Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. / Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

Screening mental health problems during adolescence: psychometric properties of the Spanish version of the Strengths and Difficulties Questionnaire.

The main purpose of the present study was to test the psychometric properties of the Strength and Difficulties Questionnaire (SDQ), self-reported version, in Spanish adolescents, introducing a five-point Likert response scale. The sample consisted of 1474 adolescents with a mean age of 15.92 years (SD = 1.18). The level of internal consistency of the SDQ Total score was .75, ranging from .56 to .71 for the subscales. Results from exploratory factor analysis revealed a three-factor structure as the most satisfactory. Confirmatory factor analyses showed that the five-factor model (with modifications) displayed better goodness of-fit indices than the other hypothetical dimensional models tested. Furthermore, strong measurement invariance by age and partial measurement invariance by gender was supported. The study of the psychometric properties confirms that the Spanish version of the SDQ, self-reported form, is a useful tool for the screening of emotional and behavioural problems in adolescents.

A polymorphism in the regulatory region of APOE associated with risk for Alzheimer's dementia.

The epsilon4 allele of the apolipoprotein E gene (APOE) has been associated with an increased risk of developing Alzheimer's disease (AD; refs 1,2). However, it is apparent that the APOEepsilon4 allele alone is neither necessary nor sufficient to cause the disease. We have recently found three new polymorphisms within the APOE transcriptional regulatory region (M.J.A. et al., manuscript submitted) and now establish an association between one of these polymorphisms (-491A/T) and dementia as observed in Alzheimer's disease, in two independent clinical populations. The results suggest that homozygosity of a common variant (-491A) is associated with increased risk for AD, and that this association is independent of APOEepsilon4 status. In vitro studies suggest that the -491A/T polymorphism may increase risk for AD by altering the level of ApoE protein expression.

The effects of letrozole on ovarian stimulation for fertility preservation in cancer-affected women.

Survival rates for fertile women with cancer have increased significantly, lending importance to considering the possibility of motherhood after cancer. This study was a retrospective analysis of a prospective database comparing two groups of patients who underwent fertility preservation after being diagnosed with either breast cancer or a non-hormone-dependent cancer between 2009 and 2011. Nineteen oncology patients were included in the study. The objective was to assess the efficacy of ovarian stimulation with aromatase inhibitors versus a standard antagonist protocol. This study sought to quantify oestradiol concentrations in patients receiving letrozole and to determine the length of time between diagnosis of malignancy and onset of fertility preservation. Number of mature oocytes retrieved in the non-hormone-dependent cancer group was comparable to that in the breast cancer group (15.4±8.19 versus 16.3±7.31). Oestradiol concentrations were higher for patients with non-hormone-dependent cancer (1666.4±739.42 pg/ml versus 829±551.11 pg/ml, P=0.006). There were no differences between the groups in the length of time between diagnosis and fertility preservation (17.4±4.93 versus 16.4±1.74 days). Oestradiol concentrations of breast cancer patients on the letrozole protocol remained much lower than those of patients on the antagonist protocol.

Cholesterol dysregulation in peripheral blood mononuclear cells of Alzheimer's disease.

Cholesterol and the immune system are involved in Alzheimer's Disease (AD). To investigate the relations among them, we compared the cholesterol content in peripheral blood mononuclear cells (PBMC) of cognitively healthy controls and patients with mild cognitive impairment (MCI) and AD in two independent samples. Free cholesterol content of PBMC was lower in MCI and AD patients, and was modulated by APOE genotype. A decrease of CD8+ and an increase of CD16+ was also found in AD patients. These results suggest that cholesterol levels in PBMCs may represent an early signature of the disease and support the involvement of immune system in AD.

Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p <  .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p =  .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p <  .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p <  .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

[Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain]. / Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20,419) was higher than among Spaniards (n = 131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

[Executive function in early childhood and Generalizability Theory: Typical babies and preterm babies]. / Desarrollo ejecutivo temprano y Teoría de la Generalizabilidad: bebés típicos y prematuros.

In the areas of Social, Health, and Behavioral Sciences, observational designs are used as one of the best ways to study human behavior in natural and quasi-natural settings. Observing and recording a sample of individual patterns of behavior is a feature common to all of them, but a broad sampling error can be implicit, especially at early ages. Sampling errors arise also as a result of the observation of only a fraction of each possible case, and this is part of the problem involved in the estimation of generalizations of data recorded by systematic observation. The sampling process usually takes place at different stages (observers, sessions, tasks, age, etc...) and requires estimating variance components that can be combined with each other to produce one or more estimates of board coefficients. The Generalizability Theory (GT) proposes that there are many (infinite) sources of variation (facets) in any measurement. Our main objective is to identify the variance components that contribute to estimation errors and implement strategies to reduce the influence of these error sources on the measurement. Executive functioning in typical and premature babies is studied at 15 and 24 months. The results show differences between groups, sources of variation, and generalizability.

[Babies' logic activity: a differential study]. / La actividad lógica de los bebés: un estudio diferencial.

From a neuroconstructivist point of view based on infant cognitive development, the aim of this study is to get to know and compare the logical organization and content of the spontaneous activity of babies with alternative developmental courses (typical babies and Down's Syndrome ones). A fundamental form of logic is observed since the beginning of babies' interaction with their environment. This protologic is constructed through their organised and significative activity with the environment and it results in the elaboration of logico-mathematical and physical knowledge. Using Systematic Observation, we recorded the spontaneous activity of n=20 babies, (n=10 typical babies, n=10 Down Syndrome babies), with a cognitive developmental level of 1; 3 years (15 months). Microgenetical and statistical analyses were applied and the results obtained showed a reduced logical content and organization of the activity of Down's Syndrome babies, which corroborates and amplifies the results of previous research works. These results make evident the need to plan early educational intervention in order to optimize babies' developmental resources.

Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad / Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain

Introducción y objetivo Existen pocos estudios sobre el potencial papel de los orígenes raciales/étnicos en el riesgo de infección de COVID-19, particularmente en Europa. Evaluamos el riesgo de COVID-19 entre los migrantes de diferentes zonas del mundo en un contexto de acceso universal gratuito a la atención médica. Material y métodos Realizamos un análisis de cohortes poblacional de la incidencia acumulada de COVID-19 confirmada mediante PCR entre los residentes adultos en Alcorcón (España) en la primera oleada de la enfermedad hasta el 25 de abril de 2020. Resultados La incidencia acumulada bruta entre los migrantes (n=20.419) fue mayor que entre los españoles (n=131.599): 8,81 y 6,51 por cada 1.000 habitantes, respectivamente (p<0,001), pero difería según la región de origen mundial. Mediante regresión binomial negativa, ajustada por edad y sexo, los riesgos relativos (RR) para COVID-19 no fueron significativamente diferentes de los españoles para los individuos provenientes de Europa, Asia o el norte de África. Por el contrario, hubo un marcado aumento del riesgo para los del África subsahariana (RR 3,66, intervalo de confianza del 95% [IC] 1,42-9,41, p=0,007), el Caribe (RR 6,35, IC 95% 3,83-10,55, p<0,001) y América Latina (RR 6,92, IC 95% 4,49-10,67, p<0,001). Conclusiones Los migrantes procedentes del África subsahariana, el Caribe y América Latina, a diferencia de los españoles o migrantes procedentes de Europa, el norte de África o Asia, presentaron un mayor riesgo de COVID-19. Nuestros datos sugieren un papel para el origen étnico en el riesgo de COVID-19. Los migrantes de algunas zonas del mundo pueden merecer una atención más cercana tanto por razones clínicas como epidemiológicas (AU)

Introduction and objectives Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. Material and methods We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. Results The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). Conclusions Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons (AU)

Evaluation of satisfaction in an extracurricular enrichment program for high-intellectual ability participants.

BACKGROUND: The objective of this study was to evaluate the satisfaction of an extracurricular enrichment program of the cognitive and personal management of participants with high intellectual ability. METHOD: At the first time point, the sample consisted of n= 38 participants, and n= 20 parents; n= 48 participants at the second time point; and n= 60 participants at the third time point. The Satisfaction Questionnaire (CSA in Spanish), both for students (CSA-S) and for parents (CSA-P), was constructed. RESULTS: The CSA-S scores showed adequate psychometric properties. Exploratory factor analysis yielded a unidimensional structure. Cronbach’s alpha ranged between 85 and .86. Test-retest reliability was 0.45 (p<.05). The generalizability coefficient was .98. A high percentage of the sample was satisfied with the program, perceived improvements in cognitive and emotional management, motivation and interest in learning, and in the frequency and quality of their interpersonal relationships. CONCLUSIONS: The evaluation of educational programs is necessary in order to determine the efficacy and the effects of their implementation on the participants’ personal and intellectual management.

The assessment of emotional and Behavioural problems: Internal structure of The Strengths and Difficulties Questionnaire.

The main purpose of this study was to analyze the internal structure and measurement invariance across gender and age of the Strengths and Difficulties Questionnaire (SDQ), self-reported version, in Spanish adolescents. The sample consisted of 1,547 participants, 606 were male (39.1%), with a mean age of 15.15 years (SD = 1.99). Results from the confirmatory factor analysis showed a five-factor model and a bifactor model with correlated errors added as the most appropriate. Nevertheless, the bifactor model displayed lower and non-significant factor loadings. The hypothesis of measurement invariance of the SDQ scores across gender and age was supported. The level of internal consistency of the Total difficulties score was .84, ranging between .71 and .75 for the SDQ subscales. The study of the psychometric properties showed that the Spanish version of the SDQ, self-reported form, seems to be an adequate tool for the screening of emotional and behavioural problems during adolescence. Future research should analyze the internal structure of the SDQ in other regions and testing the measurement invariance across cultures.

El principal objetivo del presente estudio fue analizar la estructura interna y la invarianza de medición en función del género y la edad del Strengths and Difficulties Questionnaire (SDQ), versión autoinforme, en adolescentes españoles. La muestra está formada por 1.547 participantes, 606 varones (39,1%), con una media de edad de 15,15 años (DT = 1,99). Los resultados del análisis factorial confirmatorio mostraron que el modelo de cinco factores y el modelo bifactor con modificaciones presentaron los mejores índices de bondad de ajuste. Sin embargo, en el modelo bifactor algunas cargas factoriales no fueron estadísticamente significativas. La hipótesis de invarianza de medición de las puntuaciones del SDQ en función del género y la edad fue confirmada. El nivel de consistencia interna de la puntuación Total de dificultades fue 0,84, mientras que para las subescalas osciló entre 0,71 y 0,75. El estudio de las propiedades psicométricas de la versión española del SDQ autoinforme parece indicar que se trata de una herramienta adecuada y útil para el cribado de problemas emocionales y comportamentales en la adolescencia. En investigaciones futuras se debería analizar la estructura interna del SDQ en otras regiones y someter a prueba la invariancia de medición en función de las culturas.

Allelic polymorphisms in the transcriptional regulatory region of apolipoprotein E gene.

In this work, we explored the existence of genetic variants within the apolipoprotein E gene transcriptional regulatory region, using a denaturing gradient gel electrophoresis screening of a region comprising nucleotides -1017 to +406. Upon a population study, three new polymorphic sites (-491, -427 and -219) and two mutations were found. Functional effects of the polymorphisms, assayed by transient transfection and electrophoretic mobility shift assays in a human hepatoma cell line, showed that polymorphisms at sites -491 and -219 of the APOE promoter produce variations in the transcriptional activity of the gene, most probably through differential binding of nuclear proteins.

Contribution of APOE promoter polymorphisms to Alzheimer's disease risk.

OBJECTIVE: To determine whether the effects of APOE promoter polymorphisms on AD are independent of the APOE-epsilon4 allele. BACKGROUND: Recently, the -491 A-->T and -219 G-->T polymorphisms located in the APOE promoter have been suggested to be risk factors for AD. However, the effects of these polymorphisms have not always been reproduced in case-control studies, possibly because of the strong linkage disequilibrium existing at this locus or the characteristics of the populations studied. METHODS: Data collection was performed from six independent samples (1,732 patients with AD and 1,926 control subjects) genotyped for APOE exon 4 and the two APOE promoter polymorphisms. The risks associated with the APOE polymorphisms for developing AD were estimated using logistic regression procedures and calculation of odds ratios with 95% CI adjusted by age, sex, and collection center. Independence of the APOE promoter polymorphisms was tested by stratification for APOE-epsilon4 and tertile design was used for age stratification. RESULTS: The independence of the -491 AA genotype was observed in the whole sample whereas the independence of the -219 TT genotype was observed only in the oldest population. CONCLUSION: The -491 and -219 APOE promoter polymorphisms incur risk for AD in addition to risk associated with the APOE-epsilon4 allele, with age accentuating the effect of the -219 TT genotype. Because these polymorphisms appear to influence apoE levels, these results suggest that APOE expression is an important determinant of AD pathogenesis.

Alzheimer's risk associated with human apolipoprotein E, alpha-2 macroglobulin and lipoprotein receptor related protein polymorphisms: absence of genetic interactions, and modulation by gender.

Apolipoprotein E (apoE), the lipoprotein receptor related protein (LRP) and alpha-2 macroglobulin (alpha2M) have been proposed as a functional complex involved in amyloid clearance, a crucial event for Alzheimer's disease development. In this work, we present an epidemiological approach aimed to study the interactions among these genes, age and gender. This approach did not reveal significant associations between the genes; however, the present study indicated that the risk associated with APOE promoter and LRP gene polymorphisms is modulated by gender.

Apolipoprotein E promoter and alpha2-macroglobulin polymorphisms are not genetically associated with Chinese late onset Alzheimer's disease.

In this study, we investigated two newly reported polymorphisms in association with late onset Alzheimer's disease (AD) in Chinese. They were a -491 A/T polymorphism in the Apolipoprotein E (APOE) promoter region and a five base pair deletion at exon 18 of alpha2-Macroglobin (A2M). There were 196 AD and 180 normal controls (N), which were age- and sex-matched. APOE epsilon4 alleles were significantly increased in AD vs. N (chi2 = 33.3, P < 0.000001). However, neither the -491 A/T (chi2 = 1.13, P = 0.29) nor A2M (chi2 = 0.18, P = 0.67) polymorphism was associated with AD risk, suggesting that these polymorphisms do not represent risk factors for AD in the Chinese population.

Production and purification of recombinant African swine fever virus attachment protein p12.

The conditions for cultivation of Spodoptera frugiperda (Sf9) insect cells for production of recombinant baculoviruses have been studied, to scale-up and improve the efficiency of the process for production of the African swine fever virus attachment protein p12 in the baculovirus expression system. It was shown that the total virus and recombinant protein production in insect cells infected with the Acp12 recombinant baculovirus were slightly dependent on cell density, but largely dependent on the serum concentration, in the case of suspended cells, but not in static monolayer cultures. The yield of recombinant protein p12 exceeded 50 mg per 1 of 2 x 10(9) cells, representing more than 10% of total cell proteins, a level > 20-fold higher than that observed with other eukaryotic expression systems. The presence of p12 in the cytoplasmic fraction of infected cells has allowed the purification of the protein by a simple two-step procedure of aqueous phase partition and octyl-glucoside solubilization. The recombinant protein p12 was able to inhibit, in a dose-dependent manner, the African swine fever virus production in swine macrophages infected with a number of different virus isolates, including attenuated, virulent, highly passaged on tissue culture, and non-haemadsorbing strains, indicating a fundamental role for p12 in the early interaction of the virus with the natural target cell receptors. However, pigs immunized with purified recombinant p12 did not develop protective immunity against African swine fever.

Effectiveness of educational interventions on the improvement of drug prescription in primary care: a critical literature review.

This paper is a critical review of studies of educational programmes designed to improve prescription practices in ambulatory care. Scientific articles were selected from the following bibliographical indices: MEDLINE, IME, ICYT and ERIC. The searches covered the time period between 1988 and 1997. The search criteria included: primary-care, educat*, prescription* and other related keywords. The inclusion criteria were studies describing educational strategies aimed at general practitioners working in ambulatory settings. The study outcome was change in prescribing behaviour of physicians through prescribing indicators. The following data were extracted: study design, target drugs, type of intervention, follow-up period of the prescription trends, type of data analysis, type of statistical analysis and reported results. We found 3233 articles that met the search criteria. Of these, 51 met the inclusion criteria and 43 studied the efficacy/effectiveness of one or various interventions as compared to no intervention. Among seven studies evaluating active strategies, four reported positive results (57%), as opposed to three of the eight studies assessing passive strategies (38%). Among the 28 studies that tested reinforced active strategies, 16 reported positive results for all variables (57%). Eight studies were classified as a high degree of evidence (16%). We concluded that the results of our review suggest that the more personalized, the more effective the strategies are. We observe that combining active and passive strategies results in a decrease of the failure rate. Finally, better studies are still needed to enhance the efficacy and efficiency of prescribing practices.