First results of phytoplankton spatial dynamics in two NW-Mediterranean bays from Chlorophyll-a estimates using Sentinel 2: potential implications for aquaculture

Shellfish aquaculture has a major socioeconomic impact on coastal areas, thus it is necessary to develop support tools for its management. In this sense, phytoplankton monitoring is crucial, as it is the main source of food for shellfish farming. The aim of this study was to assess the applicability of Sentinel 2 multispectral imagery (MSI) to monitor the phytoplankton biomass at Ebro Delta bays and to assess its potential as a tool for shellfish management. In situ chlorophyll-a data from Ebro Delta bays (NE Spain) were coupled with several band combination and band ratio spectral indices derived from Sentinel 2A levels 1C and 2A for time-series mapping. The best results (AIC = 72.17, APD < 10%, and MAE < 0.7 mg/m3) were obtained with a simple blue-to-green ratio applied over Rayleigh corrected images. Sentinel 2–derived maps provided coverage of the farm sites at both bays allowing relating the spatiotemporal distribution of phytoplankton with the environmental forcing under different states of the bays. The applied methodology will be further improved but the results show the potential of using Sentinel 2 MSI imagery as a tool for assessing phytoplankton spatiotemporal dynamics and to encourage better future practices in the management of the aquaculture in Ebro Delta bays.info:eu-repo/semantics/publishedVersio

New models are needed to optimise the management of new medicines

Abstract: Countries struggling to fund new premium priced medicines with ever increasing prices. In addition, substantial savings as medicines lose their patents. This requires co-ordinated approaches. Models are being developed centring on three pillars: pre-launch including horizon scanning; peri-launch including P & R/ risk sharing; post-launch including assessing effectiveness. This will continue to enable access to safe, effective and affordable medicines. Introduction: Countries are struggling to fund new premium priced medicines with ever increasing prices. In addition, substantial savings as medicines lose their patents. This requires co-ordinated approaches. Models are being developed centring on three pillars: pre-launch including horizon scanning; peri-launch including P & R/ risk sharing; post-launch including assessing effectiveness [1,2]. This will continue to enable access to safe, effective and affordable medicines. Methodology: Desk research of regulatory and other relevant policy documents as well as a thorough and extensive literature search in peer-reviewed databases. Results: Models to optimise the use of new medicines are being developed. These centre on three pillars: pre-launch activities including horizon scanning with a specific focus on unmet needs, drugs’ expected place in therapy, drugs’ preliminary budget impact and forecasting (including medicines likely to lose their patents); peri-launch activities including P & R assessment and assessments of risk sharing arrangements; post-launch activities include assessing the effectiveness and safety of new medicines in routine clinical care [1,2]. Pre-launch activities to agree the number of potential patients for new cancer medicines resulted in hospitals staying within budget [3]; and health authorities that had instigated activities pre-launch saw limited excess bleeding with dabigatran [3]. Risk-sharing arrangements have increased access to new medicines; however, concerns with their confidential nature and administrative burden [2,3]. Qualitative and/or quantitative approaches are also being developed to better value (new) medicines. There is also growing use of patient level data post launch, e.g. studies highlighted concerns with dabigatran prescribing in Spain and anti-obesity medicines in Sweden. Long-term follow-up studies have shown greater effectiveness of ciclosporin vs. tacrolimus for transplants despite the rhetoric. Conclusion: Stakeholders in the health care field are working together and developing methods to increase funding for new valued medicines whilst restricting their use where there are concerns to optimise resource use. This will (need to) continue to enable access to safe, (cost-) effective and affordable medicines

Lipid-lowering drugs in ischaemic heart disease : a quasi-experimental uncontrolled before-and-after study of the effectiveness of clinical practice guidelines

Background: Cardiovascular diseases(CVD), specifically ischaemic heart disease(IHD), are the main causes of death in industrialized countries. Statins are not usually prescribed in the most appropriate way. To ensure the correct prescription of these drugs, it is necessary to develop, disseminate and implement clinical practice guidelines(CPGs), and subsequently evaluate them. The main objective of this study is to evaluate the effectiveness of the implementation of consensual Lipid-lowering drugs (LLD) prescription guidelines in hospital and primary care settings, to improve the control of Low-Density Lipoprotein Cholesterol (LDL-C) levels in patients with IHD in the Terres de l'Ebre region covered by the Catalonian Health Institute. Secondary bjectives are to assess the improvement of the prescription profile of these LLDs, to assess cardiovascular morbimortality and the professional profile and participant centre characteristics that govern the control of LDL-C. Methods/Design Design: Quasi-experimental uncontrolled before and after study. The intervention consists of the delivery of training strategies for guideline implementation (classroom clinical sessions and on-line courses) aimed at primary care and hospital physicians. The improvement in the control of LDL-C levels in the 3,402 patients with IHD in our territory is then assessed. Scope: Primary care physicians from 11 basic health areas(BHAs) and two hospital services (internal medicine and cardiology). Sample: 3,402 patients registered with IHD in the database of the Catalan Institute of Health(E-cap) before December 2008 and patients newly diagnosed during 2009-2010. Variables: Percentage of patients achieving good control of LDL-C, measured in milligrams per decilitre. The aim of the intervention is to achieve levels of LDL-C < 100 mg/dl in patients with IHD. Secondary variables measure type and time of diagnosis of IHD, type and dose of prescribed cholesterol-lowering drugs, level of physician participation in training activities and their professional profile. Discussion: The development of prescription guidelines previously agreed by various medical specialists involved in treating IHD patients have usually improved drug prescription. The guideline presented in this study aims to improve the control of LDL-C by training physicians through presential and on-line courses on the dissemination of this guideline, and by providing feedback on their personal results a year after this training intervention

First results of phytoplankton spatial dynamics in two NW-Mediterranean bays from chlorophyll-a estimates using sentinel 2: potential implications for aquaculture

Shellfish aquaculture has a major socioeconomic impact on coastal areas, thus it is necessary to develop support tools for its management. In this sense, phytoplankton monitoring is crucial, as it is the main source of food for shellfish farming. The aim of this study was to assess the applicability of Sentinel 2 multispectral imagery (MSI) to monitor the phytoplankton biomass at Ebro Delta bays and to assess its potential as a tool for shellfish management. In situ chlorophyll-a data from Ebro Delta bays (NE Spain) were coupled with several band combination and band ratio spectral indices derived from Sentinel 2A levels 1C and 2A for time-series mapping. The best results (AIC = 72.17, APD < 10%, and MAE < 0.7 mg/m3) were obtained with a simple blue-to-green ratio applied over Rayleigh from Sentinel 2A levels 1C and 2A for time-series mapping. The best results (AIC = 72.17, APD < 10%, and MAE < 0.7 mg/m3) were obtained with a simple blue-to-green ratio applied over Rayleigh corrected images. Sentinel 2–derived maps provided coverage of the farm sites at both bays allowing relating the spatiotemporal distribution of phytoplankton with the environmental forcing under different states of the bays. The applied methodology will be further improved but the results show the potential of using Sentinel 2 MSI imagery as a tool for assessing phytoplankton spatiotemporal dynamics and to encourage better future practices in the management of the aquaculture in EbroPeer ReviewedPostprint (published version