Richness, not evenness, varies across water availability gradients in grassy biomes on five continents.

We sought to understand the role that water availability (expressed as an aridity index) plays in determining regional and global patterns of richness and evenness, and in turn how these water availability-diversity relationships may result in different richness-evenness relationships at regional and global scales. We examined relationships between water availability, richness and evenness for eight grassy biomes spanning broad water availability gradients on five continents. Our study found that relationships between richness and water availability switched from positive for drier (South Africa, Tibet and USA) vs. negative for wetter (India) biomes, though were not significant for the remaining biomes. In contrast, only the India biome showed a significant relationship between water availability and evenness, which was negative. Globally, the richness-water availability relationship was hump-shaped, however, not significant for evenness. At the regional scale, a positive richness-evenness relationship was found for grassy biomes in India and Inner Mongolia, China. In contrast, this relationship was weakly concave-up globally. These results suggest that different, independent factors are determining patterns of species richness and evenness in grassy biomes, resulting in differing richness-evenness relationships at regional and global scales. As a consequence, richness and evenness may respond very differently across spatial gradients to anthropogenic changes, such as climate change.

Estimating the Impact of Ecological Migrants on the South-to-North Water Diversion in China.

The South-to-North Water Diversion (SNWD) provides significant benefits in facilitating water security and improving ecology in northern China. However, few studies have estimated the water value of the SNWD and the corresponding subsequent subsidies of the ecological migrants in Xichuan County displaced by the project. Based on the Google Earth Engine (GEE), this study analyzed the water ecosystem changes in Xichuan County in 2000-2020 and valued the water transfer of the SNWD. We calculated the water cost, the water value of the trunk line project, and the four provinces (Hebei, Henan, Beijing, and Tianjin) of CNY 4.04, 39.64, and 120.93 billion, respectively, and the proportion of the three was 1:10:30 during 2014-2020. The water ecosystem area showed a rapid increase when the SNWD became operational since the end of 2014. The subsequent annual subsidy gap of ecological migrants was CNY 0.84 billion, which only accounted for 4.31% of the gross profit of SNWD. Our results imply that relevant water sectors have sufficient profits to support corresponding subsequent subsidies for ecological migrants. Ecological migrants are a major challenge for water transfer projects. Overall, this study fills a gap of interactions between subsequent policies and ecological migrants and provides a typical case for managing the migration problem caused by sustainable water management worldwide.

The MARAS dataset, vegetation and soil characteristics of dryland rangelands across Patagonia.

We present the MARAS (Environmental Monitoring of Arid and Semiarid Regions) dataset, which stores vegetation and soil data of 426 rangeland monitoring plots installed throughout Patagonia, a 624.500 km2 area of southern Argentina and Chile. Data for each monitoring plot includes basic climatic and landscape features, photographs, 500 point intercepts for vegetation cover, plant species list and biodiversity indexes, 50-m line-intercept transect for vegetation spatial pattern analysis, land function indexes drawn from 11 measures of soil surface characteristics and laboratory soil analysis (pH, conductivity, organic matter, N and texture). Monitoring plots were installed between 2007 and 2019, and are being reassessed at 5-year intervals (247 have been surveyed twice). The MARAS dataset provides a baseline from which to evaluate the impacts of climate change and changes in land use intensity in Patagonian ecosystems, which collectively constitute one of the world´s largest rangeland areas. This dataset will be of interest to scientists exploring key ecological questions such as biodiversity-ecosystem functioning relationships, plant-soil interactions and climatic controls on ecosystem structure and functioning.

Valor predictivo de la albúmina plasmática, la vitamina D y las apolipoproteínas A y B como biomarcadores de riesgo coronario en el estudio REGICOR / Analysis of plasma albumin, vitamin D, and apolipoproteins A and B as predictive coronary risk biomarkers in the REGICOR study

Introducción y objetivos: La inclusión de biomarcadores en las funciones de riesgo clásicas puede mejorar la estimación del riesgo. Los objetivos del estudio son determinar la asociación entre las concentraciones de apolipoproteína A1 (apoA1), apolipoproteína B (apoB), albúmina y 25-OH-vitamina D circulantes y la incidencia de eventos coronarios y analizar si estos biomarcadores mejoran la capacidad predictiva de la función REGICOR. Métodos: Estudio de cohorte de casos. De una cohorte inicial de 5.404 participantes con edades entre los 35 y los 74 años y 5 años de seguimiento, se seleccionó a todos los que presentaron un evento coronario (n = 117) y una subcohorte elegida al azar de 667 participantes. Finalmente, se incluyó a 105 casos y 651 participantes de la subcohorte con muestra biológica disponible. Los eventos de interés fueron la aparición de angina, infarto de miocardio mortal o no mortal y muerte por enfermedad coronaria. Resultados: Los casos eran de más edad, tenían mayores proporciones de varones y factores de riesgo clásicos y concentraciones de apoB, y menores concentraciones de apoA1, cociente apoA1/apoB, 25-OH-vitamina D y albúmina que el grupo control. Al ajustar por los factores de riesgo clásicos, el único biomarcador que mantuvo la asociación con eventos coronarios fue la albúmina plasmática (HR = 0,73; p = 0,002). Además, las concentraciones de albúmina permitieron reclasificar correctamente a un número significativo de participantes, especialmente en la categoría de riesgo moderado (mejora neta en la reclasificación = 32,3; p = 0,048). Conclusiones: La albúmina plasmática se asocia independiente e inversamente con el riesgo de eventos coronarios y mejora la capacidad predictiva de la función de riesgo REGICOR

Introduction and objectives: New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. Methods: A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. Results: Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). Conclusions: Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions

Tasas de incidencia y mortalidad, y letalidad poblacional a 28 días del infarto agudo de miocardio en adultos mayores. Estudio REGICOR / Acute myocardial infarction population incidence and mortality rates, and 28-day case-fatality in older adults. The REGICOR Study

Introducción y objetivos: Los objetivos son determinar las tasas de incidencia y mortalidad, y la mortalidad poblacional y hospitalaria por infarto agudo de miocardio (IAM) de la población mayor de 74 años, la variabilidad en las características clínicas y el tratamiento de los pacientes hospitalizados, y los cambios en las tasas de incidencia y mortalidad, en la letalidad hospitalaria y en el tratamiento del IAM por grupos de edad entre 1996-1997 y 2007-2008. Métodos: Registro poblacional de IAM en Girona (Cataluña) que incluyó a pacientes con IAM mayores de 34 años. Resultados: La tasa de incidencia aumentó con la edad en varones y mujeres, respectivamente, de 169 y 28 casos/100.000/año en el grupo de 35-64 años a 2.306 y 1.384 casos/100.000/año en el de 85-94 años. La letalidad poblacional también aumentó con la edad, del 19% en el grupo de 35-64 años al 84% en el de 85-94 años. Se observó un descenso en la letalidad poblacional en el segundo periodo analizado, explicado por un descenso en la letalidad hospitalaria. El uso de procedimientos invasivos y fármacos de eficacia demostrada disminuyó con la edad, aunque aumentó en el segundo periodo en todos los grupos de edad hasta los 84 años. Conclusiones: La incidencia, la mortalidad y la letalidad hospitalaria del IAM aumentaron exponencialmente con la edad. Todavía se observan diferencias en el uso de procedimientos invasivos y fármacos de eficacia demostrada entre grupos de edad

Introduction and objectives: Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. Methods: A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. Results: The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. Conclusions: Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients

Analysis of Plasma Albumin, Vitamin D, and Apolipoproteins A and B as Predictive Coronary Risk Biomarkers in the REGICOR Study.

INTRODUCTION AND OBJECTIVES: New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. METHODS: A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. RESULTS: Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). CONCLUSIONS: Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions.

Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study.

INTRODUCTION AND OBJECTIVES: Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. METHODS: A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. RESULTS: The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. CONCLUSIONS: Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients.

COMPOSIÇÃO CORPORAL DE PENTATLETAS ADOLESCENTES AVALIADA COM A ABSORTOMETRIA RADIOLÓGICA DE DUPLA ENERGIA / BODY COMPOSITION OF ADOLESCENTS PENTATHLETES ASSESSMENT USING THE DUAL ENERGY X-RAY ABSORPTIOMETRY

RESUMO Os objetivos do estudo foram elaborar referências e analisar as características da composição corporal de atletas adolescentes de pentatlo moderno nos sexos feminino e masculino, por meio do DXA, em diferentes fases da puberdade. Participaram 48 atletas adolescentes praticantes de pentatlo moderno, sendo 21 meninas (14,67±2,35) e 27 meninos (15,15±1,51 anos). Em atletas do sexo feminino o percentual de gordura foi considerado alto no grupo de púberes; o aumento da massa magra e a estabilidade da gordura corporal, em púberes avançados e pós-púberes, são efeitos decorrentes dos efeitos do treinamento de pentatlo moderno. Os atletas masculinos apresentaram alterações comuns na composição corporal durante todas as fases da puberdade. A avaliação do BMC e BMD parecem pertinentes as adolescentes na mesma fase da puberdade praticantes de outras modalidades esportivas no masculino e feminino, demonstrando impacto positivo do treinamento.

ABSTRACT The aims of the study were to elaborate references and analyze the characteristics of body composition of adolescent modern pentathlon athletes in female and male, through DXA at different pubertal stages . A total of 48 adolescent athletes practitioners of modern pentathlon, 21 girls (14.67 ± 2.35) and 27 boys (15.15 ± 1.51 years). In female athletes the percentage of fat was considered high in pubescent group; increased lean body mass and the stability of body fat in advanced pubescent and post-pubescent, are effects of the practice of modern pentathlon training. Male athletes showed changes in body composition that are common during the puberty. The evaluation of BMC and BMD in male and female seem appropriate to adolescents at the same stage of puberty practitioners of other sports, demonstrating the positive impact of the training.

Impacto teórico en la enfermedad coronaria de usar un sistema informatizado de ayuda en la prescripción del tratamiento hipolipemiante / Theoretical impact on coronary disease of using a computerized clinical decision support system in the prescription of lipid-lowering treatment

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Plant species richness and shrub cover attenuate drought effects on ecosystem functioning across Patagonian rangelands.

Drought is an increasingly common phenomenon in drylands as a consequence of climate change. We used 311 sites across a broad range of environmental conditions in Patagonian rangelands to evaluate how drought severity and temperature (abiotic factors) and vegetation structure (biotic factors) modulate the impact of a drought event on the annual integral of normalized difference vegetation index (NDVI-I), our surrogate of ecosystem functioning. We found that NDVI-I decreases were larger with both increasing drought severity and temperature. Plant species richness (SR) and shrub cover (SC) attenuated the effects of drought on NDVI-I. Grass cover did not affect the impacts of drought on NDVI-I. Our results suggest that warming and species loss, two important imprints of global environmental change, could increase the vulnerability of Patagonian ecosystems to drought. Therefore, maintaining SR through appropriate grazing management can attenuate the adverse effects of climate change on ecosystem functioning.

Prolongación extrema del intervalo QT y taquicardia helicoidal (torsade de pointes) en el síndrome coronario agudo sin elevación del ST / Extreme QT interval prolongation and helicoid ventricular tachycardia ( Torsade de Pointes) in non-ST-elevation acute coronary syndrome

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[Natural history of and risk factors for idiopathic atrial fibrillation recurrence (FAP Registry)]. / Historia natural y factores de riesgo de recurrencia de la fibrilación auricular primaria (Registro FAP).

INTRODUCTION AND OBJECTIVES: The natural history of idiopathic atrial fibrillation is not well understood. The aim of this study was to investigate the frequency of and risk factors for disease recurrence. METHODS: The study involved 115 patients with a first episode of paroxysmal atrial fibrillation of unknown origin who were included the FAP registry, which contains data from 11 district hospitals in Catalonia, Spain. All patients underwent comprehensive clinical, laboratory, electro-cardiographic and echocardiographic investigations at baseline and were followed up periodically every 6 months to identify the occurrence of new symptomatic episodes and their complications. RESULTS: During a mean follow-up period of 912 (445) days, 32 (27.8%) patients experienced recurrence of atrial fibrillation. Those who experienced recurrence had a significantly higher left ventricular ejection fraction (P=.023) and smaller end-systolic volume (P<.001), and they were more likely to consume alcohol regularly (P=.013). Cox regression analysis confirmed that these variables had independent prognostic value. In contrast, the occurrence of syncope during the initial episode was associated with a lower likelihood of recurrence (P=.017). CONCLUSIONS: The risk of recurrence of idiopathic atrial fibrillation was high, and was enhanced by moderate alcohol consumption and increased left ventricular activity, probably of sympathetic origin. This trend was less marked in paroxysmal atrial fibrillation of vagal origin.

Historia natural y factores de riesgo de recurrencia de la fibrilación auricular primaria (Registro FAP) / Natural history of and risk factors for idiopathic atrial fibrillation recurrence (FAP Registry)

Introducción y objetivos. La historia natural de la fibrilación auricular (FA) primaria o idiopática tiene aspectos poco conocidos. El objeto del estudio fue describir la frecuencia y los factores determinantes de las recurrencias. Métodos. Se estudió a 115 pacientes atendidos en su primera crisis de FA paroxística sin causa conocida incluidos en el «registro FAP», en el que participan 11 centros comarcales de Cataluña. Se les practicó un estudio clínico, analítico, electrocardiográfico y ecocardiográfico exhaustivo y fueron seguidos periódicamente cada 6 meses para detectar la aparición de nuevas crisis sintomáticas y sus complicaciones. Resultados. Durante el seguimiento de 912 ± 445 días de promedio, 32 (27,8%) pacientes presentaron una recidiva de la fibrilación auricular. Los pacientes con recurrencias tenían una fracción de eyección más elevada (p = 0,023), un menor volumen telesistólico (p < 0,001) y eran con mayor frecuencia consumidores habituales de alcohol (p = 0,013). El análisis de regresión de Cox confirmó el valor predictivo independiente de estas variables. En cambio, la presencia de lipotimias en el episodio agudo se asoció con una menor tendencia a recidivar (p = 0,017). Conclusiones. La fibrilación auricular idiopática mostró una notable tendencia a las recidivas, favorecida por el consumo moderado de alcohol y el aumento de la actividad ventricular, probablemente de origen simpático. La tendencia fue menor en la fibrilación paroxística de origen vagal

Introduction and objectives. The natural history of idiopathic atrial fibrillation is not well understood. The aim of this study was to investigate the frequency of and risk factors for disease recurrence. Methods. The study involved 115 patients with a first episode of paroxysmal atrial fibrillation of unknown origin who were included the FAP registry, which contains data from 11 district hospitals in Catalonia, Spain. All patients underwent comprehensive clinical, laboratory, electro-cardiographic and echocardiographic investigations at baseline and were followed up periodically every 6 months to identify the occurrence of new symptomatic episodes and their complications. Results. During a mean follow-up period of 912 (445) days, 32 (27.8%) patients experienced recurrence of atrial fibrillation. Those who experienced recurrence had a significantly higher left ventricular ejection fraction (P=.023) and smaller end-systolic volume (P<.001), and they were more likely to consume alcohol regularly (P=.013). Cox regression analysis confirmed that these variables had independent prognostic value. In contrast, the occurrence of syncope during the initial episode was associated with a lower likelihood of recurrence (P=.017). Conclusions. The risk of recurrence of idiopathic atrial fibrillation was high, and was enhanced by moderate alcohol consumption and increased left ventricular activity, probably of sympathetic origin. This trend was less marked in paroxysmal atrial fibrillation of vagal origin

Gestión por procesos. Creación de una "Unidad Funcional de Cardiopatía Isquémica" en una área sanitaria comarcal / Process management. The development of the Funtional Unit of Ischemic Cardiopathy in a health care area

Objetivos: Los objetivos fundamentales fueron: mejorar la eficacia, la adecuación, la accesibilidad, mantener la continuidad asistencial y disminuir la variabilidad clínica en la atención de los pacientes con cardiopatía isquémica. Métodos: Analizar los motivos de derivación de estos pacientes desde los Centros de Atención Primaria a las consultas externas de Cardiología y su atención hospitalaria, buscando las oportunidades de mejora en cada uno de ellos, y crear una Unidad Funcional de Cardiopatía Isquémica con la metodología de una gestión por procesos y con los objetivos planteados. Resultados: Se describen los resultados del período junio 1999 a junio 2000. Se elaboraron de forma interdisciplinaria nueve Guías de Práctica Clínica sobre cardiopatía isquémica, se organizó una consulta externa de un Programa de Diagnóstico Rápido del Dolor Torácico con la incorporación de pruebas complementarias cardíacas. Se atendieron todas las interconsultas sobre cardiopatía isquémica procedentes de los distintos centros y se estableció la realización de una sesión semanal del equipo de la unidad. Desde el inicio del funcionamiento de la misma se observó una reducción del 71,9 por ciento en las listas de espera de las primeras visitas de Cardiología en las consultas externas hospitalarias y una leve disminución en la multiconsulta (8,4 por ciento).Conclusiones: La puesta en marcha de la unidad funcional, como primera experiencia en gestión por procesos de nuestro grupo sanitario, ha logrado una mejoría en la gestión asistencial de los pacientes con cardiopatía isquémica permitiendo iniciar el camino hacia el objetivo de disminuir la variabilidad de la práctica clínica e integrar, a partir de los diferentes conocimientos y experiencias, la actuación multidisciplinar de un equipo de profesionales que asegure la continuidad asistencial y lleve a la organización hacia un cambio cultural de gestión (AU)