Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

El desarrollo equitativo, competitivo y sostenible del sector agropecuario en Colombia

Pretende analizar la eficiencia de la economía desde la agricultura familiar, y que tanto lo es en comparación a la agricultura empresarial de mediana y gran escala; también busca descubrir si la agricultura familiar puede llegar a potenciar la salida de la pobreza de los hogares rurales

El desarrollo equitativo, competitivo y sostenible del sector agropecuario en Colombia

Este libro es el resultado de un esfuerzo conjunto entre el Banco de la República y CAF - Banco de Desarrollo de América Latina. Su objetivo es facilitar la mejor comprensión de los obstáculos estructurales que enfrenta el sector agropecuario en Colombia, sector de vital importancia para el desarrollo económico y social del país. En cada uno de sus capítulos esta obra propone posibles soluciones de políticas públicas a las diferentes barreras que enfrenta el desarrollo de las zonas rurales en Colombia. En el primer capítulo se presentan algunas reflexiones e hipótesis sobre la problemática del sector agropecuario en Colombia y se proveen algunas recomendaciones de política pública. A continuación, el libro está dividido en cuatro partes. En la primera parte se examinan las condiciones sociales y económicas de la población rural. En la segunda parte del libro, se abordan los temas de tecnología, productividad y eficiencia de la producción agropecuaria. En la tercera parte se reúnen los artículos que estudian temas relacionados con el sector cafetero y las asociaciones de productores. En la última se estudian los contratos agroindustriales, la financiación en el sector rural y la competencia. Carlos Gustavo Cano Sanz Es economista por la Universidad de los Andes, con maestría en economía en la Universidad de Lancaster. Cursó un postgrado de Government, Business and the International Economy en la Universidad de Harvard y otro en el Instituto de Alta Dirección Empresarial (Inalde). En la actualidad es codirector del Banco de la República. Se ha desempeñado, entre otros, como gerente general de la Federación Nacional de Arroceros (Fedearroz), presidente de la Sociedad de Agricultores de Colombia (SAC), fundador y director de la Corporación Colombia Internacional (CCI), presidente de la Caja Agraria, presidente de Comunican S. A. (diario El Espectador) y ministro de Agricultura y Desarrollo Rural. María Teresa Ramírez Giraldo Economista por la Universidad de los Andes, con maestrías en Economía dicha universidad y en la Universidad de Illinois, donde también obtuvo su doctorado en Economía. En la actualidad se desempeña como investigadora principal de la Unidad de Investigaciones del Banco de la República. Sus estudios se han centrado principalmente en crecimiento económico, desarrollo económico e historia económica. Es autora de varios artículos publicados en libros y revistas nacionales e internacionales, así como editora de libros. También, se desempeñó como editora de la Revista Ensayos sobre Política Económica. Ana María Tribín Uribe Es economista por la Universidad Javeriana, con maestrías en Economía de dicha universidad y de la Universidad de Brown, donde también obtuvo su doctorado en Economía. En la actualidad se desempeña como investigadora de la Unidad de Investigaciones del Banco de la República. Sus estudios se han centrado principalmente en desarrollo económico, economía política y economía experimental y del comportamiento. Es autora de varios artículos publicados en libros y revistas nacionales e internacionales. Ana María Iregui Bohórquez Es economista por la Universidad de los Andes con maestrías en Economía de dicha universidad y de la Universidad de Warwick, donde también obtuvo su doctorado en Economía. En la actualidad se desempeña como investigadora principal de la Unidad de Investigaciones del Banco de la República. Sus estudios se han centrado, en especial, en modelos de equilibrio general computables, desarrollo económico y finanzas públicas. Es autora de varios artículos publicados en libros y revistas nacionales e internacionales. También, se desempeñó como editora de la Revista Ensayos sobre Política Económica

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

International audienceAbstract Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

: Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified