Encefalopatía de Wernicke y polineuropatía asociada a déficit de complejo B después de una cirugía bariátrica

Bariatric surgery is a treatment that guarantees a substantial and lasting weight loss in addition to thetangible benefits relating to obesity-associated medical conditions. The increasing number of bariatric surgeries has revealed an increasing number of complications related to this procedure, including Wernicke´s encephalopathy and vitamin B deficiency polyneuropathies. Herein, a 7-week post-surgerycase of Wernicke´s encephalopathy is presented that emphasizes the importance of an early recognition of these symptoms so as to initiate intervention during the reversible phase of these potentially lethal pathologies. doi: http://dx.doi.org/10.7705/biomedica.v32i4.765La cirugía bariátrica es un tratamiento que garantiza una pérdida de peso sustancial y duradera, y beneficios tangibles respecto a condiciones médicas asociadas a la obesidad. El aumento del número de cirugías bariátricas ha llevado también a un aumento de las complicaciones relacionadas con ella, incluyendo la encefalopatía de Wernicke y la polineuropatía por deficiencia de vitaminas del complejo B.En este artículo se reporta un caso de encefalopatía de Wernicke siete semanas después de la cirugía, enfatizando en la importancia de reconocer el espectro de la sintomatología para hacer un diagnóstico temprano, que permita intervenir en la fase reversible de esta enfermedad potencialmente letal. doi: http://dx.doi.org/10.7705/biomedica.v32i4.76

A multidecadal assessment of climate indices over Europe

Monitoring and management of several environmental and socioeconomic sectors require climate data that can be summarized using a set of standard and meaningful climate metrics. This study describes a newly developed gridded dataset for the whole of Europe, which employed a set of 125 climate indices spanning different periods based on data availability, but mainly 1950–2017 and 1979–2017. This dataset comprehensively summarizes climate variability in Europe for a wide range of climate variables and conditions, including air temperature, precipitation, biometeorology, aridity, continentality, drought, amongst others. Climate indices were computed at different temporal scales (i.e. monthly, seasonal and annual) and mapped at a grid interval of 0.25°. We intend to update these indices on an annual basis. This dataset is freely available to research and end-user communities

Relationship of ST segment/heart rate slope index and ST segment change index scores on the heart rate change during conventional stress test with the presentation of new cardiovascular events

Introducción: La prueba de esfuerzo convencional es una herramienta diagnóstica de fácil interpretación y accesibilidad que se utiliza de forma frecuente en la evaluación del dolor torácico, no obstante, sus características operativas están influenciadas por múltiples variables resultando en una capacidad limitada para la predicción global de desenlaces cardiovasculares. El uso de los índices y las variables adicionales en su interpretación podrían mejorar la predicción de los desenlaces cardiovasculares. Métodos: Mediante la realización de un estudio descriptivo, analítico y retrospectivo, se evaluó la relación y capacidad de predicción de los índices pendiente ST/FC y ST/FC con el desarrollo de eventos cardiovasculares a un año. De un total de 438 estudios, se seleccionaron 138 que cumplían con los criterios para evaluación. Se realizó un análisis descriptivo de las variables de interés y posteriormente se procedió a realizar un análisis univariado y multivariado de las diferentes variables y desenlaces de interés. Conclusiones: Se encontró una relación estadísticamente significativa entre la capacidad del ejercicio, el índice pendiente ST/FC y el desarrollo de los desenlaces cardiovasculares, sin encontrar relación significativa con el índice pendiente ST/FC. Se observa discreta mejoría de la capacidad de predicción global de la prueba de esfuerzo convencional con la adición del índice pendiente ST/FC (AUC 0,70 a AUC 0,74).Q4Artículo original5-9Introduction: Conventional stress test is a diagnostic tool easy to interpret and of easy access frequently used in the assessment of chest pain; however, its operational characteristics are influenced by multiple variables, resulting in a limited ability for global prediction of cardiovascular outcomes. The use of indexes and additional variables in their interpretation could improve prediction of cardiovascular outcomes. Methods: By conducting a descriptive, analytical and retrospective study, the relationship and prediction ability of the slope ST/HR and ST/HR indexes with the development of cardiovascular events were assessed at one year. Out of a total of 438 studies, 138 were selected that complied with the evaluation criteria. A descriptive analysis of the variables of interest was carried out, and later on a univariate and multivariate analysis of the different variables and outcomes of interest. Conclusions: A statistically significant relationship was found between exercise capacity, ST/HR slope index and the development of cardiovascular events, without findings of a significant relationship with the ST/HR slope index. A discreet improvement of the global prediction capacity of the conventional stress test with the addition of the ST/HR slope index (AUC 0.70 to AUC 0.74) is observed.https://orcid.org/0000-0002-3606-210

Relación entre los puntajes del índice de pendiente del segmento ST/frecuencia cardiaca y el índice del cambio del segmento ST sobre el cambio de la frecuencia cardiaca durante la realización de la prueba de esfuerzo convencional con la presentación de nuevos eventos cardiovasculares

Introducción: La prueba de esfuerzo convencional es una herramienta diagnóstica de fácil interpretación y accesibilidad que se utiliza de forma frecuente en la evaluación del dolor torácico, no obstante, sus características operativas están influenciadas por múltiples variables resultando en una capacidad limitada para la predicción global de desenlaces cardiovasculares. El uso de los índices y las variables adicionales en su interpretación podrían mejorar la predicción de los desenlaces cardiovasculares. Métodos: Mediante la realización de un estudio descriptivo, analítico y retrospectivo, se evaluó la relación y capacidad de predicción de los índices pendiente ST/FC y ST/FC con el desarrollo de eventos cardiovasculares a un ano. ˜ De un total de 438 estudios, se seleccionaron 138 que cumplían con los criterios para evaluación. Se realizó un análisis descriptivo de las variables de interés y posteriormente se procedió a realizar un análisis univariado y multivariado de las diferentes variables y desenlaces de interés. Conclusiones: Se encontró una relación estadísticamente significativa entre la capacidad del ejercicio, el índice pendiente ST/FC y el desarrollo de los desenlaces cardiovasculares, sin encontrar relación significativa con el índice pendiente ST/FC. Se observa discreta mejoría de la capacidad de predicción global de la prueba de esfuerzo convencional con la adición del índice pendiente ST/FC (AUC 0,70 a AUC 0,74). Relationship of ST segment/heart rate slope index and ST segment change index scores on the heart rate change during conventional stress test with the presentation of new cardiovascular events. © 2016 Sociedad Colombiana de Cardiolog´ıa y Cirug´ıa Cardiovascular. Publicado por Elsevier Espana, ˜ S.L.U. Este es un art´ıculo Open Access bajo la licencia CC BY-NC-ND (http:// creativecommons.org/licenses/by-nc-nd/4.0/)Q4Artículo original5-9Introduction: Conventional stress test is a diagnostic tool easy to interpret and of easy access frequently used in the assessment of chest pain; however, its operational characteristics are influenced by multiple variables, resulting in a limited ability for global prediction of cardiovascular outcomes. The use of indexes and additional variables in their interpretation could improve prediction of cardiovascular outcomes. Methods: By conducting a descriptive, analytical and retrospective study, the relationship and prediction ability of the slope ST/HR and ST/HR indexes with the development of cardiovascular events were assessed at one year. Out of a total of 438 studies, 138 were selected that complied with the evaluation criteria. A descriptive analysis of the variables of interest was carried out, and later on a univariate and multivariate analysis of the different variables and outcomes of interest. Conclusions: A statistically significant relationship was found between exercise capacity, ST/HR slope index and the development of cardiovascular events, without findings of a significant relationship with the ST/HR slope index. A discreet improvement of the global prediction capacity of the conventional stress test with the addition of the ST/HR slope index (AUC 0.70 to AUC 0.74) is observed. © 2016 Sociedad Colombiana de Cardiolog´ıa y Cirug´ıa Cardiovascular. Published by Elsevier Espana, ˜ S.L.U. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/)

Increased Vegetation in Mountainous Headwaters Amplifies Water Stress During Dry Periods

The dynamics of blue and green water partitioning under vegetation and climate change, as well as their different interactions during wet and dry periods, are poorly understood in the literature. We analyzed the impact of vegetation changes on blue water generation in a central Spanish Pyrenees basin undergoing intense afforestation. We found that vegetation change is a key driver of large decreases in blue water availability. The effect of vegetation increase is amplified during dry years, and mainly during the dry season, with streamflow reductions of more than 50%. This pattern can be attributed primarily to increased plant water consumption. Our findings highlight the importance of vegetation changes in reinforcing the decrease in water resource availability. With aridity expected to rise in southern Europe over the next few decades, interactions between climate and land management practices appear to be amplifying future hydrological drought risk in the region.This work was supported by projects CGL2017-82216-R, PCI2019-103631, and PID2019-108589RA-I00 financed by the Spanish Commission of Science and Technology and FEDER; CROSSDRO project financed by AXIS (Assess-ment of Cross(X)-sectoral climate Impacts and pathways for Sustainable transformation), JPI-Climate co-funded call of the European Commission and INDECIS which is part of ERA4CS, an ERA-NET initiated by JPI Climate, and funded by FORMAS (SE), DLR (DE), BMWFW (AT), IFD (DK), MINECO (ES), ANR (FR) with co-funding by the European Union (Grant 690462). Dhais Peña-Angulo received a “Juan de la Cierva” postdoctoral contract (FJCI-2017-33652 Spanish Ministry of Economy and Competitiveness, MEC). Miquel Tomas-Burguera received a “Juan de la Cierva” postdoctoral contract (FJCI-2019-039261-I Spanish Ministry of Science and Innovation). C. Azorin-Molina and S. Grainger. acknowledge funding from the Irish Environmental Protection Agency grant 2019-CCRP-MS.60. C. Juez acknowl-edges funding from the H2020-MSCA-IF-2018 programme (Marie Sklodows-ka-Curie Actions) of the European Union under REA grant agreement, number 834329-SEDILAND

Dating historical droughts from religious ceremonies, the international pro pluvia rogation database

Climate proxy data are required for improved understanding of climate variability and change in the pre-instrumental period. We present the first international initiative to compile and share information on pro pluvia rogation ceremonies, which is a well-studied proxy of agricultural drought. Currently, the database has more than 3500 dates of celebration of rogation ceremonies, providing information for 153 locations across 11 countries spanning the period from 1333 to 1949. This product provides data for better understanding of the pre-instrumental drought variability, validating natural proxies and model simulations, and multi-proxy rainfall reconstructions, amongst other climatic exercises. The database is freely available and can be easily accessed and visualized via http://inpro.unizar.es/.info:eu-repo/semantics/publishedVersio

A high-resolution spatial assessment of the impacts of drought variability on vegetation activity in Spain from 1981 to 2015

59 Pags.- 12 Tabls.- 35 Figs. © Author(s) 2019. This work is distributed under the Creative Commons Attribution 4.0 License.Drought is a major driver of vegetation activity in Spain, with significant impacts on crop yield, forest growth, and the occurrence of forest fires. Nonetheless, the sensitivity of vegetation to drought conditions differs largely amongst vegetation types and climates. We used a high-resolution (1.1 km) spatial dataset of the normalized difference vegetation index (NDVI) for the whole of Spain spanning the period from 1981 to 2015, combined with a dataset of the standardized precipitation evapotranspiration index (SPEI) to assess the sensitivity of vegetation types to drought across Spain. Specifically, this study explores the drought timescales at which vegetation activity shows its highest response to drought severity at different moments of the year. Results demonstrate that – over large areas of Spain – vegetation activity is controlled largely by the interannual variability of drought. More than 90 % of the land areas exhibited statistically significant positive correlations between the NDVI and the SPEI during dry summers (JJA). Nevertheless, there are some considerable spatio-temporal variations, which can be linked to differences in land cover and aridity conditions. In comparison to other climatic regions across Spain, results indicate that vegetation types located in arid regions showed the strongest response to drought. Importantly, this study stresses that the timescale at which drought is assessed is a dominant factor in understanding the different responses of vegetation activity to drought.This research has been supported by the Spanish Commission of Science and Technology and FEDER (grant no. PCIN-2015-220), the Spanish Commission of Science and Technology and FEDER (grant no. CGL2014-52135-C03-01), the Spanish Commission of Science and Technology and FEDER (grant no. CGL2017-83866-C3-3-R), the Spanish Commission of Science and Technology and FEDER (grant no. CGL2017-82216-R), WaterWorks 2014 (grant no. 690462, IMDROFLOOD), the JPI Climate (grant no. 690462, INDECIS), and WaterWorks 2015 (FORWARD grant).Peer reviewe

A global drought monitoring system and dataset based on ERA5 reanalysis: A focus on crop-growing regions

14 Pags.- 12 Figs. © 2022 The Authors. Geoscience Data Journal published by Royal Meteorological Society and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License.Drought monitoring systems are real-time information systems focused on drought severity data. They are useful for determining the drought onset and development and defining the spatial extent of drought at any time. Effective drought monitoring requires databases with high spatial and temporal resolution and large spatial and temporal coverage. Recent reanalysis datasets meet these requirements and offer an excellent alternative to observational data. In addition, reanalysis data allow better quantification of some variables that affect drought severity and are more seldom observed. This study presents a global drought dataset and a monitoring system based on the Standardized Precipitation Evapotranspiration Index (SPEI) and ERA5 reanalysis data. Computation of the atmospheric evaporative demand for the SPEI follows the FAO-56 Penman-Monteith equation. The system is updated weekly, providing near real-time information at a 0.5° spatial resolution and global coverage. It also contains a historical dataset with the values of the SPEI at different time scales since January 1979. The drought monitoring system includes the assessment of drought severity for dominant crop-growing areas. A comparison between SPEI computed from the ERA5 and CRU datasets shows generally good spatial and temporal agreement, albeit with some important differences originating mainly from the different spatial patterns of SPEI anomalies, as well as from employing long-term climate trends for different regions worldwide. The results show that the ERA5 dataset offers robust results and supports its use for drought monitoring. The new system and dataset are publicly available at the link https://global-drought-crops.csic.es/.This work was supported by projects PCI2019-103631 financed by the Spanish Commission of Science and Technology and FEDER and CROSSDRO project funded by AXIS (Assessment of Cross [X]- sectoral climate Impacts and pathways for Sustainable transformation), JPI- Climate co- funded call of the European Commission.Peer reviewe

A view of the Brazil-Malvinas confluence, March 2015

The encountering of the subtropical Brazil Current (BC) and the subantarctic Malvinas Current (MC) along the western margin of the Argentine Basin forms the Brazil-Malvinas Confluence (BMC), one of the most intense open-ocean fronts in the world ocean and a site for the formation of intermediate water masses. Here, we provide a comprehensive description of the BMC based on physical and biogeochemical data – hydrographic stations, profiling floats and subsurface drifters – gathered in March 2015. We use these data in order to characterize the impinging and outflowing currents and to describe the cross- and along-frontal thermohaline structure. In addition, we compare the in-situ measurements with both climatological data and the Mercator Ocean eddy-resolving reanalysis. The hydrographic sections illustrate the contrasting properties between the two western boundary currents: warm, salty, nutrient- and oxygen-poor oligotrophic subtropical waters carried southward by the BC and the cold, fresh, oxygen- and nutrient-rich subantarctic waters carried northward by the MC. The frontal system is also characterized by the presence of thermohaline intrusions, with the cross-frontal gradients and along-front velocities sharpening as the colliding currents shape the frontal system. We also observe brackish waters spreading on top of the frontal jet as a result of both the confluence dynamics and off-shelf advection favored by north-easterly winds. These low-salinity waters are positively correlated with surface ageostrophic speeds over the frontal jet. The cruise data illustrates the high regional and mesoscale variability as compared with climatological conditions, and further document the submesoscale subsurface complexity, which is not properly captured by available operational models.Fil: Orúe Echevarría, Dorleta. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Pelegrí, Josep L.. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Alonso González, Iván J.. Oceomic, Marine Bio And Technology S.L; EspañaFil: Benítez Barrios, Verónica M.. Oceomic, Marine Bio And Technology S.L; EspañaFil: Emelianov, Mikhail. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: García Olivares, Antonio. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Gasser i Rubinat, Marc. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: De La Fuente, Patricia. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Herrero, Carmen. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Isern Fontanet, Jordi. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Masdeu Navarro, Marta. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Peña Izquierdo, Jesús. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Piola, Alberto Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; ArgentinaFil: Ramírez Garrido, Sergio. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Rosell Fieschi, Miquel. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Salvador, Joaquín. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Saraceno, Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Universidad de Barcelona; EspañaFil: Valla, Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias de la Atmósfera y los Océanos; ArgentinaFil: Vallès Casanova, Ignasi. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Vidal, Montserrat. Universidad de Barcelona; Españ