Las masas actuales de Quercus petraea en Galicia

The presence and characterization of Quercus petraea in the northwest of the Iberian Peninsula have been slightly studied. Although Rivas (1987) restricts his filings to the Orocantábrica Province, subsequent studies have confirmed the presence of Quercus petraea out of this place. The present investigation was undertaken to study the placing and dasometry of that specie in Galicia (Spain). Twenty-two plots with Quercus petraea as dominant specie were studied. Data about placing characteristics (location, orography, fisiografia, vegetation...) and stand variables (diametrical measurements, height, and sticks extraction for analysing of ages and growths) were checked. Basic parameters of dasometric characterization were obtained in cabinet, and subsequently the statistic analysis of multiple variables was used to study and classify stands. With both studies, we can assure that it is possible to speak of two big groups of stands: one of them clearly has typical features of hybridisation with Quercus robur and Quercus pyrenaica, that are localized near Orocantábrica Province; and the other group, that does not present those hybridisation features, is localized in the more oriental mountains. Finally, this classification in confirmed with other results as weight parameters, age, growth, etc. Consequently, the more pure stands produce data of greater maturity and a clear relation between their distribution and the classic idea of their preference by shady exhibitions is not observed in this area.La presencia y caracterización de Quercus petraea en el noroeste de la Península Ibérica han sido poco estudiadas. Aunque Rivas (1987) limita a la Provincia Orocantábrica sus manifestaciones, trabajos posteriores han constatado la presencia de dicha especie fuera de esa zona. Se presenta a continuación información acerca de la localización y dasometría de la especie dentro de la zona en la que está presente en Galicia. Los datos analizados corresponden a un total de 22 parcelas de muestreo pobladas con Quercus petraea como especie dominante. En ellas se han tomado datos sobre características de la estación (localización, orografía, fisiografía, vegetación...) y de la masa (mediciones diametrales, de altura y extracción de bastones para análisis de edades y crecimientos). En gabinete se obtienen parámetros de caracterización dasométrica básicos, para luego realizar un análisis estadístico de variables múltiples para el estudio y clasificación de las masas. Combinando ambos estudios nos permiten asegurar que se puede hablar de dos grandes bloques de masas: las que claramente manifiestan rasgos de hibridación con Quercus robur o con Quercus pyrenaica, que se sitúan en los límites de la Provincia Orocantábrica; y las que no, siendo estas últimas las de las montañas más orientales. Finalmente, esta misma división se ratifica con otros resultados, como son los parámetros de masa, edad, crecimiento, etc. Consecuentemente, las masas más puras arrojan datos de mayor madurez y no se observa en esta área una relación clara entre su distribución y la clásica idea de su preferencia por exposiciones de umbría

Reliability of Monte Carlo event generators for gamma-ray dark matter searches

We study the differences in the gamma-ray spectra simulated by four Monte Carlo event generator packages developed in particle physics. Two different versions of PYTHIA and two of HERWIG are analyzed, namely PYTHIA 6.418 and HERWIG 6.5.10 in Fortran and PYTHIA 8.165 and HERWIG 2.6.1 in C++. For all the studied channels, the intrinsic differences between them are shown to be significative and may play an important role in misunderstanding dark matter signals

Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation

BACKGROUND: The Bladder Cancer Index (BCI) is so far the only instrument applicable across all bladder cancer patients, independent of tumor infiltration or treatment applied. We developed a Spanish version of the BCI, and assessed its acceptability and metric properties. METHODS: For the adaptation into Spanish we used the forward and back-translation method, expert panels, and cognitive debriefing patient interviews. For the assessment of metric properties we used data from 197 bladder cancer patients from a multi-center prospective study. The Spanish BCI and the SF-36 Health Survey were self-administered before and 12 months after treatment. Reliability was estimated by Cronbach's alpha. Construct validity was assessed through the multi-trait multi-method matrix. The magnitude of change was quantified by effect sizes to assess responsiveness. RESULTS: Reliability coefficients ranged 0.75-0.97. The validity analysis confirmed moderate associations between the BCI function and bother subscales for urinary (r = 0.61) and bowel (r = 0.53) domains; conceptual independence among all BCI domains (r ≤ 0.3); and low correlation coefficients with the SF-36 scores, ranging 0.14-0.48. Among patients reporting global improvement at follow-up, pre-post treatment changes were statistically significant for the urinary domain and urinary bother subscale, with effect sizes of 0.38 and 0.53. CONCLUSIONS: The Spanish BCI is well accepted, reliable, valid, responsive, and similar in performance compared to the original instrument. These findings support its use, both in Spanish and international studies, as a valuable and comprehensive tool for assessing quality of life across a wide range of bladder cancer patients

Incidence, clinical characteristics and management of inflammatory bowel disease in Spain: large-scale epidemiological study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD—Crohn’s disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)—during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100, 000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31–56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Optimisation of pressurised liquid extraction for the determination of monosaccharides and polyalcohols in woods used in wine aging

Background: The carbohydrate profile of woods used to age wines and spirits is largely unstudied in spite of its possible influence on the quality of aged beverages. This experiment evaluated the feasibility of employing pressurized liquid extraction to isolate monosaccharides and polyalcohols from woods used in aging, yielding a reliable analytical extraction method for characterising these compounds. Various solvents were tested and the extraction procedure was optimised by a three-level factorial experimentaldesign based on two main factors: extraction temperatureandextraction time. The totalextraction yield of target compounds was taken as response variable, and model parameters were estimated by multiple linear regression. Results: Methanol was best at extracting the target compounds and hence was selected as solvent. Temperature was the most important factor in the extraction process, and the optimal extraction conditions were 90°C for 15 min. Conclusion: Pressurised liquid extraction proved to be a highly suitable and powerful technique for extracting the monosaccharides and polyalcohols from wood samples. Analysis of the carbohydrate profile of the woods revealed differences among samples of different species and types of wood. © 2009 Society of Chemical Industry.Peer Reviewe

Influence of geographical location, site and silvicultural parameters, on volatile composition of Quercus pyrenaica Willd. wood used in wine aging

For the current study, the volatile and semi-volatile composition of several samples of Quercus pyrenaica wood from NW Spain were analyzed and compared. The research was performed on a wide sample set of more than 100 samples (test tubes) obtained from different stands of this species. The relationship between some silvicultural and site parameters and volatile composition was studied. Altitude seemed to be the most influential parameter on the volatile composition. However, other factors such as distance from tree center, average annual precipitation, and number of trees per hectare whose effects on the volatile compounds were not significant. The influence of soil texture was not a determining factor while geographical location seemed to have a more specific impact on the extractive volatile content. The content of all extractable compounds studied allowed a good separation of oak samples of the same species according to their geographical origin. © 2011 Elsevier B.V.Peer Reviewe

A series of patients with refractory myasthenia gravis

Introduction: Advances in the treatment of myasthenia gravis (MG) have improved quality of life and prognosis for the majority of patients. However, 10%–20% of patients present refractory MG, with frequent relapses and significant functional limitations. Patients and methods: Patients with refractory MG were selected from a cohort of patients diagnosed with MG between January 2008 and June 2019. Refractory MG was defined as lack of response to treatment with prednisone and at least 2 immunosuppressants, inability to withdraw treatment without relapse in the last 12 months, or intolerance to treatment with severe adverse reactions. Results: We identified 84 patients with MG, 11 of whom (13%) met criteria for refractory MG. Mean (standard deviation) age was 47 (18) years; 64% of patients with refractory MG had early-onset generalised myasthenia (as compared to 22% in the group of patients with MG; P < .01), with a higher proportion of women in this group (P < .01). Disease severity at diagnosis and at the time of data analysis was higher among patients with refractory MG, who presented more relapses during follow-up. Logistic regression analysis revealed an independent association between refractory MG and the number of severe relapses. Conclusions: The percentage of patients with refractory MG in our series (13%) is similar to those reported in previous studies; these patients were often women and presented early onset, severe forms of onset, and repeated relapses requiring hospital admission during follow-up. Resumen: Introducción: Los avances en el tratamiento de la miastenia gravis (MG) han conseguido mejoría en la calidad de vida y el pronóstico de la mayoría de los pacientes. Sin embargo, un 10-20% presenta la denominada MG refractaria sin alcanzar mejoría, con frecuentes recaídas e importante repercusión funcional. Pacientes y métodos: Se seleccionó a pacientes con MG refractaria a partir de una cohorte de pacientes con MG diagnosticados desde enero del 2008 hasta junio del 2019. Se definió MG refractaria como falta de respuesta al tratamiento con prednisona y al menos 2 inmunosupresores o imposibilidad para la retirada del tratamiento sin recaídas en los últimos 12 meses o intolerancia al mismo con graves efectos secundarios. Resultados: Se registraron 84 pacientes con MG, 11 cumplían los criterios de MG refractaria (13%), con una edad media de 47 ± 18 años; un 64% los pacientes con MG refractaria fueron clasificados como miastenia generalizada de comienzo precoz (p < 0,01) con una mayor proporción de mujeres (p < 0,01). La gravedad de la enfermedad al diagnóstico, así como en el momento del análisis de los datos, fue superior en el grupo de MG refractaria con un mayor número de recaídas en el seguimiento. En el modelo de regresión logística se obtuvo una asociación independiente entre MG-R y el número de reagudizaciones graves. Conclusiones: El porcentaje de pacientes con MG refractaria en nuestra serie (13%) es similar al descrito en estudios previos, con frecuencia mujeres con inicio precoz, formas graves de inicio y reiteradas reagudizaciones con ingreso hospitalario en el seguimiento

¿Se ha producido un cambio en la etiología del ictus isquémico en las últimas décadas? Análisis y comparación de una base de datos de ictus actual frente a las históricas

Resumen: Objetivos: Comprobar si han existido variaciones en la etiología del ictus isquémico en los últimos años e investigar las posibles causas que lo justifiquen. Pacientes y métodos: Análisis de los antecedentes epidemiológicos y factores de riesgo vascular de los pacientes diagnosticados de ictus isquémico en el Complejo Hospitalario Universitario de Albacete (CHUA) entre 2009 y 2014. La clasificación etiológica del ictus isquémico se realizó según los criterios TOAST. Se compararon los resultados con los de la clásica Stroke Data Bank (SDB) y se contrastaron ambas series con otros registros hospitalarios publicados en el periodo que las separa. Resultados: Se analiza a 1.664 pacientes, 58% varones, mediana de edad 74 años. Según la clasificación etiológica los resultados obtenidos son (CHUA/SDB): aterotrombóticos (12%/9%), lacunares (13%/25%), cardioembólicos (32%/19%), causa infrecuente (3%/4%) e indeterminados (40%/44%). El 63% de los pacientes del CHUA era mayor de 70 años, en la SDB solo el 42% superaba esa edad. En ambos registros el subtipo cardioembólico era más prevalente en mayores de 70 años. La HTA no tratada era más frecuente en la SDB (SDB = 31% vs. CHUA = 10%). El análisis de otras bases de datos muestra una tendencia progresiva a escala mundial al aumento en la prevalencia del ictus cardioembólico. Conclusiones: Nuestro estudio muestra tanto en nuestro centro como a escala mundial una disminución del porcentaje de ictus lacunares y un aumento del de cardioembólicos respecto a la SDB. Estas diferencias pudieran justificarse por el envejecimiento de los pacientes, el mejor control de la HTA actualmente y mayor capacidad para detectar arritmias cardioembólicas en las Unidades de Ictus. Abstract: Objectives: We aimed to determine whether the aetiology of ischaemic stroke has changed in recent years and, if so, to ascertain the possible reasons for these changes. Patients and methods: We analysed the epidemiological history and vascular risk factors of all patients diagnosed with ischaemic stroke at Complejo Hospitalario Universitario de Albacete (CHUA) from 2009 to 2014. Ischaemic stroke subtypes were established using the TOAST criteria. Our results were compared to data from the classic Stroke Data Bank (SDB); in addition, both series were compared to those of other hospital databases covering the period between the two. Results: We analysed 1664 patients (58% were men) with a mean age of 74 years. Stroke aetiology in both series (CHUA, SDB) was as follows: atherosclerosis (12%, 9%), small-vessel occlusion (13%, 25%), cardioembolism (32%, 19%), stroke of other determined aetiology (3%, 4%), and stroke of undetermined aetiology (40%, 44%). Sixty-three percent of the patients from the CHUA and 42% of the patients from the SDB were older than 70 years. Cardioembolic strokes were more prevalent in patients older than 70 years in both series. Untreated hypertension was more frequent in the SDB (SDB  =  31% vs CHUA  =  10%). The analysis of other databases shows that the prevalence of cardioembolic stroke is increasing worldwide. Conclusions: Our data show that the prevalence of lacunar strokes is decreasing worldwide whereas cardioembolic strokes are increasingly more frequent in both our hospital and other series compared to the SDB. These differences may be explained by population ageing and the improvements in management of hypertension and detection of cardioembolic arrhythmias in stroke units. Palabras clave: Base de Datos de Ictus, Etiología del ictus, Subtipos de ictus, TOAST, Factores de riesgo vascular, Fibrilación auricular, Keywords: Stroke Data Bank, Stroke aetiology, Stroke subtypes, TOAST, Vascular risk factors, Atrial fibrillatio