Several genomic epidemiology tools have been developed to track the public and population health impact of SARS-CoV-2 community spread worldwide. A SARS-CoV-2 Variant of Concern (VOC) B.1.1.7, known as 501Y.V1, which shows increased transmissibility, has rapidly become the dominant VOC in the United States (US). Our objective was to develop an evidenced-based genomic surveillance algorithm that combines RT-PCR and sequencing technologies to identify VOCs. Deidentified data were obtained from 508,969 patients tested for COVID-19 with the TaqPath COVID-19 RT-PCR Combo Kit (ThermoFisher) in four CLIA certified clinical laboratories in Puerto Rico (n=86,639) and in three CLIA certified clinical laboratories in the US (n=422,330). TaqPath data revealed a frequency of S Gene Target Failure (SGTF) >47% for the last week of March 2021, in both Puerto Rico and US laboratories. The monthly frequency of SGTF in Puerto Rico steadily increased exponentially from 4% in November 2020 to 47% in March 2021.The weekly SGTF rate in US samples was high (>8%) from late December to early January, and then also increased exponentially through April (48%). The exponential increase in SGFT prevalence in Puerto Rico is concurrent with a sharp increase in VOCs among all SARS-CoV-2 sequences from Puerto Rico uploaded to GISAID (n=461). B.1.1.7 frequency increased from <1% in the last week of January 2021 to 51.5% of viral sequences from Puerto Rico collected in the last week of March 2021. The exponential increase in SGTF and B.1.1.7 prevalence in Puerto Rico and US requires an urgent response. According to the proposed evidence-based algorithm, approximately 50% of all positive samples should be managed as potential B.1.1.7 carriers with VOC quarantine and contact tracing protocols while their lineage is confirmed by WGS in surveillance laboratories. Patients infected with VOCs should be effectively triaged for isolation, contact tracing and follow-up treatment purposes.

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic revealed a worldwide lack of effective molecular surveillance networks at local, state, and national levels, which are essential to identify, monitor, and limit viral community spread. SARS‐CoV‐2 variants of concern (VOCs) such as Alpha and Omicron, which show increased transmissibility and immune evasion, rapidly became dominant VOCs worldwide. Our objective was to develop an evidenced‐based genomic surveillance algorithm, combining reverse transcription polymerase chain reaction (RT‐PCR) and sequencing technologies to quickly identify highly contagious VOCs, before cases accumulate exponentially. Methods Deidentified data were obtained from 508,969 patients tested for coronavirus disease 2019 (COVID‐19) with the TaqPath COVID‐19 RT‐PCR Combo Kit (ThermoFisher) in four CLIA‐certified clinical laboratories in Puerto Rico ( n = 86,639) and in three CLIA‐certified clinical laboratories in the United States ( n = 422,330). Results TaqPath data revealed a frequency of S Gene Target Failure (SGTF) > 47% for the last week of March 2021 in both, Puerto Rico and US laboratories. The monthly frequency of SGTF in Puerto Rico steadily increased exponentially from 4% in November 2020 to 47% in March 2021. The weekly SGTF rate in US samples was high (>8%) from late December to early January and then also increased exponentially through April (48%). The exponential increase in SGFT prevalence in Puerto Rico was concurrent with a sharp increase in VOCs among all SARS‐CoV‐2 sequences from Puerto Rico uploaded to Global Influenza Surveillance and Response System (GISAID) ( n = 461). Alpha variant frequency increased from <1% in the last week of January 2021 to 51.5% of viral sequences from Puerto Rico collected in the last week of March 2021. Conclusions According to the proposed evidence‐based algorithm, approximately 50% of all SGTF patients should be managed with VOCs self‐quarantine and contact tracing protocols, while WGS confirms their lineage in genomic surveillance laboratories. Our results suggest this workflow is useful for tracking VOCs with SGTF.

Mutations and polymorphisms in the vitamin D receptor gene (VDR) were highly correlated with melanoma and other types of cancer. VDR is a transcription factor that regulates the expression of several genes through

Como parte de la propuesta para definir al cerro "El Potosí" como Reserva Especial de la Biosfera, se elaboró un mapa de zonificación que considera las zonas núcleo, de amortiguamiento y de recuperación de hábitat. Los criterios para la zonificación consideraron la distribución de la vegetación y las poblaciones de fauna silvestre, derivada de la interpretación cartográfica elaborada ad hoc, utilizando una imagen de satélite, además de la información sobre la biodiversidad. Se definieron para la región diez tipos de vegetación y cuatro tipos de uso del suelo, en donde se distribuyen 45 especies bajo estatus de conservación: 19 de plantas y 26 de animales.

Resumen Objetivos La hipoplasia suprarrenal congénita ligada al cromosoma X es una enfermedad rara con base genética conocida, que se presenta con insuficiencia suprarrenal e hipogonadismo hipogonadotrófico y expresión clínica variable. Caso clínico Paciente varón, de 26 días, que ingresó con síntomas compatibles con insuficiencia suprarrenal, hiponatremia e hiperpotasemia, requiriendo sueroterapia con suplementos de NaCl y fludrocortisona, consiguiéndose estabilidad clínica. Se descartó la hiperplasia suprarrenal congénita tras la medición de 17-OH-progesterona. El resto de hormonas estaban dentro de los intervalos de referencia, salvo la hormona adrenocorticotrópica (ACTH), sensiblemente por encima, y la aldosterona, por debajo. En los siguientes análisis se estudiaron los ácidos grasos de cadena muy larga para descartar adrenoleucodistrofia, el gen CYP11B2 (aldosterona sintasa), y se realizó una RMN para descartar otras alteraciones morfológicas. Todas estas pruebas resultaron normales. Finalmente, tras detectar déficit de cortisol en una analítica, se realizó un estudio genético más amplio donde se describió una mutación en el gen NR0B1, estableciéndose el diagnóstico de hipoplasia suprarrenal congénita. Conclusiones La hipoplasia suprarrenal congénita es una enfermedad de diagnóstico complejo debido a la variabilidad en la expresión clínica y el grado de alteración de las pruebas de laboratorio, requiriéndose un seguimiento exhaustivo y la realización de pruebas genéticas para llegar al diagnóstico.