Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. 187–194, 1990. T. Faist, “Transnationalization in international migration: implications for the study of citizenship and culture,” Ethnic and Racial Studies, vol. The Social Process of International Migration from Western Mexico, University of California Press, Berkeley, Calif, USA, 1987. T. Hammar and K. Tamas, “Why do people go or stay?” in International Migration, Immobility and Development, Multidisciplinary Perspectives, T. Hammar, G. Brochmann, K. Tamas, and T. Faist, Eds., pp. In people with meningitis, the fluid often shows a low sugar level along with an increased white blood cell count and increased protein. M. P. Smith, Transnational Urbanism: Locating Globalization, Blackwell, Oxford, UK, 2001. I will have to go to a pay clinic, but I will do so in my home country where I have to pay, but at least the doctor understands me.” (A 34-year-old female domestic worker from Alcalá de Henares). Until that date, immigrants from the two countries had but limited circulation of up to three months to work without a residency permit in Spain). 42, no. The situation intensified as of 2007 after Romania entered the EU. As was indicated earlier in this article, transnational Romanian migration was enhanced by EU community legislation and the opening of borders. Current concepts on, Cross AS, Kim KS, Wright DC, Sadoff JC, Gemski P. Role of lipopolysaccharide and capsule in the serum resistance of bacteremic strains of, Kim KS, Kang JH, Cross AS. 4, pp. It is unclear how 67-kDa LR is matured and synthesized from the 37-kDa LRP, but mature 67-kDa LR is shown to be present on the cell surface and functions as a membrane receptor for the adhesive basement membrane protein laminin (80). Meningitis can be caused by different germs. CNF1, however, is a cytoplasmic protein and execution of its contribution to E. coli invasion of the blood–brain barrier requires its secretion from the bacterial cytoplasm. D. Roman, Fragmented Identities. For that reason they have never let me go; they have no reason to do so. A. Sayad, La Double Absence, Editions du Seuil, Paris, Drance, 1999. We point out that return migration is not only a life plan but also a state of mind influenced by the current situation in which society in general finds itself. Keywords: Guarnizo [15] and Landolt [16] refer to a “transnational social formation”. Meningitis-causing E. coli has been shown to traverse the blood-brain barrier without altering the integrity of the HBMEC monolayer and without affecting the blood-brain barrier permeability (30, 42). Was ist Meningitis? This is not life. Transnational migration is developed in the framework of strong relationships between the countries of origin and destination, based on the premise that migrants have the freedom to decide. R. Miles and D. Thränhardt, Migration and European Integration: The Dynamics of Inclusion and Exclusion, Pinter Publisher, London, UK, 1995. A study using E. coli DNA microarray examined the gene expression patterns of HBMEC-associated E. coli, which revealed that type 1 fimbriae play an important role in E. coli binding to HBMEC (59). This concept was shown by the demonstration that purified S fimbriae or a recombinant E. coli strain HB101 expressing S fimbriae was shown to bind to the luminal surfaces of the brain vascular endothelium in neonatal rat brain tissues (63). As of now, what is likely is that we will go when the summer and the heat come. 2, pp. Twenty-nine percent of those interviewed affirm that they “come and go”, and, therefore, maintain a partial and continuous return. Even for those who wish to remain in Spain, the attachment they feel for that country is manifested in a relatively lesser manner, as evidenced by only 25% of those interviewed. This concept is supported by the demonstrations that the F-actin condensation occurs with invading bacteria and blockade of actin condensation with microfilament-disrupting agents such as cytochalasin D inhibits E. coli invasion of HBMECs (33). Networks that favored intense cyclical mobility between Romania and Spain were formed, which has made it impossible to closely follow the annual, monthly, and even daily movement by Romanians. Moriel DG, Bertoldi I, Spagnuolo A, Marchi S, Rosini R, Nesta B, Pastorello I, Corea VA, Torricelli G, Cartocci E, Savino S, Scarselli M, Dobrindt U, Hacker J, Tettelin H, Tallon LJ, Sullivan S, Wieler LH, Ewers C, Pickard D, Dougan G, Fontana MR, Rappuoli R, Pizza M, Serino L. Identification of protective and broadly conserved vaccine antigens from the genome of extraintestinal pathogenic, Xie Y, Kolisnychenko V, Paul-Satyaseela M, Elliott S, Parthasarathy G, Yao Y, Plunkett G, III, Blattner FR, Kim KS. 215–231, 2001. [3, 4] introduced the notion of transmigration to academic discourse. And she does speak Spanish. At the end of 2006 and the beginning of 2007, the Spanish National Statistical Institute (INE) did an extensive study called the National Immigrant Survey (ENI) that sampled 15,500 persons. Comunidad; Desnutrición; Geriátrico; Hospitales; Residencias. The inflammation from meningitis typically triggers symptoms such as headache, fever and a stiff neck. But what am I saying? It is possible that the negative image some immigrant groups have while competing in the local market, may spring from sources other than crime. Division of Pediatric Infectious Diseases Johns Hopkins University School of Medicine Baltimore, MD 21287, USA, The publisher's final edited version of this article is available at. “I believe that we have to return there, where we were born. Besides the reasons adduced here, this can be explained because it deals with persons whose average age (40–45 years) surpasses the total average, those who are considered “older” in the logic of migration. Since I always worked with Romanian people, I never practiced. Please enable it to take advantage of the complete set of features! Dawson KG, Emerson JC, Burns JL. P. R. Pessar, Caribbean Circuits. (The mechanism of circular labour mobility can be explained, thus, migrants leave their own country and work for a period of time in foreign lands, return to their homeland, and remain for a time while in general they invest the earnings obtained during their stay. A hierarchical clustering revealed that these strains can be categorized into two groups. It remains, however, incompletely understood how and why several bacterial factors of meningitis-causing E. coli are involved in HBMEC binding. Coslada, Arganda del Rey, and Alcalá de Henares reached their goal during the period 2002–2006, which is to say, after the opening of the Schengen border region to Romania (Figure 2). Recent functional E. coli genomic studies identified several E. coli factors that are shown to contribute to bacteremia (21, 43, 50, 51). Symptoms include fever, severe headache, neck stiffness, nausea, vomiting and light sensitivity. Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes c … Then, once we are without money, we would have to think about Sweden or Norway. A. S. Williams and P. C. Jobes, “Economic and quality-of-life considerations in urban-rural migration,” Journal of Rural Studies, vol. Kim KS. Prevention of Escherichia coli K1 penetration of the blood-brain barrier by counteracting the host cell receptor and signaling molecule involved in E. coli invasion of human brain microvascular endothelial cells. Returning to Romania as a plan is significant and depends on the situation of those interviewed, and the situation is conditioned by their life experiences in the two countries. The term meningitis is often applied to . Yu H, Kim KS. As of the 1990s, Spain became one of the destinations of Romanian emigration. Later, they return to the same foreign country, or another, where they have a network of fellow country men or acquaintances. 253–279, 2004. CNF1-expressing E. coli has been shown to up-regulate 67-kDa LR expression on the surface of HBMEC and recruit 67-kDa LR to the site of invading E. coli in a CNF1-dependent manner (81). Both clinical and experimental data indicate limited efficacy with antimicrobial chemotherapy alone (11, 12). A similar concept is shown with host factors, e.g., gp96 functions as the receptor for E. coli OmpA and L. monocytogenes Vip. Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. The weight of Romanian immigrants in the CAM who are concerned about the potential loss of work was relatively small in 2008 (only 14%), while in 2009 it had grown to 55%. At the same time, the most religious are not Orthodox but Seventh-Day Adventists. C. Grbich, Qualitative Data Analysis: An Introduction, Sage, London, UK, 2007. Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). 3, pp. Weiterhin können neurologische Symptome wie Reizbarkeit, Schläfrigkeit, Stupor bis zum Koma sowie Krampfanfälle oder Hirnnervenlähmungen auftreten. Most people get better on their own without treatment. For example, a significantly higher incidence of E. coli meningitis was noted in neonates who had bacterial counts in blood higher than 103 colony forming units (CFUs)/ml (6 of 11 or 55%), compared to those with blood bacterial counts lower than 103 CFUs/ml (1 of 19 or 5%) (13). In 2010, the rate of unemployment among immigrants to Spain reached 45% [39]. Most cases of meningitis in the United States are caused by a viral infection. Among those who do not wish to return, along with those who are undecided and want to return at some point in the future, we can distinguish between persons who arrived in Spain more than a decade ago, those who have permanent work permits, and those who have undergone family reunification. Studies in these hematogenous meningitis models indicate that the primary site of entry into the brain for circulating E. coli is the cerebral microvessels, not the choroid plexus (14). Taken together, meningitis-causing E. coli traverses the blood-brain barrier using a transcellular mechanism without altering the blood-brain barrier permeability. The values of this variable change slowly over time. 2016 Nov 29;33(6):1438-1443. doi: 10.20960/nh.807. Additional studies are needed to elucidate the microbial–host factors that contribute to E. coli invasion of HBMEC and also can serve as a novel target for prevention and therapy of E. coli meningitis. Gram-negative bacillary meningitis continues to be an important cause of mortality and morbidity throughout the world despite advances in antimicrobial chemotherapy and supportive care. This receptor, 37-kDa laminin receptor precursor (LRP), interacted with the N-terminal CNF1 and full-length CNF1 but not with the C-terminal CNF1. Die Meningitis ist eine sehr gefährliche Erkrankung, die Ärzte so schnell wie möglich behandeln müssen. Throughout the past two decades, the migration of Romanians within Europe has been closely linked to the policies of the European Community. Diese Bakterien können eine gefährliche Hirnhautentzündung ( Meningitis) auslösen, weshalb die Impfung umgangssprachlich auch "Meningitis-Impfung" genannt wird. 1) and transmigrate through HBMECs via an enclosed vacuole without intracellular multiplication and without any change in the integrity of HBMEC monolayers (20, 30, 33). Meningitis-causing E. coli penetration into the brain requires E. coli binding to and invasion of HBMEC, involving specific microbial and host factors, and host cell signaling molecules (7, 21-25, 28). The host–microbial factors exploiting such host cell signaling molecules for E. coli invasion of the blood-brain barrier, however, remain incompletely elucidated. Group 1 includes strains RS218, C5, IHE3034, A90, RS167, E334, S88, and S95, while strains EC10, RS168, and E334 belong to group 2. Role of S fimbriae in, Zhu L, Maruvada R, Sapirstein A, Malik KU, Peters-Golden M, Kim KS. 84, pp. These findings suggest that type 1 fimbriae, OmpA and NlpI are likely to contribute to HBMEC binding and invasion independent of each other. This perception of migration networks as a form of social capital also underlies assumptions about the existence of transnational social spaces. A. Zaiceva and K. F. Zimmermann, “Scale, diversity, and determinants of labour migration in Europe,” Oxford Review of Economic Policy, vol. Several E. coli determinants have been identified to be involved in HBMEC binding and subsequent invasion into HBMECs (52, 56-59). The surveys of the Romanian immigrant population were conducted throughout Spain. The knowledge of the language of the receiving country is one of the most dynamic indicators of the intention of return [55, 56]. It also remains to be determined whether complete abolition of HBMEC binding and invasion requires deletion of all the non-redundant bacterial factors contributing to HBMEC binding and invasion. Phosphatidylinositol 3-kinase activation and interaction with focal adhesion kinase in, Reddy MA, Wass CA, Kim KS, Schlaepfer DD, Prasadarao NV. Between 2007 and 2009, Spain and other EU countries imposed a moratorium that prevented Romanians and Bulgarians from freely entering the labour market. 68, pp. The conclusions point towards a possible renewal of the study of migration within the EU framework which links the border dynamic with the migration process. On a scientific basis, immigrants’ mobility and return is considered from the point of view of transnationalism. It is a life-threatening medical emergency. Besides, I have been here for more than 10 years and would not return because of the situation there. The author conducted interviews in Romanian and digitally recorded, with the permission of the research participants, and translated them before undertaking the analysis. La emigración internacional de rumanos desde un enfoque territorial,” Cuadernos de Geografía, vol. López Lirola EM, Iríbar Ibabe MC, Peinado Herreros JM. This new mobility was to be noted in the global tendencies of migration worldwide. The roles of those E. coli structures in HBMEC binding have been verified by deletion and complementation experiments, as shown by the demonstration that isogenic deletion mutants were significantly less able to bind HBMECs and their binding abilities were restored to the levels of parent strain by complementation with wild type genes. Unable to load your collection due to an error, Unable to load your delegates due to an error. Many organisms can cause meningitis including bacteria, viruses, fungi . The .gov means it’s official. At the same time, the realistic critique of the bad situation of the country of origin compared with the receiving country can be a real reason in making the decision not to return to Romania. The in vitro blood-brain barrier model has been developed with human brain microvascular endothelial cells (HBMECs). T. Hägerstrand, “On the definition of migration,” in Readings in Social Geography, E. Jones, Ed., pp. At this point, it is necessary to point out the family character of Romanian immigration to Madrid in particular and Spain in general. The Bacterial Meningitis Score has a sensitivity of 99% to 100% and a specificity of 52% to 62%, and appears to be the most specific tool available currently, although it is not widely used. 222, Universidad de Barcelona, 2006, http://www.ub.es/geocrit/sn/sn-222.htm. Bonacorsi S, Clermont O, Houdouin V, Cordevant C, Brahimi N, Marecat A, Tinsley C, Nassif X, Lange M, Bingen E. Molecular analysis and experimental virulence of French and North American, Kim KS, Kang JH, Cross AS, Kaufman B, Zollinger W, Sadoff J. Functional activities of monoclonal antibodies to the O side chain of, Sarff LD, McCracken GH, Jr, Schiffer MS, Glode MP, Robbins JB, Orskov I, Orskov F. Epidemiology of. In addition, pharmacological inhibition and gene deletion of host cell signaling molecules (e. g., cPLA2α) involved in E. coli invasion of HBMECs was efficient in preventing E. coli penetration into the brain (40, 41). Mechanisms involved in E. coli penetration of the blood-brain barrier and E. coli factors contributing to translocation of the blood-brain barrier. 1, no. Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors. The qualitative survey was complemented by in-depth interviews that were conducted with Romanians in the four communities already mentioned (Within the framework of the project, there were 75 in-depth interviews with Romanian males and females of working age. 10, no. The .gov means it’s official. Huang SH, Chen YH, Fu Q, Stins M, Wang Y, Wass C, Kim KS. P. Levitt, The Transnational Villagers, University of California Press, Los Angeles, Calif, USA, 2001. Meningitis can also cause confusion or seizures if it becomes severe. The second period, 1994–2002, was characterised by the acceleration of the mechanisms of mobility despite the difficulty in obtaining the necessary visas, and the great amount of clandestine activities. Introducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida. HHS Vulnerability Disclosure, Help Unhanand M, Mustafa MM, McCracken GH, Jr, Nelson JD. The article analyzes the process by which Romanian immigrants to the Autonomous Community of Madrid (Spain) return to their country. According to the data obtained, Romanians who live in Alcalá de Henares know the language best, while those in Arganda del Rey know it least. All group 1 strains belong to the phylogenetic group B2, which is predominant in meningitis isolates, and group 2 strains belong to less common phylogenetic groups A and D (97). Date of interview: May 2, 2009. Several studies have shown that the N-terminal portion of OmpA and its surface-exposed loops contribute to binding to HBMEC (57, 58, 68), and that OmpA interacts with HBMEC through N-acetylglucosamine (GlcNAc) residues of gp 96 (69, 70). Date of interview: November 10, 2008. This was the period of the most intense migration of Romanians to Spain (Madrid), characterised by the appearance of the phenomenon of circular labour migration that was based on the networks established during the preceding decade. T. Faist, “Transnationale Migration als relative Immobilität in einer globalisierten Welt,” Berliner Journal fur Soziologie, vol. “No, I do not speak well. When the family group in migration includes children, then the propensity to remain in the CAM increases (38% of those who are in this family situation). Int J Environ Res Public Health. Federal government websites often end in .gov or .mil. Die Meningokokken-Impfung ist eine Schutzimpfung gegen Meningokokken (Neisseria meningitidis). Most cases of meningitis in the United States are caused by a viral infection. However, other factors may also play a part. In addition, E. coli transmigrate through HBMECs via an enclosed vacuole without any change in the integrity of HBMEC monolayers (21, 30, 33), and no free bacteria are found in the cytoplasm of HBMECs or between adjacent HBMECs. 37, pp. Bacterial meningitis is characterized by inflammation of the meninges that occurs in response to bacteria and bacterial products, resulting in release of cytokines and chemokines as well as pathophysiological alterations such as infiltration of leukocytes and blood–brain barrier dysfunction (7, 21, 24, 25, 28). Bei der Meningitis kommt es zu einer Entzündung der Hirn- und /oder Rückenmarkshäute (Meningen). In Arganda, 30% of the population is older than 45 (the pioneers of Romanian immigration, as opposed to 22% in the four populations surveyed). Scale bar = 1 μm. Epidemics of meningitis are seen across the world, particularly in sub-Saharan Africa. and transmitted securely. CNF1 is an AB-type toxin, composed of the N-terminal cell binding domain and the C-terminal catalytic domain possessing a deaminase activity through the site-specific deamination of a Gln residue to Glu (76, 77). Clipboard, Search History, and several other advanced features are temporarily unavailable. Health is an important factor to take into consideration, relative to the state of mind of the person interviewed. After 2009, Spain lifted the moratorium and allowed free circulation for Romanians and Bulgarians (The moratorium on the free circulation of Romanian and Bulgarian workers within Spanish territory lasted from January 2007 until the end of 2008. The evidence above confirms that subjective states of mind, which may or may not be created in relation to objective data, count a great deal in the decisions to return to one’s country of origin. The site is secure. M. Boyd, “Family and personal networks in international migration: recent developments and new agendas,” International Migration Review, vol. INTRODUCTION — Bacterial meningitis is a medical emergency, and immediate steps must be taken to establish the specific cause and initiate effective therapy. This led to the third phase, 2002–2009, in the migration process. Bethesda, MD 20894, Web Policies Type-specific contributions to chromosome size differences in, Bloch CA, Huang SH, Rode CK, Kim KS. N. Glick Schiller, L. Basch, and C. Szanton Blanc, “From immigrant to transmigrant: theorizing transnational migration,” Anthropological Quarterly, vol. Guillamón-Escudero C, Diago-Galmés A, Zuazua Rico D, Maestro-González A, Tenías-Burillo JM, Soriano JM, Fernández-Garrido JJ. Xie Y, Yao Y, Kolisnychenko V, Teng CH, Kim KS. NlpI is shown to be an important factor of Crohn's disease-associated E. coli strain LF82 (083:H1) to interact with intestinal epithelial cells (72). 638–670, 1989. Meningitis is an infection of the meninges, the membranes that surround the brain and spinal cord. When questioned about the time of their departure, only 47% of those questioned said that they wish to return to their country within the next five years. OmpA and IbeA proteins of meningitis-causing E. coli are shown to be involved in FAK and PI3K activations as well as in STAT3 and Rac1 activations, while FimH and CNF1 in RhoA activation, OmpA and NlpI in cPLA2α and PKCα activations, and CNF1 in ERM activation. The actual chromosomal size difference between RS218 and MG1655 was approximately 450 kb, which is slightly smaller than the previously estimated genome size difference between RS218 and MG1655 (91). Not to Romania, not now, because we have time to work more and travel the world. There are 2 types of meningococcal vaccines available in the United States: Meningococcal conjugate or MenACWY vaccines (Menactra ® , Menveo ®, and MenQuadfi ®) 2, pp. 874–892, 2003. Ménard S, Tagliabue E, Colnaghi MI. We note how Arganda del Rey has the greatest percentage of persons who wish to return to their country. The first part of the article presents the phases of Romanian migration to the Autonomous Community of Madrid. Thirty-nine percent of those interviewed hold intermediate intentions of returning. Kim YV, DiCello F, Hillaire CS, Kim KS. A combination methodology that is both quantitative and qualitative will be used, focusing on four areas of the Community of Madrid which have seen the arrival of most of the Romanians over the last two years, Alcalá de Henares, Coslada, Torrejón de Ardoz, and Arganda del Rey. Epub 2019 Jan 18. 100–116, 2009. the contents by NLM or the National Institutes of Health. Kim KS. 65–83, 2004. . CNF1 contributes to E. coli invasion of HBMECs in vitro and penetration into the brain in vivo, and these in vitro and in vivo effects of CNF1 depend on RhoA activation (55). Religion can also be an important factor influencing the decision on the part of immigrants about returning [43]. Outer membrane A promoted cytoskeletal rearrangement of brain microvascular endothelial cells is required for E. coli invasion. These strains include RS218 (O18:K1), C5 (18:K1), IHE3034 (O18:K1), EC10 (O7:K1), A90 (O1:K1), RS168 (O1:K1), RS167 (O16:K1), E253 (O12:K1), E334 (O12:K1), S88 (O45:K1), and S95 (O45:K1). Similarly, the weight of those who expected that the next six months would be bad or very bad, from the perspective of work or personally, grew from 19% in 2008 to 60% in 2009. 93, no. 49–86, Il Mulino, Bologna, Italy, 2005. 135–152, 2008. 24, no. Forty-five percent of those who say that they will soon return to Romania assert that their children’s future is in both countries. The tendency to bring family members together in Spain is shown to have diminished. According to those interviewed, in Romania “there will be work, because my country is being built,” and besides “schools in Romania are better; there the studies are harder and better than in Spain.”. Relación con la edad y sexo del paciente. The K1 capsule modulates trafficking of E. coli- containing vacuoles and enhances intracellular bacterial survival in human brain microvascular endothelial cells. NlpI facilitates deposition of C4bp on, Wieser A, Magistro G, Nörenberg D, Hoffmann C, Schubert S. First multi-epitope subunit vaccine against extraintestinal pathogenic, Khan NA, Wang Y, Kim KJ, Chung JW, Wass CA, Kim KS. The basis for requiring a high-degree of bacteremia for penetration into the brain, however, remains unclear. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. E. coli is the most common Gram-negative bacillary organism that causes meningitis, in particular during the neonatal period. However, we have decided to analyze the return of Romanians in the Community of Madrid, given that the differences between the Autonomous Communities are consistent; Madrid has 206,000 Romanians registered in its territory (29% of the total), followed by the Community of Valencia (19% of the total). For example, some of the identified E. coli factors are shown to be uncommon in CSF isolates (e.g., CNF1) (98). Continued investigation on the microbial and host factors contributing to a high-degree of bacteremia and E. coli invasion of the blood-brain barrier is likely to identify new targets for prevention and therapy of E. coli meningitis. As can be noted in Figure 5, the weight of those who intend to return to their home country grows from 34% for those who know the language very well to 41% for those who know it well, and to 64% for those who do not know the language well. [63] from various backgrounds, studied this linkage in their work while taking a step towards creating a new theory. The article analyses the presence of Romanians in the Autonomous Community of Madrid (CAM). In the first place, the persons having the greatest probably of returning are those who are unhappy about the effects that, from their point of view, living in Spain and the CAM has had upon their family. Being older, having a limited amount of education, and working in the construction industry appear to favor ignorance of the Spanish language. Why not do it here in Spain? Als tuberkulöse Meningitis wird eine Meningitis bezeichnet, die durch eine Infektion mit dem Erreger Mycobacterium tuberculosis verursacht wird. Die Meningitis-Symtpome unterscheiden sich je nach Alter und Ursache (Bakterien, Viren oder ohne Keime, etwa durch Krankheiten). It is possible to think that those who put off their return are those who feel the closest link to their country of origin. 281–322, 1997. The flow of Romanians towards Spain intensified in 2007 when Romania entered the EU. “Here, I cannot go to the doctor; I do not have a card, nor does he understand me. Romanian migration to Spain, specifically, the Autonomous Community of Madrid, came in three phases: during the first period (1990–1994), it was relatively small and was constituted by pioneer migrants; the few who could find solutions in the midst of the scarcity of the time. The interviews were completed during November 2008 and May 2009. Caretaker of aged persons). Selective expression of adhesion molecules on human brain microvascular endothelial cells. To die here? I have been told that they earn a lot there. At the same time, they have a relatively lower level of education and scant knowledge of the Spanish language. Finally, when asked about the probability of return, those who were certain or very certain about returning to their country within the next five years represented only 39% of the total number of Romanian immigrants in the CAM. Sandu [54], for his part, sees in this type of migrant a continuous “evaluator” of the situation in his own country and of the receiving country, which in this case is Spain. 2, pp. Of interest, the T6SS clusters have two hcp-like genes located next to each other in the chromosome of strain RS218, and the two Hcp family proteins have been shown to exhibit different roles in meningitis-causing E. coli infection and coordinately contribute to the pathogenesis of E. coli interaction with HBMEC, e. g., E. coli binding to and invasion of HBMEC as well as release of IL-6 from HBMEC (102).