Use of water in the Iberoamérican dry lands: hydro-environmental and socioeconomic efficiency indicators

Uso del agua en tierras secas de Iberoamérica: indicadores de eficiencia hidro-ambiental y socio-económica. Las tierras secas comprenden una superficie sustancial de Iberoamérica (25% de América Latina y el Caribe, o más de la mitad del estado español). En este contexto, Brasil posee una porción significativa de los recursos hídricos superficiales y subterráneos. Sin embargo, en su territorio se encuentran áreas semi-áridas, con extrema escasez hídrica, que comprenden 1300 municipios (cerca del 25% del total de municipios del país), distribuidos en 9 estados, en los que viven más de 22,5 millones de habitantes. Estos se encuentran afectados directa o indirectamente por una situación de severa escasez de recursos hídricos agravada por cambios climáticos, consecuencia del calentamiento global. Resulta importante conocer el acervo de tecnologías tradicionales y no tradicionales para captar, almacenar, y utilizar el agua, adaptadas a las diferentes situaciones socio-económicas e hidro-ambientales, así como indicadores del uso eficiente del agua, validados y homologados como herramienta estratégica de gestión en políticas y programas de seguridad hídrica. Este trabajo tiene como objetivo conocer el estado de nuestro conocimiento sobre dichos indicadores y discutir el caso del semi-árido brasileño en el contexto de las tierras secas de Iberoamérica, y del Plan Nacional de Recursos Hídricos del Estado de Bahía.The dry lands cover  expressive  surface  of  Iberoamerican  (25%  of  Latin  American  and  Caribbean  and  more  than  half  of  the  Spanish  territory).  In  this context, Brazil is a country that possesses significant volume of the world superficial and underground water resources. However, more than 1300 municipal districts (about 25% of the total of municipal districts of the country), distributed in 9 states are directly or indirectly affected  by  extreme  shortage  of  water  resources  which  has  been  worsened  by  the  climatic  changes,  as  a  consequence  of  the  global warming.  More  than  22.5  million  inhabitants  live  in  the  semi-arid areas of Brazil. It is important to scrutiny all traditional and not traditional technologies  for  reception,  storage  and  use  of  the  water,  adapted  for  different  socioeconomic  and  hydro-environmental  situations  and approve and validate indicators of water use efficiency, as a management strategic tool for water security politics and programs. This work aimed to understand the state of the art on indicators and to discuss the Brazilian case of the semi-arid in the context of the Iberoamerican dry lands, based on the National Plan of Water Resources and on the State of Bahia Plan for Water Resource Management.Fil: Carneiro, A. P.. Universidad Politécnica de Catalunya; EspañaFil: da Silva, H. P.. Universidade Federal da Bahia; BrasilFil: Abraham, Elena Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Morató, J.. No especifíca;Fil: Subirana, A.. Universidad Politécnica de Catalunya; EspañaFil: Tomasoni, M.. Universidade Federal da Bahia; Brasi

Recommendations for vaccination in patients with multiple sclerosis who are eligible for immunosuppressive therapies: Spanish consensus statement

Esclerosis múltiple; Vacunación; ConsensoEsclerosi múltiple; Vacunació; ConsensMultiple sclerosis; Vaccination; ConsensusAntecedentes La reciente aparición de terapias de alta efectividad para el tratamiento de la esclerosis múltiple (EM), con potencial riesgo de complicaciones infecciosas, obliga plantear estrategias de prevención y minimización de riesgos. La vacunación constituye una parte esencial del manejo de estos pacientes. Este consenso recoge una serie de pautas y escenarios prácticos de vacunación en pacientes adultos con EM candidatos a tratamiento inmunosupresor. Metodología Se llevó a cabo un consenso de tipo formal. Tras definir el alcance del documento, se realizó una búsqueda bibliográfica de vacunación en pacientes con EM, así como guías de vacunación específicas de pacientes inmunosuprimidos y en tratamiento biológico con otras enfermedades. Para la formulación de las recomendaciones se empleó la metodología de Modified Nominal Group Technique. Desarrollo La vacunación en pacientes candidatos a tratamiento inmunosupresor se debe plantear antes de iniciar un tratamiento inmunosupresor siempre que la situación clínica del paciente lo permita. Se recomendarán tanto aquellas indicadas en el calendario vacunal del adulto, como algunas específicas, en función de la inmunidad previa. Si ya está instaurado el tratamiento inmunosupresor las vacunas vivas atenuadas estarán contraindicadas. Para aquellas vacunas que dispongan de un correlato de protección se recomienda monitorizar la respuesta serológica transcurridos de uno a 2 meses de la última dosis.Background The recent development of highly effective treatments for multiple sclerosis (MS) and the potential risk of infectious complications require the development of prevention and risk minimisation strategies. Vaccination is an essential element of the management of these patients. This consensus statement includes a series of recommendations and practical scenarios for the vaccination of adult patients with MS who are eligible for highly effective immunosuppressive treatments. Methodology A formal consensus procedure was followed. Having defined the scope of the statement, we conducted a literature search on recommendations for the vaccination of patients with MS and specific vaccination guidelines for immunosuppressed patients receiving biological therapy for other conditions. The modified nominal group technique methodology was used to formulate the recommendations. Development Vaccination in patients who are candidates for immunosuppressive therapy should be considered before starting immunosuppressive treatment providing the patient's clinical situation allows. Vaccines included in the routine adult vaccination schedule, as well as some specific ones, are recommended depending on the pre-existing immunity status. If immunosuppressive treatment is already established, live attenuated vaccines are contraindicated. For vaccines with a correlate of protection, it is recommended to monitor the serological response in an optimal interval of 1-2 months from the last dose

Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme.

Background In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. Methods and Results The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. Conclusions Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate

B-cell leukemia transdifferentiation to macrophage involves reconfiguration of DNA methylation for long-range regulation

Altres ajuts: We thank CERCA Programme/Generalitat de Catalunya for institutional support. [...] BMJ is a Ramon y Cajal fellow (RYC-2016-19655). This work was supported by the Health Department PERIS-project no. SLT/002/16/00374 and [...]; and CIBERONC CB16/12/00312 and CB16/12/00489; [...]; the Cellex Foundation; and "la Caixa" Bank Foundation (LCF/PR/GN18/51140001). We thank Dr Thomas Graf for providing the transdifferentiation model.Altres ajuts: MEFP/FPU17-0242

Prevalence of Symptomatic and Asymptomatic Peripheral Arterial Disease and the Value of the Ankle-brachial Index to Stratify Cardiovascular Risk

AbstractObjectivesTo determine the prevalence of ankle-brachial index (ABI)<0.9 and symptomatic peripheral arterial disease (PAD), association with cardiovascular risk factors (CVRF), and impact of adding ABI measurement to coronary heart disease (CHD) risk screening.DesignPopulation-based cross-sectional survey of 6262 participants aged 35–79 in Girona, Spain.MethodsStandardized measurements (CVRF, ABI, 10-year CHD risk) and history of intermittent claudication (IC), CHD, and stroke were recorded. ABI<0.9 was considered equivalent to moderate-to-high CHD risk (≥10%).ResultsABI<0.9 prevalence was 4.5%. Only 0.62% presented low ABI and IC. Age, current smoker, cardiovascular disease, and uncontrolled hypertension independently associated with ABI<0.9 in both sexes; IC was also associated in men and diabetes in women. Among participants 35–74 free of cardiovascular disease, 6.1% showed moderate-to-high 10-year CHD risk; adding ABI measurement yielded 8.7%. Conversely, the risk function identified 16.8% of these participants as having 10-year CHD risk>10%. In participants 75–79 free of cardiovascular disease, the prevalence of ABI<0.9 (i.e., CHD risk≥10%) was 11.9%.ConclusionsABI<0.9 is relatively frequent in those 35–79, particularly over 74. However, IC and CHD risk≥10% indicators are often missing. Adding ABI measurement to CHD-risk screening better identifies moderate-to-high cardiovascular risk patients

CNVassoc: Association analysis of CNV data using R

Background: Copy number variants (CNV) are a potentially important component of the genetic contribution to risk of common complex diseases. Analysis of the association between CNVs and disease requires that uncertainty in CNV copy-number calls, which can be substantial, be taken into account; failure to consider this uncertainty can lead to biased results. Therefore, there is a need to develop and use appropriate statistical tools. To address this issue, we have developed CNVassoc, an R package for carrying out association analysis of common copy number variants in population-based studies. This package includes functions for testing for association with different classes of response variables (e.g. class status, censored data, counts) under a series of study designs (case-control, cohort, etc) and inheritance models, adjusting for covariates. The package includes functions for inferring copy number (CNV genotype calling), but can also accept copy number data generated by other algorithms (e.g. CANARY, CGHcall, IMPUTE). Results: Here we present a new R package, CNVassoc, that can deal with different types of CNV arising from different platforms such as MLPA o aCGH. Through a real data example we illustrate that our method is able to incorporate uncertainty in the association process. We also show how our package can also be useful when analyzing imputed data when analyzing imputed SNPs. Through a simulation study we show that CNVassoc outperforms CNVtools in terms of computing time as well as in convergence failure rate. Conclusions: We provide a package that outperforms the existing ones in terms of modelling flexibility, power, convergence rate, ease of covariate adjustment, and requirements for sample size and signal quality. Therefore, we offer CNVassoc as a method for routine use in CNV association studiesThis work has been supported by the Spanish Ministry of Science and Innovation (MTM2008-02457 to JRG, BIO2009-12458 to RD-U and statistical genetics network MTM2010-09526-E (subprograma MTM) to JRG, IS, GL and RD-U). GL is supported by the Juan de la Cierva Program of the Spanish Ministry of Science and Innovation

APP-derived peptides reflect neurodegeneration in frontotemporal dementia

Altres ajuts: The Catalan frontotemporal initiative (CATFI) is funded by the Health Department of the Government of Catalonia (grant PERIS SLT002/16/00408 to Alberto Lleó and Raquel Sánchez-Valle). This work was also supported by research grants from the CIBERNED Program (Program 1, Alzheimer Disease to Alberto Lleó and SIGNAL study, file://www.signalstudy.es), partly funded by Fondo Europeo de Desarrollo Regional (FEDER), Unión Europea, "Una manera de hacer Europa." This work has also been supported by a "Marató TV3" grant (20141210 to Juan Fortea, 044412 to Rafael Blesa, 20143710 to Ricard Rojas-García and 20143810 to Raquel Sánchez-Valle) and Fundación BBVA (grant to A. Lleó) and a grant from the Fundació Bancaria La Caixa to Rafael Blesa. Ignacio Illán-Gala and Sergi Borrego-Écija are supported by the Rio Hortega grant from "Acción estratégica en Salud 2013-2016" and the European Social Fund. Ignacio Illán-Gala is supported by the Global Brain Health Institute (Atlantic Fellow for Equity in Brain Health). We acknowledge all the participants in this study and all the collaborators of the SPIN cohort. We also acknowledge Soraya Torres and Laia Muñoz for technical assistance. We thank EUROIMMUN for providing Aβ1-38 and Aβ1-40 ELISA assays for this study.Objective: We aimed to investigate the relationship between cerebrospinal fluid levels (CSF) of amyloid precursor protein (APP)-derived peptides related to the amyloidogenic pathway, cortical thickness, neuropsychological performance, and cortical gene expression profiles in frontotemporal lobar degeneration (FTLD)-related syndromes, Alzheimer's disease (AD), and healthy controls. Methods: We included 214 participants with CSF available recruited at two centers: 93 with FTLD-related syndromes, 57 patients with AD, and 64 healthy controls. CSF levels of amyloid β (Aβ)1-42, Aβ1-40, Aβ1-38, and soluble β fragment of APP (sAPPβ) were centrally analyzed. We compared CSF levels of APP-derived peptides between groups and, we studied the correlation between CSF biomarkers, cortical thickness, and domain-specific cognitive composites in each group. Then, we explored the relationship between cortical thickness, CSF levels of APP-derived peptides, and regional gene expression profile using a brain-wide regional gene expression data in combination with gene set enrichment analysis. Results: The CSF levels of Aβ1-40, Aβ1-38, and sAPPβ were lower in the FTLD-related syndromes group than in the AD and healthy controls group. CSF levels of all APP-derived peptides showed a positive correlation with cortical thickness and the executive cognitive composite in the FTLD-related syndromes group but not in the healthy control or AD groups. In the cortical regions where we observed a significant association between cortical thickness and CSF levels of APP-derived peptides, we found a reduced expression of genes related to synaptic function. Interpretation: APP-derived peptides in CSF may reflect FTLD-related neurodegeneration. This observation has important implications as Aβ1-42 levels are considered an indirect biomarker of cerebral amyloidosis