The Role and Need for Space-Based Forest Biomass-Related Measurements in Environmental Management and Policy

The achievement of international goals and national commitments related to forest conservation and management, climate change, and sustainable development requires credible, accurate, and reliable monitoring of stocks and changes in forest biomass and carbon. Most prominently, the Paris Agreement on Climate Change and the United Nations’ Sustainable Development Goals in particular require data on biomass to monitor progress. Unprecedented opportunities to provide forest biomass data are created by a series of upcoming space-based missions, many of which provide open data targeted at large areas and better spatial resolution biomass monitoring than has previously been achieved. We assess various policy needs for biomass data and recommend a long-term collaborative effort among forest biomass data producers and users to meet these needs. A gap remains, however, between what can be achieved in the research domain and what is required to support policy making and meet reporting requirements. There is no single biomass dataset that serves all users in terms of definition and type of biomass measurement, geographic area, and uncertainty requirements, and whether there is need for the most recent up-to-date biomass estimate or a long-term biomass trend. The research and user communities should embrace the potential strength of the multitude of upcoming missions in combination to provide for these varying needs and to ensure continuity for long-term data provision which one-off research missions cannot provide. International coordination bodies such as Global Forest Observations Initiative (GFOI), Committee on Earth Observation Satellites (CEOS), and Global Observation of Forest Cover and Land Dynamics (GOFC‐GOLD) will be integral in addressing these issues in a way that fulfils these needs in a timely fashion. Further coordination work should particularly look into how space-based data can be better linked with field reference data sources such as forest plot networks, and there is also a need to ensure that reference data cover a range of forest types, management regimes, and disturbance regimes worldwide

Using Small Satellites for New Applications: Next Generation Swedish Space Corporation Spacecraft

Focusing on small satellites to perform scientific and technical demonstrator missions have been a successful concept within the Swedish Space Corporation (SSC) for two decades. This paper will focus on two missions that are currently underway, PRISMA, which is in Phase C, and SVEA, which has completed Pre-phase A studies. Both missions require advanced and newly developed technologies to operate as intended and are meant to extend the capabilities of small satellites to areas previously limited to medium to large satellites, such as formation flying, environment and security. This paper will describe the PRISMA formation flying two satellite platform and how it will demonstrate techniques such as formation flying, proximity ranging and novel propulsion technologies, each of which may have significant impact on future spacecrafts. The subsequent section will describe the SVEA high resolution Earth observation platform. SVEA would be an operational satellite within the Swedish government and be at the disposal to various Swedish agencies. It will show that high resolution images can be obtained from a low-cost small satellite. The technology development and knowledge gained from PRISMA will be taken advantage of in SVEA. The paper concludes by showing how such missions as PRISMA and SVEA demonstrate areas where small satellites can be key to mission success

Tectonic fault control of wetland distributions in the Central Amazon revealed by JERS-1 radar imagery

A mosaic of JERS-1 L-band synthetic aperture radar (SAR) images was used to investigate the influence of tectonic faults on wetland distributions in ~ 200,000 km2 of central Amazon lowland (0-4°Lat. S, 60-64°Long. W). The geographic distribution of flooded wetland was clearly evident on the mosaic due to the unique characteristics of L-band radar. Two distinct linear boundaries were encountered limiting the northern distribution of wetlands, one north of the Negro river main channel and west of the Branco river, oriented WNW-ESE, and one south of the Negro main channel and east of the Branco, oriented NW-SE. The orientations and positions of these boundaries were consistent with the prevailing tectonic fracture pattern in the region. Geophysical, pedological and geomorphological data supported the hypothesis that these boundaries are tectonically controlled. The ecological, economic and biogeochemical implications of the observed wetland distribution were considered. The distributions of wetland-dependent biota were expected to be severely limited north of the Negro main channel. Fish production, wetland timber yields and methane emissions were also predicted to be exceptionally low in this region. (C) 2000 Elsevier Science Ltd and INQUA. All rights reserved

Cost-effectiveness of screening for atrial fibrillation in a single primary care center at a 3-year follow-up

Objectives The aim of this study was to estimate the cost-effectiveness of intermittent electrocardiogram (ECG) screening for atrial fibrillation (AF) among 70-74-year old individuals in primary care. We also aimed to assess adherence to anticoagulants, severe bleeding, stroke and mortality among screening-detected AF cases at three-year follow-up. Methods A post hoc analysis based on a cross-sectional screening study for AF among 70-74-year old patients, who were registered at a single primary care center, was followed for three years for mortality. Data about adherence to anticoagulants, incidence of stroke and severe bleeding among screening-detected AF cases, were collected from patients records. Markov model and Monte Carlo simulation were used to assess the cost-effectiveness of the screening program. Results The mortality rate among screening-detected AF cases (n = 16) did not differ compared to the 274 individuals with no AF (hazard ratio 0.86, CI 0.12-6.44). Adherence to anticoagulants was 92%. There was no stroke or severe bleeding. The incremental cost-effectiveness ratio of screening versus no screening was EUR 2389/quality-adjusted life year (QALY) gained. The screening showed a 99% probability of being cost-effective compared to no screening at a willingness-to-pay threshold of EUR 20,000 per QALY. Conclusion Screening for AF among 70-74-year olds in primary care using intermittent ECG appears to be cost-effective at 3-year follow-up with high anticoagulants adherence and no increased mortality.Funding: M. R. has received research grants, lecture and consulting honoraria from the following sources. Abbott, Carl Bennett AB, Bristol Myers Squibb, Medtronic, MSD, Pfizer, Roche, Sanofi, and Zenicor. L. L. has received economic support for lecturing, advisory boards and research from AstraZeneca, Bayer, Boehringer Ingelheim and Pfizer. F. A. has received lecture fees from Bristol-Myers-Squibb, Pfizer, Boehringer-Ingelheim, and Bayer. M. A. employed by AstraZeneca. </p

QALY Weights for Diabetic Retinopathy—A Comparison of Health State Valuations with HUI-3, EQ-5D, EQ-VAS, and TTO

AbstractObjectiveTo estimate quality-adjusted life-year weights for patients with diabetic retinopathy by using various methods and to investigate the empirical validity of the different measures.MethodsThe study population comprised 152 patients with diabetes in Östergötland County, Sweden. Participants were interviewed by telephone by using the time trade-off (TTO) method and a visual analogue scale (EQ-VAS) (direct valuations) as well as the EuroQol five-dimensional questionnaire (EQ-5D) and the health utilities index mark 3 (HUI-3) (indirect valuations). The quality-adjusted life-year weights were adjusted for potential confounders by using analysis of covariance. The empirical validity of the measures was examined by testing their ability to detect hypothetical differences between severity levels of diabetic retinopathy and by investigating the correlation between the measures and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25).ResultsAll measures detected significant differences in scores between patient groups classified according to visual impairment in the better eye (analysis of covariance, P < 0.05), but only HUI-3 and EQ-VAS detected significant differences between patient groups classified according to visual impairment or pathological progression in the worse eye. HUI-3 recorded a difference of 0.43 in values between normal vision and blindness in the better eye, which was more than twice the differences captured by the other measures (0.15–0.20). In addition, HUI-3 showed the highest correlation with NEI VFQ-25 (r = 0.54; P < 0.001).ConclusionsIn cost-utility analyses, the choice of quality-adjusted life-year measure may affect whether an intervention is considered cost-effective. Furthermore, if decisions are to be based on values from the general public, HUI-3 can be recommended for cost-utility analyses of interventions directed at diabetic retinopathy

Implementation of Empagliflozin in Patients with Diabetes Mellitus Type 2 and Established Cardiovascular Disease : Estimation of 5-Year Survival and Costs in Sweden

Introduction Cardiovascular disease (CVD) affects approximately 30% of patients with diabetes mellitus type 2 (T2D) and leads to increased morbidity, decreased survival and increased healthcare utilization. The aim of this study was to estimate the impact of treating these patients with the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagliflozin on survival and healthcare utilization. Methods Actual survival and healthcare utilization data from a 5-year retrospective cohort study on patients with T2D and CVD in the Region of Östergötland, Sweden were used as a starting point. Actual data were adjusted in accordance with risk reductions for mortality and CV events related to empagliflozin treatment as reported in the EMPA-REG OUTCOME study. Results Applying the risk reductions related to empagliflozin treatment on the cohort of patients with T2D and CVD in Östergötland resulted in an increase in 5-year survival of 96 days per patient and reduced costs for healthcare and drugs other than empagliflozin. Including the cost of empagliflozin, treatment led to an increased net cost per patient of approximately SEK 18,000 over 5 years. Conclusion Empagliflozin treatment would reduce mortality and healthcare utilization in the patient group. The treatment strategy should be considered cost-effective, supporting a broad implementation of empagliflozin for patients with T2D and established CVD, in line with current national and international guidelines.Funding Agencies|Boehringer Ingelheim AB, Sweden - Linkoping University Library</p

Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study

IntroductionType 2 diabetes (T2D) is a complex chronic disease with an increasing prevalence worldwide. It is commonly associated with complications, such as cardiovascular disease (CVD). Patients with both T2D and established CVD are exposed to increased risk of further cardiovascular events, which means increased healthcare costs and impairments to quality of life and survival. To determine the added burden of CVD for T2D patients, we have analyzed the consumption and costs of healthcare and mortality in two T2D patient cohorts, with and without established CVD, respectively, during a 5-year follow-up in a Swedish region.MethodsPatients with T2D on 1 January 2012 were identified using the administrative database of Region ostergotland and the Swedish National Diabetes Register. Established CVD was defined as the presence of a CVD-related healthcare visit in the period 2002-2011. Identified T2D patients were then followed retrospectively for 5 years (2012-2016) and data collected on utilization of healthcare resources, healthcare costs, and survival. Data pertinent to the study were retrieved from regional databases and national registries.ResultsOn the index date (1 January 2012) there were 19,731 patients with T2D (prevalence 4.5%) in Region ostergotland, of whom 5490 had established CVD. Those patients with established CVD were older, more often men, and had longer diabetes duration and worse kidney function than those without. Compared to T2D patients without CVD, those with CVD had a significantly higher healthcare consumption, experienced higher costs, and had lower survival during the follow-up.ConclusionThis study confirms that established CVD is common among patients with T2D (approximately 30%). Established CVD has negative effects on the utilization of healthcare resources, healthcare costs, and mortality. It is therefore very important to improve the treatment strategy of this patient group

Effects of UV radiation on transcript and metabolite accumulation are dependent on monochromatic light background in cucumber

During recent years we have advanced our understanding of plant molecular responses to ultraviolet radiation (UV, 280-400 nm); however, how plants respond to UV radiation under different spectral light qualities is poorly understood. In this study, cucumber plants (Cucumis sativus ‘Lausanna RZ F1’) were grown under monochromatic blue, green, red and broadband white light in combination with UV radiation. The effects of light quality and UV radiation on acclimatory responses were assessed by measuring transcript accumulation of ELONGATED HYPOCOTYL 5 (HY5), CHALCONE SYNTHASE 2 (CHS2) and LIGHT HARVESTING COMPLEX II (LHCII), and the accumulation of flavonoids and hydroxycinnamic acids in the leaves. The growth light backgrounds differentially regulated gene expression and metabolite accumulation. While HY5 and CHS2 transcripts were induced by blue and white light, LHCII was induced by white and red light. Furthermore, UV radiation antagonized the effects of blue, red, green, and white light on transcript accumulation in a gene dependent manner. Plants grown under blue light with supplementary UV radiation increased phenylalanine, flavonol disaccharide I and caffeic acid contents compared to those exposed only to blue light. UV radiation also induced the accumulation of flavonol disaccharide I and II, ferulic acid hexose and coumaric acid hexose in plants grown under green light. Our findings provide further understanding of plant responses to UV radiation in combination with different light spectra and contribute to the design of light recipes for horticultural practices that aim to modify plant metabolism and ultimately improve crop quality.Funding agencies:GUDP (Danish Ministry of Food, Agriculture and Fisheries)Faculty for Business, Science and Technology at Örebro UniversityÖrebro University</p