¿La depresión aumenta el riesgo de demencia? Meta-análisis actualizado de estudios prospectivos

Objetivo. Realizar un meta-análisis actualizado de estudios prospectivos que evalúen la asociación entre la depresión y el riesgo de demencia. Metodología. Se realizó una búsqueda bibliográfica en Pubmed para identificar estudios publicados desde enero de 2014 hasta marzo del 2019. Se seleccionaron estudios prospectivos con seguimiento mínimo de 1 año; evaluación de la depresión y ausencia de demencia y deterioro cognitivo leve (DCL) al inicio del estudio. Calculamos el riesgo relativo combinado (RR) mediante un modelo de efectos aleatorios, y la fracción de demencia poblacional atribuible (FAP) a la depresión. Resultados. Ocho cohortes fueron incluidas. Obtuvimos una asociación estadísticamente significativa entre la depresión y el riesgo de demencia, con un RR global de 1, 63 (IC 95%: 1, 30-2, 04), y una FAP de 9, 0% (IC 95%: 4, 5%-14, 1%). Conclusiones. La depresión se asocia con un aumento de riesgo de demencia en este meta-análisis. Background. Our primary aim was to conduct an update meta-analysis of prospective studies investigating the association between depression and dementia risk. Methods. We searched Pubmed database to identify all relevant papers published from January 2014 to March 2019. Prospective studies with a minimum follow-up period of 1 year, baseline depression assessment, absence of dementia or mild cognitive impairment at baseline were selected. We calculated pooled relative risks (RR), with a random effect model, as well as compute population attributable fraction (PAF) of dementia due to depression. Results. Eight cohorts were included. A statistically significant association between depression and dementia risk, with a pooled RR of 1.63 (95% CI: 1.30-2.04), and a PAF of 9.0% (95% CI: 4.5%-14.1%), were found. Conclusions. Depression is associated with an increased risk of dementia in this meta-analysis

Handlebar injury in children: Are we ignoring the signs?

AbstractThe diagnosis of blunt intestinal injury in children is difficult and often delayed. We describe two cases of delayed diagnosis of intestinal injury following handlebar injury with abdominal wall tattooing. We review the literature to try and determine the usefulness of handlebar tattooing characteristics as a clinical sign for underlying small bowel injury in order to reduce delayed treatment. We propose a management algorithm for patients with handlebar tattooing

A New Probe of Dense Gas at High Redshift: Detection of HCO+(5-4) Line Emission in APM 08279+5255

We report the detection of HCO+(5-4) emission from the Broad Absorption Line (BAL) quasar APM08279+5255 at z=3.911 based on observations conducted at the IRAM Plateau de Bure interferometer. This represents the first detection of this molecular ion at such a high redshift. The inferred line luminosity, uncorrected for lensing, is L'(HCO+)=(3.5+-0.6)x10^10 Kkms^-1pc^2. The HCO+ J=5-4 source position coincides within the errors with that reported from previous HCN J=5-4 and high-J CO line observations of this quasar. The HCO+ line profile central velocity and width are consistent with those derived from HCN. This result suggests that HCO+(5-4) emission comes roughly from the same circumnuclear region probed by HCN. However, the HCN(5-4)/HCO+(5-4) intensity ratio measured in APM08279+5255 is significantly larger than that predicted by simple radiative transfer models, which assume collisional excitation and equal molecular abundances. This could imply that the [HCN]/[HCO^+] abundance ratio is particularly large in this source, or that the J=5 rotational levels are predominantly excited by IR fluorescent radiation.Comment: Accepted for publication in ApJ Letters, May 2

Levels and patterns of objectively assessed physical activity and compliance with different public health guidelines in university students

ArticleBackground Physical activity (PA) is associated with health enhancement. The aim of this study was to assess: 1) levels and patterns of PA in university students by using accelerometers; and 2) the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines. Methods Observational cross-sectional study (Cuenca’s Adults Study) involving 296 (206 women) healthy Spanish university students aged 18–25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA) was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (p<0.05). Only 30.3% of participants accumulated 30 min/day at least five days a week of MVPA. A total of 5.4% of students met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day. Conclusions Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used.Fundación para la Investigación SanitariaMinistry of Health and Consumer AffairsInstituto de Salud Carlos IIIRed de Investigación en Actividades Preventivas y de Promoción de Salu

Generally covariant theories: the Noether obstruction for realizing certain space-time diffeomorphisms in phase space

Relying on known results of the Noether theory of symmetries extended to constrained systems, it is shown that there exists an obstruction that prevents certain tangent-space diffeomorphisms to be projectable to phase-space, for generally covariant theories. This main result throws new light on the old fact that the algebra of gauge generators in the phase space of General Relativity, or other generally covariant theories, only closes as a soft algebra and not a a Lie algebra. The deep relationship between these two issues is clarified. In particular, we see that the second one may be understood as a side effect of the procedure to solve the first. It is explicitly shown how the adoption of specific metric-dependent diffeomorphisms, as a way to achieve projectability, causes the algebra of gauge generators (constraints) in phase space not to be a Lie algebra --with structure constants-- but a soft algebra --with structure {\it functions}.Comment: 22 pages, version to be published in Classical & Quantum Gravit

Towards a resolved Kennicutt-Schmidt law at high redshift

Massive galaxies in the distant Universe form stars at much higher rates than today. Although direct resolution of the star forming regions of these galaxies is still a challenge, recent molecular gas observations at the IRAM Plateau de Bure interferometer enable us to study the star formation efficiency on subgalactic scales around redshift z = 1.2. We present a method for obtaining the gas and star formation rate (SFR) surface densities of ensembles of clumps composing galaxies at this redshift, even though the corresponding scales are not resolved. This method is based on identifying these structures in position-velocity diagrams corresponding to slices within the galaxies. We use unique IRAM observations of the CO(3-2) rotational line and DEEP2 spectra of four massive star forming distant galaxies - EGS13003805, EGS13004291, EGS12007881, and EGS13019128 in the AEGIS terminology - to determine the gas and SFR surface densities of the identifiable ensembles of clumps that constitute them. The integrated CO line luminosity is assumed to be directly proportional to the total gas mass, and the SFR is deduced from the [OII] line. We identify the ensembles of clumps with the angular resolution available in both CO and [OII] spectroscopy; i.e., 1-1.5". SFR and gas surface densities are averaged in areas of this size, which is also the thickness of the DEEP2 slits and of the extracted IRAM slices, and we derive a spatially resolved Kennicutt-Schmidt (KS) relation on a scale of ~8 kpc. The data generally indicates an average depletion time of 1.9 Gyr, but with significant variations from point to point within the galaxies.Comment: 6 pages, 4 figures, 2 tables, accepted by Astronomy and Astrophysic

Noncommutative vector bundles over fuzzy CP^N and their covariant derivatives

We generalise the construction of fuzzy CP^N in a manner that allows us to access all noncommutative equivariant complex vector bundles over this space. We give a simplified construction of polarization tensors on S^2 that generalizes to complex projective space, identify Laplacians and natural noncommutative covariant derivative operators that map between the modules that describe noncommuative sections. In the process we find a natural generalization of the Schwinger-Jordan construction to su(n) and identify composite oscillators that obey a Heisenberg algebra on an appropriate Fock space.Comment: 34 pages, v2 contains minor corrections to the published versio

Predictive model of pheochromocytoma based on the imaging features of the adrenal tumours

The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.3 +/- 33.2 versus 20.6 +/- 9.2 mm respectively; P < 0.001). Mean unenhanced CT attenuation was higher in PHEO (52.4 +/- 43.1 versus 4.7 +/- 17.9HU; P < 0.001). High lipid content in CT was more frequent among non-PHEO (83.6% versus 3.8% respectively; P < 0.001); and this feature alone had 83.6% sensitivity and 96.2% specificity to rule out pheochromocytoma with an area under the receiver operating characteristics curve (AUC-ROC) of 0.899. The combination of high lipid content and tumour size improved the diagnostic accuracy (AUC-ROC 0.961, sensitivity 88.1% and specificity 92.3%). The probability of having a pheochromocytoma was 0.1% for adrenal lesions smaller than 20 mm showing high lipid content in CT. Ninety percent of non-PHEO presented loss of signal in the out of phase MRI sequence compared to 39.0% of PHEO (P < 0.001), but the specificity of this feature for the diagnosis of non-PHEO lesions low. In conclusion, our study suggests that sparing biochemical screening for pheochromocytoma might be reasonable in patients with adrenal lesions smaller than 20 mm showing high lipid content in the CT scan, if there are no typical signs and symptoms of pheochromocytoma

The metallicity dependence of the CO {\rightarrow} H_2 conversion factor in z>1 star forming galaxies

We use the first systematic samples of CO millimeter emission in z>1 'main-sequence' star forming galaxies (SFGs) to study the metallicity dependence of the conversion factor {\alpha}CO, from CO line luminosity to molecular gas mass. The molecular gas depletion rate inferred from the ratio of the star formation rate (SFR) to CO luminosity, is ~1 Gyr-1 for near-solar metallicity galaxies with stellar masses above M_S~1e11 M_sun. In this regime the depletion rate does not vary more than a factor of two to three as a function of molecular gas surface density, or redshift between z~0 and 2. Below M_S the depletion rate increases rapidly with decreasing metallicity. We argue that this trend is not caused by starburst events, by changes in the physical parameters of the molecular clouds, or by the impact of the fundamental metallicity-SFR-stellar mass relation. A more probable explanation is that the conversion factor is metallicity dependent and that star formation can occur in 'CO-dark' gas. The trend is also expected theoretically from the effect of enhanced photodissociation of CO by ultraviolet radiation at low metallicity. From the available z~0 and z~1-3 samples we constrain the slope of the log({\alpha}CO) -log (metallicity) relation to range between -1 and -2, fairly insensitive to the assumed slope of the gas-star formation rate relation. Because of the lower metallicities near the peak of the galaxy formation activity at z~1-2 compared to z~0, we suggest that molecular gas masses estimated from CO luminosities have to be substantially corrected upward for galaxies below M_S.Comment: ApJ in pres