Development of a danger index of forest fires by using multinomial logistic regression and its application in different zones of the region of Castile and Leon (Spain)

La aplicación de las nuevas tecnologías ha mejorado los sistemas de protección contra incendios forestales. Como resultado, es sencillo poder predecir el comportamiento de futuros incendios teniendo en cuenta algunos factores tales como: modelos de combustible, velocidad de viento, humedad relativa,... Un nuevo punto de vista para la determinación del riesgo de incendio forestal es analizado en este estudio mediante la combinación de dos métodos diferentes que ha sido llevada a cabo para desarrollar un nuevo índice de peligro: la aplicación de un programa informático de Sistemas de Información Geográfica (SIG) y un modelo estadístico que está basado en una regresión logística multinomial. Este nuevo índice de peligro se centra en las diferentes zonas dentro de un mismo término municipal en vez de en sus límites administrativos.Producción Vegetal y Recursos forestalesMáster en Ingeniería de Monte

Estimation of conversion factors for wood stacks in landings and their influencing parameters: a comprehensive literature review for America and Europe

In commercial transaction of stacked roundwood, the estimation of the stack net volume plays a key role. One generalized method to determine the net volume is using conversion factors that relate the gross and net volumes. In this literature review the developed methods to estimate the conversion factors as well as their influencing parameters were analyzed based on 153 references from America and Europe. According to the results, 48 different methods (including their variants) for estimating the conversion factors were developed. The newest methods enabled their accurate determination inexpensively, e.g., photo-optical methods or 3D simulation models. The analyzed references revealed that 30 parameters influence the conversion factors. Based on this comprehensive review, each stakeholder involved in the roundwood supply chain can know which method is used for estimating the conversion factors in the analyzed territories and which influencing parameters should be considered when purchasing roundwood in order to accurately assess the solid wood content in the stacks

Ingeniería Geológica en Terrenos Volcánicos. Métodos, Técnicas y Experiencias en las Islas Canarias

La presente obra es un compendio de conceptos, metodologías y técnicas útiles para acometer proyectos y obras en terrenos volcánicos desde el punto de vista de la ingeniería geológica y la geotecnia. El libro se presenta en tres partes diferenciadas. La primera es conceptual y metodológica, con capítulos que tratan sobre la clasificación de las rocas volcánicas con fines geotécnicos, la caracterización geomecánica, los problemas geotécnicos y constructivos asociados a los distintos materiales, y una guía metodológica para la redacción de informes geotécnicos para la edificación. La segunda parte aborda las aplicaciones a obras de ingeniería, incluyendo deslizamientos, obras subterráneas,infraestructuras marítimas y obras públicas. La tercera parte recoge capítulos dedicados a describir distintos casos prácticos de obras y proyectos en los que la problemática geotécnica en terrenos volcánicos ha tenido un papel relevante. Los capítulos han sido elaborados por técnicos y científicos de reconocido prestigio en el campo de la ingeniería geológica en terrenos volcánicos, que han plasmado en ellos sus conocimientos y experiencias en la materia.Los editores y autores de parte de los capítulos del libro, los Doctores Luis E. Hernández Gutiérrez (Geólogo) y Juan Carlos Santamarta Cerezal (Ingeniero de Montes, Civil y Minas), son los responsables del grupo de investigación INGENIA (Ingeniería Geológica, Innovación y Aguas). Su actividad investigadora comprende más de 200 publicaciones en el área de la ingeniería geológica, la geotecnia, medio ambiente y el aprovechamiento del agua en islas y terrenos volcánicos. En relación a la docencia han impartido y dirigido más de 90 seminarios y cursos de especialización a nivel nacional e internacional, incluyendo la organización de 4 congresos internacionales. Fueron premiados por la Universidad de La Laguna en los años 2012, 2013 y 2014 por su calidad docente e innovación universitaria, y son pioneros en los laboratorios virtuales para la enseñanza de la ingeniería. Participan activamente como profesores colaboradores e investigadores en varias universidades e instituciones españolas e internacionales. Todas sus publicaciones están disponibles en internet, con libre acceso. Ingeniería geológica en terrenos volcánicos, es una obra de gran interés para, consultores, técnicos de administraciones públicas, proyectistas y demás profesionales implicados en obras y proyectos de infraestructuras en terrenos volcánicos; también es útil para académicos y estudiantes de ingeniería o ciencias geológicas que quieran investigar o iniciarse en las singularidades que presentan los materiales volcánicos en la edificación o en la ingeniería civil y minera

Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort

Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (+/- 16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

Analysis of the Influence That Parameters Crookedness and Taper Have on Stack Volume by Using a 3D-Simulation Model of Wood Stacks

The influence that parameters crookedness and taper have on the stack volume was analyzed by using a 3D-simulation model in this study. To do so, log length, diameters at the midpoint and both ends, crookedness, bark thickness, taper and ovality were measured in 1000 logs of Scots pine. From this database, several data sets with different proportions of crooked and tapered logs in stack as well as with different degrees of taper and crookedness were created and taken as basis to simulate the stacks and carry out the analysis. The results show how the variation of these parameters influences the stack volume and provide their volume variation grades. These rates of variation were compared with measurement guidelines of some countries and previous research works. In conclusion, the parameters crookedness and taper influence the stack volume to a considerable extent. Specifically, the stack volume is increased as the crookedness degree or the proportion of crooked logs increases. In contrast, the stack volume is reduced as the taper degree or the proportion of tapered logs increases. Furthermore, the results demonstrate the capability of this simulation model to provide accurate results which can serve as a basis for future studies