Diet and dynamic of the first christians in Algarve during the 13th - 14th AD

Stable isotopes study of carbon, nitrogen and sulfur isotopic systems in bone remains in order to assess diet of a Christian population during the 13th and 14th Centuries AD. The population studied was from a Necropolis excavated in Cacela-a-Velha (Algarve, Portugal) and belonged to the first Christians from the Kingdom of Portugal that settled in the region after the conquest of the Algarve in the first half of the 13th century. This study seeks to provide a better understanding of the food, resources and cultural practices of the already mentioned population, in order to have a wider point of view of the reality lived by this community, and its immediate and regional context during that period of time. Differences were seen among faunal bone collagen samples, making possible to infer distinctions in agricultural practices and trading in the region. The δ13C, δ15N and δ34S results of human bone collagen evidenced a heterogeneous diet in the population that could be caused by social and political factors. The study not only would provide isotopic data that could be used for future studies, but also, it provides a deeper perspective of the Christian societies of medieval Iberian Peninsula, since the data was contrasted and complemented with historical and anthropological information. This could be useful to provide a more complex conceptualization of the medieval Iberian cultures; Dieta e dinâmica dos primeiros cristãos no Algarve durante os séculos XIII e XIV RESUMO: Para avaliar a dieta de uma população cristã dos séculos XIII e XIV d. C. foi realizado o estudo das razões isotópicas em carbono, azoto e enxofre em restos ósseos humanos recuperados de uma Necrópole escavada em Cacela-a-Velha (Algarve, Portugal). Estas populações, consideradas dos primeiros Cristãos do Reino de Portugal, instalaram-se nesta região após a conquista do Algarve durante a primeira metade do século XIII. Com este estudo pretende-se obter informação sobre os hábitos alimentares, utilização de recursos e práticas culturais desta população, com o objectivo de obter uma visão mais alargada da realidade vivida por esta comunidade, do seu contexto quotidiano e regional durante esse período. Foram observadas diferenças nas razões isotópicas no colagénio ósseo da fauna contemporânea aos restos humanos, permitindo reconhecer algumas diferenças nas práticas agrícolas e no comércio da região. Os resultados de δ13C, δ15N e δ34S do colagénio ósseo humano evidenciaram uma dieta heterogénea na população que poderia ser resultante de factores sociais e políticos. O estudo permitiu obter dados isotópicos que poderão ser enquadrados em futuros estudos, mas também, permitiu obter uma perspectiva mais profunda das sociedades cristãs da Península Ibérica medieval, já que os dados foram comparados e complementados com informação histórica e antropológica. Esta informação poderá ser útil para proporcionar uma conceptualização mais complexa das culturas ibéricas medievais

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Una memoria de difícil desarraigo

El valor de la fiesta en México es casi religioso. Está ligado a la renovación del espacio y del tiempo. Cada fiesta implica a la vez interrupción de una secuencia lineal, conmemoración, comunión o encuentro físico con los otros. Una oportunidad para volver al origen, al estadio primordial en el que cada uno se funde con el todo, la gran mezcla universal, el baño en las aguas del comienzo. Esto explica que las fiestas cívicas, las religiosas y las manifestaciones multitudinarias no sean la excepción, sino la regla que confirma esa necesidad del ser social del mexicano a lo largo de los siglos. Aquí, por ser un país milenario de enorme diversidad cultural, los festejos para celebrar a la nación adoptarían una significación polisémica en ese mismo sentido: sus componentes cósmico-rituales simbolizarían a la vez un retorno a la tierra, un reclamo a despertar la semilla y un zambullido a los antiguos símbolos; una concelebración anónima capaz de conjugar simultáneamente el ejercicio del poder teocrático, el amor y respeto a los ancestros, la condición inescapable de estar juntos, y el cumplimiento de plazos calendáricos específicos.The value of celebrations in Mexico is almost religious. It is linked to renewal of space and time. Each feast involves both the interruption of a linear sequence, commemoration, communion or physical encounter with others. An opportunity to return to the source, the primordial stage in which each one merges with the whole, the great universal mix, bathing in the waters of the beginning. This explains why civic and religious festivals, and also mass demonstrations are not the exception, but a social Mexican necessity which confirms the rule throughout centuries. Being a millenary country of enormous cultural diversity, festivities to celebrate Mexico as independent nation would adopt a polysemic significance along the same lines: their cosmic and ritual components symbolize both a return to the land, a claim to awaken the seed and an immersion at the ancient symbols. Meaning, an anonymous remembrance able to combine simultaneously the exercise of theocratic power, love and respect for the ancestors, the inescapable condition of being together, and the compliance with specific calendrical deadlines

Una memoria de difícil desarraigo

The value of celebrations in Mexico is almost religious. It is linked to renewal of space and time. Each feast involves both the interruption of a linear sequence, commemoration, communion or physical encounter with others. An opportunity to return to the source, the primordial stage in which each one merges with the whole, the great universal mix, bathing in the waters of the beginning. This explains why civic and religious festivals, and also mass demonstrations are not the exception, but a social Mexican necessity which confirms the rule throughout centuries. Being a millenary country of enormous cultural diversity, festivities to celebrate Mexico as independent nation would adopt a polysemic significance along the same lines: their cosmic and ritual components symbolize both a return to the land, a claim to awaken the seed and an immersion at the ancient symbols. Meaning, an anonymous remembrance able to combine simultaneously the exercise of theocratic power, love and respect for the ancestors, the inescapable condition of being together, and the compliance with specific calendrical deadlines

Una memoria de difícil desarraigo

The value of celebrations in Mexico is almost religious. It is linked to renewal of space and time. Each feast involves both the interruption of a linear sequence, commemoration, communion or physical encounter with others. An opportunity to return to the source, the primordial stage in which each one merges with the whole, the great universal mix, bathing in the waters of the beginning. This explains why civic and religious festivals, and also mass demonstrations are not the exception, but a social Mexican necessity which confirms the rule throughout centuries. Being a millenary country of enormous cultural diversity, festivities to celebrate Mexico as independent nation would adopt a polysemic significance along the same lines: their cosmic and ritual components symbolize both a return to the land, a claim to awaken the seed and an immersion at the ancient symbols. Meaning, an anonymous remembrance able to combine simultaneously the exercise of theocratic power, love and respect for the ancestors, the inescapable condition of being together, and the compliance with specific calendrical deadlines