Amyloid-ß PET Classification on Cognitive Aging Stages Using the Centiloid Scale.

PROPOSE: This study aims to explore the use of the Centiloid (CL) method in amyloid-ß PET quantification to evaluate distinct cognitive aging stages, investigating subjects' mismatch classification using different cut-points for amyloid-ß positivity. PROCEDURES: The CL equation was applied in four groups of individuals: SuperAgers (SA), healthy age-matched controls (AC), healthy middle-aged controls (MC), and Alzheimer's disease (AD). The amyloid-ß burden was calculated and compared between groups and quantitative variables. Three different cut-points (Jack CR, Wiste HJ, Weigand SD, et al., Alzheimer's Dement 13:205-216, 2017; Salvadó G, Molinuevo JL, Brugulat-Serrat A, et al., Alzheimer's Res Ther 11:27, 2019; and Amadoru S, Doré V, McLean CA, et al., Alzheimer's Res Ther 12:22, 2020) were applied in CL values to differentiate the earliest abnormal pathophysiological accumulation of Aß and the established Aß pathology. RESULTS: The AD group exhibited a significantly increased Aß burden compared to the MC, but not AC groups. Both healthy control (MC and AC) groups were not significantly different. Visually, the SA group showed a diverse distribution of CL values compared with MC; however, the difference was not significant. The CL values have a moderate and significant relationship between Aß visual read, RAVLT DR and MMSE. Depending on the cut-point used, 10 CL, 19 CL, or 30 CL, 7.5% of our individuals had a different classification in the Aß positivity. For the AC group, we obtained about 40 to 60% of the individuals classified as positive. CONCLUSION: SuperAgers exhibited a similar Aß load to AC and MC, differing in cognitive performance. Independently of cut-point used (10 CL, 19 CL, or 30 CL), three SA individuals were classified as Aß positive, showing the duality between the individual's clinics and the biological definition of Alzheimer's. Different cut-points lead to Aß positivity classification mismatch in individuals, and an extra care is needed for individuals who have a CL value between 10 and 30 CL.

Amyloid and anatomical correlates of executive functioning in middle-aged offspring of patients with late-onset Alzheimer's disease.

A traditional hallmark of cognitive impairment associated with late-onset Alzheimer´s disease (LOAD) is episodic memory impairment. However, early alterations have been identified in brain regions associated with executive function in asymptomatic, middle-age offspring of patients with LOAD (O-LOAD) compared to those with no family history. We hypothesized that executive function among O-LOAD would correlate with structural and amyloid brain imaging differently from those without a family history of LOAD (control subjects, CS). Executive function, cortical thickness, and in-vivo Aß deposits were quantified in 30 O-LOAD and 25 CS. Associations were observed among O-LOAD only. Cortical thickness in the left lateral orbitofrontal cortex was positively associated with Design Fluency. The Stroop Color and Word Test, correlated positively with right rostral mid-frontal cortex thickness. Trails Making Test-B was inversely related to left medial orbitofrontal thickness. Tower of London total time was positively associated with ß-amyloid deposition in the right precuneus. These results support previous evidence that early executive dysfunction might reflect subtle, early changes in persons at risk of LOAD and suggests that executive function alterations deserve further exploration in the LOAD literature.

Costos en salud: un asunto polémico / Healthcare costs. A polemic matter

Existen dos problemas que complican el manejo de los costos en las organizaciones sanitarias. Uno es el carácter humanista, solidario y ético de esta actividad al que, en consecuencia, no le son aplicables muchos de los criterios y métodos que se emplean en la industria, el comercio e incluso en otros servicios. El otro tiene que ver con el complejo entramado de los procesos en esas organizaciones, donde prácticamente cada paciente o cada especialidad tiene su propio recorrido que lo caracteriza en términos de: lugares físicos, secuencia, tipo de persona a intervenir, desplazamientos, intensidad, medios técnicos, instrumentos, materiales a emplear y características de los resultados que deben esperarse. Derivado del primero aparecen criterios sobre - salud a cualquier costo - la buena salud es cara o mientras mayor porcentaje obtengamos del producto interno bruto mejor salud haremos. . Del segundo aparecen sistemas suficientemente complicados para no hacer notar que en muchas ocasiones los recursos consumidos no se convierten en efectos positivos para las personas y las poblaciones. Se trata entonces de despejar ambos problemas y sobre todo de alertar dónde están los puntos débiles y qué se puede hacer al respecto(AU)

There are two problems that complicate the management of costs in health organizations. One is the humanist, solidary and ethical character of this activity and to which, consequently, many of the criterions and methods are not applied as they are in industry, trade, and even other services. The other problem is related with the complex intertwining of processes in those organizations, where virtually every patient or specialty have their own follow-up features characterizing them in terms of physical spaces, sequence, type of intervened person, movement, intensity, equipment, instruments, used materials, and characteristics of expected outcome. The first one creates criterions about health at any costs, quality health is expensive, the higher percentage from the growth domestic product, the better health will be provided. The second creates systems complicated enough to conceal that consumed resources mostly don't turn into positive effects for people and populations. This is then about isolating both problems and, above all, warning about weaknesses and how to deal with them(AU)

Does Cereal crops asymmetrically affect Agriculture gross domestic product in Pakistan? Using NARDL model approach / As colheitas de cereais afetam assimetricamente o produto interno bruto da agricultura no Paquistão? Usando a abordagem do modelo NARDL

This study contributes to the extant literature on the nexus among rice, maize and wheat production with agriculture gross domestic product (AGDP) of Pakistan. We use time series data from 1970 to 2017 and employ the Non-linear Autoregressive Distributed Lag (NARDL) model. Short run and long run shocks between the selected variables and results is checked through the co-integration and nonlinear error correction model.Autoregressive distributed lag bound testing approach for co-integration and to find the relationship between variables Granger causality test is applied.Our results confirm co-integration, positive shocks results show that rice, maize and wheat production have significantly influence on AGDP. The asymmetrically positive shocks of three crops have neutral effect on AGDP. While in symmetric results show the unidirectional effect between rice, maize production with AGDP and wheat production do not have ganger causality with AGDP. Finally, results depict that wheat, maize and rice production significantly contributes to agricultural GDP in the case of Pakistan.(AU).

Este estudo contribui para a literatura existente sobre o nexo entre a produção de arroz, milho e trigo com produto interno bruto agrícola (AGDP) do Paquistão. Utilizamos dados de séries temporais de 1970 a 2017 e empregamos o modelo NARDL (Non-linear Autoregressive Distributed Lag). Choques de curto e longo prazo entre as variáveis selecionadas e os resultados são verificados por meio do modelo de co-integração e correção não linear de erros. É aplicada uma abordagem de teste de atraso retardado distribuído autorregressivo para co-integração e para encontrar a relação entre variáveis. Nossos resultados confirmam a co-integração; os resultados de choques positivos mostram que a produção de arroz, milho e trigo influencia significativamente na AGDP. Os choques assimétricos positivos de três culturas têm efeito neutro no AGDP. Enquanto nos resultados simétricos mostram o efeito unidirecional entre o arroz, a produção de milho com AGDP e a produção de trigo não têm causalidade de ganger com AGDP. Finalmente, os resultados mostram que a produção de trigo, milho e arroz contribui significativamente para o PIB agrícola no caso do Paquistão.(AU)

Does Cereal crops asymmetrically affect Agriculture gross domestic product in Pakistan? Using NARDL model approach / As colheitas de cereais afetam assimetricamente o produto interno bruto da agricultura no Paquistão? Usando a abordagem do modelo NARDL

ABSTRACT: This study contributes to the extant literature on the nexus among rice, maize and wheat production with agriculture gross domestic product (AGDP) of Pakistan. We use time series data from 1970 to 2017 and employ the Non-linear Autoregressive Distributed Lag (NARDL) model. Short run and long run shocks between the selected variables and result's is checked through the co-integration and nonlinear error correction model.Autoregressive distributed lag bound testing approach for co-integration and to find the relationship between variables Granger causality test is applied.Our results confirm co-integration, positive shocks results show that rice, maize and wheat production have significantly influence on AGDP. The asymmetrically positive shocks of three crops have neutral effect on AGDP. While in symmetric results show the unidirectional effect between rice, maize production with AGDP and wheat production do not have ganger causality with AGDP. Finally, results depict that wheat, maize and rice production significantly contributes to agricultural GDP in the case of Pakistan.

RESUMO: Este estudo contribui para a literatura existente sobre o nexo entre a produção de arroz, milho e trigo com produto interno bruto agrícola (AGDP) do Paquistão. Utilizamos dados de séries temporais de 1970 a 2017 e empregamos o modelo NARDL (Non-linear Autoregressive Distributed Lag). Choques de curto e longo prazo entre as variáveis selecionadas e os resultados são verificados por meio do modelo de co-integração e correção não linear de erros. É aplicada uma abordagem de teste de atraso retardado distribuído autorregressivo para co-integração e para encontrar a relação entre variáveis. Nossos resultados confirmam a co-integração; os resultados de choques positivos mostram que a produção de arroz, milho e trigo influencia significativamente na AGDP. Os choques assimétricos positivos de três culturas têm efeito neutro no AGDP. Enquanto nos resultados simétricos mostram o efeito unidirecional entre o arroz, a produção de milho com AGDP e a produção de trigo não têm causalidade de ganger com AGDP. Finalmente, os resultados mostram que a produção de trigo, milho e arroz contribui significativamente para o PIB agrícola no caso do Paquistão.

Fully-automated radiosynthesis of the amyloid tracer [11C] PiB via direct [11C]CO2 fixation-reduction.

BACKGROUND: The ß-amyloid radiotracer [11C] PiB is extensively used for the Positron Emission Tomography (PET) diagnosis of Alzheimer's Disease and related dementias. For clinical use, [11C] PiB is produced using the 11C-methylation method ([11C] Methyl iodide or [11C] methyl triflate as 11C-methylation agents), which represents the most employed 11C-labelling strategy for the synthesis of 11C-radiopharmaceuticals. Recently, the use of direct [11C]CO2 fixation for the syntheses of 11C-tracers has gained interest in the radiochemical community due to its importance in terms of radiochemical versatility and for permitting the direct employment of the cyclotron-produced precursor [11C]CO2. This paper presents an optimised alternative one-pot methodology of [11C]CO2 fixation-reduction for the rapid synthesis of [11C] PiB using an automated commercial platform and its quality control. RESULTS: [11C] PiB was obtained from a (25.9 ± 13.2)% (Average ± Variation Coefficient, n = 3) (end of synthesis, decay corrected) radiochemical yield from trapped [11C]CO2 after 1 min of labelling time using PhSiH3 / TBAF as the fixation-reduction system in Diglyme at 150 °C. The radiochemical purity was higher than 95% in all cases, and the molar activity was (61.4 ± 1.6) GBq/µmol. The radiochemical yield and activity (EOS) of formulated [11C] PiB from cyclotron-produced [11C]CO2 was (14.8 ± 12.1)%, decay corrected) and 9.88 GBq (± 6.0%), respectively. These are higher values compared to that of the 11C-methylation method with [11C]CH3OTf (~ 8.3%). CONCLUSIONS: The viability of the system PhSiH3 / TBAF to efficiently promote the radiosynthesis of [11C] PiB via direct [11C]CO2 fixation-reduction has been demonstrated. [11C] PiB was obtained through a fully automated radiosynthesis with a satisfactory yield, purity and molar activity. According to the results, the one-pot methodology employed could reliably yield sufficiently high tracer amounts for preclinical and clinical use.

Relationships Between Executive Control Circuit Activity, Amyloid Burden, and Education in Cognitively Healthy Older Adults.

INTRODUCTION: In cognitively healthy older adults, amyloid-beta (Aß) burden is associated with greater activity on task-based functional magnetic resonance imaging. Higher levels of functional activation are associated with other factors along with amyloid and the authors investigated these relationships as well as how they relate to Aß in cognitively healthy older adults. METHODS: The authors recruited cognitive healthy older adults (N = 50) from the Pittsburgh community that underwent extensive cognitive batteries, activation during a working memory (digit symbol substitution task, DSST), positron emission tomography scan for Pittsburgh Compound B (PiB, measuring amyloid), and other demographic measures. The authors tested the association between DSST activation and global PiB, neurocognitive batteries, and education. RESULTS: The authors found that the DSST robustly activated expected structures involved in working memory. The authors found that greater global Aß deposition was associated with greater DSST activation in the right calcarine, precuneus, middle temporal as well as the left insula and inferior frontal gyrus. The authors also found that greater education was associated with lower DSST activation - however this was not significant after adjusting for Aß. DISCUSSION: Greater amyloid was associated with greater activation, which may represent compensatory activation. Greater education was associated with lower activation, which may represent more efficient activation (i.e., less activation for the same task). After adjusting for amyloid, education was not significantly associated with activation suggesting that during the preclinical stage amyloid is the primary determinant of activation. Further, activation was not associated with cognitive function. Compensatory activation in the preclinical stage may help maintain cognitive function.

Cortical thickness, brain metabolic activity, and in vivo amyloid deposition in asymptomatic, middle-aged offspring of patients with late-onset Alzheimer's disease.

The natural history of preclinical late-onset Alzheimer's disease (LOAD) remains obscure and has received less attention than that of early-onset AD (EOAD), in spite of accounting for more than 99% of cases of AD. With the purpose of detecting early structural and functional traits associated with the disorder, we sought to characterize cortical thickness and subcortical grey matter volume, cerebral metabolism, and amyloid deposition in persons at risk for LOAD in comparison with a similar group without family history of AD. We obtained 3T T1 images for gray matter volume, FDG-PET to evaluate regional cerebral metabolism, and PET-PiB to detect fibrillar amyloid deposition in 30 middle-aged, asymptomatic, cognitively normal individuals with one parent diagnosed with LOAD (O-LOAD), and 25 comparable controls (CS) without family history of neurodegenerative disorders (CS). We observed isocortical thinning in AD-relevant areas including posterior cingulate, precuneus, and areas of the prefrontal and temporoparietal cortex in O-LOAD. Unexpectedly, this group displayed increased cerebral metabolism, in some cases overlapping with the areas of cortical thinning, and no differences in bilateral hippocampal volume and hippocampal metabolism. Given the importance of age in this sample of individuals potentially developing early AD-related changes, we controlled results for age and observed that most differences in cortical thickness and metabolism became nonsignificant; however, greater deposition of ß-amyloid was observed in the right hemisphere including temporoparietal cortex, postcentral gyrus, fusiform inferior and middle temporal and lingual gyri. If replicated, the present observations of morphological, metabolic, and amyloid changes in cognitively normal persons with family history of LOAD may bear important implications for the definition of very early phenotypes of this disorder.

A influência da capacidade econômica e da formação de receitas públicas no desenvolvimento humano / La influencia de la capacidad económica y de formación de ingressos económicos en desarrollo humano / The influence of economic capacity and the formation of public revenues on human development

Resumo A promoção do desenvolvimento humano, relacionada com a melhoria de diversas dimensões socioeconômicas, sofre influência do financiamento público e da circulação econômica. Nesse contexto, e considerando a importância do crescimento econômico para o desenvolvimento humano, o presente estudo tem por objetivo identificar as relações estruturais entre capacidade e perfil econômicos, arrecadação própria, transferências financeiras e desenvolvimento humano. Foram utilizados dados em painel logístico binomial. Os resultados apontaram a importância do PIB dos setores industrial e agropecuário e o volume das transferências intergovernamentais como influenciadores do desenvolvimento humano. Por outro lado, o setor de serviços apresentou efeito negativo, embora não se possa desconsiderar sua importância. O fato pode ser explicado pela sua presença em todos os municípios brasileiros, principalmente naqueles de pequeno porte, que na maioria das vezes apresentam baixa infraestrutura urbana, social e econômica e, consequentemente, concentram baixo valor agregado nesse setor econômico.

Resumen La promoción del desarrollo humano, relacionada a la mejora de diversas dimensiones socioeconómicas, sufre influencia del financiamiento público y de la circulación económica. En este contexto, teniendo en cuenta la importancia económica sobre el desarrollo humano, este artículo tiene el objetivo de identificar las relaciones estructurales entre las características económicas, propia capacidad de almacenamiento, las transferencias financieras y el desarrollo humano. Fue utilizado uno panel de datos, con la metodología logística binomial. Los resultados mostraron la importancia del PIB de los sectores industrial y agropecuario y el volumen de las transferencias intergubernamentales como influyentes del desarrollo humano. Por otro lado, el sector de servicio presentó un efecto negativo, aunque no se puede desconsiderar la importancia de este sector. Esto puede explicarse por su presencia en todos los municipios brasileños, principalmente en aquellos de pequeño porte que en la mayoría de las veces presentan baja infraestructura urbana, social y económica y, consecuentemente, concentran bajo valor agregado en este sector económico.

Abstract The promotion of human development, related to the improvement of several socioeconomic dimensions, is influenced by public funding and economic circulation. Considering the importance of economic growth to human development, this study aims to identify the structural relations of Brazilian municipalities' economic profile and capacity, their tax revenue, financial transfers and municipal human development. A binomial logistic regression with panel data was used. The results pointed out the importance of the industrial and agricultural GDP, as well as the volume of intergovernmental transfers as a conditioning factor of municipal human development. On the other hand, the service sector presented a negative influence, although its importance must not be disregarded. This can be explained by the presence of this sector in all Brazilian municipalities, especially the smaller ones, which in most cases have low urban, social and economic infrastructure and, consequently, concentrate low added value to this sector.

Testing long-run relationship between agricultural gross domestic product and fruits production: evidence from Pakistan / Teste de relação de longo prazo entre o produto interno bruto agrícola e produção de frutos: evidência do Paquistão

This paper analyses the long-run relationship between agricultural gross domestic product (GDP) and fruits production of Pakistans economy over a period of 1961-2015 by employing Johansen and autoregressive distributed lag (ARDL) modern econometric technique. Three fruits were selected namely mango, apple and peach in this study. Augmented Dickey-Fuller and Phillips-Perron tests were used to check the data stationarity and conclude that the series are integrated of order one. The Johansen approach was applied to check the joint evolution of all the variables for co-integration. The Johansen test suggests that a long-run co-integration exists between agricultural GDP and fruits production. Results of the ARDL model (Bound test) detect the existence of long-run relationship between agricultural GDP and fruits production. The coefficient of the short-run form of ARDL model reveals that all the fruits have a positive impact on agricultural GDP. Moreover, the coefficients of the long-run form of ARDL model have apositive and significant influence on agricultural GDP of Pakistan. These results suggest that a 1% increase in mango, apple and peach production will increase agricultural GDP by 0.06%, 0.03% and 0.03% respectively. Finally, forecast error variance decomposition and impulse response function results depict that mango, apple and peach production significantly contributes to agricultural GDP in the case of Pakistan.(AU)

Este artigo analisa a relação de longa duração entre o Produto Interno Bruto agrícola (PIB) e a produção de frutos na economia do Paquistão durante um período de 1961-2015, empregando Johansen e o modelo ARDL (Autoregressive Distributed Lag) técnica de cointegração ou técnica de cointegração vinculada. Três frutas foram selecionadas neste estudo: manga, maçã e pêssego. Testes aumentados de Dickey-Fuller e Phillips-Perron foram utilizados para verificar a estacionária de dados e concluir que a série está integrada na ordem um. A abordagem de Johansen foi aplicada para verificar a evolução conjunta de todas as variáveis para a cointegração. O teste de Johansen sugere que existe uma cooperação de longa duração entre o PIB agrícola e a produção de frutos. Os resultados do modelo ARDL (Bound test) detectam a existência de uma relação de longa duração entre o PIB agrícola e a produção de frutos. O coeficiente da forma de curto prazo do modelo ARDL revela que todos os frutos têm um impacto positivo no PIB agrícola. Além disso, os coeficientes da forma de longo prazo do modelo ARDL têm uma influência positiva e significativa sobre o PIB agrícola do Paquistão. Estes resultados sugerem que um aumento de 1% na produção de manga, maçã e pêssego irá aumentar o PIB agrícola em 0,6%, 0,3% e 0,3%, respectivamente. Finalmente, a previsão de desvio de erros e resultados da função de resposta de impulso retratam que a produção de manga, maçã e pêssego contribui significativamente para o PIB agrícola do Paquistão.(AU)

Testing long-run relationship between agricultural gross domestic product and fruits production: evidence from Pakistan / Teste de relação de longo prazo entre o produto interno bruto agrícola e produçãode frutos: evidência do Paquistão

ABSTRACT: This paper analyses the long-run relationship between agricultural gross domestic product (GDP) and fruits production of Pakistan's economy over a period of 1961-2015 by employing Johansen and autoregressive distributed lag (ARDL) modern econometric technique. Three fruits were selected namely mango, apple and peach in this study. Augmented Dickey-Fuller and Phillips-Perron tests were used to check the data stationarity and conclude that the series are integrated of order one. The Johansen approach was applied to check the joint evolution of all the variables for co-integration. The Johansen test suggests that a long-run co-integration exists between agricultural GDP and fruits production. Results of the ARDL model (Bound test) detect the existence of long-run relationship between agricultural GDP and fruits production. The coefficient of the short-run form of ARDL model reveals that all the fruits have a positive impact on agricultural GDP. Moreover, the coefficients of the long-run form of ARDL model have apositive and significant influence on agricultural GDP of Pakistan. These results suggest that a 1% increase in mango, apple and peach production will increase agricultural GDP by 0.06%, 0.03% and 0.03% respectively. Finally, forecast error variance decomposition and impulse response function results depict that mango, apple and peach production significantly contributes to agricultural GDP in the case of Pakistan.

RESUMO: Este artigo analisa a relação de longa duração entre o Produto Interno Bruto agrícola (PIB) e a produção de frutos na economia do Paquistão durante um período de 1961-2015, empregando Johansen e o modelo ARDL (Autoregressive Distributed Lag) técnica de cointegração ou técnica de cointegração vinculada. Três frutas foram selecionadas neste estudo: manga, maçã e pêssego. Testes aumentados de Dickey-Fuller e Phillips-Perron foram utilizados para verificar a estacionária de dados e concluir que a série está integrada na ordem um. A abordagem de Johansen foi aplicada para verificar a evolução conjunta de todas as variáveis para a cointegração. O teste de Johansen sugere que existe uma cooperação de longa duração entre o PIB agrícola e a produção de frutos. Os resultados do modelo ARDL (Bound test) detectam a existência de uma relação de longa duração entre o PIB agrícola e a produção de frutos. O coeficiente da forma de curto prazo do modelo ARDL revela que todos os frutos têm um impacto positivo no PIB agrícola. Além disso, os coeficientes da forma de longo prazo do modelo ARDL têm uma influência positiva e significativa sobre o PIB agrícola do Paquistão. Estes resultados sugerem que um aumento de 1% na produção de manga, maçã e pêssego irá aumentar o PIB agrícola em 0,6%, 0,3% e 0,3%, respectivamente. Finalmente, a previsão de desvio de erros e resultados da função de resposta de impulso retratam que a produção de manga, maçã e pêssego contribui significativamente para o PIB agrícola do Paquistão.

Impacto macroeconómico generado por la pandemia del VIH/SIDA informado por la literatura internacional desde 1990 a 2013 / Macroeconomic impact generated by the pandemic of HIV/AIDS informed by the international literature since 1990 to 2013

Introducción: en 2013, ONUSIDA reportó más de 62 millones de personas infectadas por el VIH desde el inicio de la pandemia; de estos, tres millones se infectaron durante el último año. El impacto del VIH/SIDA a nivel individual ha sido bien documentado, mas los efectos de la pandemia a nivel macroeconómico mundial han sido menos estudiados. Objetivo: determinar el impacto a nivel macroeconómico del VIH/SIDA. Materiales y métodos: estudio hermenéutico sobre fuentes secundarias de información que mediante la triangulación de esta con la teoría económica, se proyectaron posibles consecuencias en los países más afectados por la pandemia. Resultados: la pandemia del VIH/SIDA impacta la oferta de trabajo, mediante el aumento de la morbilidad y mortalidad. El SIDA reduce la productividad laboral, creando así crisis fiscales. El gasto público relacionado con el VIH/SIDA aumentará dentro del rango de 0,2% y 3,5% del presupuesto del gobierno. La baja productividad del sector primario nacional aumenta la importación de alimentos. En Sudáfrica para el año 2010 el PIB sería un 17% menor a un escenario sin VIH/SIDA. Conclusiones: se estima que el VIH/SIDA aumentará los costos de mantenimiento de la fuerza de trabajo, alterará la balanza comercial, induciendo déficit fiscal, así como una caída de la productividad cercana al 75% y del crecimiento económico de 5% del PIB en los próximos diez años. Aunque se realizó una búsqueda a nivel mundial, los resultados obtenidos se concentran en África.

Background: in 2013, UNAIDS reports more than 62 million people infected with HIV since the onset of the pandemic, of which 3 million became infected during the past year. The impact of HIV/AIDS at the individual level has been well documented, but the effects of the pandemic at the global macroeconomic level have been less studied. Objective: to determine the macroeconomic impact of HIV/AIDS. Materials and methods: hermeneutic study on secondary sources of information that through triangulation of this information with the economic theory was documented predictions of what will happen in the countries most affected by the pandemic. Results: the HIV/AIDS pandemic impacts the labour supply, through increased morbidity and mortality. AIDS reduces labour productivity, thus creating fiscal crises. Public spending related to HIV/AIDS will increase within the range of 0.2% and 3.5% of the government budget. The low productivity of the national primary sector increases the import of food. Slope of GDP in South Africa by 2010 the GDP would be 17% lower than a scenario without HIV/AIDS. Conclusions: it is estimated that HIV/AIDS will increase the costs of maintaining the labour force, will alter the trade balance, inducing a fiscal deficit, as well as a productivity decrease of close to 75% and economic growth of 5% of GDP in the next ten years. Although a search was carried out worldwide, the results obtained are concentrated in Africa.

Testing long-run relationship between agricultural gross domestic product and fruits production: evidence from Pakistan / Teste de relação de longo prazo entre o produto interno bruto agrícola e produção de frutos: evidência do Paquistão

This paper analyses the long-run relationship between agricultural gross domestic product (GDP) and fruits production of Pakistans economy over a period of 1961-2015 by employing Johansen and autoregressive distributed lag (ARDL) modern econometric technique. Three fruits were selected namely mango, apple and peach in this study. Augmented Dickey-Fuller and Phillips-Perron tests were used to check the data stationarity and conclude that the series are integrated of order one. The Johansen approach was applied to check the joint evolution of all the variables for co-integration. The Johansen test suggests that a long-run co-integration exists between agricultural GDP and fruits production. Results of the ARDL model (Bound test) detect the existence of long-run relationship between agricultural GDP and fruits production. The coefficient of the short-run form of ARDL model reveals that all the fruits have a positive impact on agricultural GDP. Moreover, the coefficients of the long-run form of ARDL model have apositive and significant influence on agricultural GDP of Pakistan. These results suggest that a 1% increase in mango, apple and peach production will increase agricultural GDP by 0.06%, 0.03% and 0.03% respectively. Finally, forecast error variance decomposition and impulse response function results depict that mango, apple and peach production significantly contributes to agricultural GDP in the case of Pakistan.

Este artigo analisa a relação de longa duração entre o Produto Interno Bruto agrícola (PIB) e a produção de frutos na economia do Paquistão durante um período de 1961-2015, empregando Johansen e o modelo ARDL (Autoregressive Distributed Lag) técnica de cointegração ou técnica de cointegração vinculada. Três frutas foram selecionadas neste estudo: manga, maçã e pêssego. Testes aumentados de Dickey-Fuller e Phillips-Perron foram utilizados para verificar a estacionária de dados e concluir que a série está integrada na ordem um. A abordagem de Johansen foi aplicada para verificar a evolução conjunta de todas as variáveis para a cointegração. O teste de Johansen sugere que existe uma cooperação de longa duração entre o PIB agrícola e a produção de frutos. Os resultados do modelo ARDL (Bound test) detectam a existência de uma relação de longa duração entre o PIB agrícola e a produção de frutos. O coeficiente da forma de curto prazo do modelo ARDL revela que todos os frutos têm um impacto positivo no PIB agrícola. Além disso, os coeficientes da forma de longo prazo do modelo ARDL têm uma influência positiva e significativa sobre o PIB agrícola do Paquistão. Estes resultados sugerem que um aumento de 1% na produção de manga, maçã e pêssego irá aumentar o PIB agrícola em 0,6%, 0,3% e 0,3%, respectivamente. Finalmente, a previsão de desvio de erros e resultados da função de resposta de impulso retratam que a produção de manga, maçã e pêssego contribui significativamente para o PIB agrícola do Paquistão.

Amyloid positron emission tomography in sporadic cerebral amyloid angiopathy: A systematic critical update.

Sporadic cerebral amyloid angiopathy (CAA) is a very common small vessel disease of the brain, showing preferential and progressive amyloid-ßdeposition in the wall of small arterioles and capillaries of the leptomeninges and cerebral cortex. CAA now encompasses not only a specific cerebrovascular pathological trait, but also different clinical syndromes - including spontaneous lobar intracerebral haemorrhage (ICH), dementia and 'amyloid spells' - an expanding spectrum of brain parenchymal MRI lesions and a set of diagnostic criteria - the Boston criteria, which have resulted in increasingly detecting CAA during life. Although currently available validated diagnostic criteria perform well in multiple lobar ICH, a formal diagnosis is currently lacking unless a brain biopsy is performed. This is partly because in practice CAA MRI biomarkers provide only indirect evidence for the disease. An accurate diagnosis of CAA in different clinical settings would have substantial impact for ICH risk stratification and antithrombotic drug use in elderly people, but also for sample homogeneity in drug trials. It has recently been demonstrated that vascular (in addition to parenchymal) amyloid-ßdeposition can be detected and quantified in vivo by positron emission tomography (PET) amyloid tracers. This non-invasive approach has the potential to provide a molecular signature of CAA, and could in turn have major clinical impact. However, several issues around amyloid-PET in CAA remain unsettled and hence its diagnostic utility is limited. In this article we systematically review and critically appraise the published literature on amyloid-PET (PiB and other tracers) in sporadic CAA. We focus on two key areas: (a) the diagnostic utility of amyloid-PET in CAA and (b) the use of amyloid-PET as a window to understand pathophysiological mechanism of the disease. Key issues around amyloid-PET imaging in CAA, including relevant technical aspects are also covered in depth. A total of six small-scale studies have addressed (or reported data useful to address) the diagnostic utility of late-phase amyloid PET imaging in CAA, and one additional study dealt with early PiB images as a proxy of brain perfusion. Across these studies, amyloid PET imaging has definite diagnostic utility (currently tested only in probable CAA): it helps rule out CAA if negative, whether compared to healthy controls or to hypertensive deep ICH controls. If positive, however, differentiation from underlying incipient Alzheimer's disease (AD) can be challenging and so far, no approach (regional values, ratios, visual assessment) seems sufficient and specific enough, although early PiB data seem to hold promise. Based on the available evidence reviewed, we suggest a tentative diagnostic flow algorithm for amyloid-PET use in the clinical setting of suspected CAA, combining early- and late-phase PiB-PET images. We also identified ten mechanistic amyloid-PET studies providing early but promising proof-of-concept data on CAA pathophysiology and its various manifestations including key MRI lesions, cognitive impairment and large scale brain alterations. Key open questions that should be addressed in future studies of amyloid-PET imaging in CAA are identified and highlighted.

Amyloid-Beta Deposition is Associated with Increased Medial Temporal Lobe Activation during Memory Encoding in the Cognitively Normal Elderly.

BACKGROUND: Much is unknown about changes that occur in the brain in the years preceding the cognitive and functional impairment associated with Alzheimer disease (AD). This period before mild cognitive impairment is present has been referred to as preclinical AD, and is thought to begin with amyloid-beta deposition and then progress to neurodegeneration and functional brain circuit alterations. Prior studies have shown that there is increased medial temporal lobe activation on functional magnetic resonance imaging (fMRI) early in the course of mild cognitive impairment. It is unknown, however, whether this altered fMRI activity precedes cognitive impairment. The purpose of this study is to address this question using Pittsburgh Compound-B (PiB) imaging and fMRI in a sample of cognitively normal older adults. METHODS: Forty-four cognitively normal older adults underwent both PiB imaging and fMRI with a face-name memory task: 21 were classified as PiB(+) and 23 were PiB(-). Additionally, thorough cognitive and neuropsychological test batteries were administered outside the scanner. The main outcome measure in this study is fMRI activation in the medial temporal lobe during a face-name memory-encoding task. RESULTS: PiB(+) subjects showed higher fMRI activation during the memory task in the hippocampus relative to PiB(-) participants. CONCLUSIONS: The increased medial temporal lobe activation in preclinical AD, observed in this study, may serve as an early biomarker of neurodegeneration. Future studies are needed to clarify whether this functional biomarker can stratify AD risk among PiB(+) older adults.

Aportes del sector de la salud a la economía cubana (2004-2013) / Health care sector contributions to the Cuban economy 2004-2013

Introducción: el valor de los servicios ofrecidos por el sector de la salud pública retribuye el peso sustancial de sus asignaciones presupuestarias y el nivel de inversión en este sector del producto interno bruto, cuestión que repercute en los resultados económicos de la nación. Objetivo: describir la relación entre los resultados de la economía cubana y el aporte del sector de la salud. Métodos: estudio longitudinal de las asignaciones presupuestarias, nivel de inversión del producto interno bruto al sector de la salud y el aporte de la salud a este producto en el período 2004-2013. Resultados: durante el periodo estudiado, la economía cubana mantuvo un discreto crecimiento asociado, entre otros elementos, al aporte del sector de la salud a la formación del producto interno bruto según la metodología de cálculo establecida; de la misma manera, se comportaron los niveles de asignación presupuestaria a ese sector. Conclusiones: la existencia de una estrecha relación entre los resultados del producto interno bruto, el presupuesto total y su asignación al sector de la salud y el aporte de este sector, refleja la complementariedad que existe entre estos aspectos. La brecha entre los niveles de asignación presupuestaria y los aportes del sector de la salud a la economía, pueden explicar la capacidad de incremento de los niveles presupuestarios al sector, de forma tal que le permita perfeccionar los servicios prestados. El sector de la salud es uno de los líderes en la economía cubana actual(AU)

Introduction: the value of services offered by the public health sector repays the substantial weight of the budget allocations and the level of investment from the gross domestic product; this is an issue that affects the economic outcomes of the nation. Objective: to describe the relationship between the results of the Cuban economy and the contribution made by the health care sector in the 2004-2013 period. Methods: a longitudinal study of budgetary allocations, level of investment of the gross domestic product into the health care sector and the contribution of this sector to the said product from 2004 to 2013. Results: during the study period, the Cuban economy kept a modest growth associated, among other elements, to the contribution of the health care sector to the formation of the domestic gross product under the set estimation methodology, whereas the level of budget allocations to health have behaved the same. Conclusions: the close relationship among the results of gross domestic product, the total budget allocation to health and the contribution of the health care sector shows that these aspects complement each other. The gap between the levels of budget allocation and the contributions of the health sector accounts for the increased capacity of budget allocations to the sector in order to improve the rendered services. The health care sector is one of the leading areas in the present Cuban economy(AU)

PET and the multitracer concept in the study of neurodegenerative diseases / PET e o conceito de multitraçador no estudo de doenças degenerativas

ABSTRACT The complexity of the pathological reactions of the brain to an aggression caused by an internal or external noxa represents a challenge for molecular imaging. Positron emission tomography (PET) can indicate in vivo,anatomopathological changes involved in the development of different clinical symptoms in patients with neurodegenerative disorders. PET and the multitracer concept can provide information from different systems in the brain tissue building an image of the whole disease. We present here the combination of 18F-flourodeoxyglucose (FDG) and N-[11C-methyl]-L-deuterodeprenyl (DED), FDG and N-[11C-methyl] 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PIB), PIB and L-[11C]-3'4-Dihydrophenylalanine (DOPA) and finally PIB and [15O]H2O.

RESUMO A complexidade das reações patológicas do cérebro à agressões causadas por noxa interna ou externa representa um desafio para a imagem molecular. Tomografia por emissão de positron (PET) pode indicar, in vivo, alterações anatomopatológicas envolvidas no desenvolvimento de diferentes sintomas clínicos em pacientes com desordens neurodegenerativas. PET e o conceito de multitraçador pode fornecer informações de diferentes sistemas no tecido cerebral, construindo assim uma imagem da doença como um todo. Nós apresentamos neste artigo a combinação de 18F-flourodeoxyglucose (FDG) e N-[11C-methyl]-L-deuterodeprenyl (DED), FDG e N-[11C-methyl] 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PIB), PIB e L-[11C]-3'4-Dihydrophenylalanine (DOPA) e finalmente, PIB e [15O]H2O .

Concordance between 11C-PIB-PET and clinical diagnosis in a memory clinic.

INTRODUCTION: Today, ligands that bind to fibrillar ß-amyloid are detectable by Positron Emission Tomography (PET) allowing for in vivo visualization for Abeta burden. However, amyloid plaques detection per se does not establish Alzheimer's Disease diagnosis. In this sense, the utility of amyloid imaging to improve clinical diagnosis was settled only for specific clinical scenarios and few studies have assessed amyloid molecular neuroimaging in a broader clinical setting. The aim of this study is to determine the frequency of PiB amyloid findings in different diagnostic syndromes grouped into high and low probability pre- test categories, taking into account pre-test clinical assumption of the presence of AD related pathology. METHODS: 144 patients were assigned into categories of high or low pretest probability according to clinical suspicion of AD pathology. The high probability group included: amnestic Mild Cognitive Impairment (MCI), amnestic and other domains MCI, Dementia of Alzheimer's Type (DAT), Posterior Cortical Atrophy (PCA), logopenic Primary Progressive Aphasia (PPA), Cerebral Amyloid Angiopathy and mixed dementia. The low assumption group included: normal controls, non-amnestic MCI, non-logopenic PPA and Frontotemporal Dementia (FTD). RESULTS: Only normal controls and DAT patients (typical and atypical presentation) were the most consistent across clinical and molecular diagnostics. MCI, non-logopenic PPA and FTD were the syndromic diagnoses that most discrepancies were found. DISCUSSION: This study demonstrates that detecting in vivo amyloid plaques by molecular imaging is considerably frequent in most of the dementia syndromes and shows that there are frequent discordance between molecular diagnosis and clinical assumption.

PET and the multitracer concept in the study of neurodegenerative diseases.

The complexity of the pathological reactions of the brain to an aggression caused by an internal or external noxa represents a challenge for molecular imaging. Positron emission tomography (PET) can indicate in vivo, anatomopathological changes involved in the development of different clinical symptoms in patients with neurodegenerative disorders. PET and the multitracer concept can provide information from different systems in the brain tissue building an image of the whole disease. We present here the combination of 18F-flourodeoxyglucose (FDG) and N-[11C-methyl]-L-deuterodeprenyl (DED), FDG and N-[11C-methyl] 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PIB), PIB and L-[11C]-3'4-Dihydrophenylalanine (DOPA) and finally PIB and [15O]H2O.

A complexidade das reações patológicas do cérebro à agressões causadas por noxa interna ou externa representa um desafio para a imagem molecular. Tomografia por emissão de positron (PET) pode indicar, in vivo, alterações anatomopatológicas envolvidas no desenvolvimento de diferentes sintomas clínicos em pacientes com desordens neurodegenerativas. PET e o conceito de multitraçador pode fornecer informações de diferentes sistemas no tecido cerebral, construindo assim uma imagem da doença como um todo. Nós apresentamos neste artigo a combinação de 18F-flourodeoxyglucose (FDG) e N-[11C-methyl]-L-deuterodeprenyl (DED), FDG e N-[11C-methyl] 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PIB), PIB e L-[11C]-3'4-Dihydrophenylalanine (DOPA) e finalmente, PIB e [15O]H2O .

The changing face of death in Trinidad and Tobago, before and after independence / La faz cambiante de la muerte en Trinidad y Tobago, antes y después de la independencia

OBJECTIVES: The aim of this study is to compare the changing patterns of mortality in adults and infants during the pre-independence period 1953 - 1962 with the post-independence period 1962 - 2006 thus providing evidence for the burden of disease and the impact of independence on the state of health of the nation. METHODS: The study examined data from 1953 - 2006, collected under statutory regulations by the Central Statistical Office. RESULTS: While the population doubled during the study period, the standardized death rate improved from 16.4 to 4.5, infant mortality also declined from 70 per 1000 live births to 10.5 per 1000 live births. Mortality from selected infectious diseases also declined, however, mortality from chronic diseases continued to increase. Deaths associated with HIV increased during the 1990s, reaching a peak of 42 per 100 000 population in 2001 before declining. CONCLUSION: Like the developed world, some developing countries have experienced similar transitions in the patterns of disease occurrence and thus will need to develop strategies to effectively cope with these new challenges.

OBJETIVOS: El objetivo de este estudio es comparar los patrones cambiantes de mortalidad en adultos y niños durante el periodo de pre-independencia de 1953 - 1962 y el periodo de la post-independencia de 1962 - 2006, y brindar así evidencia en relación con la carga de enfermedades y el impacto de la independencia sobre el estado de salud de la nación. MÉTODOS: El estudio examinó los datos de 1953 - 2006, recogidos bajo regulaciones obligatorias por la Oficina Central de Estadísticas. RESULTADOS: Aunque la población se duplicó durante el periodo de estudio, la tasa de mortalidad estandarizada mejoró de 16.4 a 4.5, la mortalidad infantil también disminuyó de 70 por 1000 nacidos vivos a 10.5 por 1000 nacidos vivos. La mortalidad por enfermedades infecciosas seleccionadas también disminuyó. Sin embargo, la mortalidad de las enfermedades crónicas continuó aumentando. Las muertes asociadas con el VIH aumentaron durante los años 90, alcanzando un pico de 42 por 100 000 de población en 2001 antes de disminuir. CONCLUSIÓN: Al igual que el mundo desarrollado, algunos países en desarrollo han experimentado transiciones similares en los patrones de manifestación de las enfermedades, y por ende necesitarán desarrollar estrategias para hacer frente a estos nuevos desafíos de manera efectiva.