Technique for validating remote sensing products of water quality

Remote sensing of water quality is initiated as an additional part of the on going activities of the EAGLE2006 project. Within this context intensive in-situ and airborne measurements campaigns were carried out over the Wolderwijd and Veluwemeer natural waters. However, in-situ measurements and image acquisitions were not simultaneous. This poses some constraints on validating air/space-borne remote sensing products of water quality. Nevertheless, the detailed insitu measurements and hydro-optical model simulations provide a bench mark for validating remote sensing products. That is realized through developing a stochastic technique to quantify the uncertainties on the retrieved aquatic inherent optical properties (IOP). The output of the proposed technique is applied to validate remote sensing products of water quality. In this processing phase, simulations of the radiative transfer in the coupled atmosphere-water system are performed to generate spectra at-sensor-level. The upper and the lower boundaries of perturbations, around each recorded spectrum, are then modelled as function of residuals between simulated and measured spectra. The perturbations are parameterized as a function of model approximations/inversion, sensor-noise and atmospheric residual signal. All error sources are treated as being of stochastic nature. Three scenarios are considered: spectrally correlated (i.e. wavelength dependent) perturbations, spectrally uncorrelated perturbations and a mixed scenario of the previous two with equal probability of occurrence. Uncertainties on the retrieved IOP are quantified with the relative contribution of each perturbation component to the total error budget of the IOP. This technique can be used to validate earth observation products of water quality in remote areas where few or no in– situ measurements are available

Long-term carriage, and transmission of methicillin-resistant Staphylococcus aureus after discharge from hospital

The purpose of this study was to determine whether patients who become carriers of methicillin-resistant Staphylococcus aureus (MRSA) during their stay in hospital, remain colonized after discharge. Thirty-six patients colonized with MRSA during one of three outbreaks at Utrecht University Hospital (1986-89) were screened 2 or 3 years after they had become carriers. Patients were also interviewed to determine factors contributing to persistent carriage, such as antibiotics, re-admissions to the hospital, presence of skin lesions and chronic diseases. At the same time transmission of MRSA to family members was determined. The epidemic MRSA strain was still found in three patients (8%). One was a cystic fibrosis patient who had had frequent re-admissions to the hospital and had received several course of antibiotic treatment. Both of the other patients had skin lesions: a fistula and a colostomy respectively. None of the 44 family members of the patients was colonized or infected with MRSA. We conclude that long-term MRSA carriage occurs with low frequency and is comparable to persistent carriage of methicillin-sensitive Staphylococcus aureus (MSSA). Transmission of MRSA to healthy individuals in an antibiotic-free environment is a rare event

Leaf Litter Decomposition and Mitigation of CO₂ Emissions in Cocoa Ecosystems

Studies simultaneously quantifying litter weight losses and rates of CO2-C evolved are few, though essential for accurate estimates of forest carbon budgets. A 120-day dry matter loss and a 130-day carbon emission experiments were concurrently conducted at the soil laboratory of the University of Reading, UK. Leaf litters of tree species comprising cocoa (Theobroma cacao), Newbouldia laevis (dominant shade tree in Eastern region (ER)) and Persea americana (dominant shade tree in Western region (WR)) of Ghana were incubated using a single tree leaf litter and/or a 1:1 mixed species leaf litters to determine and predict the litter decomposition and C dynamics in cocoa systems with or without the shade trees. Decomposition and C release trends in the ER systems followed: shade > mixed cocoa-shade = predicted mixed litter > cocoa; and in the WR, the order was: cocoa = mixed cocoa-shade > predicted mixed > shade. Differences between released C estimated from litter weight loss and CO2-C evolution measurement methods were not consistent. Regression analysis revealed a strong (R2 = 0.71) relationship between loss of litter C and the CO2-C evolution during litter decomposition. The large C pool for shaded cocoa systems indicates the potential to store more C and thus, its promotion could play a significant role in atmospheric CO2 mitigations

Locally recurrent rectal cancer and distant metastases:is there still a chance ofcure?

Introduction: Patients with locally recurrent rectal cancer (LRRC) generally have poor prognosis, especially those who have (a history of) distant metastases. The aim of this study was to investigate the impact of distant metastases on oncological outcomes in LRRC patients undergoing curative treatment. Methods: Consecutive patients with surgically treated LRRC between 2005 and 2019 in two tertiary referral hospitals were retrospectively analysed. Oncological survival of patients without distant metastases were compared with outcomes of patients with synchronous distant metastases with the primary tumour, patients with distant metastases in the primary-recurrence interval, and patients with synchronous LRRC distant metastases. Results: A total of 535 LRRC patients were analysed, of whom 398 (74%) had no (history of) metastases, 22 (4%) had synchronous metastases with the primary tumour, 44 (8%) had metachronous metastases, and 71 (13%) had synchronous LRRC metastases. Patients with synchronous LRRC metastases had worse survival compared to patients without metastases (adjusted hazard ratio: 1.56 [1.15–2.12]), whilst survival of patients with synchronous primary metastases and metachronous metastases of the primary tumour was similar as those patients who had no metastases. In LRRC patients who had metastases in primary-recurrence interval, patients with early metachronous metastases had better disease-free survival as patients with late metachronous metastases (3-year disease-free survival: 48% vs 22%, p = 0.039). Conclusion: LRRC patients with synchronous distant metastases undergoing curative surgery have relatively poor prognosis. However, LRRC patients with a history of distant metastases diagnosed nearby the primary tumour have comparable (oncological) survival as LRRC patients without distant metastases.</p

A Single-Center Comparison of Extended and Restricted THROMBOPROPHYLAXIS with LMWH after Metabolic Surgery

IntroductionMorbid obesity is an important risk factor for developing a venous thromboembolic events (VTE) after surgery. Fast-track protocols in metabolic surgery can lower the risk of VTE in the postoperative period by reducing the immobilization period. Administration of thromboprophylaxis can be a burden for patients. This study aims to compare extended to restricted thromboprophylaxis with low molecular weight heparin (LMWH) for patients undergoing metabolic surgery.MethodsIn this single center retrospective cohort study, data was collected from patients undergoing a primary Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2014 and 2018. Patients operated in 2014-2017 received thromboprophylaxis for two weeks. In 2018, patients only received thromboprophylaxis during hospital admission. Patients already using anticoagulants were analyzed as a separate subgroup. The primary outcome measure was the rate of clinically significant VTEs within three months. Secondary outcome measures were postoperative hemorrhage and reoperations for hemorrhage.Results3666 Patients underwent a primary RYGB or SG following the fast-track protocol. In total, two patients in the 2014-2017 cohort were diagnosed with VTE versus zero patients in the 2018 cohort. In the historic group, 34/2599 (1.3%) hemorrhages occurred and in the recent cohort 8/720 (1.1%). Postoperative hemorrhage rates did not differ between the two cohorts (multivariable analysis, p=0.475). In the subgroup of patients using anticoagulants, 21/347(6.1%) patients developed a postoperative hemorrhage. Anticoagulant use was a significant predictor of postoperative hemorrhage (

How large is the gap between present and efficient transport prices in Europe?

In this paper we analyse the gap between present transport prices and efficient transport prices. Efficient transport prices are those prices that maximise economic welfare, including external costs (congestion, air pollution, accidents). The methodology is applied to six urban and interregional case studies using one common optimal pricing model. The case studies cover passenger as well as freight transport and cover all modes. We find that prices need to be raised most for peak urban passenger car transport and to a lesser extent for interregional road transport. Optimal pricing results for public transport are more mixed. We show that current external costs on congested roads are a bad guide for optimal taxes and tolls: the optimal toll that takes into account the reaction of demand is often less than one third of the present marginal external cost.transport pricing; external costs; social costs; congestion pricing