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Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.
Brain derived neurotrophic factor (BDNF) is the most widely distributed and highly expressed neurotrophin in the CNS. BDNF gene have been associated with increased risk psychiatric disorders. It has been described interaction between BDNF and serotonin system at a neural and genetic level. Neuroticism as a personality trait relevant in borderline personality disorder (BPD) has genetic inheritance and is associated with serotonergic dysfunction. Has been reported that BDNF Val66Met variant is associated with neuroticism in general population. The aim of this study is to test the association between Val66Met and neuroticism and evaluate if the presence of Val66Met allele interacts with polymorphism in promoter region of serotonin transporter gene (5-HTTLPR) for develop neuroticism in BPD. We evaluate personality with NEO PI R in 104 BPD subjects that did not meet criteria for axis I diagnoses and other personality disorders. Genetic analysis of BDNF was performed determining the presence of Val/Val Val/Met and Met/Met BDNF variants. 5-HTTLPR was performed determining the presence of L and S 5-HTTLPR alleles. Statistical analysis were tested with parametric and correlation method with Stata10. We did not found differences in neuroticism between BDNF variants, but when controlled by BDNF alleles we found that Met/Met modulate the expression of 5-HTTLPR, with S-carriers (LS+SS) having higher neuroticism than LL (F = 6.36, p = 0.0031). We found no differences in expression of 5-HTTLPR in other BDNF variants. We conclude that BDNF have a differential modulating effect of 5-HTTLPR in neuroticism in BPD.
Neuroticism is characterized by emotional instability and the tendency to experience negative emotions such as anger, anxiety and depressed mood. Subjects with borderline personality disorder (BPD) present this personality dimension as a temperamental core trait. There has been proposed that neuroticism can appropriately describe the most important characteristics of BPD. The polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been implicated in depression, anxiety and suicide. It is estimated that 5-HTTLPR polymorphism account to 7 to 9% of inherited variance of neuroticism in personality. The aim of this study is to evaluate the association between neuroticism and 5-HTTLPR polymorphism in BPD. We evaluate personality with NEO PI R inventory in 104 BPD subjects (76 female/28 male) that did not meet criteria for axis I diagnoses and other personality disorders. The genetic analysis of 5-HTTLPR were performed determining the presence of long and short alleles, subjects were grouped in long/long (LL) and S-carriers (LS+SS). Statistical analysis were tested with parametric and correlation method with Stata10. We found significant difference in neuroticism between the genotype groups (F = 8.57, p = 0.0004) and lower levels of neuroticism in LL than S-carriers. Female have higher neuroticism than male. 5-HTTLPR polymorphism explains 18.02% of inherited variance in neuroticism. The S-carriers had 11.9 times higher risk of presenting elevated neuroticism compared with LL. We conclude that there are relation between 5-HTTLPR polymorphism and neuroticism in BPD. These results should contribute to the genetic study of BPD.
This study explores magnetization exhibited by nanoscale platinum-based structures embedded in pure silica plates. A superposition of laser pulses in the samples produced periodic linear arrangements of micro-sized structures. The samples were integrated by PtO2 microstructures (PtOΣs) with dispersed Pt oxide nanoparticles in their surroundings. The characterization of the materials was performed by high transmission electron microscopy studies. Furthermore, topographical and magnetic effects on the sample surfaces were analyzed by atomic force microscopy and magnetic force microscopy, respectively. The magnetic measurements indicated an enhancement in the gradient phase shift and in the gradient force related to the magnetic PtOΣs. The possibility of tuning the magnetic characteristics of the samples through contact with a Nd2Fe14B magnet was demonstrated. This process corresponds to an innovative method for obtaining magnetic PtOΣs induced by laser pulses. Moreover, an increase in the compactness of the silica with platinum-based structures was confirmed by an evaluation of the effective elastic modulus with reference to pure silica. The multimodal magnetic structures studied in this work seem to be candidates for developing high-density magnetic storage media.
Human papillomavirus (HPV) is a DNA virus linked to mucosal and cutaneous carcinogenesis. More than 200 different HPV types exist. We carried out a transversal study to investigate the prevalence of HPV types in two regions of Mexico. A total of 724 genital and non-genital samples from women (F) and men (M) were studied; 241 (33%) from North-Eastern (NE) and 483 (66%) from South-Central (SC) Mexico. The overall prevalence was 87%. In genital lesions from females, the NE group showed a prevalence of HPV types 16 (37%), 6 (13%), 59 (6%), 11, 18 and 66 (5.4% each); and the SC group showed types 6 (17%), 16 (15%), 11 (14.5%), 18 (12%) and 53 (6%). In the genital lesions from males, NE group showed types 16 (38%), 6 (21%), 11 (13%) and 59 plus 31 (7.5%) and the SC group showed types 6 (25%), 11 (22%), 18 (17%) and 16 (11.5%). When the two regions were compared, a higher prevalence of low-risk HPV 6 and 11 was found in the SC region and of high-risk HPV 59, 31 and 66 (the latter can also be present in benign lesions) in the NE region. Our findings complement efforts to understand HPV demographics as a prerequisite to guide and assess the impact of preventive interventions.
Asymptomatic colonisation of the gastrointestinal tract by carbapenemase-producing Enterobacteriaceae is an important reservoir for transmission, which may precede infection. This retrospective observational case–control study was designed to identify risk factors for developing clinical infection with OXA-48-producing Klebsiella pneumoniae in rectal carriers during hospitalisation. Case patients (n = 76) had carbapenemase-producing K. pneumoniae (CPKP) infection and positive rectal culture for CPKP. Control patients (n = 174) were those with rectal colonisation with CPKP but without CPKP infection. Multivariate analysis identified the presence of a central venous catheter (OR 4·38; 95% CI 2·27–8·42; P = 0·008), the number of transfers between hospital units (OR 1·27; 95% CI (1·06–1·52); P < 0·001) and time at risk (OR 1·02 95% CI 1·01–1·03; P = 0·01) as independent risk factors for CPKP infection in rectal carriers. Awareness of these risk factors may help to identify patients at higher risk of developing CPKP infection.
Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster.
We developed a system dynamics computational model that predicts community functioning after a disaster. The computational model outputted the time course of community functioning before, during, and after a disaster, which was used to calculate resistance, recovery, and resilience for all US counties.
The conceptual model explicitly separated resilience from community functioning and identified all key components for each, which were translated into a system dynamics computational model with connections and feedbacks. The components were represented by publicly available measures at the county level. Baseline community functioning, resistance, recovery, and resilience evidenced a range of values and geographic clustering, consistent with hypotheses based on the disaster literature.
The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127–137)
The main goal of this work consisted in cloning, purifying and characterizing a protein phosphatase 2C (PP2C) from promastigotes of Leishmania major. The gene was cloned and amplified by PCR using specific oligonucleotides and the recombinant protein was purified by affinity chromatography. The peak with maximal protein concentration was analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and revealed a protein of 44·9 kDa with PP2C activity. This activity was dependent on divalent cations (Mg+2 and Mn+2) and was optimal at pH of 8·5, using phosphothreonine as the substrate. Sanguinarine inhibited the activity of the recombinant LmPP2C, while protein tyrosine phosphatase inhibitors had no effect. The recombinant LmPP2C was used to generate polyclonal antibodies. These antibodies recognized a protein of 44·9 kDa in different Leishmania species; the LmPP2C was localized in the flagellar pocket and the flagellum of promastigotes.
Parasites can exert strong effects on population to ecosystem level processes, but data on parasites are limited for many global regions, especially tropical marine systems. Characterizing parasite diversity and distributions are the first steps towards understanding the potential impacts of parasites. The Panama Canal serves as an interesting location to examine tropical parasite diversity and distribution, as it is a conduit between two oceans and a hub for international trade. We examined metazoan and protistan parasites associated with ten oyster species collected from both Panamanian coasts, including the Panama Canal and Bocas del Toro. We found multiple metazoan taxa (pea crabs, Stylochus spp., Urastoma cyrinae). Our molecular screening for protistan parasites detected four species of Perkinsus (Perkinsus marinus, Perkinsus chesapeaki, Perkinsus olseni, Perkinsus beihaiensis) and several haplosporidians, including two genera (Minchinia, Haplosporidium). Species richness was higher for the protistan parasites than for the metazoans, with haplosporidian richness being higher than Perkinsus richness. Perkinsus species were the most frequently detected and most geographically widespread among parasite groups. Parasite richness and overlap differed between regions, locations and oyster hosts. These results have important implications for tropical parasite richness and the dispersal of parasites due to shipping associated with the Panama Canal.
Phosphatase activity of Leishmania spp. has been shown to deregulate the signalling pathways of the host cell. We here show that Leishmania mexicana promastigotes and amastigotes secrete proteins with phosphatase activity to the culture medium, which was higher in the Promastigote Secretion Medium (PSM) as compared with the Amastigote Secretion Medium (ASM) and was not due to cell lysis, since parasite viability was not affected by the secretion process. The biochemical characterization showed that the phosphatase activity present in PSM was higher in dephosphorylating the peptide END (pY) INASL as compared with the peptide RRA (pT)VA. In contrast, the phosphatase activity in ASM showed little dephosphorylating capacity for both peptides. Inhibition assays demonstrated that the phosphatase activity of both PSM and ASM was sensible only to protein tyrosine phosphatases inhibitors. An antibody against a protein phosphatase 2C (PP2C) of Leishmania major cross-reacted with a 44·9 kDa molecule in different cellular fractions of L. mexicana promastigotes and amastigotes, however, in PSM and ASM, the antibody recognized a protein about 70 kDa. By electron microscopy, the PP2C was localized in the flagellar pocket of amastigotes. PSM and ASM induced the production of tumor necrosis factor alpha, IL-1β, IL-12p70 and IL-10 in human macrophages.
I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6–7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.
This study aimed to determine Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Assessment Battery total score diagnostic accuracy in the diagnosis of mild cognitive impairment (MCI) and dementia in familial Alzheimer's disease (FAD) with E280A mutation on presenilin-1 gene (PSEN1).
A cross-sectional study was conducted in a cohort of PSEN1 E280A carriers and non-carriers assessed between January 1995 and February 2013. During the first neuropsychological assessment, 76 were having dementia, 46 had MCI, and 1,576 were asymptomatic. CERAD cut-off points were established for MCI and dementia using a Receiver Operating Characteristics (ROC) analysis, and were further analyzed according to education level in two groups: low education level (eight years or less), and high education level (over eight years).
The area under curve–ROC CERAD total score for dementia was 0.994 (95% CI = 0.989–0.999), and that for MCI was 0.862 (95% CI = 0.816–0.908). The dementia diagnosis cut-off point for the low education group was 54, (98.4% sensitivity, 92.6% specificity), and that for the high education group was 67 (100% sensitivity, 94.1% specificity). The MCI diagnosis cut-off point for the low education group was 66 (91.2% sensitivity, 56.4% specificity), and that for the high education group was 72 (91.7% sensitivity, 76.3% specificity).
The CERAD total score is a useful screening tool for dementia and MCI in a population at risk of FAD.
Asteroseismology has the capability of precisely determining stellar properties that would otherwise be inaccessible, such as radii, masses, and thus ages of field stars. When coupling this information with classical determinations of stellar parameters, such as metallicities, effective temperatures, and angular diameters, powerful new diagnostics for Galactic studies can be obtained. An overview of the ongoing Strömgren survey for Asteroseismology and Galactic Archaeology (SAGA) is presented, along with recent results using asteroseismology to investigate the vertical age structure of the Milky Way disc.
Background: Perinatal stroke causes hemiparetic cerebral palsy. Constraint therapy (CIMT) improves function in congenital hemiparesis and adult stroke. Repetitive transcranial magnetic stimulation (rTMS) may improve function in adult stroke. The two have not been tested in perinatal stroke. Methods: PLASTIC CHAMPS (www.clinicaltrials.gov/NCT01189058) was a controlled factorial trial of rTMS and CIMT in perinatal-stroke hemiparesis. Children 6-18 years participated in a 2 week peer-supported motor learning camp, randomized to daily inhibitory rTMS (1200 stimulations, contralesional M1), CIMT, both or neither. Primary outcomes were Assisting Hand Assessment (AHA) and Canadian Occupational Performance Measure (COPM) at 1, 8, and 24 weeks. Quality-of-life, safety and tolerability were evaluated. Change was assessed across treatment groups over time (linear mixed effects model). Results: All forty-five subjects completed the trial (median 11.4yrs). COPM scores increased >100% with maximal gains at 6 months (p<0.002). Addition of rTMS and/or CIMT doubled the chances of clinically significant gains. Combined rTMS+CIMT resulted in larger AHA gains at all time points (6 months p=0.006). CIMT or rTMS alone had more modest effects. Neither treatment decreased function in either hand. Procedures were well tolerated. Conclusions: Children with hemiparesis participating in intensive, psychosocial rehabilitation programs perceive marked increases in function. Non-invasive brain stimulation may enhance motor learning therapy in perinatal stroke hemiparesis.
According to the reports of Z.E. Horvath et al  and Liu Yun-quan et al , carbon nanotubes can be synthesized by spray pyrolysis from different carbon sources (n-pentane, n-hexane, n-heptane, cyclohexane, toluene and acrylonitrile) and several metallocene catalysts (ferrocene, cobaltocene and nickelocene). This paper describes two different existing methods for growth of carbon nanotubes and the influence of applied parameters (oven temperature, synthesis time, catalyst concentration, carrier gas flow and solution flow) on the CNT's morphology. Also, a possible influence of number of carbons in carbon sources and structures of their compounds (linear or aromatic) on properties of formed carbon nanotubes. Transmission Electron Microscopy (TEM), Infrared Spectroscopy (FTIR) and Raman spectroscopy were applied for characterization of obtained materials.
Collagen-covered prostheses can be used as a non-circumferential segmental tracheal replacement. However, the applicability of these implants in young subjects has not yet been reported.
In this experimental, longitudinal study, dogs aged 29–32 days underwent limited segmental tracheal replacement with a polyester prosthesis or were allocated to a control, untreated group. The dogs were evaluated clinically, endoscopically and tomographically for up to one year.
Although there was evidence of tracheal growth in the experimental group, tomographic measurements were significantly smaller in this group than in the control group throughout the observation period. At the end of the study, there was no evidence of implant rejection, stenosis or collapse. Normal respiratory epithelium had grown across the implanted membrane in the experimental group.
The homologous collagen mersylene membrane allowed for limited structural tracheal growth and was functionally integrated into the segmented tracheal wall in growing dogs.
Protozoan parasites of genus Leishmania are the causative agents of leishmaniasis. Leishmania promastigotes primarily infect macrophages in the host, where they transform into amastigotes and multiply. Lipophosphoglycan (LPG), the most abundant surface molecule of the parasite, is a virulence determinant that regulates the host immune response. Promastigotes are able to modulate this effect through LPG, creating a favourable environment for parasite survival, although the mechanisms underlying this modulation remain unknown. We analysed the participation of TLR2 and TLR4 in the production of cytokines and explored the possible phosphorylation of ERK and/or p38 MAP kinase signalling cascades in human macrophages stimulated with Leishmania mexicana LPG. The results show that LPG induced the production of TNF-α, IL-1β, IL-12p40, IL-12p70 and IL-10 and led to phosphorylation of ERK and p38 MAP kinase. Specific inhibitors of ERK or p38 MAP kinases and mAbs against TLR2 and TLR4 reduced cytokine production and phosphorylation of both kinases. Our results suggest that L. mexicana LPG binds TLR2 and TLR4 receptors in human macrophages, leading to ERK and MAP kinase phosphorylation and production of pro-inflammatory cytokines.
Zinc Oxide (ZnO) Thin-Film Transistors (TFTs) using Aluminum (Al) and Aluminum-doped zinc Oxide (AZO) as Source-Drain (S-D) contacts are reported. The fabrication process was carried out using five photolithography steps with a maximum processing temperature of 100 °C, which makes the process compatible with flexible/transparent applications. The AZO and ZnO films were deposited using Pulsed Laser Deposition (PLD). Aluminum was deposited using ebeam. The devices showed mobilities >10 cm2/V-s, threshold voltage in the range of 7 V and On/Off current ratios >105. The resistance analysis showed that AZO is a better contact with lower contact resistance as identified in the TFTs. The AZO and ZnO stacks characterized by UV-V shows an optical transmission >80 %.