The relation between firms and translation within the agro-food sector in Andalusia

En una época dominada por una crisis económica que se prolonga en el tiempo, las empresas optan por diversificar riesgos y mercados entrando en nuevos países, con el principal objetivo de complementar una demanda local fuertemente sacudida por la escasez de ingresos. En este estudio presentamos los primeros resultados de una investigación empírica en la que las empresas agroalimentarias andaluzas son preguntadas sobre sus estrategias frente a las necesidades lingüísticas que les surgen en los procesos de internacionalización en que se encuentran inmersas. El estudio arroja conclusiones sobre la relación entre el tamaño y las características de las empresas y el uso que estas hacen de los servicios de traducción e interpretación, así como sobre las situaciones en las que se contratan los servicios de traducción o el uso del inglés como lengua franca.Nowadays, with a long crisis that seems to have no end, many firms find in other countries the way to diversify risks and markets, with the main goal of serving as a back-up for a weakened domestic demand, triggered by low income. This paper shows the first results of an empirical research on agri-food firms in Andalusia and how they meet verbal and written needs arising from their internationalisation process. This study sheds light on the relations between size and characteristics of the firms and how they use translation and interpreting services; on the situations where firms use these services, or on the use of English as “lingua franca”

Coronavirus disease 2019 in patients with rheumatic immune-mediated diseases in a single university hospital, matched case-control study and literature review

Background: COVID-19 may present different degrees of severity. Viral infections in patients with rheumatic inflammatory diseases (R-IMID) trend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce. Objectives: To compare predisposing factors, clinical, serological features, and severity of COVID-19 infection in patients with and without R-IMID. Methods: Case-control study in a single University Hospital. We included all consecutive patients with a diagnosis of an R-IMID and COVID-19 infection up to March 31st, 2021. This cohort was compared to patients without R-IMID and not receiving immunosuppressive therapy, matched for sex and age (±5 years). Confirmed infection was defined if a patient had a positive nasopharyngeal swab for SARS-CoV-2. Severity was divided into mild, moderate, severe and critical according to the United States National Institute of Health (NIH) guidelines. Results: We included 274 R-IMID patients (185 women/89 men), mean age 59.1 ± 18 years. More frequent R-IMID were: Rheumatoid arthritis (28.8%), Psoriatic Arthritis (20.1%), axial Spondyloarthritis (12.4%), Polymyalgia Rheumatica (8%) and Systemic Lupus Erythematosus (8%). Hypertension and dyslipidemia were more frequent in patients with R-IMID. Although most of the cases were mild, critical cases and deaths were more frequent in R-IMID. When adjusted by comorbidities, no statistical differences were observed. Conclusion: R-IMID have a very similar clinical presentation when compared to the general population. There is a trend to an increased severity of the disease in patients with R-IMID

Clinical and immunological study of tofacitinib and baricitinib in refractory blau syndrome: case report and literature review

Blau syndrome (BS) is an autoinflammatory disorder characterized by non-caseating granulomatous dermatitis, arthritis, and uveitis. We present a case of refractory and severe BS that was treated with the Janus kinase inhibitors (JAKINIBS), Tofacitinib (TOFA) and then Baricitinib (BARI). Our aim was to describe the clinical and immunological outcomes after treatment with JAKINIBS. Blood tests and serum samples were obtained during follow-up with TOFA and BARI. We assessed their effects on clinical outcomes, acute phase reactants, absolute lymphocyte counts (ALCs), lymphocyte subset counts, immunoglobulins, and cytokine levels. A review of the literature on the use of JAKINIBS for the treatment of uveitis and sarcoidosis was also conducted. TOFA led to a rapid and maintained disease control and a steroid-sparing effect. A decrease from baseline was observed in ALC, CD3+, CD4+, CD8+, and natural killer (NK) cell counts. B-cells were stable. Serum levels of interleukin (IL)-4 and tumor necrosis factor alpha (TNF-?) increased, whereas IL-2, IL-6, IL-10, and IL-17 maintained stable. TOFA was discontinued after 19 months due to significant lymphopenia. The initiation of BARI allowed maintaining adequate control of disease activity with an adequate safety profile. The literature review showed seven patients with uveitis and five with sarcoidosis treated with JAKINIBS. No cases of BS treated with JAKINIBS were found. We report the successful use of JAKINIBS in a patient with refractory and severe BS.Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by Redes Temáticas de Investigación Cooperativa en Salud (RETICS) Program, RD16/0012 Red de Investigación en Inflamación y Enfermedades Reumáticas (RIER) from ISCIII from "Instituto de Salud Carlos III" (ISCIII) (Spain)

Mural Endocarditis: The GAMES Registry Series and Review of the Literature

Introduction: Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis. Methods: Patients with infectious endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series. Results: Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device-associated IE (DIE), patients with MIE were younger (median age 59 years, p \0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE, p \ 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE, p = 0.006), catheter source (59.3% versus 9.7% VIE and 8.8% DIE, p \ 0.01) and Candida etiology (22.2% versus 2% DIE and 1.2% VIE, p \ 0.01) were more common in MIE, whereas the Charlson Index was lower (4 versus 5 in non MIE, p = 0.006). Mortality was similar.MIE from the literature shared many characteristics with MIE from GAMES, although patients were younger (45 years vs. 56 years, p \ 0.001), the Charlson Index was lower (1.3 vs. 4.3, p = 0.0001), catheter source was less common (13.9% vs. 59.3%) and there were more IVDUs (25% vs. 3.7%). S. aureus was the most frequent microorganism (50%, p = 0.035). Systemic complications were more common but mortality was similar. Conclusion: MIE is a rare entity. It is often a complication of catheter use, particularly in immunocompromised and hemodialysis patients. Fungal etiology is common. Mortality is similar to other IEs

Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune Mediated Inflammatory Diseases. A Multicenter Study

We aimed to assess the e cacy of biologic therapy in refractory non-Multiple Sclerosis (MS) Optic Neuritis (ON), a condition more infrequent, chronic and severe than MS ON. This was an open-label multicenter study of patients with non-MS ON refractory to systemic corticosteroids and at least one conventional immunosuppressive drug. The main outcomes were Best Corrected Visual Acuity (BCVA) and both Macular Thickness (MT) and Retinal Nerve Fiber Layer (RNFL) using Optical Coherence Tomography (OCT). These outcome variables were assessed at baseline, 1 week, and 1, 3, 6 and 12 months after biologic therapy initiation. Remission was defined as the absence of ON symptoms and signs that lasted longer than 24 h, with or without an associated new lesion on magnetic resonance imaging with gadolinium contrast agents for at least 3 months. We studied 19 patients (11 women/8 men; mean age, 34.8 13.9 years). The underlying diseases were Bechet?s disease (n = 5), neuromyelitis optica (n = 3), systemic lupus erythematosus (n = 2), sarcoidosis (n = 1), relapsing polychondritis (n = 1) and anti-neutrophil cytoplasmic antibody -associated vasculitis (n = 1). It was idiopathic in 6 patients. The first biologic agent used in each patient was: adalimumab (n = 6), rituximab (n = 6), infliximab (n = 5) and tocilizumab (n = 2). A second immunosuppressive drug was simultaneously used in 11 patients: methotrexate (n = 11), azathioprine (n = 2), mycophenolate mofetil (n = 1) and hydroxychloroquine (n = 1). Improvement of the main outcomes was observed after 1 year of therapy when compared with baseline data: mean SD BCVA (0.8 0.3 LogMAR vs. 0.6 0.3 LogMAR; p = 0.03), mean SD RNFL (190.5 175.4 m vs. 183.4 139.5 m; p = 0.02), mean SD MT (270.7 23.2 m vs. 369.6 137.4 m; p = 0.03). Besides, the median (IQR) prednisone-dose was also reduced from 40 (10?61.5) mg/day at baseline to. 2.5 (0?5) mg/day after one year of follow-up; p = 0.001. After a mean SD follow-up of 35 months, 15 patients (78.9%) achieved ocular remission, and 2 (10.5%) experienced severe adverse events. Biologic therapy is e ective in patients with refractory non-MS ON

Do specific antimicrobial stewardship interventions have an impact on carbapenem resistance in Gram-negative bacilli? A multicentre quasi-experimental ecological study: time-trend analysis and characterization of carbapenemases

CarbaPIRASOA team.[Background] Carbapenem-resistant Gram-negative bacilli (CR-GNB) are among the most threatening microorganisms worldwide and carbapenem use facilitates their spread. Antimicrobial stewardship programmes (ASPs) can help to optimize the use of antibiotics. This study evaluates the impact of a multifaceted educational ASP on carbapenem use and on the epidemiology of CR-GNB.[Methods] We conducted a quasi-experimental, time-series study in seven hospitals, from January 2014 to September 2018. The key intervention was composed of educational interviews promoting the appropriate use of carbapenems. The primary endpoints were carbapenem consumption and incidence density (ID) of CR-GNB. All non-duplicated CR-GNB clinical isolates were tested using phenotypic assays and PCR for the presence of carbapenemases. Joinpoint regression and interrupted time-series analyses were used to determine trends.[Results] A decrease in carbapenem consumption throughout the study period [average quarterly percentage change (AQPC) −1.5%, P < 0.001] and a −8.170 (−16.064 to −0.277) level change following the intervention were observed. The ID of CR-Acinetobacter baumannii decreased (AQPC −3.5%, P = 0.02) and the overall ID of CR-GNB remained stable (AQPC −0.4%, P = 0.52). CR-GNB, CR-Pseudomonas aeruginosa and CR-A. baumannii IDs per hospital correlated with the local consumption of carbapenems. The most prevalent carbapenem resistance mechanisms were OXA-23 for CR-A. baumannii (76.1%), OXA-48 for CR-Klebsiella pneumoniae (66%) and no carbapenemases for CR-P. aeruginosa (91.7%). The epidemiology of carbapenemases was heterogeneous throughout the study, especially for carbapenemase-producing Enterobacteriaceae.[Conclusions] In conclusion, a multifaceted, educational interview-based ASP targeting carbapenem prescribing reduced carbapenem use and the ID of CR-A. baumannii.This work was funded by the Spanish Infectious Diseases and Clinical Microbiology Society (SEIMC).Peer reviewe

Plan de Acción Tutorial Integrado, en Educación

En el proyecto que se presenta se parte no solamente de una amplia trayectoria de los Grados de la Facultad de Ciencias de la Educación de la UGR en orientación universitaria, sino, además, de una necesidad patente plasmada en los Objetivos Estratégicos que se incluyen dentro del Sistema para la Garantía de la Calidad de la Facultad; siendo el segundo objetivo “Orientación y tutoría académica”, y una de sus acciones (Plan Director 19-21): Crear curriculum complementario para los estudiantes (desarrollo de competencias transversales a través de un PAT). Otras acciones relacionadas y en las que continuamos trabajando en el Plan Director 22 24 son Establecer acciones de tutorización coordinadas y complementarias al PAT, formar a los tutores de grupo-curso, establecer un plan general de orientación profesional y empleabilidad, potenciar la orientación académica y profesional de los estudiantes NEAE, entre otras. Con el diseño del Plan de Acción Tutorial Integrado, en Educación, se pretende desarrollar en el estudiantado de los Grados en Pedagogía, Ed. Social, Ed. Infantil y Ed. Primaria, competencias transversales que complementen su formación académica y le ayuden en su desarrollo académico, personal y profesional. En él participará profesorado, alumnado y PAS de la Facultad, no solamente para fomentar su sentimiento de pertenencia y favorecer un clima de comunidad universitaria, sino además, para enriquecerse unos a otros, aprendiendo juntos, solventando dudas, guiando, orientando y haciendo que el paso por la Universidad de todo el alumnado que participe del mismo, sea lo más enriquecedor y productivo posible, logrando un elevado rendimiento académico, un adecuado desarrollo personal y un posterior futuro profesional colmado de éxitos. Para ello se ha llevado a cabo un análisis de necesidades mediante el Cuestionario para detección de necesidades formativas transversales del alumnado en la Facultad de Ciencias de la Educación (Escala de competencias transversales del cuestionario CECTGRA de Martínez y González, 2018), a partir del cual se diseñan diferentes talleres orientados a cada curso según sus intereses, motivaciones y necesidades, haciendo una posterior evaluación de los resultados y un análisis de los mismos. Se ha logrado además del diseño del PAT, dotar de unidad a todas las actividades que desde la Facultad se realizaban en torno a la orientación del estudiantado. Se ha realizado un esfuerzo porque los resultados obtenidos se vean reflejados en las diferentes materias, no solamente a nivel transversal sino de forma directa. Por ejemplo, al trabajarse la normativa APA se ha introducido este punto en las rúbricas de evaluación de diferentes asignaturas para, de este modo, relacionar su aprendizaje con la evaluación y rendimiento académico. Al centrarse el primer curso fundamentalmente en el análisis de necesidades, la asistencia ha sido mucho mayor en el segundo curso (21-22), haciendo especial hincapié en la difusión de las actividades, siguiendo el Plan de Comunicación del Centro, a través de la web de la Facultad y de la figura de los tutores de grupo curso. Un objetivo a largo plazo, es incluir las competencias aprendidas en los talleres dirigidos al estudiantado de 4º en la calificación del Trabajo Fin de Grado. Este punto no ha dado tiempo a consolidarlo en dos cursos académicos, pero seguiremos trabajando en ello ya que consideramos que es fundamental además de poder dar de esta forma respuesta a una de las alegaciones realizadas por la DEVA en el informe de la renovación de la acreditación de los Grados.This project is based not only on a wide trajectory of the Degrees of the Faculty of Education Sciences of the UGR in university orientation, but, in addition, from a patent need embodied in the Strategic Objectives that are included within the System for the Guarantee of the Quality of the Faculty; the second objective being "Academic guidance and tutoring", and one of its actions (Master Plan 19-21): Create complementary curriculum for students (development of transversal competences through a PAT). Other related actions and in which we continue to work in the Master Plan 22 24 are To establish coordinated and complementary tutoring actions to the PAT, to train the group-course tutors, to establish a general plan of professional orientation and employability, to enhance the academic and professional orientation of the NEAE students, among others. With the design of the Integrated Tutorial Action Plan, in Education, it is intended to develop in the students of the Degrees in Pedagogy, Social Ed., Infant Ed. and Primary Ed., transversal competences that complement their academic training and help them in their academic, personal and professional development. It will involve teachers, students and PAS of the Faculty, not only to promote the feeling of belonging of the same and favor a climate of university community, but, in addition, to enrich each other, learning together, solving doubts, guiding, guiding and making the passage through the University of all the students who participate in it, as enriching and productive as possible, achieving a high academic performance, a competent personal development and a subsequent professional future full of successes. To this end, a needs analysis has been carried out (through the Questionnaire for the detection of transversal training needs of students in the Faculty of Education Sciences (Scale of transversal competences of the CECTGRA questionnaire of Martínez y González, 2018), reflected in different workshops oriented to each course according to their interests, motivations and needs, making a subsequent evaluation of the results and analysis of them. It has been achieved in addition to the design of the PAT, to provide unity to all the activities that from the Faculty were carried out around the orientation of the students. We have worked so that the results obtained are reflected in the different subjects, not only at a transversal level but directly. For example, when working on the APA regulations, it has been introduced in the evaluation rubrics of different subjects in order to relate their learning with evaluation and academic performance. By focusing the first course mainly on the analysis of needs, the attendance has been much higher in the second year (21 22), with special emphasis on the dissemination of the activities, following the Communication Plan of the Center, through the website of the Faculty and the figure of the tutors of the course group. A long-term objective is to include the skills learned in the workshops of the 4th grade students in the TFG qualification. This point has not given time to consolidate it in two academic years but we will continue working on it since we consider that it is fundamental in addition to being able to respond in this way to one of the allegations made by the DEVA in the report of the renewal of the accreditation of the Degrees.Unidad de Calidad, Innovación Docente y Prospectiva. Universidad de Granada

Seven-versus 14-day course of antibiotics for the treatment of bloodstream infections by Enterobacterales: a randomized, controlled trial

[Objective] To prove that 7-day courses of antibiotics for bloodstream infections caused by members of the Enterobacterales (eBSIs) allow a reduction in patients' exposure to antibiotics while achieving clinical outcomes similar to those of 14-day schemes.[Methods] A randomized trial was performed. Adult patients developing eBSI with appropriate source control were assigned to 7 or 14 days of treatment, and followed 28 days after treatment cessation; treatments could be resumed whenever necessary. The primary endpoint was days of treatment at the end of follow-up. Clinical outcomes included clinical cure, relapse of eBSI and relapse of fever. A superiority margin of 3 days was set for the primary endpoint, and a non-inferiority margin of 10% was set for clinical outcomes. Efficacy and safety were assessed together with a DOOR/RADAR (desirability of outcome ranking and response adjusted for duration of antibiotic risk) analysis.[Results] 248 patients were assigned to 7 (n = 119) or 14 (n = 129) days of treatment. In the intention-to-treat analysis, median days of treatment at the end of follow-up were 7 and 14 days (difference 7, 95%CI 7–7). The non-inferiority margin was also met for clinical outcomes, except for relapse of fever (–0.2%, 95%CI –10.4 to 10.1). The DOOR/RADAR showed that 7-day schemes had a 77.7% probability of achieving better results than 14-day treatments.[Conclusions] 7-day schemes allowed a reduction in antibiotic exposure of patients with eBSI while achieving outcomes similar to those of 14-day schemes. The possibility of relapsing fever in a limited number of patients, without relevance to final outcomes, may not be excluded, but was overcome by the benefits of shortening treatments.This work received technical support from the Spanish Network of Research in Infectious Diseases (REIPI) and the Spanish Clinical Research Network (SCReN) of the Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Spanish Government (PT13/0002/0010).Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio