Prostatic artery embolization (PAE) using polyethylene glycol microspheres: safety and efficacy in 81 patients

Purpose: To evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). Materials and methods: This multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien-Dindo classification. Results: Technical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P <.01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P <.01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P <.05) at 12 months. Minor complications (Clavien-Dindo grades I-II) occurred in 13.6% of patients, without major complications observed. Conclusion: PAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcome

Ecosystem services in emergy terms: Danish energy crops

Currently, benefits generated by natural environments, such as carbon sequestration or water retention and others, are measured in economic terms based on “willingness to pay” of society (using the TEV or Total Economic Valuation). Thanks to these measurements, decisions can be made about items related to natural ecosystems in the field of politics, construction projects and quantification of financial aids for the agricultural sector. However, a group of scientists involved in Environmental Economy, thinks that this method is not suitable, as society do not really know the true value of the functions of the ecosystems. Even more, they add that solution has to do with the energy measurement of those benefits in order to give them their real value (objective value). In contrast, another group of scientists consider that Ecosystem Services (ES) valuation based on society’s opinion is completely necessary, justifying that these values are lated used as a politic tool. Therefore, the Thesis borns on order to answer this controversy, beginning with the energy calculations of the benefits produced by agricultural environments dedicated to energy crops. Besides, it also aims to clear if the current subjective method of valuation, the TEV, is the best choice for the job of political tool or if there is instead, another better way of doing this. To do that, It has been used an innovative method; The Emergy Method (spelled with “m”). This method consist of determining the necessary energy investment for developing services such as carbon sequestration or water retention, among others. In other words, it allows to obtain the environmental effort printed on the implementation of beneficial ecological functions for human being. With results already obtained, it can be seen; first, the energy investment necessary for biomass production; second, the current method, based on Total Economic Valuation does not express the true value of the ecosystem functions as are undervalued in 331 dollars per hectare and year (in energy crops); third, the best way for valuing ES implies a combination of methods, the Emergy and the TEV. Finally, through the obtention of the energy investment required by the environment for the biomass production, first steps for developing an application that allows to define the most proper areas for a biomass burner industry are given. These areas bounds the surface in which the obtention of a joule of electricity using energy crops requires less environmental effort that the same joule based on fossil fuels, taking on account the terrain, the geometry of the roads used for supplying the industry of biomass and the efficiency of the combustion process.Ingeniería AgronómicaNekazaritza Ingeniaritz

Can crop-climate models be accurate and precise? A case study for wheat production in Denmark

Crop models, used to make projections of climate change impacts, differ greatly in structural detail. Complexity of model structure has generic effects on uncertainty and error propagation in climate change impact assessments. We applied Bayesian calibration to three distinctly different empirical and mechanistic wheat models to assess how differences in the extent of process understanding in models affects uncertainties in projected impact. Predictive power of the models was tested via both accuracy (bias) and precision (or tightness of grouping) of yield projections for extrapolated weather conditions. Yields predicted by the mechanistic model were generally more accurate than the empirical models for extrapolated conditions. This trend does not hold for all extrapolations; mechanistic and empirical models responded differently due to their sensitivities to distinct weather features. However, higher accuracy comes at the cost of precision of the mechanistic model to embrace all observations within given boundaries. The approaches showed complementarity in sensitivity to weather variables and in accuracy for different extrapolation domains. Their differences in model precision and accuracy make them suitable for generic model ensembles for near-term agricultural impact assessments of climate change