Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Post-Fire Regeneration and Diversity Response to Burn Severity in Pinus halepensis Mill. Forests

In recent decades, fire regimes have been modified by various factors such as changes in land use, global change or forest management policies. The vulnerability of Mediterranean terrestrial ecosystems is increasing due to more severe and frequent droughts. This study aimed to determine the plant response of ecosystems during the short-term post-fire period by relating alpha diversity, floristic richness and tree recruitment dynamics to burn severity 5 years after a wildfire. Our results conclude that in the short term, Pinus halepensis Mill. stands in southeastern Spain quickly recovered alpha diversity values, mainly in areas burned with low severity. We observed that moderate and high severities affected the ecosystem more significantly, showing higher values for the Shannon Index but lower for the Simpson index. Pine recruitment was higher in burned areas, and we found the highest number of Aleppo pine seedlings under a moderate burn severity. Post-fire regeneration functional groups (obligate seeders and resprouters) were promoted under moderate and high burn severity, increasing their abundance. Annual species (mainly herbs) colonized burned areas, persisting with higher presence under moderate burn severity. Restoration tools should be focused on reducing fire severity, mainly in areas at high risk of desertification, and promoting resistance, vulnerability and resilience of these ecosystems

Dinámica temporal post-incendio en ecosistemas forestales mediterráneos: respuesta de la vegetación y la interfaz suelo-planta a la severidad de quemado en masas de pino carraco

En la presente tesis doctoral se estudia la dinámica post-incendio de manera sincrónica y diacrónica en masas forestales de Pinus halepensis Mill. (pino carrasco) del sureste de España afectadas por incendios forestales en las últimas décadas. Debido al incremento de grandes incendios forestales en las últimas décadas, se hace especialmente necesario conocer con detalle la respuesta de los ecosistemas maduros de pino carrasco situados en el límite de los ombroclimas seco-semiárido, para poder dar respuesta a los problemas que puedan surgir en el futuro, debido al incremento esperado de temperatura y de periodos de sequía en el sur de Europa y con el fin último de ayudar en la toma de decisiones en la gestión y manejo forestal post incendio de estas masas Para realizar el presente estudio se seleccionaron tres zonas con similares características ecológicas afectadas por grandes incendios forestales en diferentes momentos a lo largo del tiempo. Estas zonas se encuentran situadas en el municipio de Hellín, provincia de Albacete, (sureste de la Península Ibérica) y sufrieron grandes incendios forestales en los años 1994, 2000 y 2012. En primer lugar, se llevó a cabo un estudio del incendio ocurrido en 2012 a lo largo de 5 años para conocer los cambios ocurridos en la vegetación y los suelos durante ese periodo de tiempo. En segundo lugar, se realizó un análisis de manera sincrónica de diversos parámetros de interés relativo a las comunidades vegetales y edáficas tras el fuego, con el fin de analizar la dinámica y evolución post incendio de dichas comunidades en el corto, medio y largo plazo. Los resultados obtenidos mostraron que, durante el corto plazo, la recuperación de la cubierta vegetal, así como la dinámica de la interfaz suelo planta se encuentran significativamente relacionadas con la severidad del incendio, siendo el factor principal que modula la recuperación del ecosistema a medio y largo plazo. Se puede observar como el ecosistema muestra una mayor actividad regeneradora de los parámetros estudiados durante el corto plazo, mientras que los resultados obtenidos a partir de 15 años después del incendio muestran que el ecosistema se encuentra mucho más próximo a las características de la etapa clímax, siendo la severidad un factor clave en la recuperación capaz de modificar el régimen de incendios actual. El desarrollo de la memoria de la presente tesis seguirá la siguiente estructura: Capítulo I: el análisis diacrónico realizado en este capítulo se basa en el estudio de la diversidad vegetal. Para ello, tomando parcelas control de referencia para establecer las características del ecosistema maduro, se compararon distintos índices de diversidad (Índice de Shannon, Índice de Simpson, riqueza florística, formas de vida…) durante el corto plazo y se analizaron esos valores 1, 3 y 5 años después del incendio. Los resultados obtenidos muestran la alta capacidad de regeneración vegetal durante este periodo de tiempo y la afectación de manera significativa de la severidad en los 5 primeros años tras el fuego El capítulo II, se realiza un estudio diacrónico de la interfaz suelo-planta. Para ello se analizaron distintos parámetros orgánicos y microbiológicos del suelo de las parcelas objeto de estudio teniendo en cuenta también las características de la cubierta vegetal. Los resultados de este capítulo nos muestran como la recuperación de los suelos la modula el cociente microbiano, siendo la severidad un factor clave en la actividad de las enzimas extracelulares del suelo, principalmente la de la fosfatasa ácida. Los siguientes capítulos se centran en el estudio de la dinámica vegetal post-incendio y la dinámica de la interfaz suelo-planta de manera sincrónica, contemplando el corto, medio y largo plazo. Para ello se analizaron de manera distintas parcelas afectadas por incendios forestales en distintos años: 1994, 2000 y 2012. En el capítulo III se realizó un estudio sincrónico en el que se evaluaron distintas características de la cubierta vegetal en función de la diversidad en parcelas de estudio afectadas por incendios forestales en diferentes años. Este estudio permitió comprender la dinámica sucesional de la vegetación en el corto, medio y largo plazo. Se concluye que, debido a la capacidad de regeneración de los ecosistemas mediterráneos preexistentes, estas comunidades vegetales son muy resilientes siendo la severidad un factor clave para la comprensión de esta dinámica vegetal. En el capítulo IV se realiza un estudio sincrónico de las mismas parcelas que en el capítulo anterior pero esta vez poniendo el foco en la interfaz planta-suelo. En este estudio los resultados obtenidos proporcionan información sobre respuesta bioquímica y microbiológica del suelo al fuego en matorrales mediterráneos propensos a incendios. Las propiedades del suelo se recuperaron en el largo plazo, aunque esta recuperación depende de la severidad del fuego y se relaciona directamente con la de la cubierta vegetal. Durante el medio y largo plazo los efectos de la severidad son poco significativos, mientras que en el corto plazo tienen una gran influencia

Post-Fire Regeneration and Diversity Response to Burn Severity in Pinus halepensis Mill. Forests

In recent decades, fire regimes have been modified by various factors such as changes in land use, global change or forest management policies. The vulnerability of Mediterranean terrestrial ecosystems is increasing due to more severe and frequent droughts. This study aimed to determine the plant response of ecosystems during the short-term post-fire period by relating alpha diversity, floristic richness and tree recruitment dynamics to burn severity 5 years after a wildfire. Our results conclude that in the short term, Pinus halepensis Mill. stands in southeastern Spain quickly recovered alpha diversity values, mainly in areas burned with low severity. We observed that moderate and high severities affected the ecosystem more significantly, showing higher values for the Shannon Index but lower for the Simpson index. Pine recruitment was higher in burned areas, and we found the highest number of Aleppo pine seedlings under a moderate burn severity. Post-fire regeneration functional groups (obligate seeders and resprouters) were promoted under moderate and high burn severity, increasing their abundance. Annual species (mainly herbs) colonized burned areas, persisting with higher presence under moderate burn severity. Restoration tools should be focused on reducing fire severity, mainly in areas at high risk of desertification, and promoting resistance, vulnerability and resilience of these ecosystems

Elaboración de asignaturas en el Campus Virtual

Memoria ID-176. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2010-2011.Posibilitar el Curso de Adaptación a los Grados de Maestro de Educación Infantil y Primaria a los maestros en ejercicio; facilitar la consecución de la mención elegida a los estudiantes de Magisterio, de cualquiera de los tres centros de la Universidad donde se imparten estas titulaciones, con independencia del centro en el que se encuentren matriculados; implicar al profesorado del centro en el proyecto de innovación, ofrecer a los estudiantes recursos didácticos disponibles a través de la red que les permita un estudio flexible y estructurado de la materia, crear experiencias de aprendizaje innovadoras en las que las plataformas digitales permitan ampliar los roles de los profesores y estudiantes, analizar las competencias adquiridas por los estudiantes mediantes estos sistemas informáticos, contribuir a la formación de los Graduados universitarios con un alto grado de autonomía intelectual, creatividad, capacidad de colaboración y predisposición para seguir aprendiendo en su vida profesional, elaborar las asignaturas en el campus virtual

Implementacion, coordinación y evaluación de las asignaturas practicum y practicum II en las titulaciones de Grado de Maestro y Grado en Turismo en la Escuela Universitaria de Educación y Turismo de Ávila

Memoria ID-245. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014

Nationwide COVID-19-EII Study : Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case&ndash;Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case&ndash;control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March&ndash;July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p &lt; 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p &lt; 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3&ndash;5.9), occupational risk (OR: 2.9; 95%CI: 1.8&ndash;4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2&ndash;2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09&ndash;0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

Pre- and post-fire comparison of forest areas in 3D

A satellite processing platform for high resolution forest assessment (FORSAT) was developed. It generates the digital surface models (DSMs) of the forest canopy by advanced processing of the very-high resolution (VHR) optical satellite imagery and automatically matches the pre- and post-fire DSMs for 3D change detection. The FORSAT software system can perform the following tasks: pre-processing, point measurement, orientation, quasi-epipolar image generation, image matching, DSM extraction, orthoimage generation, photogrammetric restitution either in mono-plotting mode or in stereo models, 3D surface matching, co-registration, comparison and change detection. It can thoroughly calculate the planimetric and volumetric changes between the epochs. It supports most of the VHR optical imagery commonly used for civil applications. Capabilities of FORSAT have been tested in two real forest fire cases, where the burned areas are located in Cyprus and Austria. The geometric characteristics of burned forest areas have been identified both in 2D plane and 3D volume dimensions, using pre- and post-fire optical image data from different sensors. The test studies showed that FORSAT is an operational software capable of providing spatial (3D) and temporal (4D) information for monitoring of forest fire areas and sustainable forest management. Beyond the wildfires, it can be used for many other forest information needs.Publisher's Versio