26 research outputs found

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    Global maps of soil temperature

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    Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-kmÂČ resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e., offset) between in-situ soil temperature measurements, based on time series from over 1200 1-kmÂČ pixels (summarized from 8500 unique temperature sensors) across all the world’s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in-situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

    Global maps of soil temperature.

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    Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km <sup>2</sup> resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km <sup>2</sup> pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

    Global maps of soil temperature

    Get PDF
    Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-kmÂČ resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e., offset) between in-situ soil temperature measurements, based on time series from over 1200 1-kmÂČ pixels (summarized from 8500 unique temperature sensors) across all the world’s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in-situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

    Global maps of soil temperature.

    Get PDF
    Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

    Optimal use of buffer volumes for the measurement of atmospheric gas concentration in multi-point systems

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    Accurate multi-point monitoring systems are required to derive atmospheric measurements of greenhouse gas concentrations both for the calculation of surface fluxes with inversion transport models and for the estimation of non-turbulent components of the mass balance equation (i.e. advection and storage fluxes) at eddy covariance sites. When a single analyser is used to monitor multiple sampling points, the deployment of buffer volumes (BVs) along sampling lines can reduce the uncertainty due to the discrete temporal sampling of the signal. In order to optimize the use of buffer volumes we explored various set-ups by simulating their effect on time series of high-frequency CO2 concentration collected at three Fluxnet sites. Besides, we proposed a novel scheme to calculate half-hourly weighted arithmetic means from discrete point samples, accounting for the probabilistic fraction of the signal generated in the averaging period. Results show that the use of BVs with the new averaging scheme reduces the mean absolute error (MAE) up to 80 % compared to a set-up without BVs and up to 60 % compared to the case with BVs and a standard, non-weighted averaging scheme. The MAE of CO2 concentration measurements was observed to depend on the variability of the concentration field and on the size of BVs, which therefore have to be carefully dimensioned. The optimal volume size depends on two main features of the instrumental set-up: the number of measurement points and the time needed to sample at one point (i.e. line purging plus sampling time). A linear and consistent relationship was observed at all sites between the sampling frequency, which summarizes the two features mentioned above, and the renewal frequency associated with the volume. Ultimately, this empirical relationship can be applied to estimate the optimal volume size according to the technical specifications of the sampling syste

    Seasonal and interannual patterns of carbon and water fluxes of a poplar plantation under peculiar eco-climatic conditions

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    This paper reports 3 years of eddy covariance measurements (2002-2004) on a poplar plantation (Populus; x cancidensis Moench, Clone I-214) in Northern Italy. We analyzed seasonal and interannual variability of the net ecosystem exchange (NEE), gross primary production (GPP), ecosystem respiration (R(ECO)) and evapotranspiration (ET) in relation to different meteorological and environmental conditions experienced by the plantation and to natural disturbances. In particular, during 2003 climatic conditions were exceptionally severe, with the highest mean air temperatures and the lowest precipitations observed in the study area in the last 50 years. In addition, during the late summer of 2004, the plantation was attacked by fall webworm larvae (Hyphantria cunea). The cumulated NEE during the three growing season (April-September) was -752.8, -626.7 and -702.7 g C m(-2) for 2002, 2003 and 2004, respectively. In the period June-August 2003, NEE was 35% and 29% higher than the NEE measured in the same period in 2002 and 2004, respectively, resulting in a lower net carbon uptake. As R(ECO) did not show large differences over the three growing seasons, the reduction in net carbon sequestration of June-August 2003 is mainly explained by a reduction of GPP (-18% and -17% in 2002 and 2004, respectively). The cumulated ET over the three growing seasons was 388, 471, 484 kg H(2)O m(-2) for 2002, 2003 and 2004, respectively. This behaviour was due to the fact that the position of the water table remained close to the roots, therefore supplying enough water to the plantation, even during the driest period. The analysis of light curve parameters, their residuals and canopy conductance suggests that the reduction Of CO(2) uptake during summer 2003 was mainly controlled by stomatal and non-stomatal limitations due to high temperatures, directly and in particular indirectly (i.e. through D) rather than by soil water stress. In conclusion, our study shows that in the presence of a heat-wave, a significant reduction of net productivity during summer may occur even in the absence of marked soil water stress. In addition to this sensitivity to high temperatures, which will likely increase in the future, the effects of natural disturbances may add further uncertainties, thus suggesting caution in the evaluation of the potential carbon sequestration of these ecosystems. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved
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