Challenges to recruitment of participants with MCI in a multicentric neuropsychological study

Background: Data on recruitment of Mild Cognitive Impairment (MCI) samples are seldom reported and this issue can be an important source of research waste. Aim: To describe the recruitment challenges and reasons for non-eligibility faced during a bi-centre clinical study assessing the predictive value of a neuropsychological battery of the progression to dementia. Methods: Potential MCI participants were identified from databases of the two memory clinics based in Milan (Italy) and invited to the screening assessment. Results: About 50% of the cases initially identified were ineligible according to inclusion/exclusion criteria and the two sites took 22 months to recruit the planned 150 people. The main reasons for non-eligibility were the MMSE score (41%), age (14%), presence of cerebrovascular disorders (9%), perceptual deficits (6%), neurological (6%) or psychiatric (4%) comorbidities and low education (5%). Conclusion: Awareness of the reasons for exclusion and of the time needed to recruit the planned sample would provide hints for the planning of future studies on MCI

SPIGVE - Sistema de Publicación de Información Geográfica mediante Gráficos Vectoriales basada en arquitecturas cliente-servidor

La explosión y crecimiento exponencial del manejo de información y su publicación se ha potenciado desde el advenimiento de internet instaurada hoy y con acceso a la población en general. Entre la variada y amplia información publicada podemos encontrar Sistemas de Información Geográfica interactivos que proveen un sinnúmero de datos relacionados con la posición geográfica de donde han sido recabados. Mediante este proyecto se pretende realizar la implementación de un sistema de Internet SIG a partir de la generación de los software de publicación a nivel del Servidor y de los de consulta de los clientes apuntando a un desarrollo regional de este tipo de trabajos y brindando información propia y característica de esta.Eje: Ingeniería de Software y Base de DatosRed de Universidades con Carreras en Informática (RedUNCI

"Mi voglio bene": a pediatrician-based randomized controlled trial for the prevention of obesity in Italian preschool children

<p>Abstract</p> <p>Background</p> <p>The first years of life are crucial to start preventive interventions that can have an impact on lifestyle and later overweight and obesity. Under the Italian National Health System (INHS), children are cared for by family pediatricians who perform health balances at regular intervals. The Italian Society of Preventive and Social Pediatrics (SIPPS) has designed a randomized controlled trial (RCT) to evaluate the effectiveness of family pediatricians for the prevention of childhood obesity in preschool children. We report the rationale and protocol of such trial, named the "Mi voglio bene" ("I love myself") study.</p> <p>Methods</p> <p>"Mi voglio bene" is a parallel-arm RCT. Family pediatricians willing to participate to the trial will be randomly assigned to a control group and to an experimental group. The control group will provide the usual standard of care while the experimental group will implement 10 preventive actions (promotion of breastfeeding, avoidance of solid foods, control of protein intake, avoidance of sugar-sweetened beverages, avoidance of bottle, active means of transportation, identification of early adiposity rebound, limitation of television viewing, promotion of movement, and teaching portion size) at 10 time points during a 6-yr follow-up. The main outcome measures is the prevalence of overweight and obesity at 6 years of age. The experimental intervention is expected to reduce the prevalence of overweight and obesity from 25% to 20% and the study requires a total of 3610 children. Each pediatrician will enroll 30 consecutive newborns into the study so that a total of 120 pediatricians will participate to the study.</p> <p>Discussion</p> <p>"Mi voglio bene" is expected to provide important information for the INHS and possibly other institutional child care settings about the effectiveness of a pediatrician-based approach to the prevention of childhood obesity. We published this study protocol with the aim of opening a discussion with all people interested in fighting childhood obesity and to receive useful criticisms.</p

PROGRAMA BOLSA FAMÍLIA: UMA ANÁLISE ESPACIAL NOS MUNICÍPIOS DO PARANÁ EM 2004, 2008 E 2012

O objetivo do presente trabalho é fazer uma análise espacial multivariada entre a taxa de pobreza e o benefício médio anual do principal programa de transferência de renda do Governo Federal (Programa Bolsa Família) nos municípios do Paraná com dados de 2004, 2008 e 2012. Para isso, o trabalho toma como metodologia a Análise Exploratória dos Dados Espaciais para se identificar os coeficientes bivariados I de Moran, os gráficos de dispersão, os mapas de significâncias e finalmente os mapas de clusters das variáveis dos municípios, cuja análise utiliza os dados fornecidos pelo Ministério de Desenvolvimento Social e Combate à Fome (MDS) e Instituto Brasileiro de Geografia e Estatística (IBGE). O estudo permite concluir que houve: incremento do benefício médio (PBF) em cidades com alto índice de pobreza e menor em cidades com menores índices de pobreza; e expansão do programa no Paraná, alcançando as regiões mais pobres do estado

Sleep habits and pattern in 1-14 years old children and relationship with video devices use and evening and night child activities

Background: Sleep in childhood and adolescence is crucial for mental and physical health; however several researches reported an increasing trend towards a sleep deprivation in this age. Due to the lack of recent epidemiological studies in Italy, the aim of our study was to depict sleep habits and patterns in Italian children aged 1-14 years and to evaluate their relationships with video devices use (TV, tablet, smartphone, PC) and evening/night child activities. Methods: A structured interview was conducted during 2015 by 72 Family Pediatricians in 2030 healthy children aged 1-14 years by a cross-sectional survey named "Ci piace sognare". Total sleep duration was calculated, 2015 National Sleep Foundation Recommendations were used as reference. Optimal sleepers were defined children sleeping in own bed all night without awakenings. Multivariable median regression was performed to identify predictors of sleep duration and multivariable logistic regression for predictors of optimal sleep. Results: Total sleep duration and numbers of awakenings decreased with age. Only 66.9% of children had sleep duration in agreement with Recommendations (50% in 10-14 years group). Before sleeping 63.5% of children used video devices (39.6% at 1-3 years), 39.1% read, 27.5% drank and 19.5% ate. Bottle users at bedtime were 30.8% at 1-3 years, 16.6% at 3-5 years and 4.9% at 5-7 years. Overall, 23.4% of children changed sleeping place during the night, 22.4% referred sleeping problems in the first year of life. Video devices use was negative predictor of sleep duration (-0.25 h [95%CI:-0.35,-0.14], p < 0.001). Optimal sleep was inversely related with bedroom TV (OR 0.63 [0.50,0.79], p < 0.001), with sleeping disorders in the first year (OR 0.62 [0.48,0.80], p < 0.001)), with bottle use (OR 0.64 [0.44,0.94], p < 0.05) and posivively related with high mother's education level (OR 1.44 [1.11,1.88], p < 0.01). Conclusions: About one third of 1 to 14 year Italian children sleep less than recommended, one half in teenage. Modifiable risk factors for sleep abnormalities such as video devices use, bedroom TV and bottle use should be target of preventive strategies for a correct sleep. Pediatricians should give priority to the identification of sleep disorders early in life

Taxa de pobreza e população rural no Brasil: análise espacial dos períodos 2000 e 2010

The purpose of this paper is to analyze the spatial distribution of rural poverty in brazilian municipalities and the relationship between rural population and poverty rate in 2000 and 2010. For this, the work utilizes the Exploratory Spatial Data Analysis to identify the bivariate moran's I coefficient, the scatter plot, the significance map and ultimately the cluster map of the municipalities variables. The data were collected in the Brazilian Institute of Geography and Statistics (IBGE) through the censuses of 2000 and 2010. It was found that between 2000 and 2010 there was a small increase in the positive spatial correlation between the percentage of rural population and poverty rate to brazilian municipalities. The conclusion of this paper is that the cities in which they concentrate a large rural population continue to show a high rate of poverty, confirming the hypothesis that the rural population has difficulty benefit from policies for combating poverty because of poor access to this information and the physical distance. On the other hand, there are indications that the National Family Farming Strengthening Program (PRONAF) emerges as a policy that can contribute to minimize its effects, even if slowly reduce rural poverty.O objetivo do presente artigo é analisar a distribuição espacial da pobreza rural nos municípios brasileiros e a relação entre população rural e taxa de pobreza nos anos de 2000 e 2010. O trabalho utiliza a Análise Exploratória dos Dados Espaciais para identificar o coeficiente bivariado I de Moran, o gráfico de dispersão, o mapa de significância e finalmente o mapa de cluster das variáveis dos municípios. Os dados são coletados no Instituto Brasileiro de Geografia e Estatística (IBGE) através dos censos de 2000 e 2010. Verificou-se que entre 2000 e 2010 ocorreu um aumento pouco expressivo da autocorrelação espacial positiva entre o percentual da população rural e taxa de pobreza para os municípios brasileiros. A conclusão do estudo é que, as cidades nas quais se concentram uma grande população rural continuam apresentando uma alta taxa de pobreza, confirmando a hipótese de que a população rural tem dificuldade em usufruir de políticas de combate à pobreza devido à dificuldade do acesso a essas informações e pelo distanciamento físico. Por outro lado, há indícios que o PRONAF surge como uma política que pode contribuir para minimizar os seus efeitos, mesmo que lentamente reduzir a pobreza rural

Understanding the coexistence of competing raptors by Markov chain analysis enhances conservation of vulnerable species.

Understanding ecological interactions among protected species is crucial for correct management to avoid conflicting outcomes of conservation planning. The occurrence of a superior competitor may drive the exclusion of a subordinate contestant, as in Sicily where the largest European population of the lanner falcon is declining because of potentially competing with the peregrine falcon. We measured the coexistence of these two ecologically equivalent species through null models and randomization algorithms on body sizes and ecological niche traits. Lanners and peregrines are morphologically very similar (Hutchinson ratios <1.3) and show 99% diet overlap, and both of these results predict competitive exclusion. In contrast, their use of diverse cliff substrates for breeding in different times of the season would predict coexistence. To compare these two mutually excluding hypotheses, we examined the pattern of inter-specific transitions in 88 sites that were studied for 14 years (2000-2013) using a Markov chain (MC) occupancy state model, and checked the sensitivity and elasticity of the community structure to changes in transition probabilities. During the study period, 1144 territorial transitions occurred in peregrine and lanner territories, and the MCs were predicted to converge to a stable equilibrium in 2065. Markovian analysis suggested that temporal and spatial segregation of habitat during reproduction might prevail over anatomical specialization for hunting and diet, allowing species coexistence, despite the prediction that peregrines will outnumber the lanners in future projections. Our approach combining niche-overlap analysis and species occupancy modelling led to practical information about conservation options available for the threatened lanner. Lanners are very sensitive to site abandonment, and measures increasing adult persistence in occupied territories could be more rewarding than those encouraging juvenile dispersal and colonization of new sites

Cardiac magnetic resonance in heart failure with preserved ejection fraction:myocyte, interstitium, microvascular, and metabolic abnormalities

Heart failure (HF) with preserved ejection fraction (HFpEF) is a chronic cardiac condition whose prevalence continues to rise, with high social and economic burden, but with no specific approved treatment. Patients diagnosed with HFpEF have a high prevalence of comorbidities and exhibit a high misdiagnosis rate. True HFpEF is likely to have multiple pathophysiological causes - with these causes being clinically ill-defined due to limitations of current measurement techniques. Myocyte, interstitium, microvascular, and metabolic abnormalities have been regarded as key components of the pathophysiology and potential therapeutic targets. Cardiac magnetic resonance (CMR) has the capability to look deeper with a number of tissue characterization techniques which are closer to the underlying specific abnormalities and which could be linked to personalized medicine for HFpEF. This review aims to discuss the potential role of CMR to better define HFpEF phenotypes and to infer measurable therapeutic targets

Spatio-temporal variation in the wintering associations of an alpine bird

Many animals make behavioural changes to cope with winter conditions, being gregariousness a common strategy. Several factors have been invoked to explain why gregariousness may evolve during winter, with individuals coming together and separating as they trade off the different costs and benefits of living in groups. These trade-offs may, however, change over space and time as a response to varying environmental conditions. Despite its importance, little is known about the factors triggering gregarious behaviour during winter and its change in response to variation in weather conditions is poorly documented. Here, we aimed at quantifying large-scale patterns in wintering associations over 23 years of the white-winged snowfinch Montifringilla nivalis nivalis. We found that individuals gather in larger groups at sites with harsh wintering conditions. Individuals at colder sites reunite later and separate earlier in the season than at warmer sites. However, the magnitude and phenology of wintering associations are ruled by changes in weather conditions. When the temperature increased or the levels of precipitation decreased, group size substantially decreased, and individuals stayed united in groups for a shorter time. These results shed light on factors driving gregariousness and points to shifting winter climate as an important factor influencing this behaviour.M.d.M.D. was financially supported by the (i) Spanish Ministry of Sciences, Innovation and Universities (no. CGL2016-79764-P) and (ii) a Spanish Ramon y Cajal grant no. RYC-2014-16263. M.B. was partly supported by the project Mediterranean Mosaics II funded by MAVA to Lipu

Correction of metachromatic leukodystrophy in the mouse model by transplantation of genetically modified hematopoietic stem cells

Gene-based delivery can establish a sustained supply of therapeutic proteins within the nervous system. For diseases characterized by extensive CNS and peripheral nervous system (PNS) involvement, widespread distribution of the exogenous gene may be required, a challenge to in vivo gene transfer strategies. Here, using lentiviral vectors (LVs), we efficiently transduced hematopoietic stem cells (HSCs) ex vivo and evaluated the potential of their progeny to target therapeutic genes to the CNS and PNS of transplanted mice and correct a neurodegenerative disorder, metachromatic leukodystrophy (MLD). We proved extensive repopulation of CNS microglia and PNS endoneurial macrophages by transgene-expressing cells. Intriguingly, recruitment of these HSC-derived cells was faster and more robust in MLD mice. By transplanting HSCs transduced with the arylsulfatase A gene, we fully reconstituted enzyme activity in the hematopoietic system of MLD mice and prevented the development of motor conduction impairment, learning and coordination deficits, and neuropathological abnormalities typical of the disease. Remarkably, ex vivo gene therapy had a significantly higher therapeutic impact than WT HSC transplantation, indicating a critical role for enzyme overexpression in the HSC progeny. These results indicate that transplantation of LV-transduced autologous HSCs represents a potentially efficacious therapeutic strategy for MLD and possibly other neurodegenerative disorders