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International audience; Spinal cord injuries remain a real public health issue. However, despite more than half a century of intensive research and numerous clinical trials, the different strategies for repairing the spinal cord remain still inconclusive, even if the diagnosis and the patient care have improved considerably. When Japan and China are embarking on cell therapy trials for chronic lesions, there is currently no treatment that would allow spinal cord injured people to preserve damaged tissue avoiding the secondary expansion of the lesion and recovering of their sensorimotor functions. We thought the stromal vascular fraction (SVF) from fat could be neuroprotective in the acute phase of spinal cord injuries. SVF is extractable in just 2 h and contains mesenchymal and hematopoietic stem cells known for their regenerative and anti-inflammatory properties. Our strategy based on an autologous injection of the SVF within 4 hours after spinal cord injuries. To check our hypothesis, we conducted a preclinical study in adult male rats. Contusions performed at thoracic level using an impactor. From a fat sample of 11.7 +/- 3.5 cc it is possible to extract 8.9 +/- 2.1 million cells of the SVF with 92.2 +/- 1.6% of viability and 77.7 +/- 0.04% of yield. A million cells then injected around injuries. The following 3 months devoted to kinematic analyses of movement, evaluation of sensorimotor recoveries using different behavioral tests (BBB test, Ladder rung walking test, CatWalk…), electrophysiology (evoked potentials, sensorimotor reflexes…), biochemistry (Elisa…), immunohistology (neurofilament labeling…). We present for the first time the results.; Les lésions de la moelle épinière restent un véritable problème de santé publique. Cependant, malgré plus d'un demi-siècle de recherches intensives et de nombreux essais cliniques, les différentes stratégies de réparation de la moelle épinière restent encore peu concluantes, même si le diagnostic et la prise en charge des patients se sont considérablement améliorés. Alors que le Japon et la Chine se lancent dans des essais de thérapie cellulaire pour les lésions chroniques, il n'existe actuellement aucun traitement qui permettrait aux blessés médullaires de préserver les tissus endommagés en évitant l'expansion secondaire de la lésion et en récupérant leurs fonctions sensorimotrices. Nous avons pensé que la fraction vasculaire stromale (FVS) de la graisse pourrait avoir un effet neuroprotecteur dans la phase aiguë des lésions de la moelle épinière. La SVF est extractible en seulement 2 heures et contient des cellules souches mésenchymateuses et hématopoïétiques connues pour leurs propriétés régénératrices et anti-inflammatoires. Notre stratégie repose sur une injection autologue de SVF dans les 4 heures suivant les lésions de la moelle épinière. Pour vérifier notre hypothèse, nous avons mené une étude préclinique chez des rats mâles adultes. Contusions réalisées au niveau thoracique à l'aide d'un impacteur. A partir d'un échantillon de graisse de 11,7 +/- 3,5 cc, il est possible d'extraire 8,9 +/- 2,1 millions de cellules du SVF avec 92,2 +/- 1,6% de viabilité et 77,7 +/- 0,04% de rendement. Un million de cellules sont ensuite injectées autour des blessures. Les 3 mois suivants ont été consacrés à l'analyse cinématique des mouvements, à l'évaluation des récupérations sensorimotrices à l'aide de différents tests comportementaux (BBB test, Ladder rung walking test, CatWalk...), à l'électrophysiologie (potentiels évoqués, réflexes sensorimoteurs...), à la biochimie (Elisa...), à l'immunohistologie (marquage des neurofilaments...).

La bronquiolitis viral es una causa importante de morbilidad y mortalidad en niños de menos de dos años de edad en todo el mundo. Las guías clínicas basadas en la evidencia sugieren que no existe un tratamiento efectivo para la bronquiolitis y que la hidratación y una adecuada oxigenación, siguen siendo la base del manejo clínico. En esta revisión, se describen las actuales guías de tratamiento haciendo énfasis en limitar los exámenes e intervenciones innecesarias. También discutimos la investigación en nuevas terapias para la bronquiolitis.

Objetivo. Determinar la prevalencia de alteraciones del sueño en alumnos de secundaria, así como identificar los posibles factores relacionados con las nuevas tecnologías que se asocian a la calidad de sueño. Material y métodos. Estudio observacional transversal sobre una muestra de 244 adolescentes que cursan Educación Secundaria Obligatoria (ESO). Se ha utilizado el cuestionario Pittsburg para evaluar la calidad del sueño y también se han recogido variables sociodemográficas, hábitos de ejercicio, consumo de tabaco, alcohol y uso de nuevas tecnologías. Resultados. Se han recogido un total de 244 encuestas (tasa de respuesta del 82%). El 52% fueron hombres. Las edades de los alumnos se encuentran entre los 12 y 18 años. El 99% tienen dispositivos electrónicos, siendo el teléfono móvil el más predominante. Las mujeres tienen mayor porcentaje de tenencia de teléfono móvil respecto a los hombres (100% vs 93,6; p=0.006) y también lo usan más horas a la semana (35 vs 14,5 horas; p

Background In a previous article (10.1007/s00701-019-03888-3), preliminary results of a survey, aiming to shed light on the number of surgical procedures performed and assisted during neurosurgery residency in Europe were reported. We here present the final results and extend the analyses. Methods Board-certified neurosurgeons of European Association of Neurosurgical Societies (EANS) member countries were asked to review their residency case logs and participate in a 31-question electronic survey (SurveyMonkey Inc., San Mateo, CA). The responses received between April 25, 2018, and April 25, 2020, were considered. We excluded responses that were incomplete, from non-EANS member countries, or from respondents that have not yet completed their residency. Results Of 430 responses, 168 were considered for analysis after checking in- and exclusion criteria. Survey responders had a mean age of 42.7 ± 8.8 years, and 88.8% were male. Responses mainly came from surgeons employed at university/teaching hospitals (85.1%) in Germany (22.0%), France (12.5%), the United Kingdom (UK; 8.3%), Switzerland (7.7%), and Greece (7.1%). Most responders graduated in the years between 2011 and 2019 (57.7%). Thirty-eight responders (22.6%) graduated before and 130 responders (77.4%) after the European WTD 2003/88/EC came into effect. The mean number of surgical procedures performed independently, supervised or assisted throughout residency was 540 (95% CI 424–657), 482 (95% CI 398–568), and 579 (95% CI 441–717), respectively. Detailed numbers for cranial, spinal, adult, and pediatric subgroups are presented in the article. There was an annual decrease of about 33 cases in total caseload between 1976 and 2019 (coeff. − 33, 95% CI − 62 to − 4, p = 0.025). Variables associated with lesser total caseload during residency were training abroad (1210 vs. 1747, p = 0.083) and female sex by trend (947 vs. 1671, p = 0.111), whereas case numbers were comparable across the EANS countries (p = 0.443). Conclusion The final results of this survey largely confirm the previously reported numbers. They provide an opportunity for current trainees to compare their own case logs with. Again, we confirm a significant decline in surgical exposure during training between 1976 and 2019. In addition, the current analysis reveals that female sex and training abroad may be variables associated with lesser case numbers during residency.

The aim of this study was to conduct a haematological evaluation of dogs and cats in Lima, Peru. A total of 460 blood samples (410 dogs and 50 cats) were collected between December 2017 and May 2018. The smears were stained with Wright and the reticulocytes were stained with Brilliant cresyl blue. Descriptive statistics were performed for quantitative variables in the erythroid, myeloid and lymphoid series, as well as the frequency analysis of qualitative variables between species indicator of type of anaemia and leukaemia, ability of medullary regeneration, abnormal morphological changes, out of physiological range and presence of extra and intracellular microorganisms. The most frequent alterations were normochromic normocytic anaemia (23.2% dog, 10% cat), megaloblastic anaemia (5.1% dog), severe hypochromic microcytic anaemia (4% cat), neutrophilic chronic myeloid leukaemia (7.1% dog, 8% cat), monocytosis with cytoplasmic vacuolization in monocytes (4.9% dog), severe thrombocytosis with platelet aggregates (6% cat), polychromatophilia (6.3% dog), dacrocytes (54.4% dog, 64% cat), acanthocytes (11.7% dog, 40% cat) , macrocytes (14.6% dog, 6% cat), small leukocytes (10% dog, 6% cat), Cytauxzoon felis (20% cat), Anaplasma spp (0.2% dog) and Mycoplasma spp (2% dog, 20% cat). Only significant differences were observed between sexes in total platelets (p=0.0087) and eosinophils (p=0.0260) being greater in male dogs. It is concluded that the prevalence of C. felis in the cats studied is relatively low and there is a risk of zoonosis of Anaplasma spp and Mycoplasma spp in the owners of affected animals in Lima, Perú., El objetivo del estudio fue realizar una evaluación hematológica a perros y gatos en Lima, Perú. Se colectaron 460 muestras de sangre (410 perros y 50 gatos) entre diciembre de 2017 y mayo de 2018. Los frotis se colorearon con Wright y las láminas de reticulocitos con Azul de cresil brillante. Se realizó estadística descriptiva para variables cuantitativas en las series eritroide, mieloide y linfoide, así como el análisis de frecuencias de variables cualitativas entre especies indicadoras de tipo de anemia y leucemia, capacidad de regeneración medular, cambios morfológicos anormales, salida de rango fisiológico y presencia de microorganismos extra e intracelular. Predominaron la anemia normocítica normocrómica (23.2% perro, 10% gato), anemia megaloblástica (5.1% perro), anemia severa microcítica hipocrómica (4% gato), leucemia mieloide crónica de neutrófilos (7.1% perro, 8% gato), monocitosis con vacuolización citoplasmática en monocitos (4.9% perro), trombocitosis severa con agregados plaquetarios (6% gato), policromatofilia (6.3% perro), los dacriocitos (54.4% perro, 64% gato), acantocitos (11.7% perro, 40% gato), macrocitos (14.6% perro, 6% gato), leucocitos pequeños (10% perro, 6% gato), Cytauxzoon felis (20% gato), Anaplasma spp (0.2% perro) y Mycoplasma spp (2% perro, 20% gato). Solo se evidenciaron diferencias significativas entre sexos en las plaquetas totales (p=0.0087) y los eosinófilos (p=0.0260) siendo mayor en perros machos. Se concluye que la prevalencia de C. felis en los gatos estudiados es relativamente baja y existe un riesgo de zoonosis de Anaplasma spp y Mycoplasma spp en los propietarios de animales afectados en Lima, Perú. &nbsp

Acute appendicitis remains a common reason for hospital admission. Reports have suggested a reduction in patients attending emergency departments during the acute phase of the SARSCoV- 2 pandemic. Moreover, a global surge in conservative management of acute appendicitis has recently been registered by the Appy Study of the Association of Italian Surgeons in Europe (ACIE)1. This is a treatment option that has been known for some years, although quite seldom used before the pandemic2–4. As most countries are experiencing new waves of the pandemic, the attitude of surgeons towards SARS-CoV-2 screening policies and personal protective equipment (PPE) used during the management of patients with acute appendicitis need to be established. According to a subanalysis of the ACIE Appy Study, half of surgeons globally were testing patients for SARS-CoV-2 only when symptomatic or there was suspicion of infection; approximately 12 per cent did not test patients at all (Fig. 1 and Table S1). There were regional differences. In Europe, respondents tested all patients (50.8 per cent) or those with suspected infection (43.9 per cent), with only 5.3 per cent not being tested at all. In the USA, the majority of participants only tested patients with a suspected infection (65.6 per cent). A similar picture of testing only those with a suspected infection was also reported from Latin America (57.2 per cent), Asia/Middle East (76.8 per cent), and Africa (41.7 per cent). Even more worrisome, 58.3 per cent of respondents from Africa and 27.6 per cent from Latin America were not testing patients at all before appendicectomy. Concerning the screening modality, most respondents used PCR alone or in combination with chest imaging. Serology was rarely used overall and never in Africa (Fig. 1 and Table S2 ). It is now accepted that chest imaging is not routinely required and that PCR is an accurate screening modality. Serology might, however, be useful to shed light on the disease course and previous exposure to the virus, but respondents from some countries still have restricted access to this test. In terms of PPE during appendicectomy, most African respondents did not use different PPE compared with the prepandemic period in patients who tested negative for COVID-19. More concerning is that 58.3 per cent did not use different PPE in untested patients. This differed from other regions where the rate of those not considering a change of PPE in untested patients did not exceed 22 per cent. One in 10 respondents from Latin America also reported that they were not using different PPE compared with the prepandemic phase in patients who tested positive for COVID-19. These data, and taking into account the high prevalence of acute appendicitis, leads to the conclusion that omission of routine patient screening may have contributed to local clusters among patients and threatened the safety of healthcare workers5. In this respect, it is likely that limited access to PPE explains the attitude of surgeons towards patients with unknown SARSCoV- 2 status or those infected, raising ethical concerns about the safety of surgical staff. It is of outmost importance that, even during challenging times and stress on economic stability, industrialized countries make efforts to sustain low-income countries and those with limited resources. This would ensure equal working conditions, safer treatment for patients with acute appendicitis, and better control of the pandemic

Respiratory diseases in pigs impact the wellbeing of animals and increase the cost of production. One of the most appropriate approaches to minimizing these negative effects is the early detection of ill animals. The use of cameras coupled with computer-based techniques could assist the early detection of physiological changes in pigs when they are beginning to become ill and prior to exhibiting clinical signs. This study consisted of two experiments that aimed to (a) evaluate the use of computer-based techniques over RGB (red, green, and blue) and thermal infrared imagery to measure heart rate and respiration rate of pigs, and (b) to investigate whether eye-temperature, heart rate and respiration rate assessed remotely could be used to identify early signs of respiratory diseases in free-moving, and group-housed growing pigs in a commercial piggery. In the first experiment, the remotely-obtained heart rate and respiration rate were compared with the measures obtained with standard methods, showing positive correlations (r = 0.61 – 0.66; p < 0.05). In the second experiment, pigs were recorded by overhead cameras and the remotely-obtained physiological measures were analysed to identify whether physiological changes could be detected in sick pigs before clinical signs were observed. The changes in eye-temperature and heart rate remotely obtained showed clear differences between sick and healthy pigs two days before clinical signs were detected. While significant changes in respiration rate occurred the day before clinical signs of illness were identified. The results of the present study indicate the possible use of computer vision technique for constant animal monitoring and rapid detection of physiological changes related to illness in commercial pigs. Further research is recommended to continue the development, automatization, and commercial practicality of this novel technology.

Purpose This study describes our clinical experience with lenvatinib for the treatment of radioactive iodine refractory differentiated thyroid cancer (RR-DTC) using a multimodal patient-centered prehabilitation multidisciplinary approach assessing its effectiveness and patient outcomes. Methods and design This is a retrospective observational real-life study of a consecutive series of RR-DTC patients treated with lenvatinib as first-line treatment at Germans Trias i Pujol University Hospital. Results Partial response was observed in 6 patients (46.1%), stable disease in 5 patients (38.5%) and disease progression in 2 patients (15.4%). PFS and OS were 16.3 and 17.9 months respectively. AEs occurred in all patients. The most common adverse event (AE) was fatigue (69%), followed by diarrhea (46%), hypertension (46%) and anorexia (38.3%). Weight loss was present in 30.7% of the patients and only 7.7% was grade 3. Conclusion In our experience, prehabilitation can be useful to decrease not only the incidence but the severity of important side effects such as weight loss, anorexia and hypertension. For these complex patients, a multidisciplinary team is useful for follow-up, treatment and prevention of possible AEs.

Multiple sclerosis can often present with nonspecific symptoms leading to difficulty in establishing a diagnosis early in the disease process. Early diagnosis and treatment is of importance due to the associated decrease in disability for those that get treatment sooner. Here we present a case with a patient the presented with changes in vision and paresthesias. Her initial workup from the neurologist was negative and further workup was delayed until her symptoms worsened. After worsening symptoms, MRI revealed that multiple sclerosis was the cause of her symptoms.

Eating is a multimodal sensory experience affected contextual situations. A limitation with traditional consumer testing is that isolated booth environments lack ecological validity and consumer's engagement in forming perceptions. Virtual reality (VR) is an emerging method to simulate different environmental contexts. The acceptability and emotional responses of full- and no-sugar chocolate determined in sensory booths and under two VR environments (headsets) were evaluated. Untrained participants (N = 50) tasted two chocolates (FS = full-sugar and NS = no-sugar, maltitol) under three environments: (1) traditional-booths, (2) positive-VR [aesthetically open-field forest], and (3) negative-VR [closed-space old room] in a 3 × 2 randomized-factorial-design. Participants rated the acceptability of sweetness, bitterness, texture, mouth-coating, aftertaste, and overall liking (9-point scale). The intensities of sweetness, bitterness, and hardness (15-cm line-scale) were assessed. Chocolate type and VR did not affect the liking of attributes (5.4–6.8). However, FS samples had higher sweetness intensity than NS samples for positive-VR (10.8 vs. 9.1). NS samples under positive-VR were associated with overall liking. The NS and FS samples under positive-VR were associated with “energetic” and “happy”; however, under traditional booths were related to “good”, and “calm”. “Bored” and “guilty” were associated with NS samples under negative-VR. VR can be used to understand the contextual effects on consumers' perceptions.

Background Diabetes prevalence is increasing in most places in the world, but prevalence is affected by both risk of developing diabetes and survival of those with diabetes. Diabetes incidence is a better metric to understand the trends in population risk of diabetes. Using a multicountry analysis, we aimed to ascertain whether the incidence of clinically diagnosed diabetes has changed over time. Methods In this multicountry data analysis, we assembled aggregated data describing trends in diagnosed total or type 2 diabetes incidence from 24 population-based data sources in 21 countries or jurisdictions. Data were from administrative sources, health insurance records, registries, and a health survey. We modelled incidence rates with Poisson regression, using age and calendar time (1995-2018) as variables, describing the effects with restricted cubic splines with six knots for age and calendar time. Findings Our data included about 22 million diabetes diagnoses from 5 billion person-years of follow-up. Data were from 19 high-income and two middle-income countries or jurisdictions. 23 data sources had data from 2010 onwards, among which 19 had a downward or stable trend, with an annual estimated change in incidence ranging from -1.1% to -10.8%. Among the four data sources with an increasing trend from 2010 onwards, the annual estimated change ranged from 0.9% to 5.6%. The findings were robust to sensitivity analyses excluding data sources in which the data quality was lower and were consistent in analyses stratified by different diabetes definitions. Interpretation The incidence of diagnosed diabetes is stabilising or declining in many high-income countries. The reasons for the declines in the incidence of diagnosed diabetes warrant further investigation with appropriate data sources. Copyright (C) 2021 Elsevier Ltd. All rights reserved.

This paper reviews the design and operation of the Chilean fiscal rule in the past 30 years. Using different empirical approaches, we assess its impact on fiscal procyclicality, public debt, and public investment. While there has been substantial progress in building a modern institutional framework for fiscal policy, we find that the rule is incomplete in two dimensions: it lacks an escape clause, and it needs to supplement the budget balance rule with a debt rule. The former is seen in the pervasive inability of the authorities to steer fiscal accounts back to their long-term sustainable path after the rule was breached the rule in 2009. The latter issue is illustrated by the speedy build-up of the public debt as a result of the need to finance fiscal deficits. We do not find, nevertheless, a negative impact of the rule on public investment. We propose reforms to improve on transparency and accountability, as well as to supplement the rule with escape clauses and a debt anchor.

Sudden unexpected death in infancy (SUDI) - defined as the death of a child under 1 year of age du ring sleep with no initially obvious cause - remains one of the most common causes of post-neonatal mortality. Approximately 3,500 infants die annually in the United States from sleep-related deaths. A complex and multifactorial origin is postulated in a vulnerable infant. However, the pathophysiology of SUDI has not been fully understood. Health care providers play a key role in promoting preventive measures described in the literature, which include sleeping in a supine position on a firm surface, avoiding smoking and co-sleeping, promoting breastfeeding, among others. The objective of this re view is to summarize the main epidemiological and physiopathological characteristics of SUDI, and safe sleep-related factors.

[EN] Despite the enormous efforts made to achieve effective tools that fight against Staphylococcus aureus, the results have not been successful. This failure may be due to the absence of truly representative experimental models. To overcome this deficiency, the present work describes and immunologically characterizes the infection for 28 days, in an experimental low-dose (300 colony-forming units) intradermal model of infection in rabbits, which reproduces the characteristic staphylococcal abscess. Surprisingly, when mutant strains in the genes involved in virulence (J Delta agr, J Delta coa Delta vwb, J Delta hla, and J Delta psm alpha) were inoculated, no strong effect on the severity of lesions was observed, unlike other models that use high doses of bacteria. The inoculation of a human rabbitized (FdltB(r)) strain demonstrated its capacity to generate a similar inflammatory response to a wild-type rabbit strain and, therefore, validated this model for conducting these experimental studies with human strains. To conclude, this model proved reproducible and may be an option of choice to check both wild-type and mutant strains of different origins., Supported by the Spanish Ministry of Economy and Competitiveness (MINECO) grant AGL2014-53405-C2-2-P, the Universidad CEU Cardenal Herrera, and European Union Development Fund (FEDER) Programme PO FEDER 2007-2013. A.M.-S., A.G.-Q., and E.M.-G. receive fellowship support from the Universidad CEU Cardenal Herrera; S.P.-F. receives fellowship support from the Generalitat Valenciana ACIF/2016/085; and M.P. and E.M.-G. receive fellowship support from the Spanish Ministry of Education, Culture, and Sport AP2010-3907 and FPU17/02708, respectively.

La muerte súbita e inesperada en la infancia (MSII) definida como la muerte de un menor de 1 año durante el sueño sin motivo evidente de manera inicial, sigue siendo una de las causas más frecuentes de mortalidad infantil tardía. Aproximadamente 3.500 lactantes mueren anualmente en Estados Unidos por muertes relacionadas con el sueño. Se postula un origen complejo y multifactorial en un lactante vulnerable, sin embargo, su fisiopatología no se ha logrado comprender por completo. Los profesionales de la salud juegan un rol clave en la promoción de las medidas preventivas descritas en la literatura que incluyen dormir en posición supina sobre una superficie firme, evitar el tabaquismo y el colecho, promover la lactancia materna, entre otros. El objetivo de esta revisión es resumir las principales características epidemiológicas y fisiopatológicas de la MSII y factores relacionados con el sueño seguro.

La medicina del sueño pediátrica ha avanzado considerablemente durante las últimas décadas; sin embargo la evidencia epidemiológica es variada y limitada, principalmente por las diversas definiciones empleadas. El presente artículo profundiza sobre aspectos de prevalencia mediante estudios que incluyen anamnesis, cuestionarios y/o estudios de sueño; se incluye el análisis de factores que pueden influir en su epidemiología; edad, género, obesidad, factores prenatales, etnia genética, nivel socioeconómico e influencia de algunas enfermedades respiratorias como asma y rinitis. Adicionalmente, se describen aspectos relacionados con la evolución natural de los trastornos respiratorios del sueño.

Contains fulltext : 162913.pdf (Publisher’s version ) (Open Access) Background. Rotavirus (RV) is the leading cause of diarrhea-related death in children worldwide and ninety-five percent of RV deaths occur in Africa and Asia where rotavirus vaccines (RVV) have lower efficacy. We hypothesize that differences in intestinal microbiome composition correlate with the decreased RVV efficacy observed in poor settings. Methods. We conducted a nested, case-control study comparing pre-vaccination, fecal microbiome compositions between 6-week old, matched RVV-responders and non-responders in rural Ghana. These infants' microbiomes were then compared to 154 age-matched, healthy Dutch infants' microbiomes, assumed to be RVV-responders. Fecal microbiota analysis was performed in all groups using the Human Intestinal Tract Chip (HITChip). Results. 78 Ghanaian infants, equalling 39 RVV responder and non-responder pairs, were analysed. The overall microbiome composition was significantly different between RVV-responders and non-responders (FDR=0.12), and Ghanaian responders were more similar to Dutch infants than non-responders (p=0.002). RVV-response correlated with an increased abundance of Streptococcus bovis and a decreased abundance of the Bacteroidetes phylum in comparisons between Ghanaian RVV-responders and non-responders (FDR=0.008, FDR=0.003) as well as between Dutch infants and Ghanaian non-responders (FDR=0.002, FDR=0.009). Conclusions. The intestinal microbiome composition correlates significantly with RVV immunogenicity and may contribute to the diminished RVV immunogenicity observed in developing countries. 8 p.

Resumen: El mejor entendimiento sobre la actividad global de la vitamina D, ha llevado a una intensa búsque da de sus implicancias en enfermedades no esqueléticas. En este artículo se presenta una revisión actualizada de la relación entre la vitamina D y la patología respiratoria pediátrica. Se realizó una búsqueda bibliográfica en PUBMED utilizando términos libres y MESH: vitamina D, enfermedades del sistema respiratorio, asma, bronquiolitis. Se seleccionó estudios en humanos menores de 18 años y animales, publicados en inglés y español hasta el 2017. Se encontraron 507 artículos, de los cuales se incluyeron 43. Evidencia indirecta apunta hacia un rol de la vitamina D y la maduración pulmonar fetal. En relación a la patología pulmonar pediátrica, los estudios son escasos y poco concluyentes. Nuevos meta - análisis, con evaluación individualizada de los participantes, muestran un importante rol protector de la suplementación en la prevención de exacerbaciones asmáticas severas e infecciones virales agudas. En bronquiolitis los resultados son contradictorios, sin relación clara entre niveles plasmáticos y severidad. No existe suficiente evidencia que evalué los beneficios en fibrosis quística y tuberculosis. Recientemente se ha propuesto una relación directa entre la severidad de los trastornos respiratorios del sueño y los niveles plasmáticos de vitamina D, aunque se desconoce los mecanismos exactos involucrados a esta asociación. La información actual permite suponer que la suplementación de vitamina D puede representar una estrategia costo - efectiva en la reducción de importantes causas de morbimortalidad infantil. Abstract: The better understanding of the global activity of vitamin D has led to an intense search for its involvement in non-skeletal diseases. This article presents an updated review of the relationship between vitamin D and pediatric respiratory pathology. A literature search was performed in PUBMED using free terms and MESH terms: vitamin D, asthma, respiratory system diseases, and bronchiolitis. Stu dies in human patients younger than 18 years and animals, published in English and Spanish until 2017 were included. 507 articles were found, of which 43 were included. Indirect evidence suggests a role of vitamin D and fetal lung maturation. In relation to pediatric pulmonary pathology, studies are scarce and inconclusive. Recent meta-analyses performed with individualized evaluation of the participants shows an important protective role of vitamin D supplementation in the prevention of severe asthma exacerbations and acute viral infections. In bronchiolitis, the results are contradictory, with no clear relationship between plasma levels and severity. There is not enough evidence to assess the benefits of vitamin D supplementation in cystic fibrosis and tuberculosis. A direct relationship between the severity of sleep-related breathing disorders and vitamin D plasma levels has recently been proposed, although the exact mechanisms involved in this association are unknown. Current information suggests that vitamin D supplementation may represent a cost-effective strategy in redu cing important causes of infant morbidity and mortality.

The better understanding of the global activity of vitamin D has led to an intense search for its involvement in non-skeletal diseases. This article presents an updated review of the relationship between vitamin D and pediatric respiratory pathology. A literature search was performed in PUBMED using free terms and MESH terms: vitamin D, asthma, respiratory system diseases, and bronchiolitis. Stu dies in human patients younger than 18 years and animals, published in English and Spanish until 2017 were included. 507 articles were found, of which 43 were included. Indirect evidence suggests a role of vitamin D and fetal lung maturation. In relation to pediatric pulmonary pathology, studies are scarce and inconclusive. Recent meta-analyses performed with individualized evaluation of the participants shows an important protective role of vitamin D supplementation in the prevention of severe asthma exacerbations and acute viral infections. In bronchiolitis, the results are contradictory, with no clear relationship between plasma levels and severity. There is not enough evidence to assess the benefits of vitamin D supplementation in cystic fibrosis and tuberculosis. A direct relationship between the severity of sleep-related breathing disorders and vitamin D plasma levels has recently been proposed, although the exact mechanisms involved in this association are unknown. Current information suggests that vitamin D supplementation may represent a cost-effective strategy in redu cing important causes of infant morbidity and mortality.

Resumen: En este trabajo se estudian las actitudes sociales respecto al derecho de autonomía de los pueblos indígenas en Chile. Basado en un estudio de opinión pública del Centro de Estudios Interculturales e Indígenas (CIIR), se concluye que la demanda por autonomía tiende a ser más relevante entre personas que se auto identifican como indígenas, jóvenes, con niveles de escolaridad baja, que viven en zonas urbanas, de izquierda, y de la macrozona centro y norte. A diferencia de otros estudios que estudian la tolerancia o aceptación de la diversidad étnica, en este estudio se explora el perfil de quienes favorecen/rechazan la autonomía indígena, realizando una contribución a la literatura al especificar que no siempre mayores niveles de escolaridad se asocian con mayor tolerancia a la diversidad y que las demandas por autonomía no necesariamente provienen de los territorios que enfrentan mayor conflictividad. Abstract: This paper addresses the social attitudes regarding the right to autonomy of indigenous peoples in Chile. Based on a public opinion study of the Center of Intercultural and Indigenous Research (CIIR), the conclusion reached is that demand for autonomy tends to be more relevant among people who identify themselves as indigenous, young people, with low educational levels, living in urban areas, left-wing, and from the center and northern areas of the country. Unlike other studies that study tolerance or acceptance of ethnic diversity, this study explores the profile of those who side with/reject indigenous autonomy, suggesting that not always greater levels of education are linked to higher support for indigenous autonomy. Moreover, we assert that the demands for autonomy are not necessarily linked to those inhabitants of conflict areas. Resumo: Neste trabalho, estudamos atitudes sociais em relação ao direito de autonomia dos povos indígenas no Chile. Com base em um estudo da opinião pública do Centro de Estudos Interculturais e Indígenas (CIIR), conclui-se que a demanda por autonomia tende a ser mais relevante entre as pessoas que se identificam como indígenas, jovens com baixos níveis de educação, que vivem em zonas urbanas, da esquerda e da grande zona do centro e do norte do país. Ao contrário de outras pesquisas que estudam tolerância ou aceitação da diversidade étnica, nesta pesquisa explora-se o perfil daqueles que favorecem/rejeitam a autonomia indígena, contribuindo para a literatura ao salientar que nem sempre maiores níveis de educação estão associados a uma maior tolerância à diversidade e que as demandas por autonomia não são necessariamente provenientes dos territórios que enfrentam maior conflitividade.

En este trabajo se estudian las actitudes sociales respecto al derecho de autonomía de los pueblos indígenas en Chile. Basado en un estudio de opinión pública del Centro de Estudios Interculturales e Indígenas (CIIR), se concluye que la demanda por autonomía tiende a ser más relevante entre personas que se auto identifican como indígenas, jóvenes, con niveles de escolaridad baja, que viven en zonas urbanas, de izquierda, y de la macrozona centro y norte. A diferencia de otros estudios que estudian la tolerancia o aceptación de la diversidad étnica, en este estudio se explora el perfil de quienes favorecen/rechazan la autonomía indígena, realizando una contribución a la literatura al especificar que no siempre mayores niveles de escolaridad se asocian con mayor tolerancia a la diversidad y que las demandas por autonomía no necesariamente provienen de los territorios que enfrentan mayor conflictividad. This paper addresses the social attitudes regarding the right to autonomy of indigenous peoples in Chile. Based on a public opinion study of the Center of Intercultural and Indigenous Research (CIIR), the conclusion reached is that demand for autonomy tends to be more relevant among people who identify themselves as indigenous, young people, with low educational levels, living in urban areas, left-wing, and from the center and northern areas of the country. Unlike other studies that study tolerance or acceptance of ethnic diversity, this study explores the profile of those who side with/reject indigenous autonomy, suggesting that not always greater levels of education are linked to higher support for indigenous autonomy. Moreover, we assert that the demands for autonomy are not necessarily linked to those inhabitants of conflict areas. Neste trabalho, estudamos atitudes sociais em relação ao direito de autonomia dos povos indígenas no Chile. Com base em um estudo da opinião pública do Centro de Estudos Interculturais e Indígenas (CIIR), conclui-se que a demanda por autonomia tende a ser mais relevante entre as pessoas que se identificam como indígenas, jovens com baixos níveis de educação, que vivem em zonas urbanas, da esquerda e da grande zona do centro e do norte do país. Ao contrário de outras pesquisas que estudam tolerância ou aceitação da diversidade étnica, nesta pesquisa explora-se o perfil daqueles que favorecem/rejeitam a autonomia indígena, contribuindo para a literatura ao salientar que nem sempre maiores níveis de educação estão associados a uma maior tolerância à diversidade e que as demandas por autonomia não são necessariamente provenientes dos territórios que enfrentam maior conflitividade.

We perform a detailed analysis of the migratory motion of human embryonic stem cells in two-dimensions, both when isolated and in close proximity to another cell, recorded with time-lapse microscopic imaging. We show that isolated cells tend to perform an unusual locally anisotropic walk, moving backwards and forwards along a preferred local direction correlated over a timescale of around 50 minutes and aligned with the axis of the cell elongation. Increasing elongation of the cell shape is associated with increased instantaneous migration speed. We also show that two cells in close proximity tend to move in the same direction, with the average separation of 70 um or less and the correlation length of around 25 um, a typical cell diameter. These results can be used as a basis for the mathematical modelling of the formation of clonal hESC colonies., 19 pages, 12 Figures

INTRODUCTION: Vertebral hemangiomas (VH) represent the most common primary bone tumor of the spine and are rarely symptomatic. Currently, there is no consensus for treatment and many therapeutic options are available, alone or in combination including cementoplasty, sclerotherapy, surgery, embolization and/or radiotherapy. OBJECTIVE: To evaluate the clinical and radiological outcome of a multimodal management for symptomatic VH. METHODS: A consecutive prospective and retrospective multicenter study was conducted to review cases of symptomatic VHs between 2005 and 2015. Clinical and radiological aspects, treatment modalities and complications were evaluated preoperatively; postoperatively and at last follow-up. We also reviewed the literature of studies concerning case series of VH, published after 1990 and involving more than 10 patients. RESULTS: Twenty-seven VHs were included in our series (mean age at diagnosis: 47.9 years), out of which 26 were symptomatic. Ten presented with neurologic deficit (37%). An epidural extension was noted in 13 patients (48%). Eleven patients (41%) underwent multimodal treatments. In the multimodal group, eradication was observed in 6 patients (54%), stable residue in 5 cases (46%) with no recurrence versus 3 eradication (23%), 9 stable residue (69%) and no recurrence in the monomodal group, (P>0.05). The literature comprised 14 studies including 458 patients. Only 4 studies were focused on multimodal treatments. CONCLUSION: Based on this study, the multimodal management of symptomatic VHs appeared safe and effective. Finally, we propose an algorithm for symptomatic VHS management based on the severity of epidural extension and fracture risk.

bariatric surgery and mental disorders Medical treatments have shown poor outcomes, bariatric surgery has become a frequent treatment alternative for obesity. Obese patients seeking treatment have higher psychiatric comorbidity than not consulting ones. Bariatric surgery has allowed a reduction in medical comorbidity and some improvement in pre surgery psychopathology. Recent evidence reports a decrease in depressive disorders rate, improvement in self-esteem and life quality, in direct association with weight reduction, with no significant anxiety changes. Although weight decrease should help to have a better social life, important difficulties in adapting to the new environment can emerge. An increase in suicides and problematic alcohol use has been observed, as well as a decrease in binge eating disorder with further appearance of compensatory behavior, distorted body image, and marital problems. Pre surgery personality disorder could be a risk factor for a negative outcome. In this context a rigorous post surgery follow up is desirable, in order to optimize mental health benefits of massive weight reduction.

An abnormal colonization pattern of the preterm gut may affect immune maturation and exert a long-term influence on the intestinal bacterial composition and host health. However, follow-up studies assessing the evolution of the fecal microbiota of infants that were born preterm are very scarce. In this work, the bacterial compositions of fecal samples, obtained from sixteen 2-year-old infants were evaluated using a phylogenetic microarray; subsequently, the results were compared with those obtained in a previous study from samples of meconium and feces collected from the same infants while they stayed in the neonatal intensive care unit (NICU). In parallel, the concentration of a wide range of cytokines, chemokines, growth factors and immunoglobulins were determined in meconium and fecal samples. Globally, a higher bacterial diversity and a lower interindividual variability were observed in 2-year-olds' feces, when compared to the samples obtained during their first days of life. Hospital-associated fecal bacteria, that were dominant during the NICU stay, seemed to be replaced, two years later, by genera, which are usually predominant in the healthy adult microbiome. The immune profile of the meconium and fecal samples differed, depending on the sampling time, showing different immune maturation statuses of the gut.

Background: We aimed to describe gender and region differences in the prevalence of binge drinking and in the association between binge drinking and well-being, among older adult Europeans. Methods: This is a cross-sectional study using the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 4, conducted between 2011 and 2012, including 58 489 individuals aged 50 years or older. Sixteen European countries were grouped in four drinking culture regions: South, Central, North and East. We categorized drinking patterns as: never, former, no-binge and binge drinkers. We used the CASP-12 questionnaire to measure well-being. To assess the association between binge drinking and well-being, we fitted two-level mixed effects linear models. Results: The highest percentage of binge drinkers was found in Central Europe (17.25% in men and 5.05% in women) and the lowest in Southern Europe (9.74% in men and 2.34% in women). Former, never and binge drinkers had a significant negative association with well-being as compared with no-binge drinkers. There was a significant interaction in this association by gender and region. Overall, associations were generally stronger in women and in Southern and Eastern Europe. The negative association of binge drinking with well-being was especially strong in Southern European women (ß =-3.80, 95%CI: -5.16 to-2.44, P value

The recent evolution of productivity has been a puzzle for economists. After a period marked by historic growth (1987-1997), aggregate productivity stagnated (1998-2012). The analysis in this paper focuses on productivity in nine major sectors of the economy to establish tentative hypotheses to try to explain the recent behavior of productivity at the aggregate level. The evidence suggests that it is necessary to deepen the analysis of the labor market and the cost of energy as potential barriers to productivity growth.

International audience; INTRODUCTION: Management of patients with poor bone stock remains difficult due to the risks of mechanical complications such as screws pullouts. At the same time, development of minimal invasive spinal techniques using a percutaneous approach is greatly adapted to these fragile patients with a reduction in operative time and complications. The aim of this study was to report our experience with cemented percutaneous screws in the management of patients with a poor bone stock.ăMETHODS: Thirty-five patients were included in this retrospective study. In each case, a percutaneous osteosynthesis using cemented screws was performed. Indications were osteoporotic fractures, metastasis or fractures on ankylosing spine. Depending on radiologic findings, short or long constructs (2 levels above and below) were performed and an anterior column support (kyphoplasty or anterior approach) was added. Evaluation of patients was based on pre and postoperative CT-scans associated with clinical follow-up with a minimum of 6 months.ăRESULTS: Eleven men and 24 women with a mean age of 73 years [60-87] were included in the study. Surgical indication was related to an osteoporotic fracture in 20 cases, a metastasis in 13 cases and a fracture on ankylosing spine in the last 2 cases. Most of the fractures were located between T10 and L2 and a long construct was performed in 22 cases. Percutaneous kyphoplasty was added in 24 cases and a complementary anterior approach in 3 cases. Average operative time was 86minutes [61-110] and blood loss was estimated as minor in all the cases. In the entire series, average volume of cement injected was 1.8 cc/screw. One patient underwent a major complication with a vascular leakage responsible for a cement pulmonary embolism. With a 9 months average follow-up [6-20], no cases of infection or mechanical complication was reported.ăCONCLUSION: Minimal invasive spinal techniques are greatly adapted to the management of fragile patients. The use of percutaneous cemented screws is, in our experience, a valuable alternative for spinal fixation in patients with poor bone stock. This technique allows a good bony fixation with a low rate of complications. However, rigorous preoperative planning is necessary in order to avoid complications.

El mejor entendimiento sobre la actividad global de la vitamina D, ha llevado a una intensa búsqueda de sus implicancias en enfermedades no esqueléticas. En este artículo se presenta una revisión actualizada de la relación entre la vitamina D y la patología respiratoria pediátrica. Se realizó una búsqueda bibliográfica en PUBMED utilizando términos libres y MESH: vitamina D, enfermedades del sistema respiratorio, asma, bronquiolitis. Se seleccionó estudios en humanos menores de 18 años y animales, publicados en inglés y español hasta el 2017. Se encontraron 507 artículos, de los cuales se incluyeron 43. Evidencia indirecta apunta hacia un rol de la vitamina D y la maduración pulmonar fetal. En relación a la patología pulmonar pediátrica, los estudios son escasos y poco concluyentes. Nuevos meta – análisis, con evaluación individualizada de los participantes, muestran un importante rol protector de la suplementación en la prevención de exacerbaciones asmáticas severas e infecciones virales agudas. En bronquiolitis los resultados son contradictorios, sin relación clara entre niveles plasmáticos y severidad. No existe suficiente evidencia que evalué los beneficios en fibrosis quística y tuberculosis. Recientemente se ha propuesto una relación directa entre la severidad de los trastornos respiratorios del sueño y los niveles plasmáticos de vitamina D, aunque se desconoce los mecanismos exactos involucrados a esta asociación. La información actual permite suponer que la suplementación de vitamina D puede representar una estrategia costo – efectiva en la reducción de importantes causas de morbimortalidad infantil.

Introduccion: La rehabilitacion respiratoria (RR) ha adquirido un papel importante en el manejo del paciente con enfermedad neuromuscular. El objetivo de este estudio fue investigar los efectos de un programa de rehabilitacion respiratoria (RR) sobre variables del test de caminata de 6 min (C6M) y funcion muscular respiratoria (FMR) en pacientes con patologia neuromuscular. Pacientes y Metodos: En el estudio se incluyeron 13 pacientes, edad: 12,5 ± 2,8 anos, de los cuales 7 son ambulantes (2 distrofia muscular (DM) fascio-escapulo-humeral, 1 DM de Becker, 1 miopatia congenita, 1 sindrome de Bethlem, 2 DM de Duchenne); y 6 no son ambulantes (4 DM de Duchenne, 1 atrofia espinal (AT) tipo 3 y 1AT 2). Se analizaron los registros de FMR y C6M al inicio y posterior a 13 semanas de entrenamiento muscular respiratorio (40-50% Pimax y 60-70% Pemax) y cardiopulmonar (50% de FCR). Se utilizo el test no parametrico de Wilcoxon con un intervalo de confianza de 95%. Resultados: Se observaron cambios significativos (p < 0,05) en el puntaje de disnea que disminuyo 1,8 puntos (de 4,4 a 2,6; -40,9%) y en la presion inspiratoria maxima sostenida (Pims) que aumento 14,3 cm de H2O (de 16 a 30,3 cm H20; +89,4%). Las otras variables que evaluaron capacidad aerobica (C6M, frecuencia cardiaca y fatiga de las piernas) y funcion de los musculos respiratorios (Pimax y Pemax) mostraron una tendencia a la mejoria, sin embargo, no alcanzaron significacion estadistica. Conclusiones: En pacientes con enfermedades neuromusculares se observan cambios significativos en la disnea posterior a un protocolo de entrenamiento cardiopulmonar. Por otra parte, el entrenamiento muscular respiratorio de moderada intensidad fue un metodo bien tolerado y efectivo para generar incrementos significativos en la Pims, constituyendo una alternativa a los protocolos previamente establecidos.

Cool-climate Shiraz is gaining increasing popularity in the past decade for its stylistic savoury and spicy aroma. Black peppery spiciness has been considered as the key identifier of high quality cool climate Shiraz in many Australian cool-climate wine regions. Rotundone, an oxygenated bicyclic sesquiterpene, was firstly identified by Australian researchers as the primary compound responsible for this iconic characteristic. In the past four years, the University of Melbourne partnered with Australian wine industry, and conducted frontier researches on this compound. We investigated the influence of ‘terroir’ and grapevine physiological responses on the production of rotundone in Shiraz grape and wine with a range of vineyard management factors which can be manipulated to increase its occurrence. We have established models to link historical climate factors with rotundone, and used this model to predict future production. The model allows realtime estimation of rotundone production during growing season and in the final wine by measuring grapevine phenological stages and cumulative heat during grape ripening. This enables adoption of precision irrigation and canopy management strategies for achieving favourable or mitigating adverse impacts of climatic change, with the aim of maximising the rotundone concentration of grape berries. Furthermore, integrated with climate projection models, we are able to predict the production of rotundone in wine in future vintages. This research allows iconic cool climate Shiraz styles to be preserved, and allows modelling of new grape growing regions in a changing climate. This report will introduce the latest progresses on the research of rotundone and associated sesquiterpene compounds and give practical instructions on how to manipulate vineyard rotundone production, which are especially important to maintain the sustainability of cool climate Shiraz style.

International audience; INTRODUCTION: Phenotype changes between primary tumor and the corresponding brain metastases are recent reported data. Breast cancer, with biological markers predicting prognosis and guiding therapeutic strategy remains an interesting model to observe and evaluate theses changes. The objective of our study was to compare molecular features (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor type 2, [HER2]) between brain metastases and its primary tumor in patients presenting with pathologically confirmed breast cancer.MATERIAL AND METHODS: This retrospective study was based on the immunohistochemical analysis of the brain metastases paraffin embedded samples stored in our institutional tumor bank, after surgical resection. The level of expression of hormonal receptors and HER2 on brain metastases were centrally reviewed and compared to the expression status in primary breast cancer from medical records.RESULTS: Forty-four samples of brain metastases were available for analysis. Hormonal receptor modification status was observed in 11/44 brain metastases (25%) for ER and 6/44 (13.6%) for PR. A modification of HER2 overexpression was observed in brain metastases in 6/44 (13.6%). Molecular subtype modification was shown in 17 cases (38.6%). A significant difference was demonstrated between time to develop brain metastases in cases without status modification (HER2, ER and PR) (med=49.5months [7.8-236.4]) and in cases in which brain metastases status differs from primary tumor (med=27.5months [0-197.3]), (P=0.0244, IC95=3.09-51.62, Mann and Whitney test).CONCLUSION: the main interest of this study was to focus on the molecular feature changes between primary tumor and their brain metastases. Time to develop brain metastases was correlated to phenotypic changes in brain metastases.; Introduction:La modification phénotypique entre une tumeur primitive et sa métastase cérébrale correspondante est une donnée récente. Le cancer du sein, de part ses biomarqueurs impactant le pronostic et la stratégie thérapeutique, constitue une pathologie d’intérêt pour observer et évaluer ce type de modification. L’objectif était de comparer les caractéristiques moléculaires (récepteurs aux estrogènes [RE], à la progestérone [PR], et récepteur au facteur de croissance épidermique humain type 2 [HER2]) des métastases cérébrales et des tumeurs primitives correspondantes de patients porteurs d’un adénocarcinome mammaire.Matériels et méthodes:Cette étude rétrospective, utilisait des échantillons tumoraux issus des métastases cérébrales réséquées, inclus en paraffine, conservés en tumorothèque. Le niveau d’expression des récepteurs hormonaux et de HER2, sur chaque couple primitif/métastase cérébrale correspondante était analysé par immunohistochimie.Résultats:Quarante-quatre échantillons de métastases cérébrales étaient exploitables. La conversion des récepteurs hormonaux a été observée pour 11/44 métastases cérébrales (25 %) pour RE et pour 6/44 cas (13,6 %) pour RP. L’expression de HER2 était modifiée au sein de la métastase cérébrale dans 6/44 cas (13,6 %). Le changement de sous-type moléculaire était montré dans 17 cas (38,6 %). Il existait une différence significative pour le délai de survenue de la métastase cérébrale entre le groupe ne présentant pas de modification pour RE, RP ou HER2, (med = 49,5 mois [7,8–236,4]) et le groupe dont le phénotype de la métastase cérébrale différait du primitif (med = 27,5 [0–197,3]), (p = 0,0244, IC95 = 3,09–51,62, test de Mann et Whitney).Conclusion:L’intérêt de ce travail était la mise en évidence de modification de signature moléculaire entre la tumeur primitive et la métastase cérébrale correspondante. Le délai de survenue de la métastase cérébrale apparaissait corrélé à la modification de statut phénotypique de la métastase cérébrale.

Lung adenocarcinoma represents one of the lung cancer subtypes with major prevalence. Accumulating evidence indicates that the immune system plays an important role in the evolution of the neoplastic process; additionally, several reports suggest that chemotherapy has an immunomodulatory effect. In order to identify the peripheral subpopulations of leukocytes that may change after chemotherapy, we evaluated several peripheral immune subpopulations of monocytes and lymphocytes by multicolor flow cytometry. In addition, we also measured cytokines and growth factors on plasma in order to evaluate the pro-inflammatory context in patients with lung adenocarcinoma after chemotherapy. We found that HLA-DR+ classical and intermediate monocytes were decreased in patients before chemotherapy, compared to controls. After chemotherapy, the relative percentage of those subpopulations was restored. In addition, interleukin 1β, interleukin 12, and interleukin 5 were increased after chemotherapy compared to prechemotherapy levels, while MIP-1β was decreased.

This paper estimates potential GDP growth and output gaps for the period 1986-2007 using three different methodologies: (i) production function, (ii) Kalman filter proxy (univariate and multivariate) and (iii) structural VAR . The output gap estimates show a high degree of mutual consistency. The methods suggest that at the beginning of the sample period the economy was overheated with considerably wide positive gaps. From 1993 through the Asian crisis, the gap was positive but small. From the crisis onwards estimates show a negative gap with a mild trend to close, but becomes positive in 2007. To evaluate the different gap measurements, real-time estimates are compared with ex-post estimates in terms of their capacity for forecasting future inflation. For potential GDP growth, the different methods yield similar results. For the full period, trend GDP growth is estimated at around 5.5%. However, significant differences exist across sub-periods, particularly showing a deceleration in the aftermath of the 1999 recession.

To estimate the neutral real interest rate for Chile, we use a variety of methods that can be classified into three categories: those derived from economic theory, the neutral rate implicit in financial assets, and statistical procedures using macroeconomic data. We conclude that the neutral rate is not constant over time, but it is closely related with—though not equivalent to—the potential GDP growth rate. The application of the different methods yields fairly similar results. The neutral real interest rate for Chile seems to be in the range from 2.1% to 3.5%, with a median of 2.8% taking data of the fourth quarter of 2007.

Los tratamientos médicos de la obesidad han demostrado baja efectividad, lo que ha llevado a que la cirugía bariátrica se haya establecido como una alternativa de tratamiento cada vez más frecuente. Las personas obesas que buscan tratamiento presentan tasas significativamente elevadas de comorbilidades psiquiátricas en comparación con las personas obesas que no consultan. La cirugía bariátrica ha permitido una reducción de las comorbilidades médicas y una mejoría de las patologías psiquiátricas presentes antes de la cirugía. Publicaciones recientes reportan una disminución de los trastornos depresivos, mejoría de la autoestima y de la calidad de vida, directamente asociados a la reducción de peso, sin variaciones significativas en los niveles de ansiedad. Si bien la pérdida de peso debería ayudar al mejoramiento de la vida social del paciente, pueden surgir importantes dificultades para adaptarse al nuevo entorno. Se ha visto un aumento de la tasa de suicidios y del uso problemático de alcohol, disminución precoz del trastorno por atracones con aparición posterior de conductas compensatorias, distorsión de la imagen corporal y aparición de conflictos conyugales. La presencia de trastorno de personalidad previo a la cirugía, constituiría un predictor negativo de resultado a largo plazo. Es en este contexto que se hace necesario un seguimiento post operatorio exhaustivo a estos pacientes, de tal forma de intervenir precozmente y optimizar los beneficios en la salud mental obtenidos con la baja de peso. Medical treatments have shown poor outcomes, bariatric surgery has become a frequent treatment alternative for obesity. Obese patients seeking treatment have higher psychiatric comorbidity than not consulting ones. Bariatric surgery has allowed a reduction in medical comorbidity and some improvement in pre surgery psychopathology. Recent evidence reports a decrease in depressive disorders rate, improvement in self-esteem and life quality, in direct association with weight reduction, with no significant anxiety changes. Although weight decrease should help to have a better social life, important difficulties in adapting to the new environment can emerge. An increase in suicides and problematic alcohol use has been observed, as well as a decrease in binge eating disorder with further appearance of compensatory behavior, distorted body image, and marital problems. Pre surgery personality disorder could be a risk factor for a negative outcome. In this context a rigorous post surgery follow up is desirable, in order to optimize mental health benefits of massive weight reduction.

Los tratamientos médicos de la obesidad han demostrado baja efectividad, lo que ha llevado a que la cirugía bariátrica se haya establecido como una alternativa de tratamiento cada vez más frecuente. Las personas obesas que buscan tratamiento presentan tasas significativamente elevadas de comorbilidades psiquiátricas en comparación con las personas obesas que no consultan. La cirugía bariátrica ha permitido una reducción de las comorbilidades médicas y una mejoría de las patologías psiquiátricas presentes antes de la cirugía. Publicaciones recientes reportan una disminución de los trastornos depresivos, mejoría de la autoestima y de la calidad de vida, directamente asociados a la reducción de peso, sin variaciones significativas en los niveles de ansiedad. Si bien la pérdida de peso debería ayudar al mejoramiento de la vida social del paciente, pueden surgir importantes dificultades para adaptarse al nuevo entorno. Se ha visto un aumento de la tasa de suicidios y del uso problemático de alcohol, disminución precoz del trastorno por atracones con aparición posterior de conductas compensatorias, distorsión de la imagen corporal y aparición de conflictos conyugales. La presencia de trastorno de personalidad previo a la cirugía, constituiría un predictor negativo de resultado a largo plazo. Es en este contexto que se hace necesario un seguimiento post operatorio exhaustivo a estos pacientes, de tal forma de intervenir precozmente y optimizar los beneficios en la salud mental obtenidos con la baja de peso.

International audience; INTRODUCTION: Spinal metastasis are getting more frequent. This raises the question of pain and neurological complications, which worsen the functional and survival prognosis of this oncological population patients. The surgical treatment must be the most complete as possible: to decompress and stabilize without delaying the management of the oncological disease. Minimal invasive surgery techniques are by definition, less harmful on musculocutaneous plan than opened ones, with a comparable efficiency demonstrated in degenerative and traumatic surgery. So they seem to be applicable and appropriate to this patient population.ăMATERIAL AND METHODS: We detailed different minimal invasive techniques proposed in the management of spinal metastasis. For this, we used our experience developed in degenerative and traumatic pathologies, and we also referred to many authors, establishing a literature review thanks to Pubmed, Embase.ăRESULTS: Thirty eight articles were selected and allowed us to describe different techniques: percutaneous methods such as vertebro-/kyphoplasty and osteosynthesis, as well as mini-opened surgery, through a posterior or anterior way.ăDISCUSSION: We propose a surgical approach using these minimal invasive techniques, first according to the predominant symptom (pain or neurologic failure), then characteristics of the lesions (number, topography, type…) and the deformity degree. Whatever the technique, the main goal is to stabilize and decompress, in order to maintain a good quality of life for these fragile patients, without delaying the medical management of the oncological disease.

This paper constructs time series data on savings per type of agent for Chile during the period 1960-2012. It is found that the economy's average savings rate increased by 11 percentage points in the period 1985-2012 compared to 1960- 1984, with particularly pronounced growth in corporate savings. The evidence suggests that this increase was driven largely by the following measures: i) pension reform that introduced mandatory savings and private sector management, ii) banking reform, iii) tax reform, iv) capital markets reform and v) privatizations.

Este trabajo se enmarca en una investigación más amplia sobre el pensamiento funcional de los estudiantes de educación primaria en España. Presentamos parte de los resultados de un estudio exploratorio desarrollado con estudiantes de primer curso (seis-siete años). Mostramos los sistemas de representación y las estrategias que utilizan los estudiantes en la realización de una tarea que involucra la relación funcional f(x)=5x. Los resultados evidencian una variedad de estrategias empleadas por los estudiantes que incluyen la identificación de diferentes relaciones funcionales (adecuadas o no a la tarea) y la utilización de distintos sistemas de representación, con predominio del pictórico. This work is developed within a wider investigation about Spanish elementary students´ functional thinking. We present part of the results of an exploratory study developed with students of year 1 (six -seven years old). We show the representation systems and strategies used by the students when solving a task which involves the functional relationship f(x)=5x. The results evidence a variety of strategies used by the students that includes the identification of different functional relationships (adequate or not to the task) and the used of distinct representation systems, with predominance of the pictorial one. Este trabajo ha sido realizado dentro del proyecto de investigación del Plan Nacional I+D con referencia EDU2013-41632-P, financiado por el Ministerio de Economía y Competitividad de España.

Este trabajo se enmarca en una investigación más amplia sobre el pensamiento funcional de los estudiantes de educación primaria en España. Presentamos parte de los resultados de un estudio exploratorio desarrollado con estudiantes de primer curso (seis-siete años). Mostramos los sistemas de representación y las estrategias que utilizan los estudiantes en la realización de una tarea que involucra la relación funcional f(x)=5x. Los resultados evidencian una variedad de estrategias empleadas por los estudiantes que incluyen la identificación de diferentes relaciones funcionales (adecuadas o no a la tarea) y la utilización de distintos sistemas de representación, con predominio del pictórico. This work is developed within a wider investigation about Spanish elementary students´ functional thinking. We present part of the results of an exploratory study developed with students of year 1 (six -seven years old). We show the representation systems and strategies used by the students when solving a task which involves the functional relationship f(x)=5x. The results evidence a variety of strategies used by the students that includes the identification of different functional relationships (adequate or not to the task) and the used of distinct representation systems, with predominance of the pictorial one. Este trabajo ha sido realizado dentro del proyecto de investigación del Plan Nacional I+D con referencia EDU2013-41632-P, financiado por el Ministerio de Economía y Competitividad de España.

This paper examines the relative position of Chile through time and compared with other emerging and industrial economies, using various economic development indicators, particularly over the past two decades. It provides a descriptive analysis, without exploring causalities or testing hypotheses on the economic growth of the country, but it reveals the strengths and weaknesses that serve as the base for growth policy discussion. The comparison of economic development indicators shows that Chile is comparatively strong in macroeconomic stability, commercial and financial integration, quality of institutions, and in the progress of other structural reforms that are manifested in its well-developed capital market and private sector involvement in production. However, when it comes to quality of education, technological innovation efforts, infrastructure quality and quantity, and some social indicators, its performance is poor.

The objective of the Registry was to characterize the population of infants receiving prophylaxis for respiratory syncytial virus (RSV) disease by describing the patterns and scope of usage of palivizumab in a cross section of US infants. RSV hospitalization outcomes were also described. The Palivizumab (Synagis, MedImmune, Inc., 25 West Watkins Mill Road, Gaithersburg, MD 20878) Outcomes Registry was a prospective multicenter survey conducted at 63 sites. Demographics, injection history, and RSV hospitalization outcomes were collected on 2,116 infants receiving palivizumab. Infants were enrolled in the Registry between September 1, 2000-March 1, 2001, at the time of their first injection. Infants born at less than 32 weeks of gestation accounted for 47% of infants enrolled, and those between 32-35 weeks accounted for 45%; approximately 8% were greater than 35 weeks of gestation. Lower RSV hospitalization rates were observed in infants who had greater adherence to regularly scheduled injections. Nearly one-half of all hospitalizations occurred within the first and second injection intervals, suggesting the importance of early RSV protection. The confirmed RSV hospitalization rate of all infants in the Registry was 2.9%; the rate was 5.8% in infants with chronic lung disease of infancy, and 2.1% in premature infants without chronic lung disease. In conclusion, these data support the continued effectiveness of palivizumab prophylaxis for severe RSV lower respiratory tract disease in a large cohort of high-risk infants from geographically diverse pediatric offices and clinics. The Palivizumab Outcomes Registry provides an opportunity to assess palivizumab utilization and clinical effectiveness in the US.

Many authors have studied the flexibility of bank interest rates in different countries. In this paper we show some evidence for the Chilean banking industry, concluding that there is some sluggishness in the adjustment of banks’ lending rates to changes in the policy rate. However, Chile is among the countries with the most flexible interest rates. On the basis of individual bank data and a theoretical model, we identified some bank characteristics that might affect the degree of stickiness. Stylized facts and estimation results suggest that larger banks with a smaller portion of past-due loans and a higher percentage of household loans adjust faster to policy rate movements.