Diferenciación de clases de ocupación del suelo según su multiangularidad

Desde los años 70 se conoce que la reflectancia de las distintas ocupaciones del suelo varía según los ángulos de observación e iluminación, es decir, las cubiertas son anisotrópicas. Por tanto, la geometría de captación es un condicionante importante a tener en cuenta a la hora de analizar las imágenes captadas, pero al mismo tiempo se podría aprovechar lo que tal anisotropía nos infiere. A este respecto, existen varios trabajos que hablan de la capacidad de estimar características estructurales de la vegetación y caracterizar distintas ocupaciones del suelo, utilizando variables multiangulares. El objetivo del presente trabajo es evaluar la posibilidad en primera instancia, de poder diferenciar distintas ocupaciones del suelo a partir de la información multiangular que nos proporciona el sensor Multi Angle Spectro Radiometer (MISR) a bordo del satélite TERRA.Para ello se ha trabajado con el producto elaborado MISR L2 Land Surface de 1.1 km de pixel, que proporciona los parámetros ρ, Θ y k para cuatro bandas, azul, verde, rojo e infrarrojo cercano, del modelo RPV, un modelo semiempírico de factor de reflectancia bidireccional (BRF). Los datos utilizados son de fecha 21/7/2005, para píxeles puros de CORINE Land Cover 2006 de la España peninsular. Los resultados muestran que las clases agrícolas tienen medias significativamente más bajas para el parámetro ρ y más altas para los parámetros Θ y k que las clases forestales para todas las bandas. Tales resultados invitan a pensar que la multiangularidad puede ayudar a la hora de mejorar las clasificaciones de imágenes y determinar estructuras en las ocupaciones del suelo

Los sistemas de pago por servicios ambientales entre la adicionalidad y la subsidiariedad: aplicación a la belleza escénica en el pantano de San Juan, Madrid, España

A payment for environmental services (PES) based on the beauty of the San Juan dam landscape is proposed containing two innovative aspect in regard to previous PES systems: the elaboration of a diagnosis oriented to obtain a shared vision of the area based in a participative process including all relevant local stakeholders, and the integration of the PES mechanism into the regional public environmental policy. The proposed system also identifies the offer and the demand of the environmental service. It shows the main problems associated to the preservation of the service and proposes management plans oriented to its conservation. Finally, the economic viability of the system is studied comparing three different scenarios according to the grade of integration of the PES model into the regional conservation public policy. This paper shows how a PES system can be used to guarantee public investments in nature conservation through a private management.Se plantea un sistema de pago por servicios ambientales (PSA) basado en la valoración de la belleza escénica en la zona del pantano de San Juan, Madrid, con dos aspectos novedosos respecto a estudios PSA previos: la elaboración de un diagnóstico basado en un proceso participativo que involucra a todos los actores sociales locales y cuyo fin es el de obtener una visión compartida sobre el área, y la integración del mecanismo PSA en la gestión pública regional de la conservación de la naturaleza. El sistema propuesto además identifica los oferentes y demandantes del servicio ambiental, muestra los principales problemas asociados a la conservación del servicio y plantea programas de gestión orientados a contribuir a su conservación. Se estudia, por último, la viabilidad económica del sistema comparando tres escenarios hipotéticos en función del grado de integración del sistema PSA en las políticas públicas de conservación de la naturaleza regionales. El trabajo muestra como un sistema PSA puede servir para garantizar las inversiones públicas en conservación a través de la gestión privada

Health-related Quality of Life in Type 1 Diabetes Mellitus Pediatric Patients and Their Caregivers in Spain: An Observational Cross-Sectional Study

Objectives: This study assessed the health-related quality of life (HRQOL) of pediatric patients with type 1 diabetes mellitus (T1DM) and their caregivers.Methods: CHRYSTAL was an observational cross-sectional study conducted in Spain in 2014 on 275 patients under 18 years old diagnosed with T1DM. Patient/caregiver pairs were stratified by patients' HbA1c level (?7.5% versus <7.5%) and by presence or absence of T1DM complications and/or comorbidities. EQ-5D and PedsQL questionnaires were administered to patients and caregivers.Results: On the EQ-5D, according to caregivers' perception, 17.7% of children experienced moderate pain or discomfort, 9.7% suffered problems performing usual activities, and 13.2% demonstrated moderate anxiety or depression. Mean EQ-5D index score was 0.95 and mean visual analog scale (VAS) score was 86.1. By HbA1c level (?7.5% versus <7.5%), mean index scores were 0.94 and 0.95, and mean VAS scores were 82.8 and 89.2, respectively. Mean index scores were 0.91 for children with complications and/or comorbidities and 0.96 for children without. Mean VAS scores were 83.7 and 87.2, respectively. HRQOL per the PedsQL tool ranged from 68.1 (ages 2-4) to 73.1 (ages 13-18). EQ-5D index and VAS scores were significantly correlated (rho = 0.29-0.43) with several age groups of the PedsQL. EQ-5D scales showed significant moderate correlation between EQ-5D-Y and EQ-5D-3L proxy VAS score (rho = 0.45; p < .001).Conclusions: Patients with few complications and controlled HbA1c reported a relatively high HRQOL. The results suggest that parent-proxy EQ-5D ratings are valid for use as part of an overall health outcomes assessment in clinical studies of T1DM in pediatric patients

Identification of COVID-19 patients at risk of hospital admission and mortality: a European multicentre retrospective analysis of mid-regional pro-adrenomedullin

Background: Mid-Regional pro-Adrenomedullin (MR-proADM) is an inflammatory biomarker that improves the prognostic assessment of patients with sepsis, septic shock and organ failure. Previous studies of MR-proADM have primarily focussed on bacterial infections. A limited number of small and monocentric studies have examined MR-proADM as a prognostic factor in patients infected with SARS-CoV-2, however there is need for multicenter validation. An evaluation of its utility in predicting need for hospitalisation in viral infections was also performed. Methods: An observational retrospective analysis of 1861 patients, with SARS-CoV-2 confirmed by RT-qPCR, from 10 hospitals across Europe was performed. Biomarkers, taken upon presentation to Emergency Departments (ED), clinical scores, patient demographics and outcomes were collected. Multiclass random forest classifier models were generated as well as calculation of area under the curve analysis. The primary endpoint was hospital admission with and without death. Results: Patients suitable for safe discharge from Emergency Departments could be identified through an MR-proADM value of ≤ 1.02&nbsp;nmol/L in combination with a CRP (C-Reactive Protein) of ≤ 20.2&nbsp;mg/L and age ≤ 64, or in combination with a SOFA (Sequential Organ Failure Assessment) score &lt; 2 if MR-proADM was ≤ 0.83&nbsp;nmol/L regardless of age. Those at an increased risk of mortality could be identified upon presentation to secondary care with an MR-proADM value of &gt; 0.85&nbsp;nmol/L, in combination with a SOFA score ≥ 2 and LDH &gt; 720 U/L, or in combination with a CRP &gt; 29.26&nbsp;mg/L and age ≤ 64, when MR-proADM was &gt; 1.02&nbsp;nmol/L. Conclusions: This international study suggests that for patients presenting to the ED with confirmed SARS-CoV-2 infection, MR-proADM in combination with age and CRP or with the patient’s SOFA score could identify patients at low risk where outpatient treatment may be safe

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p&lt;00001), age 70 years or older versus younger than 70 years (230 [165-322], p&lt;00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p&lt;00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research