Cosmic voids in modified gravity scenarios

Modified gravity (MG) theories aim to reproduce the observed acceleration of the Universe by reducing the dark sector while simultaneously recovering General Relativity (GR) within dense environments. Void studies appear to be a suitable scenario to search for imprints of alternative gravity models on cosmological scales. Voids cover an interesting range of density scales where screening mechanisms fade out, which reaches from a density contrast $\delta \approx -1$ close to their centers to $\delta \approx 0$ close to their boundaries. We present an analysis of the level of distinction between GR and two modified gravity theories, the Hu-Sawicki $f(R)$ and the symmetron theory. This study relies on the abundance, linear bias, and density profile of voids detected in n-body cosmological simulations. We define voids as connected regions made up of the union of spheres with a {\it \textup{mean}} density given by $\overline\rho_v=0.2\,\overline\rho_m$, but disconnected from any other voids. We find that the height of void walls is considerably affected by the gravitational theory, such that it increases for stronger gravity modifications. Finally, we show that at the level of dark matter n-body simulations, our constraints allow us to distinguish between GR and MG models with $|f_{R0}| > 10^{-6}$ and $z_{SSB} > 1$. Differences of best-fit values for MG parameters that are derived independently from multiple void probes may indicate an incorrect MG model. This serves as an important consistency check.Comment: 15 pages, 12 figure

The Impact of Kidney Development on the Life Course: A Consensus Document for Action

Hypertension and chronic kidney disease (CKD) have a significant impact on global morbidity and mortality. The Low Birth Weight and Nephron Number Working Group has prepared a consensus document aimed to address the relatively neglected issue for the developmental programming of hypertension and CKD. It emerged from a workshop held on April 2, 2016, including eminent internationally recognized experts in the field of obstetrics, neonatology, and nephrology. Through multidisciplinary engagement, the goal of the workshop was to highlight the association between fetal and childhood development and an increased risk of adult diseases, focusing on hypertension and CKD, and to suggest possible practical solutions for the future. The recommendations for action of the consensus workshop are the results of combined clinical experience, shared research expertise, and a review of the literature. They highlight the need to act early to prevent CKD and other related noncommunicable diseases later in life by reducing low birth weight, small for gestational age, prematurity, and low nephron numbers at birth through coordinated interventions. Meeting the current unmet needs would help to define the most cost-effective strategies and to optimize interventions to limit or interrupt the developmental programming cycle of CKD later in life, especially in the poorest part of the world

A construção do mercado para o café em Alto Paraíso de Goiás.

Este estudo apresenta os principais resultados da análise de como habitantes de Alto Paraíso de Goiás estão buscando alternativas para o desenvolvimento sustentável do município, por meio da implantação, pela Embrapa, de projeto relativo ao resgate do café. A mineração e as atividades agropecuárias foram exercidas na região até os anos 60, quando a atividade principal passou a ser o turismo, a partir da criação do Parque Nacional da Chapada dos Veadeiros e da inauguração de Brasília. Em 2000, o fluxo de turistas decaiu devido a problemas relativos à saúde pública, acarretando estagnação da economia local. Nos últimos anos, produtores familiares despertaram para a existência, ali, de um café que pode ser comercializado em nichos de mercado de grãos especiais: orgânicos e de origem definida, e buscaram, na Embrapa, o desenvolvimento de projeto de pesquisa. O estudo na região revelou que por meio do desvelamento de valores - história, cultura e tradições - é possível estabelecer estratégia mais eficiente de busca de mercado, a partir da experiência revelada no trabalho concreto e na cultura dos produtores. E que o desenvolvimento rural deve ser buscado por meio do desenvolvimento de atividades da nova ruralidade e da aplicação de abordagem territorial de desenvolvimento

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

An artificial intelligence generated automated algorithm to measure total kidney volume in ADPKD

Introduction Accurate tools to inform individual prognosis in patients with autosomal dominant polycystic kidney disease (ADPKD) are lacking. Here, we report an artificial intelligence (AI) generated method for routinely measuring total kidney volume (TKV). Methods An ensemble U-net algorithm was created using the nnUNet approach. The training and internal cross-validation cohort consisted of all 1.5T MRI data acquired using 5 different MRI scanners (454 kidneys, 227 scans) in the CYSTic consortium which was first manually segmented by a single human operator. As an independent validation cohort, we utilised 48 sequential clinical MRI scans with reference results of manual segmentation acquired by 6 individual analysts at a single centre. The tool was then implemented for clinical use and its performance analysed. Results The training / internal validation cohort was younger (mean age 44.0 vs 51.5 years) and the female-male ratio higher (1.2 v 0.94) compared to the clinical validation cohort. The majority of CYSTic patients had PKD1 mutations (79%) and typical disease (Mayo Imaging Class 1, 86%). The median DICE score on the clinical validation dataset between the algorithm and human analysts was 0.96 for left and right kidneys with a median TKV error of -1.8%. The time taken to manually segment kidneys in the CYSTic dataset was 56 (±28) min whereas manual corrections of the algorithm output took 8.5 (±9.2) min per scan. Conclusions Our AI-based algorithm demonstrates performance comparable to manual segmentation. Its rapidity and precision in real-world clinical cases demonstrate its suitability for clinical application

Molecular mechanism of edema formation in nephrotic syndrome: therapeutic implications

Sodium retention and edema are common features of nephrotic syndrome that are classically attributed to hypovolemia and activation of the renin–angiotensin–aldosterone system. However, numbers of clinical and experimental findings argue against this underfill theory. In this review we analyze data from the literature in both nephrotic patients and experimental models of nephrotic syndrome that converge to demonstrate that sodium retention is not related to the renin–angiotensin–aldosterone status and that fluid leakage from capillary to the interstitium does not result from an imbalance of Starling forces, but from changes of the intrinsic properties of the capillary endothelial filtration barrier. We also discuss how most recent findings on the cellular and molecular mechanisms of sodium retention has allowed the development of an efficient treatment of edema in nephrotic patients