Epidemiology of sports injuries in european union countries

La práctica deportiva es una actividad que se recomienda para mantener y promocionar la salud y los buenos hábitos. Sin embargo puede acarrear un riesgo importante de lesiones. Este estudio presenta, mediante técnicas de análisis multivariante, la relación que existe entre la tipo de lesiones, lugares del cuerpo donde se producen, los deportes más populares; fútbol, baloncesto, voleibol, y gimnasia, edad y países donde se practica, tomando datos de cinco países de la Unión Europea. Si relacionamos estas características entre sí, podemos elaborar estrategias específicas al tipo de deporte y país donde se practica, con el objeto de mejorar la prevención y poder disminuir la cantidad de lesiones que se producen.Participation in sports is a health promotion activity and maintains good habits that entail an important injury risk. The present article is a study using Multivariatye Analysis, the relationship between type of injury, location of injury, the most popular sports; soccer, basketball, volleyball, gymnastics, county where it has been practiced and age, in five European Union countries. With these relationships, we can develop specific strategies to improve prevention and to reduce the injuries that occur

Progression from ocular hypertension to visual field loss in the English hospital eye service

Background There are more than one million National Health Service visits in England and Wales each year for patients with glaucoma or ocular hypertension (OHT). With the ageing population and an increase in optometric testing, the economic burden of glaucoma-related visits is predicted to increase. We examined the conversion rates of OHT to primary open-angle glaucoma (POAG) in England and assessed factors associated with risk of conversion. Methods Electronic medical records of 45 309 patients from five regionally different glaucoma clinics in England were retrospectively examined. Conversion to POAG from OHT was defined by deterioration in visual field (two consecutive tests classified as stage 1 or worse as per the glaucoma staging system 2). Cox proportional hazards models were used to examine factors (age, sex, treatment status and baseline intraocular pressure (IOP)) associated with conversion. Results The cumulative risk of conversion to POAG was 17.5% (95% CI 15.4% to 19.6%) at 5 years. Older age (HR 1.35 per decade, 95% CI 1.22 to 1.50, p<0.001) was associated with a higher risk of conversion. IOP-lowering therapy (HR 0.45, 95% CI 0.35 to 0.57, p<0.001) was associated with a lower risk of conversion. Predicted 5-year conversion rates for treated and untreated groups were 14.0% and 26.9%, respectively. Conclusion Less than one-fifth of OHT patients managed in glaucoma clinics in the UK converted to POAG over a 5-year period, suggesting many patients may require less intensive follow-up. Our study provides real-world evidence for the efficacy of current management (including IOP-lowering treatment) at reducing risk of conversion

Managed Aquifer Recharge as a Tool to Enhance Sustainable Groundwater Management in California

A growing population and an increased demand for water resources have resulted in a global trend of groundwater depletion. Arid and semi-arid climates are particularly susceptible, often relying on groundwater to support large population centers or irrigated agriculture in the absence of sufficient surface water resources. In an effort to increase the security of groundwater resources, managed aquifer recharge (MAR) programs have been developed and implemented globally. MAR is the approach of intentionally harvesting and infiltrating water to recharge depleted aquifer storage. California is a prime example of this growing problem, with three cities that have over a million residents and an agricultural industry that was valued at 47 billion dollars in 2015. The present-day groundwater overdraft of over 100 km3 (since 1962) indicates a clear disparity between surface water supply and water demand within the state. In the face of groundwater overdraft and the anticipated effects of climate change, many new MAR projects are being constructed or investigated throughout California, adding to those that have existed for decades. Some common MAR types utilized in California include injection wells, infiltration basins (also known as spreading basins, percolation basins, or recharge basins), and low-impact development. An emerging MAR type that is actively being investigated is the winter flooding of agricultural fields using existing irrigation infrastructure and excess surface water resources, known as agricultural MAR. California therefore provides an excellent case study to look at the historical use and performance of MAR, ongoing and emerging challenges, novel MAR applications, and the potential for expansion of MAR. Effective MAR projects are an essential tool for increasing groundwater security, both in California and on a global scale. This chapter aims to provide an overview of the most common MAR types and applications within the State of California and neighboring semi-arid regions

Age effect on retina and optic disc normal values

Purpose: To investigate retinal thickness and optic disc parameters by the Retinal Thickness Analyzer (RTA) glaucoma program in older normal subjects and to determine any age effect. Methods: Subjects over 40 years of age without any prior history of eye diseases were recruited. Only subjects completely normal on clinical ophthalmologic examination and on visual field testing by Humphrey Field Analyzer (HFA) using the SITA 24-2 program were included. A total of 74 eyes from 74 subjects with even age distribution over the decades were enrolled and underwent topographic measurements of the posterior pole and of the optic disc by RTA. The `glaucoma full' program in software version 4.11B was applied. Results: Mean patient age was 59.9 +/- 10.3 years with a range from 40 to 80 years. The only parameter intraocular pressure (IOP) correlated with was retinal posterior pole asymmetry (r=0.27, p=0.02). IOP itself increased significantly with age (r=0.341, p=0.003). Mean defect and pattern standard deviation of the HFA did not correlate with any of the retinal or optic disc measurements. Increasing age correlated significantly with some of the morphologic measurements of the RTA: decreasing perifoveal minimum thickness (r=-0.258, p=0.026), increased cup-to-disc area ratio (r=0.302, p=0.016) and increased cup area (r=0.338 p=0.007). Conclusions: An age effect exists for some of the retina and optic disc measurements obtained by the RTA. Copyright (C) 2005 S. Karger AG, Basel

A Forecasting Model to Predict the Demand of Roses in an Ecuadorian Small Business Under Uncertain Scenarios

[EN] Ecuador is worldwide considered as one of the main natural flower producers and exporters ¿being roses the most salient ones. Such a fact has naturally led the emergence of small and medium sized companies devoted to the production of quality roses in the Ecuadorian highlands, which intrinsically entails resource usage optimization. One of the first steps towards optimizing the use of resources is to forecast demand, since it enables a fair perspective of the future, in such a manner that the in-advance raw materials supply can be previewed against eventualities, resources usage can be properly planned, as well as the misuse can be avoided. Within this approach, the problem of forecasting the supply of roses was solved into two phases: the first phase consists of the macro-forecast of the total amount to be exported by the Ecuadorian flower sector by the year 2020, using multi-layer neural networks. In the second phase, the monthly demand for the main rose varieties offered by the study company was micro-forecasted by testing seven models. In addition, a Bayesian network model is designed, which takes into consideration macroeconomic aspects, the level of employability in Ecuador and weather-related aspects. This Bayesian network provided satisfactory results without the need for a large amount of historical data and at a low-computational cost.Authors of this publication acknowledge the contribution of the Project 691249, RUC-APS ¿Enhancing and implementing Knowledge based ICT solutions within high Risk and Uncertain Conditions for Agriculture Production Systems¿ (www.ruc-aps.eu), funded by the European Union under their funding scheme H2020-MSCA-RISE-2015. In addition, the authors are greatly grateful by the support given by the SDAS Research Group (www.sdas-group.com)Herrera-Granda, ID.; Lorente-Leyva, LL.; Peluffo-Ordóñez, DH.; Alemany Díaz, MDM. (2021). 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Primary trabeculectomy versus primary glaucoma eye drops for newly diagnosed advanced glaucoma: TAGS RCT

Background: Patients diagnosed with advanced primary open-angle glaucoma are at a high risk of lifetime blindness. Uncertainty exists about whether primary medical management (glaucoma eye drops) or primary surgical treatment (augmented trabeculectomy) provide the best and safest patient outcomes. // Objectives: To compare primary medical management with primary surgical treatment (augmented trabeculectomy) in patients with primary open-angle glaucoma presenting with advanced disease in terms of health-related quality of life, clinical effectiveness, safety and cost-effectiveness. // Design: This was a two-arm, parallel, multicentre, pragmatic randomised controlled trial. // Setting: Secondary care eye services. // Participants: Adult patients presenting with advanced primary open-angle glaucoma in at least one eye, as defined by the Hodapp–Parrish–Anderson classification of severe glaucoma. // Intervention: Primary medical treatment – escalating medical management with glaucoma eye drops. Primary trabeculectomy treatment – trabeculectomy augmented with mitomycin C. // Main outcome measures: The primary outcome was health-related quality of life measured with the Visual Function Questionnaire-25 at 2 years post randomisation. Secondary outcomes were mean intraocular pressure; EQ-5D-5L; Health Utilities Index 3; Glaucoma Utility Index; cost and cost-effectiveness; generic, vision-specific and disease-specific health-related quality of life; clinical effectiveness; and safety. // Results: A total of 453 participants were recruited. The mean age of the participants was 67 years (standard deviation 12 years) in the trabeculectomy arm and 68 years (standard deviation 12 years) in the medical management arm. Over 65% of participants were male and more than 80% were white. At 24 months, the mean difference in Visual Function Questionnaire-25 score was 1.06 (95% confidence interval –1.32 to 3.43; p = 0.383). There was no evidence of a difference between arms in the EQ-5D-5L score, the Health Utilities Index or the Glaucoma Utility Index. At 24 months, the mean intraocular pressure was 12.40 mmHg in the trabeculectomy arm and 15.07 mmHg in the medical management arm (mean difference –2.75 mmHg, 95% confidence interval –3.84 to –1.66 mmHg; p < 0.001). Fewer types of glaucoma eye drops were required in the trabeculectomy arm. LogMAR visual acuity was slightly better in the medical management arm (mean difference 0.07, 95% confidence interval 0.02 to 0.11; p = 0.006) than in the trabeculectomy arm. There was no evidence of difference in safety between the two arms. A discrete choice experiment updated the utility values for the Glaucoma Utility Index. The within-trial economic analysis found a small increase in the mean EQ-5D-5L score (0.04) and that trabeculectomy has a higher probability of being cost-effective than medical management. The incremental cost of trabeculectomy per quality-adjusted life-year was £45,456. Therefore, at 2 years, surgery is unlikely to be considered cost-effective at a threshold of £20,000 per quality-adjusted life-year. When extrapolated over a patient’s lifetime in a model-based analysis, trabeculectomy, compared with medical treatment, was associated with higher costs (average £2687), a larger number of quality-adjusted life-years (average 0.28) and higher incremental cost per quality-adjusted life-year gained (average £9679). The likelihood of trabeculectomy being cost-effective at a willingness-to-pay threshold of £20,000 per quality-adjusted life year gained was 73%. // Conclusions: Our results suggested that there was no difference between treatment arms in health-related quality of life, as measured with the Visual Function Questionnaire-25 at 24 months. Intraocular pressure was better controlled in the trabeculectomy arm, and this may reduce visual field progression. Modelling over the patient’s lifetime suggests that trabeculectomy may be cost-effective over the range of values of society’s willingness to pay for a quality-adjusted life-year

Drought and the Sacramento-San Joaquin Delta, 2012–2016: Environmental Review and Lessons

This paper reviews environmental management and the use of science in the Sacramento–San Joaquin Delta during California’s 2012–2016 drought. The review is based on available reports and data, and guided by discussions with 27 agency staff, stake-holders, and researchers. Key management actions for the drought are discussed relative to four major drought water management priorities stated by water managers: support public health and safety, control saltwater intrusion, preserve cold water in Shasta Reservoir, and maintain minimum protections for endangered species. Despite some success in streamlining communication through interagency task forces, conflicting management mandates sometimes led to confusion about priorities and actions during the drought (i.e., water delivery, the environment, etc.). This report highlights several lessons and offers suggestions to improve management for future droughts. Recommendations include use of pre-drought warnings, timely drought declarations, improved transparency and useful documentation, better scientific preparation, development of a Delta drought management plan (including preparing for salinity barriers), and improved water accounting. Finally, better environmental outcomes occur when resources are applied to improving habitat and bolstering populations of native species during inter-drought periods, well before stressful conditions occur.

VAMOS: a Pathfinder for the HAWC Gamma-Ray Observatory

VAMOS was a prototype detector built in 2011 at an altitude of 4100m a.s.l. in the state of Puebla, Mexico. The aim of VAMOS was to finalize the design, construction techniques and data acquisition system of the HAWC observatory. HAWC is an air-shower array currently under construction at the same site of VAMOS with the purpose to study the TeV sky. The VAMOS setup included six water Cherenkov detectors and two different data acquisition systems. It was in operation between October 2011 and May 2012 with an average live time of 30%. Besides the scientific verification purposes, the eight months of data were used to obtain the results presented in this paper: the detector response to the Forbush decrease of March 2012, and the analysis of possible emission, at energies above 30 GeV, for long gamma-ray bursts GRB111016B and GRB120328B.Comment: Accepted for pubblication in Astroparticle Physics Journal (20 pages, 10 figures). Corresponding authors: A.Marinelli and D.Zaboro