Innovation in the Fight Against Infectious Diseases

The discovery of antibiotics in 1928 led the world to believe that the fight against infectious diseases was one to be won within a few years. Nowadays, nearly 90 years following the discovery of penicillin, infectious diseases remain one of the main causes of mortality worldwide, with lower respiratory tract infections, diarrhoeal diseases, and tuberculosis ranking among the top 10 causes of death according to the World Health Organization (WHO). In recent years, the advent of antibiotic resistance, the anti-vaccination movement, and humanitarian crises have seen a rise in infectious diseases that were once thought to be nearly eradicated, such as polio, tuberculosis and measles

Study on the proposal evaluation system for the EU R&I framework programme. Final Report

RAND Europe wurde von der Generaldirektion Forschung und Innovation (bekannt unter dem Kürzel DG RTD) beauftragt, eine umfassende Überprüfung der in Horizont 2020 (H2020) verwendeten Verfahren zur Bewertung von Vorschlägen durchzuführen und ein internationales Benchmarking dieser Verfahren im Vergleich zur anerkannten Praxis und der breiteren Wissensbasis in diesem Bereich vorzunehmen. Der vorliegende Bericht enthält die Ergebnisse dieser Studie und soll als Grundlage für die Gestaltung von Vorschlagsbewertungsverfahren für Horizont Europa dienen. Die Arbeit kann auch für andere Organisationen, die Forschung und Innovation (F&I) finanzieren, sowie für die gesamte europäische Forschungs- und Innovationsgemeinschaft von Interesse sein. Der vorliegende Bericht enthält die wichtigsten Ergebnisse der Analyse. Ihm ist ein Anhang beigefügt, der nähere Einzelheiten zu den Methoden und den verwendeten und zu Referenzzwecken erstellten Daten sowie zu den durchgeführten spezifischen Analysen enthält. In diese Studie sind die von Clarivate durchgeführte bibliometrische Analyse und die fachliche Beratung durch Prof. Jonathan Grant, Prof. Liv Langfeldt, Prof. Ana Marušić und Prof. Ulf Sandström eingeflossen

Fonoaudiología en salas de urgencias: Perspectiva desde una revisión documental

Emergency rooms are spaces with coordinate protocols and sequential diagnostic and therapeutic actions. Emergency rehabilitation professionals contribute    to decision-making on hospitalization or egress behaviors, home plans, diagnostic aids, and referral to specialists. The purpose of this literature analysis was to identify international evidence, about the phono-audiologist in the emergency room and his professional actions with patients, family members and health teams. Materials and methods. Evidence was reviewed from the Ebsco, PubMed, Scielo, Elsevier and Web of Science databases, from January 2015 to September 2020, with search terms:  speech language pathology, speech therapy, emergency room in Spanish and English. They selected documents informing about emergency room rehabilitation processes, including actions from speech therapy. Sand analyzed 51 documents according to inclusion criteria. The evidence shows the incursion of speech therapy work in a non-traditional context, motivated by the needs in clinical decision-making in interdisciplinary dialogue, mainly under conditions of dysphagia and swallowing disorders. Professional actions in this context include the promotion and prevention of emergency room admissions, up to critical, acute, and end-of-life care. This context represents professional challenges towards clinical judgment skills, professional scientific argumentation, use of detection tools and interdisciplinary work. that make the difference between aspects such as egress and hospitalization, a treatment or procedure and in some cases, between life and death.Las salas de urgencias son espacios con protocolos coordinados y actuaciones diagnósticas y terapéuticas secuenciales. Los profesionales de rehabilitación en urgencias aportan a la toma de decisiones sobre conductas de hospitalización o egreso, planes caseros, ayudas diagnósticas y remisión a especialistas. El propósito de este análisis de literatura fue identificar evidencia internacional, sobre el fonoaudiólogo en sala de urgencias y sus acciones profesionales con pacientes, familiares y equipos de salud. Materiales y métodos. Se revisó evidencia de las bases de datos Ebsco, PubMed, Scielo, Elsevier y Web of Science, entre enero de 2015 hasta septiembre de 2020, con términos de búsqueda: speech language pathology, speech therapy, emergency room en español e inglés. Se seleccionaron documentos que informaran sobre procesos de rehabilitación en salas de urgencias, que incluyeran acciones desde fonoaudiología. Se analizaron 51 documentos según criterios de inclusión. La evidencia muestra la incursión del trabajo fonoaudiológico en un contexto no tradicional, motivado por las necesidades en la toma de decisiones clínicas en diálogo interdisciplinar, principalmente en condiciones de disfagia y alteraciones deglutorias. Las acciones profesionales en este contexto incluyen la promoción y prevención de ingresos a sala de urgencias, hasta la atención en condiciones críticas, agudas y al final de la vida. Este contexto representa retos profesionales hacia habilidades de juicio clínico, argumentación científico profesional, uso de instrumentos de detección y trabajo interdisciplinar. que hacen la diferencia entre aspectos como el egreso y la hospitalización, un tratamiento o procedimiento y en algunos casos, entre la vida y la muerte

Stepwise pathogenic evolution of Mycobacterium abscessus.

Although almost all mycobacterial species are saprophytic environmental organisms, a few, such as Mycobacterium tuberculosis, have evolved to cause transmissible human infection. By analyzing the recent emergence and spread of the environmental organism M. abscessus through the global cystic fibrosis population, we have defined key, generalizable steps involved in the pathogenic evolution of mycobacteria. We show that epigenetic modifiers, acquired through horizontal gene transfer, cause saltational increases in the pathogenic potential of specific environmental clones. Allopatric parallel evolution during chronic lung infection then promotes rapid increases in virulence through mutations in a discrete gene network; these mutations enhance growth within macrophages but impair fomite survival. As a consequence, we observe constrained pathogenic evolution while person-to-person transmission remains indirect, but postulate accelerated pathogenic adaptation once direct transmission is possible, as observed for M. tuberculosis Our findings indicate how key interventions, such as early treatment and cross-infection control, might restrict the spread of existing mycobacterial pathogens and prevent new, emergent ones

Serum angiopoietin-like 3 levels are elevated in obese non diabetic men but are unaffected during an oral glucose tolerance test

This study aimed to determine ANGPTL3 serum levels in healthy young lean and obese non-diabetic men during an oral glucose tolerance test (OGTT) and correlate them with anthropometric, biochemical and hormonal parameters. A case–control study was carried out and 30 young obese non-diabetic (23.90 ± 3.84 years and BMI 37.92 ± 4.85 kg/m2) and 28 age-matched healthy lean (24.56 ± 3.50 years and BMI of 22.10 ± 1.72 kg/m2) men were included in this study. The primary outcome measures were serum basal ANGPTL3 and ANGPTL3–area under the curve (AUC) levels. The percentage of body fat was measured by dual-energy X-ray absorptiometry and biochemical, hormonal and insulin resistance indices were determined. Basal ANGPTL3 and ANGPTL3–AUC levels were significantly elevated (p < 0.05) in young obese subjects compared with lean subjects and were positively and significantly associated with different anthropometric measurements. Fasting ANGPTL3 serum levels were positively correlated with fasting insulin, leptin, Leptin/Adiponectin index and triglyceride—glucose index. Moreover, ANGPTL3–AUC was negatively correlated with Matsuda index. In this regard, chronically high ANGPTL3 levels in young obese subjects might favor triglyceride-rich lipoprotein clearance to replenish triglyceride stores by white adipose tissue rather than oxidative tissues.Centro de Investigaciones Inmunológicas Básicas y Aplicada

La investigación formativa en ciencias empresariales: .Experiencias de investigación formativa POLIPIF

El material propuesto en el libro resume gran parte de la calidad de los trabajos presentados y la evolución en el desarrollo de las capacidades de los estudiantes en un contexto actual, complejo y retador, que refleja la realidad de las organizaciones actuales sobre escenarios estratégicos y manejo de situaciones complejas, para que, cuando lleguen a ser empleados o emprendedores, sepan afrontar cada paso hacia el cambio

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

XVI International Congress of Control Electronics and Telecommunications: "Techno-scientific considerations for a post-pandemic world intensive in knowledge, innovation and sustainable local development"

Este título, sugestivo por los impactos durante la situación de la Covid 19 en el mundo, y que en Colombia lastimosamente han sido muy críticos, permiten asumir la obligada superación de tensiones sociales, políticas, y económicas; pero sobre todo científicas y tecnológicas. Inicialmente, esto supone la existencia de una capacidad de la sociedad colombiana por recuperar su estado inicial después de que haya cesado la perturbación a la que fue sometida por la catastrófica pandemia, y superar ese anterior estado de cosas ya que se encontraban -y aún se encuentran- muchos problemas locales mal resueltos, medianamente resueltos, y muchos sin resolver: es decir, habrá que rediseñar y fortalecer una probada resiliencia social existente - producto del prolongado conflicto social colombiano superado parcialmente por un proceso de paz exitoso - desde la tecnociencia local; como lo indicaba Markus Brunnermeier - economista alemán y catedrático de economía de la Universidad de Princeton- en su libro The Resilient Society…La cuestión no es preveerlo todo sino poder reaccionar…aprender a recuperarse rápido.This title, suggestive of the impacts during the Covid 19 situation in the world, and which have unfortunately been very critical in Colombia, allows us to assume the obligatory overcoming of social, political, and economic tensions; but above all scientific and technological. Initially, this supposes the existence of a capacity of Colombian society to recover its initial state after the disturbance to which it was subjected by the catastrophic pandemic has ceased, and to overcome that previous state of affairs since it was found -and still is find - many local problems poorly resolved, moderately resolved, and many unresolved: that is, an existing social resilience test will have to be redesigned and strengthened - product of the prolonged Colombian social conflict partially overcome by a successful peace process - from local technoscience; As Markus Brunnermeier - German economist and professor of economics at Princeton University - indicates in his book The Resilient Society...The question is not to foresee everything but to be able to react...learn to recover quickly.Bogot

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Tackling Mycobacterium abscessus infection in Cystic Fibrosis

Mycobacterium abscessus is an emerging pathogen with infections increasing worldwide, especially among Cystic Fibrosis (CF) patients. During my PhD, I studied key aspects of the biology of M. abscessus spp.; particularly, I studied host-pathogen interactions, antimicrobial resistance mechanisms, and genetic determinants of virulence. First, I performed phenotypic characterization of M. abscessus spp. clinical isolates obtained from CF patients classified according to subspecies and clustering. I found clustered isolates, representing probable transmission events, were phenotypically distinct from sporadic isolates and showed adaptation phenotypes associated with chronic lung infection, such as enhanced intracellular survival, increased antibiotic resistance, and metabolic adaptations to the host environment. Second, I assessed the role of an inserted element containing an active methyltransferase in M. a. massiliense. Infection experiments with an isolate containing the inserted element (BIR1049wt) and a knockout strain (BIR1049Δ1809078_1815649) showed decreased survival of BIR1049Δ1809078_1815649 within macrophages. RNAseq analysis showed a distinct gene expression pattern between both isolates, with a number of mycobacterial virulence factors upregulated in BIR1049wt. Third, I studied heritable non-mutational antibiotic resistance mechanisms in M. abscessus to linezolid and clofazimine. For both antibiotics, I found clonal isolates of M. abscessus spp. with varying susceptibilities and different gene expression patterns, suggesting transcriptional regulation of antibiotic resistance. Mutation- mediated resistance to clofazimine was also found due to mutations in two transcriptional regulators predicted to regulate efflux pumps. Last, I evaluated the potential of repurposing a kinase inhibitor (compound H) in clinical trials for the treatment of cancer and CF, to treat M. abscessus infection. I found compound H enhanced killing of intracellular M. abscessus in macrophages through stimulation of autophagy and lysosomal function. I further studied over 60 chemical analogues of compound H in order to find a more active and specific compound for M. abscessus infection.CF Trus