Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Translation, validation and cultural adaptation of the SANE (Single Assessment Numeric Evaluation) in patients with shoulder pathology

Introducción: La evaluación SANE (Single Assessment Numeric Evaluation) es un tipo de desenlace reportado por el paciente, corto y fácil de administrar que se correlaciona con otras evaluaciones funcionales del hombro más extensas. Hasta la fecha no se encuentra validada en nuestra lengua. Objetivo: Traducir, validar y adaptar la evaluación SANE al idioma español. Material y métodos: Se realizó la traducción y contra-traducción por dos evaluadores expertos bilingües y un traductor oficial. Se determinó la validez de constructo con un grupo de expertos en cirugía de hombro, la validez de criterio con la escala de American Shoulder and Elbow Surgeons (ASES) previamente validada en español y la reproducibilidad de la prueba. Resultados: Se evaluaron 113 pacientes con un promedio de edad de 53.6 años, siendo 56% mujeres. El diagnóstico más frecuente fue síndrome de manguito rotador en un 78.6% seguido por artrosis glenohumeral y acromioclavicular, hombro congelado e inestabilidad del hombro. El índice de correlación de Pearson entre el SANE y el ASES fue de 0.699. La reproducibilidad de la prueba fue alta con un coeficiente de correlación intraclase de 0.86. Conclusiones: La evaluación SANE es una medida de desenlace centrada en el paciente fiable y válida, que tiene una buena correlación con puntajes funcionales previamente validados al español más extensos. Se presenta la versión traducida y adaptada al español, que puede ser utilizada como medida de desenlace para intervenciones quirúrgicas o no quirúrgicas en patologías de hombro.Introduction: The Single Assessment Numeric Evaluation (SANE) score is a brief method of evaluating patients’ perception of the shoulder joint and has proven high correlation with other outcome measures that are more lengthy and time-consuming in daily practice. The SANE score to date has not been validated in Spanish. Objective: To translate, adapt, and validate the SANE score in Spanish. Material and methods: An initial translation and counter-translation was conducted by two bilingual evaluators and an offi cial translator. Content validity was evaluated by a group of experts in shoulder surgery. The criteria validity was determined by determining correlation with the previously translated and validated ASES score. Reliability of the test was determined. Results: 113 patients were evaluated, with an average age of 53.6 being 56% female. The most frequent diagnosis was rotator cuff syndrome in 78.6% followed by frozen shoulder, glenohumeral and acromioclavicular osteoarthritis and shoulder instability and acromioclavicular dislocation. Correlation between the SANE and ASES results was 0.699. The test was highly reliable with an intraclass correlation coeffi cient of 0.86. Conclusion: The SANE score is a valid and reliable patient centered outcome measure that has a good correlation with other previously validated scores in Spanish that are less practical. We present a translated valid version of the SANE score in Spanish that can be used as a patient reported outcome measure for shoulder pathologies.https://orcid.org/0000-0002-1993-3797Revista Internacional - IndexadaS

Macroeconomic Impact of Climate Change in Colombia

En este documento se hace una revisión de la literatura relativa a los efectos macroeconómicos esperados de los riesgos físicos y de transición asociados al cambio climático (RACC), identificando las principales fortalezas, debilidades y vacíos en dicha literatura. Esta revisión busca contextualizar su impacto potencial en Colombia en las próximas décadas y reflexionar sobre los desafíos que plantea para el manejo de diversos ámbitos de la política económica. En primer lugar, se examinan los efectos esperados sobre la actividad económica en las próximas décadas. Luego se revisan los posibles efectos de los RACC en el sector externo y se realizan proyecciones del balance en cuenta corriente bajo distintos escenarios climáticos. Enseguida se examina el impacto sobre las finanzas públicas y se presentan los resultados de ejercicios para evaluar diversas alternativas de política sobre la evolución del déficit y la deuda del gobierno nacional. A continuación, se presentan los desafíos que enfrentan las instituciones financieras y las autoridades y se presentan los resultados de un ejercicio de sensibilidad sobre las entidades crediticias en Colombia. Finalmente, se revisa la forma en que se afectarán los objetivos primarios de los bancos centrales, la formulación de sus políticas y sus mecanismos de transmisión.This document reviews the literature on the expected macroeconomic effects of climate related physical and transition risks (CRR), identifying the main strengths, weaknesses and gaps in said literature. This review seeks to contextualize its potential impact on Colombia in the coming decades and reflect on the challenges it poses for the management of various areas of economic policy. First, the expected effects on economic activity are examined. Then, the possible effects of the CRR on the external sector are reviewed and current account balance projections are made under different climate scenarios. Next, the impact on public finances is examined and the results of exercises to evaluate various policy alternatives on the evolution of the national government's deficit and debt are presented. The challenges faced by financial institutions and authorities are discussed, as well as the results of a sensitivity exercise on banks and credit institutions in Colombia. Finally, the way in which the primary objectives of central banks, the formulation of their policies and their transmission mechanisms will be affected is reviewed.Enfoque En este documento se hace una revisión de la literatura relativa a los efectos macroeconómicos esperados de los riesgos físicos y de transición del cambio climático, identificando las principales fortalezas, debilidades y vacíos. Esta revisión busca contextualizar su impacto potencial en Colombia en las próximas décadas y reflexionar sobre los desafíos que plantea para el manejo de diversos ámbitos de la política económica

Divulgación Científica No.4

En las instituciones encargadas de adelantar proyectos de investigación, como es el caso de la universidad, debemos reflexionar sobre lo que hacemos y sus implicaciones, de tal forma que encontremos claves para propiciar, desde nuestros saberes, agentes dinamizadores que animen la discusión, el debate y la comparación. Lo anterior con el enfoque de proponer caminos y soluciones para problemas actuales que nos aquejan como individuos. Las distintas búsquedas que hacemos apuntan a contribuir a la construcción de mejores sociedades, y la investigación es una valiosa herramienta con a que contamos para lograrlo. Es necesario entender la investigación como un agente que permite y propicia cambios.In the institutions in charge of carrying out research projects, such as the university, we must reflect on what we do and its implications, in such a way that we find keys to promote, from our knowledge, dynamic agents that encourage discussion, debate and the comparison. The above with the focus of proposing paths and solutions for current problems that afflict us as individuals. The different searches that we do aim to contribute to the construction of better societies, and research is a valuable tool that we have to achieve it. It is necessary to understand research as an agent that allows and promotes changes

Divulgación Científica No.4

En las instituciones encargadas de adelantar proyectos de investigación, como es el caso de la universidad, debemos reflexionar sobre lo que hacemos y sus implicaciones, de tal forma que encontremos claves para propiciar, desde nuestros saberes, agentes dinamizadores que animen la discusión, el debate y la comparación. Lo anterior con el enfoque de proponer caminos y soluciones para problemas actuales que nos aquejan como individuos. Las distintas búsquedas que hacemos apuntan a contribuir a la construcción de mejores sociedades, y la investigación es una valiosa herramienta con a que contamos para lograrlo. Es necesario entender la investigación como un agente que permite y propicia cambios.In the institutions in charge of carrying out research projects, such as the university, we must reflect on what we do and its implications, in such a way that we find keys to promote, from our knowledge, dynamic agents that encourage discussion, debate and the comparison. The above with the focus of proposing paths and solutions for current problems that afflict us as individuals. The different searches that we do aim to contribute to the construction of better societies, and research is a valuable tool that we have to achieve it. It is necessary to understand research as an agent that allows and promotes changes

The Principles of Menu Making (Second Edition)

Determining the distribution of disease prevalence among heterogeneous populations at the national scale is fundamental for epidemiology and public health. Here, we use a combination of methods (spatial scan statistic, topological data analysis, epidemic profile) to study measurable differences in malaria intensity by regions and populations of Colombia. This study explores three main questions: What are the regions of Colombia where malaria is epidemic? What are the regions and populations in Colombia where malaria is endemic? What associations exist between epidemic outbreaks between regions in Colombia? \textit{Plasmodium falciparum} is most prevalent in the Pacific Coast, some regions of the Amazon Basin, and some regions of the Magdalena Basin. \textit{Plasmodium vivax} is the most prevalent parasite in Colombia, particularly in the Northern Amazon Basin, the Caribbean, and municipalities of Sucre, Antioquia and Cordoba. Malaria has been reported to be most common among 15-45 year old men. We find that the age-class suffering high risk of malaria infection ranges from 20 to 30 with an acute peak at 25 years of age. Second, this pattern was not found to be generalizable across Colombian populations, Indigenous and Afrocolombian populations experience endemic malaria (with household transmission). Third, clusters of epidemic malaria for \textit{Plasmodium vivax} were detected across Southern Colombia including the Amazon Basin and the Southern Pacific region. \textit{Plasmodium falciparum}, was is epidemic in 13 of the 1,123 municipalities (1.2\%). Some key locations act as bridges between epidemic and endemic regions. Finally, we generate a regional classification based on intensity and synchrony, dividing the country into epidemic areas and bridge areas