Study and Evolution of the Dune Field of La Banya Spit in Ebro Delta (Spain) Using LiDAR Data and GPR

La Banya spit, located at the south of the River Ebro Delta, is a sandy formation, developed by annexation of bars forming successive beach ridges, which are oriented and modeled by the eastern and southern waves. The initial ridges run parallel to the coastline, and above them small dunes developed, the crests of which are oriented by dominant winds, forming foredune ridges and barchans. This study attempted to test a number of techniques in order to understand the dune dynamic on this coastal spit between 2004 and 2012: LiDAR data were used to reconstruct changes to the surface and volume of the barchan dunes and foredunes; ground-penetrating radar was applied to obtain an image of their internal structure, which would help to understand their recent evolution. GPS data taken on the field, together with application of GIS techniques, made possible the combination of results and their comparison. The results showed a different trend between the barchan dunes and the foredunes. While the barchan dunes increased in area and volume between 2004 and 2012, the foredunes lost thickness. This was also reflected in the radargrams: the barchan dunes showed reflectors related to the growth of the foresets while those associated with foredunes presented truncations associated with storm events. However, the global balance of dune occupation for the period 2004-2012 was positive

Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities

Background: Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities. Methods: It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation. Results: In the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95%CI 1.42-1.67), Madrid (RR = 1.57 95%CI 1.49-1.65) and Seville (RR = 1.53 95%CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women. Conclusion: This study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment.This article was partially supported by Fondo de Investigaciones Ssanitarias (FIS) projects numbers PI042013, PI040041, PI040170, PI040069, PI042602 PI040388, PI040489, PI042098 , PI041260, PI040399, PI081488 and by the CIBER en Epidemiología y Salud Pública (CIBERESP), Spain and by the program of “Intensificación de la Actividad Investigadora (Carme Borrell)” funded by the “Instituto de Salud Carlos III” and “Departament de Salut. Generalitat de Catalunya”

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Relict sand waves in the continental shelf of the Gulf of Valencia (Western Mediterranean)

The presence of fossil or relict bedforms is common in the Quaternary fill of modern continental shelf due to sea level oscillations, tectonic subsidence and migration of associated sedimentary facies. The continental margin of the Gulf of Valencia has been strongly influenced by glacio-eustasy and neotectonics. High-resolution multibeam bathymetry data, seismic reflection profiles and box core samples were collected across the continental shelf of the Gulf of Valencia during the DERIVA cruises carried out in 2010 and 2011. The integrated analysis of this data set and high-resolution mapping of the relict bedforms on the Valencian continental shelf, ranging between 50 and 90 m allowed the study of previously identified system of sand waves located in front of the present-day Albufera de Valencia lagoon. The system is composed of 27 ridges with a NNE–SSW orientation, i.e. oblique to the present shoreline, in which the lateral horns point backwards. These sand waves can reach 10 m in height and 3 km in length resulting in a maximum slope of 6°. According to seismic stratigraphic and relative sea level curve reconstructions, these sand waves were formed during the Younger Dryas (~ 12–10 ky BP). Consequently, they have been classified as Holocene sand waves associated with coastal sedimentary evolution

Mapping of landslide susceptibility of coastal cliffs: the Mont-Roig del Camp case study

The weathered and fractured conglomerate cliffs of Mont Roig del Camp constitute a rock fall hazard for the surrounding pocket beaches and, therefore, for the population that frequent them, especially over the summer. Landslide susceptibility of the cliff has been assessed using the Rock Engineering System method (RES). The determinant and triggering factors considered in this study include: wave exposure, shoreline variations, cliff height, cliff slope, geotechnical quality of the rocky mass, superficial runoff and cliff orientations favoring landslides. Geographic Information Systems (GIS) have been employed to facilitate the information analysis and generate new susceptibility maps. The quality of the rock mass and cliff orientation are the most interactive factors for the stability of the cliff. However, shoreline variations and surface runoff are the most dominant factors in the system. Thus, the quality of the rock mass has been determined to be a basic variable in the cliff characterization because of its high dependence on the variations of the remaining factors. The landslide susceptibility map depicts a predominance of surfaces with moderate degrees of susceptibility concentrated mainly in the headlands, where the combined actions of subaerial and marine processes control the weathering and eroding processes. Therefore, the landslide susceptibility assessment based on this methodology has allowed the identification of hazardous areas that should be considered in future management plans

Protein adsorption and activity on carbon xerogels with narrow pore size distributions covering a wide mesoporous range

Four carbon xerogels (CXs) were used to study the effect of the average pore size (APS) on the adsorption and activity of cytochrome c (cyt c). Pore size distributions of the CXs were relatively narrow with APSs covering the whole mesoporosity range (5, 15, 30 and 55 nm), as determined by mercury porosimetry. Selected techniques verified that all carbons were identical in terms of composition and surface chemistry. The best APS for cyt c adsorption (in terms of capacity) was 30 nm, with loadings of 180 mg of protein (g of support)−1. The CX with APS of 15 nm also hosted high amounts of cyt c, followed by the material with 55 nm. The CX with 5 nm APS did not adsorb cyt c. The pH of adsorption had little effect on the final amount adsorbed, thus stressing the hydrophobic nature of the protein/carbon surface interaction. The activity of the resulting materials towards the ABTS oxidation was similar regardless the amount of cyt c adsorbed on their surface/pores. Their performance in successive cycles of re-use was different depending on the carbon support; xerogels bearing APSs ≥15 nm presented an increasing activity with increasing the number of cycles.This work was funded by the PCTI Asturias/FEDER (EU) (Project GRUPIN14-117). LARM thanks CONACYT (México) for a post-doctoral grant (CVU No 330625, 2016).Peer reviewe

Opportunistic AI-enabled automated bone mineral density measurements in lung cancer screening and coronary calcium scoring CT scans are equivalent

Rationale and objectivesWe previously reported a novel manual method for measuring bone mineral density (BMD) in coronary artery calcium (CAC) scans and validated our method against Dual X-Ray Absorptiometry (DEXA). Furthermore, we have developed and validated an artificial intelligence (AI) based automated BMD (AutoBMD) measurement as an opportunistic add-on to CAC scans that recently received FDA approval. In this report, we present evidence of equivalency between AutoBMD measurements in cardiac vs lung CT scans.Materials and methodsAI models were trained using 132 cases with 7649 (3&nbsp;mm) slices for CAC, and 37 cases with 21918 (0.5&nbsp;mm) slices for lung scans. To validate AutoBMD against manual measurements, we used 6776 cases of BMD measured manually on CAC scans in the Multi-Ethnic Study of Atherosclerosis (MESA). We then used 165 additional cases from Harbor UCLA Lundquist Institute to compare AutoBMD in patients who underwent both cardiac and lung scans on the same day.ResultsMean±SD for age was 69&nbsp;±&nbsp;9.4 years with 52.4% male. AutoBMD in lung and cardiac scans, and manual BMD in cardiac scans were 153.7&nbsp;±&nbsp;43.9, 155.1&nbsp;±&nbsp;44.4, and 163.6&nbsp;±&nbsp;45.3&nbsp;g/cm3, respectively (p&nbsp;=&nbsp;0.09). Bland-Altman agreement analysis between AutoBMD lung and cardiac scans resulted in 1.37&nbsp;g/cm3 mean differences. Pearson correlation coefficient between lung and cardiac AutoBMD was R2 =&nbsp;0.95 (p&nbsp;&lt;&nbsp;0.0001).ConclusionOpportunistic BMD measurement using AutoBMD in CAC and lung cancer screening scans is promising and yields similar results. No extra radiation plus the high prevalence of asymptomatic osteoporosis makes AutoBMD an ideal screening tool for osteopenia and osteoporosis in CT scans done for other reasons