DETERMINACIÓN DEL FUNCIONAMIENTO HIDRÁULICO DE LOS SISTEMAS DE CAMPOS ELEVADOS DE LA CULTURA MUISCA EN LAS LLANURAS INUNDABLES DE LA SABANA DE BOGOTÁ

Este proyecto busca dar inicio a la recuperación los sistemas de campos elevados,  a través de un enfoque metodológico llamado “Arqueología Tecnológica” cuyo fin es encontrar soluciones a las problemáticas ambientales actuales mediante el uso de las tecnologías ancestrales, con esta finalidad, se tomaron como base los resultados de las investigaciones realizadas por la arqueóloga Ana María Boada (2006) en la Sabana de Bogotá y se realizó una reconstrucción artificial de los canales que componen los sistemas de campos elevados Muiscas a partir de un modelo paramétrico para la comparación de sus variables de flujo,  considerando su comportamiento como el de un canal abierto  sus características hidráulicas y posibles usos

Suppression of Age-Related Salivary Gland Autoimmunity by Glycosylation-Dependent galectin-1-driven Immune Inhibitory Circuits

Aging elicits quantitative and qualitative changes in different immune components, leading to disruption of tolerogenic circuits and development of autoimmune disorders. Galectin-1 (Gal1), an endogenous glycan-binding protein, has emerged as a regulator of immune cell homeostasis by shaping the fate of myeloid and lymphoid cells. Here, we demonstrate that aged Gal1-null mutant (Lgals1−/−) mice develop a spontaneous inflammatory process in salivary glands that resembles Sjögren's syndrome. This spontaneous autoimmune phenotype was recapitulated in mice lacking β1,6N-acetylglucosaminyltransferase V (Mgat5), an enzyme responsible for generating β1,6-branched complex N-glycans, which serve as a major ligand for this lectin. Lack of Gal1 resulted in CD11c+ dendritic cells (DCs) with higher immunogenic potential, lower frequency of Foxp3+ regulatory T cells (Tregs), and increased number of CD8+ T cells with greater effector capacity. Supporting its tolerogenic activity, Gal1 expression decreased with age in autoimmunity-prone nonobese diabetic (NOD) mice. Treatment with recombinant Gal1 restored tolerogenic mechanisms and reduced salivary gland inflammation. Accordingly, labial biopsies from primary Sjögren's syndrome patients showed reduced Gal1 expression concomitant with higher number of infiltrating CD8+ T cells. Thus, endogenous Gal1 serves as a homeostatic rheostat that safeguards immune tolerance and prevents age-dependent development of spontaneous autoimmunity.Fil: Martínez Allo, Verónica Candela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Hauk, Vanesa Cintia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Sarbia, Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Pinto, Nicolás Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Croci Russo, Diego Omar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Dalotto Moreno, Tomás. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Morales, Rosa M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Gatto, Sabrina Gisela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Manselle Cocco, Montana Nicolle. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Stupirski, Juan Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Deladoey, Ángel. Hospital Bernardino Rivadavia; ArgentinaFil: Maronna, Esteban. Sanatorio Mater Dei; ArgentinaFil: Marcaida, Priscila. Hospital Bernardino Rivadavia; ArgentinaFil: Durigan, Virginia. Hospital Bernardino Rivadavia; ArgentinaFil: Secco, Anastasia. Hospital Bernardino Rivadavia; ArgentinaFil: Mamani, Marta. Hospital Bernardino Rivadavia; ArgentinaFil: Santos, Alicia Dos. Hospital Bernardino Rivadavia; ArgentinaFil: Pellet, Antonio Catalán. Hospital Bernardino Rivadavia; ArgentinaFil: Leiros, Claudia Pérez. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Rabinovich, Gabriel Adrián. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Toscano, Marta Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentin

Semilleros de Investigación 2017

Con esta publicación de los resultados de investigación elaborados por semilleros compuestos por estudiantes de pregrado, pertenecientes a sus dos unidades académicas, la Facultad de Derecho, Ciencias Políticas y Sociales de la Universidad Nacional de Colombia celebra los veinte años de una política académica que ha permitido, dentro de sus programas curriculares básicos, la integración entre la docencia y la investigación, y favorecido la interrelación con la sociedad colombiana. Los semilleros de investigación han constituido una actividad multiforme que aparte de ofrecerle a los y las estudiantes de los programas académicos de Derecho y Ciencia Política la posibilidad de empezar a transitar por el camino de la investigación académica les permite diseñar e implementar programas propios de autoformación en áreas específicas del conocimiento, orientados por docentes de planta u ocasionales y por docentes de posgrado. Asimismo, ha permitido la incorporación de dichos estudiantes a los grupos de investigación, la sistematización de procesos de reflexión iniciados en una o varias asignaturas o la participación en proyectos que buscan responder a los problemas políticos y sociales que afectan a la sociedad colombiana, latinoamericana y, en ocasiones, a las de otros continentes o que tienen una dimensión global. Por tal razón, constituyen escenarios alternos e informales de docencia y extensión. Investigaciones en Construcción incluye los artículos escritos por las y los participantes de nueve semilleros. Cuatro de ellos del Departamento de Derecho, conformados por once estudiantes, y cinco del Departamento de Ciencia Política, conformados por veintiún estudiantes. Aunque la mayor parte de las investigaciones tienen una orientación interdisciplinaria, llama la atención que en ninguno de los semilleros se haya logrado la articulación entre alumnos de Derecho y Ciencia Política. La sinergia entre estos dos campos del conocimiento, como un criterio para las convocatorias de los próximos años, podría ser un mecanismo de integración académica destinado a evitar la hiperespecialización que tiende a fragmentar e individualizar las investigaciones universitarias y a trivializar las reformas curriculares que buscan desarrollar capacidades intelectuales complejas. Los temas escogidos por los semilleros ilustran los intereses de las nuevas generaciones de estudiantes. El análisis crítico de la jurisprudencia constitucional y de la dogmática jurídica, en temas relacionados con la teoría de la sustitución (pp. 17-45) o con las Zonas de Interés de Desarrollo Rural, Económico y Social (Zidres) (pp. 47-79) demuestran la pretensión de realizar investigaciones que, sin abandonar la especificidad de lo jurídico, estén guiadas por preguntas sobre los efectos y las casusas sociales y políticas de las normas positivas y los fallos judiciales. En estos artículos resulta clara la preocupación por encontrar metodologías que permitan responder a los interrogantes generados en el campo del derecho y, simultáneamente, orientar las investigaciones hacia análisis social, más allá de las dicotomías artificiales entre lo técnico-jurídico y lo sociojurídico. Al mismo tiempo, la perspectiva intercultural invita a superar el eurocentrismo jurídico y político, predominante en la academia colombiana. La dualidad entre la norma social y la jurídica, resaltada en el artículo sobre el pueblo indígena murui muina (pp. 81- 116), refleja la inexistencia en la sociedad colombiana de purismos culturales, más allá de los reivindicados por ciertos sectores indigenistas que ven en ellos una estrategia política para proteger a las comunidades amenazadas desde las posiciones culturales hegemónicas o por corrientes que, dentro de ópticas racistas, pretenden imponer la cultura occidental como arquetipo de la civilización. Algo similar, en términos del descentramiento cultural, sucede en el estudio decolonial que, desde la participación de la comunidad campesina en el debate sobre las delimitaciones del páramo de Sumapaz, dialoga con la filosofía rawlsiana, para encontrarle alternativas deliberativas al régimen político colombiano (pp. 117-146). El carácter pluriétnico y pluricultural consagrado en la Constitución Política colombiana exige, de acuerdo con estos textos, la superación de un multiculturalismo que se fundamenta en el reconocimiento de la diversidad, sin propugnar por la igualdad dentro de la diferencia. Dentro del campo de la cultura política, otro de los semilleros analiza, desde la teoría de las redes sociales, las representaciones de los actores estatales y no gubernamentales sobre la seguridad y defensa de líderes sociales y defensores de derechos humanos en Colombia (pp. 147-176). Su trabajo evidencia cómo la desarticulación gubernamental en este campo dificulta la construcción de una política pública coherente, para responder al asesinato de líderes y lideresas, y a la denuncia de las organizaciones populares y de derechos humanos, orientada a solucionar una de las principales fallas de la democracia colombiana, la relacionada con la más elemental protección de la vida de quienes dirigen o conforman las organizaciones populares y la protesta que estas promueven. Desde otra perspectiva, la relacionada con el análisis crítico del discurso en los medios de comunicación digital, específicamente en El Tiempo y El Espectador, otro grupo de estudiantes analiza las ambigüedades de ambos periódicos frente a la Jurisdicción Especial para la Paz (jep) (pp. 177-205), la cual, según el artículo, lleva a enfatizar en el manejo de las noticias, los temas relativos a la justicia punitiva y a los beneficios y garantías a los victimarios, sobre los referentes a la reparación de las víctimas, como parte de la reconstrucción del tejido social, y al tránsito de los excombatientes a la vida civil. El único texto teórico de la publicación trabaja la recepción de la teoría política de Gramsci en América Latina, y su retroalimentación, alrededor de tres ejes analíticos: 1) los procesos de constitución de los sujetos políticos; 2) la relación entre “estructura y super-estructura”, y 3) el economicismo en el análisis de los procesos revolucionarios (pp. 207-226). La lectura crítica que hace el semillero, sin caer en anacronismos, y el análisis de las interpretaciones latinoamericanas de la obra gramsciana, demuestra la fertilidad de las investigaciones que permitan entender no solo la recepción de teorías producidas en otros contextos culturales, sino también la posibilidad de enriquecerlas y transformarlas mediante la mutación de sus conceptos y de su articulación sistemática, de acuerdo con ámbitos espaciales y temporales diferentes a los de las sociedades y las relaciones sociales en los que tuvieron origen. La corriente denominada poscolonial no puede limitarse a la afirmación de la otredad frente a las formas de pensamiento dominantes, sin importar el espectro político, sino que debe deconstruirlas críticamente para comprender, en medio de diálogos interculturales, sus potencialidades o limitaciones. La clausura cultural en tono a una identidad cerrada y reactiva sea esta teórica, analítica, académica o meramente subjetiva, es una herencia negativa de la experiencia colonial. Finalmente, como corolario de un eje que resulta transversal a todas las investigaciones, la alteridad social y política frente a los actores o sujetos hegemónicos en la vida política y social colombiana, adquiere relevancia en los artículos sobre la concepción de la democracia en las farc (pp. 227-249) y sobre la participación y representación de las mujeres en la rama legislativa colombiana entre 2010 y 2018 (pp. 251-297). En ambos casos, se intenta hacer visibles elementos de una organización insurgente o de la lucha de las mujeres por la igualdad en la diferencia, que tienden a quedar en la penumbra del conocimiento académico colombiano. Más allá de los esquemas interpretativos sobre las clases sociales y las diferencias de género o sexo, los artículos intentan ilustrar el ideario democrático de una de las principales organizaciones insurgentes de la historia colombiana o la importancia, en lo atinente a las luchas de las mujeres por el reconocimiento y la equidad, del ejercicio de la representación política institucional en el poder legislativo colombiano. Dentro de la universidad colombiana, en términos generales, solo los docentes tienen la oportunidad de apreciar la riqueza de los análisis de los dicentes, aunque con frecuencia, en medio de las limitaciones que tienen los trabajos dentro de las asignaturas ofrecidas en el currículo formal. Por el contrario, publicaciones como Investigaciones en Construcción les permite a los lectores interesados en el derecho y la ciencia política conocer la riqueza analítica e interpretativa de los estudiantes de una institución pública como la Universidad Nacional de Colombia. Como resulta obvio dentro de un proceso de formación, junto a las fortalezas académicas y heurísticas de los textos, y las investigaciones que los soportan, hay debilidades en lo atinente a la relación entre los métodos y los marcos teóricos, las generalizaciones no sustentadas, el enriquecimiento argumentativo de prejuicios previos o la ausencia de estados de arte sistemáticos sobre los temas tratados. Sin embargo, estos problemas, que incluso se presentan en los documentos de investigadores con un largo recorrido académico, no socavan la vitalidad y creatividad del trabajo de los estudiantes de la Facultad de Derecho, Ciencias Políticas y Sociales, que, posteriormente van a cualificar la vida académica, social y política del país

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

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.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements