How did the COVID-19 crisis affect different types of workers in the developing world?

This paper examines how the COVID-19 pandemic affected the employment of different groups of workers across 40 mostly low and middle-income countries. Employment outcomes during the crisis are tracked through high-frequency phone surveys conducted by the World Bank and national statistics offices. Our results show that larger shares of female, young, less educated, and urban workers stopped working at the beginning of the pandemic. Gender gaps in work stoppage stemmed mainly from gender differences within sectors rather than differential employment patterns of men and women across sectors. Differences in work stoppage between urban and rural workers were markedly smaller than those across gender, age, and education groups. Preliminary results from 10 countries suggest that following the initial shock at the start of the pandemic, employment rates partially recovered between April and August 2020, with greater gains for those groups that had borne the brunt of the early jobs losses. Although the high-frequency phone surveys over-represent household heads and therefore overestimate employment rates, a validation exercise for five countries suggests that they provide a reasonably accurate measure of disparities in employment levels by gender, education, and urban/rural location following the onset of the crisis, although they perform less well in capturing disparities between age groups. These results shed new light on the distributional labor market consequences of the COVID-19 crisis in developing countries, and suggest that real-time phone surveys, despite their lack of representativeness, are a valuable source of information to measure differential employment impacts across groups during an unfolding crisis.

Propuestas para la incorporación del rol de enfermería en la certificación de unidades de espondiloartritis axial. Revisión bibliográfica y consenso entre expertas / Proposals for the Incorporation of the Nursing role in the Certification of Axial Spondyloarthritis Units. Literature Review and Expert Consensus

Objetivo: Analizar el papel de enfermería en el abordaje de la espondiloartritis axial (EspAax) y plantear propuestas que permitan incluir el rol de las consultas de enfermería en reumatología (CER) en la certificación de calidad de las unidades especializadas. Métodos: Revisión sistemática del rol de enfermería en los sistemas de certificación de calidad en el abordaje de la EspAax, seguida de conferencia de consenso con participación de 3enfermeras especializadas en reumatología para determinar elementos que considerar en futuras revisiones de las normas de certificación. Resultados: La revisión sistemática arrojó 5documentos relevantes. Ninguna de las publicaciones revisadas proponía estándares aplicables a la labor asistencial de enfermería en el manejo de pacientes con EspAax, aunque contemplaban actividades propias de este colectivo. Las propuestas consensuadas para incorporar el rol de las CER en las normas de certificación de las unidades monográficas de EspAax incluyeron: equipamientos y recursos básicos, organización, administración de tratamientos farmacológicos y promoción de la adherencia, programas estandarizados para EspAax, consulta telemática para control del paciente estable y promoción de la continuidad asistencial y registro de medidas de resultados informados por los pacientes. Conclusiones: La literatura sobre estándares de calidad y normas de certificación de las unidades monográficas de EspAax es escasa y apenas refleja el papel de las CER en la provisión de una atención de calidad. Las propuestas consensuadas en este trabajo incorporarían las CER en las normas de certificación de calidad. En el futuro, la mayor presencia de CER en España debiera ir acompañada de la actualización de los estándares.(AU)

Objective: To analyse the role of nursing in the approach to axial spondyloarthritis (axSpA) and to make proposals to include the role of rheumatology nursing consultations (RECs) in the quality certification of these specialized units. Methods: A systematic review of the nursing role in quality certification systems in the management of axSpA was conducted. Subsequently a consensus conference was held with the participation of 3rheumatology nurses to determine elements that should be considered in future revisions of certification standards. Results: The systematic review yielded 5papers as relevant. None of the publications reviewed explicitly proposed standards applicable to nursing care in the management of patients with axSpA, although they contemplated the activities of this professional group. The proposals agreed upon to incorporate the role of RECs in the certification standards for axSpA monographic units included the following: basic equipment and resources, organization, administration of pharmacological treatments and promotion of adherence, standardized programmes for axSpA, telematic consultation (e-consultation) for monitoring the stable patient and promoting continuity of care and registry of patient-reported outcome measures. Conclusions: The literature on quality standards and certification standards for axSpA monographic units is scarce and hardly reflects the role of RECs in providing quality care. The consensus proposals in this study would incorporate RECs into quality certification standards. In the future, the increased presence of RECs in Spain should be accompanied by a review of the indicators regarding their role.(AU)

Proposals for the incorporation of the nursing role in the certification of axial spondyloarthritis units. Literature review and expert consensus.

OBJECTIVE: To analyse the role of nursing in the approach to axial spondyloarthritis (axSpA) and to make proposals to include the role of rheumatology nursing consultations (RECs) in the quality certification of these specialized units. METHODS: A systematic review of the nursing role in quality certification systems in the management of axSpA was conducted. Subsequently a consensus conference was held with the participation of three rheumatology nurses to determine elements that should be considered in future revisions of certification standards. RESULTS: The systematic review yielded five papers as relevant. None of the publications reviewed explicitly proposed standards applicable to nursing care in the management of patients with axSpA, although they contemplated the activities of this professional group. The proposals agreed upon to incorporate the role of RECs in the certification standards for axSpA monographic units included the following: basic equipment and resources, organization, administration of pharmacological treatments and promotion of adherence, standardized programmes for axSpA, telematic consultation for monitoring the stable patient, registry of patient-reported outcome measures and e-consultation. CONCLUSIONS: The literature on quality standards and certification standards for axSpA monographic units is scarce and hardly reflects the role of RECs in providing quality care. The consensus proposals in this study would incorporate RECs into quality certification standards. In the future, the increased presence of RECs in Spain should be accompanied by a review of the indicators regarding their role.

Physical activity and sedentary time in a rural adult population in Malawi compared with an age-matched US urban population.

OBJECTIVES: This study was designed to assess patterns of objectively measured physical activity (PA) and sedentary behaviour in a sample of adults in a rural setting from a low-income Sub-Saharan African country (Malawi). The patterns of PA and sedentary behaviour in Malawi were compared with US data collected and analysed using the same methodology. METHODS: The Malawi PA data were collected as part of a survey experiment on the measurement of agricultural labor conducted under the World Bank Living Standards Measurement Study program. ActiGraph accelerometers (model GT3X) were worn on the right hip in a household-based sample of 414 working-age adults (15-85 years). RESULTS: Mean total and 95% CIs for PA by category in min/day for Malawi adults were: sedentary 387.6 (377.4-397.8), low-light 222.1 (214.7-229.5), high-light 136.3 (132.7-139.9), moderate 71.6 (68.8-74.5), vigorous 1.1 (0.5-1.8) and moderate-to-vigorous physical activity (MVPA) 72.8 (69.7-75.9). Mean of PA and sedentary behavior (min/day) summed across age and sex groups are compared between Malawi and US samples: sedentary behaviour, 387.6 vs 525.8 (p<0.001); low-light, 222.1 vs 217.0 (p=ns); high-light, 136.3 vs 45.6 (p<0.001); moderate, 71.6 vs 28.0 (p<0.001); vigorous, 1.1 vs 2.5 (p<0.001); MVPA, 72.8 vs 30.5 (p<0.001). Compared with the USA, Malawi participants averaged consistently less sedentary time/day and more minutes/day in all intensity levels of PA, except for low-light and vigorous PA. CONCLUSION: Overall, levels of MVPA and high-light activity in adults in Malawi were substantially higher and sedentary time was substantially lower than those observed in US samples using near identical data collection, scoring and analysis.

Preferencias en la vía de administración del tratamiento de pacientes con artritis reumatoide / Rheumatoid arthritis patient preferences for the treatment administration route

No disponible

Targeting RNA structure in SMN2 reverses spinal muscular atrophy molecular phenotypes.

Modification of SMN2 exon 7 (E7) splicing is a validated therapeutic strategy against spinal muscular atrophy (SMA). However, a target-based approach to identify small-molecule E7 splicing modifiers has not been attempted, which could reveal novel therapies with improved mechanistic insight. Here, we chose as a target the stem-loop RNA structure TSL2, which overlaps with the 5' splicing site of E7. A small-molecule TSL2-binding compound, homocarbonyltopsentin (PK4C9), was identified that increases E7 splicing to therapeutic levels and rescues downstream molecular alterations in SMA cells. High-resolution NMR combined with molecular modelling revealed that PK4C9 binds to pentaloop conformations of TSL2 and promotes a shift to triloop conformations that display enhanced E7 splicing. Collectively, our study validates TSL2 as a target for small-molecule drug discovery in SMA, identifies a novel mechanism of action for an E7 splicing modifier, and sets a precedent for other splicing-mediated diseases where RNA structure could be similarly targeted.

How much of the labor in African agriculture is provided by women?

The contribution of women to labor in African agriculture is regularly quoted in the range of 60-80%. Using individual, plot-level labor input data from nationally representative household surveys across six Sub-Saharan African countries, this study estimates the average female labor share in crop production at 40%. It is slightly above 50% in Malawi, Tanzania, and Uganda, and substantially lower in Nigeria (37%), Ethiopia (29%), and Niger (24%). There are no systematic differences across crops and activities, but female labor shares tend to be higher in households where women own a larger share of the land and when they are more educated. Controlling for the gender and knowledge profile of the respondents does not meaningfully change the predicted female labor shares. The findings question prevailing assertions regarding substantial gains in aggregate crop output as a result of increasing female agricultural productivity.

Muscleblind, BSF and TBPH are mislocalized in the muscle sarcomere of a Drosophila myotonic dystrophy model.

Myotonic dystrophy type 1 (DM1) is a genetic disease caused by the pathological expansion of a CTG trinucleotide repeat in the 3' UTR of the DMPK gene. In the DMPK transcripts, the CUG expansions sequester RNA-binding proteins into nuclear foci, including transcription factors and alternative splicing regulators such as MBNL1. MBNL1 sequestration has been associated with key features of DM1. However, the basis behind a number of molecular and histological alterations in DM1 remain unclear. To help identify new pathogenic components of the disease, we carried out a genetic screen using a Drosophila model of DM1 that expresses 480 interrupted CTG repeats, i(CTG)480, and a collection of 1215 transgenic RNA interference (RNAi) fly lines. Of the 34 modifiers identified, two RNA-binding proteins, TBPH (homolog of human TAR DNA-binding protein 43 or TDP-43) and BSF (Bicoid stability factor; homolog of human LRPPRC), were of particular interest. These factors modified i(CTG)480 phenotypes in the fly eye and wing, and TBPH silencing also suppressed CTG-induced defects in the flight muscles. In Drosophila flight muscle, TBPH, BSF and the fly ortholog of MBNL1, Muscleblind (Mbl), were detected in sarcomeric bands. Expression of i(CTG)480 resulted in changes in the sarcomeric patterns of these proteins, which could be restored by coexpression with human MBNL1. Epistasis studies showed that Mbl silencing was sufficient to induce a subcellular redistribution of TBPH and BSF proteins in the muscle, which mimicked the effect of i(CTG)480 expression. These results provide the first description of TBPH and BSF as targets of Mbl-mediated CTG toxicity, and they suggest an important role of these proteins in DM1 muscle pathology.

Expanded CTG repeats trigger miRNA alterations in Drosophila that are conserved in myotonic dystrophy type 1 patients.

Myotonic dystrophy type 1 (DM1) is caused by the expansion of CTG repeats in the 3' untranslated region of the DMPK gene. Several missplicing events and transcriptional alterations have been described in DM1 patients. A large number of these defects have been reproduced in animal models expressing CTG repeats alone. Recent studies have also reported miRNA dysregulation in DM1 patients. In this work, a Drosophila model was used to investigate miRNA transcriptome alterations in the muscle, specifically triggered by CTG expansions. Twenty miRNAs were differentially expressed in CTG-expressing flies. Of these, 19 were down-regulated, whereas 1 was up-regulated. This trend was confirmed for those miRNAs conserved between Drosophila and humans (miR-1, miR-7 and miR-10) in muscle biopsies from DM1 patients. Consistently, at least seven target transcripts of these miRNAs were up-regulated in DM1 skeletal muscles. The mechanisms involved in dysregulation of miR-7 included a reduction of its primary precursor both in CTG-expressing flies and in DM1 patients. Additionally, a regulatory role for Muscleblind (Mbl) was also suggested for miR-1 and miR-7, as these miRNAs were down-regulated in flies where Mbl had been silenced. Finally, the physiological relevance of miRNA dysregulation was demonstrated for miR-10, since over-expression of this miRNA in Drosophila extended the lifespan of CTG-expressing flies. Taken together, our results contribute to our understanding of the origin and the role of miRNA alterations in DM1.

Efectividad de la técnica de resolución de problemas aplicada por enfermeras: disminución de la ansiedad y la depresión en cuidadoras familiares / Effectiveness of problem solving technique applied by nurses: Decreased anxiety and depression in family caregivers

Objetivo: Conocer la efectividad de la técnica de resolución de problemas en la reducción de la ansiedad y la depresión, y en el aumento del bienestar percibido en cuidadoras familiares de personas dependientes. Diseño: Ensayo clínico. Emplazamiento: Centros de atención primaria de Tarragona, España. Período 2007-2011. Participantes: Muestra 122 cuidadoras de pacientes incluidos en programa de atención domiciliaria, con síntomas de ansiedad, depresión o bienestar emocional comprometido. Se asignaron aleatoriamente al grupo control o de intervención. Intervenciones: En el grupo experimental las enfermeras aplicaban a la cuidadora, durante las visitas domiciliarias, la técnica según protocolo de 4 sesiones. En el grupo control la enfermera realizó la atención habitual. Al mes de finalizar la intervención, se realizó nuevamente la medición de las variables dependientes en ambos grupos. Mediciones principales: Las variables dependientes, ansiedad y depresión, se midieron mediante la escala Goldberg y el bienestar emocional mediante la escala de salud emocional del cuidador principal. Resultados: Se detecta una mejora estadísticamente significativa en el grupo intervención de los síntomas de ansiedad, depresión y bienestar percibido en relación con el grupo control. Conclusiones: La técnica de resolución de problemas es una herramienta terapéutica útil para la disminución de los síntomas de malestar emocional de las cuidadoras familiares de pacientes crónicos(AU)

Objective: To determine the effectiveness of Problem Solving Technique in reducing anxiety and depression, and increased perceived well-being in women family caregivers of chronic patients. Design: A clinical trial. Field of study: Health centres in Tarragona, Spain, during 2007-2011. Participants: A sample 122 caregivers of patients in home care programs that met the inclusion criteria, were assigned to intervention or control group according to a simple random process. Interventions: In the experimental group, the nurses applied the Problem Solving Technique to the caregiver according to a four-session protocol. The nurses provided the usual care to the caregivers In the control group. One month after intervention, the dependent vriables were measured again in both groups. Principal measurement: The dependent variables of anxiety and depression were measured using the Goldberg scale, and the emotional well-being variable by the scale of emotional health of the primary caregiver. Results: A statistically significant improvement was detected in the anxiety and depression symptoms, as well as the perceived well-being in the intervention group compared to the control group. Conclusions: Implementation of the Problem Solving Technique is a useful therapeutic tool for reducing symptoms of distress in family caregivers of chronic patients(AU)

[Effectiveness of problem solving technique applied by nurses: decreased anxiety and depression in family caregivers]. / Efectividad de la técnica de resolución de problemas aplicada por enfermeras: disminución de la ansiedad y la depresión en cuidadoras familiares.

OBJECTIVE: To determine the effectiveness of Problem Solving Technique in reducing anxiety and depression, and increased perceived well-being in women family caregivers of chronic patients. DESIGN: A clinical trial FIELD OF STUDY: Health centres in Tarragona, Spain, during 2007-2011. PARTICIPANTS: A sample 122 caregivers of patients in home care programs that met the inclusion criteria, were assigned to intervention or control group according to a simple random process. INTERVENTIONS: In the experimental group, the nurses applied the Problem Solving Technique to the caregiver according to a four-session protocol. The nurses provided the usual care to the caregivers In the control group. One month after intervention, the dependent vriables were measured again in both groups. PRINCIPAL MEASUREMENT: The dependent variables of anxiety and depression were measured using the Goldberg scale, and the emotional well-being variable by the scale of emotional health of the primary caregiver. RESULTS: A statistically significant improvement was detected in the anxiety and depression symptoms, as well as the perceived well-being in the intervention group compared to the control group. CONCLUSIONS: Implementation of the Problem Solving Technique is a useful therapeutic tool for reducing symptoms of distress in family caregivers of chronic patients.

In vivo discovery of a peptide that prevents CUG-RNA hairpin formation and reverses RNA toxicity in myotonic dystrophy models.

Myotonic dystrophy type 1 (DM1) is caused by the expansion of noncoding CTG repeats in the dystrophia myotonica-protein kinase gene. Mutant transcripts form CUG hairpins that sequester RNA-binding factors into nuclear foci, including Muscleblind-like-1 protein (MBNL1), which regulate alternative splicing and gene expression. To identify molecules that target toxic CUG transcripts in vivo, we performed a positional scanning combinatorial peptide library screen using a Drosophila model of DM1. The screen identified a D-amino acid hexapeptide (ABP1) that reduced CUG foci formation and suppressed CUG-induced lethality and muscle degeneration when administered orally. Transgenic expression of natural, L-amino acid ABP1 analogues reduced CUG-induced toxicity in fly eyes and muscles. Furthermore, ABP1 reversed muscle histopathology and splicing misregulation of MBNL1 targets in DM1 model mice. In vitro, ABP1 bound to CUG hairpins and induced a switch to a single-stranded conformation. Our findings demonstrate that ABP1 shows antimyotonic dystrophy activity by targeting the core of CUG toxicity.

Laberinto de cristal en el liderazgo de las mujeres / Glass maze in women’s leadership

Las teorías sobre la discriminación de género han ido evolucionando a lo largo de los treinta últimos años y se han hecho más complejas en un intento por comprender la realidad social. Uno de los ámbitos preferentes de investigación es el referido al laberinto de cristal en la carrera directiva de las mujeres. El objetivo de este trabajo consiste en poner de manifiesto la evolución en las explicaciones del enfoque de género al estudio del liderazgo, incidiendo en las transformaciones desde las hipótesis centradas en la división sexual del trabajo, hasta las formulaciones más recientes de carácter interactivo. La psicología social ha destacado el papel de las creencias, a través de los roles estereotipados, las actitudes prejuiciosas hacia las mujeres, la ideología sexista y neo-sexista o el desarrollo de identidades de género. Las interpretaciones actuales inciden en la variabilidad del concepto de género, que a veces se manifiesta a través de las conductas que realizan los hombres y las mujeres, pero también está presente en la elaboración que se hace de dichas conductas y, sobre todo, se observa en las relaciones de poder en el transcurso de las interacciones sociales de la organización laboral (AU)

Psychological gender discrimination explanations have changed over the past thirty years, becoming more complex in order to obtain a better understanding of the social reality. At the present moment, one of the most interesting research areas is the one referring to the ‘glass maze’ phenomenon in women’s management careers. The main purpose of this work is to reveal the theoretical evolution in an attempt to explain the leadership study from a gender perspective. The consecutive hypotheses, starting with the labour sexual division idea, are becoming more interactive in order to understand the current labour-social situation. Social psychology has underlined the role of beliefs, observed via gender stereotyped roles, prejudiced attitudes against women, sexist and neosexist ideology, or masculine, feminine and androgynous identity development. New psychological interpretations insist on the variability of the gender concept, where gender is sometimes observed through men and women’s behaviours, and other times through those behaviour expectations. But gender is mainly observed though the power relations between men and women during social interactions in labour organizations (AU)

Alternative splicing regulation by Muscleblind proteins: from development to disease.

Regulated use of exons in pre-mRNAs, a process known as alternative splicing, strongly contributes to proteome diversity. Alternative splicing is finely regulated by factors that bind specific sequences within the precursor mRNAs. Members of the Muscleblind (Mbl) family of splicing factors control critical exon use changes during the development of specific tissues, particularly heart and skeletal muscle. Muscleblind homologs are only found in metazoans from Nematoda to mammals. Splicing targets and recognition mechanisms are also conserved through evolution. In this recognition, Muscleblind CCCH-type zinc finger domains bind to intronic motifs in pre-mRNA targets in which the protein can either activate or repress splicing of nearby exons, depending on the localization of the binding motifs relative to the regulated alternative exon. In humans, the Muscleblind-like 1 (MBNL1) proteins play a critical role in hereditary diseases caused by microsatellite expansions, particularly myotonic dystrophy type 1 (DM1), in which depletion of MBNL1 activity through sequestration explains most misregulated alternative splicing events, at least in murine models. Because of the involvement of these proteins in human diseases, further understanding of the molecular mechanisms by which MBNL1 regulates splicing will help design therapies to revert pathological splicing alterations. Here we summarize the most relevant findings on this family of proteins in recent years, focusing on recently described functional motifs, transcriptional regulation of Muscleblind, regulatory activity on splicing, and involvement in human diseases.

[Glass maze in women's leadership]. / Laberinto de cristal en el liderazgo de las mujeres.

Psychological gender discrimination explanations have changed over the past thirty years, becoming more complex in order to obtain a better understanding of the social reality. At the present moment, one of the most interesting research areas is the one referring to the 'glass maze' phenomenon in women's management careers. The main purpose of this work is to reveal the theoretical evolution in an attempt to explain the leadership study from a gender perspective. The consecutive hypotheses, starting with the labour sexual division idea, are becoming more interactive in order to understand the current labour-social situation. Social psychology has underlined the role of beliefs, observed via gender stereotyped roles, prejudiced attitudes against women, sexist and neo-sexist ideology, or masculine, feminine and androgynous identity development. New psychological interpretations insist on the variability of the gender concept, where gender is sometimes observed through men and women's behaviours, and other times through those behaviour expectations. But gender is mainly observed though the power relations between men and women during social interactions in labour organizations.

[Incidence and clinical characteristics of community-acquired pneumonia managed as outpatient among elderly people in Tarragona-Valls, Spain]. / Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005.

BACKGROUND: Few information exists about community-acquired pneumonia (CAP) not hospitalized. This study assessed incidence and clinical characteristics of community-acquired pneumonia (CAP) managed as outpatient among elderly population. METHODS: Prospective cohort study that included 11,240 individuals 65 years or older who were assigned to 8 Primary Care Centers in the region of Tarragona-Valls, Spain. All cases of CAP managed as outpatient occurred among cohort members from January 1, 2002 to April 30, 2005 were included. All cases were x-ray proved and validated by checking clinical records. RESULTS: An amount of 118 cases of CAP managed as outpatient were observed (45 diagnosed in Primary Care and 73 diagnosed in Emergence Units) which means an incidence of 34.8 cases per 10,000 elderly persons-year (95% CI: 28.8-41.7). Incidence was greater among males (41.9 per 10,000) and among those aged 75 years or older (47.5 per 10,000). When diagnosis, 68.6% of patients had fever, (80% in 65-74 years and 60.3 in 75 years or older, p=0.037), 36.4% dyspnea, 44.9% pleural pain, 77.1% cough, 50.0% expectoraton and 5.7% had altered mental state. The combination of "fever, cough and pleural pain" occurred in 27.1% of cases (95% CI: 19.3-36.1). CONCLUSIONS: The incidence of outpatient CAP among elderly people is considerable. A great proportion of cases, specially older patients, had not typical clinical manifestations of pneumonia.

Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005 / Incidence and clinical characteristics of community-acquired pneumonia managed as outpatient among elderly people in Tarragona-Valls, Spain

Fundamentos: La información existente sobre la epidemiología de la neumonía adquirida en la comunidad (NAC) tratada extrahospitalariamente es limitada. Este estudio analizó la incidencia poblacional y características clínicas de las NAC no hospitalizadas en personas de edad avanzada. Métodos: Estudio prospectivo de cohortes sin grupo control, ámbito poblacional, que incluyó un total de 11.240 personas mayores de 65 años adscritas a 8 Areas Básicas de Salud (ABS) de Tarragona-Valls. Se reclutaron todos los casos de NAC trata- dos ambulatoriamente (diagnosticados en Servicios de Urgencia hospitalarios de referencia y/o en las ocho ABS participantes) ocurridos en la cohorte de estudio entre enero de 2002 y abril de 2005. Todos los casos incluidos fueron radiográficamente confirmados y validados mediante revisión de historia clínica. Resultados: Se observaron un total de 118 casos de NAC que no requirieron hospitalización (73 diagnosticados en Servicios de Urgencias hospitalarios y 45 en las diferentes ABS), con una densidad de incidencia de 34,8 casos por 10.000 personas- año (IC 95%: 28,8-41,7). La incidencia fue más alta en varones (41,9 por 10.000) y en personas mayores de 75 años (47,5 por 10.000). Al diagnóstico, 68,6% de los pacientes presentaban fiebre (80% en 65-74 años y 60,3 en mayores de 75 años; p=0.037), 36,4% disnea, 44,9% dolor torácico, 77,1% tos, 50,0% expectoración, y 5,7% confusión mental. La tríada “fiebre, tos y dolor torácico” estaba presente en el 27,1% (IC 95%: 19,3-36,1). Conclusiones: Entre las personas mayores, la incidencia de NAC tratada ambulatoriamente es considerable. Más de la mitad de los pacientes no presentan los signos y síntomas típicos, especialmente los de mayor edad (AU)

Background: Few information exists about community- acquired pneumonia (CAP) not hospitalized. This study assessed incidence and clinical characteristics of community- acquired pneumonia (CAP) managed as outpatient among elderly population. Methods: Prospective cohort study that included 11,240 individuals 65 years or older who were assigned to 8 Primary Care Centers in the region of Tarragona-Valls, Spain. All cases of CAP managed as outpatient occurred among cohort members from January 1, 2002 to April 30, 2005 were included. All cases were x-ray proved and validated by checking clinical records. Results: An amount of 118 cases of CAP managed as outpatient were observed (45 diagnosed in Primary Care and 73 diagnosed in Emergence Units) which means an incidence of 34.8 cases per 10,000 elderly persons-year (95% CI: 28.8-41.7). Incidence was greater among males (41.9 per 10,000) and among those aged 75 years or older (47.5 per 10,000). When diagnosis, 68.6% of patients had fever, (80% in 65-74 years and 60.3 in 75 years or older, p=0.037), 36.4% dyspnea, 44.9% pleural pain, 77.1% cough, 50.0% expectoraton and 5.7% had altered mental state. The combination of “fever, cough and pleural pain” occurred in 27.1% of cases (95% CI: 19.3-36.1). Conclusions: The incidence of outpatient CAP among elderly people is considerable. A great proportion of cases, specially older patients, had not typical clinical manifestations of pneumonia (AU)

The insect nephrocyte is a podocyte-like cell with a filtration slit diaphragm.

The nephron is the basic structural and functional unit of the vertebrate kidney. It is composed of a glomerulus, the site of ultrafiltration, and a renal tubule, along which the filtrate is modified. Although widely regarded as a vertebrate adaptation, 'nephron-like' features can be found in the excretory systems of many invertebrates, raising the possibility that components of the vertebrate excretory system were inherited from their invertebrate ancestors. Here we show that the insect nephrocyte has remarkable anatomical, molecular and functional similarity to the glomerular podocyte, a cell in the vertebrate kidney that forms the main size-selective barrier as blood is ultrafiltered to make urine. In particular, both cell types possess a specialized filtration diaphragm, known as the slit diaphragm in podocytes or the nephrocyte diaphragm in nephrocytes. We find that fly (Drosophila melanogaster) orthologues of the major constituents of the slit diaphragm, including nephrin, NEPH1 (also known as KIRREL), CD2AP, ZO-1 (TJP1) and podocin, are expressed in the nephrocyte and form a complex of interacting proteins that closely mirrors the vertebrate slit diaphragm complex. Furthermore, we find that the nephrocyte diaphragm is completely lost in flies lacking the orthologues of nephrin or NEPH1-a phenotype resembling loss of the slit diaphragm in the absence of either nephrin (as in human congenital nephrotic syndrome of the Finnish type, NPHS1) or NEPH1. These changes markedly impair filtration function in the nephrocyte. The similarities we describe between invertebrate nephrocytes and vertebrate podocytes provide evidence suggesting that the two cell types are evolutionarily related, and establish the nephrocyte as a simple model in which to study podocyte biology and podocyte-associated diseases.

Genetic and chemical modifiers of a CUG toxicity model in Drosophila.

Non-coding CUG repeat expansions interfere with the activity of human Muscleblind-like (MBNL) proteins contributing to myotonic dystrophy 1 (DM1). To understand this toxic RNA gain-of-function mechanism we developed a Drosophila model expressing 60 pure and 480 interrupted CUG repeats in the context of a non-translatable RNA. These flies reproduced aspects of the DM1 pathology, most notably nuclear accumulation of CUG transcripts, muscle degeneration, splicing misregulation, and diminished Muscleblind function in vivo. Reduced Muscleblind activity was evident from the sensitivity of CUG-induced phenotypes to a decrease in muscleblind genetic dosage and rescue by MBNL1 expression, and further supported by the co-localization of Muscleblind and CUG repeat RNA in ribonuclear foci. Targeted expression of CUG repeats to the developing eye and brain mushroom bodies was toxic leading to rough eyes and semilethality, respectively. These phenotypes were utilized to identify genetic and chemical modifiers of the CUG-induced toxicity. 15 genetic modifiers of the rough eye phenotype were isolated. These genes identify putative cellular processes unknown to be altered by CUG repeat RNA, and they include mRNA export factor Aly, apoptosis inhibitor Thread, chromatin remodelling factor Nurf-38, and extracellular matrix structural component Viking. Ten chemical compounds suppressed the semilethal phenotype. These compounds significantly improved viability of CUG expressing flies and included non-steroidal anti-inflammatory agents (ketoprofen), muscarinic, cholinergic and histamine receptor inhibitors (orphenadrine), and drugs that can affect sodium and calcium metabolism such as clenbuterol and spironolactone. These findings provide new insights into the DM1 phenotype, and suggest novel candidates for DM1 treatments.