Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People : A Cross-Sectional Study

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency

Propiedades antioxidantes y antiinflamatorias de huauzontle (Chenopodium berlandieri subsp. nuttalliae, Chenopodiaceae) fermentado por Lactiplantibacillus plantarum Lp22

Background and Aims: Huauzontle (Chenopodium berlandieri subsp. nuttalliae) is a pseudocereal native to Mexico and is part of its culinary tradition. This pseudocereal is recognized for its high nutritional value and components that are associated with beneficial health effects. However, there is currently no literature on the impact that the fermentation process would have on its bioactive properties. Therefore, the aim of this research was to evaluate the effect of fermentation by Lactiplantibacillus plantarum Lp22 in huauzontle seeds suspended in water on their antioxidant and anti-inflammatory properties in vitro. Methods: Huauzontle seeds were suspended in water (0.3%, w/v), inoculated with L. plantarum Lp22 (1%, v/v) at 108 CFU/ml, and allowed to ferment for 24 h at 37 °C. Then, seeds were recovered by filtration, grounded and aqueous extract was obtained. The antioxidant activity of the extracts was determined by the ABTS and ORAC methods. Moreover, the inhibition of the enzymes lipoxygenase (LOX) and trypsin was evaluated and the total phenolic compounds in methanolic extract (Folin-Ciocalteu method) were also determined. Key results: The antioxidant activity represented as mM of Trolox equivalents was 812.50 and 927.50 by ABTS and 1384.32 and 3391.11 for ORAC, for unfermented and fermented huauzontle, respectively (p&lt;0.05). The inhibition of LOX activity was 40.06% and 37.24% for unfermented and fermented huauzontle, respectively, while for trypsin it was 12.53% and 14.38% (p&gt;0.05). Besides, total phenol content was 7.49 and 20.24 mg/ml (p&lt;0.05), respectively. Conclusions: Our findings evidence that fermentation of huauzontle improves the antioxidant and anti-inflammatory properties, which may be associated with increased phenol content. Therefore, its consumption could enhance the antioxidant and immune system of the human organism.Antecedentes y Objetivos: El huauzontle (Chenopodium berlandieri subsp. nuttalliae) es un pseudocereal nativo de México y forma parte de su tradición culinaria. Este pseudocereal es reconocido por su alto valor nutricional y componentes que se asocian a efectos benéficos a la salud. Sin embargo, al momento no se cuenta con literatura sobre el impacto que tendría el proceso de fermentación sobre sus propiedades bioactivas. Por ello, el objetivo de la presente investigación fue evaluar el efecto de la fermentación por Lactiplantibacillus plantarum Lp22, en semillas de huauzontle suspendidas en agua, sobre sus propiedades antioxidantes y antiinflamatorias in vitro. Métodos: Semillas de huauzontle se suspendieron en agua (0.3% p/v), se inocularon con L. plantarum Lp22 (1% v/v) a una concentración de 108 UFC/ml y se fermentaron por 24 h a 37 °C. Finalmente, las semillas fueron recuperadas por filtración, se molieron y del extracto acuoso se determinó la actividad antioxidante por los métodos de ABTS y ORAC. Además, se evaluó la inhibición de las enzimas lipooxigenasa (LOX) y tripsina y se determinó la concentración de fenoles totales (método de Folin-Ciocalteu) en extractos metanólicos. Resultados clave: La actividad antioxidante representada como mM de equivalentes Trolox fue de 812.50 y 927.50 por ABTS, y 1384.32 y 3391.11, para ORAC, para huauzontle no fermentado y fermentado, respectivamente (p&lt;0.05). La inhibición de la actividad de LOX fue de 40.06% y 37.24%, y para tripsina fue de 12.53% y 14.38% (p&gt;0.05), para no fermentado y fermentado, respectivamente, mientras que el contenido de fenoles totales fue de 7.49 y 20.24 mg/ml (p&lt;0.05), respectivamente. Conclusiones: Estos hallazgos indican que la fermentación del huauzontle mejora las propiedades antioxidantes y antiinflamatorias, y que pueden estar asociados con el incremento en el contenido de fenoles, por lo que su consumo podría fortalecer el mecanismo antioxidante y sistema inmune del organismo humano

Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City

Objective To evaluate the association of 2008-9 seasonal trivalent inactivated vaccine with cases of influenza A/H1N1 during the epidemic in Mexico

Depth of response in multiple myeloma: A pooled analysis of three PETHEMA/GEM clinical trials

On behalf of the GEM (Grupo Español de Mieloma)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group.[Purpose]: To perform a critical analysis on the impact of depth of response in newly diagnosed multiple myeloma (MM). [Patients and Methods]: Data were analyzed from 609 patients who were enrolled in the GEM (Grupo Español de Mieloma) 2000 and GEM2005MENOS65 studies for transplant-eligible MM and the GEM2010MAS65 clinical trial for elderly patients with MM who had minimal residual disease (MRD) assessments 9 months after study enrollment. Median follow-up of the series was 71 months. [Results]: Achievement of complete remission (CR) in the absence of MRD negativity was not associated with prolonged progression-free survival (PFS) and overall survival (OS) compared with near-CR or partial response (median PFS, 27, 27, and 29 months, respectively; median OS, 59, 64, and 65 months, respectively). MRD-negative status was strongly associated with prolonged PFS (median, 63 months; P operational cure> was high; median PFS was 12 years, and the 10-year OS rate was 94%. [Conclusion]: Our results demonstrate that MRD-negative status surpasses the prognostic value of CR achievement for PFS and OS across the disease spectrum, regardless of the type of treatment or patient risk group. MRD negativity should be considered as one of the most relevant end points for transplant-eligible and elderly fit patients with MM.Supported by the Centro de Investigación Biomédica en Red – Area de Oncologia - del Instituto de Salud Carlos III (CIBERONC; CB16/12/00369; CB16/12/00400; CB16/12/00233; CB16/12/00284), formerly named as Cooperative Research Thematic Network (Grants No. RD12/0036/0058, RD12/0036/0048, RD12/0036/0046, and RD12/0036/0061) of the Red de Cancer (Cancer Network of Excellence); Instituto de Salud Carlos III/Subdirección General de Investigación Sanitaria; funded in part by the European Regional Development Fund (FIS No. 98/1239, 00/10160, 01/0089, 02/0089, 02/0905, G03/136, PI051284, PI06033906/1354, PS09/01897/01370, PI12/01761, PI12/02311, PI13/01469, PI14/01867, G03/136); Sara Borrell (No. CD13/00340); Asociación Española Contra el Cáncer (No. GCB120981SAN); and Federación Española de Enfermedades Raras. Also supported internationally by the Black Swan Research Initiative of the International Myeloma Foundation and the European Research Council 2015 Starting Grant (MYELOMANEXT).Peer Reviewe

Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders

Towards a common vision of climate security in Guatamela

CGIAR’s Climate Resilience Initiative, also known as ClimBeR, is working to address these needs. On the 21st and 22nd of February, we ran in Guatemala City the first climate security workshop in Central America: Towards a common vision on the relationship between climate, conflict, and human security in Guatemala. The workshop was organized by the Alliance of Bioversity and CIAT along with the CGIAR’s Climate Resilience Initiative; the Fragility, Conflict, and Migration Initiative; the regional integrated initiative AgriLAC Resiliente; and the CGIAR FOCUS Climate Security and benefited from the participation of 45 individuals from 20 different organizations, including regional & local organizations, government institutions, UN agencies, and national universitie

Hacia una visión compartida sobre la seguridad climática en Guatemala

Este infore explora las interconexiones entre el cambio climático, la seguridad humana y los conflictos en Guatemala basándose en el Taller sobre Seguridad Climática celebrado en Ciudad de Guatemala los días 21 y 22 de febrero de 2023. Las implicaciones del cambio climático para la seguridad, comúnmente conocidas como el nexo clima-seguridad, han sido ampliamente discutidas tanto en círculos políticos como académicos. La seguridad climática se refiere las amenazas y riesgos de seguridad a estados, sociedades e individuos causados directa o indirectamente por los efectos del cambio climático. Los riesgos de seguridad en este documento son entendidos de una manera amplia enfocándose no solo en los riesgos de seguridad nacional vistos desde el punto de vista de los estados sino, principalmente, en los riesgos de seguridad humana enfocados en los retos para la supervivencia y los medios de vida de la población que incluye la seguridad económica, alimentaria, sanitaria, medioambiental, personal, comunitaria y política (UNTFHS, 2016)

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Prognostic value of antigen expression in multiple myeloma: a PETHEMA/GEM study on 1,265 patients enrolled in four consecutive clinical trials

Persistence of minimal residual disease (MRD) after treatment for myeloma predicts inferior outcomes, but within MRD-positive patients there is great heterogeneity with both early and very late relapses. Among different MRD techniques, flow cytometry provides additional information about antigen expression on tumor cells, which could potentially contribute to stratify MRD-positive patients. We investigated the prognostic value of those antigens required to monitor MRD in 1265 newly diagnosed patients enrolled in the GEM2000, GEM2005MENOS65, GEM2005MAS65 and GEM2010MAS65 protocols. Overall, CD19pos, CD27neg, CD38lo, CD45pos, CD81pos, CD117neg and CD138lo expression predicted inferior outcomes. Through principal component analysis, we found that simultaneous CD38lowCD81posCD117neg expression emerged as the most powerful combination with independent prognostic value for progression-free survival (HR:1.69; P=0.002). This unique phenotypic profile retained prognostic value among MRD-positive patients. We then used next-generation flow to determine antigen stability throughout the course of the disease, and found that the expression of antigens required to monitor MRD is mostly stable from diagnosis to MRD stages, except for CD81 whose expression progressively increased from baseline to chemoresistant tumor cells (14 vs 28%). Altogether, we showed that the phenotypic profile of tumor cells provides additional prognostic information, and could be used to further predict risk of relapse among MRD-positive patients

Depth of Response in Multiple Myeloma: A Pooled Analysis of Three PETHEMA/GEM Clinical Trials

Purpose To perform a critical analysis on the impact of depth of response in newly diagnosed multiple myeloma (MM). Patients and Methods Data were analyzed from 609 patients who were enrolled in the GEM (Grupo Español de Mieloma) 2000 and GEM2005MENOS65 studies for transplant-eligible MM and the GEM2010MAS65 clinical trial for elderly patients with MM who had minimal residual disease (MRD) assessments 9 months after study enrollment. Median follow-up of the series was 71 months. Results Achievement of complete remission (CR) in the absence of MRD negativity was not associated with prolonged progression-free survival (PFS) and overall survival (OS) compared with near-CR or partial response (median PFS, 27, 27, and 29 months, respectively; median OS, 59, 64, and 65 months, respectively). MRD-negative status was strongly associated with prolonged PFS (median, 63 months; P , .001) and OS (median not reached; P , .001) overall and in subgroups defined by prior transplantation, disease stage, and cytogenetics, with prognostic superiority of MRD negativity versus CR particularly evident in patients with high-risk cytogenetics. Accordingly, Harrell C statistics showed higher discrimination for both PFS and OS in Cox models that included MRD (as opposed to CR) for response assessment. Superior MRD-negative rates after different induction regimens anticipated prolonged PFS. Among 34 MRD-negative patients withMMand a phenotypic pattern of bone marrow involvement similar to monoclonal gammopathy of undetermined significance at diagnosis, the probability of “operational cure” was high; median PFS was 12 years, and the 10-year OS rate was 94%. Conclusion Our results demonstrate that MRD-negative status surpasses the prognostic value of CR achievement for PFS and OS across the disease spectrum, regardless of the type of treatment or patient risk group. MRD negativity should be considered as one of the most relevant end points for transplant-eligible and elderly fit patients with MM