The management of a UNESCO Global Geopark (UGGp) requires a vast wealth of miscellaneous scientific knowledge that can be successfully organised using a Geographical Information System (GIS). This ...paper presents a pragmatic GIS database to assist in the suitable governance of the Courel Mountains UGGp (2017) in Northwest Spain. The database is structured in 66 coverages compiled from public sources and previous works or produced through traditional mapping (combining fieldwork and photointerpretation) and GIS tools. The acquired data was later homogenised and validated by a multidisciplinary team and archived in independent coverages. Forty thematic maps illustrate the broad range of cartographic information included in the GIS database. Among them, 25 basic maps provide an overview of the UGGp and 15 new maps focus on crosscutting and technical issues. All maps illustrate the huge potential of GIS to create new resources combining coverages and adapting the legend according to their purpose and audience. The database facilitates the suitable publishing of consistent outputs (e.g., brochures, books, panels, webpages, web serves), as well as the elaboration of technical data to assist the park management. The database furnishes information on the design of education actions, touristic routes, activities and Geopark facilities. The GIS database is also a supportive tool for scientific research and provides the necessary knowledge to conduct geoconservation actions based on land use, geological hazards and the occurrence of natural and cultural heritages. Altogether, the GIS database constitutes a powerful instrument for policy-making, facilitating the identification and evaluation of alternative strategy plans.
Fusarium circinatum (Nirenberg and O’ Donnell) is the causal agent of pine pitch canker (PPC) disease, one of the most devastating forest diseases worldwide. Long-distance spread occurs mainly ...through the movement of infected seeds whereas at regional level, the movement of seedlings, substrates, or containers may play an important role in fungal dispersal. Invasion of nurseries takes place via infected seeds and further spread can occur by planting contaminated seedlings, especially due to the possibility of infected plants remaining symptomless. Once established, F. circinatum spreads by rain, wind, and insects. The natural spread of the pathogen is limited due to the short dispersal distances of the spores and the fairly short flight distances of disseminating insects. In this review, we summarize the currently known dispersal pathways of the pathogen, discussing both natural and human-assisted processes. With the purpose of understanding how to best intervene in the disease’s development in nurseries and forests, we outline the epidemiology of the pathogen describing the key factors influencing its spread. Preventive measures to control the spread of F. circinatum locally and globally are described with special emphasis on the challenges in implementing them.
Background
Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those ...patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity.
Methods
This was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts. Patients were distributed into two groups depending on their Sequential Organ Failure Assessment score at ICU admission (SOFA < 8,
n
= 122 and SOFA ≥ 8,
n
= 156), and the association between immunoglobulin levels at ICU admission with mortality was studied in each group by Kaplan–Meier and multivariate logistic regression analysis.
Results
ICU/hospital mortality in the SOFA < 8 group was 14.8/23.0%, compared to 30.1/35.3% in the SOFA ≥ 8 group. In the group with SOFA < 8, the simultaneous presence of total IgG < 407 mg/dl, IgM < 43 mg/dl and IgA < 219 mg/dl was associated with a reduction in the survival mean time of 6.6 days in the first 28 days and was a robust predictor of mortality risk either during the acute or during the post-acute phase of the disease (OR for ICU mortality: 13.79; OR for hospital mortality: 7.98). This predictive ability remained in the absence of prior immunosuppression (OR for ICU mortality: 17.53; OR for hospital mortality: 5.63). Total IgG < 407 mg/dl or IgG1 < 332 mg/dl was also an independent predictor of ICU mortality in this group. In contrast, in the SOFA ≥ 8 group, we found no immunoglobulin thresholds associated with neither ICU nor hospital mortality.
Conclusions
Endogenous immunoglobulin levels may have a different impact on the mortality risk of sepsis patients based on their severity. In patients with moderate organ failure, the simultaneous presence of low levels of IgG, IgA and IgM was a consistent predictor of both acute and post-acute mortalities.
Proceso de tratamiento médico nutricional Martín Folgueras, Tomás; Vidal Casariego, Alfonso; Álvarez Hernández, Julia ...
Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral,
10/2022, Letnik:
39, Številka:
5
Journal Article
Odprti dostop
Resumen El tratamiento médico nutricional es de gran utilidad en el mantenimiento y recuperación de la salud de los pacientes con desnutrición relacionada con la enfermedad, aunque su implementación ...puede ser compleja y no está exenta de riesgos. Se entiende por proceso aquel conjunto de actividades que están mutuamente relacionadas o que interactúan para transformar elementos de entrada en resultados. Desde el Grupo de Trabajo de Gestión de la SENPE presentamos el Proceso de Tratamiento Médico Nutricional (PTMN), que tiene por objetivo facilitar la gestión de la nutrición clínica, pensando en un equipo de soporte nutricional multidisciplinar de atención al paciente hospitalizado. En este documento se describen los siete subprocesos que constituyen el PTMN, además de un subproceso previo de cribado nutricional. Cada subproceso se divide en una primera sección con una ficha técnica en la que se detallan sus aspectos generales, mientras que en la segunda sección se proponen objetivos clave, indicadores de calidad y estándares para su evaluación.
Background
Parkinson's disease (PD) is characterized by motor and nonmotor symptoms that progress with time, causing disability. The performance of a disease‐specific, self‐applied tool for assessing ...disability, the MDS‐UPDRS Part II, is tested against generic and rater‐based rating scales.
Methods
An international, cross‐sectional, observational study was performed. Patients were assessed with the Hoehn and Yahr (HY) and five disability measures: MDS‐UPDRS Part II, Schwab and England Scale (S&E), Clinical Impression of Severity Index‐PD (CISI‐PD) Disability item, Barthel Index (BI), and Rapid Assessment of Disability Scale (RADS). Data analysis included correlation coefficients, Mann‐Whitney and Kruskal‐Wallis tests, and intraclass‐correlation coefficient for concordance.
Results
The sample was composed of 451 patients, 55.2% men, with a mean age of 65.06 years (SD = 10.71). Disability rating scales correlated from |0.75| (CISI‐PD Disability with BI) to 0.87 (MDS‐UPDRS Part II with RADS). In general, MDS‐UPDRS Part II showed high correlation coefficients with clinical variables and satisfactory concordance with the rest of disability measures, with ICC ranging from 0.83 (with BI) to 0.93 (with RADS). All disability rating scales showed statistical significant differences in the sample grouped by sex, age, disease duration, and severity level.
Conclusions
The MDS‐UPDRS Part II showed an appropriate performance to assess disability in PD, even better than some rater‐based, generic or specific, scales applied in this study.
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