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Objective: To determine the effect of SARS-CoV-2 variants on non-respiratory features of COVID-19 in vaccinated and not fully vaccinated patients using a University of California database., Methods: A longitudinal retrospective review of medical records (n = 63,454) from 1/1/2020-4/26/2022 using the UCCORDS database was performed to compare non-respiratory features, vaccination status, and mortality between variants. Chi-square tests were used to study the relationship between categorical variables using a contingency matrix., Results: Fever was the most common feature across all variants. Fever was significantly higher in not fully vaccinated during the Delta and Omicron waves (p = 0.001; p = 0.001). Cardiac features were statistically higher in not fully vaccinated during Omicron; tachycardia was only a feature of not fully vaccinated during Delta and Omicron; diabetes and GI reflux were features of all variants regardless of vaccine status. Odds of death were significantly increased among those not fully vaccinated in the Delta and Omicron variants (Delta OR: 1.64, p = 0.052; Omicron OR: 1.96, p < 0.01). Vaccination was associated with a decrease in the frequency of non-respiratory features., Conclusions: Risk of non-respiratory features of COVID-19 is statistically higher in those not fully vaccinated across all variants. Risk of death and correlation with vaccination status varied., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Numerous health conditions in the older adult population can be attributed to falls, including traumatic brain injury (TBI), which can lead to devastating short and long-term sequelae. Older adults are also more likely to experience frailty, which encompasses physical, psychological, and social deficits that may lead to adverse health outcomes. Our literature review synthesizes current evidence for understanding frailty in the context of TBI among older adults using the Integral Model of Frailty as a framework., Content Synthesis: A total of 32 articles were identified, and 9 articles were included. The results of this review indicate that outcomes resulting from TBI are closely linked to the physical, psychological, and social domains of frailty., Conclusions: A small amount of literature currently examines frailty in the context of TBI among older adults. Using the Integral Model of Frailty to understand frailty in the context of TBI can help clinicians anticipate patient outcomes and improve care plans. We emphasize the need for a greater understanding of TBI concerning frailty to improve health outcomes among older adult patients., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

SARS-CoV-2 (COVID-19) has caused over 80 million infections 973,000 deaths in the United States, and mutations are linked to increased transmissibility. This study aimed to determine the effect of SARS-CoV-2 variants on respiratory features, mortality, and to determine the effect of vaccination status. A retrospective review of medical records (n = 55,406 unique patients) using the University of California Health COvid Research Data Set (UC CORDS) was performed to identify respiratory features, vaccination status, and mortality from 01/01/2020 to 04/26/2022. Variants were identified using the CDC data tracker. Increased odds of death were observed amongst unvaccinated individuals and fully vaccinated, partially vaccinated, or individuals who received any vaccination during multiple waves of the pandemic. Vaccination status was associated with survival and a decreased frequency of many respiratory features. More recent SARS-CoV-2 variants show a reduction in lower respiratory tract features with an increase in upper respiratory tract features. Being fully vaccinated results in fewer respiratory features and higher odds of survival, supporting vaccination in preventing morbidity and mortality from COVID-19., (© 2023. The Author(s).)

Abstract: It is critical to detect latent tuberculosis infection through screening and testing individuals at high risk of progression to active tuberculosis, including patients who are immunocompromised. NPs should be familiar with available testing for accurate diagnosis in order to expedite treatment., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Psoriasis is a chronic inflammatory dermatosis, a with variable clinical presentation and whose multifactorial etiology carries an essential genetic component. Multiple genetic variations associated with psoriasis have been described around the world. However, these variants are unknown among the Colombian population. This study aimed to evaluate the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene and its ssociation with the development of psoriasis in a Colombian population., Methods: An observational, unmatched, case-control study was performed, including 51 patients with psoriasis and 151 population controls, all with self-reported Paisa ancestry (from the Antioquia region). All individuals were genotyped for the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene, and its association with psoriasis was pursued. Both groups were demographically characterized, and cases were also assessed for clinical variables., Results: Through the allelic association analysis, cases were found to have a lower frequency of the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene than controls; 5% versus 22.67%, respectively. There were no significant differences in age or sex. We also found that psoriasis vulgaris was the most common variant (78%), that about half of the cases had nail psoriasis (56%), 19.6% had psoriatic arthritis, and that 45% had some comorbidity., Conclusions: The results obtained from this study confirm that carriers of the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene have a decreased risk of developing psoriasis.

Caribbean islands, including Puerto Rico, are biodiversity hotspots threatened by microplastics (<5 mm). Little is known about the extent of microplastic pollution in coastal sandy beaches of Puerto Rico. Sand from six northern beaches was collected in the high tide line to determine microplastic abundance (0.3-4.75 mm). Península La Esperanza, the most polluted beach, exhibited higher average abundance (17 items/kg dw) and diversity. High urbanization, industrial/port activities, and riverine input are likely sources of plastic debris on this beach. The other beaches showed lower and similar average abundance (3 to 7 items/kg dw) despite having distinct potential point and non-point sources. Overall, fibers (40%), fragments (28%) and foams (27%) predominated (n = 102 particles). Results showed comparable levels to other world beaches, some classified as highly contaminated, but only when transforming units to items/m 2 . Preliminary ATR-FTIR analysis identified mainly polyethylene. It is imperative to have plastics source reduction through waste management., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Little is known about the presence and effects of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in Puerto Rico's waters. Four coastal aquatic systems were investigated using low-density polyethylene passive sampling for PCBs and OCPs in water and its overlying air. The highest total freely dissolved and gaseous concentrations of PCBs were found in Guánica Bay, with 4000 pg/L and 270 pg/m 3 , respectively. Five OCPs were detected, mainly in water, with greatest concentrations (pg/L) in Guánica Bay: α-HCH (7400), p,p'-DDE (390), aldrin (2000), dieldrin (420), and endrin (77). The compound α-HCH was also measured at elevated water concentrations in Condado Lagoon (5700 pg/L) and Laguna Grande (2900 pg/L). Jobos Bay did not show values of concern for these persistence organic pollutants. Levels of PCBs and OCPs in water, particularly in Guánica Bay, exceeded USEPA ambient water quality criteria values representing a human health risk regarding consumption of aquatic organisms.

The various toxic effects associated with inorganic arsenic (iAs) warrants that exposure sources be identified. This pilot study evaluated if greater seafood consumption from Vieques-Puerto Rico is associated with increased exposure to iAs. Nail, hair, and urine samples were used as biomarkers of iAs exposure in adult women and men from Vieques classified as high (n = 31) and low (n = 21) seafood consumers, who reported eating fish and/or shellfish ≥1 time per week and once per month or less, respectively. The sum of urinary iAs (As III + As V), monomethylarsonic acid (MA[V]), and dimethylarsinic acid (DMA[V]), denoted as SumAs, fluctuated from 3.3 µg/g Cr (1.2 μg/L) to 42.7 μg/g Cr (42 μg/L) (n = 52). Levels of As in nail samples (n = 49) varied from 0.04 to 0.82 μg/g dry weight (dw), whereas in hair (n = 49) As was only detected in 49 % of the samples with a maximum value of 0.95 μg/g dw. None of the biomarkers of exposure to As exceeded exposure reference values for urine (50 μg/g Cr or 50 μg/L), nails (1 μg/g), or hair (1 μg/g). However, median (10.0 μg/g Cr; 10.6 μg/L) and 95th percentile (31.9 μg/g Cr; 40.4 μg/L) of urinary SumAs were higher in Vieques samples than in the those from the general population of other countries. Among the three biomarkers of exposure, nail samples reflected better the exposure to iAs from seafood consumption with significantly higher average As concentrations in high (0.24 μg/g) than low (0.12 μg/g) seafood consumers. Multivariate results for As in nail samples (R(2) = 0.55, p < 0.0001) showed a positive association with fish consumption, particularly for men, with levels increasing with years of residency in Vieques.

Arsenic (As) and lead (Pb) were determined in hair of 12 adult women and 27 children living in a soil-metal contaminated community in Puerto Rico. Average concentrations in residential soils ranged from 24 to 109 μg/g for As and from 42 to 1,585 μg/g for Pb. For hair-As, about 75% of the samples were below 0.08 μg/g. Hair-Pb presented levels of health concern, with 10% of the samples above a reference value of 5 μg/g, indicating significant exposure to Pb. Multivariate analyses revealed that children's Pb hair levels were predicted by age and sex, while consumption of home-grown animals influenced the association with soil-Pb.

Exposure to metals through fish consumption may represent a health risk, especially for high-fish-consumption populations such as fishing communities in the Jobos Bay and La Parguera areas in Puerto Rico. This study determined levels of As, Cd, Cu, Pb, Hg, Se, and Zn in muscle tissues of fish from the Jobos Bay and La Parguera (reference site) areas and estimated the health risk posed by fish ingestion to local fishermen and their children. Fish collected included S. cavalla ("sierra"; n = 14), M. undulatus ("roncón"; n = 21), L. synagris ("arrayado"; n = 18), and L. analis ("sama"; n = 11) in the Jobos Bay area and S. regalis (sierra; n = 10) and L. synagris (arrayado; n = 8) in La Parguera. Only As and Hg were detected at levels of human health concern. Average As and Hg levels (μg/g, wet wt) in the four species of Jobos Bay were 0.74 and 0.10 for roncón, 0.83 and 0.09 for sama, 1.00 and 0.26 for sierra, and 2.49 and 0.15 for arrayado, respectively. In La Parguera, average As and Hg levels (μg/g, wet wt) were 0.61 and 0.12 for sierra and 1.27 and 0.20 for arrayado, respectively. At both sites, the species with the highest As levels was arrayado, while for Hg, sierra obtained the highest concentrations. A risk estimation using U.S. Environmental Protection Agency standard exposure factors, and assuming that 10% of total As is the inorganic form and 100% of the total Hg is methyl Hg, predicted adverse health effects (cancer and noncancer) from fish consumption, being higher for children than for adults. However, speciation of As in fish muscle is recommended for better risk estimates. Sierra fish from Jobos Bay triggered the most restricted consumption advisories for Hg noncancer effects, where a child should not consume >1 fish meal (0.1135 kg)/month and adults should not have >3 fish meals (0.227 kg)/month. Fish consumption advisories, particularly for Hg, should be established by the local government to protect the health of susceptible populations such as children and pregnant or childbearing-age women.

This study provides baseline information on the extent of contamination in sediments of the Jobos Bay estuary and surrounding areas in Puerto Rico. Sediments from Jobos Bay area (n=14) had higher overall average concentrations than those from La Parguera area (n=5, used as reference site), in microg/g dw, for As (17 vs 9), Cu (29 vs 14), Pb (11 vs 4), and Zn (64 vs 28); and in %, for Fe (2.6 vs 0.6). Sediments (n=8) screened for PAHs and PCBs exhibited total concentrations (ng/g dw) that ranged from 40.4 to 1912, and from not detected to 11.21, respectively. The quality of sediments of Jobos Bay could be classified as low to moderate pollution. The proximity to anthropogenic sources of contamination warrants a monitoring program for inorganic and organic pollutants in Jobos Bay area for an effective coastal management program of this tropical ecosystem., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Concentrations of As, Cd, Cu, Fe, Hg, Pb and Zn were evaluated in surface sediments of two estuaries from Puerto Rico, known as San José Lagoon (SJL) and Joyuda Lagoon. Significantly higher concentrations in microg/g dw of Cd (1.8 vs. 0.1), Cu (105 vs. 22), Hg (1.9 vs. 0.17), Pb (219 vs. 8), and Zn (531 vs. 52) were found in sediment samples from SJL when compared to Joyuda Lagoon. Average concentrations of Hg, Pb, and Zn in some sediment samples from SJL were above the effect range median (ERM) that predict toxic effects to aquatic organisms. Enrichments factors using Fe as a normalizer, and correlation matrices showed that metal pollution in SJL was the product of anthropogenic sources, while the metal content in Joyuda Lagoon was of natural origins. Sediment metal concentrations found in SJL were comparable to aquatic systems classified as contaminated from other regions of the world.

Fine atmospheric particulate PM2.5 (particles with diameters of < 2.5 microm) were sampled in an urban industrialized area--Guaynabo, Puerto Rico (Figure 1)--and in a reference less polluted site Fajardo, Puerto Rico--and analyzed for trace metals, and inorganic and organic elemental carbon. PM2.5 samples were collected from November 2000 to September 2001 using an Andersen Instruments RAAS2.5-400 for periods of 72 h. Metals analyzed were arsenic (As), cadmium (Cd), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), vanadium (V) and zinc (Zn) by atomic absorption. Levels of elemental and organic carbon (EC/OC) were also determined. All metals analyzed, except for Fe, were significantly higher in PM2.5 from Guaynabo when compared to Fajardo. Average levels of PM2.5 in Guaynabo were 11.6 versus 8.5 microg/m3 in Fajardo. Average levels of EC were 1.5 and <0.14 microg/m3; and OC levels were 2.2 and < 1 microg/m3 for Guaynabo and Fajardo, respectively. Levels of Ni (17 ng/m3) and V (40 ng/m3) determined in PM2.5 from the Guaynabo area were high when compared to other cities, and these metals could be responsible for respiratory problems reported in the area. Multivariate analyses showed strong relationships in Guaynabo between Ni and V, PM2.5 and Fe and As and Cu and Pb. In Fajardo, the strongest associations were obtained between PM2.5 and Fe, Cd and V and Ni and Pb and Cu, these last three elements exhibiting an inverse relationship.

The effect that three extraction techniques (e.g., Soxhlet, ultrasound and microwave-assisted extraction) have on the toxicity, as measured by submitochondrial particle (SMP) and Microtox assays, of organic extracts was compared from three sources of airborne particulate matter (APM). The extraction technique influenced the toxicity response of APM extracts and it was dependent on the bioassay method, and APM sample source. APM extracts from microwave-assisted extraction (MAE) were similar or more toxic than the conventional extraction techniques of Soxhlet and ultrasound, thus, providing an alternate extraction method. The microwave extraction technique has the advantage of using less solvent volume, less extraction time, and the capacity to simultaneously extract twelve samples. The ordering of APM toxicity was generally urban dust > diesel dust > PM10 (particles with diameter < 10 microm), thus, reflecting different chemical composition of the samples. This study is the first to report the suitability of two standard in-vitro bioassays for the future toxicological characterization of APM collected from Puerto Rico, with the SMP generally showing better sensitivity to the well-known Microtox bioassay.

Exposure to lead in children living on a former landfill in Vega Baja-Puerto Rico, a United States Environmental Protection Agency (USEPA) designated Superfund Site, is a major health concern. Direct contact with lead-contaminated soil is considered a major exposure source. However, there is a lack of information regarding the contribution of lead-contaminated house dust to children's blood lead concentrations. This study evaluated the relationship between lead contaminated-house dust and children's blood lead levels. Blood from 42 children, aged 6 years old or less, and dust from 29 houses were analyzed for lead, and face-to-face interviews were performed to gather information on potential risk factors for high blood lead levels. Blood lead levels ranged from 0.97 to 7.79 micrograms/dL. Lead values for floors fluctuated from 0.12 to 98.30 micrograms/ft2, with 17% of houses surpassing the USEPA standard of 40 micrograms/ft2. Multiple regression analysis showed that lead in window sills, toy chewing and soil eating habits were significant predictors of blood lead levels. Further investigations aimed at assessing the long-term effects of constant exposure to environmental lead in these children are warranted.