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Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil

World Journal of Gastroenterology 2015年第4期21卷 1197-1206页

作者： josé miguel luz parente Claudio Saddy Rodrigues Coy Viriato Campelo Mírian Perpétua Palha Dias parente Leonardo Araújo Costa Renata Mendes da Silva Celso Stephan josé Murilo Robilotta Zeitune Center for Health Sciences Federal University of Piaui (Universidade Federal do Piauí - UFPI)TeresinaPiauí 64049-550Brazil Department of Surgery School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas)CampinasS?o Paulo 13083-970Brazil Center of Health Sciences State University of Piaui (Universidade Estadual do Piauí - UESPI)TeresinaPiauí 64001-280Brazil Federal University of Piaui (Universidade Federal do Piauí - UFPI) TeresinaPiauí 64049-550Brazil Department of Public Health School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas - Unicamp)CampinasS?o Paulo 13083-970Brazil Department of Internal Medicine School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas - Unicamp)CampinasS?o Paulo 13083-970Brazil

AIM: To evaluate the demographic characteristics and clinical phenotypes of inflammatory bowel disease(IBD) in a geographic area in Northeastern Brazil.METHODS: This retrospective study was conducted at the Hospital of the Federal University of Piauí in Northeastern Brazil. Demographic characteristics and clinical phenotypes of IBD were analyzed in relation to the time of diagnostic confirmation, which was defined as the date of disease onset. Data were collected between January 2011 and December 2012 and included all census patients 18 years of age or older during that period for whom there was diagnostic confirmation of Crohn's disease(CD), ulcerative colitis(UC), or unclassified colitis according to the Montreal criteria. We also analyzed the period of time between the onset of clinical manifestations and the diagnosis of IBD(delay in the diagnosis). Statistical analyses included means and standard deviations for numeric variables and the Pearson χ2 adherence test for nominal variables. The annual index occurrence and overall prevalence of IBD at our institution were also calculated, with P values < 0.05 indicating statistical significance. This study was approved by the Institutional Ethics and Research Committee.RESULTS: A total of 252 patients with IBD were included, including 152(60.3%) UC patients and 100(39.7%) CD patients. The clinical and demographic characteristics of all patients with IBD showed a female to male ratio of 1.3:1.0 and a mean age of35.2(SD = 14.5) years. In addition, the majority of patients were miscegenated(171, 67.9%), had received higher education(157, 62.4%), lived in urban areas(217, 86.1%), and were under the age of 40 years(97, 62.5%). For patients with CD, according to the Montreal classification, the predominant features present from the onset of disease were an age between 17 and 40 years(A2); colonic disease location(L2); and nonstricturing, nonfistulizing disease behavior(B1). However, approximately one-quarter of all CD patients demonstrated perineal involvement. We also o

关键词： Inflammatory bowel diseases Crohn’s disease Ulcera

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Risk factors associated with inflammatory bowel disease: A multicenter case-control study in Brazil

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World Journal of Gastroenterology 2020年第25期26卷 3611-3624页

作者： Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Lucio Fernandes Boéchat Isabella Sued Leao Bianca do Carmo Schorr josémiguel luz parente Daniela Calado Lima Eduardo Santos Silveira Júnior Genoile Oliveira Santana Silva Neogélia Pereira Almeida Andrea Vieira Maria Luiza Queiroz de Bueno Júlio Maria Chebli érika Ruback Bertges Luísa Martins da Costa Brugnara Columbano Junqueira Neto Stefania Burjack Gabriel Campbell Luana Letiza Discacciati Joao Paulo Silva Cézar Tiago Nunes Gilaad G Kaplan Cyrla Zaltman Division of Gastroenterology Department of Internal MedicineClementino Fraga Filho HospitalFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Institute for Studies in Public Health Federal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Multidisciplinary Research Laboratory Clementino Fraga Filho HospitalInstitute of Thoracic DiseasesFaculty of MedicineFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of PiauíPiauí64049-550Brazil Almeida Division of GastroenterologyInflammatory Bowel Disease Outpatient ClinicRoberto Santos General Hospital(HGRS)of the Bahia State Department of HealthBahia 40110-060Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicIrmandade Santa Casa da Misericórdia of São PauloSão Paulo 01221020Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of Juiz de ForaMinas Gerais 36036-247Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicFederal District Base HospitalBrasília 70330-150Brazil Gastrointestinal Physiology Institute of Nutritional ScienceNestle Research CenterLausanne 1000Switzerland Departments of Medicine and Community Health Sciences University of CalgaryCalgary T2N4Z6Canada

BACKGROUND The etiology of inflammatory bowel disease(IBD)is unknown,but it is believed to be multifactorial.The hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated diseases.AIM To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of Brazil with diverse socioeconomic development indices.METHODS A multicenter case-control study was carried out with 548 Crohn’s disease(CD)and 492 ulcerative colitis(UC)outpatients and 416 healthy controls,from six IBD centers within different Brazilian states at diverse socioeconomic development stages.A semi-structured questionnaire with 87 socioeconomic and environmental questions was applied.Logistic regression model was created to assess the odds ratio(OR)with P value and 95%confidence intervals(CI).RESULTS Predictive variables for both diseases(CD and UC)were women[odd ratios(OR)=1.31;OR=1.69],low monthly family income(OR=1.78;OR=1.57),lower number of cohabitants(OR=1.70;OR=1.60),absence of vaccination(OR=3.11;OR=2.51),previous history of bowel infections(OR=1.78;OR=1.49),and family history of IBD(OR=5.26;OR=3.33).Associated risk factors for CD were age(18-39 years)(OR=1.73),higher educational level(OR=2.22),absence of infectious childhood diseases(OR=1.99).The UC predictive variables were living in an urban area(OR=1.62),inadequate living conditions(OR=1.48)and former smokers(OR=3.36).Appendectomy was a risk factor for CD(OR=1.58)with inverse association with UC(OR=4.79).Consumption of treated and untreated water was associated with risk of CD(OR=1.38)and UC(OR=1.53),respectively.CONCLUSION This is the first examining environmental exposures as risk factors for inflammatory bowel disease in Brazil.Most of the variables associated with disease risk support the role of the hygiene hypothesis in IBD development.

关键词： Crohn’s disease Ulcerative colitis Risk factors Environmental factors Hygiene hypothesis

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Real-world disease activity and sociodemographic,clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil

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World Journal of Gastroenterology 2021年第2期27卷 208-223页

作者： Cyrla Zaltman Rogério Serafim Parra Ligia Yukie Sassaki Genoile Oliveira Santana Maria de Lourdes Abreu Ferrari Sender J Miszputen Heda M B S Amarante Roberto Luiz Kaiser Junior Cristina Flores Wilson R Catapani josémiguel luz parente Mauro Bafutto Odery Ramos Carolina D Gonçalves Isabella Miranda Guimaraes jose J R da Rocha Marley R Feitosa Omar Feres Rogerio Saad-Hossne Francisco Guilherme Cancela Penna Pedro Ferrari Sales Cunha Tarcia NF Gomes Rodrigo Bremer Nones Mikaell Alexandre Gouvea Faria Mírian Perpétua Palha Dias parente António S Scotton Rosana Fusaro Caratin Juliana Senra Júlio Maria Chebli Department of Internal Medicine Federal University of Rio de JaneiroRio de Janeiro 21941-913Brazil Department of Surgery and Anatomy Ribeirão Preto Medical SchoolUniversity of São PauloRibeirao Preto 14049-900São PauloBrazil Department of Internal Medicine São Paulo State University(UNESP)Medical SchoolBotucatu 18618-687São PauloBrazil IBD Unit Federal University of BahiaSalvador 41150-000BahiaBrazil Department of Clinical Medicine Medical SchoolUniversidade Federal de Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Department of Gastroenterology Escola Paulista de MedicinaSão Paulo 04023-900Brazil Hospital de Clinicas Universidade Federal do ParanaCuritiba 80060-900ParanaBrazil Department of Proctology Beneficencia Portuguesa Hospital/Kaiser Day HospitalSao Jose do Rio Preto 15015110São PauloBrazil Department of Gastroenterology and Hepatology Sciences Hospital de ClínicasUniversidade Federal do Rio Grande do SulPorto Alegre 90560002Rio Grande do SulBrazil Department of Gastroenterology Faculdade de Medicina do ABCSanto Andre 09060-870São PauloBrazil Department of General Medicine Gastroenterology UnitUniversity HospitalFederal University of PiauiTeresina 64049-550PiauíBrazil Department of Gastroenterology Faculdade de MedicinaUniversidade Federal de GoiásGoiania 74535-170GoiasBrazil Department of Surgery Botucatu Medical School at São Paulo State University(UNESP)Botucatu 18618687São PauloBrazil Department of Gastroenterology UNIFESPSão Paulo 04040-002Brazil IBD unit Gastroenterology DepartmentHospital Nossa Senhora das GraçasCuritiba 80810-040ParanaBrazil Department of Proctology Kaiser Hospital DiaSao Jose do Rio Preto 15015-110São PauloBrazil Health Sciences Center Epidemiology UnitState University of PiauiTeresina 64001-280PiauíBrazil Department of Gastroenterology CMIP Centro Mineiro de PesquisaJuiz de Fora 36010-570Minas GeraisBrazil Scientific Affairs Takeda Pharmaceuticals BrazilSão Paulo 04709-011Brazil Clinical Research Takeda Pharma

BACKGROUND Understanding the treatment landscape of inflammatory bowel diseases(IBD)is essential for improving disease management and patient outcomes.Brazil is the largest Latin American country,and it presents socioeconomic and health care differences across its geographical regions.This country has the highest increase in IBD incidence and prevalence in Latin America,but information about the clinical and treatment characteristics of IBD is scarce.AIM To describe the sociodemographic,clinical,and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast,South and Northeast/Midwest regions.METHODS Multicenter,cross-sectional study with a 3-year retrospective chart review component.Patients with moderate-to-severe Crohn’s disease(CD)or ulcerative colitis(UC)were consecutively enrolled between October 2016 and February 2017.Active CD at enrollment was defined as a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or a calprotectin level>200μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year;active UC was defined as a partial Mayo score≥5.Descriptive statistics were used to analyze all variables.RESULTS In a total of 407 included patients,CD was more frequent than UC,both overall(264 CD/143 UC patients)and by region(CD:UC ratios of 2.1 in the Southeast,1.6 in the South and 1.2 in the Northeast/Midwest).The majority of patients were female(54.2%of CD;56.6%of UC),and the mean ages were 45.9±13.8 years(CD)and 42.9±13.0 years(UC).The median disease duration was 10.0(range:0.5-45)years for both IBD types.At enrollment,44.7%[95%confidence interval(CI):38.7-50.7]of CD patients and 25.2%(95%CI:18.1-32.3)of UC patients presented with active disease.More than 95%of IBD patients were receiving treatment at enrollment;CD patients were commonly treated with biologics(71.6%)and immunosuppressors(67.4%),and UC patients were commonly treated with mesalazine[5-Aminosalicylic acid(5-ASA)]derivates(69.9%)and immunosuppressors(44.1%).More than 50%of the CD

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Disease activity Epidemiology Treatment

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Real-world treatment patterns and disease control over one year in patients with inflammatory bowel disease in Brazil

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World Journal of Gastroenterology 2021年第23期27卷 3396-3412页

作者： Ligia Yukie Sassaki Sender J Miszputen Roberto Luiz Kaiser Junior Wilson R Catapani Mauro Bafutto António S Scotton Cyrla Zaltman Julio Pinheiro Baima Hagata S Ramos Mikaell Alexandre Gouvea Faria Carolina D Gonçalves Isabella Miranda Guimaraes Cristina Flores Heda M B S Amarante Rodrigo Bremer Nones josémiguel luz parente Murilo Moura Lima Júlio Maria Chebli Maria de Lourdes Abreu Ferrari Julia F Campos Maria G P Sanna Odery Ramos Rogério Serafim Parra jose J R da Rocha Omar Feres Marley R Feitosa Rosana Fusaro Caratin Juliana Tosta Senra Genoile Oliveira Santana Department of Internal Medicine Botucatu Medical School at Sao Paulo State University(UNESP)Botucatu 18618-687São PauloBrazil Department of Gastroenterology Escola Paulista de MedicinaSao PauloSão Paulo 18618-687São PauloBrazil Department of Proctology Kaiser Day HospitalSão Jose do Rio Preto 15015-110São PauloBrazil Department of Gastroenterology Faculdade de Medicina do ABCSanto Andre 09060-870São PauloBrazil Department of Gastroenterology Faculdade de MedicinaGoiania 74535-170GoiásBrazil Department of Gastroenterology CMIP Centro Mineiro de PesquisaJuiz de Fora 36010-570Minas GeraisBrazil Department of Internal Medicine Federal University of Rio de JaneiroRio de Janeiro 21941-913Rio de JaneiroBrazil Department of Gastroenterology Escola Paulista de MedicinaSão Paulo 04023-900São PauloBrazil Hospital de Clínicas de Porto Alegre Hospital de Clínicas de Porto AlegrePorto Alegre 90035-903Rio Grande do SulBrazil Hospital de Clinicas da Universidade Federal do Paraná Hospital de Clinicas da Universidade Federal do ParanáCuritiba ParanáParanáBrazil Gastroenterology Department Hospital Nossa Senhora das GraçasCuritiba 80810-040ParanáBrazil Department of General Medicine Universidade Federal do PiauíTeresina 64049-550PiauíBrazil Gastroenterology Hospital Universitario da Universidade Federal do PiauiTeresina 64049-550PiauíBrazil Department of Medicine University Hospital of Federal University of Juiz de ForaJuiz de ForaJuiz de Fora 36036-247Minas GeraisBrazil Department of Clinical Medicine Universidade Federal de Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Hospital de Clinicas da Universidade Federal do Paraná Hospital de Clinicas da Universidade Federal do ParanáCuritiba 80060-900ParanáBrazil Department of Surgery and Anatomy Ribeirao Preto Medical SchoolUniversity of Sao PauloRibeirão Preto 14048-900São PauloBrazil Scientific Affairs Takeda Pharmaceuticals BrazilSao Paulo 04709-011Brazil Clinical Research Takeda PharmaceuticalsSão Paulo 04709-011Sã

BACKGROUND Crohn’s disease(CD)and ulcerative colitis(UC)are inflammatory bowel diseases(IBDs)with a remission-relapsing presentation and symptomatic exacerbations that have detrimental impacts on patient quality of life and are associated with a high cost burden,especially in patients with moderate-to-severe disease.The Real-world Data of Moderate-to-Severe Inflammatory Bowel Disease in Brazil(RISE BR)study was a noninterventional study designed to evaluate disease control,treatment patterns,disease burden and health-related quality of life in patients with moderate-to-severe active IBD.We report findings from the prospective follow-up phase of the RISE BR study in patients with active UC or CD.AIM To describe the 12-mo disease evolution and treatment patterns among patients with active moderate-to-severe IBD in Brazil.METHODS This was a prospective,noninterventional study of adult patients with active Crohn’s disease(CD:Harvey-Bradshaw Index≥8,CD Activity Index≥220),inadequate CD control(i.e.,calprotectin>200μg/g or colonoscopy previous results),or active ulcerative colitis(UC:Partial Mayo score≥5).Enrollment occurred in 14 centers from October 2016 to February 2017.The proportion of active IBD patients after 9-12 mo of follow-up,Kaplan-Meier estimates of the time to mild or no activity and a summary of treatment initiation,discontinuation and dose changes were examined.RESULTS The study included 118 CD and 36 UC patients,with mean±SD ages of 43.3±12.6 and 44.9±16.5 years,respectively.The most frequent drug classes at index were biologics for CD(62.7%)and 5-aminosalicylate derivates for UC patients(91.7%).During follow-up,65.3%of CD and 86.1%of UC patients initiated a new treatment at least once.Discontinuations/dose changes occurred in 68.1%of CD patients[median 2.0(IQR:2-5)]and 94.3%of UC patients[median 4.0(IQR:3-7)].On average,CD and UC patients had 4.4±2.6 and 5.0±3.3 outpatient visits,respectively.The median time to first mild or no activity was 319(IQR:239-358)d for CD and 320(IQR:288-358)d for UC patient

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel diseases Prospective study

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Bispecific sigma-1 receptor antagonism and mu-opioid receptor partial agonism:WLB-73502,an analgesic with improved efficacy and safety profile compared to strong opioids

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Acta Pharmaceutica Sinica B 2023年第1期13卷 82-99页

作者： Alba Vidal-Torres Begoña Fernández-Pastor Mónica García Eva Ayet Anna Cabot Javier Burgueño Xavier Monroy Bertrand Aubel Xavier Codony luz Romero Rosalía Pascual Maria Teresa Serafini Gregorio Encina Carmen Almansa Daniel Zamanillo Manuel Merlos josémiguel Vela WeLab Barcelona Parc Cientific de BarcelonaBarcelona 08028Spain

Opioids are the most effective painkillers,but their benefit-risk balance often hinder their therapeutic use.WLB-73502 is a dual,bispecific compound that binds sigma-1(S1R)and mu-opioid(MOR)receptors.WLB-73502 is an antagonist at the S1R.It behaved as a partial MOR agonist at the G-protein pathway and produced no/unsignificantβ-arrestin-2 recruitment,thus demonstrating low intrinsic efficacy on MOR at both signalling pathways.Despite its partial MOR agonism,WLB-73502exerted full antinociceptive efficacy,with potency superior to morphine and similar to oxycodone against nociceptive,inflammatory and osteoarthritis pain,and superior to both morphine and oxycodone against neuropathic pain.WLB-73502 crosses the blood-brain barrier and binds brain S1R and MOR to an extent consistent with its antinociceptive effect.Contrary to morphine and oxycodone,tolerance to its antinociceptive effect did not develop after repeated 4-week administration.Also,contrary to opioid comparators,WLB-73502 did not inhibit gastrointestinal transit or respiratory function in rats at doses inducing full efficacy,and it was devoid of proemetic effect(retching and vomiting)in ferrets at potentially effective doses.WLB-73502 benefits from its bivalent S1R antagonist and partial MOR agonist nature to provide an improved antinociceptive and safety profile respect to strong opioid therapy.

关键词： WLB-73502 Sigma-1 receptor Mu-opioid receptor Biased agonist Analgesic activity Chronic pain Neuropathic pain Safety

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基于几何形态测量学的亚欧大陆已灭绝食肉动物齿痕埋藏特征

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Science Bulletin 2022年第16期67卷 1644-1648,M0003,M0004页

作者： josé Yravedra Lloyd Austin Courtenay Darío Herranz-Rodrigo Gonzalo Linares-Matás Juan joséRodríguez-Alba Verónica Estaca-Gómez Carmen luzón Alexia Serrano-Ramos miguelÁngel Maté-González joséAntonio Solano Diego González-Aguilera Juan Manuel Jiménez-Arenas Department of Prehistory Ancient History and ArchaeologyComplutense University of MadridMadrid 28040Spain C.A.I.Archaeometry and Archaeological Analysis Complutense UniversityMadrid 28040Spain Grupo de Investigación Ecosistemas Cuaternarios Complutense UniversityMadrid 28040Spain Grupo de Investigación Arqueología Prehistórica Complutense UniversityMadrid 28040Spain Museo Primeros Pobladores de Europa‘josep Gibert’ Orce 18858Spain Department of Cartographic and Land Engineering Higher Polytechnic School of AvilaUniversity of SalamancaAvila 05003Spain School of Archaeology St.Hugh’s CollegeUniversity of OxfordOxford 01865United Kingdom History and Arts Doctoral Program University of GranadaGranada 18071Spain Escuela Técnica Superior de Ingenieros en Topografía Geodesia y Cartografía.Universidad Politécnica de MadridMadrid 28031Spain Department of Prehistory and Archaeology University of GranadaGranada 18071Spain

确定动物遗骸状况的形成原因是法医学、考古学、古生物学与兽医学的主要研究方向之一.食肉动物因其进食习惯成为对尸体最具破坏力的群体之一.为识别Venta Micena3(奥尔赛,格拉纳达,西班牙)古生物遗址形成与变化过程中起决定作用的已灭... 详细信息

确定动物遗骸状况的形成原因是法医学、考古学、古生物学与兽医学的主要研究方向之一.食肉动物因其进食习惯成为对尸体最具破坏力的群体之一.为识别Venta Micena3(奥尔赛,格拉纳达,西班牙)古生物遗址形成与变化过程中起决定作用的已灭绝食肉动物,本研究采用10个已灭绝有蹄类动物长骨骨干上的28处齿痕与483个现存食肉动物齿痕进行了比较.基于3D扫描成像技术,研究团队重建了28处有待识别齿痕,并为每份样本放置25个界标(landmarks),通过广义普氏分析法进行几何形态学分析.在进行多变量分析时,采用了主成分分析法.与此同时,运用机器学习(machine learning)算法对全部参与识别齿痕化石进行了分类预测,平均准确率为94%.研究证实20处齿痕来自鬣狗科动物,6处来自大型猫科动物,1处来自犬属动物,另有1处无法确定来源.本研究提供了由已灭绝食肉动物牙痕构成的研究样例.

关键词：几何形态测量学埋藏特征有蹄类动物齿痕几何形态学机器学习分类预测多变量分析

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Impact of payment source, referral site, and place of residence on outcomes after allogeneic transplantation in Mexico

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World Journal of Transplantation 2024年第2期14卷 76-87页

作者： Andrés Gómez-De León Yesica A López-Mora Valeria García-Zárate Ana Varela-Constantino Sergio U Villegas-De Leon Xitlaly J González-Leal Raúl del Toro-Mijares Anna C Rodríguez-Zúñiga Juan F Barrios-Ruiz Victor Mingura-Ledezma Perla R Colunga-Pedraza Olga G Cantú-Rodríguez César H Gutiérrez-Aguirre luz Tarín-Arzaga Elías E González-López David Gómez-Almaguer Hematology Service Universidad Autónoma de Nuevo LeónFacultad de Medicina y Hospital Universitario Dr.JoséEleuterio GonzálezMonterrey 64460Nuevo LeónMexico Hemato-logy Service Clínica Gómez AlmaguerMonterrey 64710Nuevo LeónMexico Hematology Service Instituto Tecnológico de Estudios Superiores de MonterreyTec SaludEscuela de Medicina Ignacio SantosMonterrey 64710Nuevo LeónMexico

BACKGROUND The impact of social determinants of health in allogeneic transplant recipients in low-and middle-income countries is poorly described.This observational study analyzes the impact of place of residence,referring institution,and transplant cost coverage(out-of-pocket vs government-funded vs private insurance)on outcomes after allogeneic hematopoietic stem cell transplantation(alloHSCT)in two of Mexico's largest public and private institutions.AIM To evaluate the impact of social determinants of health and their relationship with outcomes among allogeneic transplant recipients in Mexico.METHODS In this retrospective cohort study,we included adolescents and adults≥16 years who received a matched sibling or haploidentical transplant from 2015-2022.Participants were selected without regard to their diagnosis and were sourced from both a private clinic and a public University Hospital in Mexico.Three payment groups were compared:Out-of-pocket(OOP),private insurance,and a federal Universal healthcare program“Seguro Popular”.Outcomes were compared between referred and institution-diagnosed patients,and between residents of Nuevo Leon and out-of-state.Primary outcomes included overall survival(OS),categorized by residence,referral,and payment source.Secondary outcomes encompassed early mortality,event-free-survival,graft-versus-host-relapse-free survival,and non-relapse-mortality(NRM).Statistical analyses employed appropriate tests,Kaplan-Meier method,and Cox proportional hazard regression modeling.Statistical software included SPSS and R with tidycmprsk library.RESULTS Our primary outcome was overall survival.We included 287 patients,n=164 who lived out of state(57.1%),and n=129 referred from another institution(44.9%).The most frequent payment source was OOP(n=139,48.4%),followed by private insurance(n=75,26.1%)and universal coverage(n=73,25.4%).No differences in OS,event-free-survival,NRM,or graft-versus-host-relapse-free survival were observed for patients diagnosed locally vs in another institution,nor pat

关键词： Hematopoietic cell transplant Social determinants of health Geography Haploidentical Out-of-pocket Financial toxicity Survival Health services and outcomes Hematopoietic malignancy Aplastic anemia

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Circulating leptin and its muscle gene expression in Nellore cattle with divergent feed efficiency

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Journal of Animal Science and Biotechnology 2018年第1期9卷 228-232页

作者： Lúcio Flávio Macedo Mota Cristina Moreira Bonafé Pamela Almeida Alexandre miguel Henrique Santana Francisco joséNovais Erika Toriyama Aldrin Vieira Pires Saulo da luz Silva Paulo Roberto Leme joséBento Sterman Ferraz Heidge Fukumasu Departmento de Zootecnia Universidade Federal dos Vales do Jequitinhonha e MucuriDiamantinaMG 39100 000Brazil Faculdade de Ciencias Agrarias e Veterinarias Universidade Estadual Paulista JaboticabalSP 14884 900Brazil Departamento de Medicina Veterinaria Faculdade de Zootecnia e Encjenharia de AlimentosUniversidade de Sao PauloAM.Duque de Caxias Norte n225Pirassununcja 13635 900SPBrazil Departmento de Zootecnia e Desenvolvimento Acjrossocioambiental Sustentavel Faculdade de VeterinariaUniversidade Federal FluminenseNiteroiRJ 24230 340Brazil Departamento de Zootecnia Faculdade de Zootecnia e Engenharia de AlimentosUniversidade de Sao PauloPirassununga 13635-900SPBrazil

Background： Leptin has a strong relation to important traits in animal production, such as carcass composition,feed intake, and reproduction. It is mainly produced by adipose cells and acts predominantly in the hypothalamus.In this study, circulating leptin and its gene expression in muscle were evaluated in two groups of young Nellore bulls with divergent feed efficiency. Individual dry matter intake（DMI） and average daily gain（ADG） of 98 Nellore bulls were evaluated in feedlot for 70 d to determinate the residual feed intake（RFI） and select 20 animals for the high feed efficient（LRFI） and 20 for the low feed efficient（HRFI） groups. Blood samples were collected on d 56 and at slaughter（80 d） to determine circulating plasma leptin. Samples of Longissimus dorsi were taken at slaughter for leptin gene expression levels.Results： DMI and RFI were different between groups and LRFI animals showed less back fat and rump fat thickness,as well as less pelvic and kidney fat weight. Circulating leptin increased over time in all animals. Plasma leptin was greater in LRFI on 56 d and at slaughter（P = 0.0049）. Gene expression of leptin were greater in LRFI animals（P = 0.0022） in accordance with the plasma levels. The animals of the LRFI group were leaner, ate less, and had more circulating leptin and its gene expression.Conclusion： These findings demonstrated that leptin plays its physiological role in young Nellore bulls, probably controlling food intake because feed efficient animals have more leptin and lower residual feed intake.

关键词： Beef cattle Energy homeostasis Fat depositon Residual feed intake

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Alluvial sedimentation and tectonostratigraphic evolution in a narrow extensional zigzag basin margin (northern Teruel Basin, Spain)

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Journal of Palaeogeography 2019年第4期8卷 368-392页

作者： Lope Ezquerro Aránzazu luzón josé L.Simón Carlos L.Liesa Departamento de Ciencias de la Tierra Facultad de Ciencias Geotransfer Research Group and Instituto de Investigación en Ciencias Ambientales (IUCA) Universidad de Zaragoza

The northern part of the eastern margin of the extensional Neogene Teruel Basin(central-eastern Spain)consists of a non-linear,zigzag fault zone made of alternating ca.2 km long,NNW-SSE trending segments and shorter NNESSW ones.Good outcrop conditions made possible a comprehensive integrated stratigraphic and structural study,especially focused on coarse clastic sediments deposited along the basin margin.Well-exposed stratal relationships with boundary faults,allowed the analysis of tectonic influence on sedimentation.Synsedimentary deformation includes growth faulting,rollover anticlines,and monoclines and associated onlap stratal terminations,angular unconformities,and other complex growth strata geometries.One of them is the onlap-over-rollover bed arrangement described here for the first time,which reveals the competition between tectonic subsidence and sedimentary supply.Both,the structural inheritance(dense Mesozoic fracture grid)and the dominant,nearly‘multidirectional’(σ1 vertical,σ2≈σ3),Pliocene extensional regime withσ3 close to E-W,are considered to have controlled the margin structure and evolution.Tectono-stratigraphic evolution includes:(i)reactivation of inherited NNW-SSE faults and development of W-SW-directed small alluvial fans(SAF)while NNE-SSW segments acted as gentle relay ramp zones;(ii)progressive activation of NNE-SSW faults and development of NW-directed very small alluvial fans(VSAF);during stages i and ii sediments were trapped close to the margin,avoiding widespread progradation;(iii)linking of NNW-SSE and NNE-SSW structural segments,overall basin sinking and widespread alluvial progradation;(iv)fault activity attenuation and alluvial retrogradation.The particular structure and kinematic evolution of this margin controlled alluvial system patterns.Size of alluvial fans,directly set up at the border faults,was conditioned by the narrowness of the margin,small catchment areas,and proximity between faults,which prevented the development of large alluvial fans.The size of the relay zones,o

关键词： Extensional basin Alluvial fan Stratal stacking pattern Structural inheritance Fault linkage

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Exploring the adjustment to parasite pressure hypothesis: differences in uropygial gland volume and haemosporidian infection in palearctic and neotropical birds

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Current Zoology 2021年第2期67卷 147-156页

作者： Sergio MAGALLANES Anders Pape MøLLER Charlene LUJÁN-VEGA Esteban FONG Daniel VECCO Wendy FLORES-SAAVEDRA luz GARCÍA-LONGORIAA Florentino DE LOPE joséA.IANNACONE Alfonso MARZAL Department of Anatomy Cellular Biology and ZoologyUniversity of ExtremaduraAvda.de Elvas S/NBadajoz ES-06006Spain Ecologie Systématique Evolution UniversitéParis-SudOrsay 91400France Key Laboratory for Biodiversity Science and Ecological Engineering of Ministry of Education College of Life SciencesBeiing Normal UniversityBeiing 100875China Pharmacology and Toxicology Graduate Group University of CaliforniaDavisDavisCA 95616USA EverGreen Institute-San Rafael Distrito de IndianaLoreto 16200Perú Centro Urku de Estudios Amazónicos Tarapoto 22202Perú Universidad Nacional Agraria La Molina Lima 15024Perú Molecular Ecology and Evolution Lab Department of BiologyLund UniversityLund 22100Sweden Laboratorio de Ingenieria Ambiental Universidad Cientifica del Sur-Villa el SalvadorLima 15067Perú Laboratorio de Invertebrados Universidad Ricardo PalmaSantiago de Surco 15039Perú

Parasites are globally widespread pathogenic organisms,which impose im portant selective forces upon their hosts.Thus,in accordance with the A djustm ent to parasite pressure hypothesis,it is expected that defenses among hosts vary relative to the selective pressure imposed by parasites.According to the latitudinal gradient in diversity,species richness and abundance of parasites peak near the equator.The uropygial gland is an im portant defensive exocrine gland against pathogens in birds.Size of the uropygial gland has been proposed to vary among species of birds because of divergent selection by pathogens on their hosts.Therefore,we should expect that bird species from the tropics should have relatively larger uropygial glands for their body size than species from higher latitudes.However,this hypothesis has not yet been explored.Here,we analyze the size of the uropygial gland of 1719 individual birds belonging to 36 bird species from 3 Neotropical(Peru)and 3 temperate areas(Spain).Relative uropygial gland volum e was 12.52%larger in bird species from the tropics than from temperate areas.This finding is consistent w ith the relative size of this defensive organ being driven by selective pressures imposed by parasites.We also explored the potential role of this gland as a means of avoiding haemosporidian infection,showing that species with large uropygial glands for their body size tend to have lower mean prevalence of haemosporidian infection,regardless o f their geographical origin.This result provides additional support for the assum ption that secretions from the uropygial gland reduce the likelihood of becoming infected with haemosporidians.

关键词： adjustment to parasite pressure hypothesis malaria Neotropical region preen oil temperate region

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