In Vivo Evaluation of Cervical Stiffness Evolution during Induced Ripening Using Shear Wave Elastography, Histology and 2 Photon Excitation Microscopy: Insight from an Animal Model

Prematurity affects 11% of the births and is the main cause of infant mortality. On the opposite case, the failure of induction of parturition in the case of delayed spontaneous birth is associated with fetal suffering. Both conditions are associated with precocious and/or delayed cervical ripening. Quantitative and objective information about the temporal evolution of the cervical ripening may provide a complementary method to identify cases at risk of preterm delivery and to assess the likelihood of successful induction of labour. In this study, the cervical stiffness was measured in vivo in pregnant sheep by using Shear Wave Elastography (SWE). This technique assesses the stiffness of tissue through the measurement of shear waves speed (SWS). In the present study, 9 pregnant ewes were used. Cervical ripening was induced at 127 days of pregnancy (term: 145 days) by dexamethasone injection in 5 animals, while 4 animals were used as control. Elastographic images of the cervix were obtained by two independent operators every 4 hours during 24 hours after injection to monitor the cervical maturation induced by the dexamethasone. Based on the measurements of SWS during vaginal ultrasound examination, the stiffness in the second ring of the cervix was quantified over a circular region of interest of 5 mm diameter. SWS was found to decrease significantly in the first 4–8 hours after dexamethasone compared to controls, which was associated with cervical ripening induced by dexamethasone (from 1.779 m/s ± 0.548 m/s, p < 0.0005, to 1.291 m/s ± 0.516 m/s, p < 0.000). Consequently a drop in the cervical elasticity was quantified too (from 9.5 kPa ± 0.9 kPa, p < 0.0005, to 5.0 kPa ± 0.8 kPa, p < 0.000). Moreover, SWE measurements were highly reproducible between both operators at all times. Cervical ripening induced by dexamethasone was confirmed by the significant increase in maternal plasma Prostaglandin E2 (PGE2), as evidenced by the assay of its metabolite PGEM. Histological analyses and two-photon excitation microscopy, combining both Second Harmonic Generation (SHG) and Two-photon Fluorescence microscopy (2PF) contrasts, were used to investigate, at the microscopic scale, the structure of cervical tissue. Results show that both collagen and 2PF-active fibrillar structures could be closely related to the mechanical properties of cervical tissue that are perceptible in elastography. In conclusion, SWE may be a valuable method to objectively quantify the cervical stiffness and as a complementary diagnostic tool for preterm birth and for labour induction success

ENPP1 Affects Insulin Action and Secretion: Evidences from In Vitro Studies

The aim of this study was to deeper investigate the mechanisms through which ENPP1, a negative modulator of insulin receptor (IR) activation, plays a role on insulin signaling, insulin secretion and eventually glucose metabolism. ENPP1 cDNA (carrying either K121 or Q121 variant) was transfected in HepG2 liver-, L6 skeletal muscle- and INS1E beta-cells. Insulin-induced IR-autophosphorylation (HepG2, L6, INS1E), Akt-Ser473, ERK1/2-Thr202/Tyr204 and GSK3-beta Ser9 phosphorylation (HepG2, L6), PEPCK mRNA levels (HepG2) and 2-deoxy-D-glucose uptake (L6) was studied. GLUT 4 mRNA (L6), insulin secretion and caspase-3 activation (INS1E) were also investigated. Insulin-induced IR-autophosphorylation was decreased in HepG2-K, L6-K, INS1E-K (20%, 52% and 11% reduction vs. untransfected cells) and twice as much in HepG2-Q, L6-Q, INS1E-Q (44%, 92% and 30%). Similar data were obtained with Akt-Ser473, ERK1/2-Thr202/Tyr204 and GSK3-beta Ser9 in HepG2 and L6. Insulin-induced reduction of PEPCK mRNA was progressively lower in untransfected, HepG2-K and HepG2-Q cells (65%, 54%, 23%). Insulin-induced glucose uptake in untransfected L6 (60% increase over basal), was totally abolished in L6-K and L6-Q cells. GLUT 4 mRNA was slightly reduced in L6-K and twice as much in L6-Q (13% and 25% reduction vs. untransfected cells). Glucose-induced insulin secretion was 60% reduced in INS1E-K and almost abolished in INS1E-Q. Serum deficiency activated caspase-3 by two, three and four folds in untransfected INS1E, INS1E-K and INS1E-Q. Glyburide-induced insulin secretion was reduced by 50% in isolated human islets from homozygous QQ donors as compared to those from KK and KQ individuals. Our data clearly indicate that ENPP1, especially when the Q121 variant is operating, affects insulin signaling and glucose metabolism in skeletal muscle- and liver-cells and both function and survival of insulin secreting beta-cells, thus representing a strong pathogenic factor predisposing to insulin resistance, defective insulin secretion and glucose metabolism abnormalities

Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia

Measuring the health-related Sustainable Development Goals in 188 countries : a baseline analysis from the Global Burden of Disease Study 2015

Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59.3 (95% uncertainty interval 56.8-61.8) and varied widely by country, ranging from 85.5 (84.2-86.5) in Iceland to 20.4 (15.4-24.9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r(2) = 0.88) and the MDG index (r(2) = 0.2), whereas the non-MDG index had a weaker relation with SDI (r(2) = 0.79). Between 2000 and 2015, the health-related SDG index improved by a median of 7.9 (IQR 5.0-10.4), and gains on the MDG index (a median change of 10.0 [6.7-13.1]) exceeded that of the non-MDG index (a median change of 5.5 [2.1-8.9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.Peer reviewe

Genotipificación y análisis filogenético de cepas colombianas del virus Dengue Tipo 2

Dengue virus is a flavivirus transmitted by the mosquito Aedes spp.and is the causative agent for an increasing public health problem in tropical areas over the world, with almost 3.000 million people at risk of infection. Dengue virus produces a broad spectrum of symptoms, varying from a mild flu-like illness called dengue fever, to a severe and some times fulminating haemorrhagic fever disease with shock. Genetic caracterization of distinct virus serotypes allow us to understand the epidemiological patterns of distribution as well as to demonstrate the presence of specific haemorrhagic strains causing very severe disease and death. In this report, we have determined the evolutionary origins of Dengue Virus Type 2 circulating in Colombia before and after the first reported haemorrhagic fever case at the ends of 1989, by means of sequence and further analysis of a 240 pb PCR amplified fragment from the E/NS1 joining region; with the sequences obtained from 5 strains isolated before 1989 and 10 from strains isolated years after, a phylogenetic tree was constructed which showed the presence of 2 different genotypes in our country; comparison with strains previously isolated from around the world determined that one of the genotypes found corresponds to the native American genotype circulating before the appearance of haemorrhagic fever, while the later isolated strains of the second genotype belonged to a Southeast Asian genotype, suggesting displacement of the native strains by more virulent genotypes.El virus del Dengue, un flavivirus transmitido por mosquitos del género Aedes, es responsable de un creciente problema de salud pública en áreas tropicales de todo el mundo, con más de 3.000 millones de personas en riesgo de infección. Este virus produce un espectro de síntomas que varía desde un malestar semejante al resfriado común, conocido como dengue clásico, hasta una enfermedad que puede ser fulminante denominada «dengue hemorrágico». La caracterización genética de los diferentes serotipos del virus permite no sólo entender los patrones epidémicos de distribución sino, además, demostrar la presencia de cepas hemorragíparas específicas como responsables de los casos más severos de la enfermedad. En este trabajo determinamos los ancestros evolutivos de los virus Dengue tipo 2 que han circulado en Colombia antes y después de la aparición del dengue hemorrágico a finales de 1989, mediante la secuenciación y análisis de un fragmento de 240 pb de la región de unión de los genes E/NS1 del virus; así, con las secuencias obtenidas de 5 cepas aisladas antes de 1989 y 10 identificadas en años posteriores, se construyó un árbol filogenético que sugiere la presencia de 2 genotipos diferentes en nuestro medio; la comparación con cepas aisladas de diferentes partes del mundo demuestra que uno de estos genotipos corresponde a cepas nativas americanas aisladas antes de la aparición del dengue hemorrágico, mientras que los virus encontrados posteriormente pertenecen al genotipo asiático, indicando el posible desplazamiento de las cepas autóctonas por genotiposposiblemente más agresivos

Boletín Económico Regional : Nororiente, IV trimestre de 2012

Al finalizar el cuarto trimestre de 2012 la economía de Nororiente presentó un saldo favorable en la mayoría de sectores, aunque se evidenciaron algunos signos de desaceleración. Balance moderadamente positivo se alcanzó en actividades como producción de petróleo, carbón; crédito de Finagro, donde asimismo sobresalió el importante incremento de la línea agropecuaria; venta de vehículos; sistema financiero, destacando el auge de las colocaciones frente a las captaciones; y transporte de pasajeros. Por el contrario la construcción y las exportaciones registraron descensos interanuales. Además, los indicadores de empleo fueron favorables especialmente en Bucaramanga, donde se presentó la tasa más baja de desempleo en el país

Boletín Económico Regional : Nororiente, I trimestre de 2013

En el primer trimestre de 2013 la economía de Nororiente alcanzó un comportamiento levemente positivo, debido al crecimiento registrado en sectores de gran importancia regional como minería, construcción, sistema financiero, comercio exterior, transporte aéreo de pasajeros y carga, al igual que turismo; por el contrario, continuaron los malos resultados en industria y comercio incluido vehículos. Por su parte, mejoraron los indicadores de empleo en Bucaramanga, mientras que en Cúcuta se deterioraron; entre tanto el IPC arrojó incrementos importantes en la primera al tiempo que en Cúcuta y Tunja fue inferior al promedio nacional

Boletín Económico Regional : Nororiente, II trimestre de 2013

Durante el segundo trimestre del año la actividad económica de Nororiente denotó un comportamiento ligeramente superior al logrado un año atrás. Sobresalió el buen resultado del sistema financiero, los créditos Finagro, construcción, e industria, destacando que este último logró recuperarse de la fuerte caída evidenciada en los dos trimestres anteriores; en menor medida se incrementó el flujo de pasajeros vía aérea. Por el contrario, se observaron moderadas reducciones en actividades como la venta de vehículos nuevos y turismo. La contracción más significativa se reflejó en minería, donde cayó tanto la explotación de petróleo como la de carbón. Entre tanto, mejoraron los indicadores de empleo a lo largo de la región, a la vez que el IPC aumentó de forma notoria en Bucaramanga, mientras en Tunja y Cúcuta no superó el promedio nacional

Administración de riesgos empresariales en Colombia, México y Argentina

Administración de Riesgos Empresariales en Colombia, México y Argentina da a conocer un completo diagnóstico del desarrollo de la administración de riesgos en grandes empresas privadas de los tres países participantes, en el cual se evidencia una importante evolución de esta disciplina en el marco del gobierno y la cultura del riesgo, las prácticas y herramientas, la comunicación y consulta, entre otros elementos estudiados -- Con esto se ratifica el valor de esta disciplina para contribuir a la responsabilidad social empresarial, y el impacto en los resultados financieros y la sostenibilidad de las empresasp. 22