Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol�which is a marker of cardiovascular risk�changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95 credible interval 3.7 million�4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. © 2020, The Author(s), under exclusive licence to Springer Nature Limited

Changes in hemoglobin in patients with hemolytic anemia [Alteraciones de la hemoglobina en pacientes con anemia hemolítica.]

Hb alterations studied throughout 2 years in 129 patients are reported, these patients had hemolytic anemia or the possibility of a hemoglobinopathy : 5 were heterozygotes to thalassemia b; 3 were compound-heterozygote of thalassemia a1 and thalassemia a2; 2 for thalassemia b and 2 for thalassemia b and Hb S; 2 homozygotes and 2 heterozygotes for Hb S; 2 was bearing unstable Hb and the other had Hereditary Persistence of Hb F. These results allow the conclusion that thalassemia is the Hb alteration which most frequently causes hemolytic anemia in our population and underscores the importance of the study of these pathologies in selected populations

Implantation of a heterologous dermo-epidermal skin substitute in a patient with deep dermal burn that enhances biomechanical and functional recovery: Case report

In Mexico, burns are considered a public health problem; approximately 93% of all burned patients are treated at public hospitals. For patients undergoing extensive burns, prompt skin coverage avoids potential complications, is life-saving, and is the key for acceptable functional and aesthetic results. Many efforts have been undertaken to find new strategies for the treatment of burns. The aim of this study was to create a human Dermo-Epidermal Skin Substitute (hDE-SS) by combining heterologous keratinocytes and fibroblasts cultured onto Radio-sterilized Human Amnion (RHA), suitable for the treatment of patients with deep dermal burns. The manufacture of hDE-SS was carried out under sterile conditions in a Class 100 Cleanroom located inside the Laboratory of Biotechnology at the National Center of Research and Attention for Burn Patients (CENIAQ, its acronym in spanish). The heterologous cells were obtained from skin remnants collected from elective aesthetic surgeries. RHA used as a scaffold was obtained from placental tissue irradiated with 25 kGy of gamma radiation. Viable constructs were obtained, revealing a positive immunophenotype for fibroblast surface antigen (1B10) and negative for human alpha smooth muscle actin protein (α-sma). Keratinocytes were positive for CK5 and CK10 to a lesser extent. hDE-SS was implanted in one patient with a deep dermal burn who fulfilled the inclusion criteria for this study. The implanted patient was followed up through days 7, 14, 21, 35, and 92 post-implantation using photographic monitoring and measurement of the following: viscoelasticity (R6); net elasticity (R5); maximal extension (R0), and hydration, melanin, and erythema with a Cutometer®. The employment of hDE-SS in a deep dermal burn showed clinical re-epithelization within a 7-day period favored by cellular migration, due to the presence of fibroblasts and keratinocytes. Also, the functional and mechanical quality of the skin was measured with the Cutometer®, demonstrating that it is optimal and similar to controls of healthy skin and an autograft, justifying the usage of hDE-SS. Keywords: Heterologous keratinocytes, Heterologous fibroblasts, Human dermo-epidermal skin substitute, Human amnion, Deep dermal burn, Suction method, Biomechanics, Cutomete

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale