Airborne S-Band SAR for forest biophysical retrieval in temperate mixed forests of the UK

Radar backscatter from forest canopies is related to forest cover, canopy structure and aboveground biomass (AGB). The S-band frequency (3.1–3.3 GHz) lies between the longer L-band (1–2 GHz) and the shorter C-band (5–6 GHz) and has been insufficiently studied for forest applications due to limited data availability. In anticipation of the British built NovaSAR-S satellite mission, this study evaluates the benefits of polarimetric S-band SAR for forest biophysical properties. To understand the scattering mechanisms in forest canopies at S-band the Michigan Microwave Canopy Scattering (MIMICS-I) radiative transfer model was used. S-band backscatter was found to have high sensitivity to the forest canopy characteristics across all polarisations and incidence angles. This sensitivity originates from ground/trunk interaction as the dominant scattering mechanism related to broadleaved species for co-polarised mode and specific incidence angles. The study was carried out in the temperate mixed forest at Savernake Forest and Wytham Woods in southern England, where airborne S-band SAR imagery and field data are available from the recent AirSAR campaign. Field data from the test sites revealed wide ranges of forest parameters, including average canopy height (6–23 m), diameter at breast-height (7–42 cm), basal area (0.2–56 m2/ha), stem density (20–350 trees/ha) and woody biomass density (31–520 t/ha). S-band backscatter-biomass relationships suggest increasing backscatter sensitivity to forest AGB with least error between 90.63 and 99.39 t/ha and coefficient of determination (r2) between 0.42 and 0.47 for the co-polarised channel at 0.25 ha resolution. The conclusion is that S-band SAR data such as from NovaSAR-S is suitable for monitoring forest aboveground biomass less than 100 t/ha at 25 m resolution in low to medium incidence angle rang

Past decade above-ground biomass change comparisons from four multi-temporal global maps

Above-ground biomass (AGB) is considered an essential climate variable that underpins our knowledge and information about the role of forests in mitigating climate change. The availability of satellite-based AGB and AGB change (Delta AGB) products has increased in recent years. Here we assessed the past decade net Delta AGB derived from four recent global multi-date AGB maps: ESA-CCI maps, WRI-Flux model, JPL time series, and SMOS-LVOD time series. Our assessments explore and use different reference data sources with biomass re-measurements within the past decade. The reference data comprise National Forest Inventory (NFI) plot data, local Delta AGB maps from airborne LiDAR, and selected Forest Resource Assessment country data from countries with well-developed monitoring capacities. Map to reference data comparisons were performed at levels ranging from 100 m to 25 km spatial scale. The comparisons revealed that LiDAR data compared most reasonably with the maps, while the comparisons using NFI only showed some agreements at aggregation levels <10 km. Regardless of the aggregation level, AGB losses and gains according to the map comparisons were consistently smaller than the reference data. Map-map comparisons at 25 km highlighted that the maps consistently captured AGB losses in known deforestation hotspots. The comparisons also identified several carbon sink regions consistently detected by all maps. However, disagreement between maps is still large in key forest regions such as the Amazon basin. The overall AAGB map cross-correlation between maps varied in the range 0.11-0.29 (r). Reported AAGB magnitudes were largest in the high-resolution datasets including the CCI map differencing (stock change) and Flux model (gain-loss) methods, while they were smallest according to the coarser-resolution LVOD and JPL time series products, especially for AGB gains. Our results suggest that AAGB assessed from current maps can be biased and any use of the estimates should take that into account. Currently, AAGB reference data are sparse especially in the tropics but that deficit can be alleviated by upcoming LiDAR data networks in the context of Supersites and GEO-Trees

A comprehensive framework for assessing the accuracy and uncertainty of global above-ground biomass maps

Over the past decade, several global maps of above-ground biomass (AGB) have been produced, but they exhibit significant differences that reduce their value for climate and carbon cycle modelling, and also for national estimates of forest carbon stocks and their changes. The number of such maps is anticipated to increase because of new satellite missions dedicated to measuring AGB. Objective and consistent methods to estimate the accuracy and uncertainty of AGB maps are therefore urgently needed. This paper develops and demonstrates a framework aimed at achieving this. The framework provides a means to compare AGB maps with AGB estimates from a global collection of National Forest Inventories and research plots that accounts for the uncertainty of plot AGB errors. This uncertainty depends strongly on plot size, and is dominated by the combined errors from tree measurements and allometric models (inter-quartile range of their standard deviation (SD) = 30–151 Mg ha−1). Estimates of sampling errors are also important, especially in the most common case where plots are smaller than map pixels (SD = 16–44 Mg ha−1). Plot uncertainty estimates are used to calculate the minimum-variance linear unbiased estimates of the mean forest AGB when averaged to 0.1∘. These are used to assess four AGB maps: Baccini (2000), GEOCARBON (2008), GlobBiomass (2010) and CCI Biomass (2017). Map bias, estimated using the differences between the plot and 0.1∘ map averages, is modelled using random forest regression driven by variables shown to affect the map estimates. The bias model is particularly sensitive to the map estimate of AGB and tree cover, and exhibits strong regional biases. Variograms indicate that AGB map errors have map-specific spatial correlation up to a range of 50–104 km, which increases the variance of spatially aggregated AGB map estimates compared to when pixel errors are independent. After bias adjustment, total pantropical AGB and its associated SD are derived for the four map epochs. This total becomes closer to the value estimated by the Forest Resources Assessment after every epoch and shows a similar decrease. The framework is applicable to both local and global-scale analysis, and is available at https://github.com/arnanaraza/PlotToMap. Our study therefore constitutes a major step towards improved AGB map validation and improvement

A comprehensive framework for assessing the accuracy and uncertainty of global above-ground biomass maps

International audienceOver the past decade, several global maps of above-ground biomass (AGB) have been produced, but they exhibit significant differences that reduce their value for climate and carbon cycle modelling, and also for national estimates of forest carbon stocks and their changes. The number of such maps is anticipated to increase because of new satellite missions dedicated to measuring AGB. Objective and consistent methods to estimate the accuracy and uncertainty of AGB maps are therefore urgently needed. This paper develops and demonstrates a framework aimed at achieving this. The framework provides a means to compare AGB maps with AGB estimates from a global collection of National Forest Inventories and research plots that accounts for the uncertainty of plot AGB errors. This uncertainty depends strongly on plot size, and is dominated by the combined errors from tree measurements and allometric models (inter-quartile range of their standard deviation (SD) = 30–151 Mg ha−1). Estimates of sampling errors are also important, especially in the most common case where plots are smaller than map pixels (SD = 16–44 Mg ha−1). Plot uncertainty estimates are used to calculate the minimum-variance linear unbiased estimates of the mean forest AGB when averaged to 0.1∘. These are used to assess four AGB maps: Baccini (2000), GEOCARBON (2008), GlobBiomass (2010) and CCI Biomass (2017). Map bias, estimated using the differences between the plot and 0.1∘ map averages, is modelled using random forest regression driven by variables shown to affect the map estimates. The bias model is particularly sensitive to the map estimate of AGB and tree cover, and exhibits strong regional biases. Variograms indicate that AGB map errors have map-specific spatial correlation up to a range of 50–104 km, which increases the variance of spatially aggregated AGB map estimates compared to when pixel errors are independent. After bias adjustment, total pantropical AGB and its associated SD are derived for the four map epochs. This total becomes closer to the value estimated by the Forest Resources Assessment after every epoch and shows a similar decrease. The framework is applicable to both local and global-scale analysis, and is available at https://github.com/arnanaraza/PlotToMap. Our study therefore constitutes a major step towards improved AGB map validation and improvement

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

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

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&lt;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&lt;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

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks