Epidemiology of neurocognitive disorders in adults from urban-marginalized areas: a door-to-door population-based study in Puente Piedra, Lima, Peru

BackgroundIn Latin America (LA), the prevalence of dementia is expected to triple to 150 million people by 2050. The 2020 Lancet Commission report identified several modifiable dementia risk factors, yet few social and environmental factors, most relevant to vulnerable regions of LA, were highlighted in this report. We sought to assess the epidemiology of neurocognitive disorders (NCD) in Puente Piedra, one of the most socially and economically vulnerable districts of Lima, the capital of Peru.MethodologyThis was a cross-sectional door-to-door observational study that used two-stage household sampling. One young adult (30–59 years) and one older adult (>60 years) per household were enrolled. We collected demographic, clinical, and neurocognitive data. Addenbrooke’s Cognitive Examination (young adults) and the RUDAS-PE (older adults) were used, classifying participants as cognitively normal, possible mild NCD, or possible major NCD.ResultsWe enrolled 247 participants (median age 46 years; 67% female). One-fourth had not completed secondary school and more than 50% completed only secondary school. Most participants were housewives (46%) and 21% did not have health insurance. The overall prevalence of possible NCD was 30% (25.6 and 41.8% among younger adults and older adults, respectively). Among younger adults, those ages 55–59 years more frequently had NCD (70%) compared to younger age ranges. Among older adults, only 3 subjects (4.5%) had major NCD.ConclusionWe found a high frequency of possible NCDs in a socially and economically vulnerable community in Lima, Peru, with younger adults showing levels of NCD higher than expected. Our findings support the need for health systems to incorporate cognitive screenings programs for NCD in younger ages. Future research on NCD would include younger populations, particularly in vulnerable communities

Characterization and schematic modeling of a family system of bovine milk producers in Ciénega de Chapala, Mexico

Systems theory states that livestock production is dependent on the environment and goals and objectives of the system itself. Therefore, family systems of bovine milk producers (FSBMP) are considered as parallel systems: those in which there is a symbiosis between man and animals and relationships are only affected by environmental factors. The aim of this research was the characterization and schematic modeling of a FSBMP in the region of Ciénega de Chapala, Mexico. For characterization of FSBMP we used general theory of systems methodology and for modeling, a black box approach to integrate criteria such as: (a) internal consistency of the system, (b) interdependence of the system’s components. As a part of characterization, the type of producers was established and milk production was determined by simple random sampling (50% of the herd), milk being weighed at 7-d intervals during 180 d. Data were analyzed using mixed models with repeated measurements methodology. The inefficiency of the FSBMP analyzed (3 416 kg of milk per 305-d of lactation) was attributed to limited formal education of the producer (basic level), which was associated with inefficiencies in administration and in assimilation of technological packages. Milk production presented an abnormal lactation curve and was not affected by the time of year (P > 0.05). In conclusion, efficient functioning of the FSBMP was limited more by knowledge of the producer about the animal component than by the environment in which the system operates

Perspectivas conceptuales para el estudio de los movimientos sociales y la participación con enfoque de género en Cusco y Puno

Este documento denominado `Perspectivas conceptuales para el estudio de los movimientos sociales y la participación con enfoque de género en Cusco y Puno¿, ha sido fruto de las reflexiones originadas en las sucesivas reuniones de trabajo por el equipo encargado de elaborar el marco analítico que será utilizado a lo largo de la investigación. El dossier presenta el marco analítico del PROYECTO: Movimientos Sociales, Participación y Género: Investigación Participante en Cusco y Puno, financiado por la Agencia Andaluza de Cooperación Internacional al Desarrollo. Esta investigación, de carácter internacional, es desarrollada por investigadores de alto nivel de las universidades de: Departamento de Trabajo Social y Servicios Sociales, Universidad Pablo de Olavide (Sevilla, España); Maestría en Trabajo Social, Universidad Nacional del Altiplano (Puno, Perú); Departamento de Trabajo Social y Servicios Sociales, Universidad de Murcia (Murcia, España); Laboratorio de Movimientos Sociales y Condiciones de Vida, Universidad Nacional de La Plata (La Plata, Argentina); Facultad de Trabajo Social, Universidad Nacional de Córdoba (Córdoba, Argentina);Departamento de Ciencias Sociales, Universidad Nacional de San Luis (San Luis, Argentina); Departamento de Trabajo Social, Universidad de Colima (Colima, México). En este sentido, estamos desarrollando una línea de investigación específica sobre temas de: género, movimientos sociales y participación conjuntamente con el personal y estudiantes de la Maestría en Trabajo Social de la Universidad Nacional del Altiplano, para lo cual se están impartiendo seminarios de formación y acciones que permiten la promoción de habilidades y competencia en materia de investigación. Así mismo tiene entre sus ejes rectores el de sensibilizar a los agentes andaluces de cooperación respecto a la participación de la mujer en los movimientos sociales de Perú desde una perspectiva de género. El proyecto tiene una clara apuesta por el paradigma de cooperación SUR-SUR participan investigadores de universidades de Latinoamérica con los que se viene desarrollando una trayectoria de trabajo y cooperación en temas relacionados con los movimientos sociales. Las sucesivas fases del proyecto se desarrollarán en Puno (formación de investigadores novel, relevamiento de datos, transferencia de conocimientos y resultados al conjunto de la sociedad civil); y en Cusco (relevamiento de datos y formación sociedad civil). La coordinación del proyecto es en la UPO (Universidad Pablo de Olavide) donde se seguirá minuciosamente la ejecución del proyecto; es también en esta localización donde se desarrollarán el análisis de la información recogida, la elaboración de informes parciales y final, y fundamentalmente, la transferencia y formación a agentes de cooperación del sistema andaluz. Para ello, se planificarán jornadas de trabajo con representantes de instituciones andaluzas (ONGs y Universidades) a los que se les transferirán resultados y los hallazgos de la investigación. La lógica que nutre el trabajo es la Investigación Participante lo que permitirá no sólo la producción de conocimiento sino también el trabajo directo con las mujeres participantes de la investigación (en un proceso colectivo que supone conocer y transformar) siguiendo con la tradición de la IP que tiene entre sus objetivos la triple función de: educación, investigación y transferencia. En tal sentido enfatizamos la propuesta de creación de un espacio donde se articulan académicos e investigadores con los sujetos de las comunidades.Departamento de Trabajo Social y Servicios SocialesPreprin

Performance of a Quantitative PCR-Based Assay and Beta-d-Glucan Detection for Diagnosis of Invasive Candidiasis in Very-Low-Birth-Weight Preterm Neonatal Patients (CANDINEO Study)

An epidemiological, multicenter, noninterventional, observational case-control study was conducted to describe the performance of serum beta-d-glucan (BDG) and Candida PCR in blood, serum, and sterile samples for the diagnosis of invasive candidiasis (IC) in very-low-birth-weight (VLBW) preterm neonates and to compare these techniques with culture of samples from blood and other sterile sites. Seventeen centers participated in the study, and the number of episodes analyzed was 159. A total of 9 episodes of IC from 9 patients (7 confirmed and 2 probable) and 150 episodes of suspected sepsis from 117 controls were identified. The prevalence of IC was 5.7% (95% confidence interval [95% CI], 2.1 to 9.3). The mortality was significantly higher in episodes of IC (44.4%) than in the non-IC episodes (11.1%, P < 0.01). The sensitivity and specificity of the PCR performed on blood/serum samples were 87.5% and 81.6%, respectively. The sensitivity and specificity of the BDG results were lower (75.0% and 64.6%). For cases with negative culture results, the PCR and the BDG results were positive in 27 (17.4%) and 52 (33.5%) episodes, respectively. The presence of multiorgan failure, improvement with empirical antifungal therapy, thrombocytopenia, and Candida colonization were significantly associated (P < 0.01) with PCR or BDG positivity regardless of the results of the cultures. Serum BDG analysis and Candida PCR could be used as complementary diagnostic techniques to detect IC in VLBW neonates.This study was initiated and financially supported by Astellas Pharma Inc. Manuel Cuenca-Estrella has received grant support from Astellas Pharma Inc., bioMérieux, Basilea, Gilead Sciences, Merck Sharp & Dohme, Pfizer, Schering Plough, Soria Melguizo SA, Ferrer International, the European Union, the ALBAN program, the Spanish Agency for International Cooperation, the Spanish Ministry of Culture and Education, the Spanish Health Research Fund, Instituto de Salud Carlos III (Spanish Ministry of Economy and Competitiveness), the Ramon Areces Foundation, and the Mutua Madrileña Foundation. Jose T. Ramos has received fees for conferences from Gilead Sciences, ViiV Healthcare, and Janssen-Cilag and grant support from the Gilead Fellowship Program. Elena Bergon-Sendin received grant support from Astellas Pharma Inc. during the conduct of the study. Paloma Anguita Alonso is an employee of Astellas Pharma Inc. The rest of us have no conflicts to report. Medical writing support was provided by Lucy Kanan on behalf of Bioscript Medical Ltd., funded by Astellas Pharma IncS

Fiber Optic Sensing System for Temperature and Gas Monitoring in Coal Waste Pile Combustion Environments

International audienceIt is presented an optical fiber sensing system projected to operate in the demanding conditions associated with coal waste piles in combustion. Distributed temperature measurement and spot gas sensing are requirements for such a system. A field prototype has been installed and is continuously gathering data, which will input a geological model of the coal waste piles in combustion aiming to understand their dynamics and evolution. Results are presented on distributed temperature and ammonia measurement, being noticed any significant methane emission in the short time period considered. Carbon dioxide is also a targeted gas for measurement, with validated results available soon. The assessment of this technology as an effective and reliable tool to address the problem of monitoring coal waste piles in combustion opens the possibility of its widespread application in view of the worldwide presence of coal related fires

A novel deep targeted sequencing method for minimal residual disease monitoring in acute myeloid leukemia

A high proportion of patients with acute myeloid leukemia who achieve minimal residual disease negative status ultimately relapse because a fraction of pathological clones remains undetected by standard methods. We designed and validated a high-throughput sequencing method for minimal residual disease assessment of cell clonotypes with mutations of NPM1, IDH1/2 and/or FLT3-single nucleotide variants. For clinical validation, 106 follow-up samples from 63 patients in complete remission were studied by sequencing, evaluating the level of mutations detected at diagnosis. The predictive value of minimal residual disease status by sequencing, multiparameter flow cytometry, or quantitative polymerase chain reaction analysis was determined by survival analysis. The sequencing method achieved a sensitivity of 10-4 for single nucleotide variants and 10-5 for insertions/deletions and could be used in acute myeloid leukemia patients who carry any mutation (86% in our diagnostic data set). Sequencing-determined minimal residual disease positive status was associated with lower disease-free survival (hazard ratio 3.4, P=0.005) and lower overall survival (hazard ratio 4.2, P<0.001). Multivariate analysis showed that minimal residual disease positive status determined by sequencing was an independent factor associated with risk of death (hazard ratio 4.54, P=0.005) and the only independent factor conferring risk of relapse (hazard ratio 3.76, P=0.012). This sequencing-based method simplifies and standardizes minimal residual disease evaluation, with high applicability in acute myeloid leukemia. It is also an improvement upon flow cytometry- and quantitative polymerase chain reaction-based prediction of outcomes of patients with acute myeloid leukemia and could be incorporated in clinical settings and clinical trials.This study was supported by the Subdirección General de Investigación Sanitaria (Instituto de Salud Carlos III, Spain) grants PI13/02387 and PI16/01530, and the CRIS against Cancer foundation grant 2014/0120. ML holds a postdoctoral fellowship of the Spanish Ministry of Economy and Competitiveness (FPDI-2013- 16409). PRP holds a postdoctoral fellowship of the Spanish Instituto de Salud Carlos III: Contrato Predoctoral de Formación en Investigación en Salud i-PFIS (IFI 14/00008).S

Novel deep targeted sequencing method for minimal residual disease monitoring in acute myeloid leukemia

A high proportion of patients with acute myeloid leukemia who achieve minimal residual disease (MRD) negative status ultimately relapse because a fraction of pathological clones remains undetected by standard methods. We designed and validated a high-throughput sequencing method for MRD assessment of cell clonotypes with mutations of NPM1, IDH1/2 and/or FLT3-SNVs. For clinical validation, 106 follow-up samples from 63 patients in complete remission were studied by NGS, evaluating the level of mutations detected at diagnosis. The predictive value of MRD status by NGS, multiparameter flow cytometry, or quantitative PCR was determined by survival analysis. The method achieved a sensitivity of 10-4 for SNV mutations and 10-5 for insertions/deletions and could be used in acute myeloid leukemia patients who carry any mutation (86% in our diagnosis data set). NGS-determined MRD positive status was associated with lower disease-free survival (hazard ratio [HR] 3.4, p=0.005) and lower overall survival (HR 4.2, p<0.001). Multivariate analysis showed that MRD positive status by NGS was an independent factor associated with risk of death (HR 4.54, p =0.005) and the only independent factor conferring risk of relapse (HR 3.76, p =0.012). This NGS based method simplifies and standardizes MRD evaluation, with high applicability in acute myeloid leukemia. It also improves upon flow cytometry and quantitative PCR to predict acute myeloid leukemia outcome and could be incorporated in clinical settings and clinical trials.This study was supported by the Subdirección General de Investigación Sanitaria (Instituto de Salud Carlos III, Spain) grants PI13/02387 and PI16/01530, and the CRIS against Cancer foundation grant 2014/0120. M.L. holds a postdoctoral fellowship of the Spanish Ministry of Economy and Competitiveness (FPDI-2013-16409). P.R.P. holds a postdoctoral fellowship of the Spanish of Instituto de Salud Carlos III: Contrato Predoctoral de Formación en Investigación en Salud i-PFIS (IFI 14/00008).S

The Quest for Dual and Binary Supermassive Black Holes: A Multi-Messenger View

The quest for binary and dual supermassive black holes (SMBHs) at the dawn of the multi-messenger era is compelling. Detecting dual active galactic nuclei (AGN) – active SMBHs at projected separations larger than several parsecs – and binary AGN – probing the scale where SMBHs are bound in a Keplerian binary – is an observational challenge. The study of AGN pairs (either dual or binary) also represents an overarching theoretical problem in cosmology and astrophysics. The AGN triggering calls for detailed knowledge of the hydrodynamical conditions of gas in the imminent surroundings of the SMBHs and, at the same time, their duality calls for detailed knowledge on how galaxies assemble through major and minor mergers and grow fed by matter along the filaments of the cosmic web. This review describes the techniques used across the electromagnetic spectrum to detect dual and binary AGN candidates and proposes new avenues for their search. The current observational status is compared with the state-of-the-art numerical simulations and models for formation of dual and binary AGN. Binary SMBHs are among the loudest sources of gravitational waves (GWs) in the Universe. The search for a background of GWs at nHz frequencies from inspiralling SMBHs at low redshifts, and the direct detection of signals from their coalescence by the Laser Interferometer Space Antenna in the next decade, make this a theme of major interest for multi-messenger astrophysics. This review discusses the future facilities and observational strategies that are likely to significantly advance this fascinating field