Acceso de los hogares a los principales servicios públicos y sociales y percepciones de calidad sobre estos servicios

Se presentan los principales resultados de la Encuesta de Calidad de Vida de 2003 sobre los servicios públicos domiciliarios y los servicios sociales en Colombia. El análisis se hace comparativo con el año 1993 y 1997 tanto a nivel geográfico como a nivel socioeconómico. Se encuentra que a pesar del decremento en el ingreso que sufrieron los hogares la calidad de estos no ha decrecido. El acceso a los servicios domiciliarios ha mejorado con algunas brechas entre regiones. En educación han disminuido las tasas de analfabetismo junto con incrementos en la cobertura de la educación primaria y secundaria sobre todo en los ingresos bajos y medios. En materia de salud, el regimen subsidiado se convierte en un importante mecanismo anticíclico.Encuenta de Calidad de Vida, Servicios Sociales, Servicios Públicos domiciliarios

High pressure metamorphic conditions in garnet amphibolite from a collisional shear zone related to the Tapo ultramafic body, Eastern Cordillera of Central Peru

A discontinuos belt of elongated ultramafic rock bodies (mostly serpentinites) occurs in the Eastern Cordillera of the central Peruvian Andes. One of the main occurrences is the Tapo Massif, a lense-shaped serpentinite body, ~2 km x 5 km, comprising small podiform chromitite deposits (Castroviejo et al., 2009) and bands or lenses of garnet-amphibolite, both strongly sheared and thrust upon the upper Paleozoic sediments of the Ambo Group (Fig. 1). Metabasite geochemistry suggests a mid-ocean ridge or an ocean island protolith. The whole sequence can be interpreted as a disrupted ophiolitic complex (Castroviejo et al., 2010). The geological setting of the Tapo occurrence is described by J.F. Rodrigues et al. (2010). To get information about its geotectonic setting we applied new geothermobarometric techniques to the garnet amphibolite. Finding representative samples with an adequate mineralogy to apply these techniques is in this case a difficult task. A common problem is the almost ubiquitous overprinting by serpentinisation or retrograde metamorphism and, locally, by metasomatism or alteration enhanced by deformation, producing a variety of rock types, as rodingites, birbirites and listvaenites. Nevertheless, careful sampling followed by petrographic examination of the rocks allowed to identify some samples in which useful assemblages are present

Modelización espacial de trips (insecta: thysanoptera) en el cultivo de aguacate (persea americana)

SE LOGRÓ ESTABLECER MEDIANTE MODELIZACIÓN ESPACIAL LA DISTRIBUCIÓN DE LAS POBLACIONES DE TRIPS EN AGUACATE EN EL ESTADO DE MÉXICO.México es el principal productor y exportador de aguacate en el mundo. Los trips son considerados una de las principales plagas de este cultivo, ya que se alimentan del fruto pequeño y forman crestas o protuberancias, las cuales al crecer el fruto son más visibles, y este pierde valor económico. Además de este daño, las heridas causadas por los trips son el principal causante para que entre la enfermedad denominada roña de fruto. Las alternativas de control de los trips han carecido de eficacia debido, entre otras causas, a que se desconoce su distribución espacial dentro de las huertas de aguacate. Este trabajo tuvo por objetivo determinar la distribución espacial de las poblaciones de trips en aguacate mediante el uso de técnicas de estadística espacial que condujeron a la generación de mapas por medio del “krigeado”. Los resultados demostraron que las poblaciones de trips presentan una distribución de tipo agregada, que fue corroborada por los mapas de densidad. Las infestaciones se distribuyeron en el 100 % de la superficie de las dos parcelas experimentales, lo cual resulta interesante para dirigir las medidas de control sobre áreas específicas de infestación. Se logró determinar estabilidad espacial y temporal a corto plazo de las poblaciones de trips

Spatial simulation op Claviceps gigantea (fuentes, of the isla, ullstrup and rodríguez) in the STATE OF MEXICO

SE LOGRO DETERMINAR LA DISTRIBUCIÓN ESPACIAL EN EL TIEMPO DE claviceps gigantea EN MAÍZ MEDIANTE SIMULACIÓN ESPACIAL EN EL ESTADO DE MÉXICO.The cultivation of corn in Mexico is one of the most important highlighting the High Valleys of Mexico, in this region the main problem of cultivation are diseases, mainly those that cause ear rot which decreases yield and represents large economic losses. One of these diseases is caused by the fungus Claviceps gigantea which is commonly known as horsetooth. This disease can invade the whole cob, preventing the formation of grain. In recent years, climatic conditions have favored the proliferation of this fungus in farms cultivated with corn Zea mays L. The present work was carried out in plots of one hectare of five municipalities of the State of Mexico, with the natural incidence of the fungus during three growing cycles (2013-2015) using geostatistical techniques and performing the conditioned and unconditioned simulation process to predict the spatial behavior of the disease over time. The results show that the simulation techniques used to predict the behavior of Claviceps gigantea are an effective tool to prevent the infestations produced by this fungus. This type of study aims to help the development of integrated management programs

Modelización espacial de frankliniella occidentalis (thysanoptera: thripidae) en aguacate

SE LOGRÓ DETERMINAR LA DISTRIBUCIÓN ESPACIAL DE Frankliniella occidentalis MEDIANTE EL ANÁLISIS GEOESTADÍSTICO EN COATEPEC HARINAS, ESTADO DE MÉXICO.El cultivo de Aguacate (Lauraceae: Persea americana Mill.) es para México de gran importancia económica en cuanto a los sistemas de producción perenne. Esto se debe a que en los últimos años la comercialización de este fruto se ha incrementado notablemente a nivel nacional e internacional. En México, se cultivaron 168113,64 ha con un rendimiento promedio de 10,2 ton/ha en 2013, obteniendo una producción aproximada de 1467837,35 ton. Como cualquier otro frutal, el aguacate puede sufrir daños ocasionados por plagas (insectos, nematodos, ácaros entre otros) y enfermedades (causadas por hongos, bacterias y virus). A este respecto, uno de los insectos con mayor problemática es Frankliniella occidentalis, que provoca pérdidas significativas en el cultivo, al preferir alimentarse de tejidos tiernos como brotes foliares, florales, hojas jóvenes y frutos en desarrollo. Los daños más severos, económicamente hablando, son notorios a simple vista, ya que originan crestas o protuberancias sobre el pericarpio y estas lesiones son más evidentes conforme madura el fruto. El objetivo del presente trabajo fue modelizar la distribución espacial de F. occidentalis mediante técnicas geoestadísticas, así como obtener mapas de densidad por medio del krigeado. Los muestreos fueron llevados a cabo quincenalmente en tres parcelas comerciales de cuatro hectáreas cada una en el municipio de Coatepec Harinas, Estado de México usando el método de cuadrantes. Los resultados indicaron que la distribución espacial de las poblaciones de F. occidentalis presentó una distribución agregada en cada una de las fechas de muestreo. La validación cruzada de los valores de los semivariogramas obtenidos corroboraron dicha información, además de una dependencia espacial alta. Los mapas obtenidos permiten delimitar áreas infestadas y áreas libres de daños, lo que permitirá establecer medidas de control en puntos específicos de cada parcela para hacer un uso eficiente de los recursos plaguicidas

NeuroBoricuas: a novel approach for incorporating neuroscience education in schools of Puerto Rico

[EN] Puerto Rico is in dire need of transforming its education system to counter the current economic recession and ensure a future with talented Puerto Ricans at the forefront of scientific research and technology development.  Here we present a group of neuroscientists and educators, the NeuroBoricuas, committed to revolutionize the scientific culture of Puerto Rico by incorporating neuroscience research training and inquiry-based activities in public and private schools. We carry out our vision through diverse methods, such as community outreach activities, where we promote neuroscience literacy using diverse learning activities. In parallel, we are designing a neuroscience course and textbook with educators to be implemented in schools. We also established neuroscience laboratories in K-12 schools and trained science teachers to manage such laboratories, using equipment from the company “Backyard Brains”. These laboratory experiences are integrated into the academic curriculum in high schools and the equipment is also available for students interested in designing their independent research projects. Lastly, we are expanding a network of committed scientists who partner with educators to help nurture future neuroscientists early in their academic endeavors. Here, we describe our trajectory and our approach to transform scientific education in Puerto Rico.We thank Dr. Gregory J. Quirk, Dr. Daniel Colon-Ramos and Dr. Mark Miller for their support. We thank Tim Marzullo, from Backyard Brains, for supporting NeuroBoricuas. We also thank Palabreria, Digi-Serv and Puerto Rico 4.0 for their constant support. We thank all the NeuroBoricuas that selflessly work hard for a better Puerto Rico. This work has been supported by generous donations from the Puerto Rican people, a grant from the University of Puerto Rico Medical Sciences Campus’ Chancellor’s office, and the Grass Foundation.http://ocs.editorial.upv.es/index.php/HEAD/HEAD18Bravo-Rivera, C.; Díaz-Ríos, M.; Aldarondo-Hernández, A.; Santos-Vera, B.; Ramos-Medina, L.; De Jesús-Burgos, M.; Bravo-Rivera, H.... (2018). NeuroBoricuas: a novel approach for incorporating neuroscience education in schools of Puerto Rico. Editorial Universitat Politècnica de València. 1447-1455. https://doi.org/10.4995/HEAD18.2018.8223OCS1447145

Effect of sex in systemic psoriasis therapy: Differences in prescription, effectiveness and safety in the BIOBADADERM prospective cohort

The effect of sex on systemic therapy for psoriasis has not been well studied. The aim of this study was to analyse a large multicentre Spanish cohort of 2,881 patients with psoriasis (58.3% males), followed from January 2008 to November 2018, to determine whether sex influences prescription, effectiveness of therapy, and the risk of adverse events. The results show that women are more likely than men to be pre-scribed biologics. There were no differences between men and women in effectiveness of therapy, measur-ed in terms of drug survival. Women were more likely to develop adverse events, but the difference in risk was small and does not justify different management. Study limitations include residual confounding and the use of drug survival as a proxy for effectiveness.The BIOBADADERM project is promoted by the Fundación Piel Sana Academia Española de Dermatología y Venereología, which receives financial support from the Spanish Medicines and Health Products Agency (Agencia Española de Medicamentos y Productos Sanitarios) and from pharmaceutical companies (Abbott/Abbvie, Pfizer, MSD, Novartis, Lilly, Janssen and Almirall)

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes

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