Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances

Anales de Edafología y Agrobiología Tomo 41 Número 11-12

Suelos. Aplicación del método de evaluación de tierras de la F.A.O. a Galicia, por F. Díaz Fierros Viqueira, F. Gil Sotres y M. Puga Pereira.-- II. Lepidocrocita, goethita y vermiculita en el solum de un Ultisol, por E. Barragán y J. lñiguez. Modelo experimental de alteración de limonita, por Hoyos de Castro A., Hernando Costa, J, Hernando Massanel, l. y Millán Pérez, R.-- La fracción arcilla de suelos de alta montaña. III. Rendolls, por L. J. Alias Pérez y J. Hernández Bastida.-- Suelos empardecidos. IV. Mineralogía de arcillas y génesis de suelos, por Hoyos de Castro, A., Paloma G.Villamil, M. L., Hernando Costa, J. y Egido Rodríguez.-- The manganese transformation in soils, por B. L. Baser and L. L. Somani.-- Effect of soil application of manganese. por B. L. Baser and L. L. Somani.-- Fraccionamiento de sustancias húmicas. por A. Hoyos, M. A. Candas y J. González.—Fertilidad de Suelos. Adsorción de fosfato por minerales de la arcilla. por Sama Cruz, F., Bolarín, M. C .. Romero, M. y Fernández, F. G.--Actividad ureásica del suelo. por Pérez Mateos, M. y González Carcedo, S.-- Adición de resíduos vegetales. l. Evolución del carbono y nitrógeno. por M. T. Hernández, J. Cegarra, A. Lax y F. Costa.-- Efecto de la aplicación molíbdica sobre el rendimiento de maíz. por P. Díaz Luis. C. E. Alvarez, V. García y B. Eleizalde.—Fisiología Vegetaly Nutrición. Almidón en estatuillas juveniles de castaño y enraizamiento. por M. T. García, A. Ballesler y E. Veitez.--Fitotoxicidad de suelo bajo brezal de Erica Australis L. por A. Carballeira.--Benzylamino purine effect on seeds in culture, por Roberto Rodríguez y Belén Fernández.-- Inducción y crecimiento de cultivos de tejidos, por J. F. Pérez Francés, E. Iglesias, N. Samarín y A. C. Blesa.-- Inhibición de la reacción de Hill por herbicidas, por J. M. Durán y M. L. Manín.-- Actividad nitrato reductasa en hojas de olivo por V. Valpuesta, L Catalina, R. Romero, C. Mazuelos y R. Sarmiemo.-- Estudios cinélicos de la actividad ureásica en suelos calizos por González Carcedo, S. Pérez Maleas. M.-- Actividad ureásica y poblaciones microbianas: efecto del tolueno, por González Carcedo, S., Pérez Maleas, M. y Fueme Marcos, M. A.-- Comportamiento de Chlorella pyrenoidosa frente a boro, por Sánchez, E., Maleo, P., Fernández, E., Bonilla, l. y Onega, P. --Influencia de la nutrición nítrica o amoniacal sobre planta de lechuga, por M. P. Sánchez Conde.-- Influencia del embrión en la actividad proteolítica, por Amonio García Díez, Mercedes Villa Robledo y M. del Carmen Rodríguez Buján.—Fisiología Vegetal y Nutrición en estaquillas juveniles de castaño y enraizamiento, por Ma. T. Garda, A. Ballester y E. Veitiez.-- Fitotoxicidad de suelo bajo brezal de Erica Australis L., por A. Carballeira.-- Benzylarnino purine effect on seeds in culture, por Roberto Rodríguez y Belén Fernández.-- Inducción y crecimiento de cultivos de tejidos, por J.F. Pérez Francés, E. Iglesias, N. Samarín y A.C. Blesa.--Inhibición de la reacción de Hill por herbicidas, por J.M.Durán y M. L. Martín.-- Actividad nitrato reductasa en hojas de olivo, por V. Va/puesta, L. Catalina, R. Romero, C. Mazuelos y R. Sarmiento.-- Estudios cinéticos de la actividad ureásica en suelos calizos, por González Carcedo, S. y Pérez Mateos, M.-- Actividad ureásica y poblaciones ¡nicrobianas: efecto del tolueno, por González Carcedo, S., Pérez Mateos, M. y Fuente Marcos, M.A.-- Comportamiento de Chlorella pyrenoidosa frente a boro, por Sánchez, E., Mateo, P., Fernández, E., Bonilla, l. y Ortega P.-- Influencia de la nutrición nítrica o amoniacal sobre planta de lechuga, por Ma. P. Sánchez Conde.-- Influencia del embrión en la actividad proteolítica, por Antonio García Díez, Mercedes Villa Robledo y Ma. del Carmen Rodríguez BujánPeer reviewe

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably