Concomitant occurrence of FXTAS and clinically defined sporadic inclusion body myositis: report of two cases.

This report describes unique presentations of inclusion body myositis (IBM) in two unrelated patients, one male and one female, with genetically and histologically confirmed fragile X-associated tremor/ataxia syndrome (FXTAS). We summarize overlapping symptoms between two disorders, clinical course, and histopathological analyses of the two patients with FXTAS and sporadic IBM, clinically defined per diagnostic criteria of the European Neuromuscular Centre. In case 1, a post-mortem analysis of available brain and muscle tissues is also described. Histopathological features (rimmed vacuoles) consistent with clinically defined IBM were detected in both presented cases. Postmortem testing in case 1 revealed the presence of an FMR1 premutation allele of 60 CGG repeats in both brain and skeletal muscle samples. Case 2 was a premutation carrier with 71 CGG repeats who had a son with FXS. Given that FXTAS is associated with immune-mediated disorders among premutation carriers, it is likely that the pathogeneses of IBM and FXTAS are linked. This is, to our knowledge, the first report of these two conditions presenting together, which expands our understanding of clinical symptoms and unusual presentations in patients with FXTAS. Following detection of a premutation allele of the FMR1 gene, FXTAS patients with severe muscle pain should be assessed for IBM

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Inversión pública y su incidencia en la generación de empleo del (PEA) región San Martín, periodo 2014-2019

“Inversión Pública y su incidencia en la Generación de Empleo del (PEA) región San Martín, periodo 2014-2019” El estudio titulado “Inversión Pública y su incidencia en la Generación de Empleo del (PEA) región San Martín, periodo 2014-2019”, tuvo como objetivo principal determinar el nivel de incidencia de la inversión pública en la generación de empleo del PEA en la región San Martín, periodo 2014-2019. Respecto a la metodología fue tipo básica, de nivel descriptivo- correlacional, además el diseño no experimental- longitudinal. Respecto a la muestra estuvo conformado por la inversión pública y la población económicamente activa durante el periodo 2014-2019de la región San Martín; por lo que para la recolección de los datos se empleó el instrumento de guía de análisis documental. Los resultados fueron que, la inversión tuvo un comportamiento variante inició con 73.4% en el 2014 y terminó con 90.8% en el 2019; por otro lado, el índice de empleo ha sido variado, pero tuvo una tendencia a crecer, ya que pasó de 72,4% en el 2014 a 75.6% en el 2019. La conclusión fue que, el Sig. (bilateral) 0,892 es mayor que 0.05, por lo tanto, se acepta la hipótesis nula, es decir, la inversión pública no incide significativamente en la generación de empleo del PEA en la región San Martín, periodo 2014-2019."Public Investment and its impact on Employment Generation in the ( EAP) San Martin region, period 2014-2019". The main objective of the study entitled "Public Investment and its impact on Employment Generation in the (EAP) San Martin region, period 2014-2019", was to determine the level of impact of public investment on employment generation in the EAP in the San Martin region, period 2014-2019. The methodology was basic, descriptive-correlational, and the design was non-experimental-longitudinal. The sample consisted of public investment and the economically active population during the period 2014-2019 in the San Martin region, the documentary analysis guide instrument was used for data collection. The results showed that, investment had a varying behavior started with 73.4% in 2014 and ended with 90.8% in 2019; on the other hand, the employment rate varied, but had a tendency to grow, as it went from 72.4% in 2014 to 75.6% in 2019. The conclusion was that, Sig. (bilateral) 0.892 is greater than 0.05, therefore, the null hypothesis is accepted, i.e., public investment does not significantly affect the generation of employment of the EAP in the San Martin region, period 2014-2019

Suicide prevention efforts in the United States and their effectiveness.

PURPOSE OF REVIEW: Suicide is a serious public health problem in the United States, and suicide rates have been increasing for more than a decade. Rural areas are more impacted than urban areas, reinforcing that social, cultural, and economic factors contribute to risk. This article reviews recent work about these contributors to suicide and how they may inform prevention efforts. RECENT FINDINGS: Current research has shown that suicide is more than a mental health problem with a psychiatric or medical solution. Universal screening and referral by gatekeepers target a large group with a low baseline risk, and there are few treatments proven to reduce death by suicide, as well as a severe shortage of mental health providers in the United States to provide them. Instead, suicide prevention polices can target various other factors that contribute to elevated suicide risk at the population level, including reducing socioeconomic deprivation and access to firearms, both of which are often higher in rural areas. Internet-based interventions also hold promise as they are highly scalable, accessible almost anywhere, and often anonymous. SUMMARY: Understanding factors that increase suicide risk guide development of evidence-based policies targeted at high-risk groups. Population-level interventions should be developed in collaboration with the target audience for cultural appropriateness

Simulación de módulo reconocedor de símbolos mediante técnicas de procesamiento de imágenes para aprendizaje del código color ADD en personas daltónicas

La presente investigación se desarrolló en Lima, Perú durante los meses de Mayo a Setiembre del año 2019, la cual tuvo como propósito alcanzar el mayor porcentaje de reconocimiento de símbolos del código colorADD utilizando el algoritmo de los momentos de Hu, como técnica de procesamiento de imagen, para lograr dicho cometido. El presente estudio se justificó por cuanto posee valor teórico, utilidad práctica y por relevancia social, debido a que generará mayor impacto en personas daltónicas. El referencial teórico se fundamenta en el concepto Rice (1999) en su libro Optical Character Recognition, quien sustenta que la aplicación de distintos métodos de procesamiento de imágenes permitieron el reconocimiento de caracteres ópticos de acuerdo al tipo de condiciones a las cuales se sometieron. Se utilizó como parte de la investigación una muestra de 10 símbolos del código colorADD ideales. Se empleó una red neuronal multicapa perceptrón de 4 capas entrenada con los valores dados por los momentos de Hu aplicada a la muestra para obtener resultados con imágenes reales impresas donde intervinieron factores de ruido. Los resultados evidencian que la simulación efectuada tuvo un 70% de éxito de reconocimiento de símbolos del código colorADD, y a su vez mantuvo su porcentaje de éxito al haberse introducido en una GUIDE. Concluyéndose que el módulo reconocedor de símbolos del código colorADD requiere de aplicar diferentes técnicas de procesamiento de imágenes para mejorar el porcentaje de reconocimiento.Tesi

Protection in sheep against heterologous challenge with serotype Asia-1 foot-and-mouth disease virus using high potency vaccine

Foot-and-mouth disease virus (FMDV) serotype Asia-1 is prevalent in countries considered high risk for incursion into Australia, and has recently been responsible for a number of outbreaks in India, Bangladesh, Pakistan and Turkey. In vitro vaccine matching has shown a number of contemporary FMDV Asia-1 strains vary antigenically to the Asia-1 Shamir vaccine strain, which could result in poor protection with use of this vaccine. Therefore it was important to test the ability of the Asia-1 Shamir vaccine to protect sheep from challenge with a recent, heterologous strain at different days post-vaccination (dpv), including in an emergency vaccination scenario (challenge 4 or 7 dpv). Sheep (5 per group) were challenged with the Asia-1/PAK/19/2014 isolate by intra-nasopharyngeal instillation 21 (V21), 7 (V7) or 4 (V4) dpv with high-potency (>6 PD50) Asia-1 Shamir vaccine. An additional five sheep were mock-vaccinated with adjuvant only (antigen-free preparation) 4 days prior to challenge (A4), and five unvaccinated (UV) control sheep were also challenged. All V21, V7 and V4 sheep were protected from clinical FMD. Eighty percent of V21 sheep and 40% of V7 sheep had sterile immunity, however all V4 sheep became systemically infected. Vaccination reduced excretion of virus in nasal and oral secretions but had no effect on the development of persistent infection. All A4 sheep and UV control sheep developed clinical FMD. The high-potency Asia-1 Shamir vaccine will protect against disease should an outbreak of contemporary Asia-1 viruses occur. Intranasopharyngeal instillation is an effective challenge method for use in vaccine efficacy studies in sheep.</p

Teaching mathematics in seven countries : results from the TIMSS 1999 video study.

The Third International Mathematics and Science Study (TIMSS) 1999 Video Study sampled eighth grade mathematics lessons in seven countries including Australia. As well as describing teaching in these countries the study aimed to : develop objective, observational measures of classroom instruction to serve as appropriate quantitative indicators of teaching practices in each country; compare teaching practices among countries and identify similar or different lesson features across countries; describe patterns of teaching within each country; and develop methods for communicating the results of the study, through written reports and video cases, for both research and professional development purposes. The results in this report are presented from an international perspective

Designing for Transformative Futures

| openaire: EC/H2020/870759/EU//CreaTures Funding Information: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 870759. The content presented in this document represents the views of the authors, and the European Commission has no liability in respect of the content. Publisher Copyright: © 2021 ACM.We discuss three cases of transformative creative practice that aim to address large-scale societal issues related to the climate emergency by taking a series of interconnected, small-scale actions. Drawing on our first-hand perspectives, we reflect on how the cases address such issues by proliferating across different social contexts and supporting creative engagements of diverse stakeholders. We offer this empirical reflection at a time of rapid social and ecological change that has affected all life on the planet. Eco-social challenges and structural inequalities caused by shifts in global economic, political and technological power require new approaches and transformative actions to stabilize and restore ecosystems on which life depends. Our research shows that creative practice in art and design has a critical role to play in these processes of transformation. By discussing the opportunities and challenges encountered by our three cases within their transformative efforts and analyzing how they proliferate across diverse scales, we aim to expand the emerging scholarship on the transformative potential of creative practice.Peer reviewe

Concomitant occurrence of FXTAS and clinically defined sporadic inclusion body myositis: report of two cases

This report describes unique presentations of inclusion body myositis (IBM) in two unrelated patients, one male and one female, with genetically and histologically confirmed fragile X-associated tremor/ataxia syndrome (FXTAS). We summarize overlapping symptoms between two disorders, clinical course, and histopathological analyses of the two patients with FXTAS and sporadic IBM, clinically defined per diagnostic criteria of the European Neuromuscular Centre. In case 1, a post-mortem analysis of available brain and muscle tissues is also described. Histopathological features (rimmed vacuoles) consistent with clinically defined IBM were detected in both presented cases. Postmortem testing in case 1 revealed the presence of an FMR1 premutation allele of 60 CGG repeats in both brain and skeletal muscle samples. Case 2 was a premutation carrier with 71 CGG repeats who had a son with FXS. Given that FXTAS is associated with immune-mediated disorders among premutation carriers, it is likely that the pathogeneses of IBM and FXTAS are linked. This is, to our knowledge, the first report of these two conditions presenting together, which expands our understanding of clinical symptoms and unusual presentations in patients with FXTAS. Following detection of a premutation allele of the FMR1 gene, FXTAS patients with severe muscle pain should be assessed for IBM