[Association between educational level and suspicion of cognitive imparirment in Chilean older people]

BACKGROUND

A low education level has been associated with cognitive impairment in older adults.

AIM

To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population.

MATERIAL AND METHODS

Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire.

RESULTS

Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education.

CONCLUSIONS

Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Sustainability of Cocoa (Theobroma cacao) Cultivation in the Mining District of Ponce Enríquez: A Trace Metal Approach

Historically, cocoa (Theobroma cacao) has been one of Ecuador's most important export crops. In the Ponce Enriquez district, artisanal and small gold mining (ASGM), and quarrying account for 42% of economic activities, while agriculture and livestock farming account for 30%, making the analysis of their synergy and interaction key to understanding the long term viability of the different activities. In this study, we evaluated the concentration of potentially toxic metals in different parts of the cocoa plant and fruit, in relation to mining activities within the area. Gold extraction generates pollution, including potentially toxic metals such as mercury (Hg), cadmium (Cd), arsenic (As), copper (Cu), lead (Pb) and zinc (Zn). In order to understand the mobility of these metals within the cocoa plant and fruit, the analysis was conducted separately for leaves, pod, husk and cocoa bean. Concentrations of the target metals in the different plant parts and soil were measured using ICP-MS, and the mobility and risk factors were calculated using the transfer factor (TF) and the risk ratio (HQ). The results suggest that Zn, Cd and Cu are indeed moving from the soil to cocoa leaves and beans. Furthermore, the results show that the concentrations of toxic metals in the different parts of the cocoa fruit and plant, particularly in the cocoa bean, which is used for chocolate manufacture, are not higher than those regulated by FAO food standards, as is the case of Cd, which is limited to 0.2 mg Cd/kg and in the samples analyzed does not exceed this limit. Even though the concentration of these metals does not exceed the safety standard, the presence of these potentially hazardous metals, and the fact they are absorbed by this important local crop, are worrying for the long-term sustainability of cocoa cultivation in the area. Therefore, it is fundamental to monitor the local environment, understanding the distribution of heavy metal pollution, and work with the local authorities in landscape management to minimize the exposure of crops to ASGM pollution.

[Prevalence of low hand grip strength in Chilean older adults. Findings from the national health survey 2016-2017]

BACKGROUND

Handgrip strength is an indicator of frailty in older people.

AIM

To determine the prevalence of low handgrip strength in older Chilean adults.

MATERIAL AND METHODS

A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively.

RESULTS

Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively.

CONCLUSIONS

The prevalence of low grip strength increased substantially with age.

[Older people in Chile: the new social, economic and health challenge for the 21st century]

Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.

Tissue-resident memory CD8+ T cells amplify anti-tumor immunity by triggering antigen spreading through dendritic cells

Tissue-resident memory CD8+ T (Trm) cells mediate potent local innate and adaptive immune responses and play a central role against solid tumors. However, whether Trm cells cross-talk with dendritic cells (DCs) to support anti-tumor immunity remains unclear. Here we show that antigen-specific activation of skin Trm cells leads to maturation and migration to draining lymph nodes of cross-presenting dermal DCs. Tumor rejection mediated by Trm cells triggers the spread of cytotoxic CD8+ T cell responses against tumor-derived neo- and self-antigens via dermal DCs. These responses suppress the growth of intradermal tumors and disseminated melanoma lacking the Trm cell-targeted epitope. Moreover, analysis of RNA sequencing data from human melanoma tumors reveals that enrichment of a Trm cell gene signature associates with DC activation and improved survival. This work unveils the ability of Trm cells to amplify the breath of cytotoxic CD8+ T cell responses through DCs, thereby strengthening anti-tumor immunity.

[Correlates of sedentary behaviors in Chile: evidence from the National Health Survey 2009-2010]

BACKGROUND

Sedentary behaviors are one of the major risk factors for cardiovascular diseases.

AIM

To identify factors associated with high sedentary behaviors in the Chilean population.

MATERIAL AND METHODS

We included 5,040 participants from the Chilean National Health Survey 2009-2010. Physical activity level and sedentary behavior (sitting time) were measured using the Global Physical Activity Questionnaire (GPAQ v2). Highly sedentary behaviors were determined as > 4 hours per day of sitting time. Logistic regression was used to identify correlates of highly sedentary behavior.

RESULTS

Forty seven percent of the study population reported spending more than 4 hours per day sitting. The prevalence was higher in women. The main factors associated with high sedentary behavior were: high income levels (Odds ratio (OR):1.91 [95% Confidence intervals (CI:1.61-2.27]); being woman (OR:1.39 [95% CI:1.24-1.56]): having central obesity (OR:1.15 [95% CI:1.02-1.30]), being physically inactive (OR:2.35 [95% CI:2.06-2.68]), and living in an urban area (OR:1.92 [95% CI:1.63-2.26]). Other factors associates with high sedentary behavior were: being smoker, having a television set, computer and private car at their homes. Participants reporting a poor self-reported health and wellbeing and those with diabetes or metabolic syndrome were more likely to be highly sedentary.

CONCLUSIONS

The main factors associated with high levels of sedentary behavior are socio-demographic issues, lifestyles and health status.

Vaccination-induced skin-resident memory CD8+ T cells mediate strong protection against cutaneous melanoma

Memory CD8⁺ T cell responses have the potential to mediate long-lasting protection against cancers. Resident memory CD8⁺ T (Trm) cells stably reside in non-lymphoid tissues and mediate superior innate and adaptive immunity against pathogens. Emerging evidence indicates that Trm cells develop in human solid cancers and play a key role in controlling tumor growth. However, the specific contribution of Trm cells to anti-tumor immunity is incompletely understood. Moreover, clinically applicable vaccination strategies that efficiently establish Trm cell responses remain largely unexplored and are expected to strongly protect against tumors. Here we demonstrated that a single intradermal administration of gene- or protein-based vaccines efficiently induces specific Trm cell responses against models of tumor-specific and self-antigens, which accumulated in vaccinated and distant non-vaccinated skin. Vaccination-induced Trm cells were largely resistant to in vivo intravascular staining and antibody-dependent depletion. Intradermal, but not intraperitoneal vaccination, generated memory precursors expressing skin-homing molecules in circulation and Trm cells in skin. Interestingly, vaccination-induced Trm cell responses strongly suppressed the growth of B16F10 melanoma, independently of circulating memory CD8⁺ T cells, and were able to infiltrate tumors. This work highlights the therapeutic potential of vaccination-induced Trm cell responses to achieve potent protection against skin malignancies.

[Effects of a lower body weight or waist circumference on cardiovascular risk]

BACKGROUND

Overall and central obesity are important risk factors for cardiovascular disease.

AIM

To investigate the association of body weight, body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors in Chile.

MATERIAL AND METHODS

We included 5,157 participants from the National Health Survey 2009-2010. Prevalence of type 2 diabetes, hypertension, metabolic syndrome and dyslipidemia (high total cholesterol and triglyceride levels and low HDL-cholesterol) were defined using international recommendations. BMI and WC were measured using standardized protocols.

RESULTS

A five percent lower body weight, BMI and WC were associated with a significant reduction in cardiovascular risk factors. For each 5% reduction in body weight, the risk for hypertension decreased by 8 and 9% in women and men respectively. Similar risk reductions were observed for diabetes (9 and 11% respectively), metabolic syndrome (23 and 30% respectively), low HDL cholesterol (13 and 13% respectively), high triglyceride levels (16 and 18% respectively) and total cholesterol (8 and 10% respectively). Similar findings were observed for BMI and WC.

CONCLUSIONS

Lower body weight, BMI or WC are associated with important reductions in cardiovascular risk factors. A 5% reduction in these adiposity markers could be a perfectly feasible goal for lifestyle interventions.

[Psychosocial risks, quality of employment, and workplace stress in Chilean wage-earning workers: a gender perspective]

This study aimed to estimate the prevalence of work-related stress in Chile and its association with exposure to workplace psychosocial risks and quality of employment, considering gender differences. The cross-sectional study included a representative probabilistic national sample of 3,010 salaried workers (1,486 women and 1,524 men). Eighteen percent reported work-related stress (23.8% of women and 14.8% of men). People exposed to psychosocial risks had a higher probability of experiencing stress, and women were more likely to suffer stress than men. Women and men in precarious work showed increased likelihood of distress, compared to workers with less precarious jobs. However, women in precarious jobs were more likely to suffer stress than men in the same situation. The study concluded that women had more precarious jobs, experienced greater exposure to psychosocial risks, and suffered more stress than men. This is evidence of double discrimination (social and gender-based) in the Chilean labor market.

Calcium Sensing Receptor as a Novel Mediator of Adipose Tissue Dysfunction: Mechanisms and Potential Clinical Implications

Obesity is currently a serious worldwide public health problem, reaching pandemic levels. For decades, dietary and behavioral approaches have failed to prevent this disease from expanding, and health authorities are challenged by the elevated prevalence of co-morbid conditions. Understanding how obesity-associated diseases develop from a basic science approach is recognized as an urgent task to face this growing problem. White adipose tissue (WAT) is an active endocrine organ, with a crucial influence on whole-body homeostasis. WAT dysfunction plays a key role linking obesity with its associated diseases such as type 2 diabetes mellitus, cardiovascular disease, and some cancers. Among the regulators of WAT physiology, the calcium-sensing receptor (CaSR) has arisen as a potential mediator of WAT dysfunction. Expression of the receptor has been described in human preadipocytes, adipocytes, and the human adipose cell lines LS14 and SW872. The evidence suggests that CaSR activation in the visceral (i.e., unhealthy) WAT is associated with an increased proliferation of adipose progenitor cells and elevated adipocyte differentiation. In addition, exposure of adipose cells to CaSR activators in vitro elevates proinflammatory cytokine expression and secretion. An increased proinflammatory environment in WAT plays a key role in the development of WAT dysfunction that leads to peripheral organ fat deposition and insulin resistance, among other consequences. We propose that CaSR may be one relevant therapeutic target in the struggle to confront the health consequences of the current worldwide obesity pandemic.

El médico general de zona: imágenes de su trabajo, valores ocupacionales y estudio de satisfacción profesional

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Preadipocyte proliferation is elevated by calcium sensing receptor activation

Obesity is a major worldwide problem, despite considerable efforts against it. While excess body fat defines obesity, adipose tissue quality and functionality are key to whether cardiovascular and metabolic comorbidities develop. Adipose tissue cellular composition can vary considerably, and excess adipocyte progenitors (preadipocytes) is associated with obesity. We have proposed that calcium sensing receptor (CaSR) activation in adipose tissue leads to dysfunction. This study evaluated whether CaSR activation elevates preadipocyte proliferation. Human LS14 preadipocytes were exposed to CaSR activators cinacalcet (2 µM), GdCl3 (5 µM) and spermine (1 µM), and cell viability was evaluated after 72h. CaSR activators elevated proliferation by 19-24%, and CaSR silencing (siRNA) abolished the effect. Cinacalcet elevated phospho-ERK1/2 content, and upstream inhibition of ERK1/2 phosphorylation reverted cinacalcet-induced proliferation. Cinacalcet also elevated expression of the proinflammatory factors IL1β, IL6 and CCL2. The results suggest that CaSR induces preadipocyte proliferation, partly through ERK1/2 activation. Considering reported proinflammatory and adipogenic CaSR effects, excess preadipocyte proliferation further supports the dysfunctional effect of CaSR in obesity.