No abstract

Abstract. A Regional Water Resources study was performed at basins within and draining to the Basque Country Region (N of Spain), with a total area of approximately 8500 km 2 . The objective was to obtain daily and monthly long-term discharges in 567 points, most of them ungauged, with basin areas ranging from 0.25 to 1850 km 2 . In order to extrapolate the calibrations at gauged points to the ungauged ones, a distributed and conceptually based model called TETIS was used. In TETIS the runoff production is modelled using five linked tanks at the each cell with different outflow relationships at each tank, which represents the main hydrological processes as snowmelt, evapotranspiration, overland flow, interflow and base flow. The routing along the channels' network couples its geomorphologic characteristics with the kinematic wave approach. The parameter estimation methodology tries to distinguish between the effective parameter used in the model at the cell scale, and the watershed characteristic estimated from the available information, being the best estimation without losing its physical meaning. The relationship between them can be considered as a correction function or, in its simple form, a correction factor. The correction factor can take into account the model input errors, the temporal and spatial scale effects and the watershed characteristics. Therefore, it is reasonable to assume the correction factor is the same for each parameter to all cells within the watershed. This approach reduces drastically the number of parameter to be calibrated, because only the common correction factors are calibrated instead of paCorrespondence to: J. J. Vélez (jjvelezu@unal.edu.co) rameter maps (number of parameters times the number of cells). In this way, the calibration can be performed using automatic methodologies. In this work, the Shuffled Complex Evolution -University of Arizona, SCE-UA algorithm was used. The available recent year's data was used to calibrate the model in 20 of the most representative flow gauge stations in 18 basins with a Nash-Sutcliffe index higher than 0.6 (10 higher than 0.8). The calibrated correction factors at each basin were similar but not equal. The validation process (in time and space) was performed using the remaining data in all flow gauge stations (62), with 42 basins with a NashSutcliffe index higher than 0.5 (25 higher than 0.7). Deficient calibration and validations were always related with flow gauge stations very close to the karstic springs. These results confirmed that it was feasible and efficient to use the SCE-UA algorithm for the automatic calibration of distributed conceptual models and the calibrated model could be used at ungauged basins. Finally, meteorological information from the past 50 years at a daily scale was used to generate a daily discharges series at 567 selected points.

To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1infected population and to explore the factors associated with multiple NARC. Methods: This was a multicentre, cross-sectional study including HIV-1-infected patients aged !50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. Results: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B = 0.032, 95% confidence interval 0.015-0.049; p = 0.0003) and between the duration of HIV-1 infection and NARC (B = 0.039, 95% confidence interval 0.017-0.059; p = 0.0005). Conclusions: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.

No abstract

No abstract

Water Sowing and Harvesting (WS&H) consists of a series of ancestral procedures by which humans collect and infiltrate (sow) rainwater and runoff underground, so as to recover (harvest) it downgradient at some later time. This management of the water has made it possible for various regions of Ibero-America -that is, Latin America plus the Iberian Peninsula-to overcome dramatic cultural and climatic changes over the centuries. The principles governing WS&H coincide with those pursued under the present paradigm of Integrated Water Resource Management. Moreover, WS&H implies a better use of water and enhanced conservation of the environment and patrimony, as well as recognition of rural communities as vital custodians of the land and of its relevant cultural aspects. The main WS&H systems that serve Ibero-American countries are described here, emphasizing the principles underlying this means of water management as exemplary of hydro-geo-ethical systems.

Abstract. A Regional Water Resources study was performed at basins within and draining to the Basque Country Region (N of Spain), with a total area of approximately 8500 km2. The objective was to obtain daily and monthly long-term discharges in 567 points, most of them ungauged, with basin areas ranging from 0.25 to 1850 km2. In order to extrapolate the calibrations at gauged points to the ungauged ones, a distributed and conceptually based model called TETIS was used. In TETIS the runoff production is modelled using five linked tanks at each cell with different outflow relationships at each tank, which represents the main hydrological processes as snowmelt, evapotranspiration, surface runoff, interflow and base flow. The routing along the channels' network couples its geomorphologic characteristics with the kinematic wave approach. The parameter estimation methodology tries to distinguish between the effective parameter used in the model at cell scale, and the watershed characteristic estimated from the available information, being the best estimation without losing its physical meaning. The relationship between them can be considered as a correction function or, in its simple form, a correction factor. The correction factor can take into account the model input errors, the temporal and spatial scale effects and the watershed characteristics. Therefore, it is reasonable to assume the correction factor is the same for each parameter to all cells within the watershed. This approach reduces dramatically the number of parameter to be calibrated, because only the common correction factors are calibrated instead of parameter maps (number of parameters times the number of cells). In this way, the calibration can be performed using automatic methodologies. In this work, the Shuffled Complex Evolution – University of Arizona, SCE-UA algorithm was used. The available recent year's data was used to calibrate the model in 20 of the most representative flow gauge stations in 18 basins with a Nash-Sutcliffe index higher than 0.6 (10 higher than 0.8). The calibrated correction factors at each basin were similar but not equal. The validation process (in time and space) was performed using the remaining data in all flow gauge stations (62), with 42 basins with a Nash-Sutcliffe index higher than 0.5 (25 higher than 0.7). Deficient calibration and validations were always related with flow gauge stations very close to the karstic springs. These results confirmed that it was feasible and efficient to use the SCE-UA algorithm for the automatic calibration of distributed conceptual models and the calibrated model could be used at ungauged basins. Finally, meteorological information from the past 50 years at a daily scale was used to generate a daily discharges series at 567 selected points.

To investigate risk factors for mortality from sepsis in an intensive care unit (ICU) in Quito-Ecuador and their association to adherence to Surviving Sepsis Campaign recommendations.Prospective cohort study of patients with severe sepsis/septic shock admitted to the ICU of a public Ecuadorian hospital from March, 2018 to March, 2019. Demographic, clinical, treatment, and outcome data were collected from patients' health records. Patients were divided into 2 groups according to ICU survival or death. Log-binomial regression models were used to identify risk factors for mortality.In total, 154 patients were included. Patients who died in the ICU (n = 42; 27.3%) had higher sequential organ failure assessment score (median 11.5 vs 9; P < .01), more organ dysfunction (median 4 vs 3; P < .0001), and received greater volumes of fluid resuscitation in the first 6 hours (median 800 vs 600 mL; P = .01). Dysfunction of > 2 organs was a risk factor for mortality (relative risks [RR] 3.80, 95% CI 1.33-10.86), while successful early resuscitation (RR 0.32, 95% CI 0.15-0.70), successful empirical antibiotic treatment (RR 0.38, 95%CI 0.18-0.82), and antibiotic de-escalation (RR 0.28, 95%CI 0.13-0.61) were protective factors.Dysfunction of >2 organs was a risk factor for mortality from sepsis while successful early resuscitation and appropriate antibiotic treatment were protective.Abbreviations: APACHE = Acute Physiology and Chronic Health Evaluation, CI = confidence interval, HEEE = Hospital de Especialidades Eugenio Espejo, ICU = intensive care unit, ROC = receiver operating characteristic, RR = relative risk, SOFA = sequential organ failure assessment.