BackgroundSeveral chronic diseases accelerate cognitive decline; however, it is still unknown how different patterns of multimorbidity influence individuals’ trajectories across the cognitive continuum. ObjectivesWe aimed to investigate the impact of multimorbidity and of specific multimorbidity patterns on the transitions across cognitive stages (normal cognition, cognitive impairment, no dementia [CIND], dementia) and death. MethodsWe included 3122 dementia-free individuals from the Swedish National study on Aging and Care in Kungsholmen. Using fuzzy c-means cluster analysis, multimorbid participants were classified into mutually exclusive groups characterized by commonly coexisting chronic diseases. Participants were followed up to 18 years to detect incident CIND, dementia, or death. Transition hazard ratios (HRs), life expectancies, and time spent in different cognitive stages were estimated using multistate Markov models. ResultsAt baseline, five multimorbidity patterns were identified: neuropsychiatric, cardiovascular, sensory impairment/cancer, respiratory/metabolic/musculoskeletal, and unspecific. Compared to the unspecific pattern, the neuropsychiatric and sensory impairment/cancer ones showed reduced hazards of reverting from CIND to normal cognition (HR 0.53, 95% CI 0.33-0.85 and HR 0.60, 95% CI 0.39-0.91). Participants in the cardiovascular pattern exhibited an increased hazard of progression from CIND to dementia (HR 1.70, 95% CI 1.15-2.52) and for all transitions to death. Subjects with the neuropsychiatric and cardiovascular patterns showed reduced life expectancy at age 75, with an anticipation of CIND (up to 1.6 and 2.2 years, respectively) and dementia onset (up to 1.8 and 3.3 years, respectively). ConclusionsMultimorbidity patterns differentially steer individual trajectories across the cognitive continuum of older adults and may be used as a risk stratification tool.

The COVID-19 pandemic posed a global health crisis, with new severe acute res-piratory syndrome coronavirus 2 (SARS-CoV-2) variants weakening vaccine -driven protection. Trained immunity could help tackle COVID-19 disease. Our objective was to analyze whether heat-killed Mycobacterium manresensis (hkMm), an environmental mycobacterium, induces trained immunity and con-fers protection against SARS-CoV-2 infection. To this end, THP-1 cells and primary monocytes were trained with hkMm. The increased secretion of tumor necrosis factor alpha (TNF-a), interleukin (IL)-6, IL-1b, and IL-10, metabolic activ-ity, and changes in epigenetic marks suggested hkMm-induced trained immu-nity in vitro. Healthcare workers at risk of SARS-CoV-2 infection were enrolled into the MANRECOVID19 clinical trial (NCT04452773) and were administered Nyaditum resae (NR, containing hkMm) or placebo. No significant differences in monocyte inflammatory responses or the incidence of SARS-CoV-2 infection were found between the groups, although NR modified the profile of circulating immune cell populations. Our results show that M. manresensis induces trained immunity in vitro but not in vivo when orally administered as NR daily for 14 days.

The original publication of this article [1] contained an incomplete author contribution section. The incorrect and correct information has been listed in this correction article. The original article has been updated. Incorrect IG, MT, MS, JP, NF, LC, FL, AK, NG, ET, PG conceptualised the project. All authors were involved with generation of the protocol. IG, MT, ATM, MS, GP and JP wrote the first draft of the manuscript. All authors listed have been implicated in the development of the ongoing project described in the protocol including patients. All authors were involved in editing and approving the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. IG, MT, MS, and AK act as guarantors. Correct. IG, MT, MS, JP, NF, GP,LC, FL, AK, NG, ET, PG conceptualised the project. All authors were involved with generation of the protocol. IG, MT, ATM, MS, GP and JP wrote the first draft of the manuscript. All authors listed (IG,MT,AM,MS,JP,NF, LC,RK,IG,MR,DR,JS,JP,PA,ET,IG ,MG,RM,RH,JH,MF,AM,AJ,AS,MJ,MC,AD,SD,PT,CF,AL ,PN,MM,HK,FS,FC,AA,MK,LK,JF,PK,TK,LC,FL,AK,PG) have been implicated in the development of the ongoing project described in the protocol including patients. All authors(IG,MT,AM,MS,JP,NF,LC,RK,IG,MR,DR,JS, JP,PA,ET,IG,MG,RM,RH,JH,MF,AM,AJ,AS,MJ,MC,AD ,SD,PT,CF,AL,PN,MM,HK,FS,FC,AA,MK,LK,JF,PK,TK ,LC,FL,AK,PG) were involved in editing and approving the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. IG, MT, MS, and AK act as guarantors. © The Author(s) 2023.

Objective: The aim of this study was to determine the impact of the lockdown measures adopted during the COVID-19 pandemic on routine childhood vaccination coverage rates in Catalonia (Spain) and to estimate its recovery once the progressive return to ‘normalcy’ had begun.Study design: We conducted a public health register-based study. Methods: Routine childhood vaccination coverage rates were analysed in three periods: a first pre-lockdown period (from January 2019 to February 2020), a second lockdown period with full re-strictions (from March 2020 to June 2020), and, finally, a third post-lockdown period with partial re-strictions (from July 2020 to December 2021).Results: During the lockdown period, most of the coverage rates remained stable, concerning the pre-lockdown period; however, when comparing the vaccination coverage rates in the post-lockdown period to the pre-lockdown period, we observed decreases in all types of vaccines and doses analysed, except for coverage with the PCV13 vaccine in 2-year-olds, which experienced an increase. The most relevant reductions were observed in measles-mumps-rubella and diphtheria-tetanus-acellular pertussis vaccination coverage rates.Conclusions: Since the beginning of the COVID-19 pandemic, there has been an overall decline in routine childhood vaccine coverage rates, and the pre-pandemic rates have not yet been recovered. Immediate and long-term support strategies must be maintained and strengthened to restore and sustain routine childhood vaccination.(c) 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The aim of this study was to describe the perception of changes that Alzheimer’s disease in grandparents has made to the relationship with their grandchildren of between 6 and 13. Qualitative methodology was used. Semi-structured interviews were carried out with 25 grandchildren living in Catalonia, Spain. Participants reported a change in roles from being the care receiver to being the caregiver, changes in the activities that they did together and a positive impact on the grandparent’s emotional wellbeing. In the physical sphere, sleeping problems were reported in grandchildren that cohabited with their grandparents. The feelings they described include fear of not being recognized by their grandparents and sadness, as well as satisfaction resulting from their affection and participating in caring. These findings suggest the need to provide information and resources for grandchildren and their families to enable them to deal with the disease.

Objective: To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC).Methods: Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. Results: 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI-0.77 to 1.36]; p = 0.726) during follow-up.Conclusions: As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression.Trial registration: ClinicalTrials.gov, NCT03136211.

[This corrects the article DOI: 10.3389/fimmu.2022.1079884.].

Ambulatory blood pressure (BP) is associated with mortality, but it is also interesting to expand its association with cardiovascular morbidity. This study sought to evaluate association with cardiovascular morbidity and cardiovascular mortality. Patients without cardiovascular disease who had a first 24-hour ambulatory BP monitoring were followed-up until the onset of the first event (a combined variable of cardiovascular mortality, coronary heart disease, cerebrovascular disease, peripheral arteriopathy, or hospital admission for heart failure). Changes in antihypertensive treatment couldn’t be collected. Cox regression analysis was adjusted for risk factors and office BP. We included 3907 patients (mean age, 58.0, SD 13.8 years), of whom 85.5% were hypertensive. The follow up period was 6.6 (95% CI 5.0-8.5) years. A total of 496 (12.7%) events were recorded. The incidence rate was 19.3 (95% CI 17.7-21.1) cases per 1000 person-years. The patients with an event compared to the rest of patients were mostly men, older, with higher office and ambulatory systolic BP, higher prevalence of diabetes, chronic kidney disease, dyslipidemia, and non-dipper or riser circadian profile. In the fully adjusted model, office BP loses its significant association with the main variable. Ambulatory BP association remained significant with cardiovascular morbidity and mortality, HR 1.494 (1.326-1.685) and 0.767 (0.654-0.899) for 24-hour systolic and diastolic BP, respectively. Nighttime systolic BP also maintained this significant association, 1.270 (1.016-1.587). We conclude that nighttime systolic BP and 24-hour BP are significantly associated with cardiovascular events and cardiovascular mortality in patients without cardiovascular disease attended under conditions of routine clinical practice.

The advertisement of food and beverages on television and social media has been widely assessed, evidencing its powerful influence on children’s dietary patterns and the development of childhood obesity. However, there is a gap in the evidence about advertisements near schools. The aim of this study was to describe and classify the nutritional quality and information of processed foods and alcoholic and non-alcoholic beverages advertised near schools in three cities in the north of Spain. A descriptive analysis was performed from September to December 2021 in the cities of Oviedo, Gijon and Aviles in the Principality of Asturias (Spain). The nutritional quality and information of processed foods or beverages advertised within a 500 m radius of schools were assessed. The Nutri-Score system was used for the classification of the nutritional quality of products and nutritional information, calories, fat, saturated fat, carbohydrates, sugars, protein and salt in 100 g or ml of each product was calculated. A total of 73.5% of the products were classified as “foods to eat less often and in small amounts,” and 22.6% and 46.3% were classified as D or E, respectively, according to the Nutri-Score system. Finally, 57.5%, 56.4% and 78.5% of the products showed a medium to high content of fat, saturated fat and sugar, respectively. In conclusion, the food and drink advertisements surrounding schools in the assessed cities promote many products of low nutritional value, rich in fat, saturated fat and sugars, which have high obesogenic potential.