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Are yessotoxins an emerging problem in Chile? Context and perspectives following the first report of YTX levels exceeding the regulatory limit in the Patagonian fjord system

Díaz PA, Araya M, Cantarero B, Miranda C, Varela D, Figueroa RI, et al.

Environ Pollut, 2024 Aug 28;361:124844.
PMID: 39209054 DOI: 10.1016/j.envpol.2024.124844

In late summer and early autumn 2022, an intense bloom of Protoceratium reticulatum-the main yessotoxin (YTX) producer along Chilean coasts and a major threat to artisanal fisheries, the aquaculture industry, and environmental health-was recorded in the Patagonian fjord system. The high YTX levels (>3.75 mg kg-1) resulted in the first ban of shellfish collection in Chile. At Puyuhuapi Fjord, a global "hotspot" of harmful algal bloom events, the cell density of P. reticulatum determined in integrated tube samples (0-10 m) at the end of April 2022 reached 407,000 cells L-1. At the same time, YTX levels well exceeded the regulatory limit by roughly 2.5-fold, with concentrations as high as 9.42 mg kg-1 measured in native populations of the blue mussel Mytilus chilensis. Five different YTX analogues, 45-OH-YTX, COOH-45-keto-YTX, COOH-45-OH-YTX, COOH-YTX, and 45,55-diOH-YTX, were also detected in relevant amounts. While the ban lasted close to 3 months, accumulation and detoxification processes were monitored over a 1-year period. This study assessed the implications of high levels of YTXs and their analogues on the local economy and ecosystem health, given the increase in P. reticulatum blooms predicted for NW Patagonia in the context of a changing climate.
The risk of high-biomass HABs: Triggers and dynamics of a non-toxic bloom of Prorocentrum micans in Chilean Patagonia

Díaz PA, Basti L, Pérez-Santos I, Schwerter C, Artal O, Rosales SA, et al.

Sci Total Environ, 2024 Dec 18;958:178140.
PMID: 39700974 DOI: 10.1016/j.scitotenv.2024.178140

Harmful algal blooms (HABs) of toxin-producing microalgae are recurrent in Patagonian fjord systems. Like toxigenic HABs, high-biomass harmful algal blooms (HB-HABs) have important socio-economic repercussions, but most studies have focused on the former. Here we report the formation and development of an intense HB-HAB of Prorocentrum micans that occurred in Northwest Chilean Patagonia in the late summer (February-March) of 2022. Concentrated and extensive brown spots were visible on the water surface, accompanied at the end of February by a strong odour. Prorocentrum micans cells were detected at relatively low densities (up to 215 cells mL-1) in January but by February 11 cell densities exceeded 1000 cells mL-1, reaching a maximum of 8.3 × 103 cell mL-1 in the surface layer. The high cell densities at Reloncaví Sound and the Gulf of Ancud were closely associated with narrow-ranging increases in the sea surface temperature (17-18.5 °C) and salinity (29-31 g kg-1). Sentinel-2 satellite images from February 22 showed a colour change corresponding to the presence of the brown patches at both locations, consistent with the increases in the normalized index of chlorophyll differences (NDCI) and chlorophyll a concentrations (~50 μg L-1). Satellite images from GHRSST indicated warmer waters in Reloncaví Sound and the Gulf of Ancud than in the Gulf of Corcovado, located 170-km to the south. An oceanographic 3-D model (MOSA) showed surface currents with a cyclonic eddy centred in the Gulf of Ancud. This circulation pattern suggested greater water retention in the study area during January and February, with the drifting and rotation of the coastal currents around the eddy maintaining the P. micans bloom. Thus, the elevated cell density of P. micans in the Gulf of Ancud, near the periphery of the eddy, confirm the presence of a material accumulation hotspot for HABs and HB-HABs.
Comparison of the third molar maturity index (I3M) between left and right lower third molars to assess the age of majority: a multi-ethnic study sample

Angelakopoulos N, Galić I, Balla SB, Kiş HC, Gómez Jiménez L, Zolotenkova G, et al.

Int J Legal Med, 2021 Nov;135(6):2423-2436.
PMID: 34228192 DOI: 10.1007/s00414-021-02656-2

The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.
Third molar maturity index (I3M) assessment according to different geographical zones: a large multi-ethnic study sample

Angelakopoulos N, De Luca S, Oliveira-Santos I, Ribeiro ILA, Bianchi I, Balla SB, et al.

Int J Legal Med, 2023 Mar;137(2):403-425.
PMID: 36520207 DOI: 10.1007/s00414-022-02930-x

Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (I3M) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (I3ML and I3MR) and the combination of both sides (I3ML_I3MR) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (I3ML; I3MR; I3ML_I3MR, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the I3ML for male African people (91%) and the higher specificity (Sp) of all the parameters (I3ML; I3MR; I3ML_I3MR) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.
Fulltext Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world

Rogers SN, Alvear A, Anesi A, Babin E, Balik A, Batstone M, et al.

Head Neck, 2020 03;42(3):498-512.
PMID: 31833121 DOI: 10.1002/hed.26027

BACKGROUND: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL).
METHODS: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias.
RESULTS: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). "Fear of the cancer returning" (39%) and "dry mouth" (37%) were most common. Twenty-five percent (524) reported less than good QOL.
CONCLUSION: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL.
Fulltext Australian vegetated coastal ecosystems as global hotspots for climate change mitigation

Serrano O, Lovelock CE, B Atwood T, Macreadie PI, Canto R, Phinn S, et al.

Nat Commun, 2019 10 02;10(1):4313.
PMID: 31575872 DOI: 10.1038/s41467-019-12176-8

Policies aiming to preserve vegetated coastal ecosystems (VCE; tidal marshes, mangroves and seagrasses) to mitigate greenhouse gas emissions require national assessments of blue carbon resources. Here, we present organic carbon (C) storage in VCE across Australian climate regions and estimate potential annual CO2 emission benefits of VCE conservation and restoration. Australia contributes 5-11% of the C stored in VCE globally (70-185 Tg C in aboveground biomass, and 1,055-1,540 Tg C in the upper 1 m of soils). Potential CO2 emissions from current VCE losses are estimated at 2.1-3.1 Tg CO2-e yr-1, increasing annual CO2 emissions from land use change in Australia by 12-21%. This assessment, the most comprehensive for any nation to-date, demonstrates the potential of conservation and restoration of VCE to underpin national policy development for reducing greenhouse gas emissions.
Fulltext Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al.

J Am Coll Cardiol, 2017 Jul 04;70(1):1-25.
PMID: 28527533 DOI: 10.1016/j.jacc.2017.04.052

BACKGROUND: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world.
OBJECTIVES: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden.
METHODS: CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.
RESULTS: In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75.
CONCLUSIONS: CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.