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An updated and complete landslide inventory is the starting point for an appropriate hazard assessment. This paper presents an improvement for landslide mapping by integrating data from two well-consolidated techniques: Differential Synthetic Aperture Radar (DInSAR) and Landscape Analysis through the normalised channel steepness index (ksn). The southwestern sector of the Sierra Nevada mountain range (Southern Spain) was selected as the case study. We first propose the double normalised steepness (ksnn) index, derived from the ksn index, to remove the active tectonics signal. The obtained ksnn anomalies (or knickzones) along rivers and the unstable ground areas from the DInSAR analysis rapidly highlighted the slopes of interest. Thus, we provided a new inventory of 28 landslides that implies an increase in the area affected by landslides compared with the previous mapping: 33.5% in the present study vs. 14.5% in the Spanish Land Movements Database. The two main typologies of identified landslides are Deep-Seated Gravitational Slope Deformations (DGSDs) and rockslides, with the prevalence of large DGSDs in Sierra Nevada being first revealed in this work. We also demonstrate that the combination of DInSAR and Landscape Analysis could overcome the limitations of each method for landslide detection. They also supported us in dealing with difficulties in recognising this type of landslides due to their poorly defined boundaries, a homogeneous lithology and the imprint of glacial and periglacial processes. Finally, a preliminary hazard perspective of these landslides was outlined. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study. Methods: Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission. Results: Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05–2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts. Conclusion: These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss. [ABSTRACT FROM AUTHOR]

Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans’ syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients. [ABSTRACT FROM AUTHOR]

(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5–58.9) to 57.1 (44.1–67.1) vs. 71.5 (59.5–81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10–0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17–1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26–2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21–1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often. [ABSTRACT FROM AUTHOR]

The individual influence of a variety of comorbidities on COVID-19 patient outcomes has already been analyzed in previous works in an isolated way. We aim to determine if different associations of diseases influence the outcomes of inpatients with COVID-19. Retrospective cohort multicenter study based on clinical practice. Data were taken from the SEMI-COVID-19 Registry, which includes most consecutive patients with confirmed COVID-19 hospitalized and discharged in Spain. Two machine learning algorithms were applied in order to classify comorbidities and patients (Random Forest -RF algorithm, and Gaussian mixed model by clustering -GMM-). The primary endpoint was a composite of either, all-cause death or intensive care unit admission during the period of hospitalization. The sample was randomly divided into training and test sets to determine the most important comorbidities related to the primary endpoint, grow several clusters with these comorbidities based on discriminant analysis and GMM, and compare these clusters. A total of 16,455 inpatients (57.4% women and 42.6% men) were analyzed. According to the RF algorithm, the most important comorbidities were heart failure/atrial fibrillation (HF/AF), vascular diseases, and neurodegenerative diseases. There were six clusters: three included patients who met the primary endpoint (clusters 4, 5, and 6) and three included patients who did not (clusters 1, 2, and 3). Patients with HF/AF, vascular diseases, and neurodegenerative diseases were distributed among clusters 3, 4 and 5. Patients in cluster 5 also had kidney, liver, and acid peptic diseases as well as a chronic obstructive pulmonary disease; it was the cluster with the worst prognosis. The interplay of several comorbidities may affect the outcome and complications of inpatients with COVID-19. [ABSTRACT FROM AUTHOR]

Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140–180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140–180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31–1.73) (BG 140–180 mg/dL; HR 1.48; 95%CI: 1.29–1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes. [ABSTRACT FROM AUTHOR]

When an active landslide is first identified in an artificial reservoir, a comprehensive study has to be quickly conducted to analyse the possible hazard that it may represent to such a critical infrastructure. This paper presents the case of the El Arrecife Landslide, located in a slope of the Rules Reservoir (Southern Spain), as an example of geological and motion data integration for elaborating a preliminary hazard assessment. For this purpose, a field survey was carried out to define the kinematics of the landslide: translational in favour of a specific foliation set, and rotational at the foot of the landslide. A possible failure surface has been proposed, as well as an estimation of the volume of the landslide: 14.7 million m3. At the same time, remote sensing and geophysical techniques were applied to obtain historical displacement rates. A mean subsidence rate of the landslide around 2 cm/year was obtained by means of synthetic aperture radar interferometry (InSAR) and ground-penetrating radar (GPR) data, during the last 5 and 22 years, respectively. The structure-from-motion (SfM) technique provided a rate up to 26 cm/year during the last 14 years of a slag heap located within the foot of the landslide, due to compaction of the anthropical deposits. All of this collected information will be valuable to optimise the planning of future monitoring surveys (i.e. differential global positioning systems, inclinometers, ground drilling, and InSAR) that should be applied in order to prevent further damage on the reservoir and related infrastructures. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay.Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine's registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100.Results: A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays.Conclusions: In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed. [ABSTRACT FROM AUTHOR]

ABSTRACT Three-dimensional ground-penetrating radar (3D-GPR) is one of the highest resolution geophysical methods for exploring the shallow subsurface and it is widely utilized in the diverse fields requiring this kind of information: for example archaeology, civil engineering and environmental studies. Currently, there are several ways to present 3D-GPR results: 2D vertical pictures (radargrams), time- and depth-slices, a mixture of radargram-slice images, GPR reflectivity maps and GPR isosurface images. All of these techniques, however, require the maximum number of details possible. When the recognition surface is not horizontal, the GPR image is distorted due the topographic irregularities. To eliminate these distortions, a classic topographic correction is applied to the GPR data set, particularly in 2D GPR profiles. Generally, this topographic information is obtained by laser levelling, total station, differential Global Positioning System (GPS) or similar equipment. This study uses a new method of topographic correction based on three-dimensional laser scanner (3D-laser scanner) technology that provides ultradense coordinates of the terrain. A strategy for applying this topographic correction to 3D-GPR vertical traces is discussed and evaluated by comparing corrected images with other uncorrected images obtained using the same standard processing flow. The GPR dataset used to test this method is from a monumental structure located in the Celtiberian site of Segeda I (Mara, Spain). The data were acquired using a 400 MHz antenna on 0.25 m spaced profiles. Although the relief of this structure is not overly complex, we demonstrate how the results obtained by applying this topographic correction technique allow a better archaeological interpretation of the internal architecture. The technique is therefore presented as a new archaeological tool to obtain clearer images of buried structures and/or their internal elements. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: We demonstrate that the age of 43ka obtained for the topmost calcrete layer in the Guadix-Baza remains the only reliable numerical dating of the flat geomorphic surface that marks the end of the sedimentation in the basin. Consequently, the late Pleistocene to Holocene erosion rates derived from the incision of the present-day drainage network into the flat geomorphic surface remain valid. The calcrete radiometric ages reported by Díaz-Hernández and Julià (2012) in their comment are untenable due to the contamination with detrital 230Th (not corrected with the applied U/Th technique) and the possible mix of textural elements with different ages (older inherited grains and newly formed grains). Díaz-Hernández and Julià also quote U/Th ages for travertine terraces formed later than the calcrete layer. These ages lack internal consistency probably due to systematic contamination and/or weathering of the samples. The archaeological ages reported by Díaz-Hernández and Julià are subjected to great uncertainties, but independently of the age assumed as most realistic, they are completely compatible with the age of 43ka that we obtained for the topmost calcrete layer in the Guadix-Baza basin. [Copyright &y& Elsevier]

The late Holocene in the central Ebro Depression is characterized by a number of morphodynamic stages that affected hillslopes and channels. Climate fluctuations and human activities together caused severe erosion and floods, resulting in alternating stages of accumulation and incision in the valley floors. Seven accumulation levels (N6-N0) correlated with Ebro River fluvial terraces have been identified in the secondary fluvial network of the central Ebro Depression. The main accumulation level (N3) corresponds to a long period of increased hillslope erosion and sedimentation in the valleys, from the Neolithic to the late Roman periods. The accumulation levels are evident throughout the valleys and extend to the valley mouths, where many connect with alluvial fans. The study of several sedimentological profiles, 14C AMS dating, and many archaeological remnants, have enabled detailed assessment of sedimentation characteristics in the alluvial fans and the relationship thereof to the presence of human settlements. Four sedimentation stages have been identified: (i) pre-Bronze Age (> 3800 years BP), (ii) Bronze Age/Iron Age (3800-2500 years BP), (iii) Roman/post-Roman period (2500-1500 years BP), and, (iv) the early Middle Ages, mainly during the Visigothic period (sixth century). The sedimentation dynamics of the alluvial fans are related to: (i) climate variability, (ii) human activities in the watershed, and (iii) the meandering character of the Ebro River, which has lateral displacements that change the local base level of tributaries and fans. Level N3 in the valley floors corresponds to stages i-iii of the alluvial fans, which are mostly related to human-induced transformation of characteristics of the secondary basins, coinciding with enhanced erosion under favorable (warm and humid) climatic conditions. In contrast, the Medieval stage, which corresponds to level N2 in the valleys, was caused by floods during a period of high climatic variability. [ABSTRACT FROM AUTHOR]

Fluvial piracy in the Guadix-Baza basin (southeast Spain) promoted erosion of a high volume of sediments during the late Quaternary, after the former internal drainage of this basin changed to external due to headward erosion by the Guadalquivir River. As a response to load release, this basin underwent uplift, which, in turn, enhanced fl uvial incision and erosional processes. Differential erosion within the Guadix-Baza basin resulted in dissimilar isostatic rebound. We numerically model the lithospheric response to sediment unloading and show a total rising of 15 m in the Guadix subbasin compared to 2 m in the Baza subbasin. This differential uplift is likely to have been accommodated along the Baza normal fault, which has been active throughout the Quaternary. Modeling results suggest that ∼13% of the total Quaternary fault throw directly arises from the differential isostatic readjustment between subbasins. This example is one of the fi rst estimates of fault slip partitioning between tectonic and isostatic effects due to unloading driven by river incision. [ABSTRACT FROM AUTHOR]

Abstract: The Sierra Nevada of the central Betic Cordillera is a 3000m-high mountain range surrounded by Neogene–Quaternary sedimentary basins, having been uplifted since Late Miocene times. The southern and western mountain fronts of the Sierra Nevada are fault-bounded, while the northern one is an unconformity between the Neogene–Quaternary sediments of the Guadix–Baza basin and the metamorphic rocks of the Nevado–Filabride complex. We have carried out a geomorphic study by examining drainage patterns and characteristics of mountain fronts in order to reveal areal variations and styles of rock uplift. Mountain front sinuosity (S mf), area–altitude relations (hypsometric curves), and valley floor entrenchment differ significantly between the northern, western, and southern mountain fronts. The lack of important faults along the northern Sierra Nevada mountain front, together with the elevated topographic position of the Guadix–Baza basin (average altitude is around 1100m), points to similar uplift of both geomorphic units (sierra and basin) in a single large-scale crustal block. The asymmetry factors show systematic asymmetries at both sides of the Lanjarón River, probably due to the presence of an active NNE–SSW oriented antiform in the western Sierra Nevada. Finally, river profiles indicate maximal river entrenchment in the western part of the Sierra Nevada, probably related to the uplift of the footwall of the Padul–Nigüelas fault-system. Therefore, our geomorphic analysis suggests that the western part of the Sierra Nevada is tectonically active by means of a combination of normal faults along the mountain front and NNE–SSW oriented active folds, which, in turn, likely have a gravitational origin related to the exhumation of the footwall of the normal fault-system. [Copyright &y& Elsevier]

Abstract: The landscape evolution in Neogene intramontane basins is a result of the interaction of climatic, lithologic, and tectonic factors. When sedimentation ceases and a basin enters an erosional stage, estimating erosion rates across the entire basin can offer a good view of landscape evolution. In this work, the erosion rates in the Guadix–Baza basin have been calculated based on a volumetric estimate of sediment loss by river erosion since the Late Pleistocene. To do so, the distribution of a glacis surface at ca. 43 kyr, characterised by a calcrete layer that caps the basin infilling, has been reconstructed. To support this age, new radiometric data of the glacis are presented. The volume of sediment loss by water erosion has been calculated for the entire basin by comparing the reconstructed geomorphic surface and the present-day topography. The resulting erosion rates vary between 4.28 and 6.57 m3 ha−1 yr−1, and are the consequence of the interaction of climatic, lithologic, topographic, and tectonic factors. Individual erosion rates for the Guadix and Baza sub-basins (11.80 m3 ha−1 yr−1 and 1.77 m3 ha−1 yr−1 respectively) suggest different stages of drainage pattern evolution in the two sub-basins. We attribute the lower values obtained in the Baza sub-basin to the down-throw of this sub-basin caused by very recent activity along the Baza fault. [Copyright &y& Elsevier]

Abstract: Active deformation structures have an incidence in topography that can be quantified by using geomorphic indices. Most of these indices have been checked in faulted regions with high-deformation rates. The application of several geomorphic indices (hypsometric curve analysis, normalized stream-length gradient, and valley width-to-valley height ratio) to the drainage network of the southern limb of the Sierra de Las Estancias antiform (Internal Zones, eastern Betic Cordillera), where low-rate active folding has been recognized, allows us to investigate the suitability of these indices to identify active structures in such a scenario. Hypsometric curves clearly identify regions with recent uplift and young topography, but they do not provide any constraint on the location of active folds. Local valley width-to-valley height index variations have been detected just coinciding whit the position of ENE–WSW active folds. Normalized stream-length gradient index serves to locate active folds in areas of hard rock substratum, but not in those areas with soft sediments (Neogene-Quaternary sedimentary basins). This is most likely due to the fact that in the basins erosion is much more intense than in the hard rock sectors. In view of these results, we consider that geomorphic indices constitute a valuable tool for identifying sectors affected by low-rate uplift related to active folding, with the best results obtained in hard rock areas. [Copyright &y& Elsevier]

This work analyzes the spatial heterogeneity of consanguinity in the Basque province of Guipúzcoa (Spain), using data provided by Catholic dispensations (1862–1980). Secular trends in consanguinity rates (%MC) and mean inbreeding coefficient ( &Fmacr; ) were similar in the seven Guipúzcoan regions considered, with peaks between 1881–1920 and subsequently a gradual decline. Substantial differences in consanguinity characteristics emerged when the regions were classified according to level of urbanization. Principal component analysis (accounting for more than 85% of the total variance in consanguinity variables) clearly discriminated between urbanized and less urbanized regions. The latter stand out for their high consanguinity rates (3.57–6.73%), mean inbreeding coefficient (0.00112–0.00240), and M22/M33 ratio (M22, first cousins; M33, second cousins), which ranged between 0.89–1.48. Moreover, in less urbanized regions, marital consanguinity was eminently local, and mainly conditioned by regional endogamy (71.4–85.0%). By contrast, urban subpopulations showed the lowest consanguinity rates (1.60–1.96%) and mean inbreeding coefficient (around 0.0007). In these regions, the M22/M33 ratio also exhibited high values (1.07–1.56), but this time at the expense of the contribution of the immigrant group. Discussion of the factors that could have modeled this spatial variation in consanguinity centers on: 1) demographic aspects related to the chronology and intensity of industrialization, 2) the geography of the territory and the geography of peopling, and 3) linguistic differences, expressed in the uneven distribution of Basque-speakers among the different territories considered. [ABSTRACT FROM AUTHOR]

Early diagenetic K-feldspar in the Triassic Buntsandstein of the Iberian Range (Spain) occurs as pseudomorphs after detrital K-feldspar (or <93) and plagioclase (Ab<96). These pseudomorphs are chemically pure (Or>99), untwined, commonly heavily clouded by vacuoles and tiny inclusions, dark-luminescing and are composed of numerous fine euhedral crystals of K-feldspar. The latter property suggests that the pseudomorphs form via dissolution of detrital K-feldspar and plagioclase and precipitation of authigenic K-feldspar. X-ray diffraction analysis shows that the authigenic K-feldspar is intermediate microcline. [ABSTRACT FROM AUTHOR]

Non-destructive techniques are widely used to explore and detect burial remains in archaeological sites. In this study, we present two sets of sensors, aerial and geophysics, that we have combined to analyze a 2 ha sector of ground in the Torreparedones Archaeological Park located in Cordoba, Spain. Aerial platforms were used in a first step to identify a Roman amphitheater located near the Roman city. To ensure greater reliability and to rule out geological causes, a geophysical survey was subsequently carried out. Magnetic gradiometer, electrical resistivity tomography (ERT), and ground-penetrating radar (GPR) methods were also used to confirm the existence of this structure, define the geometry and, to the greatest possible extent, determine the degree of preservation of this construction. The adverse conditions for data acquisition was one of the main constraints, since the area of interest was an almond plantation which conditioned geophysical profiles. In addition, due to the low dielectric and magnetic contrast between the structures and the embedding material, meticulous data processing was required. In order to obtain further evidence of this amphitheater and to corroborate the aerial images and the geophysical models, an archaeological excavation was carried out. The results confirmed the cross-validation with the predicted non-destructive models. Therefore, this work can serve as an example to be used prior to conservation actions to investigate the suburbs and landscapes near similar roman cities in Spain. [ABSTRACT FROM AUTHOR]

Brucella spp. should be considered in the differential diagnosis of acute meningitis of children living in areas where brucellosis is endemic. [ABSTRACT FROM AUTHOR]

The object of this study was to analyze the role of information and communication technology (ICT) from the faculty's perspective. With a qualitative focus, a discussion group was used as the methodology and the nvivo software as the facilitator in the process of analyzing the information produced. Through qualitative methodology, the discussion group debated the use of ICT as a subject of learning and a teaching resource. A series of perceived weaknesses should be considered in possible improvements, especially in the settings of teacher training and student motivation. The study proved the need to eliminate the resistance to new technologies in order to minimize the effects of the digital gap, and to develop, through permanent learning, ways to train citizens who are more integrated into society, especially at older ages. [ABSTRACT FROM AUTHOR]

Abstract: In this study, allelic frequencies of the CODIS core short tandem repeat (STR) loci were estimated in a population sample consisting in 101 unrelated healthy autochthonous individuals from the Basque province of Alava (Northern Spain). Frequency distributions for all 13 STR loci were obtained using the AmpFlSTR Profiler Plus and AmpFlSTR COfiler amplification kits. The allelic frequencies generated were employed to calculate genetic and forensic useful parameters. [Copyright &y& Elsevier]

Abstract: Active tectonic deformation influencing the streams and hillslopes of the Sierra Alhamilla ridge (anticlinorium) in southeast Spain is related to the dextral-reverse Polopos Fault Zone to the north and east of the ridge and to normal faulting in the southern side of the ridge. A fault segmentation and fluvial terrace mapping is presented in this paper. The following geomorphic indices were calculated in the area: the mountain-front sinuosity, valley floor width-to-height ratio, drainage basin asymmetry factor, basin hypsometric curve and integral, longitudinal river profile and stream-length gradient index normalized by the graded river gradient (SLk index). The SLk map shows two sets of high anomalies: a) an E–W-striking anomaly, due to the dextral-reverse Polopos Fault Zone located in the northern limb of the anticlinorium; b) a group of NNW–SSE-striking anomalies, associated with Pliocene–Quaternary NW–SE- to NNW–SSE-striking high-angle normal faults that cut the southern limb. Late Pleistocene–Holocene activity occurred along the North Alhamilla Reverse Fault and the dextral transpressive South Gafarillos Fault, two segments in the Polopos Fault Zone. The former fault produces rejuvenation of the streams at the base of the northern slope. In this area, mountain-front sinuosity and valley floor width-to-height ratio suggest Quaternary uplift rates between 0.05 and 0.5mky−1. Holocene to present-day activity of the South Gafarillos Fault is demonstrated by faulted late Pleistocene terraces and Holocene colluvial deposits and suggested by deflected streams that have complex or convex hypsometric curves. Pliocene–Quaternary high-angle normal faults control the relief in the southern limb and the western end of the Sierra Alhamilla. These faults produce low mountain-front sinuosity and valley floor width-to-height ratio indices typical of uplift rates quite higher than field-based rates from some other studies. [Copyright &y& Elsevier]

Abstract: The recent evolution of the Adra River delta in southeastern Spain has been reconstructed from historical maps, aerial photographs, and submarine multibeam bathymetric data. We have distinguished three main evolutionary stages whose development took place as a direct response to the main anthropic and natural influences on the river system. The first stage (4000BC to 1872AD) represents the natural behavior of the deltaic system with negligible anthropic influence. This long stage is characterized by coastline advance with the formation of a small asymmetric triangular delta in the natural river mouth and a typical prodeltaic deposit. In contrast, the second and third stages are characterized by anthropic interventions in the catchment and the river mouth, which heavily modified the natural dynamics of the deltaic system. The second stage (1872AD to 1972AD) coincided with damming of the natural river channel very close to its mouth and the construction of two successive artificial channels to deviate the river flow. The coastal dynamics changed during this second stage with erosion of the original delta and the formation of a new, asymmetrical delta at the mouth of the artificial channels. This younger eastern delta comprises two infralittoral wedges in the submarine realm, which recorded changes of lateral redistribution processes and enhanced influence of energetic events and can only be explained if the sediment supply from the river source was reduced during this period. The third stage (1972AD to present-day) started with the damming of the trunk river in the central sector of the catchment, thus drastically reducing sediment flow to the coastal realm and triggering general erosion and coastline retreat. [Copyright &y& Elsevier]

Abstract: We correlate Upper Pleistocene glacial and fluvial deposits of the Cinca and Gállego River valleys (south central Pyrenees and Ebro basin, Spain) using geomorphic position, luminescence dates, and time-related trends in soil development. The ages obtained from glacial deposits indicate glacial periods at 85±5 ka, 64±11 ka, and 36±3 ka (from glacial till) and 20±3 ka (from loess). The fluvial drainage system, fed by glaciers in the headwaters, developed extensive terrace systems in the Cinca River valley at 178±21 ka, 97±16 ka, 61±4 ka, 47±4 ka, and 11±1 ka, and in the Gállego River valley at 151±11 ka, 68±7 ka, and 45±3 ka. The times of maximum geomorphic activity related to cold phases coincide with Late Pleistocene marine isotope stages and Heinrich events. The maximum extent of glaciers during the last glacial occurred at 64±11 ka, and the terraces correlated with this glacial phase are the most extensive in both the Cinca (61±4 ka) and Gállego (68±7 ka) valleys, indicating a strong increase in fluvial discharge and availability of sediments related to the transition to deglaciation. The global Last Glacial Maximum is scarcely represented in the south central Pyrenees owing to dominantly dry conditions at that time. Precipitation must be controlled by the position of the Iberian Peninsula with respect to the North Atlantic atmospheric circulation system. The glacial systems and the associated fluvial dynamic seem sensitive to 1) global climate changes controlled by insolation, 2) North Atlantic thermohaline circulation influenced by freshwater pulses into the North Atlantic, and 3) anomalies in atmospheric circulation in the North Atlantic controlling precipitation on the Iberian Peninsula. Our scenario of glacial and fluvial evolution during the Late Pleistocene in northern Spain could be extrapolated to other glaciated mountainous areas in southern Europe. [Copyright &y& Elsevier]

Examines the use of lopinavir/ritonavir as a single-drug therapy for maintenance of HIV-1 viral suppression by researchers from Madrid, Spain. Evaluation of the maintenance with lopinavir/ritonavir monotherapy against continuing polinavir/ritonavir combined with 2 nucleosides; Indications showing most patients maintained with lopinavir/ritonavir monotherapy remain with undetectable viral load after 48 weeks; Significance of the study on the development of novel treatment approaches in the management of HIV-1 infection.

In this work, we prove the usefulness of morphometric analyses, typically applied to basin-border faults, to define the tectonic geomorphology of a slow-moving, intrabasinal structure: the Galera Fault (Guadix-Baza Basin, southern Spain). The Galera Fault is a 30 km-long, oblique-slip fault with major left-lateral and minor vertical slip components. Through geological and structural analyses, we define for the first time the detailed surface geometry of the fault, which is characterized by features typical of left-lateral strike-slip faults. The morphometric analysis indicates that a combination of slow slip rates and the high erodibility of the juxtaposed basin infill deposits favours a rapid landscape response to fault activity that erases many landscape effects related to active tectonics. This masking is more effective on features generated by strike-slip displacement, leaving only subtle evidence, such as local stream deflections and upstream widening of catchments. In contrast, geomorphic effects related to vertical displacement are better preserved, including the control of the geometry of the main rivers and morphological differences in the drainage network between the two fault blocks. On the upthrown fault block, streams are generally shorter and steeper and have greater valley incision, leading to the development of a badland landscape. Moreover, the vertical deformation of a Middle Pleistocene glacis surface (ca. 90 m) demonstrates the important role of this slow-moving intrabasinal fault in the generation of relief in the Betic Cordillera during recent Quaternary time. Although the impact of this fault on relief building is very low in comparison with oblique-slip, basin-border faults in the mountain range, it has a key control on the Quaternary landscape evolution. • Tectonic geomorphological study of an oblique-slip, slow intrabasinal fault (S Spain) • Uses fault analysis and geomorphic indices (PRR, surface marker offset, k sn , AF, Vf) • Erosion dominates landscape, masking typical fault-related geomorphic evidence. • Geomorphic indices are useful for revealing a fault-related geomorphic response. • Major intrabasinal faults have low impact on broader mountain belt relief development. [ABSTRACT FROM AUTHOR]

Background: Common Variable Immunodeficiency (CVID) represents a heterogenic group of primary immunodeficiencies (PID) characterized by impaired antibody production and susceptibility to infections. Non-infectious complications, such as autoimmune diseases, lymphoproliferative disorders, and malignancies, now significantly impact prognosis. Moreover, both hematologic and solid organ malignancies are more frequently observed in CVID patients compared to other PIDs. The risk factors for carcinogenesis in CVID remain largely unknown., Objective: This multicenter study aims to characterize the clinical profile of cancer in CVID patients in Spain and to identify independent risk factors associated with malignancy development, focusing on the role of immune dysregulation., Methods: A nationwide, cross-sectional study was conducted from November 2019 to May 2022, involving 17 hospitals treating PID patients in Spain. Data were collected systematically on demographics, infectious and non-infectious comorbidities, immunological parameters, and treatment. Statistical analysis, including multivariate logistic regression, was performed to identify risk factors associated to malignancy., Results: Of 250 CVID patients, 38 (15.26%) were diagnosed with cancer, predominantly non-Hodgkin lymphoma, gastric cancer, and lung adenocarcinoma. Cancer patients were significantly older (mean age 60.70 vs. 49.36 years, p<0.001) and had higher rates of immune dysregulation (81.58% vs. 59.7%, p=0.01). Immune dysregulation was an independent risk factor for cancer (OR 2.19, p=0.04), alongside previous immunosuppressant therapy (OR 2, p=0.031), higher IgM levels (OR 1.008 per SD, p=0.012), older age (OR 1.04, p<0.001), and lower CD4 cell counts at diagnosis (OR 0.997, p<0.001)., Conclusions: This study highlights the increased cancer risk in CVID patients, with immune dysregulation, prior immunosuppressant use, elevated IgM levels, and lower CD4 cell counts as conjointly associated. These findings underscore the need for vigilant cancer screening and tailored management strategies in CVID patients to improve outcomes. Future research should focus on elucidating the molecular mechanisms linking immune dysregulation and malignancy in CVID., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cabañero-Navalon, Garcia-Bustos, Balastegui-Martin, Bracke, Mateu, Solanich, Carrillo-Linares, Robles-Marhuenda, Puchades, Pelaez Ballesta, Lopez-Osle, Torralba-Cabeza, Bielsa Masdeu, Gil Niño, Tornador Gaya, Castellanos, Sánchez-Martínez, Barragán-Casas, González-García, Patier de la Peña, López-Wolf, Rufete, Canovas Mora and Moral Moral.)

Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans' syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cabañero-Navalon, Garcia-Bustos, Nuñez-Beltran, Císcar Fernández, Mateu, Solanich, Carrillo-Linares, Robles-Marhuenda, Puchades-Gimeno, Pelaez Ballesta, López-Osle, Torralba-Cabeza, Bielsa Masdeu, Diego Gil, Tornador Gaya, Pascual Castellanos, Sánchez-Martínez, Barragán-Casas, González-García, Patier de la Peña, López-Wolf, Mora Rufete, Canovas Mora, Forner Giner and Moral Moral.)

Background: The impact of statins on COVID-19 outcomes is important given the high prevalence of their use among individuals at risk for severe COVID-19. Our aim is to assess whether patients receiving chronic statin treatment who are hospitalized with COVID-19 have reduced in-hospital mortality if statin therapy is maintained during hospitalization., Methods: This work is a cross-sectional, observational, retrospective multicenter study that analyzed 2921 patients who required hospital admission at 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics and COVID-19 disease outcomes between patients receiving chronic statin therapy who maintained this therapy during hospitalization versus those who did not. Propensity score matching was used to match each statin user whose therapy was maintained during hospitalization to a statin user whose therapy was withdrawn during hospitalization., Results: After propensity score matching, continuation of statin therapy was associated with lower all-cause mortality (OR 0.67, 0.54-0.83, p < 0.001); lower incidence of acute kidney injury (AKI) (OR 0.76,0.6-0.97, p = 0.025), acute respiratory distress syndrome (ARDS) (OR 0.78, 0.69- 0.89, p < 0.001), and sepsis (4.82% vs 9.85%, p = 0.008); and less need for invasive mechanical ventilation (IMV) (5.35% vs 8.57, p < 0.001) compared to patients whose statin therapy was withdrawn during hospitalization., Conclusions: Patients previously treated with statins who are hospitalized for COVID-19 and maintain statin therapy during hospitalization have a lower mortality rate than those in whom therapy is withdrawn. In addition, statin therapy was associated with a decreased probability that patients with COVID-19 will develop AKI, ARDS, or sepsis and decreases the need for IMV.

Castleman disease (CD) represents a heterogeneous group of lymphoproliferative disorders that share well-defined histopathological features. An observational study of patients with CD was conducted. A total of 53 patients had CD: 20 had the unicentric form (UCD) and 33 the multicentric (MCD) variant; 10 of the latter cases were infected with human herpesvirus-8 (HHV-8) and 23 were idiopathic (iMCD). Median age differed between UCD and iMCD (30 vs. 49 years, p  = .004). Males were completely predominant in HHV-8-associated MCD (100%), and females were more frequent in UCD (75 vs. 48%, p  = .06). Relapses were more frequent in iMCD (57 vs. 10% UCD, p  = .002), and mortality was significantly higher in iMCD and the HHV-8-associated form with respect to UCD. We conclude that UCD is a benign disorder of younger ages and female predominance, while iMCD represents a different entity with more disease relapses and higher mortality.

Background and Aims: Several studies have reported that a significant number of HIV patients not co-infected with HCV/HBV develop liver damage of uncertain origin (LDUO). The objective of our study was to evaluate the incidence of and risk factors for the development of LDUO in HIV infected patients not co-infected with HCV/HBV., Methods: Prospective longitudinal study that included HIV-infected patients free of previous liver damage and viral hepatitis B or C co-infections. Patients were followed up at 6-monthly intervals. Liver stiffness was measured at each visit. Abnormal liver stiffness (ALS) was defined as a liver stiffness value greater than 7.2 kPa at two consecutive measurements. For patients who developed ALS, a protocol was followed to diagnose the cause of liver damage. Those patients who could not be diagnosed with any specific cause of liver disease were diagnosed as LDUO and liver biopsy was proposed., Results: 210 patients matched the inclusion criteria and were included. 198 patients completed the study. After a median (Q1-Q3) follow-up of 18 (IQR 12-26) months, 21 patients (10.6%) developed ALS. Of these, fifteen patients were diagnosed as LDUO. The incidence of LDUO was 7.64 cases/100 patient-years. Histological studies were performed on ten (66.6%) patients and all showed liver steatosis. A higher HOMA-IR value and body mass index were independently associated with the development of LDUO., Conclusion: We found a high incidence of LDUO in HIV-infected patients associated with metabolic risk factors. The leading cause of LDUO in our study was non-alcoholic fatty liver disease.

Polymorphic Alu insertions from the MHC class I region were analyzed in 215 autochthonous Basques from Guipuzcoa and Navarre provinces, with the aim of contributing new MHC Alu data in European ancestry populations. We also seek to assess both the genetic position of native Basques among worldwide samples and the efficiency of the MHC Alu elements as ancestry informative markers (AIMs). According to the MDS and AMOVA results, worldwide populations included in the comparative analyses were grouped in three major clusters defined by genetic ancestry (Africans, Asians and Europeans). The δ values (differences in weighted allele frequencies) among ancestry groups indicated that Alu elements within the alpha-block (AluHF, AluHJ and AluHG) showed an adequate resolving power to discriminate appropriately between some of the major ancestry groups. Alpha block Alu were also revealing of the exceptionality of Basques, as they allowed for the detection of genetic heterogeneity even between Basques and the other Iberian collection considered in the analysis (Valencia). Thus, analysis of the Alu loci within the alpha-block may represent a reliable, informative and cost-effective method to explore the ancestry, geographic origins and demographic history of human populations, which can be very helpful for studies into epidemiological, forensic or evolutionary perspectives., (Copyright © 2012 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)

Background: The objective of this work is to study the impact of HAART at a population level and to identify socio-demographic factors that may affect it, which is essential for deciding interventions., Methods: An open, prospective cohort of HIV seroconverters recruited in the Centro Sanitario Sandoval (1986-2009), and followed up in collaboration with referral hospitals in the Comunidad Autónoma de Madrid. Cumulative incidence of AIDS and death was calculated by the multiple decrements method, and predictive Fine & Gray models were developed to identify associated factors. A calendar period (<1997; ≥ 1997) was introduced as a proxy of HAART availability., Results: A total of 479 HIV seroconverters were identified. Hazard Ratio (HR) for progression to AIDS was 0.215 (95% CI: 0.11-0.519; P<.01) for the period ≥ 1997. Risk increased with age at the time of seroconversion (for each year older HR=1.071; 95% CI: 1.038-1.105; P<.01), but only prior to 1997. In the following period, only a high educational level showed to be a protective factor (HR=0.982; 95% CI: 0.936-1.031; P=.06). HR for progression to death was 0.134 (95% CI: 0.052-0.346; P<.01) for the period after 1997, 0.383 (95% CI: 0.168-0.875; P=.02) in people with high educational level and 1.048 (95% CI: 1.014-1.084; P<.01) for each year increase in age at seroconversion, both latter effects being homogeneous throughout the two periods., Conclusion: HAART has had a great impact on the risk of progression to AIDS and death, but this benefit appears to be influenced by age at HIV infection and educational level of the patient, which highlights the importance of a global approach to case management and of the implementation of policies that address social inequities in health., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)

Autochthonous Basques are thought to be a trace from the human population contraction that occurred during the Last Glacial Maximum, based mainly on the salient frequencies and coalescence ages registered for haplogroups V, H1, and H3 of mitochondrial DNA in current Basque populations. However, variability of the maternal lineages still remains relatively unexplored in an important fraction of the Iberian Basque community. In this study, mitochondrial DNA diversity in Navarre (North Spain) was addressed for the first time. To that end, HVS-I and HVS-II sequences from 110 individuals were examined to identify the most relevant lineages, including analysis of coding region SNPs for the refinement of haplogroup assignment. We found a prominent frequency of subhaplogroup J1c (11.8%) in Navarre, coinciding with previous studies on Basques. Subhaplogroup H2a5, a putative autochthonous Basque lineage, was also observed in Navarre, pointing to a common origin of current Basque geographical groups. In contrast to other Basque subpopulations, comparative analyses at Iberian and European scales revealed a relevant frequency of subhaplogroup H3 (10.9%) and a frequency peak for U5b (15.5%) in Navarre. Furthermore, we observed low frequencies for maternal lineages HV0 and H1 in Navarre relative to other northern Iberian populations. All these findings might be indicative of intense genetic drift episodes generated by population fragmentation in the area of the Franco-Cantabrian refuge until recent times, which could have promoted genetic microdifferentiation between the different Basque subpopulations., (Copyright © 2011 Wiley-Liss, Inc.)

Aims: Implantable cardioverter defibrillators (ICDs) are increasingly being used for treatment of ventricular tachycardia (VT)/fibrillation. Inappropriate therapy delivery remains the most frequent complication in patients with ICDs, resulting in psychological distress, proarrhythmia, and battery life reduction. We aim to determine if inappropriate therapies could be reduced by using a morphology discrimination criterion., Methods and Results: We evaluated the performance of the Wavelet morphology discrimination algorithm (Medtronic, Inc.) independently from other discrimination enhancements (rate onset and interval stability). A non-randomized, prospective, multicenter, and observational study was designed to determine the sensitivity and specificity of the new morphology criterion. Sensitivity and specificity in slow tachycardia with cycle length (CL) between 340 and 500 ms were analysed as a pre-specified secondary endpoint. A total of 771 spontaneous episodes in 106 patients were analysed. Five hundred and twenty-two episodes corresponded to true supraventricular tachycardia (SVT) with ventricular CL in the VT or FVT zone, of which 473 had therapy appropriately withheld. Of the 249 episodes of true VT/FVT, 21 were classified according to the Wavelet criteria as SVT (specificity: 90.6%; sensitivity: 91.6%). All of them were spontaneously terminated with no adverse clinical consequences. No syncopal episodes occurred. For VTs in the slowest analysed range (CL: 340-500 ms), a total of 235 episodes were studied, yielding a specificity of 95.9% and sensitivity of 83.2%., Conclusion: Wavelet discrimination criteria in single-chamber ICDs as the sole discriminator can significantly reduce inappropriate therapy for SVT, not only in the range of VTs in the slowest analysed range (340-500 ms for this study) but also for faster VTs. No significant clinical consequences were found when the algorithm was used, but final data should prompt the use of the algorithm in combination with a high rate time-out feature.

Purpose: To appraise the incidence of liver toxicity in a population of patients receiving fosamprenavir/ritonavir (FPV/r) with a high frequency of viral hepatitis co-infection., Method: 636 patients, 341 (54%) with HCV antibodies and 38 (5.6%) bearing serum HBsAg, were recruited. All of them received FPV/r 700/100 twice every day. 93 (27%) patients who tested positive for HCV antibodies showed an AST to platelet ratio index (APRI) higher than 1.5, consistent with significant liver fibrosis., Results: After a median (range) follow-up time of 6.91 (0.46-20.66) months, 3 (0.47%) patients developed grade 3 ALT elevation. All the former patients were hepatitis virus co-infected, 2 with hepatitis C virus and 1 with hepatitis B virus. The frequency of grade 3 ALT elevation in patients with HCV antibodies was 0.58% and in those harbouring HBsAg it was 2.63%. 4 (0.62%) patients suffered from a liver decompensation and 1 died due to a hepatic cause while on follow-up. No patients with APRI equal to or higher than 1.5 showed grade 3 ALT elevation., Conclusion: The incidence of adverse hepatic events in patients receiving FPV/r including combinations seems to be low, even in subjects co-infected with hepatitis virus and in those with significant liver fibrosis.

Background: The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ)., Methods: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed., Results: Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92., Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15., Conclusion: Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance., Trial Registration: Clinical Trials Register NCT00349544.

In this work, seven multiallelic short-tandem repeat (STR) loci from the nonrecombining region of the human Y-chromosome (DYS19, DYS389 I, DYS389 II, DYS390, DYS391, DYS392, and DYS393) were typed in a sample of residents in the Basque Country (RBAS). In all, 40 different Y-STR haplotypic combinations were identified, resulting in a value of haplotypic diversity of 0.979. Y-STR data compiled from previous works were used for studying Y-chromosome diversity in the Iberian Peninsula and for assessing the effects of migratory movements on the genetic background of the population living currently in territories traditionally occupied by native (autochthonous) Basques. An analysis of the spatial distribution of allelic frequencies of the Y-STRs revealed a geographic pattern characterized by variation gradients (frequency clines) oriented for the most part in the direction southwest-northeast. Accordingly, a neighbor-joining analysis showed a relative polarization between populations located in the northeast and center of the Iberian Peninsula, and the rest of the samples considered. The study sample (RBAS) occupied an intermediate position in the population tree between the autochthonous Basques (BASQ) and the remaining samples. Interestingly, the RBAS collection only showed genetic heterogeneity with that of native Basques (PhiST = 0.013, P < 0.05). Estimates of admixture proportions in the gene pool of RBAS indicated a high level of hybridization with Basque (56%) and non-Basque (44%) genes, which could explain the genetic differentiation observed between BASQ and RBAS.

This survey reports primary results of classical allele frequencies on ten protein loci in a Basque population sample from northern Navarre, the less known from an anthropological and genetic point of view than the populations of the other Basque territories of Spain. Since ancient times this has been a zone of Basque population settlement, and the Basque language (Euskera) still remains deeply rooted among its autochthonous population. A total of 122 blood samples from unrelated northern Navarrese with autochthonous ascendants to the third generation were typed for GC, HP, PI, TF, ACP1, AK1, CA2, ESD, PGD and PGM1 genetic systems. Basque surnames and birthplaces were the criteria used to define family origins. Genetic structure was analyzed on different population hierarchical levels. Northern Navarre seems to be the most genetically deviated area in comparison with other Basque groups. The highest level of differentiation is observed between Navarrese and Alava Basques whereas Guipúzcoa province, the territory adjacent to northern Navarre, presents the lowest genetic distance from the study area. Northern Navarrese show some distinguishing genetic characteristics in relation to other Basque relative samples, which include high frequencies for PI*M1 and TF*C1 and low levels of PGD*C and PGM1*2 alleles. When the genetic data reported here are analyzed jointly with GM allotypes frequencies, the results significantly reinforce the relative position of Navarrese Basques as well as the topology of the Basque cluster on genetic maps. The analysis of relationships among the genetic structures of Basque population samples leads us to ask ourselves which of them fits in best with the ancient Basque population. Classical geographers placed the tribe of the Vascones in the geographical region currently known as Navarre, so extant Navarrese Basques might be considered firm candidates to denote the anthropological and genomic distinctiveness of the ancient Basques.

The aim of this study was to investigate whether there is an increase on premature deaths due to genetically determined factors at the beginning of a demographic transition. We also analyzed the effects of parental consanguinity on offspring mortality from an epidemiological viewpoint, using parish records for family reconstitution in a Basque population (1800-1990). Among the offspring of unrelated parents, 13.1% died before their first year of life (infant mortality), and 22.8% died before the age of 16 (pre-reproductive mortality). Significant increases in both infant (23.6%) and pre-reproductive (38.5%) deaths were found among the progeny of first cousins or closer relatives, 1C (F > or = 0.0625). The corresponding relative risks of mortality were 1.79 (95% confidence limits: 1.37-2.28) and 1.68 (1.38-2.01), respectively. Estimates of the population attributable risks indicate that 4% of pre-reproductive mortality is ascribable to consanguineous unions, although kinships other than 1C produced only slight increases in offspring mortality. Evidence on the relationship between the demographic transition and the increase in premature deaths due to genetic factors was obtained through a principal component analysis (95.1% of variance accounted for). During the initial stages of the demographic transition, the population experienced substantial elevations in mean family size, natural increase of the population, frequency of close consanguineous matings (1C), and death rate due to congenital anomalies and perinatal diseases. These findings are of interest for the health services of many developing societies in Asia, Africa, and Latin America, which are nowadays immersed in the demographic transition process., (Copyright 2005 Wiley-Liss, Inc)

Genomic diversity based on 13 short tandem repeat (STR) loci (D3S1358, vWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820, D16S539, TH01, TPOX, and CSF1PO) is reported for the first time in Basques from the provinces of Guipúzcoa and Navarre (Spain). STR data from previous studies on Basques from Alava and Vizcaya provinces were also examined using hierarchal analysis of molecular variance (AMOVA) and genetic admixture estimations to ascertain whether the Basques are genetically heterogeneous. To assess the genetic position of Basques in a broader geographic context, we conducted phylogenetic analyses based on F(ST) genetic distances [neighbor-joining trees and multidimensional scaling (MDS)] using data compiled in previous publications. The genetic profile of the Basque groups revealed distinctive regional partitioning of short tandem repeat (STR) diversity. Consistent with the above, native Basques clearly segregated from other populations from Europe (including Spain), North Africa, and the Middle East. The main line of genetic discontinuity inferred from the spatial variability of the microsatellite diversity in Basques significantly overlapped the geographic distribution of the Basque language. The genetic heterogeneity among native Basque groups correlates with the peculiar geography of peopling and marital structure in rural Basque zones and with language boundaries resulting from the uneven impact of Romance languages in the different Basque territories.

Analysis of the interaction between mortality patterns and opportunity for natural selection could help to elucidate potential evolutionary implications of epidemic mortality. In this paper secular trends are studied in relation to Crow's index (It) and its components of mortality (Im) and fertility (If), using parish records for family reconstitution in a Basque population. A principal components analysis (91% of the variance accounted for) showed marked quantitative and qualitative variations of Im and If depending on the stage of demographic transition of the population analyzed: In pretransitional societies the opportunity for natural selection is determined mainly by differential prereproductive mortality, whereas in posttransitional societies selection resulting from differential fertility plays a key role. The highest values for the mortality component (range 0.81-1.26) and for the relative contribution of Im, to It (range 47.1-57.2%) were observed in periods with a high incidence of infectious diseases and when the most severe mortality crises were detected (1830-1859, 1860-1889, and 1890-1919). A differential incidence of epidemic mortality was also found at prereproductive ages (before 16 years) and at reproductive ages (16-45 years), which provides strong support for the idea of the long-term genetic consequences of mortality crises.

The focus of this work is the analysis of changes in completed family size and possible determinants of that size over time, in an attempt to characterize the evolution of reproductive patterns during the demographic transition. With this purpose in mind, time trends are studied in relation to the mean number of live births per family (as an indirect measure of fertility), using family reconstitution techniques to trace the reproductive history of each married woman. The population surveyed is a Spanish rural community called Lanciego, located at the southern end of the province of Alava (Basque Country). A total of 24,510 parish records of baptisms, marriages and burials made between 1800 and 1969 were examined to obtain the demographic data set. For each reconstituted family, the variables included in the study were the number of live births per family or family size (FAMS), year of marriage (YEAR), age at marriage of both partners (AMAN, AWOM), wife's age at the end of marriage (WEND), duration of marriage (MARD), age at first maternity (A1CH), length of reproductive span (REPS) and number of children dying before their first anniversary (MINF). Through a principal component analysis, three factors were found that explained more than 75% of the total variance. Association of variables in factors I and III was particularly useful in characterizing the variability of mean family size in pre-transitional, transitional and post-transitional cohorts. During demographic transition, a decreasing trend is observed in the variables FAMS, REPS and MINF, while variables AWOM, AMAN, WEND and A1CH show a tendency to increase over the 20th century. Results obtained by multiple regression analysis confirm that the best predictors of family size (dependent variable) were REPS and MINF, which between them explained over 85% of the total variation in FAMS (R2 = 0.853). In Lanciego, birth control seems to be present on the evidence of an increase in age at first maternity and a decrease in age at last parturition, indicating that the beginning of the reproductive span is delayed and its end is brought forward. Interaction between family size and infant mortality is discussed in the light of various hypotheses, including replacement of descendants, the so-called biological effect and the theory of r and k selection.

Unlike other jurisdictions in the United States where the basis of the law can be traced more exclusively to the common law of England, the legal system in Louisiana also has origins in the laws of France and Spain. In this article, the authors describe the laws and procedures that developed early in Louisiana's history for the involuntary care and civil commitment of the mentally ill, focusing on the laws that were passed after the American takeover in 1803.

In this work, the evolution of demographic and health patterns in a Basque rural population from Spain is analysed, as they relate to progress in demographic and epidemiological transition. For this purpose, parochial record data on 13,298 births and 9,215 deaths, registered during the 19th and 20th centuries (1800-1990), were examined. The study area is a rural community called Lanciego, which is located at the southern end of the Rioja Alavesa area (Alava Province, Basque Country). In Lanciego, demographic transition began in the final decade of the 19th century, when a definite, irreversible trend began towards a reduction in mortality. The decrease in the birth rate came later than that in the death rate, and did not start until the 1930s. The post-transitional stage seemed to be reached in the 1970s, when the birth and death rates showed values below 20 per 1,000. Other characteristics observed for the post-transitional stage in Lanciego are: (i) very low rates of infant mortality achieved at the expense of effective control of exogenous mortality; (ii) the mortality curve by ages changes from a U-shape (typical of populations with a high infant mortality rate and low life expectancy at birth) to a J-shape more characteristic of modern societies where longevity and life expectancy are considerably higher; (iii) a certain level of over-mortality among women in the senior age group (>65); and (iv) a significant proportion of mortality in recent times (1970-90) resulting from cardiovascular diseases and malignant neoplasms (post-transition causes). This last point is in contrast with observations from the first four decades of the 20th century, when infectious diseases and respiratory ailments were determining factors in mortality among this population. The data provided by the study of the variation over time in demographic and health patterns indicate that reducing the risk of mortality is one of the most important preconditions for fertility decline.