BODY CONDITION OF THE UPLAND SANDPIPER (BARTRAMIA LONGICAUDA) EN ROUTE THROUGH CENTRAL MEXICO

Abstract∙ There is little information on the body condition of the Upland Sandpiper (Bartramia longicauda) during migration. We measured biometric traits and body condition parameters of B. longicauda in central Mexico in 2016 and 2017. Mean morphometric values were 170.4 ± 4.3 mm (wing length), 28.9 ± 1.7 mm (bill length), 61.5 ± 2.2 mm (head length), and 55.3 ± 2.6 mm (tarsus length). Mean body condition parameters were 169.7 ± 24.1 g (body weight), and 4.6 ± 1.8 (fat score). Body condition values were higher during 2017 than 2016 (P < 0.05) but similar between sexes and sites. Fluctuating asymmetry (FA) was low compared to other studies, but was present in rectrices, tarsus, and wings. We found a negative correlation between wing FA and fat score, and a positive correlation between body weight and fat score, suggesting that birds with higher fat scores were in better condition during molt, leading to lower asymmetry. Our Data showed a 1:1.6 male:female ratio, similar across years and sites. Contrary to other studies, we found no significant sexual size dimorphism. Birds in our sample had higher body weight, tarsus, and wing length but were similar in head length to birds wintering in South America, but smaller than birds from Minnesota. We recommend carrying out further studies on stop-over sites to contribute to a better understanding of patterns on the functional ecology of the species. Resumen ∙ Condición corporal del Zarapito Ganga o Batitú (Bartramia longicauda) en ruta a través del centro de México Existe poca información sobre la condición corporal del Zarapito Ganga o Batitú (Bartramia longicauda) durante la migración. Medimos parámetros de condición corporal de B. longicauda en el centro de México en 2016 y 2017. Los valores morfométricos promedio fueron 170.4 ± 4.3 mm (ala), 28.9 ± 1.7 mm (culmen), 61.5 ± 2.2 mm (cabeza) y 55.3 ± 2.6 mm (tarso). Los parámetros promedio de condición corporal fueron 169.7 ± 24.1 g (peso corporal) y 4.6 ± 1.8 (grasa). Los valores de condición corporal fueron mayores durante 2017 que durante 2016 (P < 0.05), aunque similares entre sexos y sitios. La asimetría fluctuante (AF) fue baja comparada a otros estudios, aunque estuvo presente en rectrices, tarsos y alas. Encontramos una correlación negativa entre AF en alas y grasa, y una correlación positiva entre peso corporal y grasa, lo cual sugiere que las aves con mayores valores de grasa se encontraban en mejor condición durante la muda de plumaje, conduciendo a menor asimetría. Nuestros datos mostraron una tasa macho:hembra de 1:1.6, similar entre años y sitios. Contrario a otros estudios, no encontramos dimorfismo sexual significativo. Las aves en nuestra muestra tuvieron mayor peso corporal, tarso y longitud de ala, pero fueron similar en longitud de cabeza a aves de Sudamérica, pero menores a aves de Minnesota. Recomendamos llevar a cabo más estudios en sitios de escala para contribuir a un mejor entendimiento de los patrones en la ecología funcional de la especie

UPDATING THE DISTRIBUTION RANGE OF THE ENDANGERED BLACK‐POLLED YELLOWTHROAT (GEOTHLYPIS SPECIOSA)

Abstract ∙  The endemic and endangered Black‐polled Yellowthroat (Geothlypis speciosa) resides in freshwater marshes within the Transvolcanic Belt in central Mexico. A decade‐long extensive survey (2005–2015) on 238 wetlands within the historical species’ range revealed that surviving populations are confined to five wetlands of central western Mexico. We provide an updated assessment of the actual distribution range of the species, including extant populations on the following wetlands: Ciénegas del Lerma, Lake Cuitzeo, Lake Yuriria, Lake Pátzcuaro, and Lake Zirahuén (a previously unreported location). The Cuitzeo, Yuriria, and Pátzcuaro populations are assumed to correspond to the distribution area of the limnatis subspecies, whereas the easternmost population confirmed at Ciénegas del Lerma correspond to the distribution area of the speciosa subspecies. We estimated the overall habitat availability for the species at 94.95 km2, and more than half (59.2%) of it is found at Lake Cuitzeo, while Lake Zirahuén holds the lowest extent (≤ 1%). The species long term survival will require urgent actions that include: (a) protection and restoration of marsh habitat for all the wetlands where the species remains, (b) implementation of specific controls for burning and illegal harvesting of aquatic plants, (c) an estimate of the population size at the five remaining sites, (d) an assessment of the degree of isolation among the remaining populations, (e) confirmation of its presence at Ciénega de Tláhuac, and (f) reintroduction to man‐made and restored wetlands within the historical range. Research effort should continue to determine basic ecological requirements, the degree of inbreeding, and nesting requirements for all extant populations.Resumen ∙ Actualizando el rango de distribución de la Mascarita Transvolcánica (Geothlypis speciosa) La Mascarita Transvolcánica (Geothlypis speciosa), una especie endémica y en peligro de extinción, reside en humedales del Eje Neovolcánico Transversal en el centro de México. Un muestreo a lo largo de una década (2005 a 2015) en 238 humedales dentro de su rango histórico, reveló que la mayoría de las poblaciones sobrevivientes se encuentran en cinco humedales del centro occidente de México. Proveemos una evaluación actualizada del rango de distribución de la especie, incluyendo poblaciones existentes en los siguientes humedales: Ciénegas del Lerma, Lago Cuitzeo, Laguna de Yuriria, Lago de Pátzcuaro y Lago Zirahuén (una localidad no reportada previamente). Asumimos que las poblaciones de Cuitzeo, Yuriria y Pátzcuaro corresponden al área de distribución de la subespecie limnatis, mientras que la población más oriental confirmada en Ciénegas del Lerma corresponde al área de distribución de la subespecie speciosa. Estimamos la disponibilidad de hábitat para la especie en 94,95 km2, más de la mitad (59,2%) encontrándose en Lago Cuitzeo, mientras que Lago Zirahuén mantiene la más baja (≤ 1%). La sobrevivencia a largo plazo de la especie requerirá acciones urgentes que incluyan: (a) protección y restauración de hábitat en todos los humedales donde la especie permanece, (b) implementación de controles específicos para quemas y cosecha ilegal de plantas acuáticas, (c) una estimación del tamaño poblacional en los cinco sitios restantes, (d) una evaluación del grado de aislamiento entre las poblaciones restantes, (e) la confirmación de su presencia en Ciénega de Tláhuac y (f) reintroducción a humedales artificiales y restaurados dentro del rango histórico de distribución. Los esfuerzos de investigación deben continuar para determinar los requerimientos ecológicos básicos, el grado de endogamia y los requerimientos de anidación en todas las poblaciones existentes

Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study

BackgroundThere is evidence suggesting racial disparities in diagnosis and treatment in bipolar disorder (BD) and schizophrenia (SZ). The purpose of this study is to compare psychiatric diagnoses and psychotropic use preceding a first episode of mania (FEM) or psychosis (FEP) in racially diverse patients.MethodsUsing a comprehensive medical records linkage system (Rochester Epidemiology Project, REP), we retrospectively identified individuals diagnosed with BD or SZ and a documented first episode of mania or psychosis. Illness trajectory before FEP/FEM were characterized as the time from first visit for a mental health complaint to incident case. Pathways to care and clinical events preceding FEP/FEM were compared based on subsequent incident case diagnosis (BD or SZ) and self-reported race (White vs. non-White).ResultsA total of 205 (FEM = 74; FEP = 131) incident cases were identified in the REP. Duration of psychiatric antecedents was significantly shorter in non-White patients, compared to White patients (2.2 ± 4.3 vs. 7.4 ± 6.6 years; p < 0.001) with an older age at time of first visit for a mental health complaint (15.7 ± 6.3 vs. 11.1 ± 6.0 years; p = 0.005). There were no significant differences by race in FEM pathway to care or age of first seeking mental health. Overall non-White patients had lower rates of psychotropic use.ConclusionThese data are unable to ascertain reasons for shorter duration of psychiatric antecedents and later age of seeking care, and more broadly first age of initial symptom presentation. If symptoms are confirmed to be earlier than first time seeking care in both groups, it would be important to identify barriers that racial minorities face to access timely psychiatric care and optimize early intervention strategies

Oligonucleotide array-CGH identifies genomic subgroups and prognostic markers for tumor stage mycosis fungoides

Mycosis fungoide (MF) patients who develop tumors or extracutaneous involvement usually have a poor prognosis with no curative therapy available so far. In the present European Organization for Research and Treatment of Cancer (EORTC) multicenter study, the genomic profile of 41 skin biopsies from tumor stage MF (MFt) was analyzed using a high-resolution oligo-array comparative genomic hybridization platform. Seventy-six percent of cases showed genomic aberrations. The most common imbalances were gains of 7q33.3q35 followed by 17q21.1, 8q24.21, 9q34qter, and 10p14 and losses of 9p21.3 followed by 9q31.2, 17p13.1, 13q14.11, 6q21.3, 10p11.22, 16q23.2, and 16q24.3. Three specific chromosomal regions, 9p21.3, 8q24.21, and 10q26qter, were defined as prognostic markers showing a significant correlation with overall survival (OS) (P=0.042, 0.017, and 0.022, respectively). Moreover, we have established two MFt genomic subgroups distinguishing a stable group (0-5 DNA aberrations) and an unstable group (>5 DNA aberrations), showing that the genomic unstable group had a shorter OS (P=0.05). We therefore conclude that specific chromosomal abnormalities, such as gains of 8q24.21 (MYC) and losses of 9p21.3 (CDKN2A, CDKN2B, and MTAP) and 10q26qter (MGMT and EBF3) may have an important role in prognosis. In addition, we describe the MFt genomic instability profile, which, to our knowledge, has not been reported earlier

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain)

Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Incidence and mortality rates of selected infection-related cancers in Puerto Rico and in the United States

<p>Abstract</p> <p>Background</p> <p>In 2002, 17.8% of the global cancer burden was attributable to infections. This study assessed the age-standardized incidence and mortality rates of stomach, liver, and cervical cancer in Puerto Rico (PR) for the period 1992-2003 and compared them to those of Hispanics (USH), non-Hispanic Whites (NHW), and non-Hispanic Blacks (NHB) in the United States (US).</p> <p>Methods</p> <p>Age-standardized rates [ASR(World)] were calculated based on cancer incidence and mortality data from the PR Cancer Central Registry and SEER, using the direct method and the world population as the standard. Annual percent changes (APC) were calculated using the Poisson regression model from 1992-2003.</p> <p>Results</p> <p>The incidence and mortality rates from stomach, liver and cervical cancer were lower in NHW than PR; with the exception of mortality from cervical cancer which was similar in both populations. Meanwhile, the incidence rates of stomach, liver and cervical cancers were similar between NHB and PR; except for NHB women who had a lower incidence rate of liver cancer than women in PR. NHB had a lower mortality from liver cancer than persons in PR, and similar mortality from stomach cancer.</p> <p>Conclusions</p> <p>The burden of liver, stomach, and cervical cancer in PR compares to that of USH and NHB and continues to be a public health priority. Public health efforts are necessary to further decrease the burden of cancers associated to infections in these groups, the largest minority population groups in the US. Future studies need to identify factors that may prevent infections with cancer-related agents in these populations. Strategies to increase the use of preventive strategies, such as vaccination and screening, among minority populations should also be developed.</p

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