Evidencias de actividad glaciar durante el Dryas reciente (12, 9-11, 7 ka BP) en la Península Ibérica

El Dryas Reciente (Younger Dryas) (GS-1, entre 12, 9 y 11, 7 ka BP) se caracterizó por un marcado descenso de la temperatura a escala global. La consecuencia fue un re avance de los glaciares que afectó también a las cordilleras más importantes de la Península Ibérica. Este trabajo revisa la información disponible sobre la localización, evolución y extensión de tales glaciares. La actividad geomorfológica durante el Dryas Reciente en la Península Ibérica se ha identificado mediante depósitos morrénicos, umbrales rocosos pulidos por el hielo, y glaciares rocosos, datados en la mayor parte de los casos mediante métodos cosmogénicos. Los mejores ejemplos de morrenas del Dryas Reciente se localizan en los Pirineos, donde se desarrollaron cortas lenguas glaciares de hasta 4 km de longitud en los macizos más elevados y numerosos glaciares de circo. También hay evidencias de pequeños glaciares de circo y glaciares rocosos en la Cordillera Cantábrica y en el Sistema Central (sierras de Gredos y Guadarrama), como indican umbrales rocosos y depósitos morrénicos en el frente de circos glaciares. En cambio, en Sierra Nevada, en el extremo meridional de la Península Ibérica, las únicas evidencias del Younger Dryas son glaciares rocosos que se desarrollaron durante el Dryas Antiguo y estuvieron funcionales durante todo el Dryas reciente. The Younger Dryas (GS-1, entre 12, 9 y 11, 7 ka BP) was characterized by a remarkable declining in temperature at a global scale. The consequence was a moderate re-advance of glaciers that also affected the main ranges of the Iberian Peninsula. This paper reviews the available information on the location, evolution and extent of such glaciers. The geomorphological activity during the Younger Dryas in the Iberian Peninsula has been identified throughout the presence of morainic deposits (dated in most cases with cosmogenic exposure ages), rocky thresholds polished by the ice, and rock glaciers. The best examples of Younger Dryas moraines were found in the Central Pyrenees, with short ice tongues of up to 4 km in length in the highest massifs and a number of glacial cirques. There is also evidence of small cirque glaciers in the Cantabrian Range and the Central System Range (Gredos and Guadarrama sierras), as deduced by rocky thresholds and morainic deposits close to cirque headwalls. Conversely, in Sierra Nevada (southernmost sector of the Iberian Peninsula) the only evidence of the Younger Dryas is the presence of rock glaciers that were developed during the Oldest Dryas and survived during the Younger Dryas

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

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Holocene history of Aleppo pine (Pinus halepensis Mill.) woodlands in the Ebro Basin (NE Spain). Climate-biased or human-induced?

This paper reviews the past distribution of Aleppo pine woodlands in the Ebro Basin, Northeastern Iberia, from the Mesolithic to Modern times based on wood charcoal data. The aim is to detail the chronological timing and the drivers explaining the long-term presence of Aleppo pine woodlands and associated thermophilous flora. The available charcoal data support the early spread of Pinus halepensis during the Mesolithic (ca. 9000 cal BP) accompanied by Mediterranean trees and shrubs like Quercus sp. evergreen, Juniperus sp., Arbutus unedo, Pistacia lentiscus, Rhamnus/Phillyrea, Cistaceae, and Rosmarinus officinalis, as a local response to global climate change in the Early Holocene. During the arrival and the propagation of the Neolithic culture (ca. 7500–5500 cal BP), anthracological records, as well as regional palynological sequences, demonstrate the progressive replacement of an conifer-dominated open parkland by both Quercus sp. deciduous and evergreen woodlands in response to the Middle Holocene rise in temperature and humidity. This evidence, however, converges with the general idea that the presence and the spread of Pinus halepensis and associated scrubland have usually been attributed to the onset of landscape anthropization. The frequency of xero-thermophilous open scrubland and the use of Aleppo pine for fuel and woodcrafting progressively increased during the Bronze and Iron Ages, and especially in Ibero-Roman and Medieval/Islamic times, when the vegetation landscape in the Middle Ebro Basin was largely deforested as a consequence of increasing demographic pressure, grazing and the establishment of proto-urban centers

Testing the Effect of Relative Pollen Productivity on the REVEALS Model: A Validated Reconstruction of Europe-Wide Holocene Vegetation

Reliable quantitative vegetation reconstructions for Europe during the Holocene are crucial to improving our understanding of landscape dynamics, making it possible to assess the past effects of environmental variables and land-use change on ecosystems and biodiversity, and mitigating their effects in the future. We present here the most spatially extensive and temporally continuous pollen-based reconstructions of plant cover in Europe (at a spatial resolution of 1 degrees x 1 degrees) over the Holocene (last 11.7 ka BP) using the 'Regional Estimates of VEgetation Abundance from Large Sites' (REVEALS) model. This study has three main aims. First, to present the most accurate and reliable generation of REVEALS reconstructions across Europe so far. This has been achieved by including a larger number of pollen records compared to former analyses, in particular from the Mediterranean area. Second, to discuss methodological issues in the quantification of past land cover by using alternative datasets of relative pollen productivities (RPPs), one of the key input parameters of REVEALS, to test model sensitivity. Finally, to validate our reconstructions with the global forest change dataset. The results suggest that the RPPs.st1 (31 taxa) dataset is best suited to producing regional vegetation cover estimates for Europe. These reconstructions offer a long-term perspective providing unique possibilities to explore spatial-temporal changes in past land cover and biodiversity

Agricultural production in the 1st millennium BCE in Northwest Iberia: results of carbon isotope analysis

This work presents the first results of carbon isotope (δ13C) analysis of seeds (Triticum dicoccum, Triticum aestivum/durum, Triticum cf. spelta and Hordeum vulgare L.) from archaeological contexts from the settlement sites of A Fontela and Castrovite in Northwest Iberia, which cover a chronological range between 1050 cal BC and 25 cal AD. In addition, 142 present-day wheat seeds from 16 plots cultivated in 2014 and 2015 across this region were analysed. The results obtained for A Fontela and Castrovite were − 23.6‰ (between − 25.3 and − 21.4) and − 24.0‰ (between − 26.6 and − 21.8), respectively. Taking into account changes in the isotope composition of atmospheric carbon (δ13Catm), the Δ13C values were 17.5‰ (A Fontela) and 18.0‰ (Castrovite). In Castrovite, differences between storage facilities were detected, which could be related to the exploitation of different areas for cultivation, possibly indicating a family-based organization of agricultural production.This work was supported by a FPU grant at the Spanish Ministerio de Educación, Cultura y Deporte (AP2012-1353) and part of this research is included in the PhD Thesis of Adrián Mora-González “Irrigación y secano en el Mediterráneo Occidental (III-I milenio A.N.E.): un estudio isotópico”. This research has been conducted within the framework of the HAR2015-66009-P “Arqueología y Química. Reconstruyendo los hábitos alimenticios en la cultura de El Argar” funded by the Spanish Ministerio de Economía y Competitividad, the Project RNM-8011 and the research groups RNM309 and HUM274 (Junta de Andalucía). The archaeobotanical studies of A Fontela and Castrovite were undertaken in the project “Paleoenvironment and Paleoeconomics during the 1st millennium BC”. We also thank Xulio Carballo Arceo, Josefa Rey Castiñeira and Cliodhna Ni Lionain for valuable comments on a draft of the text, leading to measurable improvements

Fondaparinux in the initial and long-term treatment of venous thromboembolism

Background: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. Methods: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular- weight heparin (LMWH) in those with cancer Results Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p < 0.05). Conclusions: An unexpected high rate of major bleeding was observed in non-cancer patients treated with longterm fondaparinux. Our small sample does not allowto derive relevant conclusions on the use of fondaparinux in cancer patients

A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs

BACKGROUND: No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmb\uf3lica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS: As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS: Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated