Clinical profile of the first 1000 fatalities for influenza A (H1N1) in Mexico

Background: Influenza is an acute respiratory disease responsible for several episodes of high mortality throughout human history. In 2009, Mexico experienced an atypical influenza outbreak caused by a mutant strain of the influenza A (H1N1) subtype, which generated significant mortality. The aim of this paper was to analyze the clinical and sociodemographic conditions of the first 1000 fatalities recorded during this outbreak.Methods: We conducted a study based on an analysis of the clinical files of patients positive for influenza A (H1N1) using Real-Time-Polymerase Chain Reaction (RT-PCR) to conduct an analysis of deaths compared to deaths in the general population.  Results: The majority of deaths occurred in patients aged 35-84 years (65.8%). Average time between symptom onset and death was 13.8 days, with an average of 7.8 days from time of hospitalization until death. Ca. 25% of deaths occurred in residents from Mexico City and from the nearby State of Mexico. In the majority of cases, we found that patients who died had a low educational and socioeconomic status along with co-morbidities such as metabolic syndrome and its individual components, as well as respiratory illnesses. In 80% of cases, patients received mechanical ventilation, and a similar percentage received antiviral therapy (oseltamivir, zanamivir).  Conclusions: The primary-care level was not utilized by patients who died from influenza. The higher prevalence of chronic degenerative diseases among deaths compared with the general population indicates that these groups of patients should be considered and prioritized in the event of future outbreaks.

Comercio internacional y distribución de beneficios de la fibra de vicuña

con este artículo de investigación se espera mostrar la influencia del comercio internacional de fibra de vicuña para la sostenibilidad social y económica, en el marco de los beneficios compartidos y bienestar para las comunidades campesinas andinas. Metodología: la investigación utilizó indicadores sociales y económicos para determinar la sostenibilidad social y económica de las comunidades andinas. Asimismo, los beneficios económicos de los acuerdos comerciales y Free on board - FOB valores del comercio internacional de fibra de vicuña para el período 1995 – 2011. Hallazgo: se encontró que aproximadamente US $13 millones generados a partir del valor FOB en ese período no tiene bienestar social en las regiones afectadas. Del mismo modo, el comercio internacional de fibra de vicuña tuvo una influencia de bajo nivel (0.0792) en su bienestar económico al igual que los US$ 21 millones generados a partir del valor FOB. Conclusión: el comercio internacional de fibra de vicuña no tuvo influencia en el bienestar social o económico de las comunidades campesinas. El aumento de los recursos humanos en estas a niveles competitivos en educación, conocimiento tecnológico, acceso a sistemas de salud y nutrición serán un avance en el marco del desarrollo sostenible de la cultura y los valores morales andinos

Cambios transformacionales para alcanzar los objetivos de la visión para la diversidad biológica al 2050

Objetivo: con este artículo se busca recomendar la implementación, a nivel mundial, de cambios transformacionales o transformadores necesarios para alcanzar los objetivos de la visión para la diversidad biológica al 2050. Metodología: se analizaron los resultados de evaluaciones globales sobre la diversidad biológica como la “Evaluación Mundial sobre la Diversidad Biológica y los Servicios de los Ecosistemas” de IPBES” y las “Perspectivas del Medio Ambiente Mundial, GEO 6: Planeta sano, personas sanas” del PNUMA, entre otros, y artículos científicos relacionados, en el marco general de la teoría del cambio (ToC). Hallazgo: los resultados de aplicación de los documentos de planificación mundial, para detener las tasas de extinción aceleradas de especies y de ecosistemas y del desarrollo sostenible, plasmadas en las Metas de Aichi de la Estrategia para la Diversidad Biológica al 2020 y los Objetivos de Desarrollo Sostenible al 2030, muestran logros débiles. Conclusión: se requieren cambios transformadores drásticos para alcanzar los objetivos de la visión para la diversidad biológica al 2050 que se complementen con acciones como reducción de la inequidad, la eliminación de las externalidades negativas para el capital natural, la buena gobernanza, la implementación de incentivos, reducciones tributarias, impuestos como estrategias económicas, el fomento al comercio justo y la economía circular.Object: The purpose of this article is to recommend the implementation of transformational or transforming changes in a global scale, needed to reach the objectives of biological diversity vision as of 2050. Methodology: Results derived from global tests about biological diversity, like the IPBES’ “Global Assessment Report on Biodiversity and Ecosystem Services”, as well as PNUMA’s “Global Environment Outlook GEO-6: Healthy Planet, Healthy People”, among others, were examined. Besides, some scientific results related to the general frame of Theory of Change. Finding: Results from the application of the documents of global planification, to halt accelerated rates of extinction in species, ecosystems and sustainable development, appearing in the Aichi Biodiversity Targets for 2020 and the Sustainable Development Goals for 2030, show weak results. Conclusion: There exist drastic transformation changes that will be needed to reach the goals traced in the vision for biological diversity in 2050 and these will need additional actions as reduction of inequity, deletion of negative externalities in benefit of natural capital, good governance, implementation of incentives, tributary reductions, taxes as economic strategies, promotion for fair commerce and circular economy

Policy challenges for agroforestry implementation in Europe

Agroforestry (AF) is a sustainable land use practice and system that increases the ecosystem services delivery from agricultural lands compared with treeless systems. Agroforestry can be considered a practice when linked to plot scale (silvoarable, silvopasture, homegarden, woody linear landscape strips, and forest farming), and a system when associated with the global farm scale. The enhancement of the ecosystem services is associated with the use and promotion of the biodiversity caused by the presence of trees that optimizes the use of the resources if adequate species are mixed. Agroforestry can be implemented at temporal and spatial scales. At the temporal scale, the use of woody perennials to increase soil fertility is a traditional technique that improves soil health and reduces the need of using herbicides (e.g., the legume Ulex sown for 10 years in between crop cultivation). Five agroforestry practices can be implemented at the plot level: silvopasture, silvoarable/alley cropping, homegardens/kitchengardens, woody linear landscape strips, and forest farming. A farm including these practices is considered an agroforestry system working at the landscape level when several farms are mixed. In spite of the acknowledgment that AF has at the European level for being included as part of Pillars I and II, the spread of AF is limited across Europe. Four challenges, linked with technical, economic, educational, and policy development, have been identified by the AFINET thematic network that, if addressed, may foster policy adoption across the EU. This article proposes 15 different policy recommendations to overcome them and the need of developing an AF strategy for the EU.We acknowledge funding through Grant 101086563 from the European Commission (Project AF4EU, HEUROPE). This study was supported by National Funds by the FCT—Portuguese Foundation for Science and Technology, under the project UIDB/04033/2020. NF-D was funded by the Pilot Program of the University of Santiago de Compostela (USC) for the hiring of distinguished research staff—call 2021, funded under the collaboration agreement between USC and Banco Santander, for the years 2021–2024. JJS-F was supported by the USC and the Spanish Ministry of Universities through the “Convocatoria de Recualificación del Sistema Universitario Español” on its modality “Margarita Salas”; Ministry of Universities - Recovery Transformation and Resilience Plan (funded by the European Union through the NextGenerationEU).info:eu-repo/semantics/publishedVersio

New glucosamine-based TLR4 agonists: design, synthesis, mechanism of action, and in vivo activity as vaccine adjuvants

20 p.-15 fig.-1 graph. abst.We disclose here a panel of small-molecule TLR4 agonists (the FP20 series) whose structure is derived from previously developed TLR4 ligands (FP18 series). The new molecules have increased chemical stability and a shorter, more efficient, and scalable synthesis. The FP20 series showed selective activity as TLR4 agonists with a potency similar to FP18. Interestingly, despite the chemical similarity with the FP18 series, FP20 showed a different mechanism of action and immunofluorescence microscopy showed no NF-κB nor p-IRF-3 nuclear translocation but rather MAPK and NLRP3-dependent inflammasome activation. The computational studies related a 3D shape of FP20 series with agonist binding properties inside the MD-2 pocket. FP20 displayed a CMC value lower than 5 μM in water, and small unilamellar vesicle (SUV) formation was observed in the biological activity concentration range. FP20 showed no toxicity in mouse vaccination experiments with OVA antigen and induced IgG production, thus indicating a promising adjuvant activity.The authors acknowledge the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie, project BactiVax (www.bactivax.eu) grant agreement no. 860325; the consortium CINMPIS; the project of excellence CHRONOS, CHRonical multifactorial disorders explored by NOvel integrated Strategies of the Department of Biotechnology and Biosciences; the Agencia Estatal de Investigacion (Spain) for project PID2021-126130OB-I00 (N.G.A.A.), PID2020-113588RB-I00 (S.M.-S.), PRE2018-086249 (A.M.-R), PRE2021-097247 (M.M.-T.); and project FEDER MINECO, the EM-platform at the CIC bioGUNE for support in cryo-EM imaging. J.J.-B. also thanks funding by CIBERES, an initiative of Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Perkin-Elmer Italia is also acknowledged for providing the cell imaging reagents.Peer reviewe

Creación de nuevo recurso educativo virtual para estudiantes de grado en Farmacia

Depto. de Farmacia Galénica y Tecnología AlimentariaFac. de FarmaciaFALSEsubmitte

Creación de un nuevo recurso educativo virtual para estudiantes de grado en Farmacia

Creación de un nuevo recurso educativo virtual para estudiantes de grado en Farmacia sobre la serialización de los medicamentos y los procesos de mezclado

CiTiEs (Ciudades: Tiempo + Espacio) Diseño e implementación de materiales didácticos para la enseñanza virtual del Patrimonio cultural de Madrid a través de la flipped classroom

Se han diseñado e implementado materiales digitales para la Educación patrimonial de Madrid, dirigidos a estudiantes de varias asignaturas. Para su utilización, se ha utilizado preferentemente el "aula invertida" (flipped classroom), adaptándose a las circunstancias excepcionales del curso académico 2020-21

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe