RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Evaluation of planar silicon pixel sensors with the RD53A readout chip for the Phase-2 Upgrade of the CMS Inner Tracker

The Large Hadron Collider (LHC) at CERN will undergo an upgrade in order to increase its luminosity to $7.5 \times 10^{34}$ cm$^{-2}$s$^{-1}$. The increased luminosity during this High-Luminosity running phase\\ (HL-LHC), starting around 2029, means a higher rate of proton-proton interactions, hence a larger ionizing dose and particle fluence for the detectors. The current tracking system of the CMS experiment will be fully replaced in order to cope with the new operating conditions. Prototype planar pixel sensors for the CMS Inner Tracker with square $50 \mu$m $\times \; 50 \mu$m and rectangular $100 \mu$m $\times \; 25 \mu$m pixels read out by the RD53A chip were characterized in the lab and at the DESY-II testbeam facility in order to identify designs that meet the requirements of CMS at the HL-LHC. A spatial resolution of approximately 3.4$\mu$m (2$\mu$m) is obtained using the modules with $50 \mu$m $\times \; 50 \mu$m ($100 \mu$m $\times \; 25 \mu$m) pixels at the optimal angle of incidence before irradiation. After irradiation to a 1 MeV neutron equivalent fluence of $\Phi_{\rm eq} = 5.3 \times 10^{15}$ cm$^{-2}$, a resolution of 9.4$\mu$m is achieved at a bias voltage of 800 V using a module with $50 \mu$m $\times \; 50 \mu$m pixel size. All modules retain a hit efficiency in excess of 99\% after irradiation to fluences up to $2.1 \times 10^{16}$ cm$^{-2}$. Further studies of the electrical properties of the modules, especially crosstalk, are also presented in this paper.The Large Hadron Collider at CERN will undergo an upgrade inorder to increase its luminosity to7.5 × 10$^{34}$ cm$^{-2}$s$^{-1}$. The increased luminosityduring this High-Luminosity running phase, starting around 2029,means a higher rate of proton-proton interactions, hence a largerionizing dose and particle fluence for the detectors. The currenttracking system of the CMS experiment will be fully replaced inorder to cope with the new operating conditions. Prototype planarpixel sensors for the CMS Inner Tracker with square50 μm × 50 μm and rectangular100 μm × 25 μm pixels read out by theRD53A chip were characterized in the lab and at the DESY-II testbeamfacility in order to identify designs that meet the requirements ofCMS during the High-Luminosity running phase. A spatial resolutionof approximately 3.4 μm (2 μm) is obtained using themodules with 50 μm × 50 μm(100 μm × 25 μm) pixels at the optimalangle of incidence before irradiation. After irradiation to a 1 MeVneutron equivalent fluence ofΦ$_{eq}$ = 5.3 × 10$^{15}$ cm$^{-2}$, a resolution of9.4 μm is achieved at a bias voltage of 800 V using a modulewith 50 μm × 50 μm pixel size. All modulesretain a hit efficiency in excess of 99% after irradiation tofluences up to 2.1 × 10$^{16}$ cm$^{-2}$. Further studies ofthe electrical properties of the modules, especially crosstalk, arealso presented in this paper.The Large Hadron Collider (LHC) at CERN will undergo an upgrade in order to increase its luminosity to $7.5 \times 10^{34}$ cm$^{-2}$s$^{-1}$. The increased luminosity during this High-Luminosity running phase (HL-LHC), starting around 2029, means a higher rate of proton-proton interactions, hence a larger ionizing dose and particle fluence for the detectors. The current tracking system of the CMS experiment will be fully replaced in order to cope with the new operating conditions. Prototype planar pixel sensors for the CMS Inner Tracker with square $50 \mu$m $\times \; 50 \mu$m and rectangular $100 \mu$m $\times \; 25 \mu$m pixels read out by the RD53A chip were characterized in the lab and at the DESY-II testbeam facility in order to identify designs that meet the requirements of CMS at the HL-LHC. A spatial resolution of approximately 3.4$\mu$m (2$\mu$m) is obtained using the modules with $50 \mu$m $\times \; 50 \mu$m ($100 \mu$m $\times \; 25 \mu$m) pixels at the optimal angle of incidence before irradiation. After irradiation to a 1 MeV neutron equivalent fluence of $\Phi_{\rm eq} = 5.3 \times 10^{15}$ cm$^{-2}$, a resolution of 9.4$\mu$m is achieved at a bias voltage of 800 V using a module with $50 \mu$m $\times \; 50 \mu$m pixel size. All modules retain a hit efficiency in excess of 99% after irradiation to fluences up to $2.1 \times 10^{16}$ cm$^{-2}$. Further studies of the electrical properties of the modules, especially crosstalk, are also presented in this paper

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions. © Copyright

Multi-messenger Observations of a Binary Neutron Star Merger

International audienceOn 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of $\sim 1.7\,{\rm{s}}$ with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg(2) at a luminosity distance of ${40}_{-8}^{+8}$ Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 $\,{M}_{\odot }$. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at $\sim 40\,{\rm{Mpc}}$) less than 11 hours after the merger by the One-Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ∼10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position $\sim 9$ and $\sim 16$ days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC 4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta