Diferencia entre tratamientos en pacientes con angioma cavernoso del tallo cerebral en el instituto nacional de neurología y neurocirugía Manuel Velasco Suárez

Introducción: la historia natural de la hemorragia en el tallo cerebral secundaria a un angioma cavernoso es benigna. Sin embargo, el riesgo de recurrencia y de mayor discapacidad parece incrementarse con el tiempo a pesar del tratamiento recibido; hecho que plantea dudas acerca de si el manejo quirúrgico de estas lesiones ofrece mayor beneficio sobre el manejo médico después del primer evento hemorrágico. El objetivo del estudio fue evaluar el riesgo de resangrado y el grado de discapacidad final en los angiomas cavernosos del tallo cerebral según el tratamiento recibido. Métodos: estudio observacional, analítico tipo cohorte. Se incluyeron pacientes con un primer sangrado en el tallo cerebral secundario a angioma cavernoso que fueron tratados en el Instituto Nacional de Neurología y Neurocirugía (INNN) de Ciudad de México. Resultados: noventa y nueve (99) pacientes fueron incluidos en un periodo de 25 años (1990-2015). Treinta y siete (37) recibieron tratamiento quirúrgico y sesenta y dos (62) recibieron tratamiento médico tras su primer sangrado. El promedio de edad fue de 38 años (DS: 14,17) para el grupo que recibió tratamiento médico y 36 años (DS: 12,82) para los que recibieron tratamiento quirúrgico. La incidencia acumulada de resangrado para el tratamiento médico fue de 5,1 por 100 años/persona y para el tratamiento quirúrgico de 3,9 por 100 años/persona (p = 0,016). Se realizó un análisis estratificado donde no se encontró ninguna asociación entre resangrado y edad o sexo del paciente. Se evaluó la discapacidad final con la escala de Rankin (mRs) sin encontrar diferencias significativas entre tratamientos (p=0.77). Por último, se realizó un modelo explicativo de regresión logística binaria donde se encontró que la edad superior a 55 años (OR: 2.19 IC 95%: 1.67-47,6), el tamaño mayor a 15 mm (OR: 2,5 IC 95%: 3,8-45,9) y la recurrencia del sangrado (OR: 1,7 IC 95%: 1,63-18,7) son factores asociados a un desenlace desfavorable en cuanto a discapacidad final. Discusión y Conclusiones: en los pacientes con angioma cavernoso del tallo cerebral que han presentado un primer evento de sangrado no se encontró una diferencia estadísticamente significativa entre el tratamiento médico o quirúrgico al evaluar la discapacidad funcional con la escala de Rankin modificada, a pesar de evidenciar una diferencia significativa en la incidencia acumulada de resangrado por grupos de tratamiento. El tamaño de la lesión, la recurrencia del sangrado y la edad superior a 55 años son factores asociados a un desenlace desfavorable en este grupo de pacientes.

Synapsing variable length crossover: Biologically inspired crossover for variable length genomes

Biological Crossover occurs during the early stages of meiosis. During this process the chromosomes undergoing crossover are synapsed together at a number of homogenous sequence sections, it is within such synapsed sections that crossover occurs. The SVLC (Synapsing Variable Length Crossover) Algorithm recurrently synapses homogenous genetic sequences together in order of length. The genomes are considered to be flexible with crossover only being permitted within the synapsed sections. Consequently, common sequences are automatically preserved with only the genetic differences being exchanged, independent of the length of such differences. In addition to providing a rationale for variable length crossover it also provides a genotypic similarity metric for variable length genomes enabling standard niche formation techniques to be utilised. In a simple variable length test problem the SVLC algorithm outperforms current variable length crossover techniques.

Extended time weather forecasts contributes to agricultural productivity estimates

Weather conditions in critical periods of the vegetative crop development influence crop productivity, thus being a basic parameter for crop forecast. Reliable extended period weather forecasts may contribute to improve the estimation of agricultural productivity. The production of soybean plays an important role in the Brazilian economy, because this country is ranked among the largest producers of soybeans in the world. This culture can be significantly affected by water conditions, depending on the intensity of water deficit. This work explores the role of extended period weather forecasts for estimating soybean productivity in the southern part of Brazil, Passo Fundo, and Londrina (State of Rio Grande do Sul and Parana, respectively) in the 2005/2006 harvest. The goal was to investigate the possible contribution of precipitation forecasts as a substitute for the use of climatological data on crop forecasts. The results suggest that the use of meteorological forecasts generate more reliable productivity estimates during the growth period than those generated only through climatological information.

Climatic simulations of the eastern Andes low-level jet and its dependency on convective parameterizations

The South American low level jet (SALLJ) of the Eastern Andes is investigated with Regional Climate Model version 3 (RegCM3) simulations during the 2002-2003 austral summer using two convective parameterizations (Grell and Emanuel). The simulated SALLJ is compared with the special observations of SALLJEX (SALLJ Experiment). Both the Grell and Emanuel schemes adequately simulate the low level flow over South America. However, there are some intensity differences. Due to the larger (smaller) convective activity, the Emanuel (Grell) scheme simulates more intense (weaker) low level wind than analysis in the tropics and subtropics. The objectives criteria of Sugahara (SJ) and Bonner (BJ) were used for LLJ identification. When applied to the observations, both criteria suggest a larger frequency of the SALLJ in Santa Cruz, followed by Mariscal, Trinidad and Asuncin. In Mariscal and Asuncin, the diurnal cycle indicates that SJ occurs mainly at 12 UTCs (morning), while the BJ criterion presents the SALLJ as more homogenously distributed. The concentration into two of the four-times-a-day observations does not allow conclusions about the diurnal cycle in Santa Cruz and Trinidad. The simulated wind profiles result in a lower than observed frequency of SALLJ using both the SJ and BJ criteria, with fewer events obtained with the BJ. Due to the stronger simulated winds, the Emanuel scheme produces an equal or greater relative frequency of SALLJ than the Grell scheme. However, the Grell scheme using the SJ criterion simulates the SALLJ diurnal cycle closer to the observed one. Although some discrepancies between observed and simulated mean vertical profiles of the horizontal wind are noted, there is large agreement between the composites of the vertical structure of the SALLJ, especially when the SJ criterion is used with the Grell scheme. On an intraseasonal scale, a larger southward displacement of SALLJ in February and December when compared with January has been noted. The Grell and Emanuel schemes simulated this observed oscillation in the low-level flow. However, the spatial pattern and intensity of rainfall and circulation anomalies simulated by the Grell scheme are closer to the analyses than those obtained with the Emanuel scheme.

Summertime moisture transport over Southeastern South America and extratropical cyclones behavior during inter-El Nio events

The impact of the inter-El Nio (EN) variability on the moisture availability over Southeastern South America (SESA) is investigated. Also, an automatic tracking scheme was used to analyze the extratropical cyclones properties (system density - SD and central pressure - CP) in this region. During the austral summer period from 1977-2000, the differences for the upper-level wave train anomaly composites seem to determine the rainfall composite differences. In fact, the positive rainfall anomalies over most of the SESA domain during the strong EN events are explained by an upper-level cyclonic center over the tropics and an anticyclonic center over the eastern subtropical area. This pattern seems to contribute to upward vertical motion at 500 hPa and reinforcement of the meridional moisture transport from the equatorial Atlantic Ocean and western Amazon basin to the SESA region. These features may contribute to the positive SD and negative CP anomalies explaining part of the positive rainfall anomalies found there. On the other hand, negative rainfall anomalies are located in the northern part of SESA for the weak EN years when compared to those for the strong events. Also, positive anomalies are found in the southern part, albeit less intense. It was associated with the weakening of the meridional moisture transport from the tropics to the SESA that seems have to contributed with smaller SD and CP anomalies over the most part of subtropics, when compared to the strong EN years.

Formulation of a tropical town energy budget (t-TEB) scheme

This work describes the tropical town energy budget (t-TEB) scheme addressed to simulate the diurnal occurrence of the urban heat island (UHI) as observed in the Metropolitan Area of Rio de Janeiro (MARJ; -22A degrees S; -44A degrees W) in Brazil. Reasoning about the tropical urban climate have guided the scheme implementation, starting from the original equations from Masson (Bound-Lay Meteorol 94:357-397, 2000). The modifications include (a) local scaling approaches for obtaining flux-gradient relationships in the roughness sub-layer, (b) the Monin-Obukhov similarity framework in the inertial sub-layer, (c) increasing aerodynamic conductance toward more unstable conditions, and (d) a modified urban subsurface drainage system to transfer the intercepted rainwater by roofs to the roads. Simulations along 2007 for the MARJ are obtained and compared with the climatology. The t-TEB simulation is consistent with the observations, suggesting that the timing and dynamics of the UHI in tropical cities could vary significantly from the familiar patterns observed in mid-latitude cities-with the peak heat island intensity occurring in the morning than at night. The simulations are suggesting that the thermal phase shift of this tropical diurnal UHI is a response of the surface energy budget to the large amount of solar radiation, intense evapotranspiration, and thermal response of the vegetated surfaces over a very humid soil layer.

Downward longwave radiation estimates for clear and all-sky conditions in the Sertozinho region of So Paulo, Brazil

The accurate estimate of the surface longwave fluxes contribution is important for the calculation of the surface radiation budget, which in turn controls all the components of the surface energy budget, such as evaporation and the sensible heat fluxes. This study evaluates the performance of the various downward longwave radiation parameterizations for clear and all-sky days applied to the Sertozinho region in So Paulo, Brazil. Equations have been adjusted to the observations of longwave radiation. The adjusted equations were evaluated for every hour throughout the day and the results showed good fits for most of the day, except near dawn and sunset, followed by nighttime. The seasonal variation was studied by comparing the dry period against the rainy period in the dataset. The least square linear regressions resulted in coefficients equal to the coefficients found for the complete period, both in the dry period and in the rainy period. It is expected that the best fit equation to the observed data for this site be used to produce estimates in other regions of the State of So Paulo, where such information is not available.

Cloud condensation nuclei from biomass burning during the Amazonian dry-to-wet transition season

Aircraft measurements of cloud condensation nuclei (CCN) during the Large-Scale Biosphere-Atmosphere Experiment in Amazonia (LBA) were conducted over the Southwestern Amazon region in September-October 2002, to emphasize the dry-to-wet transition season. The CCN concentrations were measured for values within the range 0.1-1.0% of supersaturation. The CCN concentration inside the boundary layer revealed a general decreasing trend during the transition from the end of the dry season to the onset of the wet season. Clean and polluted areas showed large differences. The differences were not so strong at high levels in the troposphere and there was evidence supporting the semi-direct aerosol effect in suppressing convection through the evaporation of clouds by aerosol absorption. The measurements also showed a diurnal cycle following biomass burning activity. Although biomass burning was the most important source of CCN, it was seen as a source of relatively efficient CCN, since the increase was significant only at high supersaturations.

The role of the South Indian and Pacific oceans in South American monsoon variability

This work has investigated the impact of three different low-frequency sea surface temperature (SST) variability modes located in the Indian and the Pacific Oceans on the interannual variability of the South American Monsoon System (SAMS) using observed and numerical data. Rotated Empirical Orthogonal Function (REOF) analysis and numerical simulations with a General Circulation Model (GCM) were used. One of the three SST variability modes is located close to southeastern Africa. According to the composites, warmer waters over this region are associated with enhanced austral summer precipitation over the sub-tropics. The GCM is able to reproduce this anomalous precipitation pattern, simulating a wave train emanating from the Indian Ocean towards South America (SA). A second SST variability mode was located in the western Pacific Ocean. REOF analysis indicates that warmer waters are associated with drought conditions over the South Atlantic Convergence Zone (SACZ) and enhanced precipitation over the sub-tropics. The GCM indicates that the warmer waters over Indonesia generate drought conditions over tropical SA through a Pacific South America-like (PSA) wave pattern emanating from the western Pacific. Finally, the third SST variability mode is located over the southwestern South Pacific. The composites indicate that warmer waters are associated with enhanced precipitation over the SACZ and drought conditions over the sub-tropics. There is a PSA-like wave train emanating from Indonesia towards SA, and another crossing the Southern Hemisphere in the extra-tropics, probably associated with transient activity. The GCM is able to reproduce the anomalous precipitation pattern, although it is weaker than observed. The PSA-like pattern is simulated, but the model fails in reproducing the extra-tropical wave activity.

Precipitation variability in Sao Paulo State, Brazil

The State of Sao Paulo is the richest in Brazil, responsible for over 30% of the Brazilian gross rate. It has a population of around 30 million and its economy is based on agriculture and industrial products. Any change in climate can have a profound influence on the socio-economics of the State. In order to determine changes in total and extreme rainfall over Sao Paulo State, climate change indices derived from daily precipitation data were calculated using specially designed software. Maps of trends for a subset of 59 rain gauge stations were analysed for the period 1950-1999 and also for a subset of this period, 1990-1999, representing more recent climate. A non-parametric Mann-Kendall test was applied to the time series. Maps of trends for six annual precipitation indices (annual total precipitation (PRCPTOT), very heavy precipitation days (R20mm), events greater than the 95th percentile (R95p), maximum five days precipitation total (RX5day), the length of the largest wet spell (CWD) and the length of the largest dry spell (CDD)) were analysed for the entire period. These exhibited statistically significant trends associated with a wetter climate. A significant increase in PRCPTOT, associated with very heavy precipitation days, were observed at more than 45% of the rain gauge stations. The Mann-Kendall test identified that the positive trend in PRCPTOT is possibly related to the increase in the R95p and R20mm indices. Therefore, the results suggest that there has been a change in precipitation intensity. In contrast, the indices for the more recent shorter time series are significantly different to the longer term indices. The results indicate that intense precipitation is becoming concentrated in a few days and spread over the period when the CDD and R20mm indices show positive trends, while negative ones are seen in the RX5day index. The trends found could be related to many anthropogenic aspects such as biomass burning aerosols and land use.