Fooled by the cycle: Permanent versus cyclical improvements in social indicators

This paper studies the time series behavior of a set of widely-used social indicators and uncovers two important stylized facts. First, not all social indicators are created equal in terms of the importance of cyclical fluctuations. While some social indicators such as the unemployment rate and monetary poverty show large cyclical fluctuations, other social measures such as the Human Development Index are, by construction, dominated by long-run trends. Second, interestingly, yet not surprisingly, a large part of the cyclical fluctuations in social indicators can be explained by cyclical changes in income (proxied by real GDP per capita). For this reason, countries with large cyclical income volatility exhibit, in turn, large cyclical changes in some of these social indicators (particularly in those indicators that are more prone to cyclical fluctuations). Since cyclical income volatility is much larger in the developing world, these two critical stylized facts raise fundamental issues regarding the duration of improvements in social indicators (like the ones observed in many developing countries during the last commodity super-cycle). After a detailed conceptual and methodological discussion of these issues, and relying on a global sample of industrial and developing countries, we dig deeper into the importance of cyclical versus permanent components by extending the seminal contribution of Datt and Ravallion (1992). In particular, we show that more than 40 percent of the fall in monetary poverty observed in Latin America and the Caribbean during the so-called Golden Decade can be attributed to cyclical changes in income. While in principle universal, our concerns are particularly relevant in the developing world where, compared to developed countries, output volatility is larger and driven, to a large extent, by external factors (such as commodity prices)

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Beamforming for large-area scan and improved SNR in array-based photoacoustic microscopy

[EN] Beamforming enhances the performance of array-based photoacoustic microscopy (PAM) systems for large-area scan. In this study, we quantify the imaging performance of a large field-of-view optical-resolution photoacoustic-microscopy system using an phased-array detector. The system combines a low-cost pulsed-laser diode with a 128-element linear ultrasound probe. Signal-to-noise ratio (SNR) and generalized contrast-to-noise ratio (gCNR) are quantified using the phased-array detector and applying three beamforming strategies: a no-beamforming method equivalent to a single-element flat transducer, a fixed focus beamforming method that mimics a single-element focused transducer, and a dynamic focus beamforming using a delay-and-sum (DAS) algorithm. The imaging capabilities of the system are demonstrated generating high-resolution images of tissue-mimicking phantoms containing sub-millimetre ink tubes and an ex vivo rabbit¿s ear. The results show that dynamic focus DAS beamforming increases and homogenizes SNR along 1-cm2 images, reaching values up to 15 dB compared to an unfocused detector and up to 30 dB compared to out-of-focus regions of the fixed focus configuration. Moreover, the obtained values of gCNR using the DAS beamformer indicate an excellent target visibility, both on phantoms and ex vivo. This strategy makes it possible to scan larger surfaces compared to standard configurations using single-element detectors, paving the way for advanced array-based PAM systems.This research has been supported by the Spanish Ministry of Science, Innovation and Universities through grant "Juan de la Cierva - Incorporación" (IJC2018-037897-I), and program "Proyectos I+D+i 2019, Spain" (PID2019-111436RB-C22), by Programa Operativo Empleo Juvenil, Spain 2014-2020 (MIN19-VAL-I3M-004), and by the Agència Valenciana de la Innovació, Spain through grant INNCON00/2020/009. Action co-financed by the European Union through the Programa Operativo del Fondo Europeo de Desarrollo Regional (FEDER) of the Comunitat Valenciana 2014-2020 (IDIFEDER/2018/022). A.C. received financial support from Generalitat Valenciana, Spain and Universitat Politècnica de València, Spain through the grants APOSTD/2018/229 and program PAID-10-19, respectively. A.D. received support from Generalitat Valenciana, Spain through grant GJIDI/2018/A/249.Cebrecos, A.; García-Garrigós, JJ.; Descals, A.; Jimenez, N.; Benlloch Baviera, JM.; Camarena Femenia, F. (2021). Beamforming for large-area scan and improved SNR in array-based photoacoustic microscopy. Ultrasonics. 111:1-8. https://doi.org/10.1016/j.ultras.2020.106317S18111Yao, J., & Wang, L. V. (2013). Photoacoustic microscopy. Laser & Photonics Reviews, 7(5), 758-778. doi:10.1002/lpor.201200060Jeon, S., Kim, J., Lee, D., Baik, J. W., & Kim, C. (2019). Review on practical photoacoustic microscopy. 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(2018). The characterization of an economic and portable LED-based photoacoustic imaging system to facilitate molecular imaging. Photoacoustics, 9, 10-20. doi:10.1016/j.pacs.2017.11.001Erfanzadeh, M., & Zhu, Q. (2019). Photoacoustic imaging with low-cost sources; A review. Photoacoustics, 14, 1-11. doi:10.1016/j.pacs.2019.01.004Yao, J., & Wang, L. V. (2014). Sensitivity of photoacoustic microscopy. Photoacoustics, 2(2), 87-101. doi:10.1016/j.pacs.2014.04.002Allen, T. J., Ogunlade, O., Zhang, E., & Beard, P. C. (2018). Large area laser scanning optical resolution photoacoustic microscopy using a fibre optic sensor. Biomedical Optics Express, 9(2), 650. doi:10.1364/boe.9.000650Song, L., Maslov, K., Shung, K. K., & Wang, L. V. (2010). Ultrasound-array-based real-time photoacoustic microscopy of human pulsatile dynamics in vivo. Journal of Biomedical Optics, 15(2), 021303. doi:10.1117/1.3333545Song, L., Maslov, K., & Wang, L. V. (2011). 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Intervención enfermera “círculos de diálogo” para la disminución del nivel de sobrecarga de cuidadores de pacientes crónico complejos y con enfermedad crónica avanzada

Introduction. The increase in life expectancy has led to an aging population and a higher prevalence of chronic diseases. This has generated the need for informal caregivers of the elderly to face caregiving situations. On the other hand, there has been a change in the epidemiological profile of the last 50 years, where there is a decrease in infectious diseases and a higher prevalence of non-communicable diseases of chronic course such as, which increase the demand of caregivers relatives. Caring for a dependent family member can negatively affect the health of the caregiver in their emotional and working life. Objectives. In the first phase, the general objective is to describe the sociodemographic characteristics of the study sample, as specific, to analyze the relationship between the level of caregiver burden and the sociodemographic variables of the main caregivers, to analyze the relationship between the level of caregiver burden and the clinical characteristics of the patient. In a second phase, it is to determine the effectiveness of the dialogue circles nurse intervention, to reduce the level of burden perceived by the main caregivers of patients identified as complex chronic patients and advanced chronic disease. As specific they are, comparing the level of overload perceived by the main caregivers before and after the intervention between the experimental group and the control group and the degree of satisfaction about the intervention nurse dialogue circles. Methodology. Quantitative study in two phases. In the first a descriptive cross-sectional study and in the second an experimental study, a randomized clinical trial with simple masking. The study will be carried out in Catalonia, in the towns of the metropolitan area of Barcelona, belonging to the Baix Llobregat Center Primary Care Service.Introducción. El aumento de la esperanza de vida ha originado el envejecimiento de la población y una mayor prevalencia de enfermedades crónicas. Esto ha generado la necesidad de cuidadores informales de adultos mayores para enfrentar situaciones de cuidado de estos. Por otra parte, se ha evidenciado un cambio en el perfil epidemiológico de los últimos 50 años, donde se observa un descenso de las enfermedades de tipo infeccioso y una mayor prevalencia de enfermedades no trasmisibles de curso crónico, las cuales aumentan la demanda de los cuidadores familiares. El cuidado de un familiar dependiente puede afectar negativamente en la salud del cuidador/a, en su vida afectiva y laboral. Objetivos. Primera fase, el objetivo general es describir las características sociodemográficas de la muestra de estudio, como específicos son: analizar la relación entre nivel de sobrecarga del cuidador y las variables sociodemográficas de los cuidadores principales, analizar la relación entre nivel de sobrecarga del cuidador y las características clínicas del paciente. Segunda fase, determinar la eficacia de la intervención de la enfermera en círculos de diálogo, para reducir el nivel de sobrecarga percibido por los cuidadores principales de pacientes identificados como paciente crónico complejo y enfermedad crónica avanzada. Como específicos son: comparar el nivel de sobrecarga percibido por los cuidadores principales antes y después de la intervención entre el grupo experimental y el grupo control, y grado de satisfacción sobre la intervención enfermera círculos de diálogos. Metodología. Estudio cuantitativo en dos fases. Primera, estudio descriptivo transversal y segunda, un estudio experimental, ensayo clínico aleatorizado con enmascaramiento simple. El estudio se realizará en Cataluña, en las poblaciones del área metropolitana de Barcelona pertenecientes al Servicio de Atención Primaria Baix Llobregat Centre

miRNAs, from Evolutionary Junk to Possible Prognostic Markers and Therapeutic Targets in COVID-19

The COVID-19 pandemic has been a public health issue around the world in the last few years. Currently, there is no specific antiviral treatment to fight the disease. Thus, it is essential to highlight possible prognostic predictors that could identify patients with a high risk of developing complications. Within this framework, miRNA biomolecules play a vital role in the genetic regulation of various genes, principally, those related to the pathophysiology of the disease. Here, we review the interaction of host and viral microRNAs with molecular and cellular elements that could potentiate the main pulmonary, cardiac, renal, circulatory, and neuronal complications in COVID-19 patients. miR-26a, miR-29b, miR-21, miR-372, and miR-2392, among others, have been associated with exacerbation of the inflammatory process, increasing the risk of a cytokine storm. In addition, increased expression of miR-15b, -199a, and -491 are related to the prognosis of the disease, and miR-192 and miR-323a were identified as clinical predictors of mortality in patients admitted to the intensive care unit. Finally, we address miR-29, miR-122, miR-155, and miR-200, among others, as possible therapeutic targets. However, more studies are required to confirm these findings

Results of a Global Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial Evaluating the Efficacy and Safety of Sebelipase Alfa as an Enzyme Replacement Therapy in Children and Adults with Lysosomal Acid Lipase Deficiency

WOS: 00034551700000