Migrantes mexicanos deportados: exploração do estado de saúde e acesso a serviços de saúde

OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico’s Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required.OBJETIVO Analisar o estado de saúde e o acesso aos serviços de saúde de imigrantes mexicanos deportados na fronteira entre México e Estados Unidos. MÉTODOS Foram analisados dados secundários do Inquérito sobre Migração na Fronteira do Norte do México de 2012. O inquérito é contínuo e desenhado para descrever fluxos migratórios na fronteira entre México e Estados Unidos com amostra de população móvel. Foram analisados indicadores de saúde e de acesso aos serviços de saúde dos imigrantes deportados em comparação aos imigrantes que retornaram voluntariamente. Nossa amostra análise incluiu 2.680 migrantes de retorno voluntário, e 6.862 deportados. Foi utilizado modelo de regressão logística ordinal para comparar as probabilidades da pior autopercepção de saúde entre os grupos estudados. RESULTADOS Em comparação com os migrantes de retorno voluntário, deportados foram menos propensos a ter seguro médico em os Estados Unidos (OR = 0,05, IC95% 0,04;0,06). No modelo de regressão uma pior saúde auto-percebida foi associado com ser deportado (OR = 1,71, IC95% 1,52;1,92), bem como a idade (OR = 1,03, IC95% 1,02;1,03) e os anos de escolaridade (OR = 0,94, IC95% 0,93;0,95). CONCLUSÕES De acordo com nossos resultados, deportados tinha menos acesso aos cuidados, enquanto em os Estados Unidos, em comparação com os migrantes de retorno voluntário. Nossos resultados também mostraram uma associação independente e estatisticamente significativa entre a deportação e ter pior saúde auto-percebida. Novas políticas de saúde pública são necessárias para promover a saúde e o acesso aos serviços de saúde nos imigrantes mexicanos deportados dos Estados Unidos

Autopercepción de la salud, presencia de comorbilidades y depresión en adultos mayores mexicanos: propuesta y validación de un marco conceptual simple

Introduction: Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person’s general health status.Objective: To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.Materials and methods: We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: “What do you think is your current health status?” Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.Results: A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).Conclusions: A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.Introducción. La autopercepción de la salud es una concepción individual y subjetiva que resulta de la intersección entre factores biológicos, sociales y psicológicos, y proporciona una evaluación única e inestimable del estado general de salud de una persona.Objetivo. Proponer y evaluar un modelo conceptual simple para entender la autopercepción de la salud y su relación con la presencia de comorbilidades, discapacidad y síntomas depresivos en adultos mayores mexicanos.Materiales y métodos. Se hizo un estudio transversal basado en una muestra representativa nacional de 8.874 adultos de 60 y más años. Se determinó la autopercepción positiva de la salud mediante una escala de tipo Likert con la pregunta: “¿Cómo considera que es su estado actual de salud?”, así como de las variables intermedias de presencia de comorbilidades, discapacidad y síntomas depresivos, y variables exógenas dicotómicas (sexo, tener pareja, percepción de la participación en las decisiones del hogar y pobreza). Para validar el modelo conceptual propuesto, se diseñó un modelo generalizado de ecuaciones estructurales con función de enlace logit para la autopercepción positiva de la salud.Resultados. Se encontró una asociación de vías directas entre la presencia de comorbilidades y la autopercepción positiva de la salud (odds ratio, OR=0,48; IC95% 0,42-0,55), entre la discapacidad y la autopercepción positiva de la salud (OR=0,35; IC95% 0,30-0,40),y entre los síntomas depresivos y la autopercepción positiva de la salud (OR=0,38; IC95% 0,34-0,43). El modelo también validó asociaciones indirectas entre discapacidad y síntomas depresivos (OR=2,25; IC95% 2,01-2,52), presencia de comorbilidades y síntomas depresivos (OR=1,79; IC95% 1,61-2,00), y presencia de comorbilidades y discapacidad (OR=1,98; IC95% 1,78-2,20).Conclusiones. Se hizo la evaluación empírica de un modelo teórico parsimonioso, lo cual permitió determinar asociaciones directas e indirectas con la autopercepción positiva de la salud

Key Aspects in Nutritional Management of COVID-19 Patients

This review deals with the relationship among nutrition, the immune system, and coronavirus disease 2019 (COVID-19). The influence of nutrients and bioactive molecules present in foodstuffs on immune system activity, the influence of COVID-19 on the nutritional status of the patients, and the dietary recommendations for hospitalized patients are addressed. Deficient nutritional status is probably due to anorexia, nausea, vomiting, diarrhea, hypoalbuminemia, hypermetabolism, and excessive nitrogen loss. There is limited knowledge regarding the nutritional support during hospital stay of COVID-19 patients. However, nutritional therapy appears as first-line treatment and should be implemented into standard practice. Optimal intake of all nutrients, mainly those playing crucial roles in immune system, should be assured through a diverse and well-balanced diet. Nevertheless, in order to reduce the risk and consequences of infections, the intakes for some micronutrients may exceed the recommended dietary allowances since infections and other stressors can reduce micronutrient status. In the case of critically ill patients, recently published guidelines are available for their nutritional management. Further, several natural bioactive compounds interact with the angiotensin-converting enzyme 2 (ACE2) receptor, the gateway for severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Natural bioactive compounds can also reduce the inflammatory response induced by SARS-CoV-2. These compounds are potential beneficial tools in the nutritional management of COVID-19 patients.This research was supported by Instituto de Salud Carlos III (CIBERobn) and University of the Basque Country (GIU18-173)

Relationship between Changes in Microbiota and Liver Steatosis Induced by High-Fat Feeding-A Review of Rodent Models

Several studies have observed that gut microbiota can play a critical role in nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) development. The gut microbiota is influenced by different environmental factors, which include diet. The aim of the present review is to summarize the information provided in the literature concerning the impact of changes in gut microbiota on the effects which dietary fat has on liver steatosis in rodent models. Most studies in which high-fat feeding has induced steatosis have reported reduced microbiota diversity, regardless of the percentage of energy provided by fat. At the phylum level, an increase in Firmicutes and a reduction in Bacteroidetes is commonly found, although widely diverging results have been described at class, order, family, and genus levels, likely due to differences in experimental design. Unfortunately, this fact makes it difficult to reach clear conclusions concerning the specific microbiota patterns associated with this feeding pattern. With regard to the relationship between high-fat feeding-induced changes in liver and microbiota composition, although several mechanisms such as alteration of gut integrity and increased permeability, inflammation, and metabolite production have been proposed, more scientific evidence is needed to address this issue and thus further studies are needed.This research was funded by MINECO (AGL-2015-65719-R-MINECO/FEDER, UE) and Instituto de Salud Carlos III (CIBERobn, CB12/03/30007

Genetic and Non-genetic Predictors of LINE-1 Methylation in Leukocyte DNA

Background: Altered DNA methylation has been associated with various diseases. Objective: We evaluated the association between levels of methylation in leukocyte DNA at long interspersed nuclear element 1 (LINE-1) and genetic and non-genetic characteristics of 892 control participants from the Spanish Bladder Cancer/EPICURO study. Methods: We determined LINE-1 methylation levels by pyrosequencing. Individual data included demographics, smoking status, nutrient intake, toenail concentrations of 12 trace elements, xenobiotic metabolism gene variants, and 515 polymorphisms among 24 genes in the one-carbon metabolism pathway. To assess the association between LINE-1 methylation levels (percentage of methylated cytosines) and potential determinants, we estimated beta coefficients (βs) by robust linear regression. Results: Women had lower levels of LINE-1 methylation than men (β = –0.7, p = 0.02). Persons who smoked blond tobacco showed lower methylation than nonsmokers (β = –0.7, p = 0.03). Arsenic toenail concentration was inversely associated with LINE-1 methylation (β = –3.6, p = 0.003). By contrast, iron (β = 0.002, p = 0.009) and nickel (β = 0.02, p = 0.004) were positively associated with LINE-1 methylation. Single nucleotide polymorphisms (SNPs) in DNMT3A (rs7581217-per allele, β = 0.3, p = 0.002), TCN2 (rs9606756-GG, β = 1.9, p = 0.008; rs4820887-AA, β = 4.0, p = 4.8 × 10–7; rs9621049-TT, β = 4.2, p = 4.7 × 10–9), AS3MT (rs7085104-GG, β = 0.7, p = 0.001), SLC19A1 (rs914238, TC vs. TT: β = 0.5 and CC vs. TT: β = –0.3, global p = 0.0007) and MTHFS (rs1380642, CT vs. CC: β = 0.3 and TT vs. CC; β = –0.8, global p = 0.05) were associated with LINE-1 methylation. Conclusions: We identified several characteristics, environmental factors, and common genetic variants that predicted DNA methylation among study participants

The autoimmune disease-associated KIF5A, CD226 and SH2B3 gene variants confer susceptibility for multiple sclerosis.

Genome-wide association studies (GWAS) have revealed that different diseases share susceptibility variants. Twelve single- nucleotide polymorphisms (SNPs) previously associated with different immune-mediated diseases in GWAS were genotyped in a Caucasian Spanish population of 2864 multiple sclerosis (MS) patients and 2930 controls. Three SNPs were found to be associated with MS: rs1678542 in KIF5A (P= 0.001, odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05–1.23); rs3184504 in SH2B3 (P= 0.00001, OR 1.19, 95% CI 1.10–1.27) and rs763361 in CD226 (P= 0.00007, OR 1.16, 95%CI 1.08–1.25). These variants have previously been associated with rheumatoid arthritis and type 1 diabetes. The SH2B3 polymorphism has additionally been associated with systemic lupus erythematosus. Our results, in addition to validating some of these loci as risk factors for MS, are consistent with shared genetic mechanisms underlying different immune-mediated diseases. These data may help to shape the contribution of each pathway to different disorders

A comparison of feature extractors for panorama stitching in an autonomous car architecture.

Panorama stitching consists on frames being put together to create a 360o view. This technique is proposed for its implementation in autonomous vehicles instead of the use of an external 360o camera, mostly due to its reduced cost and improved aerodynamics. This strategy requires a fast and robust set of features to be extracted from the images obtained by the cameras located around the inside of the car, in order to effectively compute the panoramic view in real time and avoid hazards on the road. In this paper, we compare and discuss three feature extraction methods (i.e. SIFT, BRISK and SURF) for image feature extraction, in order to decide which one is more suitable for a panorama stitching application in an autonomous car architecture. Experimental validation shows that SURF exhibits an improved performance under a variety of image transformations, and thus appears to be the most suitable of these three methods, given its accuracy when comparing features between both images, while maintaining a low time consumption. Furthermore, a comparison of the results obtained with respect to similar work allows to increase the reliability of our methodology and the reach of our conclusions

Evaluación productiva y de emisiones de gases de efecto invernadero en dos sistemas de cría bovina contrastantes del Chaco Seco argentino = Production and greenhouse gas emissions evaluation in two contrasting bovine farming systems in the Argentine Chaco Seco

El desafío actual de los sistemas bovinos del Chaco Seco está centrado en el incremento de la producción a través de la intensificación, sin la necesidad de expandir la frontera agropecuaria hacia ecosistemas naturales y disminuyendo las externalidades negativas. El objetivo de este estudio fue cuantificar la diferencia en la producción de peso vivo (PV) y en la intensidad de emisión de gases de efecto invernadero en dos módulos experimentales contrastantes de cría bovina en su nivel de intensificación, localizados en el Chaco Seco argentino. El trabajo se realizó en el Instituto de Investigación Animal del Chaco Semiárido (INTA), utilizando módulos experimentales y un modelo de simulación. Un módulo experimental se denominó Cría Pastoril (CrP) y se basó en una alimentación pastoril y una carga animal moderada (0,64 vacas/ha/año) para la zona. El otro se denominó módulo de Cría Intensiva (CrI), y utilizó un sistema de alimentación pastoril con apoyo de silaje de maíz como suplemento alimenticio para las vacas, y una carga animal elevada (1,66 vacas/ha/año). La producción de peso vivo fue 98 y 264 kg PV/ha/año para CrP y CrI respectivamente (Tukey; p < 0,05). No se encontraron diferencias significativas en la intensidad de emisiones, con valores de 16,5 y 16,0 kg CO2 eq/kg PV producido para CrP y CrI respectivamente. El Chaco Seco es una región ganadera en desarrollo, pero con restricciones en la expansión de la superficie productiva, y este trabajo evidencia que es posible incrementar la producción ganadera regional y en paralelo disminuir la intensidad de las emisiones de gases de efecto invernadero.The current challenge of the Chaco Seco beef cattle system is focused on increasing production through intensification, without expanding the agricultural frontier towards natural ecosystems and reducing externalities. The aim of this study was to quantify the difference in live weight (LW) productivity and in greenhouse gases emission intensity of two contrasting cow-calf modules differing in their intensification level. This work was carried out at the Instituto de Investigación Animal del Chaco Semiárido (INTA) using two experimental modules and a simulation model. The grazing cow-calf module (CrP) was based on a grazing system with a moderate stocking rate (0.64 cows/he/year). The intensive cow-calf module (CrI) used a grazing system, but supported by corn silage as supplement for cows, and a high stocking rate (1.66 cows/ha/year). Live weight production was 98 and 264 kg LW/ha/year for CrP and CrI respectively (Tukey; p < 0.05). Non-significant differences were found in the emission intensity, with values ranging from 16.5 and 16.0 kg CO2 eq/kg LW produced for CrP and CrI respectively. The Chaco Seco is a developing cattle region but with restrictions in the expansion of the productive surface, and this work throws evidence that it is possible to increase regional livestock production and decrease greenhouse gas emissions intensity.Instituto de Investigación Animal del Chaco SemiáridoFil: Nasca, Jose Andres. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; Argentina.Fil: Banegas, Natalia Romina. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Banegas, Natalia Romina. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia; ArgentinaFil: Garcia Posse, Fernando Raúl. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Martin, Alfredo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Martin, Alfredo Alberto. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia; ArgentinaFil: Della Rosa, María Milagros. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Molina Arias, Alvaro Marcelo. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; Argentina.Fil: Fernéndez, P. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; Argentina.Fil: Fernández, P. Consejo Nacional de Investigación Científica y Tecnológica. Instituto De Ecología Regional; Argentin