Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

Coseismic slip distribution of the February 27, 2010 Mw 8.8 Maule, Chile earthquake

International audienceStatic offsets produced by the February 27, 2010 Mw = 8.8 Maule, Chile earthquake as measured by GPS and InSAR constrain coseismic slip along a section of the Andean megathrust of dimensions 650 km (in length) × 180 km (in width). GPS data have been collected from both campaign and continuous sites sampling both the near-field and far field. ALOS/PALSAR data from several ascending and descending tracks constrain the near-field crustal deformation. Inversions of the geodetic data for distributed slip on the megathrust reveal a pronounced slip maximum of order 15 m at ∼15-25 km depth on the megathrust offshore Lloca, indicating that seismic slip was greatest north of the epicenter of the bilaterally propagating rupture. A secondary slip maximum appears at depth ∼25 km on the megathrust just west of Concepción. Coseismic slip is negligible below 35 km depth. Estimates of the seismic moment based on different datasets and modeling approaches vary from 1.8 to 2.6 × 1022 N m. Our study is the first to model the static displacement field using a layered spherical Earth model, allowing us to incorporate both near-field and far-field static displacements in a consistent manner. The obtained seismic moment of 1.97 × 1022 N m, corresponding to a moment magnitude of 8.8, is similar to that obtained by previous seismic and geodetic inversions

Anáfora: revista literaria de humanidades

48 páginas ; fotografías.Colección: HumanidadesFotografías galardonadas en el primer concurso de de fotografía BICROMATO 2022. | Galardonados del IV Concurso de cuento 2021. | Galardonados del I y II Concurso de poesía Palabras al Vuelo.Este primer número de Anáfora reúne los trabajos ganadores de las convocatorias de Cuento, Poesía y Fotografía, que se convoca desde la coordinación de Humanidades del CETYS Preparatoria, campus Tijuana

Dementia in Latin America: Paving the way toward a regional action plan.

Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)