Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

Crohn's disease; Immigrant; Inflammatory bowel diseaseEnfermedad de Crohn; Inmigrante; Enfermedad inflamatoria intestinalMalaltia de Crohn; Immigrant; Malaltia inflamatòria de l'intestíBackground: Previous studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. Methods: Prospective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. Results: We included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 ± 12 vs. 54 ± 16 years, p < 0.001), had been diagnosed younger (31 ± 12 vs. 36 ± 15 years, p < 0.001), and had a shorter disease duration (14 ± 7 vs. 18 ± 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92-2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0-1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. Conclusions: Compared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe

Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry

Adalimumab; Ulcerative colitis; Clinical resultsAdalimumab; Colitis ulcerosa; Resultados clínicosAdalimumab; Colitis ulcerosa; Resultats clínicsBackground: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF. Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients. Design: Retrospective observational study. Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially). Results: Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission. Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The ENEIDA registry of GETECCU is supported by AbbVie, Galápagos, Janssen, Biogen, Takeda, and Pfizer. PT received a ‘Beca Germans Trias Talents’ research grant from Fundació Catalunya La Pedrera

Risk of Dengue Incidence in Children and Adolescents in Zulia, Venezuela, using a Negative Binomial Generalized Linear Mixed Model

Introduction: Dengue is the most important arboviral disease. Its incidence has increased 30-fold over the last 50 years, causing global concerns. Studies have showed children to be the most vulnerable. Methods: Observational study using dengue cases from Zulia state, Venezuela, modelling through a Negative Binomial Generalized Linear Mixed Model (GLMM) accounting for heterogeneity in the variance via a hierarchical Bayesian framework, was done. We assessed risk factors such as age and sex. The Bayesian framework enabled the estimation of Relative Risk (RR) and a Binomial regression was run using the WinBUGS software. Results: During 2002-2008, there were 49,330 cases of dengue in Zulia state, Venezuela. Most of them (18.71%) in 2007. The model revealed that children aged from 5 to 14 y-old had 1.59-higher risk (95%CI 1.41-1.79) compared with those aged from 0-4 y-old. Those aged 25-44 years old and ≥45, have significantly less RR than the baseline category, RR 0.5228 (95%CI 0.46-0.59) and 0.3069 (95%CI 0.27-0.34). Conclusions: The findings confirmed that groups most at risk were children aged 5 to 14 years. Modelling and predicting dengue epidemiology are still a need in multiple countries, especially those at risk of newer epidemics, as is the case of Zulia and Venezuela

La paleodieta de cinco especies de mamíferos herbívoros rancholabreanos de valsequillo (Puebla, México)

Through the use of the 13C/12C and 18O/16O isotopic relationships found at enamel and osteodentine, here it is inferred the diet and preferred habitat in which five extinct herbivore species from the Late Pleistocene of Valsequillo, Puebla, México. The horses, mammoths, and sloths showed a diet mainly based in C4, meanwhile the capybaraand gomphotheres were mixed C3/C4 feeders. The vegetation in which those animals lived was open with some trees, similar to the one proposed in other studies based in some macromammals species found in the locality.Usando las relaciones isotópicas de 13C/12C y 18O/16O presentes en el esmalte y la osteodentina, se infirió la dieta y el ambiente en el cual vivieron cinco especies extintas de herbívoros procedentes del Pleistoceno Tardío de Valsequillo, Puebla, México. Los caballos, los mamutes y el perezoso mostraban una dieta basada exclusivamente en plantas C4, mientras que el carpincho y los gonfoterios exhibían una dieta mixta C3/C4. El tipo de vegetación en el cual estos animales habitaron fue abierto con poca cobertura arbórea, misma que ha sido propuesta en otros estudios usando la presencia de algunas especies de micromamíferos encontradosen la zona

Risk of Dengue Incidence in Children and Adolescents in Zulia, Venezuela, using a Negative Binomial Generalized Linear Mixed Model

Introduction: Dengue is the most important arboviral disease. Its incidence has increased 30-fold over the last 50 years, causing global concerns. Studies have showed children to be the most vulnerable. Methods: Observational study using dengue cases from Zulia state, Venezuela, modelling through a Negative Binomial Generalized Linear Mixed Model (GLMM) accounting for heterogeneity in the variance via a hierarchical Bayesian framework, was done. We assessed risk factors such as age and sex. The Bayesian framework enabled the estimation of Relative Risk (RR) and a Binomial regression was run using the WinBUGS software. Results: During 2002-2008, there were 49,330 cases of dengue in Zulia state, Venezuela. Most of them (18.71%) in 2007. The model revealed that children aged from 5 to 14 y-old had 1.59-higher risk (95%CI 1.41-1.79) compared with those aged from 0-4 y-old. Those aged 25-44 years old and ≥45, have significantly less RR than the baseline category, RR 0.5228 (95%CI 0.46-0.59) and 0.3069 (95%CI 0.27-0.34). Conclusions: The findings confirmed that groups most at risk were children aged 5 to 14 years. Modelling and predicting dengue epidemiology are still a need in multiple countries, especially those at risk of newer epidemics, as is the case of Zulia and Venezuela

Proyecto de inversión de una granja de ganado porcino en el municipio de Delicias, Chihuahua

El presente trabajo se realizó en   el Municipio de   Delicias, Chihuahua para evaluar la factibilidad financiera y   economica de una granja de ganado porcino.   Se utilizó el formato de formulación y evaluación  de proyectos  de inversión  de  Programa de  Apoyo  para la  Productividad de  la Mujer Emprendedora de la SAGARPA. La granja es de ciclo completo con una produccion el primer año de 453 cerdos cuya raza es hibrida, son cruza de Landrace, Yorkshire y Duroc; y asi aumentando propocionalmente año con año. El canal de distribución   más conveniente para el proyecto es el representado por    Productor – Introductor – Consumidor final.    La evaluación economica dio como resultados  una TIR  del  45.51%   con  una VAN(10%)  de   $865,751.57    ademas  de una  relación Beneficio Costo de (10%)  1.14  por lo que el proyecto es financieramente viable

Feeding habits and habitat of herbivorous mammals from the Early–Late Hemphillian (Miocene) of Costa Rica

Carbon and oxygen stable isotope values in the dental enamel of fossils were used to infer the diet and habitat of the extinct equids Calippus hondurensis, Dinohippus mexicanus, and Protohippus gidleyi, the gomphothere Gomphotherium hondurensis, and the llama Hemiauchenia vera of the Early–Late Hemphillian (Hh2) from San Gerardo de Limoncito, Puntarenas province, Costa Rica. The results suggest that these mammals fed mainly on C3 plants and lived in clearings of rainforests. This contrasts with previous studies from North America that indicated that the same species lived in forest savannas and fed mainly on C4 plants, but it is similar to the results obtained from the palynological record of the area, as well as with several vegetation models suggesting the presence of humid tropical forest during the Miocene in Central America

Distribution of minerals in the organs of green pea and snap bean plants that could be used in Industry 4.0

Objective: Know the composition of minerals, essential trace elements and toxic trace elements of the organs of pea (Pisum sativum L.) and snap bean (Phaseolus vulgaris) plants for their possible use in industry 4.0. Design/methodology/approach: The concentration of mineral elements was determined through inductively coupled plasma mass spectrometry (ICP-MS) and the relationship of the amount of minerals with the flours of the different organs (root, stem, leaves and fruits of peas (P. sativum L.) and green beans (P. vulgaris). Results: The leaves represent an important fraction of the dry matter (30-40%) in the plants evaluated and are rich in minerals (calcium, magnesium, phosphorus, potassium), essential trace elements (manganese, iron, selenium, zinc) , toxic trace elements (aluminum, strontium, boron, tin, ba-rium) and rare earth elements (cerium, yttrium, lanthanum and neodymium). Limitations on study/implications: The production condition of the crops is unknown, on which the content of mineral elements largely depends. Findings/conclusions: The organs of pea and snap bean plants represent an alternative as raw material in the production of foods and biomaterials enriched with minerals, essential trace elements, toxic trace elements and rare earth elements, since these accumulate and biocontain -focus on these organs and these plants can be used as indicators or as phytoextractors to be selected as inputs in industry 4.0 processes

Mendelian Randomization Analysis of the Relationship Between Native American Ancestry and Gallbladder Cancer Risk

Background A strong association between the proportion of Native American ancestry and the risk of gallbladder cancer (GBC) has been reported in observational studies. Chileans show the highest incidence of GBC worldwide, and the Mapuche are the largest Native American people in Chile. We set out to investigate the causal association between Native American Mapuche ancestry and GBC risk, and the possible mediating effects of gallstone disease and body mass index (BMI) on this association. Methods Markers of Mapuche ancestry were selected based on the informativeness for assignment measure and then used as instrumental variables in two-sample mendelian randomization (MR) analyses and complementary sensitivity analyses. Result We found evidence of a causal effect of Mapuche ancestry on GBC risk (inverse variance-weighted (IVW) risk increase of 0.8% for every 1% increase in Mapuche ancestry proportion, 95% CI 0.4% to 1.2%, p = 6.6×10-5). Mapuche ancestry was also causally linked to gallstone disease (IVW risk increase of 3.6% per 1% increase in Mapuche proportion, 95% CI 3.1% to 4.0%, p = 1.0×10-59), suggesting a mediating effect of gallstones in the relationship between Mapuche ancestry and GBC. In contrast, the proportion of Mapuche ancestry showed a negative causal effect on BMI (IVW estimate -0.006 kg/m2 per 1% increase in Mapuche proportion, 95% CI -0.009 to -0.003, p = 4.4×10-5). Conclusions The results presented here may have significant implications for GBC prevention and are important for future admixture mapping studies. Given that the association between Mapuche ancestry and GBC risk previously noted in observational studies appears to be causal, primary and secondary prevention strategies that take into account the individual proportion of Mapuche ancestry could be particularly efficient

Retos, avances y reflexiones transdisciplinares desde contextos educativos diversos

La publicación de las ponencias que conformaron el V Congreso Internacional de Educación de la Universidad Nacional de Educación, titulado Retos, avances y reflexiones transdisciplinares desde contextos educativos diversos, ofrece una visión comprensiva y multifacética de la educación contemporánea. A través de ocho ejes temáticos, entre los que se incluye la formación integral y el desarrollo profesional, la teoría y la práctica en la formación profesional docente, la relación entre sociedad y escuela, la gestión educativa y las tecnologías para la educación, esta recopilación busca contribuir al conocimiento académico sobre la educación y, al mismo tiempo, ser fuente de información e inspiración para educadores, investigadores y todas aquellas personas interesadas en el desarrollo educativo