Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

BACKGROUND: The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. METHODS: A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. RESULTS: Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p < .001). The costs for absenteeism were the most substantial with a mean of 91.41 (134.76) Euros per family, resulting in a loss of 2.45 (3.17) days of work. In RVAGE patients, the absenteeism cost was 120.4 (154) Euros compared with 75.8 (123) for the other etiologies (p = .002), because of loss of 3.5 (3.6) vs 1.9 (2.9) days of work (p < .001). Meals costs were 2-fold-higher (48.5 (55) vs 24.3 (46) Euros, p < .001) and travel costs were 2.6-fold-higher (32 (92) vs 12.5 (21.1) Euros, p = .005) in RVAGE patients compared with those with other etiologies. There were no differences between RVAGE and other etiologies groups regarding costs of hiring of caregivers or purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p < .001). CONCLUSIONS: Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries

Homo antecessor y su relación con los neandertales y las poblaciones humanas modernas

Este trabajo examina las evidencias morfológicas del conjunto de fósiles humanos recuperados del nivel TD6-2 del yacimiento de la cueva de la Gran Dolina (sierra de Atapuerca, Burgos). Estos fósiles, incluidos en la especie Homo antecessor y con una cronología compatible con el MIS 21, presentan rasgos plesiomorfos del clado Homo, rasgos derivados compartidos con H. sapiens, rasgos derivados compartidos con H. neanderthalensis, rasgos derivados compartidos con estas dos últimas especies y rasgos derivados compartidos con poblaciones del Pleistoceno Medio de Eurasia. Este complejo mosaico, con un sello netamente europeo, podría ser explicado en el marco de un proceso de cladogénesis, ocurrido durante el Pleistoceno Inferior, posiblemente en el suroeste de Asia. La población polimórfica resultante de este proceso pudo originar diferentes pulsos migratorios al menos hacia Europa cuando las condiciones climáticas fueron favorables. Este proceso pudo ser muy complejo desde el punto de vista de las relaciones de la “población madre” con otros grupos humanos y tendría que contemplar al menos una migración hacia el continente africano a través del Corredor Levantino. Solo así se podría justificar el origen y evolución de H. sapiens en África durante el Pleistoceno Medio.This report examines the morphological evidences of the human fossils recovered from the TD6-2 level of the Gran Dolina cave site (Sierra de Atapuerca, Burgos, northern Spain). These fossils, which were included in the species Homo antecessor and might have been deposited during the MIS 21, exhibit plesiomorphic features for the Homo clade, apomorphic features shared with H. sapiens, apomorphic features shared with H. neanderthalensis, apomorphic features shared with the two latter species, and apomorphic features shared with the Eurasian Middle Pleistocene populations. This complex mosaic, which has a distinctly European hallmark, could be explained in the framework of a cladogenetic process occurred during the early Pleistocene, probably in Southwest Asia. The polymorphic population originated in this process might have been source of different migratory waves, at least towards Europe, during favourable climatic conditions. This process could have been very complex concerning the interactions of the “mother population” with other human groups and must consider at least one migration to the African continent through the Levantine Corridor. Only this way we could justify the origin and evolution of H. sapiens in Africa during the Middle Pleistocene.Este trabajo ha sido realizado en el marco del proyecto CGL2012-38434-C03-02, del Ministerio de Economía y Competitividad, el proyecto de excavaciones anual subvencionado por las Consejerías de Cultura y Turismo y Familia e Igualdad de Oportunidades de la Junta de Castilla y León, la Fundación Atapuerca y la Fundación Leakey, a través de donaciones realizadas por Gordon Getty y Dub Crook

Rotavirus infection beyond the gut

The landscape of rotavirus (RV) infection has changed substantially in recent years. Autoimmune triggering has been added to clinical spectrum of this pathology, which is now known to be much broader than diarrhea. The impact of RV vaccines in these other conditions is becoming a growing field of research. The importance of host genetic background in RV susceptibility has been revealed, therefore increasing our understanding of vaccine effectiveness and giving some clues about the limited efficacy of RV vaccines in low-income settings. Also, interaction of RV with intestinal microbiota seems to play a key role in the process of infection vaccine effect. This article reviews current findings on the extraintestinal impact of RV infection and their widening clinical picture, and the recently described mechanisms of host susceptibility to infection and vaccine effectiveness. RV infection is a systemic disease with clinical and pathophysiological implications beyond the gut. We propose an "iceberg" model for this pathology with almost hidden clinical implications away from the gastrointestinal tract and eventually triggering the development of autoimmune diseases. Impact of current vaccines is being influenced by host genetics and gut microbiota interactions and these factors must be taken into account in the development of public health programs

Acute onset supraclavicular lymphadenopathy coinciding with intramuscular mRNA vaccination against COVID-19 may be related to vaccine injection technique, Spain, January and February 2021

Monitoring adverse reactions following immunisation is essential, particularly for new vaccines such as those against COVID-19. We describe 20 cases of acute onset of a single supraclavicular lymphadenopathy manifesting between 24 h and 9 days after ipsilateral intramuscular administration of an mRNA-based COVID-19 vaccine, referred to our WHO Collaborating Centre for Vaccine Safety. Our results indicate that the swelling of supraclavicular lymph nodes following immunisation may constitute a benign and self-limited condition, related to a higher than recommended injection siteS

Bacteremia in Children Hospitalized with Respiratory Syncytial Virus Infection

Background The risk of bacteremia is considered low in children with acute bronchiolitis. However the rate of occult bacteremia in infants with RSV infection is not well established. The aim was to determine the actual rate and predictive factors of bacteremia in children admitted to hospital due to confirmed RSV acute respiratory illness (ARI), using both conventional culture and molecular techniques. Methods A prospective multicenter study (GENDRES-network) was conducted between 2011–2013 in children under the age of two admitted to hospital because of an ARI. Among those RSV-positive, bacterial presence in blood was assessed using PCR for Meningococcus, Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus, in addition to conventional cultures. Results 66 children with positive RSV respiratory illness were included. In 10.6% patients, bacterial presence was detected: H. influenzae (n = 4) and S. pneumoniae (n = 2). In those patients with bacteremia, there was a previous suspicion of bacterial superinfection and had received empirical antibiotic treatment 6 out of 7 (85.7%) patients. There were significant differences in terms of severity between children with positive bacterial PCR and those with negative results: PICU admission (100% vs. 50%, P-value = 0.015); respiratory support necessity (100% vs. 18.6%, P-value < 0.001); Wood-Downes score (mean = 8.7 vs. 4.8 points, P-value < 0.001); GENVIP scale (mean = 17 vs. 10.1, P-value < 0.001); and length of hospitalization (mean = 12.1 vs. 7.5 days, P-value = 0.007). Conclusion Bacteremia is not frequent in infants hospitalized with RSV respiratory infection, however, it should be considered in the most severe casesThis work was supported by the Spanish Government (Research Program Health Research Fund (FIS; PI10/00540 y PI13/02382) National Plan I + D + I and FEDER funds) and Regional Galician funds (Promotion of Research Project 10 PXIB 918 184 PR) (FMT), and Ministerio de Ciencia e Innovación (SAF2011-26983) and the Plan Galego IDT, Xunta de Galicia (EM 2012/045) (AS). MC’s research activities had been supported by grants from Instituto de Investigación Sanitaria de Santiago de Compostela. FMT’s research activities have been supported by grants from Instituto Carlos III (Intensificación de la actividad investigadora). Investigators received funding from the European Union’s Seventh Framework Program under ECGA no. 279185 (EUCLIDS) during the production of this paperS

The earliest Baltic amber in Western Europe

This study has been supported by the R&D Project 'Metal y Ámbar II: Circulación de bronce y ámbar en el Sureste peninsular durante la Edad del Bronce' (PID2019-108289GB-I00/AEI/10.13039/501100011033) and the R&D Project ‘Social and Exchange Networks in the Argaric Society’ (PID2022-137494NB-I00/AEI/10.13039/501100011033) funded by the Spanish Ministry of Science and Innovation. The contribution of M.M.T. was supported by funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 101021480, Project REVERSEACTION). We want to thank D. Pérez L’Huiller for editing Fig. , and M. Vilar Welter for editing Fig. . We are also grateful to J.F. Gibaja Bao, M.E. Subirà and M. Fontanals-Colls, who kindly shared the AMS radiocarbon dates funded by their respective projects. Date CF-X30-C4-134 was obtained in the framework of the R&D Project ‘Aproximación a las primeras comunidades neolíticas del NE peninsular a través de sus prácticas funerarias’ (HAR2011-23149) funded by the Spanish Ministry of Science and Innovation, IP: J. Gibaja and M.E. Subirà. Date CF-S19-C4R-56 was obtained in the framework of the R&D Project ‘NEOMEDIS: Neolithic Mediterranean diet through stable Isotope analysis’, funded in the framework of the Marie Skłodowska-Curie Fellowship (ID: 792130), IP: M. Fontanals.The online version contains supplementary material available at https://doi. org/10.1038/s41598-023-41293-0The occurrence of Baltic amber through Europe has traditionally been associated to the spread of the Bell Beaker culture during the 3rd millennium BC. In Iberia, this phenomenon is particularly noticeable in the southern half. Here we present an amber bead recovered in a Late Neolithic funerary cave (3634–3363 cal BC) from northeastern Iberia where more than 12 individuals had been buried. Fourier transform infrared spectroscopy results of four samples revealed their complete resemblance with Baltic succinite reference spectra. Despite being a single bead, this finding provides the earliest evidence for the arrival of Baltic amber to the Mediterranean and Western Europe, before the Bell Beaker phenomenon and more than a millennium earlier than traditionally thought. This finding has implications for our understanding of early exchange networks of exotic materials, and their associated social structures.Social and Exchange Networks in the Argaric Society PID2022-137494NB-I00/AEI/10.13039/501100011033Horizon 2020 Framework Programme 101021480, 792130, HAR2011-23149 H2020European Research Council ERCMinisterio de Ciencia e Innovación MICIN

Rotavirus infection beyond the gut

The landscape of rotavirus (RV) infection has changed substantially in recent years. Autoimmune triggering has been added to clinical spectrum of this pathology, which is now known to be much broader than diarrhea. The impact of RV vaccines in these other conditions is becoming a growing field of research. The importance of host genetic background in RV susceptibility has been revealed, therefore increasing our understanding of vaccine effectiveness and giving some clues about the limited efficacy of RV vaccines in low-income settings. Also, interaction of RV with intestinal microbiota seems to play a key role in the process of infection vaccine effect. This article reviews current findings on the extraintestinal impact of RV infection and their widening clinical picture, and the recently described mechanisms of host susceptibility to infection and vaccine effectiveness. RV infection is a systemic disease with clinical and pathophysiological implications beyond the gut. We propose an “iceberg” model for this pathology with almost hidden clinical implications away from the gastrointestinal tract and eventually triggering the development of autoimmune diseases. Impact of current vaccines is being influenced by host genetics and gut microbiota interactions and these factors must be taken into account in the development of public health programs.This work was supported by grants from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): project GePEM ISCIII/PI16/01478/Cofinanciado FEDER (AS) and project ReSVinext ISCIII/PI16/01569/Cofinanciado FEDER (FMT); Consellería de Sanidade, Xunta de Galicia (RHI07/2-intensificación actividad investigadora, PS09749 and 10PXIB918184PR), Instituto de Salud Carlos III (Intensificación de la actividad investigadora 2007-2012, PI16/01569), Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540) del plan nacional de I + D + I (FMT), and 2016-PG071 Consolidación e Estructuración REDES 2016GI-1344 G3VIP (Grupo Gallego de Genética Vacunas Infecciones y Pediatría, ED341D R2016/021) (AS and FMT)S

Further considerations on rotavirus vaccination and seizure-related hospitalization rates

Response to letter to the editor: Sánchez A, López-Lacort M, Muñoz-Quiles C, Martinez-Beneito MA, Díez-Domingo J. Letter to the editor regarding “Rotavirus infection beyond the gut”. Infect Drug Resist. 2019;12:707-708 https://doi.org/10.2147/IDR.S202716S

The complete mitogenome of a 500-year-old Inca child mummy

In 1985, a frozen mummy was found in Cerro Aconcagua (Argentina). Archaeological studies identified the mummy as a seven-year-old Inca sacrifice victim who lived >500 years ago, at the time of the expansion of the Inca Empire towards the southern cone. The sequence of its entire mitogenome was obtained. After querying a large worldwide database of mitogenomes (>28,000) we found that the Inca haplotype belonged to a branch of haplogroup C1b (C1bi) that has not yet been identified in modern Native Americans. The expansion of C1b into the Americas, as estimated using 203 C1b mitogenomes, dates to the initial Paleoindian settlements (~18.3 thousand years ago [kya]); however, its internal variation differs between Mesoamerica and South America. By querying large databases of control region haplotypes (>150,000), we found only a few C1bi members in Peru and Bolivia (e.g. Aymaras), including one haplotype retrieved from ancient DNA of an individual belonging to the Wari Empire (Peruvian Andes). Overall, the results suggest that the profile of the mummy represents a very rare sub-clade that arose 14.3 (5–23.6) kya and could have been more frequent in the past. A Peruvian Inca origin for present-day C1bi haplotypes would satisfy both the genetic and paleo-anthropological findings.The research leading to these results has received funding from the “Ministerio de Ciencia e Innovación” (SAF2011–26983), the Plan Galego IDT (EM 2012/045) and a grant from the Sistema Universitario Gallego- Modalidad REDES (2012-PG226) from the Xunta de Galicia (A.S.); Instituto Carlos III (Intensificación de la actividad investigadora) and Fondo de Investigación Sanitaria (FIS; PI10/00540 and PI13/02382) of the Plan Nacional de I+ D+ I and Fondos FEDER (F.M.T)S

Comparative analysis of the Gran Dolina-TD6 (Spain) and Tighennif (Algeria) hominin mandibles

We present a comparative study of the Tighennif (Algeria) and Gran Dolina-TD6 (Spain) hominin mandibles, which represent two geographically near and contemporaneous populations separated by the Mediterranean sea, in order to test the hypothesis that these populations belong to the same evolutionary lineage, as it has been suggested by some authors. The Tighennif mandibles show a clear primitive structural pattern, derived in some features with regard to the oldest Homo specimens from H. habilis, as well as from the Javanese H. erectus. In addition, the Tighennif specimens share all these derived features with H. ergaster and, some of them, with H. antecessor. However, the Gran Dolina-TD6 specimens are remarkably smaller than those of Tighennif, and lack the robustness which characterizes the African Pleistocene mandibles. The main difference between both groups in terms of mandibular dimensions can be related to the higher corpus height characteristic of Tighennif specimens. The dental evidence reveals that North African Middle Pleistocene populations are morphologically closer to African Early Pleistocene populations than to TD6 fossils. We conclude that the Spanish and Algerian hominins belong to different hominin lineages. The Tighennif hominins, together with other contemporaneous (Thomas Quarry and Oulad Hamida 1), and perhaps later North African specimens (Sidi Abderrahaman, Salé, and Rabat [Kebitat]) should be considered as a subspecies of the H. ergaster species, i.e. H. ergaster mauritanicus, and may be the result of an evolution in isolation in this African area. In agreement with the mandibular and dental evidences, the Gran Dolina-TD6 hominins could belong to an exclusive Eurasian lineage.Nous présentons une analyse comparée des mandibules des hominidés de Tighennif (Algérie) et de la Gran Dolina-TD6 (Espagne), qui représentent deux populations proches dans l’espace et le temps mais séparées par la mer Méditerranée, afin de vérifier l’hypothèse que les deux échantillons appartiennent au même lignage évolutif, comme certains auteurs l’ont suggéré. Les mandibules de Tighennif ont un pattern morphologique structurel primitif, avec certains caractères dérivés par rapport à ceux des spécimens de H. habilis et de H. erectus de Java. Les mandibules de Tighennif partagent tous ces caractères dérivés avec H. ergaster et quelques uns avec H. antecessor. Néanmoins, les spécimens de la Gran Dolina-TD6 sont remarquablement plus petits que ceux de Tighennif, et sont moins robustes que les mandibules du Pléistocène d’Afrique. La principale différence entre les deux échantillons, en ce qui concerne les dimensions mandibulaires, est la grande hauteur du corps de la mandibule des spécimens de Tighennif. Les caractères dentaires révèlent que les populations du Pléistocène moyen du Nord de l’Afrique sont, du point de vue morphologique, plus proches des hominidés du Pléistocène inférieur de l’Afrique que de ceux de la Gran Dolina-TD6. Nous concluons donc que les hominidés de Tighennif et de la Gran Dolina-TD6 appartiennent à deux lignées différentes. Les hominidés de Tighennif pourraient être réunis avec les spécimens contemporains de Thomas Quarry et de Oulad Hamida 1, et peut-être avec d’autres plus tardifs comme ceux de Sidi Abderrahaman, Salé, et Rabat [Kebitat] du Nord de l’Afrique dans une même sous-espèce de H. ergaster, i.e. H. ergaster mauritanicus, qui serait le résultat d’une évolution locale en isolement relatif dans cette région de l’Afrique. Les hominidés de la Gran Dolina-TD6 appartiennent à une lignée exclusive de l’Eurasie, conformément aux données dentaires et mandibulaires