Methodology for the detection of land cover changes in time series of daily satellite images. Application to burned area detection

Revista oficial de la Asociación Española de Teledetección[EN] We have developed a methodology for detection of observable phenomena at pixel level over time series of daily satellite images, based on using a Bayesian classifier. This methodology has been applied successfully to detect burned areas in the North American boreal forests using the LTDR dataset. The LTDR dataset represents the longest time series of global daily satellite images with 0.05° (~5 km) of spatial resolution. The proposed methodology has several stages: 1) pre-processing daily images to obtain composite images of n days; 2) building of space of statistical variables or attributes to consider; 3) designing an algorithm, by selecting and filtering the training cases; 4) obtaining probability maps related to the considered thematic classes; 5) post-processing to improve the results obtained by applying multiple techniques (filters, ranges, spatial coherence, etc.). The generated results are analyzed using accuracy metrics derived from the error matrix (commission and omission errors, percentage of estimation) and using scattering plots against reference data (correlation coefficient and slope of the regression line). The quality of the results obtained improves, in terms of spatial and timing accuracy, to other burned area products that use images of higher spatial resolution (500 m and 1 km), but they are only available after year 2000 as MCD45A1 and BA GEOLAND-2: the total burned area estimation for the study region for the years 2001-2011 was 28.56 millions of ha according to reference data and 12.41, 138.43 and 19.41 millions of ha for the MCD45A1, BA GEOLAND-2 and BA-LTDR burned area products, respectively.[ES] Se ha desarrollado una metodología para la detección de cambios de la cubierta vegetal, a nivel de píxel, en se-ries temporales de imágenes de satélites diarias mediante la utilización de un clasificador bayesiano. Dicha metodología ha sido aplicada satisfactoriamente a la detección de áreas quemadas en los bosques boreales de Norte América en el período 1981 a 2011, utilizando el conjunto de datos Long Term Data Record (LTDR) que constituye la serie temporal más larga de imágenes diarias de satélite a escala global, con una resolución espacial de 0,05° (~5 km). La metodología pro-puesta consta de varias etapas: 1) pre-procesamiento de las imágenes diarias y obtención de imágenes compuestas de ndías; 2) construcción del espacio de las variables o atributos a considerar; 3) diseño del algoritmo, mediante la selección y refinamiento de los casos de entrenamiento; 4) obtención de los mapas de probabilidad relacionados con las clases temáticas a considerar; 5) post-procesamiento para mejorar los resultados obtenidos mediante la aplicación de múltiples técnicas (filtros, rangos, coherencia espacial, etc.). Los resultados finales obtenidos son comparados con los datos de referencia mediante métricas de exactitud derivadas de la matriz de error (errores de comisión y omisión, porcentaje de estimación) y de gráficos de dispersión (coeficiente de correlación y pendientes de la recta de regresión, etc.). La calidad de los resultados obtenidos al aplicar esta metodología a las imágenes LTDR para la detección de área quemada en la región boreal de Norte América mejora en términos de exactitud espacio-temporal a la de los otros dos productos de área quemada globales comparados (MCD45A1, BA GEOLAND-2) a pesar de que utilizan imágenes de mayor resolución espa-cial (y sólo disponibles a partir del año 2000): la estimación de área quemada total sobre la región de estudio en el periodo 2001-2011 fue de 28,56 millones de hectáreas según los datos de referencia y de 12,41, 138,43 y de 19,41 millones de hectáreas para los productos MCD45A1, BA GEOLAND-2 y BA-LTDR, respectivamente.Este trabajo está financiado por el Ministerio de Economía y Competitividad de España a través del proyecto CGL2013-48202-C2-2-R. Un especial agradecimiento a las Agencias y Servicios de procesamiento de datos de satélite de NASA y NOAA, las cuales nos han suministrado la mayor parte de las imágenes empleadas en este trabajo (LANDSAT, MODIS, LAC and LTDR). Finalmente agradecer a los revisores anónimos por sus comentarios constructivos, los cuales fueron especialmente tenidos en consideración.Moreno-Ruiz, J.; Arbelo, M.; García-Lázaro, J.; Riaño-Arribas, D. (2014). Desarrollo de una metodología para la detección de cambios de la cubierta vegetal en series temporales de imágenes de satélite diarias. Aplicación a la detección de áreas quemadas. Revista de Teledetección. (42):11-28. https://doi.org/10.4995/raet.2014.2280SWORD11284

Proof-of-concept trial of the combination of lactitol with Bifidobacterium bifidum and Lactobacillus acidophilus for the eradication of intestinal OXA-48-producing Enterobacteriaceae

Background: The major reservoir of carbapenemase-producing Enterobacteriaceae (CPE) is the gastrointestinal tract of colonized patients. Colonization is silent and may last for months, but the risk of infection by CPE in colonized patients is significant. Methods: Eight long-Term intestinal carriers of OXA-48-producing Enterobacteriaceae (OXA-PE) were treated during 3 weeks with daily oral lactitol (Emportal®), Bifidobacterium bifidum and Lactobacillus acidophilus (Infloran®). Weekly stool samples were collected during the treatment period and 6 weeks later. The presence of OXA-PE was investigated by microbiological cultures and qPCR. Results: At the end of treatment (EoT, secondary endpoint 1), four of the subjects had negative OXA-PE cultures. Three weeks later (secondary endpoint 2), six subjects were negative. Six weeks after the EoT (primary endpoint), three subjects had negative OXA-PE cultures. The relative intestinal load of OXA-PE decreased in all the patients during treatment. Conclusions: The combination of prebiotics and probiotics was well tolerated. A rapid reduction on the OXA-PE intestinal loads was observed. At the EoT, decolonization was achieved in three patients

Epidemiología y características del ictus isquémico en el adulto joven en Aragón

Introducción Alrededor de 15 millones de personas sufren un ictus cada año, de los que un 10-15% ocurre en menores de 50 años (ictus en el adulto joven). La prevalencia de los distintos factores de riesgo vascular y las estrategias sanitarias para el manejo del ictus varían a nivel mundial, siendo interesante conocer la epidemiología y las características específicas de cada región. El objetivo de este estudio fue determinar la prevalencia de los diferentes factores de riesgo vascular, la etiología y las características de los ictus isquémicos en el adulto joven en la comunidad autónoma de Aragón. Métodos Estudio multicéntrico, de corte transversal, realizado por los Servicios de Neurología de todos los hospitales del Servicio Aragonés de Salud (SALUD). Se identificó a todos los pacientes entre 18 y 50 años que ingresaron en cualquiera de estos hospitales con el diagnóstico de ictus isquémico o AIT entre enero del 2005 y diciembre del 2015. Se recogieron variables demográficas, factores de riesgo vascular y tipo de ictus isquémico entre otras. Resultados En el periodo de estudio, 786 pacientes entre 18 y 50 años ingresaron con el diagnóstico de ictus isquémico o AIT en algún hospital del SALUD, con una tasa anual promedio de 12, 3 por 100.000 habitantes. La mediana de su edad fue de 45 años (RIQ: 40-48 años). El factor de riesgo vascular más prevalente fue el tabaquismo, 404 (51, 4%). La mayoría fue de causa indeterminada (36, 2%), seguida por «otras causas» (26, 5%). La mediana de puntuación en la escala NIHSS fue de 3, 5 (RIQ: 2, 07, 0). En total, 211 (26, 8%) de los ingresos fueron por AIT. De los pacientes que ingresaron con el diagnóstico de ictus isquémico, 59 (10, 3%) se fibrinolizaron. Conclusiones El ictus isquémico en el adulto joven no es infrecuente en Aragón y en un importante número de casos es de etiología indeterminada, por lo que es necesario implementar medidas que nos permitan mejorar su estudio, disminuir su incidencia y prevenir su recurrencia. Introduction: Stroke affects around 15 million people per year, with 10%-15% occurring in individuals under 50 years old (stroke in young adults). The prevalence of different vascular risk factors and healthcare strategies for stroke management vary worldwide, making the epidemiology and specific characteristics of stroke in each region an important area of research. This study aimed to determine the prevalence of different vascular risk factors and the aetiology and characteristics of ischaemic stroke in young adults in the autonomous community of Aragon, Spain. Methods: A cross-sectional, multi-centre study was conducted by the neurology departments of all hospitals in the Aragonese Health Service. We identified all patients aged between 18 and 50 years who were admitted to any of these hospitals with a diagnosis of ischaemic stroke or TIA between January 2005 and December 2015. Data were collected on demographic variables, vascular risk factors, and type of stroke, among other variables. Results: During the study period, 786 patients between 18 and 50 years old were admitted with a diagnosis of ischaemic stroke or TIA to any hospital of Aragon, at a mean annual rate of 12.3 per 100 000 population. The median age was 45 years (IQR: 40-48 years). The most prevalent vascular risk factor was tobacco use, in 404 patients (51.4%). The majority of strokes were of undetermined cause (36.2%), followed by other causes (26.5%). The median NIHSS score was 3.5 (IQR: 2.0-7.0). In total, 211 patients (26.8%) presented TIA. Fifty-nine per cent of the patients admitted with a diagnosis of ischaemic stroke (10.3%) were treated with fibrinolysis. Conclusions: Ischaemic stroke in young adults is not uncommon in Aragon, and is of undetermined aetiology in a considerable number of cases; it is therefore necessary to implement measures to improve study of the condition, to reduce its incidence, and to prevent its recurrence

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Ideal cardiovascular health and inflammation in European adolescents: The HELENA study

Background and aims Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. Methods and results As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. Conclusion Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention

Nutrición parenteral domiciliaria en españa 2016; informe del grupo de nutrición artificial domiciliaria y ambulatoria NAYDA

Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria (NADYA-SENPE; www.nadya-senpe.com) del año 2016. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2016. Resultados: se registraron 286 pacientes (54, 2% mujeres), 34 niños y 252 adultos, procedentes de 42 hospitales españoles con 294 episodios, lo que representa una tasa de prevalencia de 6, 16 pacientes/millón de habitantes/año 2016. El diagnóstico más frecuente en adultos fue de oncológico paliativo (25, 8%), seguido de otros. En niños, fue de alteraciones de la motilidad con 6 casos (17, 6%), la enfermedad de Hirschsprung y la enterocolitis necrotizante, ambos con 5 niños (14, 7%). El primer motivo de indicación fue síndrome de intestino corto tanto en niños (64, 7%) como en adultos (37, 3%), seguido de obstrucción intestinal, 28, 6% en adultos y 14, 7% en niños. El tipo de catéter más utilizado fue el tunelizado tanto en niños (70, 6%) como en adultos (37, 9%), y la complicación más frecuente en adultos fue la infección relacionada con el catéter, que presentó una tasa de 0, 48 infecciones/1.000 días de NPD. Durante este periodo, finalizaron 71 episodios en adultos siendo la causa de finalización principal el fallecimiento (57, 7%) y paso a vía oral (31%). Conclusiones: se constata un incremento progresivo de centros y profesionales colaboradores en el registro de pacientes que reciben NPD. Las principales indicaciones de NPD y de motivo de finalización se mantienen estables. Objective: To communicate HPN data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.com) for the year 2016. Material and methods: Descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1st, 2016 to December 31st, 2016. Results: There were 286 patients from 42 Spanish hospitals (54.2% women), 34 children and 252 adults, with 294 episodes, which represent a prevalence rate of 6.16 patients/million inhabitants/year 2016. The most frequent diagnosis in adults was “palliative cancer” (25.8%), followed by “others”. In children it was “motility alterations” with 6 cases (17.6%), Hirschsprung’s disease and necrotising enterocolitis, both with 5 children (14.7%). The first indication was short bowel syndrome in both children (64.7%) and adults (37.3%), followed by intestinal obstruction in 28.6% adults and 14.7% in children. The most frequently used type of catheter was tunnelled in both children (70.6%) and adults (37.9%). The most frequent complication in adults was infection related to the catheter, which presented a rate of 0.48 infections/1, 000 days of NPD. During this period, 71 episodes ended in adults and the main cause was death (57.7%) followed by resuming the oral route (31%). Conclusions: There is a progressive increase of centers and professional collaborators in the registry who report patients receiving parenteral nutrition at home. The main indications of HPN and the motive for ending have remained stable

Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome

Background: Patients infected with influenza A (H1N1)pdm09 virus requiring admission to the ICU remain an important source of mortality during the influenza season. The objective of the study was to assess the impact of a delay in diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection on clinical outcome in critically ill patients admitted to the ICU. Methods: A prospective multicenter observational cohort study was based on data from the GETGAG/SEMICYUC registry (2009–2015) collected by 148 Spanish ICUs. All patients admitted to the ICU in which diagnosis of influenza A (H1N1)pdm09 virus infection had been established within the first week of hospitalization were included. Patients were classified into two groups according to the time at which the diagnosis was made: early (within the first 2 days of hospital admission) and late (between the 3rd and 7th day of hospital admission). Factors associated with a delay in diagnosis were assessed by logistic regression analysis. Results: In 2059 ICU patients diagnosed with influenza A (H1N1)pdm09 virus infection within the first 7 days of hospitalization, the diagnosis was established early in 1314 (63.8 %) patients and late in the remaining 745 (36.2 %). Independent variables related to a late diagnosis were: age (odds ratio (OR) = 1.02, 95 % confidence interval (CI) 1.01–1.03, P < 0.001); first seasonal period (2009–2012) (OR = 2.08, 95 % CI 1.64–2.63, P < 0.001); days of hospital stay before ICU admission (OR = 1.26, 95 % CI 1.17–1.35, P < 0.001); mechanical ventilation (OR = 1.58, 95 % CI 1.17–2.13, P = 0.002); and continuous venovenous hemofiltration (OR = 1.54, 95 % CI 1.08–2.18, P = 0.016). The intra-ICU mortality was significantly higher among patients with late diagnosis as compared with early diagnosis (26.9 % vs 17.1 %, P < 0.001). Diagnostic delay was one independent risk factor for mortality (OR = 1.36, 95 % CI 1.03–1.81, P < 0.001). Conclusions: Late diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection is associated with a delay in ICU admission, greater possibilities of respiratory and renal failure, and higher mortality rate. Delay in diagnosis of flu is an independent variable related to death