Clinical presentations and outcomes of HIV-1 and HIV-2 among infected children in Guinea-Bissau: a nationwide study

OBJECTIVES

Disease progression, loss to follow-up, and mortality of HIV-2 compared with HIV-1 in children is not well understood. This is the first nationwide study reporting outcomes in children with the two HIV types in Guinea-Bissau.

STUDY DESIGN

Nationwide retrospective follow-up study.

METHODS

This is a retrospective follow-up study among HIV-infected children <15 years at nine ART centers from 2006 to 2021. Baseline parameters and disease outcomes for children with HIV-2 and HIV-1 were compared.

RESULTS

The annual number of children diagnosed with HIV peaked in 2017. HIV-2 (n = 64) and HIV-1 (n = 1945) infected children were different concerning baseline median age (6.5 vs 3.1 years, P < 0.01), but had similar levels of severe immunodeficiency (P = 0.58) and severe anemia (P = 0.26). Within the first year of follow-up, 36.3% were lost, 5.9% died, 2.7% had transferred clinic, and 55.2% remained for follow-up. Mortality (HR = 1.05 95% CI: 0.53-2.08 for HIV-2) and attrition (HR = 0.86 95% CI: 0.62-1.19 for HIV-2) rates were similar for HIV types.

CONCLUSIONS

The decline in children diagnosed per year since 2017 is possibly due to lower HIV prevalence, lack of HIV tests, and the SARS-CoV-2 epidemic. Children with HIV-2 were twice as old as HIV-1 infected when diagnosed, which suggests a slower disease progression. However, once they develop immunosuppression mortality is similar.

Biocidal effects of organometallic materials supported on ZSM-5 Zeolite: Influence of the physicochemical and surface properties

Antifouling coatings containing biocidal agents can be used to prevent the accumulation of biotic deposits on submerged surfaces; however, several commercial biocides can negatively affect the ecosystem. In this study, various formulations of a potential biocide product comprising copper nanoparticles and capsaicin supported on zeolite ZSM-5 were analyzed to determine the influence of the concentration of each component. The incorporation of copper was evidenced by scanning electron microscopy and energy dispersive spectroscopy. Similarly, Fourier-transform infrared spectroscopy confirmed that capsaicin was supported on the zeolite surface. The presence of capsaicin on the external zeolite surface significantly reduced the surface area of the zeolite. Finally, bacterial growth inhibition analysis showed that copper nanoparticles inhibited the growth of strains Idiomarina loihiensis UCO25, Pseudoalteromonas sp. UCO92, and Halomonas boliviensis UCO24 while the organic component acted as a reinforcing biocide.

Results from the 2022 Mexican report card on physical activity for children and adolescents

Introduction

The Mexican Report Card on Physical Activity for Children and Adolescents aims to assess the prevalence of movement behaviors and opportunities to perform them.

Methods

Data on 11 indicators were obtained from national health surveys, census data, government documents, websites, and published studies. Data were compared against established benchmarks, and a grade between 0 and 10 was assigned to each indicator.

Results

For Daily Behaviors, we found 34.5% of Mexican children and adolescents meet Physical Activity recommendations (Grade 3), 48.4% participate in Organized Sports (Grade 5), 35-75.8% engage in Active Play outdoors (Grade 4), 54.1% use Active Transportation (Grade 5), 43.6% spend <2 h in Sedentary Behavior per day (Grade 4), and 65-91% meet Sleep recommendations (Grade 7). Girls have lower physical activity levels and sports participation than boys of the same age. For Physical Fitness, we found 56.2-61.8% of children and adolescents have an adequate body mass index for their age (Grade 6). For Sources of Influence, we found 65-67% of parents engage in physical activity or sports in a week (Grade 7), 32.2-53.3% of basic education schools have a physical education teacher (Grade 6), and 37% of neighborhoods in Mexico have sidewalks with trees (Grade 4). Regarding Government, several policies and programs aimed at improving children physical activity were launched but their impact and allocated implementation budget are unknown (Grade 6).

Discussion

Mexican children and adolescents engage in low levels of movement behaviors and have limited opportunities to perform such behaviors. The grades and recommendations provided here should be considered to improve such opportunities.

Factores asociados con el cumplimiento de los comportamientos del movimiento en adultos mexicanos: Ensanut 2022

OBJETIVO

Examinar las características sociodemográficas e indicadores de salud asociados con el cumplimiento de las recomendaciones de los comportamientos del movimiento en adultos mexicanos. Material y métodos. Estudio transversal que utilizó datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2022. Se obtuvo información de actividad física (AF), sedentarismo y sueño, características sociodemográficas e indicadores de salud en adultos de 20-78 años. Para el análisis se utilizaron regresiones logísticas y lineales ajustadas y no por covariables.

RESULTADOS

Los adultos que viven en áreas urbanas tuvieron mayor posibilidad de no cumplir las recomendaciones de actividad física, sedentarismo, sueño y los comportamientos del movimiento (CM) en conjunto. No cumplir las recomendaciones de los tres CM se asoció con mayores niveles de glucosa, colesterol y tensión arterial elevada. Conclusión. La asociación de los CM con indicadores de salud muestra la importancia de identificar estrategias para promover estos comportamientos en la población mexicana.

The elucidation of the life cycle of Saccocoelioides nanii Szidat, 1954 (Digenea: Haploporidae) using molecular techniques

In South America, the knowledge of trematode diversity parasitizing freshwater fishes is still scarce, as less than 5% of the freshwater fish fauna has been examined for parasites. A similar situation applies to studies on digenean life cycles, which have become increasingly rare. Among the digenean families parasitizing freshwater fishes in the region, Haploporidae is considered the richest in species diversity. However, information about the developmental stages of haploporid life cycles remains fragmentary. Particularly, in Argentina, nine cercariae attributed to the family Haploporidae have been described using morphological analysis, and only two life cycles of this family have been completely elucidated. In this study a new type of cercaria, morphologically assigned to the family Haploporidae and collected from the snail Heleobia parchappii (Cochliopidae) in Los Padres shallow lake, Buenos Aires province, was identified using morphological and molecular techniques. The molecular analysis, based on 28S and ITS2 sequences, revealed that the cercariae were 100% identical to adult specimens of Saccocoelioides nanii (Haploporidae) parasitizing the fish Prochilodus lineatus (Prochilodontidae) from Los Talas, Buenos Aires province. Our results not only provide information about the life cycle of S.nanii but also show that a molecular and morphological approach can be extremely useful in identifying the developmental stages of digeneans and elucidating their life cycles.

Efficient Indirect Interatomic Coulombic Decay Induced by Photoelectron Impact Excitation in Large Pure Helium Nanodroplets

Ionization of matter by energetic radiation generally causes complex secondary reactions that are hard to decipher. Using large helium nanodroplets irradiated by extreme ultraviolet (XUV) photons, we show that the full chain of processes ensuing primary photoionization can be tracked in detail by means of high-resolution electron spectroscopy. We find that elastic and inelastic scattering of photoelectrons efficiently induces interatomic Coulombic decay (ICD) in the droplets. This type of indirect ICD even becomes the dominant process of electron emission in nearly the entire XUV range in large droplets with radius ≳40  nm. Indirect ICD processes induced by electron scattering likely play an important role in other condensed-phase systems exposed to ionizing radiation as well, including biological matter.

Prevalencia de comportamientos del movimiento en población mexicana

OBJETIVO

Describir la prevalencia de los comportamientos del movimiento (CM) en 24 horas en población mexicana. Material y métodos. Se recolectó información de actividad física (AF), tiempo sedentario y sueño para individuos de 10 a 78 años por medio de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022).

RESULTADOS

Más de 65% de niños y niñas no cumple con las recomendaciones de AF y pasan >2 horas/día frente a pantallas. Casi 91% de los adolescentes pasan >2 horas/día frente a pantalla. Más de 30% de los adolescentes y adultos no cumple con las recomendaciones de sueño. Sólo 1.5% de niños y niñas, 4.7% de adolescentes, 4.0% de los adultos y 1.5% de adultos mayores cumplieron las recomendaciones de los tres CM. Conclusión. Se evidencia la necesidad de desarrollar estrategias para contrarrestar la inactividad física, el comportamiento sedentario y el sueño insuficiente desde temprana edad hasta la adultez en población mexicana.

Towards recycling of waste carbon fiber: Strength, morphology and structural features of recovered carbon fibers

Carbon fiber is one of the most widely used materials in high demand applications due to its high specific properties, however, its post-recycling properties limit its use to low performance applications. In this research, the carbon fiber recovering is examined using two methods: two-step pyrolysis and microwave-assisted thermolysis. The results indicate that the fibers recovered by pyrolysis show reduced surface and structural damage, maintaining the original mechanical properties of the fiber with losses below 5%. The fibers recovered by microwaves undergo significant surface changes that reduce their tensile strength by up to 60% and changes in their graphitic structure, increasing their degree of crystallinity by Raman index I_D/I_G from 1.98 to 2.86 and their amorphous degree by I_D"/I_G ratio from 0.411 to 1.599. Recovering fibers from microwave technique is 70% faster compared to two step pyrolysis, and provides recycled fibers with superior surface activation with the presence of polar functional groups -OH, -CO, and -CH that react with the epoxy matrix. The thermal, morphological, structural and mechanical characterizations of the recovered fibers detailed in this work provide valuable findings to evaluate their direct reuse in new composite materials.

Determinants of exposure to Aedes mosquitoes: A comprehensive geospatial analysis in peri-urban Cambodia

Aedes mosquitoes are some of the most important and globally expansive vectors of disease. Public health efforts are largely focused on prevention of human-vector contact. A range of entomological indices are used to measure risk of disease, though with conflicting results (i.e. larval or adult abundance does not always predict risk of disease). There is a growing interest in the development and use of biomarkers for exposure to mosquito saliva, including for Aedes spp, as a proxy for disease risk. In this study, we conduct a comprehensive geostatistical analysis of exposure to Aedes mosquito bites among a pediatric cohort in a peri‑urban setting endemic to dengue, Zika, and chikungunya viruses. We use demographic, household, and environmental variables (the flooding index (NFI), land type, and proximity to a river) in a Bayesian geostatistical model to predict areas of exposure to Aedes aegypti bites. We found that hotspots of exposure to Ae. aegypti salivary gland extract (SGE) were relatively small (< 500 m and sometimes < 250 m) and stable across the two-year study period. Age was negatively associated with antibody responses to Ae. aegypti SGE. Those living in agricultural settings had lower antibody responses than those living in urban settings, whereas those living near recent surface water accumulation were more likely to have higher antibody responses. Finally, we incorporated measures of larval and adult density in our geostatistical models and found that they did not show associations with antibody responses to Ae. aegypti SGE after controlling for other covariates in the model. Our results indicate that targeted house- or neighborhood-focused interventions may be appropriate for vector control in this setting. Further, demographic and environmental factors more capably predicted exposure to Ae. aegypti mosquitoes than commonly used entomological indices.

Association between density of convenience and small grocery stores with diet quality in adults living in Mexico City: A cross sectional study

There is evidence of the association between different retail stores and food consumption, yet research is still limited in low- and medium-income countries, where the context of the food retail environment is different from that observed in high-income countries. Specifically, less is known about how convenience and small grocery stores, which offer products with immediate access, are associated with the diet as a whole. The present study assessed the association between density of convenience and small grocery stores and diet quality in adults from the Mexico City Representative Diabetes Survey 2015. A final sample size of 1,023 adults aged 20–69 years was analyzed. The density of stores was measured using Euclidean buffers within 500 meters of each participant's home. The Mexican Alternate Healthy Eating Index (MxAHEI) was used to assess diet quality. Multivariable Poisson models were used to test the association of convenience and small grocery stores densities with the MxAHEI. Although our results were not statistically significant, we observed a lower diet quality score among adults from Mexico City living in areas with a higher density of small grocery and convenience stores. More research is needed on the influence of environmental food retail on food consumption.

Systematic literature review of instruments that measure the healthfulness of food and beverages sold in informal food outlets

BACKGROUND

Informal food outlets, defined as vendors who rarely have access to water and toilets, much less shelter and electricity, are a common component of the food environment, particularly in many non-Western countries. The purpose of this study was to review available instruments that measure the quality and particularly the healthfulness of food and beverages sold within informal food outlets.

METHODS

PubMed, LILACS, Web of Science, and Scopus databases were used. Articles were included if they reported instruments that measured the availability or type of healthy and unhealthy foods and beverages by informal food outlets, were written in English or Spanish, and published between January 1, 2010, and July 31, 2020. Two trained researchers reviewed the title, abstract and full text of selected articles; discrepancies were solved by two independent researchers. In addition, the list of references for selected articles was reviewed for any additional articles of relevance. The quality of published articles and documents was evaluated using JBI Critical appraisal checklist for analytical cross-sectional studies.

RESULTS

We identified 1078 articles of which 14 were included after applying the selection criteria. Three additional articles were considered after reviewing the references from the selected articles. From the final 17 articles, 13 measurement tools were identified. Most of the instruments were used in low- and middle-income countries (LMIC). Products were classified as healthy/unhealthy or produce/non-produce or processed/unprocessed based on availability and type. Six studies reported psychometric tests, whereas one was tested within the informal food sector.

CONCLUSIONS

Few instruments can measure the healthfulness of food and beverages sold in informal food outlets, of which the most valid and reliable have been used to measure formal food outlets as well. Therefore, it is necessary to develop an instrument that manages to measure, specifically, the elements available within an informal one. These actions are extremely important to better understand the food environment that is a central contributor to poor diets that are increasingly associated with the obesity and Non-communicable disease (NCD) pandemic.

Development and Validation of the Mexican Public Open Spaces Tool (MexPOS)

Public open spaces (POS) are "publicly owned spaces such as parks, green areas, squares, marketplaces, streets and highways which are of public access". Some attributes could increase or decrease participants' attendance. Thus, reliable and valid audit tools are needed in order to measure these attributes. This study aimed to develop and validate a tool to assess POS features within the Mexico City context. The Mexican Public Open Spaces Tool (MexPOS) was developed based on (1) two validated POS audit tools, (2) several visits to the POS, (3) pilot testing, and (4) multiple work sessions with a group of specialists. The original tool included 181 items divided into nine sections. Trained personnel visited and evaluated 944 POS in Mexico City. An exploratory factor analysis was performed to examine the construct validity of the items and the relationship between the subscales. The final model resulted in seven factors: (1) Food and Wellness Environment (α = 0.15), (2) Maintenance (α = 0.81), (3) Amenities (α = 0.72), (4) Legibility (α = 0.59), (5) Security (α = 0.48), (6) Perceived Environment (α = 0.65), and (7) Urban Environment (α = 0.58). Our study highlights the relevance of using a validated tool to measure POS characteristics related to participants' attendance to help assess infrastructure improvements and identify priority areas for changing socio-urban environments for physical activity.

Oxytocin-Cholinergic Central Interaction: Implications for Non-Social Memory Formation

Oxytocin (OT) and vasopressin (AVP) are two closely related neuropeptides implicated in learning and memory processes, anxiety, nociception, addiction, feeding behavior and social information processing. Regarding learning and memory, OT has induced long-lasting impairment in different behaviors, while the opposite was observed with AVP. We have previously evaluated the effect of peripheral administration of OT or its antagonist (AOT) on the inhibitory avoidance response of mice and on the modulation of cholinergic mechanisms. Here, we replicate and validate those results, but this time through central administration of neuropeptides, considering their poor passage through the blood-brain barrier (BBB). When we delivered OT (0.10 ng/mouse) and its antagonist (0.10 ng/mouse) through intracerebroventricular (ICV) injections, the neuropeptide impaired and AOT enhanced the behavioral performance on an inhibitory avoidance response evaluated 48 h after training in a dose-dependent manner. On top of that, we investigated a possible central interaction between OT and the cholinergic system. Administration of anticholinesterases inhibitors with access to the central nervous system (CNS), the activation of muscarinic acetylcholine (Ach) receptors and the increase of evoked ACh release using linopirdine (Lino) (3-10 µg/kg, IP), reversed the impairment of retention performance induced by OT. Besides, either muscarinic or nicotinic antagonists with unrestricted access to the CNS reduced the magnitude of the performance-facilitating effect of AOT's central infusion. We suggest that OT might induce a cholinergic hypofunction state, resulting in an impairment of IA memory formation, a process for which the cholinergic system is crucially necessary.

Walking for transportation in large Latin American cities: walking-only trips and total walking events and their sociodemographic correlates

Walking for transportation is a common and accessible means of achieving recommended physical activity levels, while providing important social and environmental co-benefits. Even though walking in rapidly growing urban areas has become especially challenging given the increasing dependence on motorised transportation, walking remains a major mode of transportation in Latin American cities. In this paper we aimed to quantify self-reported walking for transportation in Mexico City, Bogota, Santiago de Chile, Sao Paulo, and Buenos Aires, by identifying both walking trips that are conducted entirely on foot and walking events involved in trips mainly conducted on other means of transportation (e.g. private vehicle, public transit) among individuals ≥5-years old. We show how walking-only trips account for approximately 30% trips in the analysed cities, and we evidence how the pedestrian dimension of mobility is largely underestimated if walking that is incidental to other transportation modes is not accounted for: when considering all walking events, we observed an increase between 73% and 217% in daily walking time. As a result, we estimated that between 19% and 25% of residents in these cities meet the WHO physical activity guidelines solely from walking for transportation. The results of the study also suggest that the promotion of public transportation in large Latin American cities can especially help certain population groups achieve the daily recommended levels of physical activity, while among low-income groups accessibility and safety seem to be the key challenges to be addressed.

Validity and reliability of the International Physical Activity Questionnaire (IPAQ) long-form in a subsample of female Mexican teachers

OBJECTIVE

To evaluate the test-retest reliability and validity of the long-form International Physical Activity Questionnaire (IPAQ-long form).

MATERIALS AND METHODS

A subsample of 86 teachers underwent telephone interviews and clinic visits in Mexico City. Through 22 months, physical activity (PA) levels were obtained from accelerometers (months 6 and 22) and IPAQ long-form (months 1, 3, 6, 9 and 12). Minutes per week of moderate (MPA), walking (WPA), vigorous (VPA) and moderate-to-vigorous physical activity (MVPA) were calculated for each intensity and domain. Variables were loga-rithmically transformed. Intra-class and Pearson correlations were used to determine the relationship between instru-ments.

RESULTS

Test-retest reliability of the average IPAQs long-form varied across intensities and domains (ranged from r= 0.24 to r= 0.65). Minutes per week of VPA and MVPA ac-celerometer 1 (AC1) were fairly associated to International Physical Activity Questionnaire-long form 3 (IPAQ3) (r= 0.60 and r= 0.31, respectively) one week apart.

CONCLUSIONS

IPAQ long-form is fairly reliable for MVPA and valid for as-sessing MVPA and VPA in a subsample of Mexican teachers.

Factors associated with changes in movement behaviors in toddlers and preschoolers during the COVID-19 pandemic: A national cross-sectional study in Mexico

Little is known about physical activity, screen time and sleep among Mexican toddlers and preschoolers. The COVID-19 pandemic led to the closure of childcare education centers and restrictions to spend time outdoors. This study aimed to investigate the correlates of changes in movement behaviors from before to during the early stages of the COVID-19 lockdown in a national sample of toddlers and preschoolers in Mexico. A cross-sectional study was conducted using an open online survey completed by caretakers of children aged 1-5 years from April to July 2020. The questionnaire enquired about the time spent in each movement behavior during a regular week before and during lockdown, and family and household characteristics. Factors associated with changes in movement behaviors were explored using adjusted linear regression models. A total of 631 children (3.3y, 95% CI: 3.1, 3.4) were included in the study. During lockdown, physical activity decreased by 25%, screen time doubled, and sleep quality declined in 17% (p < 0.001). Toddlers and preschoolers of older age, attending a childcare education center before the lockdown, with a screen in their bedroom, higher access to electronic devices, and lower socioeconomic level experienced greater changes during this period. Those with limits on the use of electronic devices, who had someone available to play with them, and availability of toys experienced less pronounced changes. Pandemic restrictions have impacted movement behaviors of toddlers and preschoolers, with disproportionate effects among lower socioeconomic levels. Interventions with a multi-level equity-oriented approach are urgently needed to mitigate these effects.

Reliability and validity of the Mexican teachers' physical activity questionnaire (MTPAQ) in a subsample of female Mexican teachers

BACKGROUND

Reliable and valid instruments are needed to estimate physical activity levels. The purposes of this study were to estimate the reliability and validity of the Physical Activity Questionnaire (MTPAQ) in a subsample of the Mexican Teachers Cohort study.

METHODS

We completed telephone interviews and clinical examinations of 82 teachers. Two MTPAQ, five International Physical Activity Questionnaire (IPAQ)-long form, and two accelerometer (AC) measures were used to determine physical activity levels throughout 24 months. Moderate and walking physical activity (MWPA min/week), vigorous physical activity (VPA min/week), and moderate-to-vigorous physical activity minutes per week (MVPA min/week) were estimated for each instrument. Pearson, Intra-class correlations and deattenuated adjustments were used to determine the reliability and validity of MTPAQ.

RESULTS

MWPA and MVPA min/week of MTPAQs were moderately correlated (r ≥ 0.54) to min/week of IPAQ-long form. MWPA and MVPA min/week average MTPAQ and MTPAQ1 and average AC, AC1 and AC2 were fairly correlated (r ≥ 0.20). A higher correlation was observed when correlation coefficients were attenuated (r ≥ 0.32).

CONCLUSIONS

MTPAQ1 is a reliable and valid tool to measure physical activity levels.

Predictors of Test Positivity, Mortality, and Seropositivity during the Early Coronavirus Disease Epidemic, Orange County, California, USA

We conducted a detailed analysis of coronavirus disease in a large population center in southern California, USA (Orange County, population 3.2 million), to determine heterogeneity in risks for infection, test positivity, and death. We used a combination of datasets, including a population-representative seroprevalence survey, to assess the actual burden of disease and testing intensity, test positivity, and mortality. In the first month of the local epidemic (March 2020), case incidence clustered in high-income areas. This pattern quickly shifted, and cases next clustered in much higher rates in the north-central area of the county, which has a lower socioeconomic status. Beginning in April 2020, a concentration of reported cases, test positivity, testing intensity, and seropositivity in a north-central area persisted. At the individual level, several factors (e.g., age, race or ethnicity, and ZIP codes with low educational attainment) strongly affected risk for seropositivity and death.

REPRODUCTIVE PERFORMANCE OF BROWN SWISS AND MESTIZO BOVINE IN HUMID TROPIC

The ability of ruminants to regulate body temperature depends on the genotype. Dairy breeds are generally more sensitive to heat stress than beef breeds. Higher-producing animals are more susceptible to heat stress because they generate more metabolic heat. The objective of evaluating reproductive performance as a response of adaptability to the management and climatic conditions of the Humid Tropics. 78 animals were used (40 Brown Swiss, from Puno and 38 Mestizas from local origin) raised in humid tropic conditions. Parametric statistics are presented as analysis of measures of central tendency and dispersion, non-parametric statistics by frequency analysis, the χ2 test of independence was used to detect differences, α = 0.05. The categorized and continuous dependent variables were evaluated with Student's t test using SPSS Software v.23. The mean age at first estrus in Brown Swiss was 12.43 months, in mestizo cattle 18.68 months (P <0.05). Average age of first calving in Brown Swiss of 25.25 months versus mestizo cattle 28.34 months (P <0.05). Interval from calving to the first service in Brown Swiss was 99.29 days. Open days observed in Brown Swiss was 107.29 days. The pregnancy rate at the first service in Brown Swiss was 70.0% pregnancy at the first service and 30.0% at the second service, for the mestizo genotype it was 68.4% at the first service, 28.9 at the second and 2.6 at the third service (P> 0.05; X2 = 0.50; p = 0.47). It is concluded that bovine animals of the Brown Swiss genotype have a good reproductive performance in the Humid Tropic climate compared to the Mestizo genotype

Physical inactivity and sitting time prevalence and trends in Mexican adults. Results from three national surveys

BACKGROUND

Physical inactivity and high sitting time are directly related to mortality and morbidity of non-communicable diseases (NCDs). Thus, improved understanding of the prevalence and trends of these behaviors could support the design of policies and interventions for NCDs prevention.

OBJECTIVE

To determine the current prevalence of physical inactivity and high sitting time, to analyze the trends, and to estimate the association of meeting/not meeting physical activity recommendations and low/high sitting time with sociodemographic characteristics and body mass index categories.

METHODOLOGY

Data from the 2018 National Health and Nutrition Survey were used. Moderate-to-vigorous physical activity (MVPA) and sitting minutes per week were calculated using the International Physical Activity Questionnaire short form (IPAQ). In total, 38,033 questionnaires of adults aged 20 to 69-year-old were analyzed. Adults were classified as physically inactive if they achieved less than 150 minutes per week of MVPA and as with high sitting time if they accumulated more than 420 minutes of sitting per day. Health and Nutrition National Surveys (ENSANUT) 2006, 2012 and 2018 were used to estimate the trends.

RESULTS

In total, 16.5% were classified as physically inactive and 11.3% within the high sitting time category. Both prevalences increased more than 40% during the 12-y period (2006-2018). In 2018, men, younger adults, those living in urban areas, and people within the highest socioeconomical status and educational levels were more likely to not achieve physical activity recommendations and to be classified in the highest sitting time category.

CONCLUSION

To stop current increased trends and achieve global targets, stronger and more concerted efforts to promote physical activity and reduce sitting time are required. Thus, continued surveillance of these behaviors is necessary.

Revisión rápida: evidencia de transmisión por Covid-19 e infecciones respiratorias agudas similares en espacios públicos abiertos

 Objetivo. Describir la evidencia disponible sobre la trans-misión por Covid-19 e infecciones respiratorias agudas simi-lares al Covid-19 en espacios públicos abiertos. Material y métodos. La búsqueda incluyó 4 926 artículos en inglés de los años 2000 a 2020. Seis investigadores revisaron el título y el resumen de los artículos de Embase y PubMed; dos inves-tigadores revisaron los de medRxiv. Todos los investigadores revisaron textos completos y otros resolvieron las discre-pancias. Resultados. De los 21 artículos seleccionados, se observó que la presencia de virus en superficies públicas, aguas residuales y áreas exteriores no fue indicativa de trans-misión. No obstante, se observó que el uso de cubrebocas, el lavado de manos, el distanciamiento social, no asistir a eventos masivos y la movilidad individual a espacios públicos podría ayudar a reducir el riesgo de transmisión. Conclusión. Esta información podría coadyuvar a generar recomendaciones en salud pública, sin embargo, es recomendable actualizar esta revisión conforme avance la evidencia científica.

Threshold stability using active fixation LV lead

Introduction

The proper functioning of the CRT devices depends on the correct positioning of the electrodes, sometimes being compromised by the absence of suitable epicardial veins, leads instability or unacceptable high thresholds, among other. In 2017, a novel quadripolar active fixation LV lead was released with an innovative helical mechanism that expands to attach the lead within the vessel.

Objectives

Study the impact of the active fixation LV lead on threshold stability and dislocations.

Methods

We included 127 consecutive patients undergoing CRT between September 2017 to December 2019 in one hospital. They were randomly assigned: 62p active fixation VI leads vs 65p standard VI leads. LV thresholds, capture losses and dislocations were collected at standard pacing checks (1 week, 2 months, 6 months).

Results

The mean age of the sample was 73,9±8,4 years. 75% patients were male and 48,4% suffered ischemic cardiomyopathy. The two groups were similar according to this variables. 5 (7.7%) dislocations were reported in the control group against 2 (3.2%) in the active fixation group (n.s). The mean threshold (V) at the moment of the implant was 1,4 in the active fixation vs 1,41 in the standard LV leads; at the first visit 1,55 vs 1,99; at two months 1,59 vs 2,13 and at six months 1,74 vs 2,48.

The threshold stability is shown in Figure 1.

Conclusions

– The active fixation LV lead provides higher threshold stability than the conventional one.

– There is a non-significant tendency to reduce dislocations.

Figure 1

Funding Acknowledgement

Type of funding source: None

Mexico's 2018 Report Card on Physical Activity for Children and Youth: Full report

Objectives.

Mexico’s 2018 Report Card evaluates the opportunities available for Mexican children and youth to reach healthy levels of physical activity, sleep, and sedentary behavior.

Methods.

The Report Card is a surveillance system that gathers data from national surveys, censuses, government documents, websites, grey literature, and published studies to evaluate 16 indicators in four categories: Daily Behaviors; Physical Fitness; Settings and Sources of Influence; and Strategies and Investments. Data were compared to established benchmarks. Each indicator was assigned a grade from 1 – 10 (< 6 is a failing grade) or “incomplete” if data was insufficient/unavailable.

Results.

Daily Behavior grades were: Overall Physical Activity, 4; Organized Sport Participation, 5; Active Play, 3; Active Transportation, 5; Sleep, 7; and Sedentary Behavior, 3. Physical Fitness, received a 7. Settings and Sources of Influence grades were: Family and Peers, incomplete; School, 3; and Community and Environment, 4. Strategies and Investments were: Government Strategies, 6; and Non-Government Organizations, 2.

Conclusion.

Low grades in 11 of the 16 indicators indicate that schools, families, communities, and government need to work together to improve physical activity opportunities for children and youth in Mexico.

Construction and demolition waste applications and maximum daily output in Spanish recycling plants

The pursuit of construction sustainability has driven the use of partially or wholly waste-based eco-materials. New applications are being sought for recycled aggregate (RA) to further the use of this material and ensure the survival of the construction and demolition waste (C&DW) industry. RA, currently used in the construction of pavements, fills and embankments and only incipiently to manufacture structural or non-structural concrete, is a mere 8.99% of the total aggregate extracted in EU countries where RA is produced. Against this backdrop, the utility of this study lies in the overview afforded of RA typology, the application of the product in bound or unbound materials, the pursuit of new applications, structural or otherwise, and the assessment of daily maximum output by C&DW recycling facilities in Spain. The findings show that irrespective of its origin, RA most commonly adopts the form of wet mix macadam, gravel or sand used primarily in unbound applications with only dubious quality standards. Plant managers contend that RA from clean waste can feasibly be used in bound applications that require higher-performance materials. Maximum daily output varies widely, with capacity under 200 t d^-1 in 30% of the plants. One of the conclusions drawn is that the current business model is in need of revision, with an emphasis on aggregate quality control (certification) and the adoption of technology for separating out impurities, pollutants and undesirable materials to improve the quality of RA.

HIV treatment in Guinea-Bissau: room for improvement and time for new treatment options

Despite advances in the treatment quality of HIV throughout the world, several countries are still facing numerous obstacles in delivering HIV treatment at a sufficiently high quality, putting patients' lives in jeopardy. The aim of this status article is to give an overview of HIV treatment outcomes in the West African country, Guinea-Bissau, and to assess how newer treatment strategies such as long-acting injectable drugs or an HIV cure may limit or stop the HIV epidemic in this politically unstable and low-resource setting. Several HIV cohorts in Guinea-Bissau have been established and are used as platforms for epidemiological, virological, immunological and clinical studies often with a special focus on HIV-2, which is prevalent in the country. The Bandim Health Project, a demographic surveillance site, has performed epidemiological HIV surveys since 1987 among an urban population in the capital Bissau. The Police cohort, an occupational cohort of police officers, has enabled analyses of persons seroconverting with estimated times of seroconversion among HIV-1 and HIV-2-infected individuals, allowing incidence measurements while the Bissau HIV Cohort and a newer Nationwide HIV Cohort have provided clinical data on large numbers of HIV-infected patients. The HIV cohorts in Guinea-Bissau are unique platforms for research and represent real life in many African countries. Poor adherence, lack of HIV viral load measurements, inadequate laboratory facilities, high rates of loss to follow-up, mortality, treatment failure and resistance development, are just some of the challenges faced putting the goal of "90-90-90″ for Guinea-Bissau well out of reach by 2020. Maintaining undetectable viral loads on treatment as a prerequisite of a cure strategy seems not possible at the moment. Thinking beyond one-pill-once-a-day, long-acting antiretroviral treatment options such as injectable drugs or implants may be a better treatment option in settings like Guinea-Bissau and may even pave the way for an HIV cure. If the delivery of antiretroviral treatment in sub-Saharan Africa in a sustainable way for the future should be improved by focusing on existing treatment options or through focusing on new treatment options remains to be determined.

Nutrition Label Use Is Related to Chronic Conditions among Mexicans: Data from the Mexican National Health and Nutrition Survey 2016

BACKGROUND

Non-communicable diseases, such as obesity, diabetes, and hypertension, can be prevented and treated through a balanced nutrient-rich diet. Nutrition labels have been recognized as crucial to preventing obesity and non-communicable diseases through a healthier diet.

OBJECTIVE

Our aim was to examine the association between nutrition label use and chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension) among an adult Mexican population.

DESIGN

This was a cross-sectional study that used data from the Mexican National Health and Nutrition Survey of 2016 (ENSANUT MC 2016).

PARTICIPANTS/SETTING

The participants were 5,013 adults aged 20 to 70 years old. Older adults (>70 years), illiterate participants, pregnant women, and participants with implausible blood pressure data were excluded from the sample. The survey was conducted from May to August 2016 in the participants' households.

MAIN OUTCOME MEASURES

We measured chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension).

STATISTICAL ANALYSES PERFORMED

Pearson χ² test was used to examine the associations among the use of nutrition labels and sociodemographic characteristics and chronic conditions. Multiple logistic regression was used to determine the association between nutrition label use and chronic conditions adjusting for the effect of confounding variables like sex, age, body mass index, education level, marital status, ethnicity, residence area, region, and socioeconomic status.

RESULTS

From the total sample, 40.9% (95% CI 38.4% to 43.8%) reported using nutrition labeling. Respondents with overweight or obesity were less likely to use nutrition labels (odds ratio 0.74; P<0.05). Participants who self-reported diabetes had significantly lower odds of nutrition label use than participants who did not report to have diabetes (odds ratio 0.66; P<0.05). Participants having 3 chronic conditions had lower odds of nutrition label use (odds ratio 0.34; P<0.01) relative to having zero chronic conditions.

CONCLUSIONS

This study suggests an association between nutrition label use and chronic conditions (obesity and diabetes). These findings demonstrate that people with obesity, diabetes, and a combination of chronic conditions were less likely to use nutrition labels than people without these conditions.

Interhospital Sepsis Code in Catalonia (Spain): Territorial model for initial care of patients with sepsis

Sepsis is a syndromic entity with high prevalence and mortality. The management of sepsis is standardized and exhibits time-dependent efficiency. However, the management of patients with sepsis is complex. The heterogeneity of the forms of presentation can make it difficult to detect and manage such cases, in the same way as differences in training, professional competences or the availability of health resources. The Advisory Commission for Patient Care with Sepsis (CAAPAS), comprising 7 scientific societies, the Emergency Medical System (SEM) and the Catalan Health Service (CatSalut), have developed the Interhospital Sepsis Code (CSI) in Catalonia (Spain). The general objective of the CSI is to increase awareness, promote early detection and facilitate initial care and interhospital coordination to attend septic patients in a homogeneous manner throughout Catalonia.

Comparative Study of the Antimicrobial Effect of Nanocomposites and Composite Based on Poly(butylene adipate-co-terephthalate) Using Cu and Cu/Cu2O Nanoparticles and CuSO4

Nanocomposites and a composite based on poly(butylene adipate-co-terephthalate) (PBAT) were synthesized using commercial copper nanoparticles (Cu-NPs), copper/cuprous oxide nanoparticles (Cu|Cu₂O-NPs), and copper sulfate (CuSO₄), respectively. The Cu|Cu₂O-NPs were synthesized using chemical reduction and characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The synthesis of Cu|Cu₂O-NPs yielded a mixture of Cu and Cu₂O, with metal Cu having a spherical morphology of approximately 40 nm in diameter and Cu₂O with a diameter of 150 nm. To prepare the nanocomposites (NCs) and the composite material (MC), the NPs and the CuSO₄ salt were incorporated into the PBAT matrix in concentrations of 1, 3, and 5% p/p via an ex situ method. Fourier transform infrared spectroscopy (FTIR), a tensile test, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and agar diffusion assays were used for structural, thermomechanical, and antimicrobial characterization. Results showed that the reinforcements did not modify the chemical structure of the PBAT and only slightly increased the percentage of crystallization. The mechanical and thermal properties of the PBAT did not change much with the addition of fillers, except for a slight increase in tensile strength and thermal stability, respectively. The agar diffusion antimicrobial assays showed that the NCs and MCs had good inhibitory responses against the nonresistant strains Enterococcus faecalis, Streptococcus mutans, and Staphylococcus aureus. The MCs based on CuSO₄ had the highest biocidal effect, even against the resistant bacteria Acinetobacter baumannii.

Autochthonous cutaneous leishmaniasis in urban domestic animals (Felis catus / Canis lupus familiaris) from central-western Venezuela

Leishmaniasis is a zoonotic disease caused by intracellular protozoa of the Leishmania genus that are spread and transmitted by sandflies. Natural infection and clinical disease in domestic cats and dogs appear to be rare or perhaps largely under-reported in endemic areas. However, previous reports on infected domestic animals usually implicate the same Leishmania species that affect humans in tropical and subtropical areas of the world suggesting a potential role for zoonotic transmission. In the present study we assessed a representative sample of cats and dogs from endemic urban / suburban areas of Lara state in central western Venezuela. In both dogs and cats, cutaneous disease exhibits a spectrum of manifestations that range from single papules or nodules, which may evolve into ulcerative, plaque-like or scaly lesions. Cytochrome b (cyt b) PCR gene sequence analysis revealed L. mexicana as the causative agent in all cases, including two human cases proceeding from the same study area at the same time the study was carried out. In order to improve our understanding on feline/canine infection with Leishmania mexicana, and address potential zoonotic concerns it is necessary to characterize its enzootic reservoirs and vectors as well as the possible anthropophilic players linking to the peridomestic and domestic cycles.

[Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016.]

OBJECTIVE

To describe the prevalence, awareness and proportion of adults with an adequate control of hypertension.

MATERIALS AND METHODS

Blood pressure was measured at 8 352 adults who participated in the Ensanut MC 2016. The adults who reported having diagnosis of hypertension or had systolic blood pressure values (TAS) ≥140mmHg or diastolic blood pressure (TAD) ≥90mmHg were classified as hypertensive. Hypertension was considered controlled when blood pressure was TAS <140mmHg and TAD <90mmHg.

RESULTS

The prevalence of hypertension was 25.5%. Of these, 40.0% were unaware of having high blood pressure. Of the hypertensive adults who had previous diagnosis of hypertension and receiving drug treatment (79.3%), 45.6% had blood pressure under control.

CONCLUSIONS

A high percentage of adults are unaware of having hypertension and nearly half have inadequate control. The relevance of current programmes for diagnosing hypertension should be assessed, as well as the effectiveness of their control strategies.

[Prevalence and trends of physical activity in children and adolescents: results of the Ensanut 2012 and Ensanut MC 2016]

OBJECTIVE

To describe the prevalence and trends of physical activity (PA) in children and adolescents from Ensanut 2012 and Ensanut MC 2016.

MATERIALS AND METHODS

Physical activity levels were obtained from the Health Behaviour in School-aged Children (HBSC) and the International Physical Activity (IPAQ) questionnaires for children and adolescents respectively.

RESULTS

More than 80% of the children and 35% of the adolescents in Mexico do not meet the PA recom¬mendations. From 2012-2016, girls and schoolchildren in the rural area showed an increase in participation in organized activities and sports.

CONCLUSIONS

The prevalence of PA is low in children and adolescents and the trend has not improved in the last six years.

Long-term effects of smallpox vaccination on expression of the HIV-1 co-receptor CCR5 in women

Background

Smallpox vaccinations were stopped globally in 1980. Recent studies have shown that in women, being smallpox vaccinated was associated with a reduced risk of HIV infection compared with not being smallpox vaccinated. At the initial infection, HIV-1 most often uses CCR5 as a co-receptor to infect the T-lymphocytes. We therefore investigated whether smallpox vaccination is associated with a down-regulation of CCR5 on the surface of peripheral T-lymphocytes in healthy women in Guinea-Bissau.

Methods

We included HIV seronegative women from Bissau, Guinea-Bissau, born before 1974, with and without a smallpox vaccination scar. Blood samples were stabilised in a TransFix buffer solution and stained for flow cytometry according to a T-cell maturation profile.

Results

Ninety-seven women were included in the study; 52 with a smallpox vaccination scar and 45 without a scar. No association between smallpox vaccination scar and CCR5 expression was found in any T-lymphocyte subtype.

Conclusion

Among HIV seronegative women, being smallpox vaccinated more than 40 years ago was not associated with a down-regulation of CCR5 receptors on the surface of peripheral T-lymphocytes.

Occupational and leisure time physical inactivity and the risk of type II diabetes and hypertension among Mexican adults: A prospective cohort study

There is a lack of longitudinal data linking physical inactivity and chronic diseases among Mexicans. Objective. To examine the relationship between total, leisure and occupational moderate-to-vigorous physical activity (MVPA) and incidence of type II diabetes (T2D) and hypertension in the Mexico City Diabetes Study. Study design and population. A prospective cohort study was conducted from 1989 to 2009 among 2282 men and non-pregnant women residing in six low-income neighborhoods in Mexico City. Main outcome. Incidence of T2D and hypertension. Results. After controlling for confounders, <1 MET/min/week of MVPA during leisure time was associated with higher risk of hypertension (HR 1.29, CI 95% 1.01, 1.66) and T2D (HR 1.31 CI 95% 1.00, 1.74). In addition, accumulating <1 MET/min/week of occupational MVPA was associated with higher risk of hypertension (HR 1.47, CI 95% 1.13, 1.90). Conclusion. The absence of leisure and occupational MVPA was associated with an increased risk of hypertension. However, no associations were found between occupational MVPA and T2D.

The challenge of discriminating between HIV-1, HIV-2 and HIV-1/2 dual infections

OBJECTIVES

Discrimination between HIV-1 and HIV-2 is important to ensure appropriate antiretroviral treatment (ART) and epidemiological surveillance. However, serological tests have shown frequent mistyping when applied in the field. We evaluated two confirmatory tests, INNO-LIA HIV I/II Score and ImmunoComb HIV 1/2 BiSpot, for HIV type discriminatory capacity.

METHODS

Samples from 239 ART-naïve HIV-infected patients from the Bissau HIV Cohort in Guinea-Bissau were selected retrospectively based on the initial HIV typing performed in Bissau, ensuring a broad representation of HIV types. INNO-LIA results were interpreted by the newest software algorithm, and three independent observers read the ImmunoComb results. HIV-1/HIV-2 RNA and DNA were measured for confirmation.

RESULTS

INNO-LIA results showed 123 HIV-1 positive samples, 69 HIV-2 positive and 47 HIV-1/2 dually reactive. There was agreement between INNO-LIA and HIV-1/HIV-2 RNA and DNA detection, although not all HIV-1/2 dually reactive samples could be confirmed by the nucleic acid results. Overall, the observers found that the ImmunoComb results differed from the INNO-LIA results, with agreements of 90.4, 91.2 and 92.5%, respectively, for HIV-1, HIV-2 and HIV-1/2. The combined kappa-score for agreement between the three observers was 0.955 (z-score 35.1; P < 0.01). Of the HIV-2 mono-reactive samples (INNO-LIA), the three observers interpreted 24.6-31.9% as HIV-1/2 dually infected by ImmunoComb. None of these samples had detectable HIV-1 RNA or DNA.

CONCLUSIONS

There was accordance between INNO-LIA calls and nucleic acid results, whereas ImmunoComb overestimated the number of HIV-1/2 dually infected patients. Confirmatory typing is needed for patients diagnosed with HIV-1/2 dual infection by ImmunoComb.

Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes

INTRODUCTION

Sedentary behaviors such as sitting time are associated with obesity and diabetes independently of total reported physical activity. This study aimed to describe the current sitting time/day prevalence and trends and to examine the association of sitting time with sociodemographic and clinical variables in Mexico City.

METHODS

Two cross-sectional representative surveys in Mexico City were used for this analysis (2006: n = 1148 and 2015: n = 1329). Sedentary behavior questions from the International Physical Activity Questionnaire included time spent sitting on a weekday in the last week or on a Wednesday. Sitting time /day was divided into deciles, and participants in the highest decile (≥ 420 minutes/day) were classified within the high sitting category; others were classified in the low sitting time category. Multivariate logistic regression was used to evaluate the associations of sitting time with sociodemographic and clinical indicators, controlling for confounders and testing for potential interactions.

RESULTS

A total of 13.7% (2006) and 14.8% (2015) adults were classified in the highest sitting time category (≥ 420 minutes/day). There was a significant increase in the average sitting time/day between the surveys (216.0 minutes in 2006 vs. 233.3 minutes in 2015, p < 0.001). In 2015, men, those aged 20-49 years, those in low-intensity jobs, students, and those with a high socioeconomic level were more likely to be in the highest sitting time category. Participants with overweight/obesity (OR = 2.37, 95% CI: 1.11, 5.09) and those with high glucose levels (survey finding) (OR = 2.34, 95% CI: 1.04, 5.25) were more likely to report sitting time in the highest category.

DISCUSSION

Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006-2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico.

Testing Hadronic Interactions at Ultrahigh Energies with Air Showers Measured by the Pierre Auger Observatory

Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170  TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

BACKGROUND

The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context.

METHODS

We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI).

FINDINGS

Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa.

INTERPRETATION

Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden.

FUNDING

Bill & Melinda Gates Foundation.

Parámetros genéticos de la prolificidad y la supervivencia hasta el sacrificio en corderos de raza Merina

Utilizando los datos del núcleo de control cárnico de la raza Merina, se ha realizado un análisis genético de la prolificidad (entendida como medida indirecta de la supervivencia de las crías hasta el nacimiento), y de la supervivencia de los corderos desde el nacimiento al final de cebo. Se realizó un análisis univariado, con un modelo umbral para la prolificidad y un modelo animal con metodología REML para la supervivencia hasta el final del cebo. La estimación de los parámetros genéticos determinó una h2 de la prolificidad de 0,115 (0,166 y 0,171 para los efectos genéticos directos y maternos respectivamente) y de 0,072 para la supervivencia postnatal (0,176 para efectos genéticos directos y 0,040 para los efectos maternos), siendo la correlación genética entre ambos caracteres de -0,044 para los efectos genéticos directos y de -0,201 para los efectos genéticos maternos. Estas h2 son suficientemente elevadas para asegurar una respuesta positiva a la selección, tanto para prolificidad, como para supervivencia hasta el final del cebo. No obstante, dada la correlación genética negativa entre ambos tipos de caracteres, la selección para la mejora de la prolificidad debe llevar acarreada una mejora ambiental y genética de la capacidad para la supervivencia de los corderos si no se quiere anular el crecimiento ponderal de corderos nacidos con un incremento de su mortalidad.

Discovery of a novel HLA-B*15 allele, HLA-B*15:379, in a patient from Guinea-Bissau

HLA-B*15:379 differs from HLA-B*15:03:01:01 by a c.T539G substitution in exon 3.

SECOND LATIN AMERICAN INTERCOMPARISON ON INTERNAL DOSE ASSESSMENT

Internal dosimetry intercomparisons are essential for the verification of applied models and the consistency of results'. To that aim, the First Regional Intercomparison was organised in 2005, and that results led to the Second Regional Intercomparison Exercise in 2013, which was organised in the frame of the RLA 9/066 and coordinated by Autoridad Regulatoria Nuclear of Argentina. Four simulated cases covering intakes of (131)I, (137)Cs and Tritium were proposed. Ninteen centres from thirteen different countries participated in this exercise. This paper analyses the participants' results in this second exercise in order to test their skills and acquired knowledge, particularly in the application of the IDEAS Guidelines. It is important to highlight the increased number of countries that participated in this exercise compared with the first one and, furthermore, the improvement in the overall performance. The impact of the International Atomic Energy Agency (IAEA) Projects since 2003 has led to a significant enhancement of internal dosimetry capabilities that strengthen the radiation protection of workers.

Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease

PURPOSE OF REVIEW

There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition.

RECENT FINDINGS

Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure.

SUMMARY

Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8±0.7(stat)±6.7(syst)  MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principles calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.