LiteBIRD is a JAXA strategic L-Class mission designed to search for the existence of primordial gravitational waves produced during the inflationary phase of the Universe. This is achieved through measurements of their imprint on the polarization of the cosmic microwave background (CMB). To fulfill the scientific objectives, observations have to be made over a wide range of frequencies (34 GHz - 448 GHz), which is accomplished by three telescopes: the Low-Frequency Telescope (LFT) led by JAXA and the Middle & High-Frequency Telescopes (MHFT) under European responsibility and led by CNES. To withstand the launch, comply with satellite requirements, and minimize the mass of the mechanical structure, we conducted finite element modeling of the entire MHFT, incorporating both modal and quasi-static load analyses. A nodal thermal study was carried out to evaluate, on the one hand, the static thermal loads of the instruments, and on the other hand the sensitivity of the instruments to sinusoidal disturbances simulating those caused by the ADR cooling system. This paper outlines the methodology employed in designing the mechanical structure of the MHFT, then summarizes the initial results and conclusions drawn from various mechanical and thermal analyses performed on the MHFT.

Carta/comentario sobre el artículo publicado por Mancebo García et al. sobre una serie de casos de difteria.

LiteBIRD, the Lite (Light) satellite for the study of B-mode polarization and Inflation from cosmic background Radiation Detection, is a space mission for primordial cosmology and fundamental physics. The Japan Aerospace Exploration Agency (JAXA) selected LiteBIRD in May 2019 as a strategic large-class (L-class) mission, with an expected launch in the late 2020s using JAXA's H3 rocket. LiteBIRD is planned to orbit the Sun-Earth Lagrangian point L2, where it will map the cosmic microwave background (CMB) polarization over the entire sky for three years, with three telescopes in 15 frequency bands between 34 and 448 GHz, to achieve an unprecedented total sensitivity of 2.2$\mu$K-arcmin, with a typical angular resolution of 0.5$^\circ$ at 100 GHz. The primary scientific objective of LiteBIRD is to search for the signal from cosmic inflation, either making a discovery or ruling out well-motivated inflationary models. The measurements of LiteBIRD will also provide us with insight into the quantum nature of gravity and other new physics beyond the standard models of particle physics and cosmology. We provide an overview of the LiteBIRD project, including scientific objectives, mission and system requirements, operation concept, spacecraft and payload module design, expected scientific outcomes, potential design extensions and synergies with other projects.

ABSTRACT Background and aims Models that can predict the risk of developing essential hypertension or increase in blood pressure (BP) can be used to identify high risk individuals. We aimed to summarize and assess prediction models developed in the general adult population using longitudinal data, as well as any external validation of such models. Methods For this systematic review, we searched the literature on Medline and Embase for studies published between database inception and February 5, 2021. We conducted a narrative synthesis of all models and assessed the risk of bias (ROB) in included studies using PROBAST. We also performed a meta-analysis of all external validation studies validating the Framingham hypertension risk model. We excluded models based on cross-sectional data, or those based on specific patient populations. Results Our review includes 29 articles which contain 42 prediction models and 11 external validation studies of existing prediction models. Among model development studies, only five models performed both internal and external validation. Among the validation studies, only two existing models were externally validated by researchers other than the ones who developed the model. Most models had low ROB in the predictors and outcomes domains, and half had low ROB in the participants domain. However, all had high ROB in the analysis domain due to inappropriate handling of missing data and/or lack of adequate performance measures, which resulted in high overall ROB for all models. Conclusions All current risk prediction models predicting hypertension or increased blood pressure have high ROB and most have not been externally validated. New studies should aim to reduce their ROB using standard reporting guidelines and externally validated existing models.

BACKGROUND:Cadmium is a heavy metal with carcinogenic properties, highly prevalent in industrialized areas worldwide. Prior reviews evaluating whether cadmium influences breast cancer have been inconclusive and not reflected several recent studies. OBJECTIVE:To evaluate the association between cadmium exposure and female breast cancer incidence, with an emphasis on separately estimating dietary vs. airborne vs. biomarker measures of cadmium and studies published until October 2022. METHODS:We evaluated risk of bias using set criteria and excluded one study judged to have high risk based on self-report of breast cancer and insufficient adjustment. We conducted a random effects meta-analysis of epidemiological studies, including subgroups by exposure route and by menopausal status. RESULTS:A total of 17 studies were eligible for our meta-analysis. Only 2 studies addressed airborne cadmium directly. Breast cancer risk was elevated in women exposed to higher levels of cadmium across all studies - pooled odds ratio: 1.13 (95% confidence interval: 1.00, 1.28), with notable heterogeneity between studies (I2 = 77%). When examining separately by exposure route, dietary cadmium was not linked with an elevated risk - (OR: 1.05; 95%CI: 0.91, 1.21; I2 = 69%), consistent with prior reviews, but biomarker-based studies showed an elevated but non-significant pooled measure (OR: 1.37; 95%CI: 0.96, 1.94; I2 = 84%). We did not observe any clear patterns of different risk by menopausal status. CONCLUSION:Findings from our meta-analysis suggest that exposure to higher cadmium increases the risk of breast cancer in women, but with remaining questions about whether non-dietary exposure may be more risky or whether residual confounding by constituents of tobacco smoke may be at play.

Background: In spite of the worth of pool testing in public health, data on the sensitivity and efficiency of real-time quantitative polymerase chain reaction (RT-qPCR) pool testing for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in middle and low-income countries are limited. Methods: We mixed single specimens of extracted RNA positive for the SARS-CoV-2 envelope (E) gene by RT-qPCR with negative specimens, in pools of 4 (n=89), 8 (n=92), 16 (n=102), and 32 (n=105) specimens each. We estimated the average change in cycle threshold (Ct) for each pool size and added it to the Ct values of the first 1,350 tests in our lab, to obtain dilution-corrected Ct values. We estimated pool sensitivity as the proportion of samples with dilution-corrected Ct >40, and used it in simulations of the efficiency (tests used/true case detected) of binary split pool testing. Results: We tested 388 pools. Average Ct changes were 2.21, 2.51, 3.27, and 3.94 cycles, for pools of 4, 8, 16, and 32 specimens, respectively. Corresponding pool tests sensitivities were 91.1%, 89.6%, 85.8% and 82.5%. Pool testing was substantially more efficient than individual testing. For prevalence of 0.5% to 2.0%, the efficiency of pools of >= 8 specimens was 30% to 280% higher, and the number of people tested was 4.4 to 13.9 times higher than those of individual testing. Conclusions: Binary split pool testing substantially increases the number of people tested and the number of true cases detected per test used. This strategy is key to curtail the transmission of SARS-CoV-2, by increasing efficiency in the identification and isolation of symptomatic and asymptomatic infected individuals.

Background: Saliva samples may be an easier, faster, safer, and cost-saving alternative to NPS samples, and can be self-collected by the patient. Whether SARS-CoV-2 RT-qPCR in saliva is more accurate than in nasopharyngeal swaps (NPS) is uncertain. We evaluated the accuracy of the RT-qPCR in both types of samples, assuming both approaches were imperfect. Methods: We assessed the limit of detection (LoD) of RT-qPCR in each type of sample. We collected paired NPS and saliva samples and tested them using the Berlin Protocol to detect SARS-CoV-2 envelope protein (E). We used a Bayesian latent class analysis (BLCA) to estimate the sensitivity and specificity of each test, while accounting for their conditional dependence. Results: The LoD were 10 copies/mL in saliva and 100 copies/mL in NPS. Paired samples of saliva and NPS were collected in 412 participants. Out of 68 infected cases, 14 were positive only in saliva. RT-qPCR sensitivity ranged from 82.7 % (95 % CrI: 54.8, 94.8) in NPS to 84.5 % (50.9, 96.5) in saliva. Corresponding specificities were 99.1 % (95 % CrI: 95.3, 99.8) and 98.4 %(95 % CrI: 92.8, 99.7). Conclusions: SARS-CoV-2 RT-qPCR test in saliva specimens has a similar or better accuracy than RT-qPCR test in NPS. Saliva specimens may be ideal for surveillance in general population, particularly in children, and in healthcare or other personnel in need of serial testing. (c) 2022 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.

La inesperada llegada de la pandemia, enfrentó a todo el mundo a cambios drásticos en la forma de vida que se disfrutaba en épocas de normalidad, obligando a la población a diferentes tipos de confinamientos. Estos trajeron consigo el cierre de casi todos los sectores y en consecuencia la interrupción de muchos servicios esenciales, como las intervenciones en el sector educativo. Muchas de estas intervenciones estaban dirigidas, además de a la educación misma, a brindar protección a los escolares, detectar condiciones de riesgo de violencia intrafamiliar, maltrato y trabajo infantil, suministrar raciones alimenticias, vigilar el cumplimiento del esquema de vacunación y a evitar la deserción escolar, entre otras. Aunque los escolares no son el grupo más afectado por COVID-19, un reciente estudio de UNICEF realizado en 87 países revela que, en noviembre de 2020, los niños y los adolescentes representaron el 11% del total de infecciones1, mientras que, en Colombia, la proporción de casos pediátricos (menores de 18 años) se estima entre 7-8% y representan el 0.025% del total de fallecimientos2. Aunque se ha reportado que el riesgo de infección en escolares es menor que el del personal docente y administrativo en instituciones de educación, esta discrepancia pudiera estar sobreestimada debido a una menor probabilidad de detección considerando el curso predominantemente asintomático de la infección en niños. Sin embargo, COVID-19 puede ser una enfermedad severa en los menores, contribuyendo no solo al número de ingresos a unidades de cuidados intensivo sino al de casos fatales3. En términos de la transmisión, un estudio conducido en población infantil evidenció que esta ocurre con mayor frecuencia en el entorno familiar, relacionándose directamente con el estadio de enfermedad del caso índice: comparados con casos asintomáticos aquellos en etapa pre sintomática fueron responsables del doble de casos secundarios (1/3 versus 1/6)4. Esto indica que los niños infectados constituyen una fuente importante de contagio para sus pares, con evidencia de mayor transmisión en el nivel de secundaria comparado con el de primaria5, así como para los miembros del personal docente y administrativo de sus escuelas. Estos últimos, a su vez generarían nuevos casos de infección en la comunidad estudiantil y dada cuenta de su mayor movilidad, también en la población general6.

En octubre 31 del 2021, Colombia inició la vacunación contra COVID-19 para niños de 3 a 11 años de edad, con la vacuna CoronaVac (Sinovac). Esta estrategia se implementó en ausencia de un informe técnico sobre la eficacia y seguridad de CoronaVac en niños, y sin una evaluación del costo-beneficio de esta, en comparación con otras estrategias. En este comentario se consideran aspectos fundamentales que debieron tomarse en cuenta al ponderar si los beneficios de esta estrategia eran mayores que sus riesgos. Específicamente, la eficacia y seguridad de CoronaVac en niños de 3 a 11 años, la relación riesgo/beneficio de la estrategia, el rol de los niños en la transmisión comunitaria de SARS-CoV-2, y las implicaciones éticas de la estrategia.

Inconsistencies in studies of chronic psychosocial stress and hypertension may be explained by the use of stress markers greatly influenced by circadian rhythm and transient stressors. We assessed whether hair cortisol, a marker that captures systemic cortisol over months, was independently associated with hypertension. We measured hair cortisol and blood pressure in 75 consecutive participants in the Survey of the Health of Wisconsin, using an ELISA test. Individuals with values ​≥ ​median (78.1 ​pg/mg) were considered exposed. We used approximate Bayesian logistic regression, with a prior odds ratio of 1.0–4.0, to quantify the multivariate-adjusted hair cortisol-hypertension association. Participants' average age was 46.9 years; 37.3% were male; and 25.3% were hypertensive. Hypertension prevalence was 2.23 times higher in exposed (95% CI: 1.69–3.03). This finding was unlikely explained by differential measurement errors, since we conducted blinded measurements of exposure and outcome. Sensitivity analyses showed the association was unlikely explained by an unmeasured confounder, survival bias, or reverse causality bias. Findings suggest elevated hair cortisol is a risk factor for hypertension. Although feasible, the clinical value of hair cortisol as a tool for hypertension risk stratification or for monitoring the effect of chronic psychosocial stress management interventions is still uncertain.

OBJECTIVE:To systematically assess the association of circulating inflammation markers with the future risk of hypertension. METHODS:We did a systematic literature search of PubMed and Scopus, from database inception to July 10, 2018. Prospective and retrospective cohort studies evaluating the association of circulating C reactive protein (CRP), high-sensitive CRP (hs-CRP), interleukin 6 (IL-6) and IL-1β to the risk of developing hypertension in the general population were included. The relative risks (RRs) for the top versus bottom tertiles of circulating biomarkers were calculated using a fixed-effects/random-effects model. A potential non-linear dose-response association was tested. RESULTS:Fourteen prospective cohort studies, two retrospective cohort studies and five nested case-control studies involving 142 640 participants and 20 676 cases were identified. The RR for the third versus first tertiles of circulating CRP was 1.23 (95% CI 1.11 to 1.35; I2=59%, n=12). The association remained unchanged after adjustment for body mass index. The RRs for other biomarkers were as follows: hs-CRP (RR 1.20, 95% CI 1.02 to 1.37; I2=74%, n=7), IL-6 (RR 1.51, 95% CI 1.30 to 1.71; I2=0%, n=5), and IL-1β (RR 1.22, 95% CI 0.92 to 1.51; I2=0%, n=3). A non-linear dose-response meta-analysis demonstrated that the risk of hypertension increased linearly with increasing circulating inflammation markers, even within the low-risk and intermediate-risk categories. CONCLUSIONS:Higher levels of circulating CRP, hs-CRP and IL-6, but not IL-1β, were associated with the risk of developing hypertension. The association persisted in subgroups of studies defined by major sources of heterogeneity.

Objective: Findings from studies of the association between Zika virus (ZIKV) infection and Guillain-Barre syndrome (GBS) are inconsistent. I conducted a systematic review and meta-analysis to clarify the nature of this association. Methods: I searched PubMed, Scopus, Cochrane, CINAHL, Web of Science, Scielo, and DOAJ for case report, ecological, and analytic studies with "Zika" and "Guillain-Barre syndrome" as keywords, published up to July 1stth 2018. I evaluated if ZIKV infection status influenced the diagnosis of GBS (detection bias) in case-report and analytic studies; assessed if changes in weekly number of cases of ZIKV infection during outbreaks were followed by changes in number of GBS cases 1-8 weeks later; gauged the likelihood of selection, confounding, information, sparse data, and time-dependent bias (i.e. when ZIKV infection was ascertained after GBS onset) in analytic studies; and calculated the average ZIKV-GBS odds ratio (OR) in studies without time-dependent bias. Results: In case reports, ZIKV infection prevalence in GBS cases was 2.4 to 25 times higher than expected. Changes in the number of ZIKV-infection cases during outbreaks were not consequentially followed by changes in the number of GBS cases (OR: 1.01; 95% CI: 0.99-1.03). Major biases were likely in all but one analytic study, which showed a non-significant ZIKV-GBS association. The average ZIKV-GBS OR in studies without time-dependent bias was 1.57 (95% CI: 0.86-2.86). Interpretation: These findings indicate the available evidence is insufficient to claim ZIKV infection causes GBS. Therefore, stakeholders may want to reconsider current ZIKV-GBS public health and patient care recommendations.

The Polarized Instrument for Long-wavelength Observation of the Tenuous interstellar medium ( PILOT ) is a balloon-borne experiment that aims to measure the polarized emission of thermal dust at a wavelength of 240 µm (1.2 THz). A first PILOT flight of the experiment took place from Timmins, Ontario, Canada, in September 2015 and a second flight took place from Alice Springs, Australia in April 2017. In this paper, we present the inflight performance of the instrument. Here we concentrate on the instrument performance as measured during the second flight, but refer to the performance observed during the first flight, if it was significantly different. We present a short description of the instrument and the flights. We measure the time constants of the detectors using the decay of the observed signal during flight following high energy particle impacts (glitches) and switching off the instrument’s internal calibration source. We use these time constants to deconvolve the timelines and analyze the optical quality of the instrument as measured on planets. We then analyze the structure and polarization of the instrumental background. We measure the detector response flat field and its time variations using the signal from the residual atmosphere and from the internal calibration source. Finally, we analyze the spectral and temporal properties of the detector noise. The inflight performance is found to be satisfactory and globally in line with expectations from ground calibrations. We conclude by assessing the expected inflight sensitivity of the instrument in light of the measured inflight performance.

ECLAIRs is a 2-D coded-mask imaging telescope on-board the Sino-French SVOM space mission, in order to detect and locate precisely Gamma-ray bursts (GRBs) in the 4 - 150 keV energy range. Its design has been drawn by the central objective of achieving a low-energy threshold of 4 keV. In that respect, the camera is formed by 6400 Schottky CdTe detectors organized on elementary hybrid matrices of 4 x 8 pixels, which will be polarized up to -450V and operated at 20 degrees C. The remarkable low-energy threshold homogeneity required for the detection plane has been achieved thanks to an extensive characterization of the innovative hybrid module composed of 32 CdTe detectors, associated to a very low-noise 32-channel ASIC chip, and both assembled on specific ceramics. In this paper, we outline the SVOM space mission, and then describe the ECLAIRs instrument. We continue by focusing on the different elements of the camera prototype named "ProtoDPIX". Indeed, this is a very important step for the project because it is the first time we are working in Camera Mode with 800 detectors. Then, we present some spectral results obtained from this, to show its great spectroscopic performance, after explaining the setup. Thus, we performed a large spectral measurements campaign at the regulated temperature of -20 degrees C, using several calibrated radioactive sources (241Am and 57Co). Moreover, we will resume the future steps of development of the final flight model camera and the different constraints due to the short planning and the very challenging technical requirements. In conclusion, thanks to this prototype we are in the process of validating a complete detection chain, from the detectors to the backend electronics, and from mechanical study through thermal design. Finally, we are checking the performance to be ready for integration, functional tests and calibration stages.

We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden.

During the last couple of years Zika virus (ZIKV) infection has been considered an international public health emergency, due to possible but yet uncertain links with newborn microcephaly and Guillain-Barré syndrome (GBS). Concerns about these links originated from case reports and surveillance data suggesting an outbreak of ZIKV in Brazil was followed by outbreaks of GBS and microcephaly (1,2). A fundamental component of the public health response has been the implementation of a system for surveillance of ZIKV disease and its complications (3).

APOE ε4 and ABCA7 variants are susceptibility genes for Alzheimer's disease (AD). Both genes are involved in the cholesterol metabolism pathway, and mid-life cholesterol levels are associated with increased risk for AD. The interaction between APOE ε4 and ABCA7has been associated with three cognitive factor scores, Verbal Learning & Memory, Working Memory, and Immediate Memory, in a study of participants from the Wisconsin Registry for Alzheimer's Prevention (WRAP), a longitudinal study of middle-aged adults enriched for a parental history of AD. As a follow-up to this study, we sought to examine the influence of total serum cholesterol on this interaction effect. Linear mixed models were used to test the influence of total serum cholesterol on the APOE ε4 x ABCA7effect on the three cognitive factor scores (n=778). Each model was adjusted for age, gender, and the top two principal components of ancestry while including random effects for family (siblings) and participant (repeated measures). Continuous serum cholesterol measures were included as a covariate where appropriate. The addition of serum cholesterol to the model did not attenuate the previously reported effect of the APOE ε4 x ABCA7 interaction on the three cognitive factor scores, suggesting serum cholesterol is not in the causal pathway for this association. When stratifying the population by mean total serum cholesterol, the effect of the APOE ε4 x ABCA7 interaction on all three cognitive factor scores differed by tertile and ABCA7SNP. Total serum cholesterol was not found to be in the causal pathway of the APOE ε4 x ABCA7 interaction, but did appear to be a modifier of the interaction effect on the cognitive factor scores. APOE ε4 and ABCA7 genotypes along with cholesterol levels should be considered together when addressing cognitive function in at-risk populations.