The Contribution of Transpiration to Precipitation Over African Watersheds.

The redistribution of biological (transpiration) and non-biological (interception loss, soil evaporation) fluxes of terrestrial evaporation via atmospheric circulation and precipitation is an important Earth system process. In vegetated ecosystems, transpiration dominates terrestrial evaporation and is thought to be crucial for regional moisture recycling and ecosystem functioning. However, the spatial and temporal variability in the dependency of precipitation on transpiration remains understudied, particularly in sparsely sampled regions like Africa. Here, we investigate how biological and non-biological sources of evaporation in Africa contribute to rainfall over the major watersheds in the continent. Our study is based on simulated atmospheric moisture trajectories derived from the Lagrangian model FLEXPART, driven by 1° resolution reanalysis data over 1981-2016. Using daily satellite-based fractions of transpiration over terrestrial evaporation, we isolate the contribution of vegetation to monthly rainfall. Furthermore, we highlight two watersheds (Congo and Senegal) for which we explore intra- and interannual variability of different precipitation sources, and where we find contrasting patterns of vegetation-sourced precipitation within and between years. Overall, our results show that almost 50% of the annual rainfall in Africa originates from transpiration, although the variability between watersheds is large (5%-68%). We conclude that, considering the current and projected patterns of land use change in Africa, a better understanding of the implications for continental-scale water availability is needed.

Short-term effects of drought on daily mortality in Spain from 2000 to 2009.

Spain is a country of southern Europe that is prone to drought, and it is likely that this type of hydrological extreme will become substantially more frequent and intense in the 21st century, which could lead to greater health risks if adequate adaptive measures are not taken. For the first time, we calculated the relative risks (RRs) of daily natural (ICD10: A00-R99), circulatory (ICD10: I00-I99), and respiratory (ICD: J00-J99) mortality associated with drought events in each province of Spain from 2000 to 2009. For this purpose, we compared the performance of the Standardized Precipitation Index (SPI) and Standardized Precipitation- Evapotranspiration Index (SPEI) obtained at 1 month of accumulation (denoted as SPI-1/SPEI-1) to estimate the short-term risks of droughts on daily mortality using generalised linear models. Attributable risks were calculated from the RR data. The main findings of this study revealed statistically significant associations between the different causes of daily mortality and drought events for the different provinces of Spain, and clear spatial heterogeneity was observed across the country. Western Spain (northwest to southwest) was the region most affected, in contrast to northern and eastern Spain, and daily respiratory mortality was the group most strongly linked to the incidence of drought conditions. Moreover, for a considerable number of provinces, the effect of SPI-1 and SPEI-1 largely reflected the impact of atmospheric pollution and/or heatwaves; however, for other regions, the effect of drought conditions on daily mortality remained when these different climatic events were controlled in Poisson models. When the performances of the SPEI and SPI were compared to identify and estimate the risks of drought on daily mortality, the results were very similar, although there were slight differences in the specific causes of daily mortality.

Measles and rubella seroprevalence in a population of young adult blood donors, France 2013.

As part of the evaluation of the French plan for the elimination of measles and rubella, we conducted a seroprevalence survey in 2013, aimed at updating seroprevalence data for people 18-32 years old. A secondary objective was to estimate measles incidence in this population during the 2009-2011 outbreak, and thus estimate the exhaustiveness of measles mandatory reporting. We used a cross-sectional survey design, targeting blood donors 18-32 years old, living in France since 2009, who came to give blood in a blood collecting site. We included 4647 people in metropolitan France, 806 people in Réunion Island and 496 in the French Caribbean. A further 3942 individuals were interviewed in the south-east region of metropolitan France to estimate the exhaustiveness of measles mandatory reporting. One of the main findings of this survey is that the proportion of people 18-32 years old susceptible to both measles and rubella infections remained high in France in 2013, 9.2% and 5.4%, respectively, in metropolitan France, even after the promotion campaigns about vaccination catch-up during and following the major measles epidemic in 2009-2011. Applying our results to French census data would suggest that around 1 million people aged 18-32 years old are currently susceptible to measles in France, despite this age group being one of the vaccination targets of the national measles elimination plan. Another important finding is that only an estimated 45% of the true number of cases in this age group was actually notified, despite notification being mandatory.

Empirical monotherapy with meropenem or combination therapy: the microbiological point of view.

The increase in the number of clinical isolates of multiresistant Enterobacteriaceae and Pseudomonas aeruginosa raises problems in decision-making on empirical treatments for severe Gram-negative bacilli-associated infections. The aim of our study is to determine the resistance of meropenem in our setting and the co-resistance of a combination of this compound with two antibiotics from different families: amikacin and ciprofloxacin. Between 2009 and 2013, a total of 81,310 clinical isolates belonging to the main species of Enterobacteriaceae and 39,191 clinical isolates of P. aeruginosa isolated in 28 hospitals in the Valencian Community on the South East Mediterranean Coast of Spain were analyzed using data provided by RedMiva (microbiological surveillance network of the Valencian Community). Meropenem resistance in Enterobacteriaceae increased from 0.16 % in 2009 to 1.25 % in 2013. Very few Enterobacteriaceae strains resistant to meropenem were sensitive to ciprofloxacin; in contrast, the combination of meropenem and amikacin led to a marked decrease in the risk of the microorganisms being resistant to both drugs (RR = 34 in 2013). In the case of P. aeruginosa, meropenem resistance also increased (from 14.32 % in 2009 to 24.52 % in 2013). Most meropenem-resistant P. aeruginosa isolates were also resistant to fluoroquinolones. However, the addition of amikacin led to a more than three-fold decrease in the risk of resistance. In our setting, empirical treatment with meropenem is adequate in enterobacterial infections, but poses difficulties when infection due to P. aeruginosa is suspected, in which case a combination of meropenem and amikacin has been shown to have a higher microbiological success rate.

French legislation on retrospective clinical research: What to know and what to do.

The French legislation on human subject research known as the Jardé law of 5th March 2012 has been applicable since November 2016. It concerns all research involving human subjects (RIPH, in French) and is defined according to 3 categories: high-risk interventional RIPH, low-risk interventional RIPH and non-interventional RIPH. This recent development in the supervision of research on human subjects had several objectives: to redefine the various categories of research, to strengthen data protection and to effectively address the ethical guidelines of international journals. The levels of constraint differ between categories of research according to level of risk, the common objective being to ensure patient protection. Retrospective studies based on information drawn from medical records or other databases, which are widely used in the surgical field, are not covered by the Jardé law. However, they require approval by local ethics committees and compliance with European legislation on personal data protection. Simplified procedures have been set up by the research and innovation departments in our university hospitals. In this update, we shall synthesize the legal prerequisites applying to retrospective studies on data from medical files.

Effects of Drought on Mortality in Macro Urban Areas of Brazil Between 2000 and 2019.

A significant fraction of Brazil's population has been exposed to drought in recent years, a situation that is expected to worsen in frequency and intensity due to climate change. This constitutes a current key environmental health concern, especially in densely urban areas such as several big cities and suburbs. For the first time, a comprehensive assessment of the short-term drought effects on weekly non-external, circulatory, and respiratory mortality was conducted in 13 major Brazilian macro-urban areas across 2000-2019. We applied quasi-Poisson regression models adjusted by temperature to explore the association between drought (defined by the Standardized Precipitation-Evapotranspiration Index) and the different mortality causes by location, sex, and age groups. We next conducted multivariate meta-analytical models separated by cause and population groups to pool individual estimates. Impact measures were expressed as the attributable fractions among the exposed population, from the relative risks (RRs). Overall, a positive association between drought exposure and mortality was evidenced in the total population, with RRs varying from 1.003 [95% CI: 0.999-1.007] to 1.010 [0.996-1.025] for non-external mortality related to moderate and extreme drought conditions, from 1.002 [0.997-1.007] to 1.008 [0.991-1.026] for circulatory mortality, and from 1.004 [0.995-1.013] to 1.013 [0.983-1.044] for respiratory mortality. Females, children, and the elderly population were the most affected groups, for whom a robust positive association was found. The study also revealed high heterogeneity between locations. We suggest that policies and action plans should pay special attention to vulnerable populations to promote efficient measures to reduce vulnerability and risks associated with droughts.

Drought effects on specific-cause mortality in Lisbon from 1983 to 2016: Risks assessment by gender and age groups.

Portugal (Southwestern Europe) experiences a high incidence of dry hazards such as drought, a phenomenon that entails a notable burden of morbidity and mortality worldwide. For the first time in the Lisbon district, a time-series study was conducted to evaluate the impact of drought measured by the Standardised Precipitation Index (SPI) and Standardised Precipitation-Evapotranspiration Index (SPEI) on the daily natural, circulatory, and respiratory mortality from 1983 to 2016. An assessment by gender and adult age population groups (45-64, 65-74, ≥75 years old) was included. To estimate the relative risks and attributable risks, generalised linear models with a Poisson link were used. Additionally, the influence of heatwaves and atmospheric pollution for the period from 2007 to 2016 (available period for pollution data) was considered. The main findings indicate statistically significant associations between drought conditions and all analysed causes of mortality. Moreover, SPEI shows an improved capability to reflect the different risks. People in the 45-64 year-old group did not indicate any significant influence in any of the cases, whereas the oldest groups had the highest risk. The drought effects on mortality among the population varied across the different study periods, and in general, the men population was affected more than the women population (except for the SPEI and circulatory mortality during the long study period). The short-term influence of droughts on mortality could be explained primarily by the effect of heatwaves and pollution; however, when both gender and age were considered in the Poisson models, the effect of drought also remained statistically significant when all climatic phenomena were included for specific groups of the total population and men. This type of study facilitates a better understanding of the population at risk and allows the development of more effective measures to mitigate the drought effects on the population.

Effects on daily mortality of droughts in Galicia (NW Spain) from 1983 to 2013.

Climate change scenarios indicate an increase in the intensity and frequency of droughts in several regions of the world in the 21st century, especially in Southern Europe, highlighting the threat to global health. For the first time, a time-series diagnostic study has been conducted regarding the impact of droughts in Galicia, a region in north-western Spain, on daily natural-cause mortality, daily circulatory-cause mortality, and daily respiratory-cause mortality, from 1983 to 2013. We analysed the drought periods over the area of interest using the daily Standardized Evapotranspiration-Precipitation Index (SPEI) and the daily Standardized Precipitation Index (SPI), obtained at various timescales (1, 3, 6, 9 months), to identify and classify the intensity of drought and non-drought periods. Generalized linear models with the Poisson regression link were used to calculate the Relative Risks (RRs) of different causes of mortality, and the percentage of Attributable Risk Mortality (%AR) was calculated based on RRs data. According to our findings, there were statistically significant (p < 0.05) associations between drought periods, measured by both the daily SPEI and SPI, and daily mortality in all provinces of Galicia (except Pontevedra) for different timescales. Furthermore, drought periods had a greater influence on daily mortality in the interior provinces of Galicia than in the coastal regions, with Lugo being the most affected. In short term, the effect of droughts (along with heatwaves) on daily mortality was observed in interior regions and was mainly explained by atmospheric pollution effect throughout 2000 to 2009 period in Ourense, being respiratory causes of mortality the group most strongly associated. The fact that droughts are likely to become increasingly frequent and intense in the context of climate change and the lack of studies that have considered the impact of droughts on specific causes of mortality make this type of analysis necessary.

Four glycoproteins are expressed in the cat zona pellucida.

The mammalian oocyte is surrounded by a matrix called the zona pellucida (ZP). This envelope participates in processes such as acrosome reaction induction, sperm binding and may be involved in speciation. In cat (Felis catus), this matrix is composed of at least three glycoproteins called ZP2, ZP3, and ZP4. However, recent studies have pointed to the presence of a fourth protein in several mammals (rat, human, hamster or rabbit), meaning that a reevaluation of cat ZP is needed. For this reason, the objective of this research was to analyze the protein composition of cat ZP by means of proteomic analysis. Using ZP from ovaries and oocytes, several peptides corresponding to four proteins were detected, yielding a coverage of 33.17%, 71.50%, 50.23%, and 49.64% for ZP1, ZP2, ZP3, and ZP4, respectively. Moreover, the expression of four genes was confirmed by molecular analysis. Using total RNA isolated from cat ovaries, the complementary deoxyribonucleic acids encoding cat ZP were partially amplified by reverse-transcribed polymerase chain reaction. Furthermore, ZP1 was totally amplified for the first time in this species. As far as we are aware, this is the first study that confirms the presence of four proteins in cat ZP.

Study of Fgf15 gene expression in developing mouse brain.

Fibroblast growth factor 15 (Fgf15) is a gene regulated by the expression of Otx2 in developing mouse brain (Proc Natl Acad Sci USA 97 (2000) 14388). Otx2 gene codes for a transcription factor and is fundamental for the regionalisation and development of the anterior neural plate and cephalic region of the vertebrate embryo (Development 124 (1997) 3639). In addition, the thalamic expression of Fgf15 has been recently reported under the control of Shh signalling gene, expressed in the diencephalic basal plate (Development 129 (2002) 4807). In the present work, we have analysed Fgf15 expression pattern during mouse neural development. Fgf15 appeared early in the developing neural epithelium, in domains where Fgf8 gene is also expressed and, at later stages, in specific groups of neural cells. Fgf8 is an important signalling protein with demonstrated morphogenetic activity in several embryonic regions. Fgf15 expression is localized, like Fgf8, in secondary neural tube organizers: the isthmic organizer (IsO) and the anterior neural ridge (ANR).

Ezrin gene, coding for a membrane-cytoskeleton linker protein, is regionally expressed in the developing mouse neuroepithelium.

Ezrin is a member of the Ezrin, Radixin, Moesin (ERM) proteins family that are proposed to act as linkers between the cytoskeleton and plasma membrane. Ezrin regulates cell-cell and cell-matrix interactions playing a role in the regulation of cellular adhesion, movement and morphology in epithelia. Alterations in the expression of Ezrin and other members of ERM family have also been observed in brain tumours. Here we report the expression pattern of Ezrin during mouse neural development, from early stages to postnatal stages. In young and middle gestation embryos, Ezrin is expressed in the roof plate of the neural tube, in the presumptive domain of the choroidal plexus, and in some precise domains of ventricular epithelium. These domains are distributed in basal and alar neuroepithelial regions, some of them in relation to the expression of cadherins. At later gestation and postnatal stages, Ezrin expression is maintained on the mature choroidal plexus and is weakly detected in the proliferative regions of the mature brain.

Therapy of visceral leishmaniasis in renal transplant recipients intolerant to pentavalent antimonials.

Visceral leishmaniasis should be suspected in renal transplant recipients in whom a fever develops of unknown origin. A 53-year-old renal transplant recipient developed pyrexia, hepatosplenomegaly, and pancytopenia 4 years after transplantation. Antileishmaniasis serology was negative, and the diagnosis was confirmed through bone marrow examination. Treatment with glucantine (N-methylglucamine antimoniate) led to acute pancreatitis, and treatment with ketoconazole plus allopurinol for 21 days was effective to eradicate Leishmania donovani.

Analysis of Fgf15 expression pattern in the mouse neural tube.

The dynamic process of neural tube regionalization in vertebrates is regulated by the expression of developmental genes which appear in characteristic patterns at neuroepithelial transversal domains, which are called secondary organizers. The molecular code present in these neuroepithelial organizers controls the generation of morphogenetic signals that induce and maintain regional characteristics in the surrounding neuroepithelium. The product of the Fgf8 gene is a secreted protein that has been demonstrated to be the key molecule for the isthmic organizer and is also expressed in two other organizer regions: the zona limitans and the anterior neural ridge. Here we analyze the expression of Fgf15 at different stages of mouse development in relation to Fgf8 and Otx2 expression patterns.

How effective has been the reduction of SO2 emissions on the effect of acid rain on ecosystems?

The paper attempts to assess the effectiveness of the reduction of SO2 emissions over recent years for protection of ecosystems in both Europe and eastern USA by analysis of temporal changes in the acidifying potential (AP) of wet deposition defined as [SO4(2-)] - ([Ca2+] + [Mg2+]). Spatial and temporal patterns of acidifying potential were studied. The main result is that there is no statistical evidence for a trend towards improvement in the acidifying potential, because there have been declines in Ca precipitation. This suggests that the reduction of SO2 emissions has not been effective as an abatement strategy.

[The value of symptoms in the diagnosis of peptic ulcer: an approximation to the primary care medium]. / Valor de los síntomas en el diagnóstico de la úlcera péptica: una aproximación al medio primario.

GOAL: To evaluate which clinical data are useful to select those patients with peptic ulcers in primary care most likely to benefit from complementary studies. METHODS: This is a prospective study done on 101 patients evaluated in a period of a year in a Primary Care Center. In all patients an endoscopy was done when a peptic ulcer was considered a possibility. In all cases a standardized questionnaire was completed before endoscopy and the patient evaluated by his primary care physician. The final diagnosis was defined according to endoscopy, done by expert endoscopists within seven days of the clinical evaluation. Statistical analysis was undertaken with SPSS software. RESULTS: An active peptic ulcer was found in 45 (44.5%) cases. A high-grade MALT lymphoma was diagnosed in one case. Male sex, smoking status, number of cigarettes, smoking-index, and a previous history of ulcer complications were significantly associated with the diagnosis, as well as severe diurnal or nocturnal pain. Mean age was lower in ulcer patients. However no clinical data in individual or combined form did show any predictive value. CONCLUSIONS: Clinical data do not permit to obviate endoscopy as the key initial procedure to diagnosis, even in primary care.

[Demand of community health services in the periphery of a metropolitan area]. / Demanda de serviço de saúde comunitária na periferia de área metropolitana.

The content of 4,319 consultations in primary health care representing 7% of all consultations from March, 1985 to March, 1986 at the Murialdo Health Center, was analyzed. The health center is located in the outskirts of Porto Alegre, RS (Brazil). Woman represented 67% of the total demand. Most consultations were for children under 10 years of age (37%) and woman of childbearing age (21%). The first twenty reasons for the visit corresponded to 63% of the total, and the most common reason for visiting the health center was for renewal of prescriptions and/or ordering medication (9.3%). Of all the diagnoses, the first twenty accounted for 62% of the total number of patients and the most frequent were: hypertension (8.8%), upper respiratory tract infection (7.8%), and immunization (5.5%). Prescription and administration of medication were the most common actions performed. Referrals resulted in 7.3% of the visits. Of these, 5% were sent to other providers within the Murialdo service. Only 0.6% were referred for hospitalization. These findings, combined with others which describe aspects of morbimortality not easily measured in studies of spontaneous demand for medical services, should help in the planning of primary health care services and in the training of health personnel.

Eradication of helicobacter pylori among patients from a primary care practice.

BACKGROUND: The eradication of Helicobacter pylori is becoming the therapy of choice for peptic ulcers, if the infection is present. Published data from primary care settings are, however, limited. METHODS: An open-ended, prospective study was undertaken that included 31 patients with active peptic ulcer demonstrated by endoscopy and H pylori infection confirmed by urease and histologic tests. After a 14-day period of treatment with omeprazole, bismuth, tetracycline, and metronidazole, healing and H pylori status were evaluated by repeat endoscopy done at least 28 days after the last treatment dose. Eradication is defined as absence of H pylori in at least four (two from the fundus and two from the antrum) samples taken from the gastric mucosa and a negative urease test. Drug side effects and patient compliance were monitored in all cases. RESULTS: Twenty-eight patients completed the protocol. Healing was obtained in all cases, and eradication was accomplished in 25 (89%). Side effects were common (69%) but mild. Compliance was good. After a mean follow-up of 300 days (range, 180 to 400), one ulcer recurrence was observed in an H pylori-positive patient and none in H pylori-negative patients. CONCLUSIONS: The treatment of H pylori infection is an effective way of healing peptic ulcers, and can be applied in primary care settings. Further studies with more patients and with shorter and easier therapies should be undertaken to confirm our findings.

[Testicular microcirculation in rats measured with laser-Doppler flowmetry]. / Microcirculación testicular en la rata medida mediante flujometría laser doppler.

Study carried out in 50 male Wistar rats distributed into 5 groups: baseline and at 2, 4, 8 and 24 hours after subcutaneous injection of Human Chorionic Gonadotropin, 100 IU. It was observed that testicular microcirculatory flow shows a rhythmical fluctuating pattern (5-10 fluctuations per minute), which becomes continuous at 4 hours but recovers at 24 hours. At the same time, there is an increased volume of testicular interstitial fluid that peaks at 8 hours, and returns to baseline levels at 24 hours. Serum testosterone values increase with HCG injection, reaching a peak at 4 hours (25.9 mg/ml), to return to nearly baseline levels at 24 hours (5.04 mg/ml). Disappearance of the rhythmical microcirculatory pattern, and the increase of interstitial fluid volume do not appear to be mediated by testosterone, since the raise in hormone levels, occurred after HCG administration, preceded the observed microcirculatory changes.