Societal Impact Statement
Tropical dry forests (TDF) underpin the wellbeing of millions, mostly rural populations; yet have suffered from severe clearing in Colombia, triggering cascading effects ...such as desertification. By engaging scientists, society, and institutions in the establishment of platforms for monitoring biodiversity and ecosystem functioning, crucial knowledge gaps will be bridged, helping to find a path toward sustainable development. Science‐led but socially and economically anchored information on biodiversity will help to incorporate nature's contributions to people into the society's cultural values. Ultimately, these transformative actions will translate into the comprehensive management of TDF through a greater impact in decision making.
Summary
Thousands of permanent plots have been established across the tropics with the purpose of monitoring tree communities. Research outcomes from these platforms, however, have been mainly directed toward the academic community, and their contribution to society has been limited so far. Here, we show how generating robust data on biodiversity has supported decision making in Colombian tropical dry forests (TDF), where less than 8% of their original cover remains. As a first step to build a national dialogue around the critical status of this ecosystem, a national collaborative network on TDF research and monitoring was born in 2014, the Red de Investigación y Monitoreo del Bosque Seco Tropical en Colombia (Red BST‐Col). Our main goal is to generate scientifically sound information that feeds into the comprehensive management of this ecosystem. To do so, a set of biodiversity monitoring platforms has been established across the country, which have already served to answer socio‐ecological questions related with deforestation drivers, citizen science, or the valuation of ecosystem services. Overall, this research agenda has nurtured the four lines that underpin the Program for the comprehensive management of dry forests in Colombia (knowledge management, preservation, restoration, and sustainable use), formulated by the Humboldt Institute, the United Nations Development Programme, and the Ministry of Environment in 2019. Many challenges are ahead, however, for a complex territory where multiple social actors and productive sectors coexist. The ultimate goal is to integrate all the dimensions of biodiversity to achieve a synthetic understanding of the functioning of the most endangered ecosystem in Colombia, and its relationship with local communities' wellbeing.
Tropical dry forests (TDF) underpin the wellbeing of millions, mostly rural populations; yet have suffered from severe clearing in Colombia, triggering cascading effects such as desertification. By engaging scientists, society, and institutions in the establishment of platforms for monitoring biodiversity and ecosystem functioning, crucial knowledge gaps will be bridged, helping to find a path toward sustainable development. Science‐led but socially and economically anchored information on biodiversity will help to incorporate nature's contributions to people into the society's cultural values. Ultimately, these transformative actions will translate into the comprehensive management of TDF through a greater impact in decision making.
La vancomicina tópica ha demostrado su eficacia para disminuir la incidencia de infección de la herida quirúrgica, sin embargo, su utilidad en cirugía cardiaca permanece en duda.
Estudiar el efecto ...de la vancomicina tópica sobre la incidencia de infección de la herida de esternotomía tras cirugía cardiaca.
Estudio observacional, retrospectivo, comparando la incidencia de infección de esternotomía entre una cohorte en la que se empleó la profilaxis antibiótica habitual, frente a otra en la que además se asoció vancomicina tópica.
Se incluyeron un total de 525 pacientes, 47,43% en el grupo tratado con vancomicina. La incidencia global de infección fue significativamente superior en el grupo sin vancomicina (3,6% frente a 10,1%) implicando un riesgo relativo de 2,8 (IC 95% 1,35-5,83; p=0,004). Las diferencias fueron significativas en la incidencia de infecciones superficial y profunda (p=0,05), sin alcanzar la significación estadística en la infección órgano-espacio (p=0,22). El efecto beneficioso de la vancomicina se mantuvo en un modelo de regresión ajustado por los posibles factores de confusión identificados (tabaquismo, reintervención, nefropatía y grado NYHA): odss ratio 3,48 (IC 95% 1,44-8,41; p=0,006). Los gramnegativos fueron el principal agente causal en el grupo con vancomicina (57,1%) y los grampositivos en el grupo sin vancomicina (66,7%), aunque estas diferencias no alcanzaron la significación estadística.
El empleo de vancomicina tópica disminuye la incidencia de infección de la herida de esternotomía, tanto superficial como profunda. Su uso podría producir un cambio en el espectro etiológico de la infección esternal.
Topical vancomycin has demonstrated effectiveness in decreasing the incidence of surgical wound infection; however, its usefulness in cardiac surgery remains in doubt.
To analyse the effectiveness of topical vancomycin in the reduction of sternal wound infection in cardiac surgery.
A retrospective observational study was conducted to compare the incidence of sternotomy infection in a cohort in which the usual antibiotic prophylaxis was used, with another cohort in which topical vancomycin was also used.
A total of 525 patients were included in the study, with 47.43% in the group treated with vancomycin. The incidence of infection was significantly higher in the group without vancomycin (3.6% versus 10.1%), implying a relative risk of infection of 2.8 (95% CI; 1.35-5.83, p=.0035). The differences were statistically significant as regards the incidence of superficial and deep infections (p=.05), but did not reach statistical significance in organ-space infection (p=.22). The beneficial effect of vancomycin was maintained in a logistic regression model adjusted for possible confounding factors (smoking, re-operation, nephropathy, and NYHA functional grade class): odss ratio 3.48 (95% CI; 1.44-8.41, p=.006). Gramnegative microorganisms were the main causative agent in the vancomycin group (57.1%), whereas it was grampositive in the group without vancomycin (66.70%), although these differences did not reach statistical significance.
The use of topical vancomycin decreases the incidence of superficial and deep sternotomy wound infections. Its use could lead to a change in the aetiological spectrum of sternal wound infection.
Genes encoding HKT1-like Na+ transporters play a key role in the salinity tolerance mechanism in Arabidopsis and other plant species by retrieving Na+ from the xylem of different organs and tissues. ...In this study, we investigated the role of two HKT1;2 allelic variants in tomato salt tolerance in relation to vegetative growth and fruit yield in plants subjected to salt treatment in a commercial greenhouse under real production conditions. We used two near-isogenic lines (NILs), homozygous for either the Solanum lycopersicum (NIL17) or S. cheesmaniae (NIL14) allele, at HKT1;2 loci and their respective RNAi-Sl/ScHKT1;2 lines. The results obtained show that both ScHKT1;2- and SlHKT1;2-silenced lines display hypersensitivity to salinity associated with an altered leaf Na+/K+ ratio, thus confirming that HKT1;2 plays an important role in Na+ homeostasis and salinity tolerance in tomato. Both silenced lines also showed Na+ over-accumulation and a slight, but significant, reduction in K+ content in the flower tissues of salt-treated plants and consequently a higher Na+/K+ ratio as compared to the respective unsilenced lines. This altered Na+/K+ ratio in flower tissues is associated with a sharp reduction in fruit yield, measured as total fresh weight and number of fruits, in both silenced lines under salinity conditions. Our findings demonstrate that Na+ transporter HKT1;2 protects the flower against Na+ toxicity and mitigates the reduction in tomato fruit yield under salinity conditions.
•Role of SlHKT1;2/ScHKT1;2 in tomato salt tolerance in terms of vegetative growth and fruit yield in a commercial greenhouse.•Two NILs, homozygous for SlHKT1;2 and ScHKT1;2, and their respective Sl/ScHKT1;2-RNAi-lines were used.•SlHKT1,2 and ScHKT1,2 Na+ transporters prevent Na+ over-accumulation in leaf tissues.•Sl/ScHKT1; 2 Na+ transporters mitigate reductions in fruit yields by reducing floral sodium content.
Resumen Introducción: El melanoma ocasiona el 75% de las muertes por cáncer de piel. Según GLOBOCAN, en 2018 se presentaron 287.723 casos nuevos de melanoma, con una mortalidad de 60.712 casos, que ...equivale al 20% del total de los casos incidentes. Las alternativas para el tratamiento del melanoma se fundamentan en la estatificación de la enfermedad, y en las características moleculares de la enfermedad. Objetivo: Consensuar, por común acuerdo de expertos, sugerencias para el diagnóstico y manejo de melanoma temprano basadas en la evidencia y ajustadas al contexto colombiano. Métodos: Se llevó a cabo un consenso de expertos multidisciplinario, constituido por 19 oncólogos clínicos, 2 cirujanos de mama y tejidos blandos, 2 dermatólogos, 2 patólogos y 2 radioterapeutas, miembros activos de la Asociación Colombiana de Hemato Oncología (ACHO). Este consenso se realizó en 4 etapas: 1. Estructuración de 29 preguntas, que se calificaron de 1 a 9. 2. Reenvío de las preguntas no consensuadas. 3. Análisis y discusión de las respuestas. 4. Las respuestas no consensuadas se llevaron a un consenso nominal. Resultados: Se discutieron 29 preguntas relacionadas con el diagnóstico y tratamiento de melanoma temprano, se construyeron sugerencias basadas en evidencia utilizada por los expertos y en guías de manejo de oncología reconocidas internacionalmente, adaptadas al contexto y realidad colombianos. Conclusiones: Se presentan sugerencias multidisciplinarias para el diagnóstico y tratamiento de melanoma temprano, las cuales debe considerarse para orientar la toma de decisiones y homogenizar la práctica clínica de acuerdo al contexto colombiano y a las características propias del sistema de salud del país. Este es un documento académico y no regulatorio.
Background Anaphylaxis after Hymenoptera sting has been described in patients with mastocytosis. Venom immunotherapy (VIT) is a safe and effective way to treat patients with Hymenoptera anaphylaxis, ...but few studies have addressed its usefulness in patients with systemic mastocytosis. Objective To study the effectiveness and safety of VIT in patients with systemic mastocytosis having anaphylaxis after Hymenoptera sting. Methods A total of 21 mastocytosis patients—4 women (19%) and 17 men (81%) with a median age of 50 years (range, 29-74 years)—with Hymenoptera sting anaphylaxis who were treated with VIT and followed for a median of 52 months (range, 2-250 months) were studied. Results In 18 of 21 patients—16 of them lacking skin involvement—anaphylaxis was the presenting symptom. Six patients (29%) experienced adverse reactions during VIT, 3 during initiation and 3 during maintenance. Twelve patients (57%) were restung while undergoing VIT; 9 (75%) presented local reactions and 3 (25%) systemic reactions, 1 of which required intubation. The Hymenoptera specific IgE decreased from 4.15 kU/L (range, 0.44-100 kU/L) before immunotherapy to 1.2 kU/L (range, 0.34-69.4 kU/L) after 4 years ( P < .003). Conclusion Venom immunotherapy is effective to treat IgE-mediated Hymenoptera anaphylaxis in patients with mastocytosis. Its use is recommended despite a relatively high risk of adverse reactions during the build-up phase because it provides protection from anaphylaxis in around 3/4 of the patients.
Catastrophic antiphospholipid syndrome (CAPS) is a rare entity, approximately 600 cases have been reported around the world, and the prevalence in Mexico is unknown.
To determine the estimated ...prevalence of CAPS in Mexico.
A literature search of isolated clinical cases or case series was conducted in diverse search engines, using the terms: "Catastrophic Antiphospholipid Syndrome" and "Mexico" in May 2022.
We found a series of retrospective cases in autopsies that included 12 cases, two reports that included 2 cases each, and reports of 11 isolated clinical cases; these publications were generated between 2003 and 2020. In total, we collected data on 27 cases of CAPS, of which 16 correspond to primary antiphospholipid syndrome, 10 are associated with systemic lupus erythematosus, and 1 case corresponds to systemic sclerosis. The estimated prevalence rate in the Mexican population in 2022 is 2 cases per 10,000,000 inhabitants. The estimated mortality was 68% in this case series.
Cases of catastrophic antiphospholipid syndrome in Mexico are underreported; identifying them will help improve current diagnostic and therapeutic strategies used in the country, encouraging the implementation of triple therapy and, in refractory cases, the use of eculizumab, to reduce current mortality.
El síndrome antifosfolípido catastrófico (SAFC) es una entidad rara, se han reportado aproximadamente 600 casos en todo el mundo, se desconoce la prevalencia en México.
Conocer la prevalencia estimada de SAFC en México.
Se realizó una búsqueda bibliográfica de casos clínicos aislados o series de casos en los diversos buscadores, utilizando los términos: SAFC y México en mayo de 2022.
Encontramos una serie de casos retrospectivos en necropsias que incluyeron 12 casos, dos reportes que incluyeron 2 casos cada uno, y también se encontraron reportes de 11 casos clínicos aislados; estas publicaciones se generaron entre 2003 y 2020. En total, se tienen datos de 27 casos de SAFC, de los cuales 16 corresponden al síndrome antifosfolípido primario, 10 en asociación con lupus eritematoso sistémico y 1 caso de esclerosis sistémica. La tasa de prevalencia estimada en la población mexicana en 2022 es de 2 casos por cada 10.000.000 de habitantes. La mortalidad estimada fue del 68% en esta serie de casos.
Los casos de Síndrome Antifosfolípido Catastrófico en México están subreportados, sin embargo, identificarlos ayudará a mejorar las estrategias diagnósticas y terapéuticas que se utilizan actualmente en el país, incentivando la implementación de la triple terapia y, en casos refractarios, el uso de eculizumab, para reducir la mortalidad actual.
INTRODUCTION: Myeloid neoplasms with mutated TP53 (MN-TP53) represent a unique category in the 2022 International Consensus Classification (ICC) of Myeloid Neoplasms. This entity has an exceedingly ...poor prognosis with the available standard therapies, and clinical trials with novel drugs show limited benefits. Recently, it has been shown that TP53 multi-hit alterations may confer even worse prognosis, compared to the monoallelic status, in myelodysplastic syndromes. However, multi-hit status has not been analysed in all MN-TP53 subtypes. Elucidating this difference and its association with responses to treatment becomes essential from a clinical perspective. Therefore, our aim was to analyse whether the allelic status of TP53 in our cohort has an impact on therapeutic outcomes. METHODS: We retrospectively collected data from four institutions, between September 2011 and February 2023. Inclusion criteria were: 1) patients diagnosed with MN-TP53; 2) available information to categorize them into multi-hit or monoallelic group according to ICC 2022; and 3) eligible for treatment. The primary endpoint was to describe the outcomes, in terms of overall response rate (ORR) and overall survival (OS), of MN-TP53 according to TP53 status (multi-hit vs monoallelic) and treatment. RESULTS: A total of 105 patients diagnosed with MN-TP53 were identified. Eighty-seven were eligible for treatment and included in the analysis. Sixty-nine patients were identified as multi-hit, and 18 as monoallelic. Table 1 summarises patient's demographics and clinical characteristics. The median OS of the entire cohort was 7 months (range 0-141); while it was 6 months (0-141) for the multi-hit group and 8.5 months (0-44) for the monoallelic group; (p=0.23) (Figure 1). In both groups, most of the patients received non-intensive treatment as first line (1L) (40 patients 58% in multi-hit group vs 14 78% in monoallelic), followed by intensive treatment (17 patients 25% in multi-hit group vs 2 patients 11% in monoallelic) and hypomethylating agent plus venetoclax (12 17% in multi-hit vs 2 11% in monoallelic). The overall response rate (ORR) was 43% for patients with multi-hit TP53 status and 67% for those with monoallelic status (p=0.38) . Correspondingly, 29% and 11% were not evaluated after 1L due to death or poor general condition. Progression after 1L of treatment was seen in 55% of patients with multi-hit TP53 status and in 43% of cases with monoallelic status (p=0.11). The subgroup analysis of the multi-hit cohort revealed no significant difference in response between intensive and non-intensive treatment (p=0.09). Nevertheless, there is a trend in favour of non-intensive treatment, including hypomethylating agents plus venetoclax (p=0.18). Allogeneic hematopoietic stem cell transplant was performed in 12 patients (17%) in the multi-hit group and in 2 patients (11%) in the monoallelic group. CONCLUSION: In this study, no difference in terms of OS was evidenced when comparing patients according to the type of TP53 status (multi-hit vs monoallelic). However, a trend to higher ORR and lower rate of progression was observed in the monoallelic group after 1L, which should be confirmed in further analysis. Concerning the TP53 multi-hit subgroup, we have not found any benefit on using intensive treatment in terms of ORR compared to non-intensive approach.
Introduction Patients aged 50 or older (≥50) with myeloid neoplasms (MNs), non-affected relatives, and no previous platelet or organ disorder are routinely not tested for germline predisposition. ...However, approximately 70% of myelodysplastic neoplasms (MDS) patients undergoing an allogeneic hematopoietic stem cell transplantation (alloHSCT) from familial donors, in 2021, were ≥50 years old (y.o.) (EBMT). Given the significant frequency of pathogenic/likely pathogenic (P/LP) germline variants in these patients (about 8%) along with the risk of transplanting cells with the same variant, it seems reasonable to perform universal germline testing in hematological neoplasms although challenging due to labor and cost constraints. Aims To address this, we developed a pragmatic approach incorporating a specific gene list to the diagnostic myeloid somatic panel to identify patients and exclude relatives with shared germline variants. To do that we: (1) Conducted a literature review to assess the gene-disease association's validity in this specific context. (2) Designed a germline-augmented virtual somatic panel (GASP) based on our findings. (3) Tested the virtual panel's performance in 133 MNs cases, aged ≥50, with matched germline-tumor exome sequencing, and no prior organ or platelet disorders. Methods We considered those genes included in the WHO Classification and NCCN Clinical Practice Guidelines as myeloid predisposition genes. For autosomal recessive disorders, heterozygous carriers were not considered. We analyzed the relation of these genes with MNs diagnosed ≥50 y.o. without prior organ or platelet dysfunction: To establish a valid association for a gene, we required the presence of P/LP variants in at least two peer-reviewed studies in the subset of interest. GASP combined genes with recurrent somatic mutations in myeloid disorders, as proposed by Duncavage et al. (Blood 2022), and those associated with the specific cohort of interest. WES was performed on paired tumoral-germline samples on a HiSeq 2000/Novaseq6000 instrument (Illumina Inc) with a target of 100x depth coverage. Results From 2018 to 2023, we collected samples from 133 patients (121 MDS and 12 CMML cases -FAB myelodysplastic variant) diagnosed with WHO-established MDS, aged ≥50, without prior organ or platelet disorders. Among the main characteristics at baseline, we highlight a median age at diagnosis of 57 years old (range, 50-88), and the presence of a first-degree relative with a myeloid neoplasm diagnosis in 7% of the cases. The literature search revealed 11 genes associated with germline predisposition within the cohort of interest. Seven were WHO/NCCN genes: DDX41, TERT, GATA2, CEBPA, SAMD9, ERCC6L2, and TP53. Additionally, four “recently associated genes” were incorporated based on recent descriptions in germline MNs ≥50 y.o. and reported at least in two peer-reviewed articles: CHEK2, DNAH9, ATM, and SH2B3 (Table 1). Next, we tested the accuracy of both the GASP and Duncavage's recommended somatic panel in our cohort of 133 myeloid neoplasms characterized by WES. Among these cases, we identified 15 (11%) P/LP germline variants in both WHO/NCCN and recently associated genes. Duncavage's somatic panel could only detect 8 out of 15 (53%) cases, while the expanded GASP detected 13 out of 15 (87%) variants (Figure 1). The GASP showed a C-index of 0.933, outperforming Duncavage's panel, which scored 0.767. Conclusions Eleven genes have been found to harbor P/LP germline variants in patients with MNs diagnosed ≥50 y.o. and no previous organ or platelet disorder. In our cohort, 11% of patients carried a P/LP germline variant in a MNs predisposition gene. Such a finding would have gone undetected as germline predisposition testing is not typically advised for these patients. Expanding the myeloid somatic panel (GASP) allows the identification of 87% of P/LP variants during the diagnosis process, enabling clinicians to exclude carrier relatives as potential allo-SCT donors.
En la actualidad, existen sistemas de vigilancia, como las herramientas de reconocimiento facial, que justifican su existencia en la noción de seguridad personal y de los Estados. Sin embargo, este ...desarrollo tecnológico y el objetivo de brindar esa sensación de seguridad entran en tensión con derechos fundamentales. El presente texto busca analizar cómo los sistemas de reconocimiento facial, enmarcados en la idea de dar seguridad, ponen en riesgo los derechos a la privacidad e intimidad. Para el cumplimento del objetivo, se acude a un diálogo interdisci-plinario entre elementos jurídicos y de la teoría social; lo primero, para comprender el derecho a la intimidad y lo segundo, con el fin de examinar los sistemas de seguridad encuadrados en un discurso de poder.
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