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In the Panama Bight, two different seasonal surface circulation patterns coincide with a strong mean sea level variation, as observed from 27 years of absolute dynamic topography (ADT) and the use of self-organizing maps. From January to April, a cyclonic gyre with a strong southwestward Panama Jet Surface Current (PJSC) dominates the basin circulation, forced by the Panama surface wind jet that also produces upwelling, reducing sea surface temperature (SST), increasing sea surface salinity (SSS) and causing an ADT decrease. From June to December, the Choco surface wind jet enhances SST, precipitation and river runoff, which reduces SSS, causing an ADT rise, which in turn forces a weak circulation in the bight, vanishing the PJSC. Interannual variability in the region is strongly affected by El Niño–Southern Oscillation (ENSO); however this climatic variability does not modify the seasonal circulation patterns in the Panama Bight. In contrast, the positive (negative) ENSO phase increases (decreases) SST and ADT in the Panama Bight, with a mean annual difference of 0.9 ∘C and 9.6 cm, respectively, between the two conditions, while its effect on SSS is small. However, as the strong seasonal SST, SSS and ADT ranges are up to 2.2 ∘C, 2.59 g kg−1 and 28.3 cm, the seasonal signal dominates over interannual variations in the bight.

Every year the Caribbean Sea faces the passage of several tropical cyclones that generate coastal extreme sea levels with potential strong and hazardous impacts. In this work we simulate the storm surges and wind waves induced by a set of 1000 tropical cyclones over the Caribbean Sea that are representative of the present-day climate. These events have been extracted from a global database of synthetic tropical cyclones spanning a 10 000-year period. The atmospheric forcing fields, associated with the set of tropical cyclones, are used to feed a coupled hydrodynamic–wave model with high resolution (∼ 2 km) along the continental and island coasts. Given the large number of events modelled, our results allow detailed statistical analyses of the magnitude and mechanisms of coastal extreme sea levels, as well as the identification of one of the most exposed areas to both storm surges and extreme wind waves.

Due to the semi-enclosed nature of the Mediterranean Sea, natural disasters and anthropogenic activities impose stronger pressures on its coastal ecosystems than in any other sea of the world. With the aim of responding adequately to science priorities and societal challenges, littoral waters must be effectively monitored with high-frequency radar (HFR) systems. This land-based remote sensing technology can provide, in near-real time, fine-resolution maps of the surface circulation over broad coastal areas, along with reliable directional wave and wind information. The main goal of this work is to showcase the current status of the Mediterranean HFR network and the future roadmap for orchestrated actions. Ongoing collaborative efforts and recent progress of this regional alliance are not only described but also connected with other European initiatives and global frameworks, highlighting the advantages of this cost-effective instrument for the multi-parameter monitoring of the sea state. Coordinated endeavors between HFR operators from different multi-disciplinary institutions are mandatory to reach a mature stage at both national and regional levels, striving to do the following: (i) harmonize deployment and maintenance practices; (ii) standardize data, metadata, and quality control procedures; (iii) centralize data management, visualization, and access platforms; and (iv) develop practical applications of societal benefit that can be used for strategic planning and informed decision-making in the Mediterranean marine environment. Such fit-for-purpose applications can serve for search and rescue operations, safe vessel navigation, tracking of marine pollutants, the monitoring of extreme events, the investigation of transport processes, and the connectivity between offshore waters and coastal ecosystems. Finally, future prospects within the Mediterranean framework are discussed along with a wealth of socioeconomic, technical, and scientific challenges to be faced during the implementation of this integrated HFR regional network.

The Mediterranean Sea is a prominent climate-change hot spot, with many socioeconomically vital coastal areas being the most vulnerable targets for maritime safety, diverse met-ocean hazards and marine pollution. Providing an unprecedented spatial and temporal resolution at wide coastal areas, high-frequency radars (HFRs) have been steadily gaining recognition as an effective land-based remote sensing technology for continuous monitoring of the surface circulation, increasingly waves and occasionally winds. HFR measurements have boosted the thorough scientific knowledge of coastal processes, also fostering a broad range of applications, which has promoted their integration in coastal ocean observing systems worldwide, with more than half of the European sites located in the Mediterranean coastal areas. In this work, we present a review of existing HFR data multidisciplinary science-based applications in the Mediterranean Sea, primarily focused on meeting end-user and science-driven requirements, addressing regional challenges in three main topics: (i) maritime safety, (ii) extreme hazards and (iii) environmental transport process. Additionally, the HFR observing and monitoring regional capabilities in the Mediterranean coastal areas required to underpin the underlying science and the further development of applications are also analyzed. The outcome of this assessment has allowed us to provide a set of recommendations for future improvement prospects to maximize the contribution to extending science-based HFR products into societally relevant downstream services to support blue growth in the Mediterranean coastal areas, helping to meet the UN's Decade of Ocean Science for Sustainable Development and the EU's Green Deal goals.

The impact of the assimilation of HFR (high-frequency radar) observations in a high-resolution regional model is evaluated, focusing on the improvement of the mesoscale dynamics. The study area is the Ibiza Channel, located in the western Mediterranean Sea. The resulting fields are tested against trajectories from 13 drifters. Six different assimilation experiments are compared to a control run (no assimilation). The experiments consist of assimilating (i) sea surface temperature, sea level anomaly, and Argo profiles (generic observation dataset); the generic observation dataset plus (ii) HFR total velocities and (iii) HFR radial velocities. Moreover, for each dataset, two different initialization methods are assessed: (a) restarting directly from the analysis after the assimilation or (b) using an intermediate initialization step applying a strong nudging towards the analysis fields. The experiments assimilating generic observations plus HFR total velocities with the direct restart provide the best results, reducing by 53 % the average separation distance between drifters and virtual particles after the first 48 h of simulation in comparison to the control run. When using the nudging initialization step, the best results are found when assimilating HFR radial velocities with a reduction of the mean separation distance by around 48 %. Results show that the integration of HFR observations in the data assimilation system enhances the prediction of surface currents inside the area covered by both antennas, while not degrading the correction achieved thanks to the assimilation of generic data sources beyond it. The assimilation of radial observations benefits from the smoothing effect associated with the application of the intermediate nudging step.

The use of high-frequency radar (HFR) data is increasing worldwide for different applications in the field of operational oceanography and data assimilation, as it provides real-time coastal surface currents at high temporal and spatial resolution. In this work, a Lagrangian-based, empirical, real-time, short-term prediction (L-STP) system is presented in order to provide short-term forecasts of up to 48 h of ocean currents. The method is based on finding historical analogs of Lagrangian trajectories obtained from HFR surface currents. Then, assuming that the present state will follow the same temporal evolution as the historical analog, we perform the forecast. The method is applied to two HFR systems covering two areas with different dynamical characteristics: the southeast Bay of Biscay and the central Red Sea. A comparison of the L-STP methodology with predictions based on persistence and reference fields is performed in order to quantify the error introduced by this approach. Furthermore, a sensitivity analysis has been conducted to determine the limit of applicability of the methodology regarding the temporal horizon of Lagrangian prediction. A real-time skill score has been developed using the results of this analysis, which allows for the identification of periods when the short-term prediction performance is more likely to be low, and persistence can be used as a better predictor for the future currents.

The spatial and temporal variability of extreme wave climate in the North Atlantic Ocean and the Mediterranean Sea is assessed using a 31-year wave model hindcast. Seasonality accounts for 50 % of the extreme wave height variability in the North Atlantic Ocean and up to 70 % in some areas of the Mediterranean Sea. Once seasonality is filtered out, the North Atlantic Oscillation and the Scandinavian index are the dominant large-scale atmospheric patterns that control the interannual variability of extreme waves during winters in the North Atlantic Ocean; to a lesser extent, the East Atlantic Oscillation also modulates extreme waves in the central part of the basin. In the Mediterranean Sea, the dominant modes are the East Atlantic and East Atlantic–Western Russia modes, which act strongly during their negative phases. A new methodology for analyzing the atmospheric signature associated with extreme waves is proposed. The method obtains the composites of significant wave height (SWH), mean sea level pressure (MSLP), and 10 m height wind velocity (U10) using the instant when specific climatic indices have a stronger correlation with extreme waves.

The morphodynamic response of a microtidal beach under a storm group is analyzed, and the effects of each individual event are inferred from a numerical model, in situ measurements and video imaging. The combination of these approaches represents a multiplatform tool for beach management, especially during adverse conditions. Here, the morphodynamic response is examined during a period with a group of three storms. The first storm, with moderate conditions (Hs ∼ 1 m during 6 h), eroded the aerial beach and generated a submerged sandbar in the breaking zone. The bar was further directed offshore during the more energetic second event (Hs = 3.5 m and 53 h). The third storm, similar to the first one, hardly affected the beach morphology, which stresses the importance of the beach configuration previous to a storm. The volume of sand mobilized during the storm group is around 17.65 m3 m−1. During the following months, which are characterized by mild wave conditions, the aerial beach recovered half of the volume of sand that is transported offshore during the storm group ( ∼ 9.27 m3 m−1). The analysis of beach evolution shows two different characteristic timescales for the erosion and recovery processes associated with the storm and mild conditions, respectively. In addition, the response depends largely on the previous beach morphological state. The work also stresses the importance of using different tools (video monitoring, modeling, and field campaign) to analyze beach morphodynamics.

High-frequency radar, HFR, is a cost-effective monitoring technique that allows us to obtain high-resolution continuous surface currents, providing new insights for understanding small-scale transport processes in the coastal ocean. In the last years, the use of Lagrangian metrics to study mixing and transport properties has been growing in importance. A common condition among all the Lagrangian techniques is that complete spatial and temporal velocity data are required to compute trajectories of virtual particles in the flow. However, hardware or software failures in the HFR system can compromise the availability of data, resulting in incomplete spatial coverage fields or periods without data. In this regard, several methods have been widely used to fill spatiotemporal gaps in HFR measurements. Despite the growing relevance of these systems there are still many open questions concerning the reliability of gap-filling methods for the Lagrangian assessment of coastal ocean dynamics. In this paper, we first develop a new methodology to reconstruct HFR velocity fields based on self-organizing maps (SOMs). Then, a comparative analysis of this method with other available gap-filling techniques is performed, i.e., open-boundary modal analysis (OMA) and data interpolating empirical orthogonal functions (DINEOFs). The performance of each approach is quantified in the Lagrangian frame through the computation of finite-size Lyapunov exponents, Lagrangian coherent structures and residence times. We determine the limit of applicability of each method regarding four experiments based on the typical temporal and spatial gap distributions observed in HFR systems unveiled by a K-means clustering analysis. Our results show that even when a large number of data are missing, the Lagrangian diagnoses still give an accurate description of oceanic transport properties.

This work assesses the impacts in reshaping coastlines as a result of sea level rise and changes in wave climate. The methodology proposed combines the SWAN and SWASH wave models to resolve the wave processes from deep waters up to the swash zone in two micro-tidal sandy beaches in Mallorca island, western Mediterranean. In a first step, the modelling approach has been validated with observations from wave gauges and from the shoreline inferred from video monitoring stations, showing a good agreement between them. Afterwards, the modelling set-up has been applied to the 21st century sea level and wave projections under two different climate scenarios, representative concentration pathways RCP45 and RCP85. Sea level projections have been retrieved from state-of-the-art regional estimates, while wave projections were obtained from regional climate models. Changes in the shoreline position have been explored under mean and extreme wave conditions. Our results indicate that the studied beaches would suffer a coastal retreat between 7 and up to 50 m, equivalent to half of the present-day aerial beach surface, under the climate scenarios considered.

On 9 September 2014, an intensive drifter deployment was carried out in the Strait of Gibraltar. In the frame of the MEDESS-4MS Project (EU MED Program), the MEDESS-GIB experiment consisted of the deployment of 35 satellite tracked drifters, mostly of CODE-type, equipped with temperature sensor sampling at a rate of 30 min. Drifters were distributed along and on both sides of the Strait of Gibraltar. The MEDESS-GIB deployment plan was designed as to ensure quasi-synoptic spatial coverage. To this end, four boats covering an area of about 680 NM2 in 6 h were coordinated. As far as these authors know, this experiment is the most important exercise in the area in terms of number of drifters released. Collected satellite-tracked data along drifter trajectories have been quality controlled and processed to build the presented MEDESS-GIB database. This paper reports the MEDESS-GIB data set that comprises drifter trajectories, derived surface currents and in situ SST measurements collected along the buoys tracks. This series of data is available through the PANGAEA (Data Publisher for Earth and Environmental Science) repository, with the following doi:10.1594/PANGAEA.853701. Likewise, the MEDESS-GIB data will be incorporated as part of the Copernicus Marine historical products. The MEDESS-GIB data set provides a complete Lagrangian view of the surface inflow of Atlantic waters through the Strait of Gibraltar and thus, very useful data for further studies on the surface circulation patterns in the Alboran Sea, and their links with one of the most energetic Mediterranean Sea flows: the Algerian Current.

Abstract Background Previous data in humans suggest that extreme physical inactivity (EPI) affects iron metabolism differently between sexes. Our objective was to deepen the underlying mechanisms by studying rats of both sexes exposed to hindlimb unloading (HU), the reference experimental model mimicking EPI. Methods Eight‐week‐old male and female Wistar rats were assigned to control (CTL) or hindlimb unloading (HU) conditions (n = 12/group). After 7 days of HU, serum, liver, spleen, and soleus muscle were removed. Iron parameters were measured in serum samples, and ICP‐MS was used to quantify iron in tissues. Iron metabolism genes and proteins were analysed by RT‐qPCR and Western blot. Results Compared with control males, control females exhibited higher iron concentrations in serum (+43.3%, p

Martha's Vineyard Sign Language (MVSL) is an extinct village sign language hypothesized to be a sister of British Sign Language (BSL) and a significant contributor to early American Sign Language (ASL) (Groce 1985). After the last deaf MVSL signer died, signs were elicited from five hearing signers. This study analyzes that data through a series of lexicostatistical comparisons following methodology from Woodward (1978) and Guerra Currie, Meier, and Walters (2002). The results show that a sample of 711 MVSL signs is 67 percent similar to ASL, 74 percent similar to Old ASL (OASL), 56 percent similar to Old French Sign Language (OLSF), and 59 percent similar to BSL. Subsequent etymological analysis suggests that most signs shared by ASL and MVSL originated in Old LSF or ASL, and that signs shared with BSL likely came through ASL to MVSL, not the reverse. This suggests that MVSL did not play a large role in shaping early ASL; however, MVSL data may still be useful in reconstructing OASL.

Cardiac arrest-induced global cerebral ischemia (GCI) results in profound cognitive impairment in survivors. Our prior work demonstrated persistent disruption of long-term potentiation (LTP) in hippocampal CA1 neurons, correlating with learning and memory deficits in a rodent model of cardiac arrest/cardiopulmonary resuscitation (CA/CPR). Delayed inhibition of the Ca2+-permeable TRPM2 ion channel restored LTP post-CA/CPR, yet the mechanisms upstream of TRPM2 activation remain elusive. This study investigates CD38 as a potential regulator of TRPM2, highlighting a novel target to reverse hippocampal synaptic plasticity deficits after ischemia. We observe elevated levels of CD38 in activated astrocytes in the CA1 region of the hippocampus 7 days following CA/CPR in both male and female mice. Delayed inhibition of CD38 reverses hippocampal synaptic plasticity impairments at subacute timepoints after CA/CPR, phenocopying TRPM2 restoration of LTP. Our previous findings demonstrated that TRPM2 inhibition reverses the CA/CPR-induced enhancement of GABAA receptor (GABAAR) clustering, which contribute to ongoing LTP deficits. We, therefore, assessed the effect of CD38 on GABAergic inhibitory potentiation and find that inhibition of CD38 reverses GABAAR clustering in a TRPM2-dependent manner. In this study, we identify astroglial CD38 as a potential target and upstream regulator of the TRPM2 channel, offering a promising approach to restore hippocampal synaptic plasticity impairments following GCI through modulation of GABAergic signaling.

Wave setup is a physical process that induces a temporal increase of the mean water level due to wave dissipation by bottom friction and breaking in the surf zone, extending over tens to hundreds of meters in the cross-shore direction. Wave setup contribution to coastal sea level solely induced by wind and atmospheric effects can increase by more than 100% under extreme events and conditions favoring its formation. It is therefore crucial to consider this phenomenon when assessing sea-level-related coastal hazards. Previous studies estimated the wave setup effect by means of numerical modeling and empirical formulations at regional and global scale. Such analyses require either high computational capacity to implement high-resolution numerical models over large domains, and/or accurate information on coastal morphological features from global or regional databases. Although the Mediterranean Sea is a fetch-limited environment, waves generated from extra-tropical cyclones are powerful enough for wave setup to develop, and subsequently for a potential significant wave setup contribution to extreme coastal sea level. Through the use of both numerical and empirical methods, we investigate the uncertainty associated to wave setup representation on the frequency and magnitude of coastal extreme sea levels occurring on sandy beaches in the Mediterranean Sea. Wave setup values are compared at beach scale between process-based modeling and empirical approaches, showing highly variable results. We also quantify the impact of wave setup on return levels of coastal sea level extremes using reconstructed sea levels. We employ various methods to calculate the wave setup component. Results show high spatial dispersion, with clear differences between the numerical and empirical approaches, especially in regions prone to the development of energetic waves. The total inter-method dispersion of 100-year return levels is often higher than 30 cm for average values of 62.4 cm. We emphasize the important limitations related to wave setup modeling (i.e., its underestimation) at large scale, and call for caution when applying empirical formulations (generally developed from local studies) at regional to global scale, which can lead to unrealistic wave setup values.

Objective: This study aimed to use the Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) to assess the experience of person-centered coordinated care among people with long-term conditions in the Balearic Islands, Spain. Methods: Over 1300 participants receiving treatment for chronic conditions or HIV pre-exposure prophylaxis were invited to complete the P3CEQ and a socio-demographic questionnaire, both administered electronically via the Naveta app. The P3CEQ assesses the key domains of the P3C through an 11-item questionnaire. Items 1, 2, 3, 4, 5, 8, 9 and 10 assess specifically person-centredness (PC subscale), while items 5, 6, 7, 8 and 9 measure care coordination (CC subscale; question 7 includes 4 sub-questions to specifically assess care plans). Descriptive statistics were used to summarize patient characteristics and P3CEQ items scores. Data analysis included chi-squared test of independence, Student’s t -test and analysis of variance test. Pairwise comparisons were adjusted by Bonferroni correction. Results: The P3CEQ and a socio-demographic questionnaire were sent to 1313 individuals (651 men, 657 women, 5 ‘other gender’). A response rate of 35.34% was achieved, with 464 P3CEQ responders (223 men and 241 women). Significant differences in response rates were observed by age, smoking status, alcohol consumption, membership of patient organizations, and use of alternative medicine. Care planning was rated significantly lower than other measured domains. Women experienced less person-centered care than men (16.64 vs 17.91) and rated care coordination worse than their male counterparts (9.18 vs 10.23). There were also differences in scores between medical condition types, with cancer and inflammatory bowel disease patients rating highest for both person-centered care (21.20 and 19.13, respectively) and care coordination (10.70 vs 10.88, respectively). Patients with skin and rheumatic diseases rated lowest their experience of person-centered care. People with higher education and those employed or studying experienced better person-centeredness. Conclusion: Using the P3CEQ, we detected significant differences in the care experiences of people with chronic conditions, suggesting the need to address potential gender biases, social inequalities, and the poorer ratings observed for certain conditions in the study population.

BackgroundPatient-reported outcome and experience measures can play a critical role in providing patient-centered and value-based health care to a growing population of patients who are chronically ill. Value-based telemedicine platforms such as the Naveta initiative may facilitate the effective integration of these tools into health care systems. ObjectiveThis study aims to evaluate the response rate to electronic patient-reported outcome measures (ePROMs) and electronic patient-reported experience measures (ePREMs) among patients participating in the Naveta telemedicine initiative and its correlations with sociodemographic and clinical characteristics, as well as the evolution of the response rates over time. MethodsBetween January 1, 2021, and June 30, 2023, a total of 53,364 ePREMs and ePROMs for 20 chronic conditions were administered through the Naveta-Phemium platform. Descriptive statistics were used to summarize continuous and categorical variables. Differences in response rates within each sociodemographic variable were analyzed using logistic regression models, with significance assessed via chi-square and post hoc Tukey tests. Two-way ANOVA was used to examine the interaction between time interval and disease type on response rate evolution. ResultsA total of 3372 patients with severe chronic diseases from 64 public hospitals in Spain participated in the Naveta health questionnaire project. The overall response rate to ePROMs and ePREMs during the first 2.5 years of the Naveta initiative was 46.12% (24,704/53,364), with a baseline rate of 53.33% (7198/13,496). Several sociodemographic factors correlated with lower response rates, including male gender, older age, lower education level, frequent alcohol use, being a student, and not being physically active. There were also significant variations in response rates among different types of chronic conditions (P

Abstract Ecosystems threatened by climate change can boost their resilience by developing spatial patterns. Spatially regular patterns in wave-exposed seagrass meadows are attributed to self-organization, yet underlying mechanisms are not well understood. Here, we show that these patterns could emerge from feedbacks between wave reflection and seagrass-induced bedform growth. We derive a theoretical model for surface waves propagating over a growing seagrass bed. Wave-induced bed shear stress shapes bedforms which, in turn, trigger wave reflection. Numerical simulations show seagrass pattern development once wave forcing exceeds a critical amplitude. In line with Mediterranean Sea field observations, these patterns have half the wavelength of the forcing waves. Our results raise the hypothesis that pattern formation optimizes the potential of seagrass meadows to reflect wave energy, and a clear direction for future field campaigns. If wave-reflecting pattern formation increases ecosystem resilience under globally intensifying wave climates, these ecosystems may inspire nature-based coastal protection measures.

Climate change is causing problems for agriculture, but the effect of combined abiotic stresses on crop nutritional quality is not clear. Here we studied the effect of 10 combinations of climatic conditions (temperature, CO2, O3 and drought) under controlled growth chamber conditions on the grain yield, protein, and mineral content of 3 wheat varieties. Results show that wheat plants under O3 exposure alone concentrated + 15 to + 31% more grain N, Fe, Mg, Mn P and Zn, reduced K by - 5%, and C did not change. Ozone in the presence of elevated CO2 and higher temperature enhanced the content of Fe, Mn, P and Zn by 2-18%. Water-limited chronic O3 exposure resulted in + 9 to + 46% higher concentrations of all the minerals, except K. The effect of climate abiotic factors could increase the ability of wheat to meet adult daily dietary requirements by + 6% to + 12% for protein, Zn and Fe, but decrease those of Mg, Mn and P by - 3% to - 6%, and K by - 62%. The role of wheat in future nutrition security is discussed.

Robotics and autonomous systems are reshaping the world, changing healthcare, food production and biodiversity management. While they will play a fundamental role in delivering the UN Sustainable Development Goals, associated opportunities and threats are yet to be considered systematically. We report on a horizon scan evaluating robotics and autonomous systems impact on all Sustainable Development Goals, involving 102 experts from around the world. Robotics and autonomous systems are likely to transform how the Sustainable Development Goals are achieved, through replacing and supporting human activities, fostering innovation, enhancing remote access and improving monitoring. Emerging threats relate to reinforcing inequalities, exacerbating environmental change, diverting resources from tried-and-tested solutions and reducing freedom and privacy through inadequate governance. Although predicting future impacts of robotics and autonomous systems on the Sustainable Development Goals is difficult, thoroughly examining technological developments early is essential to prevent unintended detrimental consequences. Additionally, robotics and autonomous systems should be considered explicitly when developing future iterations of the Sustainable Development Goals to avoid reversing progress or exacerbating inequalities.

Abstract Shoreline position is a key parameter of a beach state, often used as a descriptor of the response of the system to changes in external forcing, such as sea-level rise. Changes in shoreline position are the result of coupled hydrodynamic and morphodynamic processes happening in the nearshore and acting at different temporal scales. Due to this complexity, methodologies aimed at reproducing shoreline evolution at decadal time scale require many simplifications. Simpler methods usually consider an equilibrium beach profile whose shape depends only on beach morphology, and whose location varies depending on incoming forcing. Here, we derive a general equation for shoreline evolution using equilibrium beach profiles. We particularize it based on several common assumptions, and evaluate changes on shoreline position caused by sea-level rise, combined with simultaneous wave and high-frequency sea-level forcing. We compare our model against other analytical equilibrium beach profile-based models and with a dynamic model explicitly computing sediment transport. Results indicate that: (i) it is necessary to consider the area of the emerged beach subject to marine forcing rather than focusing only on the submerged part, (ii) the rates of shoreline recession may change for narrow beaches, defined as those for which marine forcings act onto all of their aerial surface, and (iii) Bruun’s Rule can describe beach shoreline evolution, but the uncertainty in selecting the landward boundary of the active profile entails a huge uncertainty in the magnitude of shoreline evolution. This problematic uncertainty can be drastically reduced if instantaneous forcing conditions are used instead of the arbitrary emerged/submerged active profile boundaries typically defined by only one statistic parameter of extreme conditions.

Acute exercise induces transient modifications in the tumor microenvironment and has been linked to reduced tumor growth along with increased infiltration of immune cells within the tumor in mouse models. In this study, we aimed to evaluate the impact of acute exercise before treatment administration on tumor growth in a mice model of MC38 colorectal cancer receiving an immune checkpoint inhibitor (ICI) and chemotherapy. Six-week-old mice injected with colorectal cancer cells (MC38) were randomized in 4 groups: control (CTRL), immuno-chemotherapy (TRT), exercise (EXE) and combined intervention (TRT/EXE). Both TRT and TRT-EXE received ICI: anti-PD1-1 (1 injection/week) and capecitabine + oxaliplatin (5 times a week) for 1 week (experimentation 1), 3 weeks (experimentation 2). TRT-EXE and EXE groups were submitted to 50 minutes of treadmill exercise before each treatment administration. Over the protocol duration, tumor size has been monitored daily. Tumor growth and microenvironment parameters were measured after the intervention on Day 7 (D7) and Day 16 (D16). From day 4 to day 7, tumor volumes decreased in the EXE/TRT group while remaining stable in the TRT group (p=0.0213). From day 7 until day 16 tumor volume decreased with no significant difference between TRT and TRT/EXE. At D7 the TRT/EXE group exhibited a higher total infiltrate T cell (p=0.0118) and CD8+ cytotoxic T cell (p=0.0031). At D16, tumor marker of apoptosis, vascular integrity and inflammation were not significantly different between TRT and TRT/EXE. Our main result was that acute exercise before immuno-chemotherapy administration significantly decreased early-phase tumor growth (D0 to D4). Additionally, exercise led to immune cell infiltration changes during the first week after exercise, while no significant molecular alterations in the tumor were observed 3 weeks after exercise.

The extreme wave height distribution in the Caribbean Sea is studied using a new method based on the maximum basin-wide aggregate of significant wave height, Hs, values per month. Besides, by means of the Self-Organizing Maps (SOM) technique, we identify coherent geographical regions with similar extreme wave height variability in the Caribbean Sea. Our findings revealed three primary regions: the eastern side with comparatively lower values, the central region with intermediate values, and the western side with the highest extreme wave heights. The study also examines the wind forcing conditions driving the spatial and temporal variability of the extreme waves, highlighting the influence of the low-pressure belt dynamics as well as the role played by the Caribbean Low-Level Jet (CLLJ) index, and the impact of cold fronts and hurricanes on extreme wave heights. Additionally, we explore the relationship between the extreme wave height distribution and climatic indices, such as the Atlantic Multidecadal Oscillation (AMO), the Atlantic Meridional Mode (AMM), the North Atlantic Oscillation (NAO) and the Oceanic Niño (ONI). The results reveal that the spatial distribution of extreme wave heights in the Caribbean Sea is mostly ruled by the influence of the CLLJ, with correlations close to 80%. In addition, significant correlations were observed between the extreme wave heights and the ENSO in the central Caribbean, as well as positive correlations between the extreme wave heights and NAO in the eastern part of the basin, and significant values of correlation with the negative phases of AMO and AMM in the whole basin. We show that, unlike conventional (or broadly used) methods deployed to identify extreme wave height, such as percentile 99th, Hs99, our methodology allows a further assessment of the wind and climate forcing conditions associated with the extreme wave events. Although, we acknowledge that the method here presented has limitations to capture extreme wave height outliers, it has the advantage of being used concomitant with the wind forcing to develop multivariate wave climate analysis at basin scale, and could be extended to a more local scale when studying coastal processes.

Introducción: El tema del cambio climático y sus efectos, en la salud, educación y transporte, es un tema emergente, que pretende la optimización del consumo y la eficiencia energética. Esta investigación se plantea como objetivo, la caracterización del uso y aprovechamiento de energías, en establecimientos de atención médica de la región capital durante el año 2022, considerando la distribución energética, eficiencia y fuentes primarias de energía utilizadas en este país. Métodos: Se trata de una investigación descriptiva, transversal y prospectiva, a través del análisis cuali-cuantitativo, con el uso de informantes clave quienes consideran importante la iluminación natural en los espacios y el mayor aprovechamiento energético en áreas como la quirúrgica y consulta externa. Resultados: Surge el uso de la energía solar, eólica e hidráulica como recursos energéticos aprovechables, así como la sostenibilidad y la mantenibilidad en el diseño y rediseño de infraestructuras hospitalarias. Los tipos de energías utilizados en Venezuela, siguen correspondiendo a la hidráulica y combustibles fósiles, se conoce la tecnología e implementación de paneles solares para la mejoría del cambio climático, la huella del carbono, el uso de energías verdes y reducción de combustibles fósiles. Su aceptación depende de regulaciones y la concientización energética como elementos fundamentales para el cambio.