Madagascar's burned area from Sentinel-2 imagery (2016-2022): Four times higher than from lower resolution sensors.

Madagascar is one of the most burned regions in the world, to the point that it has been called the 'Isle of fire' or the 'Burning Island'. An accurate characterization of the burned area (BA) is crucial for understanding the true situation and impacts of fires on this island, where there is an active scientific debate on how fire affects multiple environmental and socioeconomic aspects, and how fire regimes should be in a complex context with differing interests. Despite this, recent advances have revealed that BA in Madagascar is poorly characterised by the currently available global BA products. In this work, we present, validate, and explore a BA database at 20 m spatial resolution for Madagascar covering the period 2016-2022. The database was built based on 75,010 Sentinel-2 images using a two-phase BA detection algorithm. The validation with independent long-term reference units showed Dice coefficients ≥79 %, omission errors ≤24 %, commission errors ≤18 %, and a relative bias ≥ - 8 %. An intercomparison with other available global BA products (GABAM, FireCCI51, C3SBA11, or MCD64) demonstrated that our product (i) exhibits temporal consistency, (ii) represents a significant accuracy improvement, as it reduces BA underestimations by about eightfold, (iii) yields BA estimates four times higher, and (iv) shows enhanced capability in detecting fires of all sizes. The observed BA spatial patterns were heterogeneous across the island, with 32 % of the grasslands burning annually, in contrast to other land cover types such as the dense tropical forest where <2 % burned every year. We conclude that the BA characterization in Madagascar must be addressed using imagery at spatial resolution higher than MODIS or Sentinel-3 (≥250 m), and temporal resolution higher than Landsat (16 days) to deal with cloudiness, the rapid attenuation of burn scars signals, and small fire patches.

Utilizing Community Engagement Studios to inform patient experience in a multicenter randomized control trial.

OBJECTIVE: To determine whether a community engagement approach can provide feedback for implementation of valuable measures to improve the outcome of a clinical trial. METHODS: Review of the results from a Community Engagement Studio (CE Studio) for the ValEAR trial: an NIH-funded, multi-institutional study designed to research the efficacy of valganciclovir in the treatment of congenital cytomegalovirus (cCMV)-induced hearing loss. Participants were given information about the trial then asked a series of questions to assess their input on the merits or weaknesses affecting their participation in the trial. RESULTS: Thirteen parents whose children have congenital CMV infection were recruited for the CE Studio. The overall theme from the responses was a desire to advance the field but a need to clearly understand the risks and benefits of participation. Many requested more educational resources, more printed materials, or greater access to researchers if questions arose. Many welcomed having patient stories and information displayed in a dedicated website or through social media. CONCLUSION: This community engagement approach provided useful feedback from families similar to those expected to be potential enrollees in the CMV ValEAR trial. In response to parental comments, two educational videos were created: one on the general topic of cCMV and the other specific to the CMV ValEAR trial. Researchers who wish to optimize their clinical trial's success should consider incorporating a CE Studio into their study design.

Impact of drains on nausea and vomiting after thyroid and parathyroid surgery: a randomized controlled trial.

OBJECTIVE: Nausea and vomiting are common side effects following thyroid and parathyroid surgery. In a prospective controlled randomized trial, postoperative nausea and vomiting (PONV) and the number of episodes of vomiting were defined as two primary endpoints. We analysed whether the placement of drains after thyroid or parathyroid surgery enhances PONV and/or influences vomiting. PATIENTS AND METHODS: From November 2007 to January 2012, 136 consecutive patients were included for thyroid or parathyroid surgery and were randomly assigned to group A (drain, n = 69) or group B (no drain, n = 67). PONV was assessed with visual analogue scale (VAS; range 0 to 10) measurements. Furthermore, episodes of vomiting as well as analgetic and antiemetic therapies were recorded. Difference in neck circumference was compared pre- and postoperatively. RESULTS: Patients' characteristics did not differ between group A and B. Postoperative VAS values for pain were 2.4 ± 0.3 (group A) and 2.6 ± 0.2 (group B) (p = 0.62), and for nausea 1.4 ± 0.2 (group A) and 1.1 ± 0.2 (group B) (p = 0.57). The relative occurrences of episodes for postoperative vomiting were equal in both groups 0.3 ± 0.1 (p = 1.0). Antiemetic drugs were administered 37 times (group A) and 18 times (group B) (p = 0.099). The total number of treatments of patients with antiemetic drugs was 23 (33.3%) in group A vs. 13 (19.4%) in group B (p = 0.081). The neck circumference postoperatively was significantly larger in group B (p = 0.0025). CONCLUSIONS: Drains after surgery do not enhance postoperative pain, nausea and vomiting. The placement of drains in thyroid surgery is recommended to avoid relevant fluid collection. Drains however may influence the amount of antiemetic drug requirements. TRIAL REGISTRATION: CLINICALTRIALS. GOV IDENTIFIER: NCT01679418.

The impact of the introduction of total mesorectal excision on local recurrence rate and survival in rectal cancer: long-term results.

PURPOSE: To investigate the influence of the introduction of total mesorectal excision (TME) on local recurrence rate and survival in patients with rectal cancer. METHODS: A total of 171 consecutive patients underwent anterior or abdominoperineal resection for primary rectal cancer. When the TME technique was introduced, the clinical setting, including the surgeons, remained the same. Group 1 (1993-95, n =53) underwent conventional surgery and group 2 (1995-2001, n = 118) underwent TME. All patients were followed for 7 years or until death. RESULTS: Between the two groups, no statistically significant differences were present with regards to patient-, treatment-, or tumor-related characteristics apart from the time point of radiotherapy. The total local recurrence rates were 11 of 53 (20.8%) in group 1 and 7 of 118 (5.9%) in group 2, and the rates of isolated local recurrences were 6 of 53 (11.3%) in group 1 and 2 of 118 (1.7%) in group 2. Both differences were highly statistically significant. The disease-free survival in groups 1 and 2 was 60.4 and 65.3% at 5 years, and 58.5 and 65.3% at 7 years, respectively. Excluding patients with synchronous or metachronous distant metastasis from the analysis, both the disease-free survival and the cancer-specific survival were statistically significantly better in group 2 than in group 1. No statistically significant difference between the two groups was detected regarding the overall survival. CONCLUSIONS: The introduction of TME led to an impressive reduction of the local recurrence rate. Survival is mainly determined by the occurrence of distant metastasis, but TME seems to improve survival in patients without systemic disease.

Diagnosis and treatment of small follicular thyroid carcinomas.

BACKGROUND: Follicular thyroid microcarcinomas (mFTCs) of 10 mm or less in size rarely manifest clinically and their clinical significance is controversial. This study assessed their characteristics and incidence, and analysed treatment modalities used for mFTC. METHODS: Members of the German Association of Endocrine Surgeons were asked to review patients with mFTC operated on between 1990 and 2005. RESULTS: Data for 90 patients from 26 institutions were reported. Histopathological slides were available for re-evaluation in 35 patients. Most initial diagnoses had to be revised because of incorrect size assessment or incorrect diagnosis (benign adenoma, papillary thyroid carcinoma (PTC), follicular variant of PTC). The diagnosis of mFTC was confirmed in only four patients. As a result of the incorrect histopathological diagnosis, unnecessary completion thyroidectomy and radioiodine ablation were performed in 17 and 20 patients respectively. The incidence of mFTC was calculated to be 0.12 per million population per year. CONCLUSION: mFTC is exceptionally rare. Such tumours are overdiagnosed, resulting in unnecessary treatment associated with avoidable morbidity. Histopathological re-evaluation by an experienced pathologist is recommended before embarking on further treatments when a diagnosis of mFTC is made.

Pulmonary vein thrombosis after lower lobectomy of the left lung.

Pulmonary vein thrombosis is a known complication after lung transplantation but has rarely been reported after lobectomy or bilobectomy. We report the case of a left upper pulmonary vein thrombosis following an uneventful left lower lobectomy for bronchial carcinoma. Postoperative arterial blood gas values and chest radiographs were normal. On postoperative day 5, the patient became progressively dyspneic, developed hemoptysis and showed total opacification of the left lung without mediastinal shift on chest radiography. The patient remained dyspneic despite intravenous antibiotic therapy for suspected pneumonia and absence of obstruction at bronchoscopy. Diagnosis of left upper pulmonary vein thrombosis was finally made by contrast-enhanced multislice computed tomography followed by pulmonary angiography. Further clinical deterioration under conservative treatment forced us to remove the remnant left upper lobe that already showed gangrenous alterations. Pulmonary vein thrombosis following lobectomy or bilobectomy is very rare. Only 7 cases have been reported in the literature so far. Conservative treatment with antibiotics and anticoagulants may be successful but in case of clinical deterioration the affected lobe has to be resected. The mechanism of thrombosis remains unclear although intraoperative torsion and injury of vessels seem to be most likely since pulmonary vein thrombosis occurred in the operated hemithorax only.

[Is a minimally-invasive treatment concept in the late stage of pleural empyema successful?]. / Ist ein minimal-invasives Behandlungskonzept in späten Stadien des Pleuraempyems erfolgreich?

INTRODUCTION: Thoracoscopic treatment of pleural empyema is still a controversial method, especially in the chronic stage of the disease. The issue is raised whether the thoracoscopic approach to the empyema-possibly combined with a small additional thoracotomy in advanced stages-is successful and of low risk. PATIENTS AND METHODS: Between January 1993 and May 1995 we treated 13 patients in advanced stages of pleural empyema. The patients were all seriously ill and had severe underlying disease. The procedures were performed under general anesthesia involving intubation with a double-lumen endotracheal tube. The steps of our standard operative procedure are outlined. RESULTS: In 5 patients with a pleural empyema in stage III thoracoscopy was facilitated by a small additional thoracotomy. A complete resolution of the disease was obtained in 12 cases and a secondary intervention was necessary in 1 patient. There was no peri- or postoperative mortality, and apart from a prolonged drainage of the pleural cavity in 3 patients no morbidity was registered. In the long-term follow up, 3 patients had died. There was no correlation between the deaths and the intervention or the empyema disease. DISCUSSION: We discuss the advantages of a limited additional thoracotomy in case of intraoperative difficulties encountered with late stages of empyema. This treatment can still be considered minimally invasive. All patients tolerated the procedure well, and the overall results were favourable in 92% of our collective. However, thoracoscopic treatment should preferably take place at an earlier stage. CONCLUSION: We recommend the thoracoscopic approach-possibly combined with a limited thoracotomy-as primary treatment in late stages of pleural empyema.

[Incidence of recurrence in long-term follow-up of 100 patients after surgery for primary hyperparathyroidism]. / Rezidivhäufigkeit in der Langzeitbeobachtung von 100 Patienten nach Operation wegen primärem Hyperparathyreoidismus.

The percentages for recurrence or persistence of hyperparathyroidism after operation for pHPT vary between 3 and 7% according to the pertinent literature. These groups of authors have a broad experience based on a large number of patients treated. At our institute we have operated for pHPT an average of 5 patients per year. Given our limited experience we reexamined 100 consecutive patients which were operated for pHPT between 1968 and 1988 in order to determine our own rate of recurrence. The rate for persistent or recurrent hyperparathyroidism was at 8% slightly higher than in the literature reviewed. When reexamining the patients we took the history concerning the preoperative symptomatology and its postoperative course. Furthermore we compared a radioimmunoassay measuring the midmolecule region of the parathyroid hormone with a immunochemiluminometric assay determining the intact and biologically active hormone regarding sensitivity and specificity. The results are presented and compared with the literature reviewed.

[Paralyses of the recurrent laryngeal nerve following strumectomy in late follow-up]. / Rekurrensparesen nach Strumektomie im Spätverlauf.

Over a period of 5 years, 323 patients underwent an operation on a goiter. A postoperative paralysis of the recurrent laryngeal nerve occurred in 31 patients, most in malignancies and recurrent goiters. 26 patients were controlled at least 1 year after operation. 65% of the patients have a fully recovered voice and normal vocal cord function. Another 14% showed a normal voice for daily use by functional compensation of the paralysis. Only in 4 patients (16%) the operation resulted in a permanent modest or severe hoarseness as consequence of a thyroidectomy in cancer.

Single transporter for sulfate, selenate, and selenite in Escherichia coli K-12.

A Michaelis-Menten kinetic analysis of the transport of sulfate, selenate, and selenite into Escherichia coli K-12 showed that the three dianions were transported by the same carrier. Km values, used as a measure of the affinity of each ligand for the carrier, showed that sulfate was bound 5 times more tightly than selenate and 37 times more tightly than selenite. The specificity ratio, Vmax/Km, also indicated that sulfate was the preferred ligand. There was little difference in the ratios for selenate and selenite.

Aerobic, Selenium-Utilizing Bacillus Isolated from Seeds of Astragalus crotalariae.

Bacillus sp. strain SS, an aerobic, gram-positive sporeformer, was isolated from seeds of Astragalus crotalariae, a selenium-accumulating plant. This bacillus grew in a nutrient broth (containing beef extract and peptone) if the medium was supplemented with high concentrations of selenium. Concentrations of Na(2)SeO(3) that supported growth ranged from 3 to 100 mM. After 24 h of growth, the culture developed a deep red color characteristic of elemental selenium. When selenium was provided in the form of selenate, the pattern of growth showed a prolonged lag period, from 24 to 48 h. Final growth remained below that of cells cultured in the presence of selenite, and only a light red color developed. Concentrations of selenate below 40 mM failed to support growth. Tellurate, though not tellurite, could replace selenite, but only over a narrow concentration range, 5 to 10 mM. By 24 h, the typical black color of elemental tellurium developed. Bacillus sp. strain SS grew also in brain heart infusion broth and Trypticase soy broth (BBL Microbiology Systems, Cockeysville, Md.) without the addition of selenium or tellurium compounds. When added to these media, 50 mM selenite was tolerated and metabolized by the organism. The crucial distinction between this bacillus and other selenium-tolerant organisms (e.g., Salmonella) remains: under certain conditions, growth requirements of Bacillus sp. strain SS are fulfilled by selenium (and tellurium) compounds.

Preparation of oligonucleotides and their use in molecular weight estimations.

Yeast RNA was used to prepare oligonucleotides employed to calibrate a G-50 Sephadex column. The oligonucleotides' preparation, isolation, desalting and characterization is described. Data obtained by chromatography of the oligonucleotides demonstrate that the molecular weights of oligonoucleotides can be easily determined by interpolation using plots of elution volumes (Ve) versus molecular weights (M). Errors greater than 20% are obtained if the conventional plot of Ve-Vo/Vs versus log M is used (where Vo is the void volume of the column and Vs is the volume of the column occupied by the inert phase, the G-50 Sephadex).