Economic Fluctuations, Child Mortality and Policy Considerations in the Least Developed Countries

Between 1990 and 2010 child mortality decreased in general terms in the Least Developed Countries (LDCs), although the differences between countries over time are significant. This paper examines the relationship between short-term economic fluctuations and changes in child mortality in the LDCs during the period 1990-2010. Unlike other studies, we consider a large group of LDCs and provide empirical evidence of the asymmetrical effects of variations in Gross Domestic Product per capita on the evolution of child mortality rate in periods of economic recession and expansion. The significance of said effects diminishes when other relevant socio-economic control variables are considered, and some development policy considerations are addressed in order to achieve the Millennium Development Goal 4 target

Impacto del ciclo económico sobre la evolución de la supervivencia infantil en el mundo en desarrollo. Determinantes de la pobreza infantil en Europa

El presente trabajo se corresponde con dos investigaciones relacionadas con la infancia en situación de riesgo y vulnerabilidad. A) Examinamos la correspondencia entre las fluctuaciones económicas cíclicas y la evolución de la mortalidad infantil en los Países Menos Adelantados (PMA) durante el periodo 1990-2010, poniendo de manifiesto efectos asimétricos de las fluctuaciones económicas sobre la evolución de la mortalidad infantil en periodos de recesión y expansión económica. B) Valoramos en qué medida las diferencias en la tasa de pobreza infantil entre los países europeos pueden explicarse simultáneamente por características de los hogares (perspectiva micro) y por factores específicos de cada país (perspectiva macro), tales como prestaciones económicas en el ámbito de la protección a la infancia o situación socio-laboral general.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Impacto del ciclo económico sobre la evolución de la supervivencia infantil en los países menos adelantados

Entre 1990 y 2010 la mortalidad infantil ha decrecido en los Países Menos Adelantados (PMA) en términos generales, aunque con significativas diferencias entre países y entre periodos. Obviamente, dicha evolución se ha visto afectada por la situación económica de los países. Este trabajo examina la relación a corto plazo entre las fluctuaciones económicas y la evolución de la mortalidad infantil en los PMA durante el periodo 1990-2010. Para ello, realizamos un análisis de varianza discriminando entre periodos con crecimiento y decrecimiento en el Producto Interior Bruto (PIB) per cápita, que complementamos con un análisis de regresión para datos de panel con objeto de comprobar los efectos asimétricos de las variaciones del PIB per cápita sobre las tasas de mortalidad infantil en periodos de recesión y expansión económica. La significatividad de los efectos de los cambios en la coyuntura económica se reduce cuando consideramos variables control como el nivel educativo de las mujeres, la prevalencia del SIDA y la tasa bruta de natalidad.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Measurement properties of the Community Wellbeing Index in older adults

PURPOSE: The international wellbeing index (IWI) consists of two scales, the personal (PWI) and national (NWI) wellbeing indices. The community wellbeing index (CWI) is a new measure of the individual's level of satisfaction with the local place of residence. The main goal of this paper is to validate the CWI in a sample of older adults. METHODS: The IWI was satisfactorily applied to survey the global quality of life of a community sample of 1,106 people aged 60 years and over residing in Spain. The CWI psychometric properties were studied using Rasch analysis. Classic psychometric parameters were also analyzed. RESULTS: Tests of unidimensionality, and exploratory and confirmatory factor analyses, revealed the presence of three subscales: community services, community attachment, and physical and social environment. To achieve adequate model fit of the three subscales to the Rasch model, one item (distribution of wealth) of the initial 11 was removed and item response categories were rescored. The person separation index was 0.82-0.85, indicating a good reliability. All items were free from gender bias. The three subscales displayed satisfactory convergent validity with the PWI and NWI and were able to discriminate between groups with high and low satisfaction with local place of residence. CONCLUSION: The CWI, made up of three subscales, is a valid and reliable measure of subjective wellbeing related to the community as assessed by older adults. Further research with this promising measure should focus on cross-national comparisons.This research was supported by the Spanish Ministry of Science and Innovation (National R&D&I Plan: ref. SEJ2006-15122-C02-00). Prieto-Flores’ position is supported by the Juan de la Cierva program for postdoctoral research, of the Spanish Ministry of Science and Innovation. The Carlos III Institute of Health team is a member of the Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas—CIBERNED). The Spanish Research Group on Quality of Life and Aging is made up as follows: (1) at the Carlos III Institute of Health by M. Joao Forjaz, Pablo Martinez-Martin, Maria-Eugenia Prieto-Flores, Belen Frades-Payo, Carmen Rodriguez-Blazquez and Concepcion Delgado-Sanz; and, (2) at the Spanish National Research Council by Gloria Fernandez-Mayoralas, Fermina Rojo-Perez, Karim Ahmed-Mohamed and Raul Lardies-Bosque

Anti-CD44-Conjugated Olive Oil Liquid Nanocapsules for Targeting Pancreatic Cancer Stem Cells

The latest trends in cancer research and nanomedicine focus on using nanocarriers to target cancer stem cells (CSCs). Specifically, lipid liquid nanocapsules are usually developed as nanocarriers for lipophilic drug delivery. Here, we developed olive oil liquid NCs (O2LNCs) functionalized by covalent coupling of an anti-CD44-fluorescein isothiocyanate antibody ({\alpha}CD44). First, O2LNCs are formed by a core of olive oil surrounded by a shell containing phospholipids, a nonionic surfactant, and deoxycholic acid molecules. Then, O2LNCs were coated with an {\alpha}CD44 antibody ({\alpha}CD44-O2LNC). The optimization of an {\alpha}CD44 coating procedure, a complete physicochemical characterization, as well as clear evidence of their efficacy in vitro and in vivo were demonstrated. Our results indicate the high targeted uptake of these {\alpha}CD44-O2LNCs, and the increased antitumor efficacy (up to four times) of paclitaxel-loaded-{\alpha}CD44-O2LNC compared to free paclitaxel in pancreatic CSCs (PCSCs). Also, {\alpha}CD44-O2LNCs were able to selectively target PCSCs in an orthotopic xenotransplant in vivo model.Comment: 16 pages, 4 figures, 1 tabl

Head-to-Head Comparison of Three Vaccination Strategies Based on DNA and Raw Insect-Derived Recombinant Proteins against Leishmania

Parasitic diseases plague billions of people among the poorest, killing millions annually, and causing additional millions of disability-adjusted life years lost. Leishmaniases affect more than 12 million people, with over 350 million people at risk. There is an urgent need for efficacious and cheap vaccines and treatments against visceral leishmaniasis (VL), its most severe form. Several vaccination strategies have been proposed but to date no head-to-head comparison was undertaken to assess which is the best in a clinical model of the disease. We simultaneously assayed three vaccination strategies against VL in the hamster model, using KMPII, TRYP, LACK, and PAPLE22 vaccine candidate antigens. Four groups of hamsters were immunized using the following approaches: 1) raw extracts of baculovirus-infected Trichoplusia ni larvae expressing individually one of the four recombinant proteins (PROT); 2) naked pVAX1 plasmids carrying the four genes individually (DNA); 3) a heterologous prime-boost (HPB) strategy involving DNA followed by PROT (DNA-PROT); and 4) a Control including empty pVAX1 plasmid followed by raw extract of wild-type baculovirus-infected T. ni larvae. Hamsters were challenged with L. infantum promastigotes and maintained for 20 weeks. While PROT vaccine was not protective, DNA vaccination achieved protection in spleen. Only DNA-PROT vaccination induced significant NO production by macrophages, accompanied by a significant parasitological protection in spleen and blood. Thus, the DNA-PROT strategy elicits strong immune responses and high parasitological protection in the clinical model of VL, better than its corresponding naked DNA or protein versions. Furthermore, we show that naked DNA coupled with raw recombinant proteins produced in insect larvae biofactories -the cheapest way of producing DNA-PROT vaccines-is a practical and cost-effective way for potential "off the shelf" supplying vaccines at very low prices for the protection against leishmaniases, and possibly against other parasitic diseases affecting the poorest of the poor.Spanish GovernmentSpanish Government [AGL2008-00748, AGL2010-16678-GAN]Generalitat de Catalunya [2005 FI 01116]Generalitat de Cataluny

Obstetric outcomes of sars-cov-2 infection in asymptomatic pregnant women

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER)Around two percent of asymptomatic women in labor test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Spain. Families and care providers face childbirth with uncertainty. We determined if SARS-CoV-2 infection at delivery among asymptomatic mothers had different obstetric outcomes compared to negative patients. This was a multicenter prospective study based on universal antenatal screening for SARS-CoV-2 infection. A total of 42 hospitals tested women admitted for delivery using polymerase chain reaction, from March to May 2020. We included positive mothers and a sample of negative mothers asymptomatic throughout the antenatal period, with 6-week postpartum follow-up. Association between SARS-CoV-2 and obstetric outcomes was evaluated by multivariate logistic regression analyses. In total, 174 asymptomatic SARS-CoV-2 positive pregnancies were compared with 430 asymptomatic negative pregnancies. No differences were observed between both groups in key maternal and neonatal outcomes at delivery and follow-up, with the exception of prelabor rupture of membranes at term (adjusted odds ratio 1.88, 95% confidence interval 1.13-3.11; p = 0.015). Asymptomatic SARS-CoV-2 positive mothers have higher odds of prelabor rupture of membranes at term, without an increase in perinatal complications, compared to negative mothers. Pregnant women testing positive for SARS-CoV-2 at admission for delivery should be reassured by their healthcare workers in the absence of symptoms

Human iPSC derived disease model of MERTK-associated retinitis pigmentosa

Retinitis pigmentosa (RP) represents a genetically heterogeneous group of retinal dystrophies affecting mainly the rod photoreceptors and in some instances also the retinal pigment epithelium (RPE) cells of the retina. Clinical symptoms and disease progression leading to moderate to severe loss of vision are well established and despite significant progress in the identification of causative genes, the disease pathology remains unclear. Lack of this understanding has so far hindered development of effective therapies. Here we report successful generation of human induced pluripotent stem cells (iPSC) from skin fibroblasts of a patient harboring a novel Ser331Cysfs*5 mutation in the MERTK gene. The patient was diagnosed with an early onset and severe form of autosomal recessive RP (arRP). Upon differentiation of these iPSC towards RPE, patient-specific RPE cells exhibited defective phagocytosis, a characteristic phenotype of MERTK deficiency observed in human patients and animal models. Thus we have created a faithful cellular model of arRP incorporating the human genetic background which will allow us to investigate in detail the disease mechanism, explore screening of a variety of therapeutic compounds/reagents and design either combined cell and gene- based therapies or independent approaches.This work was supported by Andalusian Health Council (PI-0324-2013), Instituto de Salud Carlos III (PI13/01331), Spanish Ministry of Economy and Competitiveness-FEDER BFU2012-36845, Instituto de Salud Carlos III RETICS RD12/0034/0010 and Academy of Finland (218050; 272808)

Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies: The GETH/GELTAMO Experience

Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM. We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relapse, and GVHD. We included 135 patients, most (85%) receiving RIC. After a median follow-up of 68 months, 5-year EFS and OS were 47 and 50%, respectively. Overall and CR rates were 86 and 80%. The CI of relapse at 1 and 3 years were 7 and 12%. NRM at day 100 and 1 year were 17 and 32%. Previous ASCT and Grade 3-4 aGVHD were associated with a higher NRM. Grade 3-4 aGVHD, donor type (mismatch non-related), and the time-period 2006-2020 were independently related to worse EFS. Patients from 1995-2005 were younger, most from HLA-identical sibling donors, and were pretreated less. Our data confirmed that allo-SCT may be a curative option in R/R MCL with low a CI of relapse, although NRM is still high, being mainly secondary to aGVHD. The arrival of new, highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, far away from the optimal timing of treatment