CD4+Foxp3+T Regulatory Cells Promote Transplantation Tolerance by Modulating Effector CD4+ T Cells in a Neuropilin-1-Dependent Manner

Several mechanisms of immune suppression have been attributed to Foxp3+ T regulatory cells (Treg) including modulation of target cells via inhibition of cell proliferation, alteration of cytokine secretion, and modification of cell phenotype, among others. Neuropilin-1 (Nrp1), a co-receptor protein highly expressed on Treg cells has been involved in tolerance-mediated responses, driving tumor growth and transplant acceptance. Here, we extend our previous findings showing that, despite expressing Foxp3, Nrp1KO Treg cells have deficient suppressive function in vitro in a contact-independent manner. In vivo, the presence of Nrp1 on Treg cells is required for driving long-term transplant tolerance. Interestingly, Nrp1 expression on Treg cells was also necessary for conventional CD4+ T cells (convT) to become Nrp1+Eos+ T cells in vivo. Furthermore, adoptive transfer experiments showed that the disruption of Nrp1 expression on Treg cells not only reduced IL-10 production on Treg cells, but also increased the frequency of IFNγ+ Treg cells. Similarly, the presence of Nrp1KO Treg cells facilitated the occurrence of IFNγ+CD4+ T cells. Interestingly, we proved that Nrp1KO Treg cells are also defective in IL-10 production, which correlates with deficient Nrp1 upregulation by convT cells. Altogether, these findings demonstrate the direct role of Nrp1 on Treg cells during the induction of transplantation tolerance, impacting indirectly the phenotype and function of conventional CD4+ T cells

NK cells in peripheral blood carry trogocytosed tumor antigens from solid cancer cells

The innate immune lymphocyte lineage natural killer (NK) cell infiltrates tumor environment where it can recognize and eliminate tumor cells. NK cell tumor infiltration is linked to patient prognosis. However, it is unknown if some of these antitumor NK cells leave the tumor environment. In blood-borne cancers, NK cells that have interacted with leukemic cells are recognized by the co-expression of two CD45 isoforms (CD45RARO cells) and/or the plasma membrane presence of tumor antigens (Ag), which NK cells acquire by trogocytosis. We evaluated solid tumor Ag uptake by trogocytosis on NK cells by performing co-cultures in vitro. We analyzed NK population subsets by unsupervised dimensional reduction techniques in blood samples from breast tumor (BC) patients and healthy donors (HD). We confirmed that NK cells perform trogocytosis from solid cancer cells in vitro. The extent of trogocytosis depends on the target cell and the antigen, but not on the amount of Ag expressed by the target cell or the sensitivity to NK cell killing. We identified by FlowSOM (Self-Organizing Maps) several NK cell clusters differentially abundant between BC patients and HD, including anti-tumor NK subsets with phenotype CD45RARO+CD107a+. These analyses showed that bona-fide NK cells that have degranulated were increased in patients and, additionally, these NK cells exhibit trogocytosis of solid tumor Ag on their surface. However, the frequency of NK cells that have trogocytosed is very low and much lower than that found in hematological cancer patients, suggesting that the number of NK cells that exit the tumor environment is scarce. To our knowledge, this is the first report describing the presence of solid tumor markers on circulating NK subsets from breast tumor patients. This NK cell immune profiling could lead to generate novel strategies to complement established therapies for BC patients or to the use of peripheral blood NK cells in the theranostic of solid cancer patients after treatment

Taxonomia da Ciência Aberta: revisada e ampliada

Objective: review the terminologies and applications of the Open Science taxonomy to build a more comprehensive version that represents the knowledge surrounding the topic theme, in accordance with the current scenario of scholarly communication and the recommendations of the United Nations Educational, Scientific and Cultural Organization (Unesco). Method: his is exploratory research with a deductive approach. The first step was the revision of the taxonomies, with the 12 researchers, who met weekly, for conceptual and epistemological discussions related to Open Science and methodological and procedural definitions for the realization of the study. Results: as a result of the analyses, a taxonomy was developed to be evaluated by the experts. For this, a questionnaire with open questions about each main axis of the taxonomy was sent to 68 specialists. We obtained 21 answers that cooperated with the modeling and exposition of the terms of the new taxonomy proposal. The new taxonomy has 10 main level facets and a total of 96 labels. Conclusions: the perception of the experts brought to light a panorama congruent with Unesco recommendations and the current scenario of Open Science

Estado del arte de la investigación en salud mental en Costa Rica

libro (no arbitrado)--Universidad de Costa Rica, Escuela de Psicología, Instituto de Investigaciones Psicológicas, Escuela de Salud Pública, Centro de Investigaciones en Biología Celular y Molecular, y Escuela de Biología. Escuela de Psicología de la Universidad Nacional. Ministerio de Salud. 2013Esta es una obra que contiene varios capítulos que brindan, en conjunto, un panorama general del estado de la investigación en Salud Mental en Costa Rica. Presentan la contextualización histórica con los eventos más relevantes en la atención de la enfermedad mental. Se muestra la investigación desarrollada en el pasado y las necesidades y líneas de investigación para un futuro cercano, de cara a las políticas públicas en Salud Mental. Se reflexiona y analiza en el concepto de la Salud Mental hacia conceptos más comprensivos como bienestar o calidad de vida, y factores socioambientales asociados. Se aportan nuevos paradigmas y enfoques con el fin de comprender la Salud Mental no sólo desde sus dimensiones físicas y psicológicas, sino considerando sus manifestaciones sociales y culturales.Universidad de Costa Rica y Ministerio de SaludUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP

Taxonomía de la ciencia abierta: revisada y ampliada

Objetivo: revisar as terminologias e aplicações da taxonomia de Ciência Aberta para a construção de uma versão mais abrangente, que represente o conhecimento em volta do tema, em conformidade com o cenário atual da comunicação científica e com as recomendações da Organização das Nações Unidas para a Educação, a Ciência e a Cultura (Unesco). Método: trata-se de uma pesquisa do tipo exploratória com abordagem dedutiva. A primeira etapa foi a revisão das taxonomias, com 12 pesquisadores1 que se reuniram, semanalmente, para discussões conceituais e epistemológicas relacionadas à Ciência Aberta, e definições metodológicas e procedimentais para a realização do estudo. Resultados: como resultado das análises, foi desenvolvida uma taxonomia para ser avaliada pelos especialistas. Para isso, foi enviado um questionário com perguntas abertas, sobre cada eixo principal da taxonomia, para 68 especialistas. Foram obtidas 21 respostas que cooperaram com a modelagem e exposição dos termos para a nova taxonomia. A taxonomia oriunda desse processo de revisão tem 10 facetas de nível principal e o total de 96 rótulos. Conclusões: a percepção dos especialistas trouxe à tona um panorama congruente com as recomendações da Unesco e do atual cenário da Ciência Aberta.Objective: review the terminologies and applications of the Open Science taxonomy to build a more comprehensive version that represents the knowledge surrounding the topic theme, in accordance with the current scenario of scholarly communication and the recommendations of the United Nations Educational, Scientific and Cultural Organization (Unesco). Method: his is exploratory research with a deductive approach. The first step was the revision of the taxonomies, with the 12 researchers, who met weekly, for conceptual and epistemological discussions related to Open Science and methodological and procedural definitions for the realization of the study. Results: as a result of the analyses, a taxonomy was developed to be evaluated by the experts. For this, a questionnaire with open questions about each main axis of the taxonomy was sent to 68 specialists. We obtained 21 answers that cooperated with the modeling and exposition of the terms of the new taxonomy proposal. The new taxonomy has 10 main level facets and a total of 96 labels. Conclusions: the perception of the experts brought to light a panorama congruent with Unesco recommendations and the current scenario of Open Science.Objetivo: revisar las terminologías y aplicaciones de la taxonomía de la Ciencia Abierta, para construir una versión más completa, que represente el conocimiento en torno al tema, de acuerdo con el escenario actual de la comunicación científica y las recomendaciones de la Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura (Unesco). Método: se trata de una investigación exploratoria con un enfoque deductivo. El primer paso fue la revisión de las taxonomías, con las 12 personas dedicadas a la investigación, que se reunieron semanalmente, para las discusiones conceptuales y epistemológicas relacionadas con la Ciencia Abierta y las definiciones metodológicas y de procedimiento para la realización del estudio. Resultados: como resultado de los análisis, se elaboró una taxonomía para ser evaluada por las personas expertas. Para ello, se envió a 68 personas expertas un cuestionario con preguntas abiertas sobre cada eje principal de la taxonomía. Se obtuvieron 21 respuestas que cooperaron con la modelización y exposición de los términos de la nueva propuesta de taxonomía. La nueva taxonomía tiene 10 facetas de nivel principal y un total de 96 etiquetas. Conclusiones: la percepción de los expertos puso de manifiesto un panorama congruente con las recomendaciones de la Unesco y el escenario actual de la Ciencia Abierta

Simposio Internacional “Mundos Conectados: Saberes, imágenes y sonidos del Caribe y Centroamérica en el mundo atlántico"

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Monetary Policy Report - July de 2021

Macroeconomic summary The Colombian economy sustained numerous shocks in the second quarter, pri¬marily related to costs and supply. The majority of these shocks were unantic¬ipated or proved more persistent than expected, interrupting the recovery in economic activity observed at the beginning of the year and pushing overall inflation above the target. Core inflation (excluding food and regulated items) increased but remained low, in line with the technical staff’s expectations. A third wave of the pandemic, which became more severe and prolonged than the previous outbreak, began in early April. This had both a high cost in terms of human life and a negative impact on Colombia's economic recovery. Between May and mid-June roadblocks and other disruptions to public order had a sig¬nificant negative effect on economic activity and inflation. The combination and magnitude of these two shocks likely led to a decline in gross domestic product (GDP) compared to the first quarter. Roadblocks also led to a significant in¬crease in food prices. The accumulated effects of global disruptions to certain value chains and increased international freight transportation prices, which since the end of 2020 have restricted supply and increased costs, also affected Colombia’s economy. The factors described above, which primarily affected the consumer price index (CPI) for goods and foods, explain to a significant degree the technical staff’s forecast errors and the increase in overall inflation above the 3% target. By contrast, increases in core inflation and in prices for regulated items were in line with the technical staff’s expectations, and can be explained largely by the elimination of various price relief measures put in place last year. An increase in perceived sovereign risk and the upward pressures that this im¬plies on international financing costs and the exchange rate were further con¬siderations. Despite significant negative shocks, economic growth in the first half of the year (9.1%) is now expected to be significantly higher than projected in the April re¬port (7.1%), a sign of a more dynamic economy that could recover more quickly than previously forecast. Diverse economic activity figures have indicated high¬er-than-expected growth since the end of 2020. This suggests that the negative effects on output from recurring waves of COVID-19 have grown weaker and less long-lasting with subsequent outbreaks. Nevertheless, the third wave of the coro¬navirus, and to an even greater degree the previously mentioned roadblocks and disruptions to public order, likely led to a decline in GDP in the second quar¬ter compared to the first. Despite this, data from the monthly economic tracking indicator (ISE) for April and May surpassed expectations, and new sector-level measures of economic activity suggest that the negative impact of the pandemic on output continues to moderate, amid reduced restrictions on mobility and im¬provements in the pace of vaccination programs. Freight transportation registers (June) and unregulated energy demand (July), among other indicators, suggest a significant recovery following the roadblocks in May. Given the above, annual GDP growth in the second quarter is expected to have been around 17.3% (previously 15.8%), explained in large part by a low basis of comparison. The technical staff revised its growth projection for 2021 upward from 6% to 7.5%. This forecast, which comes with an unusually high degree of uncertain¬ty, assumes no additional disruptions to public order and that any new waves of COVID-19 will not have significant additional negative effects on economic activity. Recovery in international demand, price levels for some of Colombia’s export com¬modities, and remittances from workers abroad have all performed better than projected in the previous report. This dynamic is expected to continue to drive recovery in the national income over the rest of the year. Continued ample international liquidity, an acceleration in vacci¬nation programs, and low interest rates can also be ex¬pected to favor economic activity. Improved performance in the second quarter, which led to an upward growth revision for all components of spending, is expected to continue, with the economy returning to 2019 production levels at the end of 2021, earlier than estimated in the April report. This forecast continues to account for the short-term effects on aggregate demand of a tax reform package along the lines of what is currently being pro-posed by the national government. Given the above, the central forecast scenario in this report projects growth in 2021 of 7.5% and in 2022 of 3.1% (Graph 1.1). In this scenar¬io, economic activity would nonetheless remain below potential. The noted improvement in these projections comes with a high degree of uncertainty. Annual inflation increased more than expected in June (3.63%) as a result of changes in food prices, while growth in core inflation (1.87%) was similar to projections. The in¬creased CPI for foods would be expected to persist for the remainder of the year, contributing to inflation remaining above the target. Overall and core inflation would be ex¬pected to return to close to 3% at the end of 2022, amid a deceleration in growth in the CPI for foods and reduced ex¬cess productive capacity. Recent increases in international freight and agricultural goods prices, as well as the live¬stock cycle and increased meat exports, have exerted up¬ward pressure on food prices, primarily in processed foods (see Box 21). In addition to these persistent factors affecting prices, national roadblocks and related disruptions to pub¬lic order in several cities throughout May and parts of June were reflected in a significant restriction of supply and an unexpected annual increase in the CPI for foods (8.52%). Inflation in regulated items (5.93%) also accelerated, due to a low basis of comparison on gasoline prices and the par¬tial lapse of relief measures on utility rates that were put in place in 2020. Inflation excluding food and regulated items recovered in line with projections to 1.87%, due to the rein¬statement of indirect taxes on certain goods and services that had been temporarily eliminated in 2020, and to up¬ward pressures exerted by prices for foods away from home (FAH), among other factors. The increase in perishable foods prices is expected to be reversed over the course of the year, assuming an absence of additional, long-lasting blockades of national roads. Increased processed food pric¬es would be expected to persist and contribute to keeping inflation above the target at the end of the year. Inflation excluding foods and regulated items is expected to contin¬ue to exhibit an upward trend, as excesses in productive ca¬pacity continue to close, and register a temporary increase in March 2022 largely due to the reinstatement of the FAH consumption tax. Given the above, overall year-end infla¬tion is expected to be 4.1% in 2021 and 3.1% in 2022 (Graph 1.2), and core inflation is expected to be 2.6% in 2021 and 3.2% in 2022 (Graph 1.3). The technical staff has interpreted the overall behavior of prices in the CPI excluding food and regulated items, alongside continued unexpected increases in economic activity, as signs of more ample excess productive capaci¬ty in the economy. This would be expected to persist over the next two years, with the output gap closing at the end of that period. Increased economic growth suggests a less negative output gap than estimated last quarter. Nevertheless, the behavior of core inflation, especially in services, suggests that potential GDP has recovered to an unanticipated degree and that ample excess capacity con¬tinues, with a persistent effect on aggregate demand. La¬bor market observation supports this interpretation, with persistent high levels of unemployment and stagnation in the recovery of jobs lost as a result of the pandemic. Increased inflation can be explained largely by shocks re¬lated to costs and supply, and by the dissolution of some price relief measures put in place in 2020. The growth and inflation forecasts described above would be consistent with a less negative output gap closing more quickly across the forecast horizon compared to the projection from the April report. Nevertheless, uncertainty surrounding excess capacity is very high and constitutes a risk to the forecast (Graphic 1.4). The fiscal accounts outlook deteriorated, Standard and Poor’s Global Ratings (S&P) and Fitch Ratings (Fitch) down¬graded Colombia’s credit rating, roadblocks and disrup¬tions to public order affected output, and the country faced a third wave of COVID-19 that was more severe and prolonged than the previous outbreak. These factors were reflected in an increased risk premium and depreciation of the peso compared to the dollar. This occurred in a favor¬able context in regard to foreign income, as international prices for oil, coffee, and other Colombian export goods in¬creased. This contributed to a recovery in the terms of trade and in the national income and mitigated upward pres¬sures on the risk premium and the exchange rate. Expected oil prices in this report are USD 68 per barrel (previous¬ly USD 61/bl) for 2021 and USD 66/bl (previously USD 60/ bl) for 2022. This increased trajectory shows convergence to oil prices below recently observed levels, as a result of increased global supply that would more than offset increased demand. As a result, the recent price increase is expected to be temporary. International financial conditions are expected to become somewhat less fa¬vorable in the current macroeconomic context, despite the improvement in foreign income due to increased demand and some higher prices for oil and other export products. Growth in foreign demand was better than expected in the previous report, with projections for 2021 and 2022 increasing from 5.2% to 6.0% and from 3.4% to 3.5%, respectively. For the year to date, figures for economic activity suggest more dynamic foreign demand than previously expected. Output recovery has been faster in the United States and China than in Latin America, as economic reactivation in the latter has been limit¬ed by outbreaks of COVID-19, restricted vaccine supplies, and a lack of fiscal space to confront the pandemic, among other factors. The positive dynamic in foreign goods trade has come amid a deterioration in value chains and a significant increase in commodities and freight prices (see Box 3). Inflation in the United States has been unexpectedly high, with observed and expected values remaining above the target, while growth forecasts have been revised upward. As a result, the beginning of a normalization in monetary policy in the U.S. could come earlier than previously projected. This report estimates that the U.S. Federal Reserve’s first rate increase will come at the end of 2022 (before the first quarter of 2023). Colombia’s risk premium is projected to be higher than forecast in the April report, and is expected to remain on a growth trajectory given the country’s accumulation of public and external debt. This would be expected to contribute to an increase in international financing costs on the forecast horizon. An expansionary monetary policy stance continues to support favorable do¬mestic financing conditions. The interbank rate and the reference banking indi¬cator (IBR)remained consistent with the policy interest rate in the second quar¬ter. Average deposit and credit rates continued at historical lows, despite some observed increases at the end of June. The peso-denominated credit portfolio continued to decelerate in annual terms and, between March and June, growth in the household credit portfolio accelerated, primarily related to housing pur¬chases. Disbursements and recovery in the commercial credit portfolio were significant, returning to high levels observed one year ago, when businesses required significant levels of liquidity to confront the economic effects of the pandemic. Meanwhile, credit risk increased, liability provisions remained high, and some banks withdrew from the balance of their past-due portfolios. Nev¬ertheless, financial system earnings have recovered, and liquidity and solvency levels remain above regulatory minimums. Beginning with this report, a new methodology will be used to quantify and communicate the uncertainty surrounding central macroeconomic fore¬casts in the context of an active monetary policy. The new methodology, known as predictive densities (PD), will be explained in detail in Box 1. PD methodology provides probability distributions of the main forecast vari¬ables (e.g. growth, inflation) based on the balance of risks of key factors that, in the technical staff’s judgment, could affect the economy on the forecast horizon. These distributions reflect the result of possible shocks (to external variables, prices, and economic activity) that the economy could sustain and the transmission effects considering Colombia’s economic structure and anticipated monetary policy responses. As a result, PD allows for the quantification of uncertainty around the central forecast and of its bias. In this report, the PD exercise shows a downward bias for both economic growth and output gap, while the op¬posite is shown for headline inflation (Graphs 1.1, 1.2 and 1.3). The balance of risks indicates more complex mone¬tary policy dilemmas than previously expected. The most significant anticipated risk regarding external financing would be a return to less favorable conditions in a sce¬nario in which the U.S. Federal Reserve promptly raises interest rates. Such a decision could come as the result of current levels of economic growth and higher-than-ex¬pected employment generating significant inflationary pressures on that country. Uncertainty regarding Colom¬bia’s fiscal outlook and the subsequent effects on the risk premium and external financing costs represent addi¬tional considerations. The risks to economic growth are mainly downside risks, relating especially to the effects of political and fiscal uncertainty on consumption and investment decisions and the potential for additional waves of COVID-19 and the subsequent effects on eco-nomic activity. Inflation risks take into account the po¬tential for more persistent shocks associated with dis¬ruption to value chains, higher international commodity and food prices, and a slower-than-expected recovery in the national agricultural chain as a result of the recent roadblocks. These would represent upward risks primarily to food and goods prices. The main downside risk to the inflation forecast would come from an increase in rental housing prices below the central scenario projection. This would be explained by weak demand and increased sup¬ply in 2022 as a result of high observed housing sales this year. All told, the PD exercise reveals a downward bias for economic growth forecast, with 90% probability of growth between 6.1% and 9.1% for 2021 and between 0.5% and 4.1% in 2022. The output gap also exhibits a downward bias to the central forecast scenario, primarily in 2022. On the contrary, an upward bias is expected for headline inflation forecast, with 90% probability ranging between 3.7% and 4.9% in 2021 and between 2.2% and 4.7% in 2022. 1.2 Monetary policy decision In its meetings in June and July the BDBR left the bench¬mark interest rate unchanged at 1.75% (Graph 1.5).Box 1. Characterizing and Communicating the Balance of Risks of Macroeconomic Forecasts: A Predictive Densities Approach for Colombia Authors: Juan Camilo Méndez-Vizcaíno, César Ánzola-Bravo, Alexander Guarín y Anderson Grajales-OlarteBox 2. Analysis of Recent Disturbances in Global Logistics Chains and their Impact on Colombian Import Markets. Authors: Aarón Garavito, Juan Diego Cortés, Stefany Andrea Moreno, Alex Fernando Pérez y Juan Esteban CarranzaBox 3. The Upward Dynamics of Food Prices. Authors: Edgar Caicedo G., Andrea Salazar D. y Jesús Daniel Sarmiento S

Envejecimiento de la población

•Actividades básicas de la vida diaria en personas mayores y factores asociados •Asociación entre depresión y posesión de mascotas en personas mayores •Calidad de vida en adultos mayores de Santiago aplicando el instrumento WHOQOL-BREF •Calidad de vida en usuarios con enfermedad de Parkinson, demencia y sus cuidadores, comuna de Vitacura •Caracterización de egresos hospitalarios de adultos mayores en Puerto Natales (2007-2009) •Comportamiento de las patologías incluidas como GES para el adulto mayor atendido en un Cesfam •Contribución de vitaminas y minerales a las ingestas recomendadas diarias en ancianos institucionalizados de Madrid •Estado de salud oral del paciente inscrito en el Programa de Visita Domiciliaria •Evaluación del programa de discapacidad severa en Casablanca con la matriz de marco lógico •Factores asociados a satisfacción vital en una cohorte de adultos mayores de Santiago, Chile •Pauta instrumental para la identificación de riesgos para el adulto mayor autovalente, en su vivienda •Perfil farmacológico del paciente geriátrico institucionalizado y posibles consecuencias en el deterioro cognitivo •Programa de cuidados paliativos y alivio del dolor en Puerto Natales •Rehabilitación mandibular implantoprotésica: efecto en calidad de vida relacionada con salud bucal en adultos mayores •Salud bucodental en adultos mayores autovalentes de la Región de Valparaíso •Transición epidemiológica y el estudio de carga de enfermedad en Brasi

Memoria del III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales

Del 05 al 07 de noviembre de 2014 se llevó a cabo en la Sede de Occidente de la Universidad de Costa Rica, el III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales, dicado a Julieta Dobles Izaguirre, Premio Nacional de Cultura Magón, 2013. Este III Coloquio Internacional fue organizado por el Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER), primer Centro de Investigaciones de una Sede Regional de la Universidad de Costa Rica. Se contó con personas investigacdoras nacionales e internacionales quienes presentaron sobre temas relacionados con la diversidad cultural y los estudios regionales.Universidad de Costa Rica/[836-B4-702]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occidente::Recinto San Ramón::Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide