Visions and history of the term 'Sustainable Development'

En este trabajo se pretende indagar en el significado del concepto de ‘Desarrollo Sostenible’ que cada día está más presente en las agendas internacionales, en la gestión de las políticas europeas, en los planes de fomento de la agricultura, de la industria, en la creación de nuevos productos, etc. La finalidad es ofrecer una visión de esta terminología más global y holística, sin descartar las críticas, teniendo en cuenta tanto sus diferentes acepciones como su evolución en las últimas décadas. Avanzando en las conclusiones se tratará de advertir que un uso erróneo o utilización sesgada puede afectar a la comprensión del mismo por diferentes sectores sociales y, por ende, a llevar a cabo acciones menos coherentes y más parceladas en torno a la sostenibilidad. De ahí que el conocimiento de una expresión tan clave como esta -junto con la educación y la sensibilización en sostenibilidad- sea decisiva para encauzar adecuadamente los cambios y procesos socioeconómicos que fraguan el futuro.The aim of this paper is to investigate the meaning of the concept of 'Sustainable Development', which is increasingly present in international agendas, in the management of European policies, in plans to promote agriculture, industry, in the creation of new products, etc. The aim is to offer a more global and holistic vision of this terminology, without discarding criticism, taking into account both its different meanings and its evolution in recent decades. Moving on to the conclusions, the aim is to point out that erroneous or biased use can affect the understanding of the term by different social sectors and, therefore, lead to less coherent and more fragmented actions in relation to sustainability. Hence, knowledge of such a key expression as this -together with education and awareness-raising in sustainability -is decisive in order to adequately channel the socio-economic changes and processes that are forging the future

Clinical validation of risk scoring systems to predict risk of delayed bleeding after EMR of large colorectal lesions

[Background and Aims]: The Endoscopic Resection Group of the Spanish Society of Endoscopy (GSEED-RE) model and the Australian Colonic Endoscopic Resection (ACER) model were proposed to predict delayed bleeding (DB) after EMR of large superficial colorectal lesions, but neither has been validated. We validated and updated these models.[Methods]: A multicenter cohort study was performed in patients with nonpedunculated lesions ≥20 mm removed by EMR. We assessed the discrimination and calibration of the GSEED-RE and ACER models. Difficulty performing EMR was subjectively categorized as low, medium, or high. We created a new model, including factors associated with DB in 3 cohort studies.[Results]: DB occurred in 45 of 1034 EMRs (4.5%); it was associated with proximal location (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.31-6.16), antiplatelet agents (OR, 2.51; 95% CI, .99-6.34) or anticoagulants (OR, 4.54; 95% CI, 2.14-9.63), difficulty of EMR (OR, 3.23; 95% CI, 1.41-7.40), and comorbidity (OR, 2.11; 95% CI, .99-4.47). The GSEED-RE and ACER models did not accurately predict DB. Re-estimation and recalibration yielded acceptable results (GSEED-RE area under the curve [AUC], .64 [95% CI, .54-.74]; ACER AUC, .65 [95% CI, .57-.73]). We used lesion size, proximal location, comorbidity, and antiplatelet or anticoagulant therapy to generate a new model, the GSEED-RE2, which achieved higher AUC values (.69-.73; 95% CI, .59-.80) and exhibited lower susceptibility to changes among datasets.[Conclusions]: The updated GSEED-RE and ACER models achieved acceptable prediction levels of DB. The GSEED-RE2 model may achieve better prediction results and could be used to guide the management of patients after validation by other external groups. (Clinical trial registration number: NCT 03050333.)Research support for this study was received from “La Caixa/Caja Navarra” Foundation (ID 100010434;project PR15/11100006)

Prediction of poor outcome in clostridioides difficile infection: A multicentre external validation of the toxin B amplification cycle

Producción CientíficaClassification of patients according to their risk of poor outcomes in Clostridioides difficile infection (CDI) would enable implementation of costly new treatment options in a subset of patients at higher risk of poor outcome. In a previous study, we found that low toxin B amplification cycle thresholds (Ct) were independently associated with poor outcome CDI. Our objective was to perform a multicentre external validation of a PCR-toxin B Ct as a marker of poor outcome CDI. We carried out a multicentre study (14 hospitals) in which the characteristics and outcome of patients with CDI were evaluated. A subanalysis of the results of the amplification curve of real-time PCR gene toxin B (XpertTM C. difficile) was performed. A total of 223 patients were included. The median age was 73.0 years, 50.2% were female, and the median Charlson index was 3.0. The comparison of poor outcome and non–poor outcome CDI episodes revealed, respectively, the following results: median age (years), 77.0 vs 72.0 (p = 0.009); patients from nursing homes, 24.4% vs 10.8% (p = 0.039); median leukocytes (cells/μl), 10,740.0 vs 8795.0 (p = 0.026); and median PCR-toxin B Ct, 23.3 vs 25.4 (p = 0.004). Multivariate analysis showed that a PCR-toxin B Ct cut-off <23.5 was significantly and independently associated with poor outcome CDI (p = 0.002; OR, 3.371; 95%CI, 1.565–7.264). This variable correctly classified 68.5% of patients. The use of this microbiological marker could facilitate early selection of patients who are at higher risk of poor outcome and are more likely to benefit from newer and more costly therapeutic options

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Dinámica de la inmigración en España (1998-2008): factores determinantes

[ES] En el contexto de un crecimiento económico rápido, laxitud financiera y envejecimiento de la población del período 1998-2008, la economía española ha generado una demanda de trabajadores extranjeros sin precedentes en la parte inferior de la jerarquía profesional. Los extranjeros han ocupado, a través de un sistema selectivo, los puestos de trabajo vacantes y otros que de otra manera no existirían en actividades de bajo valor añadido en las regiones donde eran demandados. En este trabajo se trata de descubrir las causas, económicas (como la configuración productiva, el ingreso per cápita, la actividad económica y la tasa de desempleo de peso) y no económicos (redes de migración e institucional) que subyacen a las decisiones de residencia de los extranjeros en las distintas regiones españolas.[EN] In the context of fast economic growth, financial laxity and aging population of the 1998-2008 period, the Spanish economy has generated an unprecedented demand for foreign workers at the bottom of the occupational hierarchy. Foreigners have been occupying, through a selective system, the vacancy jobs and others that otherwise would not exist in low value-added activities in the regions where they were requested. This paper seeks to uncover the causes, economic (such as productive configuration, per capita income, economic activity and weight unemployment rate) and no economic (migration networks and institutional) that underlie in location decisions of foreigners in Spain.Tesis Univ. Jaén. Departamento de Economía. Leída el 19 de abril de 201