Cost-effectiveness of a technology-supported multimodal prehabilitation program in moderate-to-high risk patients undergoing lung cancer resection: randomized controlled trial protocol

Background: Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality are needed to clarify the benefits of prehabilitation. The main aim of the current protocol is to evaluate the cost-effectiveness of a multimodal prehabilitation program supported by information and communication technologies in moderate-to-high risk lung cancer patients undergoing thoracic surgery. Methods: A Quadruple Aim approach will be adopted, assessing the prehabilitation program at the following levels: i) Patients' and professionals' experience outcomes (by means of standardized questionnaires, focus groups and structured interviews); ii) Population health-based outcomes (e.g. hospital length of stay, number and severity of postoperative complications, peak oxygen uptake and levels of systemic inflammation); and, iii) Healthcare costs. Discussion: This study protocol should contribute not only to increase the scientific basis on prehabilitation but also to detect the main factors modulating service adoption. Trial registration: NCT04052100 (August 9, 2019)

Evaluating different metrics from the thermal-based two-source energy balance model for monitoring grapevine water stress

Precision irrigation management requires operational monitoring of crop water status. However, there is still some controversy on how to account for crop water stress. To address this question, several physiological, several physiological metrics have been proposed, such as the leaf/stem water potentials, stomatal conductance, or sap flow. On the other hand, thermal remote sensing has been shown to be a promising tool for efficiently evaluating crop stress at adequate spatial and temporal scales, via the Crop Water Stress Index (CWSI), one of the most common indices used for assessing plant stress. CWSI relates the actual crop evapotranspiration ET (related to the canopy radiometric temperature) to the potential ET (or minimum crop temperature). However, remotely sensed surface temperature from satellite sensors includes a mixture of plant canopy and soil/substrate temperatures, while what is required for accurate crop stress detection is more related to canopy metrics, such as transpiration, as the latter one avoids the influence of soil/substrate in determining crop water status or stress. The Two-Source Energy Balance (TSEB) model is one of the most widely used and robust evapotranspiration model for remote sensing. It has the capability of partitioning ET into the crop transpiration and soil evaporation components, which is required for accurate crop water stress estimates. This study aims at evaluating different TSEB metrics related to its retrievals of actual ET, transpiration and stomatal conductance, to track crop water stress in a vineyard in California, part of the GRAPEX experiment. Four eddy covariance towers were deployed in a Variable Rate Irrigation system in a Merlot vineyard that was subject to different stress periods. In addition, root-zone soil moisture, stomatal conductance and leaf/stem water potential were collected as proxy for in situ crop water stress. Results showed that the most robust variable for tracking water stress was the TSEB derived leaf stomatal conductance, with the strongest correlation with both the measured root-zone soil moisture and stomatal conductance gas exchange measurements. In addition, these metrics showed a better ability in tracking stress when the observations are taken early after noon.Funding and logistical support for the GRAPEX project were provided by E. & J. Gallo Winery and from the NASA Applied Sciences-Water Resources Program (Grant no. NNH17AE39I). This research was also supported in part by the U.S. Department of Agriculture, Agricultural Research Service. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.Peer reviewe

Sección abierta de homenaje a Laura Rubio

Secció oberta d'homenatge a Laura RubioOpen section tribute to Laura RubioSección abierta de homenaje a Laura Rubi

Sección abierta de homenaje a Laura Rubio

Sección abierta de homenaje a Laura Rubi

Evaluation of TSEB Turbulent Fluxes Using Different Methods for the Retrieval of Soil and Canopy Component Temperatures from UAV Thermal and Multispectral Imagery

The thermal-based Two-Source Energy Balance (TSEB) model partitions the evapotranspiration (ET) and energy fluxes from vegetation and soil components providing the capability for estimating soil evaporation (E) and canopy transpiration (T). However, it is crucial for ET partitioning to retrieve reliable estimates of canopy and soil temperatures and net radiation, as the latter determines the available energy for water and heat exchange from soil and canopy sources. These two factors become especially relevant in row crops with wide spacing and strongly clumped vegetation such as vineyards and orchards. To better understand these effects, very high spatial resolution remote-sensing data from an unmanned aerial vehicle were collected over vineyards in California, as part of the Grape Remote sensing and Atmospheric Profile and Evapotranspiration eXperiment and used in four different TSEB approaches to estimate the component soil and canopy temperatures, and ET partitioning between soil and canopy. Two approaches rely on the use of composite Trad, and assume initially that the canopy transpires at the Priestley–Taylor potential rate. The other two algorithms are based on the contextual relationship between optical and thermal imagery partition Trad into soil and canopy component temperatures, which are then used to drive the TSEB without requiring a priori assumptions regarding initial canopy transpiration rate. The results showed that a simple contextual algorithm based on the inverse relationship of a vegetation index and Trad to derive soil and canopy temperatures yielded the closest agreement with flux tower measurements. The utility in very high-resolution remote-sensing data for estimating ET and E and T partitioning at the canopy level is also discussed

The risk of hepatic adverse events of systemic medications for psoriasis: a prospective cohort study using the BIOBADADERM registry

Background Limited information is available regarding the risk of incident liver disease in patients with psoriasis receiving systemic therapies. Objectives To describe the liver safety findings of conventional and modern systemic therapies for moderate-to-severe psoriasis, and to compare the relative incidence rates of hepatic adverse events (AEs) for each drug. Methods All the patients on the BIOBADADERM registry were included. Crude and adjusted incidence rate ratios (cIRR and aIRR, respectively) of hepatic AEs, using anti-TNF drugs as reference, were determined. Outcomes of interest were hypertransaminasemia, nonalcoholic fatty liver disease (NADFLD) and a group of other, less represented, hepatic AEs. Results Our study included 3,171 patients exposed to systemic drugs (6279 treatment cycles). Incident hypertransaminasemia was the most frequent hepatic AE (incidence rate of 21 per 1000 patients-years [CI 95% 18–23]), followed by NAFLD (8 cases per 1000 patients-years [95% CI 6–10]). Methotrexate (aIRR 3.06 [2.31–4.4]; p = 0.000) and cyclosporine (aIRR 2.37 [1.05–5.35]; p = .0378) were associated with an increased risk for hypertransaminasemia when compared to anti-TNF-α agents. No differences were observed between different groups of biologics. Conventional therapies were not associated with new incident NAFLD. Conclusions Comparative information of the incidence of hepatic AEs could facilitate drug selection in moderate-to-severe psoriasis