Recommendations for quantitative uncertainty consideration in ecology and evolution.

Ecological and evolutionary studies are currently failing to achieve complete and consistent reporting of model-related uncertainty. We identify three key barriers - a focus on parameter-related uncertainty, obscure uncertainty metrics, and limited recognition of uncertainty propagation - which have led to gaps in uncertainty consideration. However, these gaps can be closed. We propose that uncertainty reporting in ecology and evolution can be improved through wider application of existing statistical solutions and by adopting good practice from other scientific fields. Our recommendations include greater consideration of input data and model structure uncertainties, field-specific uncertainty standards for methods and reporting, and increased uncertainty propagation through the use of hierarchical models.

Epistemología, historia y fundamentos de la Terapia Breve Estratégica. El Modelo de Giorgio Nardone / Epistemology, history and foundations of Brief Strategic Therapy. Giorgio Nardone´s Mode

La terapia breve estratégica modelo evolucionado de Giorgio Nardone, está considerada en la actualidad como una psicoterapia que evidencia una alta eficacia y eficiencia, en una variedad de trastornos emocionales. En este artículo se presenta la historia y los fundamentos epistemológicos de la terapia breve estratégica, fundamentadas en el pensamiento sistémico, la cibernética, la teoría general de los sistemas y el constructivismo. Se analiza la evolución y desarrollo histórico desde el Mental Research Institute en Palo Alto hasta la creación del Centro en Arezzo Italia. Se presentan las bases teóricas de la terapia breve estratégica centrada en el presente y en las soluciones, partiendo de la premisa de que los intentos de solución mantienen el problema y planteando que desde la lógica estratégica siempre la solución se adapta al problema y a su objeto de estudio.(AU)

Giorgio Nardone's evolved model of brief strategic therapy is a psychotherapy that is currently considered to demonstrate high efficacy and efficiency for a variety of emotional disorders. This article presents the history and epistemological foundations of brief strategic therapy, based on systems thinking, cybernetics, general systems theory, and constructivism. The evolution and historical development are analyzed, from the Mental Research Institute in Palo Alto to the creation of the Strategic Therapy Center in Arezzo Italy. The theoretical foundations of brief strategic therapy focused on the present and solutions are presented, starting from the premise that attempts at solution actually maintain the problem and proposing that based on strategic logic the solution always adapts to the problem and its object of study.(AU)

Insights into the quantification and reporting of model-related uncertainty across different disciplines.

Quantifying uncertainty associated with our models is the only way we can express how much we know about any phenomenon. Incomplete consideration of model-based uncertainties can lead to overstated conclusions with real-world impacts in diverse spheres, including conservation, epidemiology, climate science, and policy. Despite these potentially damaging consequences, we still know little about how different fields quantify and report uncertainty. We introduce the "sources of uncertainty" framework, using it to conduct a systematic audit of model-related uncertainty quantification from seven scientific fields, spanning the biological, physical, and political sciences. Our interdisciplinary audit shows no field fully considers all possible sources of uncertainty, but each has its own best practices alongside shared outstanding challenges. We make ten easy-to-implement recommendations to improve the consistency, completeness, and clarity of reporting on model-related uncertainty. These recommendations serve as a guide to best practices across scientific fields and expand our toolbox for high-quality research.

Alongshore upwelling modulates the intensity of marine heatwaves in a temperate coastal sea.

Analyses of long-term temperature records based on satellite data have revealed an increase in the frequency and intensity of marine heatwaves (MHWs) in the world oceans, a trend directly associated with global change according to climate model simulations. However, these analyses often target open ocean pelagic systems and rarely include local scale, field temperature records that are more adequate to assess the impact of MHWs close to the land-sea interface. Here, we compared the incidence and characteristics of open ocean MHWs detected by satellites with those observed in the field over two decades (1998-2019) at two temperate intertidal locations in the central Cantabrian Sea, southern Bay of Biscay. Satellite retrievals tended to smooth out cooling events associated with intermittent, alongshore upwelling, especially during summer. These biases propagated to the characterization of MHWs and resulted in an overestimation of their incidence and duration close to the coast. To reconcile satellite and field records, we developed a downscaling approach based on regression modeling that enabled the reconstruction of past temperatures and analyze MHW trends. Despite the cooling effect due to upwelling, the temperature reconstructions revealed a six-fold increase in the incidence of MHWs in the Cantabrian Sea over the last four decades. A comparison between static (no trend) vs. dynamic (featuring a linear warming trend) MHW detection thresholds allowed us to attribute over half of the increase in MHW incidence to the ocean warming trend. Our results highlight the importance of local processes to fully characterize the complexity and impacts of MHWs on marine coastal ecosystems and call for the conservation of climate refugia associated with coastal upwelling to counter the impacts of climate warming.

Incidence, risk factors, and thrombotic load of pulmonary embolism in patients hospitalized for COVID-19 infection.

OBJECTIVE: To determine the incidence, characteristics, and risk factors of pulmonary embolism (PE) among patients hospitalized for COVID-19. PATIENTS AND METHODS: We performed a prospective observational study of a randomly selected cohort of consecutive patients hospitalized for COVID-19 infection between March 8, 2020 through April 25, 2020. All eligible patients underwent a computed tomography pulmonary angiography independently of their PE clinical suspicion and were pre-screened for a baseline elevated D-dimer level. RESULTS: 119 patients were randomly selected from the 372 admitted to one tertiary hospital in Valencia (Spain) for COVID-19 infection during the period of study. Seventy-three patients fulfilled both the inclusion criteria and none of the exclusion criteria and were finally included in the study. Despite a high level of pharmacological thromboprophylaxis (89%), the incidence of PE was 35.6% (95% confidence interval [CI], 29.6 to 41.6%), mostly with a peripheral location and low thrombotic load (Qanadli score 18.5%). Multivariate analysis showed that heart rate (Hazard Ratio [HR], 1.04), room-air oxygen saturation (spO2) (HR, 0.87), D-dimer (HR, 1.02), and C-reactive protein (CRP) levels (HR, 1.01) at the time of admission were independent predictors of incident PE during hospitalization. A risk score was constructed with these four variables showing a high predictive value of incident PE (AUC-ROC: 0.86; 95% CI: 0.80 to 0.93). CONCLUSIONS: Our findings confirmed a high incidence of PE in hospitalized COVID-19 patients. Heart rate, spO2, D-dimer, and CRP levels at admission were associated with higher rates of PE during hospitalization.

Controversies in acute multiligamentary knee injuries (MLKI).

Multiligament injuries of the knee (MLKI), remain an infrequent pathology especially in developed countries compared to mono-ligament lesions. In Colombia, MLKI is frequent due to the high accident rate on motorcycles. In the city of Bogota alone, about 160 motorcycle accidents have been estimated daily, being one of the cities that proportionately use this means of transport less compared to small cities. The term MLKI, include all ruptures of two or more major ligaments and therefore it has a broad spectrum of clinical presentation which creates a great challenge for the orthopedists and the surgeons envolved in this topic. The literature is rich in studies level IV but very poor in level I and level II, which generates controversies and little consensus in the diagnosis and treatment of this pathology. However there has been a gradual and better understanding of all factors involved in the treatment of MLKI that has improved the functional results of these knees in our patients, in fact we currently are more precise to achieve accurate diagnosis, evolved from not surgical approach to operate most, applying new anatomical and biomechanical concepts, with specialized and skill surgical techniques with more stable and biocompatible fixation implants, which allow in most cases to initiate an early integral rehabilitation program. Nevertheless due to the complexity and severity of the lesions, in some patients the functional results are poor. The goal of this revision is to identify the most frequent controversies in the diagnosis and treatment of MLKI, defining which of them are agreed according to what is reported in the literature and share some concepts based from the experience of more than 25 years of the senior author (MM) in the management of these injuries. LEVEL OF EVIDENCE: V - Expert Opinion.

Current HHT genetic overview in Spain and its phenotypic correlation: data from RiHHTa registry.

BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare vascular disease with autosomal dominant inheritance. Disease-causing variants in endoglin (ENG) and activin A receptor type II-like 1 (ACVRL1) genes are detected in more than 90% of cases submitted to molecular diagnosis. METHODS: We used data from the RiHHTa (Computerized Registry of Hereditary Hemorrhagic Telangiectasia) registry to describe genetic variants and to assess their genotype-phenotype correlation among HHT patients in Spain. RESULTS: By May 2019, 215 patients were included in the RiHHTa registry with a mean age of 52.5 ± 16.5 years and 136 (63.3%) were women. Definitive HHT diagnosis defined by the Curaçao criteria were met by 172 (80%) patients. Among 113 patients with genetic test, 77 (68.1%) showed a genetic variant in ACVRL1 and 36 (31.8%) in ENG gene. The identified genetic variants in ACVRL1 and ENG genes and their clinical significance are provided. ACVRL1 mutations were more frequently nonsense (50%) while ENG mutations were more frequently, frameshift (39.1%). ENG patients were significantly younger at diagnosis (36.9 vs 45.7 years) and had pulmonary arteriovenous malformations (AVMs) (71.4% vs 24.4%) and cerebral AVMs (17.6% vs 2%) more often than patients with ACVRL1 variants. Patients with ACVRL1 variants had a higher cardiac index (2.62 vs 3.46), higher levels of hepatic functional blood tests, and anemia (28.5% vs 56.7%) more often than ENG patients. CONCLUSIONS: ACVRL1 variants are more frequent than ENG in Spain. ACVRL1 patients developed symptomatic liver disease and anemia more often than ENG patients. Compared to ACVRL1, those with ENG variants are younger at diagnosis and show pulmonary and cerebral AVMs more frequently.

Bacterial, Archaeal, and Eukaryotic Diversity across Distinct Microhabitats in an Acid Mine Drainage.

Acid mine drainages are characterized by their low pH and the presence of dissolved toxic metallic species. Microorganisms survive in different microhabitats within the ecosystem, namely water, sediments, and biofilms. In this report, we surveyed the microbial diversity within all domains of life in the different microhabitats at Los Rueldos abandoned mercury underground mine (NW Spain), and predicted bacterial function based on community composition. Sediment samples contained higher proportions of soil bacteria (AD3, Acidobacteria), as well as Crenarchaeota and Methanomassiliicoccaceae archaea. Oxic and hypoxic biofilm samples were enriched in bacterial iron oxidizers from the genus Leptospirillum, order Acidithiobacillales, class Betaproteobacteria, and archaea from the class Thermoplasmata. Water samples were enriched in Cyanobacteria and Thermoplasmata archaea at a 3-98% of the sunlight influence, whilst Betaproteobacteria, Thermoplasmata archaea, and Micrarchaea dominated in acid water collected in total darkness. Stalactites hanging from the Fe-rich mine ceiling were dominated by the neutrophilic iron oxidizer Gallionella and other lineages that were absent in the rest of the microhabitats (e.g., Chlorobi, Chloroflexi). Eukaryotes were detected in biofilms and open-air water samples, and belonged mainly to clades SAR (Alveolata and Stramenopiles), and Opisthokonta (Fungi). Oxic and hypoxic biofilms displayed higher proportions of ciliates (Gonostomum, Oxytricha), whereas water samples were enriched in fungi (Paramicrosporidium and unknown microbial Helotiales). Predicted function through bacterial community composition suggested adaptive evolutive convergence of function in heterogeneous communities. Our study showcases a broad description of the microbial diversity across different microhabitats in the same environment and expands the knowledge on the diversity of microbial eukaryotes in AMD habitats.

Use of Endophytic and Rhizosphere Bacteria To Improve Phytoremediation of Arsenic-Contaminated Industrial Soils by Autochthonous Betula celtiberica.

The aim of this study was to investigate the potential of indigenous arsenic-tolerant bacteria to enhance arsenic phytoremediation by the autochthonous pseudometallophyte Betula celtiberica The first goal was to perform an initial analysis of the entire rhizosphere and endophytic bacterial communities of the above-named accumulator plant, including the cultivable bacterial species. B. celtiberica's microbiome was dominated by taxa related to Flavobacteriales, Burkholderiales, and Pseudomonadales, especially the Pseudomonas and Flavobacterium genera. A total of 54 cultivable rhizobacteria and 41 root endophytes, mainly affiliated with the phyla Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria, were isolated and characterized with respect to several potentially useful features for metal plant accumulation, such as the ability to promote plant growth, metal chelation, and/or mitigation of heavy-metal stress. Seven bacterial isolates were further selected and tested for in vitro accumulation of arsenic in plants; four of them were finally assayed in field-scale bioaugmentation experiments. The exposure to arsenic in vitro caused an increase in the total nonprotein thiol compound content in roots, suggesting a detoxification mechanism through phytochelatin complexation. In the contaminated field, the siderophore and indole-3-acetic acid producers of the endophytic bacterial consortium enhanced arsenic accumulation in the leaves and roots of Betula celtiberica, whereas the rhizosphere isolate Ensifer adhaerens strain 91R mainly promoted plant growth. Field experimentation showed that additional factors, such as soil arsenic content and pH, influenced arsenic uptake in the plant, attesting to the relevance of field conditions in the success of phytoextraction strategies.IMPORTANCE Microorganisms and plants have developed several ways of dealing with arsenic, allowing them to resist and metabolize this metalloid. These properties form the basis of phytoremediation treatments and the understanding that the interactions of plants with soil bacteria are crucial for the optimization of arsenic uptake. To address this in our work, we initially performed a microbiome analysis of the autochthonous Betula celtiberica plants growing in arsenic-contaminated soils, including endosphere and rhizosphere bacterial communities. We then proceeded to isolate and characterize the cultivable bacteria that were potentially better suited to enhance phytoextraction efficiency. Eventually, we went to the field application stage. Our results corroborated the idea that recovery of pseudometallophyte-associated bacteria adapted to a large historically contaminated site and their use in bioaugmentation technologies are affordable experimental approaches and potentially very useful for implementing effective phytoremediation strategies with plants and their indigenous bacteria.

Responses of five Mediterranean halophytes to seasonal changes in environmental conditions.

In their natural habitats, different mechanisms may contribute to the tolerance of halophytes to high soil salinity and other abiotic stresses, but their relative contribution and ecological relevance, for a given species, remain largely unknown. We studied the responses to changing environmental conditions of five halophytes (Sarcocornia fruticosa, Inula crithmoides, Plantago crassifolia, Juncus maritimus and J. acutus) in a Mediterranean salt marsh, from summer 2009 to autumn 2010. A principal component analysis was used to correlate soil and climatic data with changes in the plants' contents of chemical markers associated with stress responses: ions, osmolytes, malondialdehyde (MDA, a marker of oxidative stress) and antioxidant systems. Stress tolerance in S. fruticosa, I. crithmoides and P. crassifolia (all succulent dicots) seemed to depend mostly on the transport of ions to aerial parts and the biosynthesis of specific osmolytes, whereas both Juncus species (monocots) were able to avoid accumulation of toxic ions, maintaining relatively high K(+)/Na(+) ratios. For the most salt-tolerant taxa (S. fruticosa and I. crithmoides), seasonal variations of Na(+), Cl(-), K(+) and glycine betaine, their major osmolyte, did not correlate with environmental parameters associated with salt or water stress, suggesting that their tolerance mechanisms are constitutive and relatively independent of external conditions, although they could be mediated by changes in the subcellular compartmentalization of ions and compatible osmolytes. Proline levels were too low in all the species to possibly have any effect on osmotic adjustment. However-except for P. crassifolia-proline may play a role in stress tolerance based on its 'osmoprotectant' functions. No correlation was observed between the degree of environmental stress and the levels of MDA or enzymatic and non-enzymatic antioxidants, indicating that the investigated halophytes are not subjected to oxidative stress under natural conditions and do not, therefore, need to activate antioxidant defence mechanisms.

Role of upwelling on larval dispersal and productivity of gooseneck barnacle populations in the Cantabrian Sea: management implications.

The effect of coastal upwelling on the recruitment and connectivity of coastal marine populations has rarely been characterized to a level of detail to be included into sound fishery management strategies. The gooseneck barnacle (Pollicipes pollicipes) fishery at the Cantabrian Coast (Northern Spain) is located at the fringes of the NW Spanish Upwelling system. This fishery is being co-managed through a fine-scale, interspersed set of protected rocks where each rock receives a distinct level of protection. Such interspersion is potentially beneficial, but the extent to which such spacing is consistent with mean larval dispersal distances is as yet unknown. We have simulated the spread of gooseneck barnacle larvae in the Central Cantabrian Coast using a high-resolution time-series of current profiles measured at a nearshore location. During a year of high upwelling activity (2009), theoretical recruitment success was 94% with peak recruitment predicted 56 km west of the emission point. However, for a year of low upwelling activity (2011) theoretical recruitment success dropped to 15.4% and peak recruitment was expected 13 km east of the emission point. This is consistent with a positive correlation between catch rates and the Integrated Upwelling Index, using a 4-year lag to allow recruits to reach commercial size. Furthermore, a net long-term westward larval transport was estimated by means of mitochondrial cytochrome c oxidase subunit I (COI) sequences for five populations in the Cantabrian Sea. Our results call into question the role of long distance dispersal, driven by the mesoscale processes in the area, in gooseneck barnacle populations and point to the prevalent role of small-scale, asymmetric connectivity more consistent with the typical scale of the co-management process in this fishery.

Are soluble carbohydrates ecologically relevant for salt tolerance in halophytes?

A general response of plants to high soil salinity relies on the cellular accumulation of osmolytes, which help the plant to maintain osmotic balance under salt stress condition and/or act as 'osmoprotectants' with chaperon or reactive oxygen species (ROS) scavenging activities. Yet the ecological relevance of this response for the salt tolerance mechanisms of halophytes in their natural habitats remains largely unknown. In this review, we describe and discuss published data supporting the participation of compatible solutes in those mechanisms, with especial focus on soluble carbohydrates. Evidence for a functional role of carbohydrates in salt tolerance include: (i) relatively high levels of specific sugars and polyols have been detected in many halophytic taxa; (ii) an increase in salt tolerance has often been observed in parallel with increased intracellular levels of particular soluble carbohydrates, in transgenic plants overexpressing the corresponding biosynthetic enzymes; (iii) there are several examples of genes involved in carbohydrate metabolism which are induced under salt stress conditions; (iv) specific sugars or polyols have been shown to accumulate in different halophytes upon controlled salt treatments; and (v) although very few field studies on environmentally induced carbohydrate changes in halophytes exist, in general they also support the involvement of this type of osmolytes in salt stress tolerance mechanisms. We also highlight the complexities of unequivocally attributing carbohydrates a biological role in salt tolerance mechanisms of a given tolerant species. It is proposed that research on halophytes in their natural ecosystems should be intensified, correlating seasonal changes in carbohydrate contents with the degree of environmental stress affecting the plants. This could be an important complement to experiments made under more controlled (but artificial) conditions, such as laboratory set-ups.

Isolated aortic coarctation: experience in 100 consecutive patients.

INTRODUCTION: Coarctation of the aorta (CoA) is a stenosis usually located in the descending aorta. Treatment consists of surgical or percutaneous removal of the obstruction and presents excellent immediate results but significant residual problems often persist. OBJECTIVES: To describe the presentation, treatment and long-term evolution of a population of 100 unselected consecutive patients with isolated CoA in a single pediatric cardiology center. METHODS: This was a retrospective study of all patients with isolated CoA treated during4 the last 21 years (1987-2008). RESULTS: The patients (n=100, 68.3% male) were diagnosed at a median age of 94 days (1 day to 16 years). The clinical presentation differed between patients aged less or more than one year, the former presenting with heart failure and the latter being asymptomatic with evidence of hypertension (88 and 63%, respectively; p < 0.01). Treatment, a median of 8 days after diagnosis, was surgical in 79 cases (20 end-to-end anastomosis, 31 subclavian flap, 28 patch) and percutaneous in the remaining 21 (15 balloon angioplasty, 6 with stenting). The mean age of surgical patients was younger than in those treated percutaneously (3.4 vs. 7.5 years; p < 0.01). Immediate mortality was 2% and occurred in the surgical group. There was no late mortality, in a mean follow-up of 7.2 +/- 5.4 years. Recoarctation occurred in 8 patients (6 surgical, 2 percutaneous). There are 46 patients who currently have hypertension (19 at rest, 27 with effort), their median age at diagnosis being older than the others (23 vs. 995 days; p < 0.01). CONCLUSIONS: Isolated CoA has an excellent short-term prognosis but a significant incidence of long-term complications, and should thus no longer be seen as a simple obstruction in the descending aorta, but rather as a complex pathology that requires careful follow-up after treatment. Its potentially insidious presentation requires a high level of clinical suspicion, femoral pulse palpation during physical examination of newborns and older children being particularly important. Delay in treatment has an impact on late morbidity and mortality. Taking into account the data currently available on late and immediate results, the final choice of therapeutic technique depends on the patient's age, associated lesions and the experience of the medical-surgical team. Hypertension should be closely monitored in the follow-up of these patients, as well as its risk factors and complications.

Bolsa de Indiana en el tratamiento de tumores malignos de la pelvis y de sus secuelas: experiencia de 20 años en el Instituto Nacional de Cancerología / Indiana pouch for the treatment of pelvic tumors and their aftermaths: a 20-year experience at the National Cancer Institute

Objetivo: Valorar la función renal y los efectos colaterales de la bolsa de Indiana como método quirúrgico. Método: Reporte de serie de casos de 75 pacientes operados desde junio de 1987 hasta junio del 2008 con bolsa de Indiana. Resultados: Los tumores incluyeron 36 cánceres de vejiga, 35 cánceres de útero, 2 melanomas vaginales, 1 cáncer de vulva y 1 osteoclastoma, La bolsa se usó en 35 cistectomías radicales y 14 exenteraciones pélvicas, y en 26 pacientes se hizo sin cirugía extirpativa tumoral. El 95% de pacientes mantuvo la función renal. Los electrolitos séricos permanecieron normales. La continencia completa se consiguió en 92% de los casos. La capacidad promedio del reservorio fue de 536,5 ml; 21 (25,8%) riñones sanos se perdieron al reimplantarse. Por otra parte, 22 (56,4%) riñones hidronefróticos llegaron a ser sanos. Complicaciones: temprana, 6,66%; tardía 46,0%. Reintervención: temprana, 8,0%; tardía 40,1%. Mortalidad perioperatoria 8,0%; mortalidad acumulativa, 45,30%. Supervivencia promedio: 30,7 meses. Conclusiones: La bolsa de Indiana es una derivación urinaria útil cuando no es factible preservar la uretra. Presenta más complicaciones tardías que tempranas. La hidronefrosis, el daño parenquimatoso y la neocistolitiasis fueron frecuentes en esta serie, con 48% de pacientes irradiados.

Objective: To evaluate the renal function and side effects of the Indiana pouch at the National Cancer Institute of Colombia. Method: 75 cases with history of Indiana Pouch reconstructive surgery were recruited from June 1987 to June, 2008. Results: 36 bladder; 35 uterine cancer; 1 vulvar cancer, vaginal cancer, 2 melanomas; and 1 osteoclastoma were included. The Indiana Pouch was used in 35 radical cystectomies, and 14 pelvic exenterations. In 26 cases, there was non-surgical tumor extirpation. 95% of patients continued with proper renal function and normal serum electrolytes. Complete continence was present in 92% of cases. The average reservoir capacity was 536.5ml; 22 (24.7%) healthy kidneys were lost after re-implantation. In contrast, 22 (56.4%) hydro-nephronic kidneys became healthy. Early complications were present in 6.66% of cases; and late complications in 46.70%. Early re-intervention was observed in 8.0%; late, 40.1%. Perioperative mortality was 8.0%; cumulative mortality, 45.3%. The average survival was 30.7 months. Conclusions: The Indiana Pouch is a useful urinary device when urethra preservation is not possible. Complications occur late rather than early. Hydronephrosis, parenchymatic damage and neo-cystolytiasis were frequent in this series, wherein 48% of patients were irradiated.