Land use and land cover (LULC) change is one of the clearest representations of the global environmental change phenomenon at various spatial and temporal scales. Chile is worldwide recognized to ...have areas dedicated to non-native forest plantations that specifically in coastal range show high environmental and economic deterioration, questioning the sustainability of the forestry industry. Currently, there are no studies in Chile that reveal the real effects of the LULC change on the water balance at basin or sub-basin scales associated with future scenarios, which might contribute to territorial decision-making and reveal the real magnitude of the effects of these dynamics. In this study, in order to study LULC dynamics in a coastal basin in South-Central Chile, we assessed and analyzed the effects of future LULC change scenarios on the hydrological processes by generating future synthetic land cover maps from Landsat (Landsat 5 TM and Landsat 8 OLI) image datasets. The hydrological model Soil Water Assessment Tool (SWAT) was calibrated and validated, using hydroclimatic time series, to simulate discharges and other hydrological components over those future LULC scenarios. The LULC future scenarios were projected using combined Markov chain analysis (CA–Markov) and cellular automata algorithms for the near (2025), middle (2035) and far (2045) future. The results revealed that the effects on the different components of the water balance of the basin are not as significant except in the soil water transfer in percolation (increase 72.4%) and groundwater flow (increase 72.5%). This trend was especially observed in sub-basins with non-native forest plantations that dominated land cover in the year 2035, in which an increase of 43.6% in percolation and groundwater flows resulted in increased aquifer recharge and water storage, mainly offset by a decrease of 27% in the evapotranspiration. This work demonstrates the importance of evaluating the impacts of the dynamics of LULC on the hydrological response of a coastal basin, and also on how the land use governance and policy are closely linked to that of water resources.
Compression ultrasonography is the most effective diagnostic tool in the emergency department (ED) for the diagnosis of deep vein thrombosis (DVT). It has been demonstrated to be highly accurate and ...cost-effective.
The objective of this study was to determine the accuracy of emergency physicians who performed three-point compression ultrasound (US) for suspected above-knee DVT within the context of using Wells score and D-dimer.
This was a prospective diagnostic test assessment of three-point ultrasound conducted in a district general hospital of patients who presented to the ED with suspected DVT of the lower limb. The accuracy of three-point ultrasound carried out by the emergency physicians was assessed by comparison of the Doppler ultrasound carried out by the Radiology Department as reference standard. The study incorporated ultrasound alongside the Wells score and D-dimer.
A total of 109 patients (66.1%) had a three-point compression point-of-care ultrasound in the ED and a second ultrasound performed by the Radiology Department. Bedside three-point compression ultrasound of the lower extremity performed by physicians in the ED had a sensitivity of 93.2% (95% confidence interval CI 83.8–97.3%) and a specificity of 90.0% (95% CI 78.6–95.7%), with an accuracy of 91.7% (95% CI 85–95.6%).
Emergency physicians can obtain a level of competence equivalent to that of radiologists, but it requires substantial training and practice to achieve and maintain this performance. Providers should be aware of their limitations and maintain regular training with ultrasound applications.
•A legislative soil concept in Chile will grant effective protection of the resource.•Chile's soil protection and sustainability depend upon a Framework Land Law.•The Claro River sub-basin ...degradation responds to a lack in soil regulations.•Sustainable soil exploitation must consider a geographical macrozone division of Chile.
Soil is a non-renewable resource on a human scale and highly vulnerable to erosion due to anthropogenic management and the variable effects of climate. In Chile, the lack of a legislative concept for soil and changes in Land Use Capacity (LUCap) have constituted the main facilitating agents of soil erosion. Given the inadequacy of current land regulations, and to guide and contribute to the sustainability of the resource, this study presents a proposal for new land use legislation in Chile. We analyse the current national legislation on changes in the LUCap and compare the current land use in the Claro River sub-basin, Chile, with existing LUCap classes, identifying the legal criteria for establishing a national land use regulation, by comparing with international law from Costa Rica and Spain. We carried out a qualitative review analysis of 20 Chilean land use regulations and a quantitative, multi-temporal analysis of LUCap change in the Claro River sub-basin, using spatial analysis tools (ArcGIS 10.1 and/or QGIS 3.14) in Raster and Vector format. Legislations from Costa Rica and Spain were chosen due to similarities with Chilean environmental regulations. We observed that Chile must introduce a Framework Land Law with principles of protection and sustainability for regulating soil. Deforestation was the main land loss driver (60% of native forest loss) in the study area during the 16-year study period, as well as inadequate agricultural management practices. It is essential to unify legislation, following the example of comparative laws of Spain, with the vision of Costa Rica.
OBJECTIVEA consistent line of investigation proposes fibromyalgia as a dysautonomia-associated neuropathic pain syndrome. Comorbid anxiety or depression amplifies fibromyalgia symptoms. The recent ...recognition of small fiber neuropathy in fibromyalgia patients supports the neuropathic nature of the illness. Corneal confocal microscopy accurately identifies small nerve fiber pathology. The newly developed Small-Fiber Symptom Survey captures the spectrum of small fiber neuropathy symptoms. We aimed to correlate corneal nerve density with different fibromyalgia disease severity questionnaires including the Small-Fiber Symptom Survey. We defined the possible confounding role of comorbid anxiety or depression severity in the clinical-pathological association.
METHODSThis is a case series of 28 women with fibromyalgia. A single ophthalmologist quantified corneal subbasal plexus nerve density. Corneal innervation was correlated (Spearman ρ) with the following clinical questionnaires scoresSmall-Fiber Symptom Survey, Revised Fibromyalgia Impact Questionnaire, and COMPASS-31 (Composite Autonomic Symptom Survey 31-Item Score). Validated inquiry forms assessed the comorbid anxiety and/or depression severity.
RESULTSThere were no clinical-pathological correlations in the group as a whole. In the subgroup of fibromyalgia women without severe anxiety or depression (n = 13), there was a strong negative correlation between corneal nerve density with the Small-Fiber Symptom Survey score (ρ = −0.771, p = 0.002) and COMPASS-31 score (ρ = −0.648, p = 0.017). Patients with profound anxiety or depression (n = 15) had more intense symptoms but had not clinical-pathological correlations.
CONCLUSIONSSmall fiber neuropathy and dysautonomia symptoms correlate with corneal denervation in women with fibromyalgia without severe anxiety or depression. This clinical-pathological association reinforces fibromyalgia as a dysautonomia-related neuropathic pain syndrome. Severe anxiety or depression distorts fibromyalgia symptoms.
PRACTICAL POINTCorneal confocal microscopy may become a useful procedure to study fibromyalgia patients.
Home mechanical ventilation (HMV) is a viable and effective strategy for patients with chronic respiratory failure (CRF). The Chilean Ministry of Health started a program for adults in 2008.
This ...study examined the following data from a prospective cohort of patients with CRF admitted to the national HMV program: characteristics, mode of admission, quality of life, time in the program and survival.
A total of 1105 patients were included. The median age was 59 years (44-58). Women accounted for 58.1% of the sample. The average body mass index (BMI) was 34.9 (26-46) kg/m
. A total of 76.2% of patients started HMV in the stable chronic mode, while 23.8% initiated HMV in the acute mode. A total of 99 patients were transferred from the children's program. There were 1047 patients on non-invasive ventilation and 58 patients on invasive ventilation. The median baseline PaCO
level was 58.2 (52-65) mmHg. The device usage time was 7.3 h/d (5.8-8.8), and the time in HMV was 21.6 (12.2-49.5) months. The diagnoses were COPD (35%), obesity hypoventilation syndrome (OHS; 23.9%), neuromuscular disease (NMD; 16.3%), non-cystic fibrosis bronchiectasis or tuberculosis (non-CF BC or TBC; 8.3%), scoliosis (5.9%) and amyotrophic lateral sclerosis (ALS; 5.24%). The baseline score on the Severe Respiratory Insufficiency questionnaire (SRI) was 47 (± 17.9) points and significantly improved over time. The lowest 1- and 3-year survival rates were observed in the ALS group, and the lowest 9-year survival rate was observed in the non-CF BC or TB and COPD groups. The best survival rates at 9 years were OHS, scoliosis and NMD. In 2017, there were 701 patients in the children's program and 722 in the adult´s program, with a prevalence of 10.4 per 100,000 inhabitants.
The most common diagnoses were COPD and OHS. The best survival was observed in patients with OHS, scoliosis and NMD. The SRI score improved significantly in the follow-up of patients with HMV. The prevalence of HMV was 10.4 per 100,000 inhabitants. Trial registration This study was approved by and registered at the ethics committee of North Metropolitan Health Service of Santiago, Chile (N° 018/2021).
...research into the potential safety concerns surrounding cannabis should be conducted in the future. Brugada syndrome is recognized clinically by a characteristic ECG appearance, including right ...precordial ST elevation and intermittent right bundle-branch block, along with a propensity toward arrhythmic syncope and sudden cardiac death.
Tuberculosis: el contrapunto del progreso Aguayo-Reyes, Alejandro; Mella-Montecinos, Sergio; Quezada-Siles, Martha ...
Revista chilena de infectología,
06/2022, Letnik:
39, Številka:
3
Journal Article
Odprti dostop
Resumen A lo largo de la historia, las enfermedades infecciosas han influido directamente en el desarrollo de la humanidad y en este proceso, la tuberculosis ha tenido un rol protagónico. Esta ...enfermedad mata más seres humanos que cualquier otra de causa infecciosa y, a pesar de esto, continúa siendo una entidad olvidada y un grave problema de salud pública, sobre todo en las naciones más pobres. La trascendencia de la tuberculosis va más allá del ámbito médico y una visión holística de ella nos permite comprender el grado de desarrollo económico y social de un Estado. Si bien Chile mantenía un programa de control históricamente exitoso, las cifras actuales no son auspiciosas y obligan a analizar el problema desde una mirada multidisciplinaria. Es en este marco que planteamos que el médico clínico, para aportar en el control de la enfermedad, debe poner nuevamente en práctica uno de los principios básicos de la Medicina: la semiología.
It is estimated that there are currently 1.9 million deafened adults living in North America?people who could once hear but have become. An invaluable guide to self-help techniques of proven value to ...deafened people.
The wide adoption of multimedia service-capable mobile devices, the availability of better networks with higher bandwidths, and the availability of platforms offering digital content has led to an ...increasing popularity of multimedia streaming services. However, multimedia streaming services can be subject to different factors that affect the quality perceived by the users, such as service interruptions or quality oscillations due to changing network conditions, particularly in mobile networks. Dynamic Adaptive Streaming over HTTP (DASH), leverages the use of content-distribution networks and the capabilities of the multimedia devices to allow multimedia players to dynamically adapt the quality of the media streaming to the available bandwidth and the device characteristics. While many elements of DASH are standardized, the algorithms providing the dynamic adaptation of the streaming are not. The adaptation is often based on the estimation of the throughput or a buffer control mechanism. In this paper, we present a new throughput estimation adaptation algorithm based on a statistical method named Adaptive Forgetting Factor (AFF). Using this method, the adaptation logic is able to react appropriately to the different conditions of different types of networks. A set of experiments with different traffic profiles show that the proposed algorithm improves video quality performance in both wired and wireless environments.
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