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Climate change influences forest ecosystems in several ways, such as modifying forest growth or ecosystem functionality. To fully understand the impact of changing climatic conditions on forest growth it is necessary to undertake long-term spatiotemporal analyses. The main purpose of this work is to describe the major trends in tree growth of Pinus pinaster in Spain over the last 70 years, differentiating homogeneous ecological units using an unsupervised classification algorithm and additive modelling techniques. We also aim to relate these growth trends with temporal series for precipitation and temperature, as well as forest variables. We leverage information from a large data set of tree cores (around 2200) extracted during the field campaign of the Fourth Spanish National Forest Inventory. An unsupervised algorithm classified the plots into five classes, which were consistent in ecological terms. We also found a general decline in growth in three of the five ecoregions since the 1970s, concomitant with an increase in temperature and a reduction in precipitation. However, this tree growth decline has not been observed in the Atlantic influenced ecoregion, where the cooler, more humid climatic conditions are more stable. Certain stand features, such as low basal area through forest management practices, may have alleviated the impact of harsh climatic conditions on some areas of inner Spain, while denser stands display a more pronounced decline in tree growth. We concluded that Southern populations show some degrees of growth decline and low growth trends while Northern populations did not exhibit growth decline and have the largest growth rates. Under a forecasted increment of temperatures, the growth decline can be expanded., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Forest biomass is an essential resource in relation to the green transition and its assessment is key for the sustainable management of forest resources. Here, we present a forest biomass dataset for Europe based on the best available inventory and satellite data, with a higher level of harmonisation and spatial resolution than other existing data. This database provides statistics and maps of the forest area, biomass stock and their share available for wood supply in the year 2020, and statistics on gross and net volume increment in 2010-2020, for 38 European countries. The statistics of most countries are available at a sub-national scale and are derived from National Forest Inventory data, harmonised using common reference definitions and estimation methodology, and updated to a common year using a modelling approach. For those counties without harmonised statistics, data were derived from the State of Europe's Forest 2020 Report at the national scale. The maps are coherent with the statistics and depict the spatial distribution of the forest variables at 100 m resolution., (© 2024. European Union and The Author(s).)

Background and Objective: The gold standard of carpal tunnel syndrome (CTS) treatment is the section of the transverse carpal ligament, the most common technique being the palmar cutaneous incision. Percutaneous techniques have been developed, although their risk/benefit ratio remains controversial., Objective: To analyze the functional outcome of patients undergoing CTS percutaneously ultrasound-guided and compare it with those of open surgery., Material and Method: Prospective observational cohort study of 50 patients undergoing CTS (25 percutaneous with WALANT technique and 25 by open surgery with local anesthesia and tourniquet). Open surgery was performed using a short palmar incision. The percutaneous technique was performed anterograde using the Kemis® H3 scalpel (Newclip). A preoperative and postoperative assessment was performed at 2 weeks, 6 weeks and 3 months. Demographic data, presence of complications, grip strength and Levine test score (BCTQ) were collected., Results: The sample consists of 14 men and 36 women with a mean age of 51.4 years (95% CI: 48.4-54.5). Percutaneous technique was performed anterograde using the Kemis® H3 scalpel (Newclip). All patients improved from their CTS clinic without obtaining statistically significant differences in BCTQ score, nor in the presence of complications (p> 0.05). Patients operated on percutaneously recovered faster grip strength at 6 weeks, but it was similar in the final review., Conclusions: In view of the results obtained, percutaneous ultrasound-guided surgery is a good alternative for the surgical treatment of CTS. Logically, this technique requires its learning curve and familiarization with the ultrasound visualization of the anatomical structures to be treated., (Copyright © 2022 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background and Objective: The gold standard of carpal tunnel syndrome (CTS) treatment is the section of the transverse carpal ligament, the most common technique being the palmar cutaneous incision. Percutaneous techniques have been developed, although their risk/benefit ratio remains controversial., Objective: To analyse the functional outcome of patients undergoing CTS percutaneously ultrasound-guided and compare it with those of open surgery., Material and Method: Prospective observational cohort study of 50 patients undergoing CTS (25 percutaneous with WALANT technique and 25 by open surgery with local anaesthesia and tourniquet). Open surgery was performed using a short palmar incision. The percutaneous technique was performed anterograde using the Kemis H3® scalpel (Newclip). A preoperative and postoperative assessment was performed at 2 weeks, 6 weeks and 3 months. Demographic data, presence of complications, grip strength and Levine test score (BCTQ) were collected., Results: The sample consists of 14 men and 36 women with a mean age of 51.4 years (95% CI: 48.4-54.5). Percutaneous technique was performed anterograde using the Kemis H3® scalpel (Newclip). All patients improved from their CTS clinic without obtaining statistically significant differences in BCTQ score, nor in the presence of complications (p>0.05). Patients operated on percutaneously recovered faster grip strength at 6 weeks, but it was similar in the final review., Conclusions: In view of the results obtained, percutaneous ultrasound-guided surgery is a good alternative for the surgical treatment of CTS. Logically, this technique requires its learning curve and familiarisation with the ultrasound visualisation of the anatomical structures to be treated., (Copyright © 2022 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe., Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed., Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically., Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture., (Copyright © 2021 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Unimodal response of tree species richness to increases in aboveground productivity is evident in grasslands but to a lesser extent in forests, where confounding factors (e.g., abiotic factors and management regimes) may alter the response and compromise the delivery of ecosystem services. We hypothesize that unimodal response of biomass accumulation through increased species richness leads to greater tree above ground carbon (AGC) stocks and thus climate regulation but not necessarily higher timber volume production for human consumption across portions of North American and European forests. We first evaluated the biodiversity-productivity pattern and assessed if the addition of potential confounding variables altered the response. Afterwards, we integrated direct and indirect effects of species richness and confounding factors in the modelling of aboveground carbon stock and timber volume. We confirm an increase in carbon stocks concomitant with an increase in tree species richness up to an optimum biomass value in both regions. Tree species richness had a marginal effect on both aboveground carbon stocks and timber volume with a trade-off in the eastern US. Biomass accumulation is lower in tree plantations than in natural forests, although volume increased with species richness. Naturally-regenerated forests needed as much as double the number of tree species than plantations to reach the same carbon stocks. Distinct ecosystem services (AGC and timber volume) showed unique pathways of achieving their maximum provisioning. As increasing forest resilience to global change requires a fundamental understanding of how tree species combine with changing climatic conditions to drive the provisioning of various ecosystem services, further examination of this study's findings across additional biogeographical regions may lead the way to unraveling such dynamics and empowering adaptive management., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Forest deadwood is a relevant factor in the provision of ecosystem services (forest biodiversity, carbon sequestration, recreational and aesthetic values), but it also influences the risk and impact of forest perturbations. Hence, reliable estimations are urgently need in the lack of detailed information in Mediterranean forests at large scales. In this study we provide, for the first time, national-level estimations for Spain based on the information from the Spanish National Forest Inventory (38,945 plots). In addition, we compare and validate two approaches for estimating deadwood stocks where data is lacking; the first of these being a modelling approach based on stand, climatic and physiographical variables, and the other considers the ratio between deadwood and living biomass. We also examine the different patterns stock across forest types in four biogeographical regions according to a broad-spectrum of species groups and forests with different degrees of anthropogenic influence. The degrees are based on levels of protection and naturalness categories. The modelling approach provides more robust deadwood estimates and better predictive capacity than the ratio approach. Alpine (6.09 Mg.ha -1 ) and Atlantic (3.53 Mg.ha -1 ) bioregion forests store significantly higher mean deadwood biomass stocks than Macaronesian and Mediterranean forests. However, the share of deadwood in relation to the total biomass stock is greater in Mediterranean biogeographical region. As regards species groups, the mean deadwood stock of mixed forests doubled the stocks found in conifer and broadleaved dominated forests. We also found significant differences in deadwood biomass stocks between forests with different levels of anthropogenic protection. However, forest types with intensive forest management had contrasting figures for deadwood stock. The mean values obtained at national level according to forest type, bioregion and degree of anthropogenic influence, provide baseline information for carbon accounting as well as for other forest policy planning and management strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

The quantification of forests available for wood supply (FAWS) is essential for decision-making with regard to the maintenance and enhancement of forest resources and their contribution to the global carbon cycle. The provision of harmonized forest statistics is necessary for the development of forest associated policies and to support decision-making. Based on the National Forest Inventory (NFI) data from 13 European countries, we quantify and compare the areas and aboveground dry biomass (AGB) of FAWS and forest not available for wood supply (FNAWS) according to national and reference definitions by determining the restrictions and associated thresholds considered at country level to classify forests as FAWS or FNAWS. FAWS represent between 75 and 95 % of forest area and AGB for most of the countries in this study. Economic restrictions are the main factor limiting the availability of forests for wood supply, accounting for 67 % of the total FNAWS area and 56 % of the total FNAWS AGB, followed by environmental restrictions. Profitability, slope and accessibility as economic restrictions, and protected areas as environmental restrictions are the factors most frequently considered to distinguish between FAWS and FNAWS. With respect to the area of FNAWS associated with each type of restriction, an overlap among the restrictions of 13.7 % was identified. For most countries, the differences in the FNAWS areas and AGB estimates between national and reference definitions ranged from 0 to 5 %. These results highlight the applicability and reliability of a FAWS reference definition for most of the European countries studied, thereby facilitating a consistent approach to assess forests available for supply for the purpose of international reporting., (© 2019 The Authors.)

Accurate carbon-balance accounting in forest soils is necessary for the development of climate change policy. However, changes in soil organic carbon (SOC) occur slowly and these changes may not be captured through repeated soil inventories. Simulation models may be used as alternatives to SOC measurement. The Yasso07 model presents a suitable alternative because most of the data required for the application are readily available in countries with common forest surveys. In this study, we test the suitability of Yasso07 for simulating SOC stocks and stock changes in a variety of European forests affected by different climatic, land use and forest management conditions and we address country-specific cases with differing resources and data availability. The simulated SOC stocks differed only slightly from measured data, providing realistic, reasonable mean SOC estimations per region or forest type. The change in the soil carbon pool over time, which is the target parameter for SOC reporting, was generally found to be plausible although not in the case of Mediterranean forest soils. As expected under stable forest management conditions, both land cover and climate play major roles in determining the SOC stock in forest soils. Greater mean SOC stocks were observed in northern latitudes (or at higher altitude) than in southern latitudes (or plains) and conifer forests were found to store a notably higher amount of SOC than broadleaf forests. Furthermore, as regards change in SOC, an inter-annual sink effect was identified for most of the European forest types studied. Our findings corroborate the suitability of Yasso07 to assess the impact of forest management and land use change on the SOC balance of forests soils, as well as to accurately simulate SOC in dead organic matter (DOM) and mineral soil pools separately. The obstacles encountered when applying the Yasso07 model reflect a lack of available input data. Future research should focus on improving our knowledge of C inputs from compartments such as shrubs, herbs, coarse woody debris and fine roots. This should include turnover rates and quality of the litter in all forest compartments from a wider variety of tree species and sites. Despite the limitations identified, the SOC balance estimations provided by the Yasso07 model are sufficiently complete, accurate and transparent to make it suitable for reporting purposes such as those required under the UNFCCC (United Nations Framework Convention on Climate Change) and KP (Kyoto Protocol) for a wide range of forest conditions in Europe., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Increased transpiration efficiency (the ratio of biomass to water transpired, TE) could lead to increased drought tolerance under some water deficit scenarios. Intrinsic (i.e., leaf-level) TE is usually considered as the primary source of variation in whole-plant TE, but empirical data usually contradict this assumption. Sunflower has a significant variability in TE, but a better knowledge of the effect of leaf and plant-level traits could be helpful to obtain more efficient genotypes for water use. The objective of this study was, therefore, to assess if genotypic variation in whole-plant TE is better related to leaf- or plant-level traits. Three experiments were conducted, aimed at verifying the existence of variability in whole-plant TE and whole-plant and leaf-level traits, and to assess their correlation. Sunflower public inbred lines and a segregating population of recombinant inbred lines were grown under controlled conditions and subjected to well-watered and water-deficit treatments. Significant genotypic variation was found for TE and related traits. These differences in whole-plant transpiration efficiency, both between genotypes and between plants within each genotype, showed no association to leaf-level traits, but were significantly and negatively correlated to biomass allocation to leaves and to the ratio of leaf area to total biomass. These associations are likely of a physiological origin, and not only a consequence of genetic linkage in the studied population. These results suggest that genotypic variation for biomass allocation could be potentially exploited as a source for increased transpiration efficiency in sunflower breeding programmes. It is also suggested that phenotyping for TE in this species should not be restricted to leaf-level measurements, but also include measurements of plant-level traits, especially those related to biomass allocation between photosynthetic and non-photosynthetic organs.

Ground vegetation (GV) is an important component from which many forest biodiversity indicators can be estimated. To formulate policies at European level, taking into account biodiversity, European National Forest Inventories (NFIs) are one of the most important sources of forest information. However, for monitoring GV, there are several definitions, data collection methods, and different possible indicators. Even though it must be considered that natural conditions in different countries form very different understory types, each one has its own cost-efficient monitoring design, and they can hardly be compared. Therefore, the development of general guidelines is a particularly complex issue. This paper is a review of data collection methods and consequently a selection of the best available methods for the set of indicators with an emphasis on GV sampling methodologies in NFIs. As a final result, recommendations on GV definitions and classifications, sampling methodologies, and indicators are formulated for NFIs. Different sampling areas are recommended for each life form (shrubs, herbs, etc.). Inventory cycles and sampling seasons (depending on the phonological stages) should be specially considered and evaluated in the results. The proposed indicators are based on composition at different levels of sampling intensity for each life form and on coverage measurements.

We report our initial experience in 2 patients with degenerative calcific aortic stenosis who underwent ultrasonic debridement of the aortic valve. Compared with preoperative studies, doppler echocardiographic and hemodynamic evaluation before hospital discharge revealed a reduction in the mean aortic valve pressure gradient (80 and 65 mmHg to less than 10 mmHg). There was no change in aortic regurgitation grade. Follow-up doppler echocardiographic evaluation at four and six months showed no changes in gradient or regurgitation in the comparison to the postoperative data. Long-term results will show the convenience to attempt or not ultrasonic salvage of the native aortic valve in severe calcific stenosis.

An investigation was made of the effect of emergency endoscopic sclerotherapy on the evaluation of digestive hemorrhage (HDA) secondary to gastroduodenal ulcer disease in two consecutive groups of patients. The control group included 92 patients and the sclerotherapy group contained 63. Both groups had the same management and basic treatment of hemodynamic stabilization, anti-H2 agents and alkaline . The sclerotherapy group also received a local injection of 1/10,000 (5-12 ml) adrenaline and 1% polydocanol (5-12 ml) if direct signs of hemorrhage (active bleeding, red clot, visible vessel) were seen at the time of early endoscopy. Surgery was indicated in the presence of persistent, recurrent or massive digestive hemorrhage. Thirty-two percent of the control group and 34% of the sclerosis group presented direct signs of hemorrhage at the time of endoscopy. Both groups were homogeneous with respect to sex distribution, NSAID intake, hemoglobin, presence of shock and etiology (33.3% and 36.3%, respectively, had duodenal ulcer). The average age was significantly higher in the control group than in the sclerotherapy group. Neither the presence of any endoscopic sign nor etiology contributed to the evolution of digestive bleeding. It is concluded that emergency endoscopic sclerotherapy with injection of adrenaline and polydocanol has a clearly favorable effect on the evolution of bleeding secondary to gastrointestinal ulcer disease evidencing direct signs on endoscopy.