Clinical Presentation and Outcomes of Kawasaki Disease in Children from Latin America: A Multicenter Observational Study from the REKAMLATINA Network

Objetivos: Describir la presentación clínica, el manejo y los resultados de la enfermedad de Kawasaki (EK) en Latinoamérica y evaluar los indicadores pronósticos tempranos de aneurisma de la arteria coronaria (AAC). Diseño del estudio: Se realizó un estudio observacional basado en el registro de la EK en 64 centros pediátricos participantes de 19 países latinoamericanos de forma retrospectiva entre el 1 de enero de 2009 y el 31 de diciembre de 2013, y de forma prospectiva desde el 1 de junio de 2014 hasta el 31 de mayo de 2017. Se recopilaron datos demográficos, clínicos y de laboratorio iniciales. Se utilizó una regresión logística que incorporaba factores clínicos y la puntuación z máxima de la arteria coronaria en la presentación inicial (entre 10 días antes y 5 días después de la inmunoglobulina intravenosa [IGIV]) para desarrollar un modelo pronóstico de AAC durante el seguimiento (>5 días después de la IGIV). Resultados: De 1853 pacientes con EK, el ingreso tardío (>10 días tras el inicio de la fiebre) se produjo en el 16%, el 25% tuvo EK incompleta y el 11% fue resistente a la IGIV. Entre los 671 sujetos con puntuación z de la arteria coronaria notificada durante el seguimiento (mediana: 79 días; IQR: 36, 186), el 21% presentaba AAC, incluido un 4% con aneurismas gigantes. Un modelo pronóstico simple que utilizaba sólo una puntuación z de la arteria coronaria máxima ≥2,5 en la presentación inicial fue óptimo para predecir la AAC durante el seguimiento (área bajo la curva: 0,84; IC del 95%: 0,80, 0,88). Conclusiones: De nuestra población latinoamericana, la puntuación z de la arteria coronaria ≥2,5 en la presentación inicial fue el factor pronóstico más importante que precedió a la AAC durante el seguimiento. Estos resultados resaltan la importancia de la ecocardiografía temprana durante la presentación inicial de la EK. © 2023 Los autoresObjectives: To describe the clinical presentation, management, and outcomes of Kawasaki disease (KD) in Latin America and to evaluate early prognostic indicators of coronary artery aneurysm (CAA). Study design: An observational KD registry-based study was conducted in 64 participating pediatric centers across 19 Latin American countries retrospectively between January 1, 2009, and December 31, 2013, and prospectively from June 1, 2014, to May 31, 2017. Demographic and initial clinical and laboratory data were collected. Logistic regression incorporating clinical factors and maximum coronary artery z-score at initial presentation (between 10 days before and 5 days after intravenous immunoglobulin [IVIG]) was used to develop a prognostic model for CAA during follow-up (>5 days after IVIG). Results: Of 1853 patients with KD, delayed admission (>10 days after fever onset) occurred in 16%, 25% had incomplete KD, and 11% were resistant to IVIG. Among 671 subjects with reported coronary artery z-score during follow-up (median: 79 days; IQR: 36, 186), 21% had CAA, including 4% with giant aneurysms. A simple prognostic model utilizing only a maximum coronary artery z-score ≥2.5 at initial presentation was optimal to predict CAA during follow-up (area under the curve: 0.84; 95% CI: 0.80, 0.88). Conclusion: From our Latin American population, coronary artery z-score ≥2.5 at initial presentation was the most important prognostic factor preceding CAA during follow-up. These results highlight the importance of early echocardiography during the initial presentation of KD. © 2023 The Author(s

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

Rhizosphere-inhabiting fungi isolated from native plants of the atacama desert affect leaf traits of chardonnay' grapevines (<i>Vitis vinifera</i> L.)

Studying new alternatives for promoting plant growth is crucial to face a changing climate. This study aimed to determine the beneficial effect of fungal strains isolated from the rhizospheric soil of two native plants from the Atacama Desert on physiological leaf traits of inoculated 'Chardonnay' grapevines. Rhizosphere fungi were isolated from Baccharis scandens and Solanum chilense and tested in vitro for plant growth-promoting traits, including indole acetic acid, phosphate solubilization, siderophore production, and polyamine production. Aspergillus niger, Microdochium bolleyi, and Westerdikeya centenaria were isolated, showing plant growth-promoting attributes and high salt tolerance in almost all tested isolates. Then, the fungi were stabilized and co-inoculated in pot-grown 'Chardonnay' plants (Vitis vinifera L.) growing in outdoor conditions to evaluate gas exchange variables, chlorophylls (as SPAD value), water potential, proline and sugar content, and lipid peroxidation in leaves. Inoculation of the fungal strains significantly increased the photosynthesis rate, which was associated with higher mesophyll conductance and SPAD values. The co-inoculation also induced an enhanced protective condition for oxidative damage. Increased carbon assimilation resulted in higher soluble sugars and intrinsic water use efficiency in leaves without altering the water status of treated plants. Our results demonstrated the beneficial effects of co-inoculating rhizosphere-inhabiting fungi isolated from native plants from the Atacama Desert on physiological traits of 'Chardonnay' grapevines

Endophytic seed-associated microbial diversity and its impact on seedling growth of the Andean tree <i>Nothofagus obliqua</i> (Mirb.) Oerst

Symbiotic microorganisms are essential for promoting plant growth and establishment from the early stages of plant development. However, the diversity of seed-associated endophytes in native Andean trees and their role in growth promotion and seedling establishment have scarcely been studied. This study aimed to characterize the microbial diversity associated with seeds of Nothofagus obliqua (Mirb.) Oerst. Viable seeds were collected from healthy young trees in a section of the Nahuelbuta Mountains, south-central Chile. Then, they were processed to characterize total microbial diversity using a 16S rRNA gene and an internal transcribed spacer (ITS) region metabarcoding approach. The diversity of culturable bacteria was determined and tested for plant growth-promoting effects. Effects on seed germination, seedling development, and plantlet establishment were evaluated by in vivo inoculations. Seed-associated microbial diversity was dominated by Ascomycota and Proteobacteria, with Diaphorte and Pantoea being the most abundant genera. Five different strains of culturable bacteria were identified, with Rahnella aquatilis being the strain with the most traits that promote plant growth. Bioaugmentation with R. aquatilis improved seed germination, plantlet growth, and establishment of N. obliqua plantlets in the field. Specifically, bioaugmentation with R. aquatilis stimulated height (+ 52%), stem cross-sectional area (+ 89%), stomatal conductance to water vapor (+ 25%), and leaf mass area (+ 29%). These results provide evidence for the beneficial properties of seed-associated bacteria that can support the establishment of native forest tree species in the southern Andes

TCF1-positive and TCF1-negative TRM CD8 T cell subsets and cDC1s orchestrate melanoma protection and immunotherapy response

Background Melanoma, the most lethal form of skin cancer, has undergone a transformative treatment shift with the advent of checkpoint blockade immunotherapy (CBI). Understanding the intricate network of immune cells infiltrating the tumor and orchestrating the control of melanoma cells and the response to CBI is currently of utmost importance. There is evidence underscoring the significance of tissue-resident memory (TRM) CD8 T cells and classic dendritic cell type 1 (cDC1) in cancer protection. Transcriptomic studies also support the existence of a TCF7+ (encoding TCF1) T cell as the most important for immunotherapy response, although uncertainty exists about whether there is a TCF1+TRM T cell due to evidence indicating TCF1 downregulation for tissue residency activation.Methods We used multiplexed immunofluorescence and spectral flow cytometry to evaluate TRM CD8 T cells and cDC1 in two melanoma patient cohorts: one immunotherapy-naive and the other receiving immunotherapy. The first cohort was divided between patients free of disease or with metastasis 2 years postdiagnosis while the second between CBI responders and non-responders.Results Our study identifies two CD8+TRM subsets, TCF1+ and TCF1−, correlating with melanoma protection. TCF1+TRM cells show heightened expression of IFN-γ and Ki67 while TCF1− TRM cells exhibit increased expression of cytotoxic molecules. In metastatic patients, TRM subsets undergo a shift in marker expression, with the TCF1− subset displaying increased expression of exhaustion markers. We observed a close spatial correlation between cDC1s and TRMs, with TCF1+TRM/cDC1 pairs enriched in the stroma and TCF1− TRM/cDC1 pairs in tumor areas. Notably, these TCF1− TRMs express cytotoxic molecules and are associated with apoptotic melanoma cells. Both TCF1+ and TCF1− TRM subsets, alongside cDC1, prove relevant to CBI response.Conclusions Our study supports the importance of TRM CD8 T cells and cDC1 in melanoma protection while also highlighting the existence of functionally distinctive TCF1+ and TCF1− TRM subsets, both crucial for melanoma control and CBI response

Acoso sexual y universidad. Realidades, debates y experiencias en el Ecuador

El acoso sexual universitario fue silenciado en el contexto ecuatoriano hasta el 2015, cuando los movimientos estudiantiles y feministas lo visibilizaron. Desde entonces, medios de comunicación, universidades y auditorios se han impregnado de conceptos, datos, denuncias, testimonios y reflexiones en torno a esta problemática. En ese decurso, en este libro se compilan debates clave con la intención de promover miradas más allá de lecturas reduccionistas, victimistas y punitivas. Escritas en diferentes registros y tonos, las secciones difractan el fenómeno y lo comprenden desde su multiplicidad, sin intenciones unívocas. Se reconocen las especificidades del acoso sexual universitario con base en cifras, también los mecanismos de dominio y sus improntas a nivel subjetivo. Se narran las experiencias asociadas a los protocolos y sus limitaciones en la aplicación, dejando entrever que garantizar normativas es fundamental, pero hay que apostar por los cambios en las dinámicas patriarcales. Se apunta que el horizonte de transformación está en los procesos de acompañamiento feminista y psicosocial y las acciones políticas colectivas. Este libro es precursor y contribuye a la lucha feminista para el reconocimiento pleno de las subjetividades en el ámbito educativo y convertir a las universidades en espacios cargados de ética del cuidado mutuo

Ongoing harlequin toad declines suggest the amphibian extinction crisis is still an emergency

Biodiversity loss is extreme in amphibians. Despite ongoing conservation action, it is difficult to determine where we stand in overcoming their extinction crisis. Among the most threatened amphibians are the 131 Neotropical harlequin toads. Many of them declined since the 1980s with several considered possibly extinct. Recently, more than 30 species have been rediscovered, raising hope for a reversing trend in the amphibian extinction crisis. We use past and present data available for harlequin toads (Atelopus), to examine whether the amphibian extinction crisis is still in an emergency state. Since 2004 no species has improved its population status, suggesting that recovery efforts have not been successful. Threats include habitat change, pathogen spread and climate change. More mitigation strategies need implementation, especially habitat protection and disease management, combined with captive conservation breeding. With harlequin toads serving as a model, it is clear that the amphibian extinction crisis is still underway. The status of the harlequin toads has not improved since 2004 despite species rediscoveries accompanied by increasing conservation efforts, and habitat destruction and degradation continue to threaten them today, according to an analysis of population status records over the period 2004-2022

Dementia in Latin America: Paving the way toward a regional action plan.

Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF