Risk factors for wound-related complications after surgical stabilization of spinal metastases with a special focus on the effect of postoperative radiation therapy.

BACKGROUND: Advancements in the field of oncological therapies during the last decades have led to a significantly prolonged survival of cancer patients. This has led to an increase in the incidence of spinal metastases. The purpose of this study was to assess risk factors for wound-related complications after surgical stabilization of spinal metastases with a special focus on the effect of postoperative RT and its timing. METHODS: Patients who had been treated for metastatic spine disease by surgical stabilization followed by radiotherapy between 01/2012 and 03/2019 were included and a retrospective chart review was performed. RESULTS: Of 604 patients who underwent stabilizing surgery for spinal metastases, 237 patients (mean age 66 years, SD 11) with a mean follow-up of 11 months (SD 7) were eligible for further analysis. Forty-one patients (17.3%) had wound-related complications, 32 of them before and 9 after beginning of the RT. Revision surgery was necessary in 26 patients (11.0%). Body weight (p = 0.021), obesity (p = 0.018), ASA > 2 (p = 0.001), and start of radiation therapy within 21 days after surgery (p = 0.047) were associated with an increased risk for wound complications. Patients with chemotherapy within 3 weeks of surgery (12%) were more likely to have a wound-related surgical revision (p = 0.031). CONCLUSION: Body weight, obesity and ASA > 2 were associated with an increased risk for wound complications. Patients with chemotherapy within 3 weeks of the surgery were more likely to have a wound-related revision surgery. Patients who had begun radiation therapy within 21 days after surgery were more likely to have a wound complication compared to patients who waited longer.

Validating MODIS and Sentinel-2 NDVI Products at a Temperate Deciduous Forest Site Using Two Independent Ground-Based Sensors.

Quantifying the accuracy of remote sensing products is a timely endeavor given the rapid increase in Earth observation missions. A validation site for Sentinel-2 products was hence established in central Germany. Automatic multispectral and hyperspectral sensor systems were installed in parallel with an existing eddy covariance flux tower, providing spectral information of the vegetation present at high temporal resolution. Normalized Difference Vegetation Index (NDVI) values from ground-based hyperspectral and multispectral sensors were compared with NDVI products derived from Sentinel-2A and Moderate-resolution Imaging Spectroradiometer (MODIS). The influence of different spatial and temporal resolutions was assessed. High correlations and similar phenological patterns between in situ and satellite-based NDVI time series demonstrated the reliability of satellite-based phenological metrics. Sentinel-2-derived metrics showed better agreement with in situ measurements than MODIS-derived metrics. Dynamic filtering with the best index slope extraction algorithm was nevertheless beneficial for Sentinel-2 NDVI time series despite the availability of quality information from the atmospheric correction procedure.

Simulation of forest tree species' bud burst dates for different climate scenarios: chilling requirements and photo-period may limit bud burst advancement.

This study investigates whether the assumed increase of winter and spring temperatures is depicted by phenological models in correspondingly earlier bud burst (BB) dates. Some studies assume that rising temperatures lead to an earlier BB, but even later BB has been detected. The phenological model PIM (promoter-inhibitor-model) fitted to the extensive phenological database of the German Weather Service was driven by several climate scenarios. This model accounts for the complicated mechanistic interactions between chilling requirements, temperature and photo-period. It predicts BB with a r 2 between 0.41 and 0.62 and a RMSE of around 1 week, depending on species. Parameter sensitivities depict species dependent interactions between growth and chilling requirements as well as photo-period. A mean trend to earlier BB was revealed for the period 2002- 2100, varying between -0.05 and -0.11 days per year, depending on species. These trends are lower than for the period 1951- 2009. Within climate scenario period, trends are decreasing for beech and chestnut, stagnating for birch and increasing for oak. Results suggest that not fulfilled chilling requirements accompanied by an increasing dependency on photo-period potentially limit future BB advancement. The combination of a powerful phenological model, a large scale phenological database and several climate scenarios, offers new insights into the mechanistic comprehension of spring phenology.