Litterfall Dynamics and Nutrient Cycling in Mangrove Forests of Southern Everglades, Florida and Terminos Lagoon, Mexico.

The objective of this dissertation was to investigate the processes that control litterfall and nutrient dynamics in two contrasting mangrove ecosystems at the Southeastern (SE) Everglades and Terminos Lagoon. The main objectives were: (a) to determine the spatial and temporal variability of litterfall dynamics, (b) to evaluate the relative importance of nutrient use efficiency as a nutrient conservation mechanism along a natural nutrient gradient, and (c) to assess the relative importance of nutrient resorption on litterfall dynamics. Two hypotheses were tested: (a) mangrove species living in nutrient-poor environments and in nutrient-rich environments do not differ in the efficiency in using nutrients, (b) nutrient resorption and nutrient immobilization do not differ along a natural nutrient gradient. Litterfall rates were lowest in a dwarf mangrove forest at SE Everglades and highest in fringe and riverine forests at Terminos Lagoon. Litterfall dynamics were linked to the local tidal pattern at each study site. Litter turnover rates were higher in areas most influenced by tides and lower in areas less affected by tides. In areas where tides were less frequent litterfall turnover was lower and nutrient immobilization was higher. Laguncularia racemosa and Rhizophora mangle were more efficient In resorbing both phosphorus and nitrogen than Avicennia germinans. This pattern was similar at both study regions; however, nutrient resorption was higher at SE Everglades sites and lower at Terminos Lagoon sites. Also, phosphorus resorption was higher than that of nitrogen, indicating that in carbonate environments phosphorus is more limiting than nitrogen. Since nutrient resorption was higher at SE Everglades, dry matter degradation was slower at these sites, relative to Terminos Lagoon. Thus, nutrient resorption plays an important role in controlling the nutrient economy in mangrove forests where phosphorus is limiting. Nutrient resorption was linked to patterns of litterfall dynamics. Thus, in mangrove forests where leaf turnover was high, nutrient conservation was enhanced at the canopy level, while at sites where leaf turnover was low, nutrient immobilization via leaf decomposition became an important mechanism to recycle nutrients

Sistema ciber-físico aplicado al mantenimiento predictivo en el sector hotelero

El sector turístico es clave para la economía española, por lo que desarrollos e innovaciones en términos de digitalización son necesarios para mejorarlo. Para ello, se plantea la utilización de sistemas ciber-físicos, los cuales parten del concepto de la virtualización de la planta mediante la adquisición de los estados de los equipos físicos. A partir de esta esta información, y mediante algoritmos específicos, se realizan acciones para cerrar los lazos de control, fomentando la digitalización del sector industrial. En este sistema ciber-físico se va a utilizar una aplicación de mantenimiento predictivo de los equipos de clima. Se ha desarrollado una red de adquisición de datos con algoritmos que se encarguen de la gestión y procesado de datos. Estos sistemas tienen conectividad a internet. Por último, cerrando el lazo de control, se actúa sobre el sistema cambiando el estado físico de los equipos. Este sistema se ha desplegado sobre una instalación hotelera específica, pudiendo ser interoperable con tecnologías de terceros

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Identification of Olives Using In-Field Hyperspectral Imaging with Lightweight Models

During the growing season, olives progress through nine different phenological stages, starting with bud development and ending with senescence. During their lifespan, olives undergo changes in their external color and chemical properties. To tackle these properties, we used hyperspectral imaging during the growing season of the olives. The objective of this study was to develop a lightweight model capable of identifying olives in the hyperspectral images using their spectral information. To achieve this goal, we utilized the hyperspectral imaging of olives while they were still on the tree and conducted this process throughout the entire growing season directly in the field without artificial light sources. The images were taken on-site every week from 9:00 to 11:00 a.m. UTC to avoid light saturation and glitters. The data were analyzed using training and testing classifiers, including Decision Tree, Logistic Regression, Random Forest, and Support Vector Machine on labeled datasets. The Logistic Regression model showed the best balance between classification success rate, size, and inference time, achieving a 98% F1-score with less than 1 KB in parameters. A reduction in size was achieved by analyzing the wavelengths that were critical in the decision making, reducing the dimensionality of the hypercube. So, with this novel model, olives in a hyperspectral image can be identified during the season, providing data to enhance a farmer’s decision-making process through further automatic applications.Universidad de Sevill

Recomendaciones para el uso racional de la prueba 25-hidroxi vitamina D Policy Brief

El incremento exponencial en la solicitud de pruebas de laboratorio de 25-Hidroxivitamina D o [25(OH)D ha encendido las alarmas y generado un fuerte llamado de atención, dado que puede reflejar falencias en la estandarización de la práctica clínica y en el uso no sistemático de la evidencia científica para la toma de decisiones en la vida real, que permitan analizar las indicaciones de la prueba, su frecuencia, interpretación e incluso para valorar el impacto para los sistemas de salud, especialmente cuando se contrasta con los mínimos o casi nulos efectos de la estrategia de tamizar o suplir indiscriminadamente a la población general, sin considerar una evaluación clínica integral de riesgos y necesidades de las personas. Desde un punto de vista meramente de impacto en salud pública, la consecuencia de solicitudes masivas y no indicadas, están afectando a la mayoría de los sistemas e instituciones de salud a nivel global. Los estudios primarios que determinaban valores de ingesta promedio poblacional, han sido ampliamente utilizados en la formulación de recomendaciones en Guías de Práctica Clínica (GPC), pero lastimosamente interpretados de forma errónea como puntos de corte para diagnosticar enfermedad y permitir la exagerada prescripción de esquemas de suplencia. El coeficiente de variación en los ensayos de rutina para medir niveles sanguíneos de 25(OH)D3 es alto (28%), disminuyendo la precisión global de la prueba y de forma simultánea, incrementando tanto los valores falsamente altos como falsamente bajos. La evidencia científica más reciente, analiza y cuestiona seriamente, la utilidad y el efecto real de la práctica masiva e indiscriminada de prescribir vitamina D sin un análisis exhaustivo de riesgo. La evidencia disponible es insuficiente para recomendar de forma general la suplencia de vitamina D para prevenir fracturas, caídas, cambios en la densidad mineral ósea, incidencia de enfermedades cardiovasculares, enfermedad cerebrovascular, neoplasias y tampoco en modificar la curva de crecimiento de hijos de madres que recibieron vitamina D como suplencia durante la gestación. Las recomendaciones presentadas en el documento se sustentan en el análisis crítico de la evidencia actual y en los principios de buenas prácticas clínicas e invitan a considerar un uso racional de las pruebas de 25(OH)D en el contexto de una práctica clínica centrada en las personas y una evaluación integral de necesidades y riesgos. Los principios de buena práctica sugieren que los clínicos puedan ser capaces de justificar que los resultados de la prueba de 25(OH)D influyen de manera contundente y definida la práctica clínica y modifican los desenlaces que interesan a las personas e impactan en su salud y bienestar. En la actualidad no hay claridad de cómo interpretar los resultados, y la relación entre los síntomas y los niveles de 25(OH)D, la cual, podría no ser consistente con la alta prevalencia de deficiencia de vitamina D reportada. Por tal razón, se sugiere revisar la racionalidad de la solicitud de pruebas para monitoreo sistemático de niveles de 25(OH)D o en todos los casos donde se realiza suplencia. Considerar el uso de las pruebas de 25(OH)D dentro de la evaluación integral de personas con sospecha o confirmación de las siguientes condiciones: raquitismo, osteomalacia, osteoporosis, híper o hipo paratiroidismo, síndromes de mala absorción, sarcopenia, enfermedad ósea metabólica

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease