Thinning of the Monte Perdido Glacier in the Spanish Pyrenees since 1981

Producción CientíficaThis paper analyzes the evolution of the Monte Perdido Glacier, the third largest glacier in the Pyrenees, from 1981 to the present. We assessed the evolution of the glacier's surface area by analysis of aerial photographs from 1981, 1999, and 2006, and changes in ice volume by geodetic methods with digital elevation models (DEMs) generated from topographic maps (1981 and 1999), airborne lidar (2010) and terrestrial laser scanning (TLS, 2011, 2012, 2013, and 2014) data. We interpreted the changes in the glacier based on climate data from nearby meteorological stations. The results indicate that the degradation of this glacier accelerated after 1999. The rate of ice surface loss was almost three times greater during 1999–2006 than during earlier periods. Moreover, the rate of glacier thinning was 1.85 times faster during 1999–2010 (rate of surface elevation change  = −8.98 ± 1.80 m, glacier-wide mass balance  = −0.73 ± 0.14 m w.e. yr−1) than during 1981–1999 (rate of surface elevation change  = −8.35 ± 2.12 m, glacier-wide mass balance  = −0.42 ± 0.10 m w.e. yr−1). From 2011 to 2014, ice thinning continued at a slower rate (rate of surface elevation change  = −1.93 ± 0.4 m yr−1, glacier-wide mass balance  = −0.58 ± 0.36 m w.e. yr−1). This deceleration in ice thinning compared to the previous 17 years can be attributed, at least in part, to two consecutive anomalously wet winters and cool summers (2012–2013 and 2013–2014), counteracted to some degree by the intense thinning that occurred during the dry and warm 2011–2012 period. However, local climatic changes observed during the study period do not seem sufficient to explain the acceleration of ice thinning of this glacier, because precipitation and air temperature did not exhibit statistically significant trends during the study period. Rather, the accelerated degradation of this glacier in recent years can be explained by a strong disequilibrium between the glacier and the current climate, and likely by other factors affecting the energy balance (e.g., increased albedo in spring) and feedback mechanisms (e.g., heat emitted from recently exposed bedrock and debris covered areas).Ministerio de Economía, Industria y Competitividad - IBERNIEVE (project CGL2014-52599-P)Ministerio de Agricultura y Pesca, Alimentación y Medio Ambiente (project 844/2013

Effect of sugammadex on processed EEG parameters in patients undergoing robot-assisted radical prostatectomy

Background: Sugammadex has been associated with increases in the bispectral index (BIS). We evaluated the effects of sugammadex administration on quantitative electroencephalographic (EEG) and electromyographic (EMG) measures. Methods: We performed a prospective observational study of adult male patients undergoing robot-assisted radical prostatectomy. All patients received a sevoflurane-based general anaesthetic and a continuous infusion of rocuronium, which was reversed with 2 mg kg1 of sugammadex i.v. BIS, EEG, and EMG measures were captured with the BIS Vista™ monitor. Results: Twenty-five patients were included in this study. Compared with baseline, BIS increased at 4e6 min (b coefficient: 3.63; 95% confidence interval [CI]: 2.22e5.04; P<0.001), spectral edge frequency 95 (SEF95) increased at 2e4 min (b coefficient: 0.29; 95% CI: 0.05e0.52; P¼0.016) and 4e6 min (b coefficient: 0.71; 95% CI: 0.47e0.94; P<0.001), and EMG increased at 4e6 min (b coefficient: 1.91; 95% CI: 1.00e2.81; P<0.001) after sugammadex administration. Compared with baseline, increased beta power was observed at 2e4 min (b coefficient: 93; 95% CI: 1e185; P¼0.046) and 4e6 min (b coefficient: 208; 95% CI: 116e300; P<0.001), and decreased delta power was observed at 4e6 min (b coefficient: 526.72; 95% CI: 778 to 276; P<0.001) after sugammadex administration. Neither SEF95 nor frequency band data analysis adjusted for EMG showed substantial differences. None of the patients showed clinical signs of awakening. Conclusions: After neuromuscular block reversal with 2 mg kg1 sugammadex, BIS, SEF95, EMG, and beta power showed small but statistically significant increases over time, while delta power decreased

Effects of dexmedetomidine on subthalamic local field potentials in parkinson's disease

Background: Dexmedetomidine is frequently used for sedation during deep brain stimulator implantation in patients with Parkinson's disease, but its effect on subthalamic nucleus activity is not well known. The aim of this study was to quantify the effect of increasing doses of dexmedetomidine in this population. Methods: Controlled clinical trial assessing changes in subthalamic activity with increasing doses of dexmedetomidine (from 0.2 to 0.6 μg kg-1 h-1) in a non-operating theatre setting. We recorded local field potentials in 12 patients with Parkinson's disease with bilateral deep brain stimulators (24 nuclei) and compared basal activity in the nuclei of each patient and activity recorded with different doses. Plasma levels of dexmedetomidine were obtained and correlated with the dose administered. Results: With dexmedetomidine infusion, patients became clinically sedated, and at higher doses (0.5-0.6 μg kg-1 h-1) a significant decrease in the characteristic Parkinsonian subthalamic activity was observed (P<0.05 in beta activity). All subjects awoke to external stimulus over a median of 1 (range: 0-9) min, showing full restoration of subthalamic activity. Dexmedetomidine dose administered and plasma levels showed a positive correlation (repeated measures correlation coefficient=0.504; P<0.001). Conclusions: Patients needing some degree of sedation throughout subthalamic deep brain stimulator implantation for Parkinson's disease can probably receive dexmedetomidine up to 0.6 μg kg-1 h-1 without significant alteration of their characteristic subthalamic activity. If patients achieve a 'sedated' state, subthalamic activity decreases, but they can be easily awakened with a non-pharmacological external stimulus and recover baseline subthalamic activity patterns in less than 10 min

Perceived helpfulness of treatment for posttraumatic stress disorder: Findings from the World Mental Health Surveys

Background: Perceived helpfulness of treatment is an important healthcare quality indicator in the era of patient-centered care. We examine probability and predictors of two key components of this indicator for posttraumatic stress disorder (PTSD). Methods: Data come from World Mental Health surveys in 16 countries. Respondents who ever sought PTSD treatment (n = 779) were asked if treatment was ever helpful and, if so, the number of professionals they had to see to obtain helpful treatment. Patients whose treatment was never helpful were asked how many professionals they saw. Parallel survival models were estimated for obtaining helpful treatment in a specific encounter and persisting in help-seeking after earlier unhelpful encounters. Results: Fifty seven percent of patients eventually received helpful treatment, but survival analysis suggests that it would have been 85.7% if all patients had persisted in help-seeking with up to six professionals after earlier unhelpful treatment. Survival analysis suggests that only 23.6% of patients would persist to that extent. Odds of ever receiving helpful treatment were positively associated with receiving treatment from a mental health professional, short delays in initiating help-seeking after onset, absence of prior comorbid anxiety disorders and childhood adversities, and initiating treatment before 2000. Some of these variables predicted helpfulness of specific treatment encounters and others predicted persistence after earlier unhelpful encounters. Conclusions: The great majority of patients with PTSD would receive treatment they considered helpful if they persisted in help-seeking after initial unhelpful encounters, but most patients whose initial treatment is unhelpful give up before receiving helpful treatment

Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys

Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful

Age of onset and cumulative risk of mental disorders:a cross-national analysis of population surveys from 29 countries

Background: Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-onset distributions, lifetime prevalence, and morbid risk. Methods: In this cross-national analysis, we analysed data from respondents aged 18 years or older to the World Mental Health surveys, a coordinated series of cross-sectional, face-to-face community epidemiological surveys administered between 2001 and 2022. In the surveys, the WHO Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders until age 75 years across surveys by sex. We did not assess ethnicity. The surveys were geographically clustered and weighted to adjust for selection probability, and standard errors of incidence rates and cumulative incidence curves were calculated using the jackknife repeated replications simulation method, taking weighting and geographical clustering of data into account. Findings: We included 156 331 respondents from 32 surveys in 29 countries, including 12 low-income and middle-income countries and 17 high-income countries, and including 85 308 (54·5%) female respondents and 71 023 (45·4%) male respondents. The lifetime prevalence of any mental disorder was 28·6% (95% CI 27·9–29·2) for male respondents and 29·8% (29·2–30·3) for female respondents. Morbid risk of any mental disorder by age 75 years was 46·4% (44·9–47·8) for male respondents and 53·1% (51·9–54·3) for female respondents. Conditional probabilities of first onset peaked at approximately age 15 years, with a median age of onset of 19 years (IQR 14–32) for male respondents and 20 years (12–36) for female respondents. The two most prevalent disorders were alcohol use disorder and major depressive disorder for male respondents and major depressive disorder and specific phobia for female respondents. Interpretation: By age 75 years, approximately half the population can expect to develop one or more of the 13 mental disorders considered in this Article. These disorders typically first emerge in childhood, adolescence, or young adulthood. Services should have the capacity to detect and treat common mental disorders promptly and to optimise care that suits people at these crucial parts of the life course. Funding: None.</p

Las adicciones no relacionadas a sustancias (DSM-5, APA, 2013): un primer paso hacia la inclusión de las Adicciones Conductuales en las clasificaciones categoriales vigentes.

Se evalúan los cambios en la nomenclatura de las Adicciones en el DSM-5 y la inclusión de una nueva categoría dentro de las mismas, a la que denomina “Trastornos no relacionados a sustancias” y con la cual se designa a las llamadas adicciones conductuales. Dentro ella se incluye incluye como única patología aprobada al juego patológico o ludopatía con un nuevo rótulo: “Trastorno por juego de apuestas”. El inconveniente de tal etiqueta diagnóstica para su aceptación y uso por el público en general es que puede dar lugar al supuesto erróneo de que la práctica del juego genera siempre enfermedad. Por otro lado, sin embargo, el considerar al juego patológico una adicción y no un trastorno del control de impulsos ha sido un gran avance. Lamentablemente no fue incluida la “Adicción a Internet” en el nuevo rubro, pese a su enorme y creciente importancia mundial. Se describen además las características clínicas de esta última enfermedad

Estudio y mejora de flujos en un aparato de aire acondicionado mediante tecnología PIV

Ingeniería IndustrialIndustria Ingeniaritz