortality rate. This condition is managed surgically, either by a percutaneous closure or an open surgical approach. Herein we report the complex case of a patient with a MAIVF fistula secondary to bacterial endocarditis. Further clinical deterioration was caused by severe aortic valve insufficiency and hemodynamic compromise, requiring surgical intervention. CASE PRESENTATION: A 74-year-old male patient was admitted to a primary care center with complaints of malaise, asthenia, adynamia, hyporexia, and lower limb edema over the past eight days. His past medical history is positive for arterial hypertension and being monorenal. A transesophageal echocardiogram (TEE) was performed, exhibiting a 56% left ventricle ejection fraction (LVEF) and complicated aortic valve endocarditis. Surgical management through an open approach included vegetation resection, valve replacement, and closure of the MAIVF fistula. After completing antibiotic therapy, the patient was discharged without complications. During postoperative follow-up, the patient remained asymptomatic, and the control echocardiogram showed no signs of MAIVF fistula.4. CONCLUSIONS: The clinical case of a patient with a MAIVF fistula secondary to endocarditis by Streptococcus Anginous was presented. The fistulous tract was not associated to p-MAIVF or aortic abscess, findings which further deteriorate the patient's condition and increase the likelihood of fatality. This case reinforces the importance of a prompt diagnosis through cardiac imaging and timely surgical closure of the defect.

Superficial Intramuscular Gluteal Lipograft by Doppler Ultrasound: A Report of 24 Patients.

Background: Gluteal fat grafting is a common procedure in liposculpture. This study proposes a Doppler ultrasound-guided intramuscular and subcutaneous gluteal lipotransfer technique that allows for visualization of the location of the gluteal vessels, avoiding approaching them during lipotransfer by having the cannula localized during fat infiltration. Methods: This new technique was applied to 24 women after obtaining informed consent and providing them with a clear explanation of potential risks and complications. Doppler ultrasound was used to locate the site and depth of blood vessels, and for quadrant scanning of vessels and superficial intramuscular visualization of the cannula's location. Intramuscular lipotransfer was performed with a volume of 400 mL per gluteus (or less), and 12 patients underwent magnetic resonance imaging before and 3 months after surgery. Results: This technique allowed for visualizing the location of the gluteal vessels, and infiltration could be easily performed in patients. In the 24 glutei reviewed postsurgery, from 12 patients who underwent pre- and postsurgery magnetic resonance imaging, intramuscular fat was found; however, there was no migration outside the gluteus maximus muscle. Conclusions: No local or systemic complications were observed. The results of our report show that fat filtration did not migrate outside the gluteus maximus muscle. This finding seeks to promote new research to create theoretical/practical precedents for the intervention of plastic surgeons and, from there, promote the standardization of a new and safe technique.

Protocol to evaluate the antiviral effect of FDA-approved drugs against dengue virus in Huh7 cells and AG129 mice.

Finding an effective therapy against diseases caused by flaviviruses remains a challenge. Here, we present a protocol to test Food and Drug Administration-approved drugs that inhibit host nuclear protein import, promoting a reduction of dengue infection. We describe steps for analyzing the drug effect on nuclear import inhibition of cellular and viral proteins by confocal microscopy or western blotting. We then describe procedures for measuring the antiviral drug effects on virus-infected cells by flow cytometry and testing drug efficacy in dengue-infected AG129 mice by survival assays. For complete details on the use and execution of this protocol, please refer to Palacios-Rápalo et al.1.

Adipose-derived stromal vascular fraction cells to treat long-term pulmonary sequelae of coronavirus disease 2019: 12-month follow-up.

BACKGROUND AIMS: Long coronavirus disease (COVID) is estimated to occur in up to 20% of patients with coronavirus disease 2019 (COVID-19) infections, with many having persistent pulmonary symptoms. Mesenchymal stromal cells (MSCs) have been shown to have powerful immunomodulatory and anti-fibrotic properties. Autologous adipose-derived (AD) stromal vascular fraction (SVF) contains MSC and other healing cell components and can be obtained by small-volume lipoaspiration and administered on the same day. This study was designed to study the safety of AD SVF infused intravenously to treat the pulmonary symptoms of long COVID. METHODS: Five subjects with persistent cough and dyspnea after hospitalization and subsequent discharge for COVID-19 pneumonia were treated with 40 million intravenous autologous AD SVF cells and followed for 12 months, to include with pulmonary function tests and computed tomography scans of the lung. RESULTS: SVF infusion was safe, with no significant adverse events related to the infusion out to 12 months. Four subjects had improvements in pulmonary symptoms, pulmonary function tests, and computed tomography scans, with some improvement noted as soon as 1 month after SVF treatment. CONCLUSIONS: It is not possible to distinguish between naturally occurring improvement or improvement caused by SVF treatment in this small, uncontrolled study. However, the results support further study of autologous AD SVF as a treatment for long COVID.

Effects of Teosinte Flour (Dioon mejiae) on Selected Physicochemical Characteristics and Consumer Perceptions of Gluten-Free Cocoa Cookies Formulated with Mung Bean (Vigna radiata) Flour.

Dioon mejiae, or teosinte, is a living fossil tree discovered in Olancho, Honduras, whose seeds have a desirable nutritional profile that can provide health benefits. As a result, the objective of this study was to evaluate the effects of teosinte flour obtained from seeds on selected physicochemical characteristics and consumer perceptions of gluten-free cocoa cookies formulated with mung bean (Vigna radiata) flour. Gluten-free cocoa cookies were prepared with different levels of teosinte flour (0%, 70%, 80%, 90%, and 100% by weight of mung bean flour) in substitution of mung bean flour. The cookies were evaluated for texture hardness, color (L*, a*, b*), moisture content, and water activity. Sensory acceptability of appearance, color, texture, aroma, flavor, and overall quality of cocoa cookies was rated by 175 consumers using a "yes/no" binomial scale. Overall liking was evaluated using a 9-point hedonic scale. Purchase intent was evaluated with a "yes/no" binomial scale. The levels of teosinte flour did not significantly affect the acceptability of appearance, color, texture, flavor, aroma, and overall quality, and neither the overall liking nor the purchase intent responses. However, the texture attribute had the lowest % acceptability response among all sensory attributes. The addition of teosinte flour did not affect water activity and color (L*, a*, b*), whereas it decreased the texture hardness (g force), producing softer cookies. Cocoa cookies stayed acceptable even at 100% teosinte flour addition (70% acceptability; mean overall liking = 5.69). Teosinte flour has an excellent nutritional profile that could be practically applied in baked goods.

Structural competency in global perspective.

This special issue aims to help fill two critical gaps in the growing literature as well as in practice. First, to bring together scholars and practitioners from around the world who develop, practice, review, and question structural competency with the aim of promoting a dialogue with related approaches, such as Latin American Social Medicine, Collective Health, and others, which have been key in diverse geographical and social settings. Second, to contribute to expanding structural competency beyond clinical medicine to include other health-related areas such as social work, global health, public health practice, epidemiological research, health policy, community organisation and beyond. This conceptual expansion is currently taking place in structural competency, and we hope that this volume will help to raise awareness and reinforce what is already happening. In sum, this collection of articles puts structural competency more rigorously and actively in conversation with different geographic, political, social, and professional contexts worldwide. We hope this conversation sparks further development in scholarly, political and community movements for social and health justice.

A Dual Pharmacological Strategy against COVID-19: The Therapeutic Potential of Metformin and Atorvastatin.

Metformin (MET) and atorvastatin (ATO) are promising treatments for COVID-19. This review explores the potential of MET and ATO, commonly prescribed for diabetes and dyslipidemia, respectively, as versatile medicines against SARS-CoV-2. Due to their immunomodulatory and antiviral capabilities, as well as their cost-effectiveness and ubiquitous availability, they are highly suitable options for treating the virus. MET's effect extends beyond managing blood sugar, impacting pathways that can potentially decrease the severity and fatality rates linked with COVID-19. It can partially block mitochondrial complex I and stimulate AMPK, which indicates that it can be used more widely in managing viral infections. ATO, however, impacts cholesterol metabolism, a crucial element of the viral replicative cycle, and demonstrates anti-inflammatory characteristics that could modulate intense immune reactions in individuals with COVID-19. Retrospective investigations and clinical trials show decreased hospitalizations, severity, and mortality rates in patients receiving these medications. Nevertheless, the journey from observing something to applying it in a therapeutic setting is intricate, and the inherent diversity of the data necessitates carefully executed, forward-looking clinical trials. This review highlights the requirement for efficacious, easily obtainable, and secure COVID-19 therapeutics and identifies MET and ATO as promising treatments in this worldwide health emergency.

Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis.

BACKGROUND: Some patients with severe asthma may benefit from treatment with biologics, but evidence has been mostly collected from randomized controlled trials (RCTs), in which patients' characteristics are different from those encountered in asthma patients in the real-world setting. The aim of this study was to describe the clinical features of complete responders versus non-complete responders to long-term treatment with biologics in patients with severe asthma attended in routine daily practice. METHODS: Data of a cohort of 90 patients with severe asthma who were treated with biologics (omalizumab, benralizumab, and mepolizumab) for at least 12 months and were followed up to March 2022. Data recorded included clinical characteristics and effectiveness of treatment (exacerbation, Asthma Control Test [ACT] score, lung function, use of maintenance oral corticosteroids [mOCS]), FeNO, and blood eosinophils at baseline, at 12 months, and at the end of follow-up. Complete response is considered if, in addition to not presenting exacerbations or the use of mOCS, the ACT score was >20 and, the FEV1 >80% predicted. RESULTS: An improvement in all asthma control parameters was observed after 12 months of treatment and a mean follow-up of 55 months. After 12 months of treatment 27.2% of patients met the criteria of complete response and this percentage even increased to 35.3% at the end of follow-up. Long-term complete response was associated to better lung function with mepolizumab and omalizumab treatment and to less previous exacerbations in the benralizumab group. The main cause of not achieving a complete response was the persistence of an airflow obstructive pattern. CONCLUSIONS: This study shows that omalizumab, benralizumab, and mepolizumab improved the clinical outcomes of patients with severe asthma in a clinic environment with similar effect sizes to RCTs in the long term follow-up. Airflow obstruction, however, was a predictor of a non-complete response to biologics.

Treatment with anti-IgE and anti-IL-5 biologics significantly improved clinical outcomes in severe asthma patients.The rate of complete responders of 27.2% at 12 months even increased to 35.3% at the end of a mean follow-up of 55 months.The persistence of an airflow obstructive pattern was the main cause of the failure to achieve complete response.

Use of computed tomography coronary calcium score for prediction of cardiovascular events in cancer patients: a retrospective cohort analysis.

BACKGROUND: CT- coronary calcium score, is one of the most studied and widely available modalities in cardiovascular medicine. Coronary artery calcium score (CACS) is an established predictor of coronary artery disease. The 'standard of care' diagnostic modality to measure CACS is ECG-gated Cardiac Multi-Detector Computed Tomography. There is convincing evidence of a strong association between CACS and major cardiovascular (CV) events in asymptomatic individuals. Cancer patients (C) may have a higher risk for CV disease than non-cancer patients (NC) related not only to cancer treatments but also to shared biological factors and pathways. Thus, identifying tools for early detection of CV disease in this population is of utmost importance. METHODS: A retrospective cohort analysis was performed with patients from Cleveland Clinic Florida and Ohio who had CACS from 2017 to 2021. Patients who had cancer diagnosis prior to CACS were matched to NC for age and sex. CV events after their index CACS events were compared between C and NC, and matched control and propensity analysis were conducted. RESULTS: Ten thousand seven hundred forty-two patients had CACS; 703 cancer patients had CACS and were eligible. Extensive CACS (> 400) were significantly higher in cancer, 94 (13.37%) vs non-cancer patients, 76 (10.83%), P = 0.011. Furthermore, after propensity matched analysis, CACS > 400 was 14.8% in C vs 9.6% in NC, P = < 0.05. CV events were similar in both cohorts (p = NS), despite less CV risk factors in cancer patients (P = < 0.05). For the combined moderate (101-400) & extensive (> 400) CACS, the prevalence of stroke and peripheral arterial disease, a marker of systemic atherosclerosis, was significantly higher in patients with cancer (P < 0.01). CONCLUSIONS: Despite having fewer CV risk factors in our study, similar CACS in cancer patients are suggestive of a higher prevalence of CV disease independent of traditional risk factors. High CACS and the overall prevalence of vascular events were more frequent in patients with cancer. Higher prevalence of peripheral arterial disease and cerebrovascular accident further suggests the increased atherosclerotic burden in C.

Comparison of Long-term Response and Remission to Omalizumab and Anti-IL-5/IL-5R Using Different Criteria in a Real-life Cohort of Severe Asthma Patients.

BACKGROUND: Evaluation of biologic therapy response is vital to monitor its effectiveness. Authors have proposed various response criteria including good responder, super-responder, non-responder, and clinical remission. OBJECTIVES: To ascertain the prevalence of response and clinical remission after long-term treatment (>6 months) of anti-IgE and anti-IL-5/IL-5Rα biologics, compare these results with existing criteria, and identify predictors for non-responders and clinical remission. METHODS: A multicenter, real-life study involving severe asthma patients in Spain. Various outcomes were assessed to gauge response and clinical remission against established criteria. RESULTS: The study included 429 patients, 209 (48.7%) omalizumab, 112 (26.1%) mepolizumab, 19 (4.4%) reslizumab and 89 (20.7%) benralizumab, with a mean treatment duration of 55.3±38.8 months. In the final year of treatment, 218 (50.8%) were super-responders, 173 (40.3%) responders, 38 (8.9%) non-responders, and clinical remission in 116 (27%), without differences among biologics. The short-term non-responders (<6 months) were 25/545 (4.6%). Substantial variations in response and clinical remission were observed when applying different published criteria. Predictors of non-response included higher BMI (OR:1.14; 95% CI:1.06-1.23; p<0.001), admissions at ICU (2.69; 1.30-5.56; p=0.01), high count of SAE (1.21; 1.03-1.42; p=0.02) before biologic treatment. High FEV1% (0.96; 0.95-0.98; p<0.001), a high ACT score (0.93; 0.88-0.99; p=0.01) before biologic treatment or NSAID-ERD (0.52; 0.29-0.91; p=0.02) showed strong associations with achieving clinical remission. CONCLUSION: A substantial proportion of severe asthma patients treated long-term with omalizumab or anti-IL5/IL-5Rα achieved a good response. Differences in response criteria highlight the need for harmonization in defining response and clinical remission in biologic therapy to enable meaningful cross-study comparisons.

Long-Term Follow-up of Untreated Adult Patients with Spondylothoracic Dysostosis (Jarcho-Levin Syndrome).

BACKGROUND: Spondylothoracic dysostosis (STD), also known as Jarcho-Levin syndrome (JLS), is a rare autosomal recessive disorder affecting the formation of the spine, characterized by a complete bilateral fusion of the ribs at the costovertebral junction, producing a "crablike" appearance of the thorax. Despite being declared a core indication for a V-osteotomy vertical expandable prosthetic titanium rib (VEPTR) expansion thoracoplasty of the posterior thorax, the natural history of STD in untreated subjects remains poorly documented. In this study, we report radiographic and pulmonary function findings and Patient-Reported Outcomes Measurement Information System (PROMIS) and 24-Item Early Onset Scoliosis Questionnaire (EOSQ-24) scores for untreated adult subjects with STD to gain insights into the natural history. METHODS: We identified 11 skeletally mature, untreated subjects with STD. Findings on medical evaluation, demographics, radiographic parameters, pulmonary function, genetic testing results, PROMIS measures, and EOSQ-24 scores were assessed. RESULTS: Five male and 6 female subjects (mean age, 32.3 years [range, 15 to 70 years]) with a confirmed STD diagnosis based on radiographs and genetic testing were evaluated. Mean body mass index (BMI) was 24.4 kg/m 2 (range, 18 to 38.9 kg/m 2 ), and mean thoracic height was 16 cm (range, 12 to 17 cm). Pulmonary function tests (PFTs) showed a mean forced vital capacity (FVC) of 22% of predicted, mean forced expiratory volume in 1 second (FEV1) of 24% of predicted, and FEV1/FVC ratio of 107% of predicted. The mean PROMIS dyspnea score was 40 ± 8 points (range, 27.7 to 52.1 points). The mean total EOSQ-24 score was 77.3 ± 18 points (range, 43.9 to 93.2 points). CONCLUSIONS: Our study characterizes the natural history of STD in untreated subjects. We confirmed the expected restrictive pattern in pulmonary function, but interestingly, our subjects exhibited better EOSQ scores compared with those reported in neuromuscular populations. PFT results and thoracic height did not correspond to PROMIS and EOSQ scores, questioning the use of those parameters as a surgical indication. We therefore suggest that the STD diagnosis as an absolute indication for VEPTR expansion thoracoplasty surgery be reconsidered. LEVEL OF EVIDENCE: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

Drug-Induced Linear IgA Bullous Dermatosis in an Oncologic Patient.

Blister formation in the skin can result from various conditions, such as autoimmune disorders, drug reactions, infections, etc. A comprehensive patient assessment may offer clues for diagnosis. Linear IgA bullous dermatosis (LABD) is a rare subepidermal blistering disorder characterized by the deposition of IgA at the basement membrane zone of the skin and mucous membranes. Here, we describe a case of a patient with a new onset of painless blisters located in the skin and oral mucosa after initiating antibiotic treatment.

The Role of Aspartate Aminotransferase-to-Lymphocyte Ratio Index (ALRI) in Predicting Mortality in SARS-CoV-2 Infection.

COVID-19 has a mortality rate exceeding 5.4 million worldwide. The early identification of patients at a high risk of mortality is essential to save their lives. The AST-to-lymphocyte ratio index (ALRI) is a novel biomarker of survival in patients with hepatocellular carcinoma, an organ susceptible to SARS-CoV-2 infection. For this study, the prognostic value of ALRI as a marker of COVID-19 mortality was evaluated. For this purpose, ALRI was compared with the main biomarkers for COVID-19 mortality (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII], platelet-to-lymphocyte ratio [PLR], lactate dehydrogenase (LDH)/lymphocyte ratio [LDH/LR]). A retrospective cohort of 225 patients with SARS-CoV-2 infection and without chronic liver disease was evaluated. In the non-survival group, the ALRI, NLR, SII, and LDH/LR were significantly higher than in the survival group (pcorrected < 0.05). ALRI had an area under the curve (AUC) of 0.81, a sensitivity of 70.37%, and a specificity of 75%, with a best cut-off value >42.42. COVID-19 patients with high ALRI levels had a mean survival time of 7.8 days. Multivariate Cox regression revealed that ALRI > 42.42 (HR = 2.32, 95% CI: 1.35-3.97; pcorrected = 0.01) was a prognostic factor of COVID-19 mortality. These findings prove that ALRI is an independent predictor of COVID-19 mortality and that it may help identify high-risk subjects with SARS-CoV-2 infection upon admission.

Análisis de 27 marcadores STR del cromosoma Y en poblaciones de la selva del Perú / Analysis of 27 STR markers of the chromosome Y in the population of the jungle from Peru

Introducción: los marcadores de repeticiones cortas en tándem del cromosoma Y (Y-STR) se ubican en la región no recombinante del cromosoma Y, su herencia es por vía paterna, no son detectables en el ADN femenino. Estas propiedades hacen de los Y-STR una herramienta útil en las investigaciones forenses, como las agresiones sexuales, paternidades y otros delitos violentos; asimismo son útiles en estudios genealógicos y evolutivos. El objetivo de la investigación es ampliar la evidencia científica de la distribución por regiones o país de los haplotipos del cromosoma sexual Y, estudios similares en poblaciones peruanas son escasas debido al número menor de polimorfismos Y-STR de uso frecuente en genética forense y de poblaciones. Material y métodos: en la investigación se analizaron 141 muestras de ADN de la selva del Perú, de las que 104 muestras corresponden a la región de Iquitos (Loreto), 29 muestras son Awajun (Amazonas) y 8 muestras de Tambopata (Madre de Dios). Las muestras fueron procesadas empleando PCR directa con el kit Yfiler™ Plus PCR Amplification para 27 STR, los productos amplificados fueron analizados por electroforesis capilar en el Applied Biosystem™ 3500XL Genetic Analyzer y los datos obtenidos se importaron al software GeneMapper® ID-X v1.5 para generar los perfiles genéticos. Con los resultados obtenidos se realizó el análisis estadístico y la estructura poblacional. Resultados: de las 141 muestras se obtuvieron 106 haplotipos únicos. La diversidad genética para cada marcador Y-STR estuvo entre 0,317 y 0,919. La diversidad haplotípica para la muestra total fue de 0,9906. El estudio registra que los haplotipos Y-STR estudiados presentaron elevado polimorfismo en la población analizada y, por lo tanto, son de gran utilidad en estudios forenses de identificación humana, así como en genética de poblaciones cuando se investigan grupos o individuos de América Latina. (AU)

Y-chromosome-specific short tandem repeat (Y-STR) markers reside on the non-recombinant portion of the Y chromosome, their inheritance is paternal, they are not detectable in female DNA. These properties make Y-STRs a useful tool in forensic investigations such as sexual assault, parenting, and other violent crimes; likewise they are also useful in genealogical and evolutionary studies. The objective of the research is to expand the scientific evidence of the distribution by region or country of the Y sex chromosome haplotypes. Similar studies in Peruvian populations are scarce due to the smaller number of Y-STR polymorphisms frequently used in Forensic and Population Genetics. Material and method: In the investigation, 141 DNA samples from the jungle of Peru were analyzed, of which comprised of 104 samples from Iquitos region (Loreto), 29 samples from Awajun (Amazonas) and 8 samples from Tambopata (Madre de Dios). The samples were processed using direct PCR with the Yfiler™ Plus PCR Amplification kit for 27 STRs, the amplified products were analyzed by capillary electrophoresis on the Applied Biosystem™ 3500XL Genetic Analyzer, and the data obtained was imported into the GeneMapper® ID-X v1.5 software to generate the genetic profiles. With the results obtained, the statistical analysis and the population structure were carried out. Results: Of the 141 samples, 106 unique haplotypes were observed. Gene diversities for each Y-STR marker ranged from 0.317 to 0.919. The haplotype diversity for the total sample was 0.9906. This study supports that the Y-STR haplotypes in this population are highly polymorphic in the analyzed population and, therefore, are very useful in forensic studies of human identification, as well as in population genetics when investigating groups or individuals from Latin America. (AU)