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This study presents results regarding the estimation of two critical variables for modelling fire behaviour and fire danger: the canopy base height (CBH) and the canopy bulk density (CBD). Both variables have been mapped as raster datasets at a 100-meter spatial resolution across Europe, harmonizing data for all EU countries. Therefore, these canopy fuels are subsequently used for further processing regarding the identification of fire danger assessment, being a key input for forest fire prevention actions. A more in-depth analysis of these findings has been submitted to a journal and is currently in a revision phase. We present here a summary of the results and ideas for future developments. The overall study consists of estimating CBH and CBD using Earth observation products combined with artificial intelligence and species-specific allometric equations, applied geo-spatially using a tree species map of Europe encompassing the 16 most important tree species. Validation was carried out by comparing the results with higher-accuracy sampling methods, combining LiDAR data and field measurements in different European latitudes, typically applied on a smaller scale and with greater detail. Results show, as expected, a higher level of uncertainty than local methods, but they are still applicable to the European scale for which they were implemented. The accuracies reported in our study, when considering aggregated data on the 7 areas in Portugal were the following: R = 0.75, RMSE = 0.890 m, and MAPE = 54% for the mean CBH, and R = 0.93, RMSE = 0.020 kg m−3, and MAPE = 57% for the mean CBD.

Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos. Abstract: Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected atthe local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.

Laser scanning data are increasingly used to segment forests into homogeneous units, called segments or stand compartments. Region growing and region merging have been traditionally employed for this purpose. Recently, alternative methods such as cellular automata (CA), self-organizing maps (SOM), and combinatorial optimization have emerged, promising more homogeneous stand delineations. However, these newer methods often require fine-tuning due to rugged stand boundaries. To address this, we propose and assess a novel hybrid approach that combines two segmentation algorithms, resulting in smoother boundaries and homogeneous stands. Our hybrid method outperforms traditional fine-tuning techniques, particularly using CA or SOM for initial segmentation and then refining it with another cellular automaton (CA’), adjusted to produce smooth boundaries. The new two-step hybrid method resulted in better segmentation results than the one-step algorithm combined with previously suggested fine-tuning methods. SOM-CA’ showed the highest degree of explained variance (R2) of the LiDAR metrics used in the segmentation. CA-CA’ reached almost the same R2 values with a larger average segment area. When the R2 of the LiDAR metrics was used as the criterion, the segments produced by the hybrid method outperformed the stand delineations of the current Spanish forest map with a clear margin.

Wildfire risk has been exacerbated across Europe by climate change favoring more damaging and severe wildfire events. This evolving wildfire risk context interacts with a broad landscape of EU policies including those on nature conservation, forestry, bioeconomy or climate and energy, all of which may increase or reduce fire hazard and the level of exposure and vulnerability of the values at risk. Coherently addressed, policies may support wildfire disaster risk management synergistically while reducing potential dysfunctions. This research conducts a content analysis of EU policies and initiatives under the European Green Deal with respect to integrated wildfire risk management and related nature-based solutions. The results show that a consistent EU policy framework to address wildfire risk reduction in a synergic way exists, with no major conflicts in the policy design. Nevertheless, better guidance on fire-smart land management practices and the conceptualization of wildfire-related nature-based solutions may enhance a more coherent policy implementation. Additional suggestions around the legal status of wildfire protection and ‘whole of government’ governance frameworks are discussed. Notably, within the laws, policies and initiatives analyzed, the beneficial side of fire addressed by integrated fire management is either missing or not explicitly mentioned, although it is considered in policy-related supporting guidelines.

Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain. Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos.

We present a browser-based App for smartphones that is freely available to end-users for collecting geotagged and oriented photos depicting vegetation biomass and fuel characteristics. Our solution builds on advantages of smartphones, allowing their use as easy sensors to collect data by imaging forest ecosystems. The strength and innovation of the proposed solution is based on the following points: (i) using a low memory footprint App, streaming images and data with as little data-volume and memory as needed; (ii) using JavaScript APIs that can be launched from both a browser or as an installed App, as it applies features such as service workers and Progressive Web App; (iii) storing both image and survey data (geolocation and sensor orientation) internally to the device on an indexed database, and synchronizing the data to a cloud-based server when the smartphone is online and when all other safety tests have been successfully passed. The goal is to achieve properly positioned and oriented photos that can be used as training and testing data for future estimation of the surface fuel types based on automatic segmentation and classification via Machine Learning and Deep Learning.

Currently, AI-designed systems in which, given a certain input or prompt, the system returns an output or response are becoming very popular. A chatbot is an example of this kind of system. However, human beings, besides processing the input stimuli or information adequately, are also capable of simultaneously expressing an emotional response to that input information. This is a major factor in the survival of our species. For years, bio-inspired AI models have been proposed in order to make AI systems more human-like. Paradigms, such as neuromorphic computing, represent an example of this trend. In this paper, we propose a new approach that we have termed hormone-morphic by designing a chatbot, Fattybot, with which it is possible to have a conversation. However, since Fattybot is endowed with both a hormonal and immune system, it can feel anxiety or some other altered condition during a conversation, which induces the chatbot to eat compulsively. The ultimate goal of the work is to propose AI systems that not only process information but also experience some of the emotional traits of human beings. In this paper, several simulation experiments are performed showing the usefulness of this approach, for example, in the simulation of a virtual patient.

Resumen: Introducción y objetivos: Las fracturas de fémur distal representan un problema por su elevado número de complicaciones. El objetivo fue comparar los resultados, las complicaciones y la estabilidad conseguidos con el enclavado intramedular retrógrado y la placa de estabilidad angular en el tratamiento de las fracturas diafisarias distales de fémur. Material y método: Se realizó un estudio clínico y experimental biomecánico mediante elementos finitos. Los resultados de las simulaciones permitieron obtener los principales resultados relacionados con la estabilidad de la osteosíntesis. En el seguimiento clínico se utilizaron frecuencias en variables cualitativas, y la prueba exacta de Fisher y la prueba χ2 para evaluar la significación de los diferentes factores, con la condición p

Abstract Continuous renal replacement techniques (CRRT) can induce complications and monitoring is crucial to ensure patient safety. We designed a prospective multicenter observational and descriptive study using the DIALYREG registry, an online database located on a REDCap web-based platform that allows real-time data analysis. Our main objective was to identify CRRT-related complications in our intensive care units (ICUs) and implement security measures accordingly. From January 2019 to December 2020, we included 323 patients with admission diagnoses of medical illness (54%), sepsis (24%), postoperative care (20%), and trauma (2%). CRRT indications were homeostasis (42%), oliguria (26%), fluid overload (15%), and hemodynamic optimization (13%). The median initial therapy dose was 30 ml/kg/h (IQR 25–40), and dynamic adjustment was performed in 61% of the treatments. Sets were anticoagulated with heparin (40%), citrate (38%) or no anticoagulation (22%). Citrate anticoagulation had several advantages: more frequent dynamic CRRT dose adjustment (77% vs. 58% with heparin and 56% without anticoagulation, p

Molecular electronics represents an avenue to enrich conventional electronics, but its reproducibility and scalability are still challenging. Here, the authors report the realization of multifunctional hybrid molecular graphene field effect transistors enabling operando spectroscopy and the implementation of optoelectronic logic gates.

Eccrine mucinous nevus is an uncommon hamartoma whose histological diagnosis is simple because of its peculiar morphological features, which include an increase in the number and/or size of the glands and eccrine ducts accompanied by abundant mucin deposits. When it presents with the typical symptom, focal hyperhidrosis, clinical suspicion is possible. El nevus mucinoso ecrino (NME) es un hamartoma escasamente reportado en la literatura cuyo diagnóstico histológico es sencillo debido a sus peculiares rasgos morfológicos, que incluye un aumento del número y/o tamaño de las glándulas ductos ecrinos acompañado de abundante depósito de mucina. Cuando presenta los hallazgos típicos, como la hiperhidrosis focal, es posible su sospecha clínica.

Encapsulated fat necrosis is a benign entity that has multiple possible conditions in the differential diagnosis. Because of this, the ultrasound and histological studies become highly relevant. We present a 14-year-old boy with this condition who exhibited numerous nodules that were detected after an intentional weight loss of 20kg. The ultrasound and histopathological examinations were necessary to confirm the diagnosis. Even though there is not a clear traumatic record in all cases, trauma constitutes the main hypothesis for its development, by decreasing the blood supply to the adipose tissue lobules and causing subsequent ischemic necrosis. Similar lesions have been described in the omentum and in the breast after surgical procedures or invasive diagnostic tests. In the ultrasound study, at least three presentation patterns have been described, which might match the three histological states, from early fat tissue degeneration to ultimate necrosis and even calcification. It is important to know the clinical characteristics, the ultrasound patterns, and the histological findings of this condition for an accurate diagnosis.

Resumen: Introducción: La mejoría de la esperanza de vida está incrementando la incidencia de fractura de cadera en centenarios. Nuestro objetivo es comparar las características basales de una serie de centenarios con fractura de cadera frente a controles de menor edad, analizando si existen diferencias en cuanto a complicaciones, mortalidad intrahospitalaria y supervivencia a corto-medio plazo. Material y métodos: Estudio retrospectivo, tipo caso control, sobre 24 centenarios y 48 controles octogenarios con fractura de cadera. Se analizó la presencia de comorbilidades y el índice de Charlson, la demora quirúrgica, las complicaciones, la estancia hospitalaria y la mortalidad durante el ingreso. Al alta se valoró la mortalidad precoz, la supervivencia después del año y el retorno a la funcionalidad previa. Resultados: No se encontraron diferencias significativas en parámetros basales ni en comorbilidades (p > 0,05), siendo el paciente tipo una mujer con fractura extracapsular. La estancia hospitalaria fue mayor en el grupo control (p = 0,038) y la complicación más frecuente la anemia, que precisó transfusión sanguínea (23/24 en los centenarios, p .05), and the type of was a woman with an extracapsular fracture. Hospital stay was longer in the control group (P = .038), and the most frequent complication was anemia requiring transfusion (23/24 in centenarians, P

Introduction and objectives: Distal femoral fractures represent a problem due to their high number of complications. The aim was to compare the results, complications and stability achieved with retrograde intramedullary nailing and the angular stable plate in the treatment of distal femoral diaphyseal fractures. Material and method: A clinical and experimental biomechanical study was carried out using finite elements. The results of the simulations allowed us to obtain the main results related to the stability of osteosynthesis. For clinical follow-up data, frequencies were used for qualitative variables, and Fisher's exact test and χ2 test were used to evaluate the significance of the different factors, with the condition of P

Introduction: The main objective of this study was to evaluate the impact of hemoadsorption on the elimination of inflammatory mediators. Methods: A prospective, bicenter, observational cohort study was conducted between March 2020 and February 2022 to explore the immunomodulatory response, demographic and clinical characteristics of individuals with COVID-19 admitted to the ICU with severe acute respiratory failure and in need of CRRT with Oxiris® with or without AKI. Results: Sixty-four patients were analyzed. Statistically significant differences were observed between exposed and unexposed groups, in relation to the reduction in D-dimer levels −15,614 (24,848.9) versus −4,136.5 (9,913.47) (p 0.031, d: 1.59, 95% CI: −21,830, −1,126). An increase in PCT was observed 0.47 (2.08) versus −0.75 (2.3) (p 0.044 95% CI: 0.03, 2.44). No differences were found in a decrease in CRP −4.21 (7.29) versus −1.6 (9.02) (p 0.22) nor in the rest of inflammatory parameters fibrinogen, IL-6, ferritin, lymphocytes, and neutrophils. Subgroup analysis in patients exposed to therapy also showed a significant decrease in D-dimer of 55% from baseline: 6,000 (1,984.5–27,750) pre-therapy versus 2,700 (2,119.5–6,145) (95% CI: −23,000, −2,489) post-therapy with a strong effect size (p 0.001, d: 0.65). Conclusion: The hemoadsorptive therapy in COVID-19 was associated with a significant decrease in D-dimer parameters without showing decreases in the rest of the clinical, inflammatory parameters and severity scales analyzed. [ABSTRACT FROM AUTHOR]