Análisis distribucional de la abeja sin aguijón Scaptotrigona mexicana (Apidae: Meliponini) en México: Información de referencia para Veracruz

Objective: To obtain the specific geographic distribution based on the stingless bee Scaptotrigonna mexicana in Mexico and the state of Veracruz. Design/methodology/approach: 2202 coordinates of the Gbif database were filtered using a spocc database manager in the programming language R. Subsequently, 55 coordinates were obtained with which multiple models of maximum entropy were calibrated with nine predictive environmental variables of 19 initials in MaxEnt 3.3 .3 in ENMeval. The best performing model (AUC> 0.897 and AICc = 0) was reclassified into 5 categories of climatic suitability with the k-means clustering technique. Results: The specific geographic distribution pattern was obtained based on the climatic suitability of S. mexicana in Mexico and Veracruz, which was classified into five categories: very low or zero, low, medium, high and very high. Here we show two large zones of climatic suitability in Mexico for S. mexicana, which could be divided by the geographical barrier of the Isthmus of Tehuantepec, the first zone is located in the Sierra Norte de Puebla and Veracruz influenced by the Transversal Mountain System and the Sierra Madre Oriental and the second in the south of the country in the South Pacific Coast, Chiapas and Guatemala. The variables that determine this pattern is the seasonality of temperature and precipitation in the wettest and driest quarter. In Veracruz, 52 municipalities were divided into two large groups with potential for the exploitation and conservation of S. mexicana, the first in the North zone and the second in the Central Zone of the state. Findings/conclusions: The incorporation of environmental variables of greater spatial and temporal resolution is necessary to extend the accuracy of the pollination pattern of S. mexicana at local scales.Objetivo: Obtener la distribución geográfica específica con base en la abeja sin aguijón Scaptotrigona mexicana en México y el estado de Veracruz. Diseño/metodología/aproximación: Se filtraron 2202 coordenadas de la base de datos Gbif utilizando un gestor de base datos spocc en el lenguaje de programación R. Posteriormente se obtuvieron 55 coordenadas con las que se calibraron múltiples  modelos de máxima entropía con nueve variables ambientales predictivas de 19 iniciales en MaxEnt 3.3.3 en ENMeval. El modelo con mejor rendimiento (AUC> 0.897 y AICc = 0) se reclasificó en cinco categorías de idoneidad climática con la técnica de clustering k-means. Resultados: Se obtuvo el patrón de distribución geográfico específico basado en la idoneidad climática de S. mexicana en México y Veracruz, el cual se clasificó en 5 categorías: muy baja o nula, baja, media, alta y muy alta. Aquí mostramos dos grandes zonas de idoneidad climática en México para S. mexicana, las cuales podrían estar divididas por la barrera geográfica del Istmo de Tehuantepec, la primera zona se localiza en la Sierra Norte de Puebla y Veracruz influenciada por el Sistema Montañoso Transversal y la Sierra Madre Oriental y la segunda al sur de país en la Costa del Pacifico Sur, Chiapas y Guatemala. En Veracruz se encontraron 50 municipios divididos en dos grandes grupos con potencial para el aprovechamiento y conservación de S. mexicana, el primero en la zona Norte y el segundo en la Zona Centro del estado. Limitaciones del estudio/implicaciones: Es necesario la incorporación de variables ambientales de mayor resolución espacial y temporal, para ampliar la precisión del patrón de polinización de S. mexicana a escalas locales. Hallazgos/conclusiones: Existen dos grandes zonas de distribución de S. mexicana en en el país, localizadas en zona norte y la zona sur delimitados claramente por el Istmo de Tehuantepec. En Veracruz hay un total de 50 municipios distribuidos en la zona norte y centro que se benefician de forma potencial por el patrón de distribución S. mexicana, con medio, alto y muy alto para el aprovechamiento de la misma

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years