Identifying Patterns in Extreme Precipitation Risk and the Related Impacts

Science.gov (United States)

Schroeer, K.; Tye, M. R.

2017-12-01

Extreme precipitation can harm human life and assets through flooding, hail, landslides, or debris flows. Flood risk assessments typically concentrate on river or mountain torrent channels, using water depth, flow velocity, and/or sediment deposition to quantify the risk. In addition, extreme events with high recurrence intervals are often the main focus. However, damages from short-term and localized convective showers often occur away from watercourses. Also, damages from more frequent small scale extremes, although usually less disastrous, can accumulate to considerable financial burdens. Extreme convective precipitation is expected to intensify in a warmer climate, and vulnerability patterns might change in tandem with changes in the character of precipitation and flood types. This has consequences for adaptation planners who want to establish effective protection measures and reduce the cost from natural hazards. Here we merge hydrological and exposure data to identify patterns of risk under varying synoptic conditions. Exposure is calculated from a database of 76k damage claims reported to the national disaster fund in 480 municipalities in south eastern Austria from 1990-2015. Hydrological data comprise sub-daily precipitation (59 gauges) and streamflow (62 gauges) observations. We use synoptic circulation types to identify typical precipitation patterns. They indicate the character of precipitation even if a gauge is not in close proximity, facilitating potential future research with regional climate model data. Results show that more claims are reported under synoptic conditions favouring convective precipitation (on average 1.5-3 times more than on other days). For agrarian municipalities, convective precipitation damages are among the costliest after long low-intensity precipitation events. In contrast, Alpine communities are particularly vulnerable to convective high-intensity rainfall. In addition to possible observational error, uncertainty is present

Risk assessment of precipitation extremes in northern Xinjiang, China

Science.gov (United States)

Yang, Jun; Pei, Ying; Zhang, Yanwei; Ge, Quansheng

2018-05-01

This study was conducted using daily precipitation records gathered at 37 meteorological stations in northern Xinjiang, China, from 1961 to 2010. We used the extreme value theory model, generalized extreme value (GEV) and generalized Pareto distribution (GPD), statistical distribution function to fit outputs of precipitation extremes with different return periods to estimate risks of precipitation extremes and diagnose aridity-humidity environmental variation and corresponding spatial patterns in northern Xinjiang. Spatiotemporal patterns of daily maximum precipitation showed that aridity-humidity conditions of northern Xinjiang could be well represented by the return periods of the precipitation data. Indices of daily maximum precipitation were effective in the prediction of floods in the study area. By analyzing future projections of daily maximum precipitation (2, 5, 10, 30, 50, and 100 years), we conclude that the flood risk will gradually increase in northern Xinjiang. GEV extreme value modeling yielded the best results, proving to be extremely valuable. Through example analysis for extreme precipitation models, the GEV statistical model was superior in terms of favorable analog extreme precipitation. The GPD model calculation results reflect annual precipitation. For most of the estimated sites' 2 and 5-year T for precipitation levels, GPD results were slightly greater than GEV results. The study found that extreme precipitation reaching a certain limit value level will cause a flood disaster. Therefore, predicting future extreme precipitation may aid warnings of flood disaster. A suitable policy concerning effective water resource management is thus urgently required.

Polygenic determinants in extremes of high-density lipoprotein cholesterol[S

Science.gov (United States)

Dron, Jacqueline S.; Wang, Jian; Low-Kam, Cécile; Khetarpal, Sumeet A.; Robinson, John F.; McIntyre, Adam D.; Ban, Matthew R.; Cao, Henian; Rhainds, David; Dubé, Marie-Pierre; Rader, Daniel J.; Lettre, Guillaume; Tardif, Jean-Claude

2017-01-01

HDL cholesterol (HDL-C) remains a superior biochemical predictor of CVD risk, but its genetic basis is incompletely defined. In patients with extreme HDL-C concentrations, we concurrently evaluated the contributions of multiple large- and small-effect genetic variants. In a discovery cohort of 255 unrelated lipid clinic patients with extreme HDL-C levels, we used a targeted next-generation sequencing panel to evaluate rare variants in known HDL metabolism genes, simultaneously with common variants bundled into a polygenic trait score. Two additional cohorts were used for validation and included 1,746 individuals from the Montréal Heart Institute Biobank and 1,048 individuals from the University of Pennsylvania. Findings were consistent between cohorts: we found rare heterozygous large-effect variants in 18.7% and 10.9% of low- and high-HDL-C patients, respectively. We also found common variant accumulation, indicated by extreme polygenic trait scores, in an additional 12.8% and 19.3% of overall cases of low- and high-HDL-C extremes, respectively. Thus, the genetic basis of extreme HDL-C concentrations encountered clinically is frequently polygenic, with contributions from both rare large-effect and common small-effect variants. Multiple types of genetic variants should be considered as contributing factors in patients with extreme dyslipidemia. PMID:28870971

Extreme Preterm Premature Rupture of Membranes: Risk Factors and Feto Maternal Outcomes

Directory of Open Access Journals (Sweden)

Nihal Al Riyami

2013-03-01

Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is defined as a rupture of the amniotic membranes occurring before 37 weeks of gestation and before the onset of labor. Extreme PPROM occurs prior to 26 weeks gestation and contributes to an increased risk of prematurity, leading to maternal and fetal complications. This study aims to estimate the risk factors associated with various maternal complications and to determine the worst outcomes in Omani females with extreme PPROM.Methods: A retrospective cohort study was conducted on 44 women with extreme PPROM, who delivered at Sultan Qaboos University Hospital (SQUH from January 2006 to December 2011. Women with incomplete information, multiple gestations, or a preterm delivery resulting from medical intervention, as well as women who delivered elsewhere were excluded from the study.Results: Forty-four women with extreme PPROM were included in our study. The results revealed the most important risk factor to be history of infection, which was noted in 24 study participants. The mean maternal age was 30 years. The mean gestational age at PPROM and at delivery were 20.7±3.2 (range: 16-26 weeks and 29.7±7.6 weeks (range: 17-40 weeks, respectively. The maternal complications observed in this study included; infection which was seen in 20 (45% patients, antepartum hemorrhage in 11 (25% patients, and cesarean section which was required in 12 (27% patients. There was no significant association between risk factors such as gestational age at delivery, parity, maternal age at PPROM, or maternal Body Mass Index (BMI and cesarean section rate. Infection played a major role, both as a risk factor and in causing extreme PPROM, which in turn increased in 12 patients (27%. In the multivariable model for predicting the need for cesarean section (gestational age at delivery, parity, maternal age at PPROM in years and maternal BMI, none of the factors were statistically significant.Conclusion: Overall

An application of extreme value theory in estimating liquidity risk

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Sonia Benito Muela

2017-09-01

Full Text Available The last global financial crisis (2007–2008 has highlighted the weaknesses of value at risk (VaR as a measure of market risk, as this metric by itself does not take liquidity risk into account. To address this problem, the academic literature has proposed incorporating liquidity risk into estimations of market risk by adding the VaR of the spread to the risk price. The parametric model is the standard approach used to estimate liquidity risk. As this approach does not generate reliable VaR estimates, we propose estimating liquidity risk using more sophisticated models based on extreme value theory (EVT. We find that the approach based on conditional extreme value theory outperforms the standard approach in terms of accurate VaR estimates and the market risk capital requirements of the Basel Capital Accord.

Optimal security investments and extreme risk.

Science.gov (United States)

Mohtadi, Hamid; Agiwal, Swati

2012-08-01

In the aftermath of 9/11, concern over security increased dramatically in both the public and the private sector. Yet, no clear algorithm exists to inform firms on the amount and the timing of security investments to mitigate the impact of catastrophic risks. The goal of this article is to devise an optimum investment strategy for firms to mitigate exposure to catastrophic risks, focusing on how much to invest and when to invest. The latter question addresses the issue of whether postponing a risk mitigating decision is an optimal strategy or not. Accordingly, we develop and estimate both a one-period model and a multiperiod model within the framework of extreme value theory (EVT). We calibrate these models using probability measures for catastrophic terrorism risks associated with attacks on the food sector. We then compare our findings with the purchase of catastrophic risk insurance. © 2012 Society for Risk Analysis.

Risk factors for lower-extremity injuries among contemporary dance students

NARCIS (Netherlands)

van Seters, Christine; van Rijn, Rogier M; van Middelkoop, Marienke; Stubbe, Janine H

2017-01-01

OBJECTIVE: To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. DESIGN: Prospective cohort study. SETTING: Codarts University of the Arts. PATIENTS: Forty-five

Upper extremity deep venous thrombosis after port insertion: What are the risk factors?

Science.gov (United States)

Tabatabaie, Omidreza; Kasumova, Gyulnara G; Kent, Tara S; Eskander, Mariam F; Fadayomi, Ayotunde B; Ng, Sing Chau; Critchlow, Jonathan F; Tawa, Nicholas E; Tseng, Jennifer F

2017-08-01

Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.

Science.gov (United States)

Bot, Sandra D M; Terwee, Caroline B; van der Windt, Daniëlle A W M; van der Beek, Allard J; Bouter, Lex M; Dekker, Joost

2007-08-01

To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.

Extreme Value Theory Approach to Simultaneous Monitoring and Thresholding of Multiple Risk Indicators

NARCIS (Netherlands)

Einmahl, J.H.J.; Li, J.; Liu, R.Y.

2006-01-01

Risk assessments often encounter extreme settings with very few or no occurrences in reality.Inferences about risk indicators in such settings face the problem of insufficient data.Extreme value theory is particularly well suited for handling this type of problems.This paper uses a multivariate

Back and upper extremity disorders among enlisted U.S. Marines: burden and individual risk factors.

Science.gov (United States)

Huang, G D; Feuerstein, M; Arroyo, F

2001-11-01

Although musculoskeletal disorders of the low back and upper extremities can affect military readiness, little is known about their extent and risk factors in the U.S. Marine Corps. Using the Defense Medical Epidemiology and Defense Medical Surveillance System databases, back and upper extremity diagnostic categories were among the top four sources of outpatient visits and duty limitation among enlisted Marines. Back disorders were also found to be the fifth most common cause for lost time. Subsequently, high-risk occupations were identified, age-related trends for clinic visit rates were determined, and rate ratios were computed for the top 15 low back and upper extremity diagnoses among enlisted Marines from 1997 through 1998. Occupational categories with the highest rates of musculoskeletal-related outpatient visits included image interpretation, auditing and accounting, disturbsing, surveillance/target acquisition, and aircraft launch equipment. Significantly increasing linear trends in rates across age groups were found for most diagnoses. For 1998, age-specific rate ratios indicated significantly higher rates for most low back and upper extremity disorders for females; lower rank (i.e., E1-E4) was also a risk, but for fewer diagnoses. The findings emphasize the need to identify modifiable (e.g., work-related, individual) risk factors and to develop focused primary and secondary prevention programs for musculoskeletal disorders in the Marine Corps. Subsequently, these efforts can assist in reducing associated effects, maximizing resource utilization, and enhancing operational readiness.

Regional Risk Assessment for the analysis of the risks related to storm surge extreme events in the coastal area of the North Adriatic Sea.

Science.gov (United States)

Rizzi, Jonathan; Torresan, Silvia; Gallina, Valentina; Critto, Andrea; Marcomini, Antonio

2013-04-01

Europe's coast faces a variety of climate change threats from extreme high tides, storm surges and rising sea levels. In particular, it is very likely that mean sea level rise will contribute to upward trends in extreme coastal high water levels, thus posing higher risks to coastal locations currently experiencing coastal erosion and inundation processes. In 2007 the European Commission approved the Flood Directive (2007/60/EC), which has the main purpose to establish a framework for the assessment and management of flood risks for inland and coastal areas, thus reducing the adverse consequences for human health, the environment, cultural heritage and economic activities. Improvements in scientific understanding are thus needed to inform decision-making about the best strategies for mitigating and managing storm surge risks in coastal areas. The CLIMDAT project is aimed at improving the understanding of the risks related to extreme storm surge events in the coastal area of the North Adriatic Sea (Italy), considering potential climate change scenarios. The project implements a Regional Risk Assessment (RRA) methodology developed in the FP7 KULTURisk project for the assessment of physical/environmental impacts posed by flood hazards and employs the DEcision support SYstem for Coastal climate change impact assessment (DESYCO) for the application of the methodology to the case study area. The proposed RRA methodology is aimed at the identification and prioritization of targets and areas at risk from water-related natural hazards in the considered region at the meso-scale. To this aim, it integrates information about extreme storm surges with bio-geophysical and socio-economic information (e.g. vegetation cover, slope, soil type, population density) of the analyzed receptors (i.e. people, economic activities, cultural heritages, natural and semi-natural systems). Extreme storm surge hazard scenarios are defined using tide gauge time series coming from 28 tide gauge

A Semi Risk-Based Approach for Managing Urban Drainage Systems under Extreme Rainfall

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Carlos Salinas-Rodriguez

2018-03-01

Full Text Available Conventional design standards for urban drainage systems are not set to deal with extreme rainfall events. As these events are becoming more frequent, there is room for proposing new planning approaches and standards that are flexible enough to cope with a wide range of rainfall events. In this paper, a semi risk-based approach is presented as a simple and practical way for the analysis and management of rainfall flooding at the precinct scale. This approach uses various rainfall events as input parameters for the analysis of the flood hazard and impacts, and categorises the flood risk in different levels, ranging from very low to very high risk. When visualised on a map, the insight into the risk levels across the precinct will enable engineers and spatial planners to identify and prioritise interventions to manage the flood risk. The approach is demonstrated for a sewer district in the city of Rotterdam, the Netherlands, using a one-dimensional (1D/two-dimensional (2D flood model. The risk level of this area is classified as being predominantly very low or low, with a couple of locations with high and very high risk. For these locations interventions, such as disconnection and lowering street profiles, have been proposed and analysed with the 1D/2D flood model. The interventions were shown to be effective in reducing the risk levels from very high/high risk to medium/low risk.

A systemic approach for managing extreme risk events-dynamic financial analysis

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Ph.D.Student Rodica Ianole

2011-12-01

Full Text Available Following the Black Swan logic, it often happens that what we do not know becomes more relevant that what we (believe to know. The management of extreme risks falls under this paradigm in the sense that it cannot be limited to a static approach based only on objective and easily quantifiable variables. Making appeal to the operational tools developed primarily for the insurance industry, the present paper aims to investigate how dynamic financial analysis (DFA can be used within the framework of extreme risk events.

Offshore wind turbine risk quantification/evaluation under extreme environmental conditions

International Nuclear Information System (INIS)

Taflanidis, Alexandros A.; Loukogeorgaki, Eva; Angelides, Demos C.

2013-01-01

A simulation-based framework is discussed in this paper for quantification/evaluation of risk and development of automated risk assessment tools, focusing on applications to offshore wind turbines under extreme environmental conditions. The framework is founded on a probabilistic characterization of the uncertainty in the models for the excitation, the turbine and its performance. Risk is then quantified as the expected value of some risk consequence measure over the probability distributions considered for the uncertain model parameters. Stochastic simulation is proposed for the risk assessment, corresponding to the evaluation of some associated probabilistic integral quantifying risk, as it allows for the adoption of comprehensive computational models for describing the dynamic turbine behavior. For improvement of the computational efficiency, a surrogate modeling approach is introduced based on moving least squares response surface approximations. The assessment is also extended to a probabilistic sensitivity analysis that identifies the importance of each of the uncertain model parameters, i.e. risk factors, towards the total risk as well as towards each of the failure modes contributing to this risk. The versatility and computational efficiency of the advocated approaches is finally exploited to support the development of standalone risk assessment applets for automated implementation of the probabilistic risk quantification/assessment. -- Highlights: ► A simulation-based risk quantification/assessment framework is discussed. ► Focus is on offshore wind turbines under extreme environmental conditions. ► Approach is founded on probabilistic description of excitation/system model parameters. ► Surrogate modeling is adopted for improved computational efficiency. ► Standalone risk assessment applets for automated implementation are supported

Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers

OpenAIRE

Tang, Ulla Hellstrand; Z?gner, Roland; Lisovskaja, Vera; Karlsson, Jon; Hagberg, Kerstin; Tranberg, Roy

2015-01-01

Objective: Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and ...

Impact of climate change on extreme rainfall events and flood risk

Indian Academy of Sciences (India)

The analysis of the frequency of rainy days, rain days and heavy rainfall days as well as one-day extreme rainfall and return period has been carried out in this study to observe the impact of climate change on extreme rainfall events and flood risk in India. The frequency of heavy rainfall events are decreasing in major parts ...

Extreme lipoprotein(a) levels and risk of myocardial infarction in the general population

DEFF Research Database (Denmark)

Kamstrup, Pia R; Benn, Marianne; Tybjaerg-Hansen, Anne

2008-01-01

Elevated lipoprotein(a) levels are associated with myocardial infarction (MI) in some but not all studies. Limitations of previous studies include lack of risk estimates for extreme lipoprotein(a) levels, measurements in long-term frozen samples, no correction for regression dilution bias, and lack...... of absolute risk estimates in the general population. We tested the hypothesis that extreme lipoprotein(a) levels predict MI in the general population, measuring levels shortly after sampling, correcting for regression dilution bias, and calculating hazard ratios and absolute risk estimates....

Thermal extremes mortality risk assessment in urban areas

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Paulo Canário

2010-06-01

Full Text Available The impact of heat waves on mortality has been the subject of numerous studies and the focus of attention of various national and international governmental bodies. In the summer of 2003 alone, which was exceptionally hot, the number of deaths in 12 European countries increased by 70,000. The overall trend of warming will lead to an increase in frequency, duration and intensity of heat waves and to an increase in heat related mortality. The need to assess the risk of death due to extreme heat, at a detailed spatial scale, has determined the implementation of a research project based on a general model of risk for potentially destructive natural phenomena; the model uses the relationship between hazard and vulnerability and was designed primarily for urban areas. The major hazardous meteorological variables are those that determine the thermal complex (air temperature, radiative temperature, wind and humidity and the variables related to air quality (mainly ozone and Particulate matter. Vulnerability takes into account the population sensitivity (at various spatial scales and their exposure to thermal extremes.

Does red noise increase or decrease extinction risk? Single extreme events versus series of unfavorable conditions.

Science.gov (United States)

Schwager, Monika; Johst, Karin; Jeltsch, Florian

2006-06-01

Recent theoretical studies have shown contrasting effects of temporal correlation of environmental fluctuations (red noise) on the risk of population extinction. It is still debated whether and under which conditions red noise increases or decreases extinction risk compared with uncorrelated (white) noise. Here, we explain the opposing effects by introducing two features of red noise time series. On the one hand, positive autocorrelation increases the probability of series of poor environmental conditions, implying increasing extinction risk. On the other hand, for a given time period, the probability of at least one extremely bad year ("catastrophe") is reduced compared with white noise, implying decreasing extinction risk. Which of these two features determines extinction risk depends on the strength of environmental fluctuations and the sensitivity of population dynamics to these fluctuations. If extreme (catastrophic) events can occur (strong noise) or sensitivity is high (overcompensatory density dependence), then temporal correlation decreases extinction risk; otherwise, it increases it. Thus, our results provide a simple explanation for the contrasting previous findings and are a crucial step toward a general understanding of the effect of noise color on extinction risk.

Portfolio optimization for heavy-tailed assets: Extreme Risk Index vs. Markowitz

OpenAIRE

Mainik, Georg; Mitov, Georgi; Rüschendorf, Ludger

2015-01-01

Using daily returns of the S&P 500 stocks from 2001 to 2011, we perform a backtesting study of the portfolio optimization strategy based on the extreme risk index (ERI). This method uses multivariate extreme value theory to minimize the probability of large portfolio losses. With more than 400 stocks to choose from, our study seems to be the first application of extreme value techniques in portfolio management on a large scale. The primary aim of our investigation is the potential of ERI in p...

Upper extremity injuries in Danish children aged 6–12, mechanisms, and risk factors

DEFF Research Database (Denmark)

Nauta, J.; Jespersen, Eva; Verhagen, Evert

2017-01-01

was found suggesting that girls are at increased acute upper extremity risk compared to boys (HR: 1.40 95% CI: 0.97–2.04). The findings that most injuries occur after a fall, that injury risk increases over age and that girls seem to be at increased injury risk provides essential information to guide future...... caused by a fall. When corrected for exposure to physical activity, this resulted in an acute upper extremity injury incidence density of 0.18 per 1000 h of physical activity. The odds of sustaining an upper extremity injury was higher in the older children (HR: 1.84, 95% CI: 1.10–3.09), a tendency...

Perdas extremas em mercados de risco Extreme losses in risk markets

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Ronaldo A Arraes

2006-12-01

risk, turning EVT into a valuable tool for an accurate evaluation of high loss risks. The estimations of expected maximum losses in financial series are investigated by means of: i traditional methods, which used all sample data in fitting the random variable pdf; ii the Extreme Value methodology, particularly the Generalized Extreme Value distribution (GEV, which only used a set of maximum values detected in the sample data in estimating the pdf of expected maximum losses. The findings indicate, firstly, an important underestimation of extreme losses with the traditional methods, mainly in the pdf lower tail limits, and, secondly, that the GEV distribution proved to be more efficient in forecasting extreme losses in the analyzed series: Ibovespa, Merval, Dow Jones.

Extreme Value Theory and Value at Risk. Application to oil market

International Nuclear Information System (INIS)

Marimoutou, Velayoudoum; Raggad, Bechir; Trabelsi, Abdelwahed

2009-01-01

Recent increases in energy prices, especially oil prices, have become a principal concern for consumers, corporations, and governments. Most analysts believe that oil price fluctuations have considerable consequences on economic activity. Oil markets have become relatively free, resulting in a high degree of oil-price volatility and generating radical changes to world energy and oil industries. Consequently, oil markets are naturally vulnerable to significant high price shifts. An example of such a case is the oil embargo crisis of 1973. In this newly created climate, protection against market risk has become a necessity. Value at Risk (VaR) measures risk exposure at a given probability level and is very important for risk management. Appealing aspects of Extreme Value Theory (EVT) have made convincing arguments for its use in managing energy price risks. In this paper, we model VaR for long and short trading positions in oil market by applying both unconditional and conditional EVT models to forecast Value at Risk. These models are compared to the performances of other well-known modelling techniques, such as GARCH, Historical Simulation and Filtered Historical Simulation. Both conditional EVT and Filtered Historical Simulation procedures offer a major improvement over the conventional methods. Furthermore, GARCH(1, 1)-t model may provide equally good results which are comparable to two combined procedures. Finally, our results confirm the importance of filtering process for the success of standard approaches. (author)

Extreme Value Theory and Value at Risk. Application to oil market

Energy Technology Data Exchange (ETDEWEB)

Marimoutou, Velayoudoum [GREQAM, Universite de la Mediterranee, Institut Francais de Pondichery (France); Raggad, Bechir; Trabelsi, Abdelwahed [BESTMOD, Institut Superieur de Gestion de Tunis (Tunisia)

2009-07-15

Recent increases in energy prices, especially oil prices, have become a principal concern for consumers, corporations, and governments. Most analysts believe that oil price fluctuations have considerable consequences on economic activity. Oil markets have become relatively free, resulting in a high degree of oil-price volatility and generating radical changes to world energy and oil industries. Consequently, oil markets are naturally vulnerable to significant high price shifts. An example of such a case is the oil embargo crisis of 1973. In this newly created climate, protection against market risk has become a necessity. Value at Risk (VaR) measures risk exposure at a given probability level and is very important for risk management. Appealing aspects of Extreme Value Theory (EVT) have made convincing arguments for its use in managing energy price risks. In this paper, we model VaR for long and short trading positions in oil market by applying both unconditional and conditional EVT models to forecast Value at Risk. These models are compared to the performances of other well-known modelling techniques, such as GARCH, Historical Simulation and Filtered Historical Simulation. Both conditional EVT and Filtered Historical Simulation procedures offer a major improvement over the conventional methods. Furthermore, GARCH(1, 1)-t model may provide equally good results which are comparable to two combined procedures. Finally, our results confirm the importance of filtering process for the success of standard approaches. (author)

Risking your life without a second thought: intuitive decision-making and extreme altruism.

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David G Rand

Full Text Available When faced with the chance to help someone in mortal danger, what is our first response? Do we leap into action, only later considering the risks to ourselves? Or must instinctive self-preservation be overcome by will-power in order to act? We investigate this question by examining the testimony of Carnegie Hero Medal Recipients (CHMRs, extreme altruists who risked their lives to save others. We collected published interviews with CHMRs where they described their decisions to help. We then had participants rate the intuitiveness versus deliberativeness of the decision-making process described in each CHMR statement. The statements were judged to be overwhelmingly dominated by intuition; to be significantly more intuitive than a set of control statements describing deliberative decision-making; and to not differ significantly from a set of intuitive control statements. This remained true when restricting to scenarios in which the CHMRs had sufficient time to reflect before acting if they had so chosen. Text-analysis software found similar results. These findings suggest that high-stakes extreme altruism may be largely motivated by automatic, intuitive processes.

Morbidity in extreme low birth weight newborns hospitalized in a high risk public maternity

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Derijulie Siqueira Sousa

Full Text Available Abstract Objectives: to determine the prevalence of the most common morbidities in extremely low birth weight (ELBW infants hospitalized in a newborn intensive care unit (NICU and to evaluate the influence of these morbidities through the length of in-hospital stay. Methods: observational, longitudinal, prospective and analytical study in a high risk reference maternity NICU from Sergipe, realized with 158 ELBW infants admitted between March 2014 and April 2015. The analysis of the hospitalization time was realized through the Kaplan-Meier method. Results: the average weight of premature was 785,2g ± 138,2g. The gestational age vary from 22 to 35 weeks and the average was 26,8 weeks. Of those admitted at NICU, sixty three (39,9% were discharged and 95 (60,1% died. The time of hospitalization was influenced for morbidities as: patent ductus arteriosus (PDA, intraventricular hemorrhage and sepsis. Acute respiratory distress syndrome was the most common complication (157 - 99,4%. The incidence of persistent arterial duct, intraventricular hemorrhage, sepsis, hypothermia, hypoglycemia and retinopathy of prematurity was 39,2%, 17,1%, 32,3%,50,3%, 52,3% e 16,6% respectively. Conclusions: the morbidities from respiratory tract, cardiac, neurological and infectious were the most prevalent, whilst PDA, intraventricular hemorrhage and sepsis were the morbidities that significantly influenced the time of hospitalization.

The Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes

OpenAIRE

McGuine, Timothy A.; Bell, David; Brooks, Margaret Alison; Hetzel, Scott; Pfaller, Adam; Post, Eric

2017-01-01

Objectives: Sport specialization has been shown to be associated with increased risk of musculoskeletal lower extremity injuries (LEI) in adolescent athletes presenting in clinical settings. However, the association of sport specialization and incidence of LEI has not been studied prospectively in a large population of adolescent athletes. The objective of this study was to compare the incidence of LEI in high school athletes identified as having low (LOW), moderate (MOD) or high (HIGH) level...

Climate Change and Hydrological Extreme Events - Risks and Perspectives for Water Management in Bavaria and Québec

Science.gov (United States)

Ludwig, R.

2017-12-01

There is as yet no confirmed knowledge whether and how climate change contributes to the magnitude and frequency of hydrological extreme events and how regional water management could adapt to the corresponding risks. The ClimEx project (2015-2019) investigates the effects of climate change on the meteorological and hydrological extreme events and their implications for water management in Bavaria and Québec. High Performance Computing is employed to enable the complex simulations in a hydro-climatological model processing chain, resulting in a unique high-resolution and transient (1950-2100) dataset of climatological and meteorological forcing and hydrological response: (1) The climate module has developed a large ensemble of high resolution data (12km) of the CRCM5 RCM for Central Europe and North-Eastern North America, downscaled from 50 members of the CanESM2 GCM. The dataset is complemented by all available data from the Euro-CORDEX project to account for the assessment of both natural climate variability and climate change. The large ensemble with several thousand model years provides the potential to catch rare extreme events and thus improves the process understanding of extreme events with return periods of 1000+ years. (2) The hydrology module comprises process-based and spatially explicit model setups (e.g. WaSiM) for all major catchments in Bavaria and Southern Québec in high temporal (3h) and spatial (500m) resolution. The simulations form the basis for in depth analysis of hydrological extreme events based on the inputs from the large climate model dataset. The specific data situation enables to establish a new method for `virtual perfect prediction', which assesses climate change impacts on flood risk and water resources management by identifying patterns in the data which reveal preferential triggers of hydrological extreme events. The presentation will highlight first results from the analysis of the large scale ClimEx model ensemble, showing the

Intra-seasonal risk of agriculturally-relevant weather extremes in West African Sudan Savanna

Science.gov (United States)

Boansi, David; Tambo, Justice A.; Müller, Marc

2018-01-01

Using household survey data and historical daily climate data for 29 communities across Upper East Ghana and Southwest Burkina Faso, we document climatic conditions deemed major threat to farming in the West African Sudan Savanna and assess risks posed by such conditions over the period 1997-2014. Based on farmers' perception, it is found that drought, low rainfall, intense precipitation, flooding, erratic rainfall pattern, extremely high temperatures, delayed rains, and early cessation of rains are the major threats farmers face. Using first-order Markov chain model and relevant indices for monitoring weather extremes, it is discovered that climatic risk is a general inherent attribute of the rainy season in the study area. Due to recent changes in onset of rains and length of the rainy season, some farmers have either resorted to early planting of drought-hardy crops, late planting of drought-sensitive crops, or spreading of planting across the first 3 months of the season to moderate harm. Each of these planting decisions however has some risk implications. The months of May, June, and October are found to be more susceptible to relatively longer duration of dry and hot spells, while July, August, and September are found to be more susceptible to intense precipitation and flooding. To moderate harm from anticipated weather extremes, farmers need to adjust their cropping calendar, adopt appropriate crop varieties, and implement soil and water management practices. For policy makers and other stakeholders, we recommend the supply of timely and accurate weather forecasts to guide farmers in their seasonal cropping decisions and investment in/installation of low cost irrigation facilities to enhance the practice of supplemental irrigation.

Prevention of postpartum psychosis and mania in women at high risk

NARCIS (Netherlands)

V. Bergink (Veerle); P.F. Bouvy (Paul); J. Vervoort (Jeroen); K.M. Koorengevel (Kathelijne); E.A.P. Steegers (Eric); S.A. Kushner (Steven)

2012-01-01

textabstractObjective: Women with a history of bipolar disorder or postpartum psychosis are at extremely high risk of relapse postpartum. Although lithium prophylaxis has demonstrated efficacy in reducing postpartum relapse, the timing of prophylaxis remains controversial given the balance of risks

Extremely low-frequency magnetic fields and risk of childhood leukemia

DEFF Research Database (Denmark)

Schüz, Joachim; Dasenbrock, Clemens; Ravazzani, Paolo

2016-01-01

Exposure to extremely low-frequency magnetic fields (ELF-MF) was evaluated in an International Agency for Research on Cancer (IARC) Monographs as "possibly carcinogenic to humans" in 2001, based on increased childhood leukemia risk observed in epidemiological studies. We conducted a hazard assess...

Extreme states of matter high energy density physics

CERN Document Server

Fortov, Vladimir E

2016-01-01

With its many beautiful colour pictures, this book gives fascinating insights into the unusual forms and behaviour of matter under extremely high pressures and temperatures. These extreme states are generated, among other things, by strong shock, detonation and electric explosion waves, dense laser beams,electron and ion beams, hypersonic entry of spacecraft into dense atmospheres of planets, and in many other situations characterized by extremely high pressures and temperatures.Written by one of the world's foremost experts on the topic, this book will inform and fascinate all scientists dealing with materials properties and physics, and also serve as an excellent introduction to plasma-, shock-wave and high-energy-density physics for students and newcomers seeking an overview. This second edition is thoroughly revised and expanded, in particular with new material on high energy-density physics, nuclear explosions and other nuclear transformation processes.

Risk-Cost Estimation of On-Site Wastewater Treatment System Failures Using Extreme Value Analysis.

Science.gov (United States)

Kohler, Laura E; Silverstein, JoAnn; Rajagopalan, Balaji

2017-05-01

  Owner resistance to increasing regulation of on-site wastewater treatment systems (OWTS), including obligatory inspections and upgrades, moratoriums and cease-and-desist orders in communities around the U.S. demonstrate the challenges associated with managing risks of inadequate performance of owner-operated wastewater treatment systems. As a result, determining appropriate and enforceable performance measures in an industry with little history of these requirements is challenging. To better support such measures, we develop a statistical method to predict lifetime failure risks, expressed as costs, in order to identify operational factors associated with costly repairs and replacement. A binomial logistic regression is used to fit data from public records of reported OWTS failures, in Boulder County, Colorado, which has 14 300 OWTS to determine the probability that an OWTS will be in a low- or high-risk category for lifetime repair and replacement costs. High-performing or low risk OWTS with repairs and replacements below the threshold of $9000 over a 40-year life are associated with more frequent inspections and upgrades following home additions. OWTS with a high risk of exceeding the repair cost threshold of $18 000 are further analyzed in a variation of extreme value analysis (EVA), Points Over Threshold (POT) where the distribution of risk-cost exceedance values are represented by a generalized Pareto distribution. The resulting threshold cost exceedance estimates for OWTS in the high-risk category over a 40-year expected life ranged from $18 000 to $44 000.

Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A.

Science.gov (United States)

Soneja, Sutyajeet; Jiang, Chengsheng; Fisher, Jared; Upperman, Crystal Romeo; Mitchell, Clifford; Sapkota, Amir

2016-04-27

Several studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012. We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma (ICD-9 code 493, n = 115,923). Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds. Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.

ClimEx - Climate change and hydrological extreme events - risks and perspectives for water management in Bavaria and Québec

Science.gov (United States)

Ludwig, Ralf; Baese, Frank; Braun, Marco; Brietzke, Gilbert; Brissette, Francois; Frigon, Anne; Giguère, Michel; Komischke, Holger; Kranzlmueller, Dieter; Leduc, Martin; Martel, Jean-Luc; Ricard, Simon; Schmid, Josef; von Trentini, Fabian; Turcotte, Richard; Weismueller, Jens; Willkofer, Florian; Wood, Raul

2017-04-01

The recent accumulation of extreme hydrological events in Bavaria and Québec has stimulated scientific and also societal interest. In addition to the challenges of an improved prediction of such situations and the implications for the associated risk management, there is, as yet, no confirmed knowledge whether and how climate change contributes to the magnitude and frequency of hydrological extreme events and how regional water management could adapt to the corresponding risks. The ClimEx project (2015-2019) investigates the effects of climate change on the meteorological and hydrological extreme events and their implications for water management in Bavaria and Québec. High Performance Computing is employed to enable the complex simulations in a hydro-climatological model processing chain, resulting in a unique high-resolution and transient (1950-2100) dataset of climatological and meteorological forcing and hydrological response: (1) The climate module has developed a large ensemble of high resolution data (12km) of the CRCM5 RCM for Central Europe and North-Eastern North America, downscaled from 50 members of the CanESM2 GCM. The dataset is complemented by all available data from the Euro-CORDEX project to account for the assessment of both natural climate variability and climate change. The large ensemble with several thousand model years provides the potential to catch rare extreme events and thus improves the process understanding of extreme events with return periods of 1000+ years. (2) The hydrology module comprises process-based and spatially explicit model setups (e.g. WaSiM) for all major catchments in Bavaria and Southern Québec in high temporal (3h) and spatial (500m) resolution. The simulations form the basis for in depth analysis of hydrological extreme events based on the inputs from the large climate model dataset. The specific data situation enables to establish a new method for 'virtual perfect prediction', which assesses climate change impacts

Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers.

Science.gov (United States)

Tang, Ulla Hellstrand; Zügner, Roland; Lisovskaja, Vera; Karlsson, Jon; Hagberg, Kerstin; Tranberg, Roy

2015-01-01

Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and high plantar pressure. Patients diagnosed with type 1 (n=27) or type 2 (n=47) diabetes (mean age 60.0±15.0 years) were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan(®). An exploratory analysis of the association of risk factors with PP was performed. Neuropathy was present in 28 (38%), and 39 (53%) had callosities in the heel region. Low forefoot arch was present in 57 (77%). Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2±0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI) was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU). Hallux valgus and hallux rigidus appeared to increase the PP under the medial

Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers

Directory of Open Access Journals (Sweden)

Ulla Hellstrand Tang

2015-06-01

Full Text Available Objective: Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and high plantar pressure. Patients and methods: Patients diagnosed with type 1 (n=27 or type 2 (n=47 diabetes (mean age 60.0±15.0 years were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan®. An exploratory analysis of the association of risk factors with PP was performed. Results: Neuropathy was present in 28 (38%, and 39 (53% had callosities in the heel region. Low forefoot arch was present in 57 (77%. Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2±0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. Conclusions: This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU. Hallux valgus

Flood-risk mapping: contributions towards an enhanced assessment of extreme events and associated risks

Directory of Open Access Journals (Sweden)

B. Büchele

2006-01-01

Full Text Available Currently, a shift from classical flood protection as engineering task towards integrated flood risk management concepts can be observed. In this context, a more consequent consideration of extreme events which exceed the design event of flood protection structures and failure scenarios such as dike breaches have to be investigated. Therefore, this study aims to enhance existing methods for hazard and risk assessment for extreme events and is divided into three parts. In the first part, a regionalization approach for flood peak discharges was further developed and substantiated, especially regarding recurrence intervals of 200 to 10 000 years and a large number of small ungauged catchments. Model comparisons show that more confidence in such flood estimates for ungauged areas and very long recurrence intervals may be given as implied by statistical analysis alone. The hydraulic simulation in the second part is oriented towards hazard mapping and risk analyses covering the whole spectrum of relevant flood events. As the hydrodynamic simulation is directly coupled with a GIS, the results can be easily processed as local inundation depths for spatial risk analyses. For this, a new GIS-based software tool was developed, being presented in the third part, which enables estimations of the direct flood damage to single buildings or areas based on different established stage-damage functions. Furthermore, a new multifactorial approach for damage estimation is presented, aiming at the improvement of damage estimation on local scale by considering factors like building quality, contamination and precautionary measures. The methods and results from this study form the base for comprehensive risk analyses and flood management strategies.

Risk-based consequences of extreme natural hazard processes in mountain regions - Multi-hazard analysis in Tyrol (Austria)

Science.gov (United States)

Huttenlau, Matthias; Stötter, Johann

2010-05-01

incorporated with additional GIS and statistic data to a comprehensive property-by-property geodatabase of the existing elements and values. This stock of elements and values geodatabase is furthermore the consistent basis for all natural hazard analyses and enables the comparison of the results. The study follows the general accepted moduls (i) hazard analysis, (ii) exposition analysis, and (iii) consequence analysis, whereas the exposition analysis estimates the elements at risk with their corresponding damage potentials and the consequence analysis estimates the PMLs. This multi-hazard analysis focuses on process types with a high to extreme potential of negative consequences on a regional scale. In this context, (i) floodings, (ii) rockslides with the potential of corresponding consequence effects (backwater ponding and outburst flood), (iii) earthquakes, (iv) hail events, and (v) winter storms were considered as hazard processes. Based on general hazard analyses (hazard maps) concrete scenarios and their spatial affectedness were determined. For the different hazard processes, different vulnerability approaches were considered to demonstrate their sensitivity and implication on the results. Thus, no absolute values of losses but probable loss ranges were estimated. It can be shown, that the most serious amount of losses would arise from extreme earthquake events with loss burdens up to more than € 7 bn. solely on buildings and inventory. Possible extreme flood events could lead to losses between € 2 and 2.5 bn., whereas a severe hail swath which affects the central Inn valley could result in losses of ca. € 455 mill. (thereof € 285 mill. on vehicles). The potential most serious rockslide with additional consequence effects would result in losses up to ca. € 185 mill. and extreme winter storms can induce losses between € 100 mill. and 150 mill..

Extreme Unconditional Dependence Vs. Multivariate GARCH Effect in the Analysis of Dependence Between High Losses on Polish and German Stock Indexes

Science.gov (United States)

Rokita, Pawel

Classical portfolio diversification methods do not take account of any dependence between extreme returns (losses). Many researchers provide, however, some empirical evidence for various assets that extreme-losses co-occur. If the co-occurrence is frequent enough to be statistically significant, it may seriously influence portfolio risk. Such effects may result from a few different properties of financial time series, like for instance: (1) extreme dependence in a (long-term) unconditional distribution, (2) extreme dependence in subsequent conditional distributions, (3) time-varying conditional covariance, (4) time-varying (long-term) unconditional covariance, (5) market contagion. Moreover, a mix of these properties may be present in return time series. Modeling each of them requires different approaches. It seams reasonable to investigate whether distinguishing between the properties is highly significant for portfolio risk measurement. If it is, identifying the effect responsible for high loss co-occurrence would be of a great importance. If it is not, the best solution would be selecting the easiest-to-apply model. This article concentrates on two of the aforementioned properties: extreme dependence (in a long-term unconditional distribution) and time-varying conditional covariance.

High dose rate brachytherapy for the treatment of soft tissue sarcoma of the extremity

International Nuclear Information System (INIS)

Speight, J.L.; Streeter, O.E.; Chawla, S.; Menendez, L.E.

1996-01-01

Purpose: we examined the role of preoperative neoadjuvant chemoradiation and adjuvant high-dose rate brachytherapy on the management of prognostically unfavorable soft tissue sarcomas of the extremities. Our goal was to examine the effect of high dose rate interstitial brachytherapy (HDR IBT) on reducing the risk of local recurrence following limb-sparing resection, as well as shortening treatment duration. Materials and methods: eleven patients, ranging in age from 31 to 73 years old, with soft tissue sarcoma of the extremity were treated at USC/Norris Comprehensive Cancer Center during 1994 and 1995. All patients had biopsy proven soft tissue sarcoma, and all were suitable candidates for limb-sparing surgery. All lesions were greater than 5cm in size and were primarily high grade. Tumor histologies included malignant fibrous histiocytoma (45%), liposarcoma (18%) and leiomyosarcoma, synovial cell sarcoma and spindle cell sarcoma (36%). Sites of tumor origin were the lower extremity (55%), upper extremity (18%) and buttock (9%), 1 patient (9%) had lesions in both the upper and lower extremity. Patients received HDR IBT following combined chemotherapy and external beam irradiation (EBRT) and en bloc resection of the sarcoma. Neoadjuvant chemotherapy consisted of three to four cycles of either Ifosfamide/Mesna with or without Adriamycin, or Mesna, Adriamycin, Ifosfamide and Dacarbazine. One patient received Cis-platin in addition to Ifos/Adr. A minimum of two cycles of chemotherapy were administered prior to EBRT. Additional cycles of chemotherapy were completed concurrently with EBRT but prior to HDR IBT. Preoperative EBRT doses ranging from 40 to 59.4 Gy were given in daily fractions of 180 to 200cGy. Following en bloc resection, HDR IBT was administered using the Omnitron tm 2000 remote afterloading system. Doses ranging from 13 to 30 Gy were delivered to the surgical tumor bed at depths of 0.5mm to 0.75mm from the radioactive source. Results: median follow-up was

Global predictability of temperature extremes

Science.gov (United States)

Coughlan de Perez, Erin; van Aalst, Maarten; Bischiniotis, Konstantinos; Mason, Simon; Nissan, Hannah; Pappenberger, Florian; Stephens, Elisabeth; Zsoter, Ervin; van den Hurk, Bart

2018-05-01

Extreme temperatures are one of the leading causes of death and disease in both developed and developing countries, and heat extremes are projected to rise in many regions. To reduce risk, heatwave plans and cold weather plans have been effectively implemented around the world. However, much of the world’s population is not yet protected by such systems, including many data-scarce but also highly vulnerable regions. In this study, we assess at a global level where such systems have the potential to be effective at reducing risk from temperature extremes, characterizing (1) long-term average occurrence of heatwaves and coldwaves, (2) seasonality of these extremes, and (3) short-term predictability of these extreme events three to ten days in advance. Using both the NOAA and ECMWF weather forecast models, we develop global maps indicating a first approximation of the locations that are likely to benefit from the development of seasonal preparedness plans and/or short-term early warning systems for extreme temperature. The extratropics generally show both short-term skill as well as strong seasonality; in the tropics, most locations do also demonstrate one or both. In fact, almost 5 billion people live in regions that have seasonality and predictability of heatwaves and/or coldwaves. Climate adaptation investments in these regions can take advantage of seasonality and predictability to reduce risks to vulnerable populations.

Automatic residue removal for high-NA extreme illumination

Science.gov (United States)

Moon, James; Nam, Byong-Sub; Jeong, Joo-Hong; Kong, Dong-Ho; Nam, Byung-Ho; Yim, Dong Gyu

2007-10-01

An epidemic for smaller node has been that, as the device architecture shrinks, lithography process requires high Numerical Aperture (NA), and extreme illumination system. This, in turn, creates many lithography problems such as low lithography process margin (Depth of Focus, Exposure Latitude), unstable Critical Dimension (CD) uniformity and restricted guideline for device design rule and so on. Especially for high NA, extreme illumination such as immersion illumination systems, above all the related problems, restricted design rule due to forbidden pitch is critical and crucial issue. This forbidden pitch is composed of numerous optical effects but majority of these forbidden pitch compose of photo resist residue and these residue must be removed to relieve some room for already tight design rule. In this study, we propose automated algorithm to remove photo resist residue due to high NA and extreme illumination condition. This algorithm automatically self assembles assist patterns based on the original design layout, therefore insuring the safety and simplicity of the generated assist pattern to the original design and removes any resist residue created by extreme illumination condition. Also we tested our automated algorithm on full chip FLASH memory device and showed the residue removal effect by using commercial verification tools as well as on actual test wafer.

Field-expedient screening and injury risk algorithm categories as predictors of noncontact lower extremity injury.

Science.gov (United States)

Lehr, M E; Plisky, P J; Butler, R J; Fink, M L; Kiesel, K B; Underwood, F B

2013-08-01

In athletics, efficient screening tools are sought to curb the rising number of noncontact injuries and associated health care costs. The authors hypothesized that an injury prediction algorithm that incorporates movement screening performance, demographic information, and injury history can accurately categorize risk of noncontact lower extremity (LE) injury. One hundred eighty-three collegiate athletes were screened during the preseason. The test scores and demographic information were entered into an injury prediction algorithm that weighted the evidence-based risk factors. Athletes were then prospectively followed for noncontact LE injury. Subsequent analysis collapsed the groupings into two risk categories: Low (normal and slight) and High (moderate and substantial). Using these groups and noncontact LE injuries, relative risk (RR), sensitivity, specificity, and likelihood ratios were calculated. Forty-two subjects sustained a noncontact LE injury over the course of the study. Athletes identified as High Risk (n = 63) were at a greater risk of noncontact LE injury (27/63) during the season [RR: 3.4 95% confidence interval 2.0 to 6.0]. These results suggest that an injury prediction algorithm composed of performance on efficient, low-cost, field-ready tests can help identify individuals at elevated risk of noncontact LE injury. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Natural disasters and the challenge of extreme events: risk management from an insurance perspective

Science.gov (United States)

Smolka, Anselm

2006-08-01

Loss statistics for natural disasters demonstrate, also after correction for inflation, a dramatic increase of the loss burden since 1950. This increase is driven by a concentration of population and values in urban areas, the development of highly exposed coastal and valley regions, the complexity of modern societies and technologies and probably, also by the beginning consequences of global warming. This process will continue unless remedial action will be taken. Managing the risk from natural disasters starts with identification of the hazards. The next step is the evaluation of the risk, where risk is a function of hazard, exposed values or human lives and the vulnerability of the exposed objects. Probabilistic computer models have been developed for the proper assessment of risks since the late 1980s. The final steps are controlling and financing future losses. Natural disaster insurance plays a key role in this context, but also private parties and governments have to share a part of the risk. A main responsibility of governments is to formulate regulations for building construction and land use. The insurance sector and the state have to act together in order to create incentives for building and business owners to take loss prevention measures. A further challenge for the insurance sector is to transfer a portion of the risk to the capital markets, and to serve better the needs of the poor. Catastrophe bonds and microinsurance are the answer to such challenges. The mechanisms described above have been developed to cope with well-known disasters like earthquakes, windstorms and floods. They can be applied, in principle, also to less well investigated and less frequent extreme disasters: submarine slides, great volcanic eruptions, meteorite impacts and tsunamis which may arise from all these hazards. But there is an urgent need to improve the state of knowledge on these more exotic hazards in order to reduce the high uncertainty in actual risk evaluation to

Mechanical characterization of alloys in extreme conditions of high strain rates and high temperature

Science.gov (United States)

Cadoni, Ezio

2018-03-01

The aim of this paper is the description of the mechanical characterization of alloys under extreme conditions of temperature and loading. In fact, in the frame of the Cost Action CA15102 “Solutions for Critical Raw Materials Under Extreme Conditions (CRM-EXTREME)” this aspect is crucial and many industrial applications have to consider the dynamic response of materials. Indeed, for a reduction and substitution of CRMs in alloys is necessary to design the materials and understand if the new materials behave better or if the substitution or reduction badly affect their performance. For this reason, a deep knowledge of the mechanical behaviour at high strain-rates of considered materials is required. In general, machinery manufacturing industry or transport industry as well as energy industry have important dynamic phenomena that are simultaneously affected by extended strain, high strain-rate, damage and pressure, as well as conspicuous temperature gradients. The experimental results in extreme conditions of high strain rate and high temperature of an austenitic stainless steel as well as a high-chromium tempered martensitic reduced activation steel Eurofer97 are presented.

Extreme weather events: Should drinking water quality management systems adapt to changing risk profiles?

Science.gov (United States)

Khan, Stuart J; Deere, Daniel; Leusch, Frederic D L; Humpage, Andrew; Jenkins, Madeleine; Cunliffe, David

2015-11-15

Among the most widely predicted and accepted consequences of global climate change are increases in both the frequency and severity of a variety of extreme weather events. Such weather events include heavy rainfall and floods, cyclones, droughts, heatwaves, extreme cold, and wildfires, each of which can potentially impact drinking water quality by affecting water catchments, storage reservoirs, the performance of water treatment processes or the integrity of distribution systems. Drinking water guidelines, such as the Australian Drinking Water Guidelines and the World Health Organization Guidelines for Drinking-water Quality, provide guidance for the safe management of drinking water. These documents present principles and strategies for managing risks that may be posed to drinking water quality. While these principles and strategies are applicable to all types of water quality risks, very little specific attention has been paid to the management of extreme weather events. We present a review of recent literature on water quality impacts of extreme weather events and consider practical opportunities for improved guidance for water managers. We conclude that there is a case for an enhanced focus on the management of water quality impacts from extreme weather events in future revisions of water quality guidance documents. Copyright © 2015 Elsevier Ltd. All rights reserved.

High Risk Scenarios and Extremes, A geometric approach

NARCIS (Netherlands)

Balkema, A.A.; Embrechts, P.A.L.

2007-01-01

Quantitative Risk Management (QRM) has become a field of research of considerable importance to numerous areas of application, including insurance, banking, energy, medicine, reliability. Mainly motivated by examples from insurance and finance, the authors develop a theory for handling multivariate

Tools used by the insurance industry to assess risk from hydroclimatic extremes

Science.gov (United States)

Higgs, Stephanie; McMullan, Caroline

2016-04-01

Probabilistic catastrophe models are widely used within the insurance industry to assess and price the risk of natural hazards to individual residences through to portfolios of millions of properties. Over the relatively short period that catastrophe models have been available (almost 30 years), the insurance industry has built up a financial resilience to key natural hazards in certain areas (e.g. US tropical cyclone, European extra-tropical cyclone and flood). However, due the rapidly expanding global population and increase in wealth, together with uncertainties in the behaviour of meteorological phenomena introduced by climate change, the domain in which natural hazards impact society is growing. As a result, the insurance industry faces new challenges in assessing the risk and uncertainty from natural hazards. As a catastrophe modelling company, AIR Worldwide has a toolbox of options available to help the insurance industry assess extreme climatic events and their associated uncertainty. Here we discuss several of these tools: from helping analysts understand how uncertainty is inherently built in to probabilistic catastrophe models, to understanding alternative stochastic catalogs for tropical cyclone based on climate conditioning. Through the use of stochastic extreme disaster events such as those provided through AIR's catalogs or through the Lloyds of London marketplace (RDS's) to provide useful benchmarks for the loss probability exceedence and tail-at-risk metrics outputted from catastrophe models; to the visualisation of 1000+ year event footprints and hazard intensity maps. Ultimately the increased transparency of catastrophe models and flexibility of a software platform that allows for customisation of modelled and non-modelled risks will drive a greater understanding of extreme hydroclimatic events within the insurance industry.

Examining Risk-Taking Behavior and Sensation Seeking Requirement in Extreme Athletes

Science.gov (United States)

Agilonu, Ali; Bastug, Gulsum; Mutlu, Tonguc Osman; Pala, Adem

2017-01-01

Extreme sports are sport branches which include actions, adventures, risks and difficulties more rather than other sports. Special materials are used in sport branches such as surfing, kite surfing, sailing, snowboarding, paragliding, diving, mountaineering, motor sports and adrenaline release is more rather than in other sport branches. On the…

16 CFR 1145.3 - Extremely flammable contact adhesives; risk of burns from explosive vapor ignition and flashback...

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Extremely flammable contact adhesives; risk... TO OTHER ACTS UNDER THE CONSUMER PRODUCT SAFETY ACT § 1145.3 Extremely flammable contact adhesives... associated with certain extremely flammable contact adhesives under the Consumer Product Safety Act rather...

Characteristics of Extreme Extratropical Cyclones in a High-Resolution Global Climate Model

Science.gov (United States)

Catalano, A. J.; Broccoli, A. J.; Kapnick, S. B.; Janoski, T. P.

2017-12-01

In the northeastern United States, many of the strongest impacts from extratropical cyclones (ETCs) are associated with storms that exhibit slow movement, unusual tracks, or exceptional intensity. Examples of extreme ETCs include the Appalachian storm of November 1950, the Perfect Storm of October 1991, and the Superstorm of March 1993. Owing to the rare nature of these events, it is difficult to quantify the associated risks (e.g. high winds, storm surge) given the limited duration of high-quality observational datasets. Furthermore, storms with even greater impacts than those observed may be possible, particularly in a warming climate. In the context of tropical cyclones, Lin and Emanuel (2016) have used the metaphor "grey swans" to refer to high-impact events that have not been observed but may be physically possible. One method for analyzing "grey swans" is to generate a larger sample of ETCs using a coupled climate model. Therefore, we use long simulations (over 1,000 years with atmospheric constituents fixed at 1990 levels) from a global climate model (GFDL FLOR) with 50km atmospheric resolution. FLOR has been shown to realistically simulate the spatial distribution and climatology of ETCs during the reanalysis era. We will discuss the climatological features of these extreme ETC events.

Vacuum-assisted closure downgrades reconstructive demands in high-risk patients with severe lower extremity injuries.

Science.gov (United States)

Kakagia, D; Karadimas, E; Drosos, G; Ververidis, A; Kazakos, D; Lazarides, M; Verettas, D

2009-01-01

Primary soft tissue reconstruction in complex leg injuries is mandatory in order to protect exposed tissues; however, it may be precluded by the patient's clinical status or by local wound conditions. This retrospective study aims to evaluate the use of negative pressure as an adjunct to delayed soft tissue reconstruction in patients with complex lower limb trauma. Forty-two patients with 49 complex lower limb injuries were treated with Vacuum assisted closure (VAC) 48 hours after bone fixation, vascular repair and surgical debridement. Wound swab cultures were obtained before and after every VAC application. Duration of therapy, wound flora, final reconstructive technique required, outcome and follow-up period were retrieved from medical records. Twenty-four male and eighteen female patients were recruited, with a mean age of 47 years. All were treated with VAC therapy for 15-42 days. Reconstruction was delayed due to the patients' critical condition, advanced age, medical co-morbidities, heavily exuding wounds and questionable viability of soft tissues. Patients were followed up for 90-895 days. Two wounds healed spontaneously, 6 were managed with delayed direct suture, 31 with split thickness skin grafts and 9 required local cutaneous, fasciocutaneous or muscular flaps. One patient died due to fat embolism. Wound bacterial flora progressively decreased in all but one patient. Scar formation was aesthetically acceptable by the patients while function depended on the initial injury. Negative pressure is a safe and effective adjunct to delayed soft tissue reconstruction in high-risk patients with severe lower extremity injuries, minimizing reconstructive requirements and therefore postoperative morbidity.

Motor Performance as Risk Factor for Lower Extremity Injuries in Children

DEFF Research Database (Denmark)

Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina

2016-01-01

PURPOSE: Physical activity related injuries in children constitute a costly public health matter. The influence of motor performance on injury risk is unclear. The purpose was to examine if motor performance was a risk factor of traumatic and overuse lower extremity injuries in a normal population...... motor performance (core stability, vertical jump, shuttle run) was positively associated with traumatic and overuse injuries, and negatively (single leg hop) associated with traumatic injuries, indicating different influence on injury risk. Previous injury was a confounder affecting the effect size...... and the significance. More studies are needed to consolidate the findings, to clarify the influence of different performance tests on different types of injuries and to examine the influence of behaviour in relation to injury risk....

Risk Management in the Original Extreme Sporting Event: The Pole Vault

Science.gov (United States)

Bemiller, Jim; Hardin, Robin

2010-01-01

The pole vault was considered the ultimate test of physical ability and daring before the advent of modern extreme sports such as skateboarding, snowboarding, and mountain biking. The inherent risks of the pole vault have been well documented. The National Center for Catastrophic Sport Injury Research reported in 2007 that the catastrophic injury…

Extremely high concentration of folates in premature newborns.

Science.gov (United States)

Zikavska, T; Brucknerova, I

2014-01-01

Extremely high concentration of folates in premature newborns: case reports. Folates are a group of water soluble compounds, which are important for metabolic processes in human body. These are important during periods of rapid cell growth. The most accurate indicator of long-term folate level status in the body is the determination of red blood cell (RBC) folate concentrations. The optimal level of RBC folate is not known in neonatal period. Authors discuss the reasons for extremely high level of RBC folate concentrations. In our work we present the cases of two premature newborns with extremely high level of RBC folate concentrations, which were analyzed immunochemically on the first day of life and after six weeks of life. In both cases we measured RBC folate concentrations on the 1st day of life. After 6 weeks we found extremely high RBC folate concentration level (5516.67 ng/ml) in the first case after RBC transfusions. In second case after two months of life the RBC folate concentration level was doubled (2335.1 ng/ml) until 24 hours after RBC transfusion compared to levels after birth. The normal range of RBC folate values vary in newborns. The upper limit of daily dose of folic acid in pregnancy and neonatal period is not known. On the other hand it is an easily excreted water-soluble vitamin but in premature newborn it can lead to the disruption of metabolic balance and slow its degradation. Some factors can have an impact on RBC folate concentration. Blood transfusion can be one of the main influences on RBC folate concentration. To clarify these mechanisms further studies are required (Ref. 29).

Will climate change increase the risk for critical infrastructure failures in Europe due to extreme precipitation?

Science.gov (United States)

Nissen, Katrin; Ulbrich, Uwe

2016-04-01

An event based detection algorithm for extreme precipitation is applied to a multi-model ensemble of regional climate model simulations. The algorithm determines extent, location, duration and severity of extreme precipitation events. We assume that precipitation in excess of the local present-day 10-year return value will potentially exceed the capacity of the drainage systems that protect critical infrastructure elements. This assumption is based on legislation for the design of drainage systems which is in place in many European countries. Thus, events exceeding the local 10-year return value are detected. In this study we distinguish between sub-daily events (3 hourly) with high precipitation intensities and long-duration events (1-3 days) with high precipitation amounts. The climate change simulations investigated here were conducted within the EURO-CORDEX framework and exhibit a horizontal resolution of approximately 12.5 km. The period between 1971-2100 forced with observed and scenario (RCP 8.5 and RCP 4.5) greenhouse gas concentrations was analysed. Examined are changes in event frequency, event duration and size. The simulations show an increase in the number of extreme precipitation events for the future climate period over most of the area, which is strongest in Northern Europe. Strength and statistical significance of the signal increase with increasing greenhouse gas concentrations. This work has been conducted within the EU project RAIN (Risk Analysis of Infrastructure Networks in response to extreme weather).

Analysis of extreme drinking in patients with alcohol dependence using Pareto regression.

Science.gov (United States)

Das, Sourish; Harel, Ofer; Dey, Dipak K; Covault, Jonathan; Kranzler, Henry R

2010-05-20

We developed a novel Pareto regression model with an unknown shape parameter to analyze extreme drinking in patients with Alcohol Dependence (AD). We used the generalized linear model (GLM) framework and the log-link to include the covariate information through the scale parameter of the generalized Pareto distribution. We proposed a Bayesian method based on Ridge prior and Zellner's g-prior for the regression coefficients. Simulation study indicated that the proposed Bayesian method performs better than the existing likelihood-based inference for the Pareto regression.We examined two issues of importance in the study of AD. First, we tested whether a single nucleotide polymorphism within GABRA2 gene, which encodes a subunit of the GABA(A) receptor, and that has been associated with AD, influences 'extreme' alcohol intake and second, the efficacy of three psychotherapies for alcoholism in treating extreme drinking behavior. We found an association between extreme drinking behavior and GABRA2. We also found that, at baseline, men with a high-risk GABRA2 allele had a significantly higher probability of extreme drinking than men with no high-risk allele. However, men with a high-risk allele responded to the therapy better than those with two copies of the low-risk allele. Women with high-risk alleles also responded to the therapy better than those with two copies of the low-risk allele, while women who received the cognitive behavioral therapy had better outcomes than those receiving either of the other two therapies. Among men, motivational enhancement therapy was the best for the treatment of the extreme drinking behavior. Copyright 2010 John Wiley & Sons, Ltd.

Risk of hospitalization for fire-related burns during extreme cold weather.

Science.gov (United States)

Ayoub, Aimina; Kosatsky, Tom; Smargiassi, Audrey; Bilodeau-Bertrand, Marianne; Auger, Nathalie

2017-10-01

Environmental factors are important predictors of fires, but no study has examined the association between outdoor temperature and fire-related burn injuries. We sought to investigate the relationship between extremely cold outdoor temperatures and the risk of hospitalization for fire-related burns. We carried out a time-stratified case-crossover study of 2470 patients hospitalized for fire-related burn injuries during cold months between 1989 and 2014 in Quebec, Canada. The main exposure was the minimum outdoor temperature on the day of and the day before the burn. We computed odds ratios (OR) and 95% confidence intervals (CI) to evaluate the relationship between minimum temperature and fire-related burns, and assessed how associations varied across sex and age. Exposure to extreme cold temperature was associated with a significantly higher risk of hospitalization for fire-related burns. Compared with 0°C, exposure to a minimum temperature of -30°C was associated with an OR of 1.51 (95% CI 1.22-1.87) for hospitalization for fire-related burns. The associations were somewhat stronger for women, youth, and the elderly. Compared with 0°C, a minimum temperature of -30°C was associated with an OR for fire-related burn hospitalization of 1.65 for women (95% CI 1.13-2.40), 1.60 for age fire-related burns. Measures to prevent fires should be implemented prior to the winter season, and enhanced during extreme cold. Copyright © 2017 Elsevier Inc. All rights reserved.

Performance of High Temperature Operational Amplifier, Type LM2904WH, under Extreme Temperatures

Science.gov (United States)

Patterson, Richard; Hammoud, Ahmad; Elbuluk, Malik

2008-01-01

Operation of electronic parts and circuits under extreme temperatures is anticipated in NASA space exploration missions as well as terrestrial applications. Exposure of electronics to extreme temperatures and wide-range thermal swings greatly affects their performance via induced changes in the semiconductor material properties, packaging and interconnects, or due to incompatibility issues between interfaces that result from thermal expansion/contraction mismatch. Electronics that are designed to withstand operation and perform efficiently in extreme temperatures would mitigate risks for failure due to thermal stresses and, therefore, improve system reliability. In addition, they contribute to reducing system size and weight, simplifying its design, and reducing development cost through the elimination of otherwise required thermal control elements for proper ambient operation. A large DC voltage gain (100 dB) operational amplifier with a maximum junction temperature of 150 C was recently introduced by STMicroelectronics [1]. This LM2904WH chip comes in a plastic package and is designed specifically for automotive and industrial control systems. It operates from a single power supply over a wide range of voltages, and it consists of two independent, high gain, internally frequency compensated operational amplifiers. Table I shows some of the device manufacturer s specifications.

The nonstationary impact of local temperature changes and ENSO on extreme precipitation at the global scale

Science.gov (United States)

Sun, Qiaohong; Miao, Chiyuan; Qiao, Yuanyuan; Duan, Qingyun

2017-12-01

The El Niño-Southern Oscillation (ENSO) and local temperature are important drivers of extreme precipitation. Understanding the impact of ENSO and temperature on the risk of extreme precipitation over global land will provide a foundation for risk assessment and climate-adaptive design of infrastructure in a changing climate. In this study, nonstationary generalized extreme value distributions were used to model extreme precipitation over global land for the period 1979-2015, with ENSO indicator and temperature as covariates. Risk factors were estimated to quantify the contrast between the influence of different ENSO phases and temperature. The results show that extreme precipitation is dominated by ENSO over 22% of global land and by temperature over 26% of global land. With a warming climate, the risk of high-intensity daily extreme precipitation increases at high latitudes but decreases in tropical regions. For ENSO, large parts of North America, southern South America, and southeastern and northeastern China are shown to suffer greater risk in El Niño years, with more than double the chance of intense extreme precipitation in El Niño years compared with La Niña years. Moreover, regions with more intense precipitation are more sensitive to ENSO. Global climate models were used to investigate the changing relationship between extreme precipitation and the covariates. The risk of extreme, high-intensity precipitation increases across high latitudes of the Northern Hemisphere but decreases in middle and lower latitudes under a warming climate scenario, and will likely trigger increases in severe flooding and droughts across the globe. However, there is some uncertainties associated with the influence of ENSO on predictions of future extreme precipitation, with the spatial extent and risk varying among the different models.

Identifying women with dense breasts at high risk for interval cancer: a cohort study.

Science.gov (United States)

Kerlikowske, Karla; Zhu, Weiwei; Tosteson, Anna N A; Sprague, Brian L; Tice, Jeffrey A; Lehman, Constance D; Miglioretti, Diana L

2015-05-19

Twenty-one states have laws requiring that women be notified if they have dense breasts and that they be advised to discuss supplemental imaging with their provider. To better direct discussions of supplemental imaging by determining which combinations of breast cancer risk and Breast Imaging Reporting and Data System (BI-RADS) breast density categories are associated with high interval cancer rates. Prospective cohort. Breast Cancer Surveillance Consortium (BCSC) breast imaging facilities. 365,426 women aged 40 to 74 years who had 831,455 digital screening mammography examinations. BI-RADS breast density, BCSC 5-year breast cancer risk, and interval cancer rate (invasive cancer ≤12 months after a normal mammography result) per 1000 mammography examinations. High interval cancer rate was defined as more than 1 case per 1000 examinations. High interval cancer rates were observed for women with 5-year risk of 1.67% or greater and extremely dense breasts or 5-year risk of 2.50% or greater and heterogeneously dense breasts (24% of all women with dense breasts). The interval rate of advanced-stage disease was highest (>0.4 case per 1000 examinations) among women with 5-year risk of 2.50% or greater and heterogeneously or extremely dense breasts (21% of all women with dense breasts). Five-year risk was low to average (0% to 1.66%) for 51.0% of women with heterogeneously dense breasts and 52.5% with extremely dense breasts, with interval cancer rates of 0.58 to 0.63 and 0.72 to 0.89 case per 1000 examinations, respectively. The benefit of supplemental imaging was not assessed. Breast density should not be the sole criterion for deciding whether supplemental imaging is justified because not all women with dense breasts have high interval cancer rates. BCSC 5-year risk combined with BI-RADS breast density can identify women at high risk for interval cancer to inform patient-provider discussions about alternative screening strategies. National Cancer Institute.

The legacy of extreme sea levels for the assessment of future coastal flood risk – A review of methods applied in Denmark, Germany and Norway

DEFF Research Database (Denmark)

Nilsen, Jan Even; Sørensen, Carlo Sass; Dangendore, Sönke

in the three countries is discussed. Here, national approaches to deal with risk, risk acceptance and uncertainty vary, among other factors, as a result of the different assessments of extreme events. In hazard and vulnerability assessments, for instance, where results are highly dependent on the quality...

Inelastic X-ray scattering experiments at extreme conditions: high temperatures and high pressures

Directory of Open Access Journals (Sweden)

S.Hosokawa

2008-03-01

Full Text Available In this article, we review the present status of experimental techniques under extreme conditions of high temperature and high pressure used for inelastic X-ray scattering (IXS experiments of liquid metals, semiconductors, molten salts, molecular liquids, and supercritical water and methanol. For high temperature experiments, some types of single-crystal sapphire cells were designed depending on the temperature of interest and the sample thickness for the X-ray transmission. Single-crystal diamond X-ray windows attached to the externally heated high-pressure vessel were used for the IXS experiment of supercritical water and methanol. Some typical experimental results are also given, and the perspective of IXS technique under extreme conditions is discussed.

Changing Global Risk Landscape - Challenges for Risk Management (Invited)

Science.gov (United States)

Wenzel, F.

2009-12-01

The exponentially growing losses related to natural disasters on a global scale reflect a changing risk landscape that is characterized by the influence of climate change and a growing population, particularly in urban agglomerations and coastal zones. In consequence of these trends we witness (a) new hazards such as landslides due to dwindling permafrost, new patterns of strong precipitation and related floods, potential for tropical cyclones in the Mediterranean, sea level rise and others; (b) new risks related to large numbers of people in very dense urban areas, and risks related to the vulnerability of infrastructure such as energy supply, water supply, transportation, communication, etc. (c) extreme events with unprecedented size and implications. An appropriate answer to these challenges goes beyond classical views of risk assessment and protection. It must include an understanding of risk as changing with time so that risk assessment needs to be supplemented by risk monitoring. It requires decision making under high uncertainty. The risks (i.e. potentials for future losses) of extreme events are not only high but also very difficult to quantify, as they are characterized by high levels of uncertainty. Uncertainties relate to frequency, time of occurrence, strength and impact of extreme events but also to the coping capacities of society in response to them. The characterization, quantification, reduction in the extent possible of the uncertainties is an inherent topic of extreme event research. However, they will not disappear, so a rational approach to extreme events must include more than reducing uncertainties. It requires us to assess and rate the irreducible uncertainties, to evaluate options for mitigation under large uncertainties, and their communication to societal sectors. Thus scientist need to develop methodologies that aim at a rational approach to extreme events associated with high levels of uncertainty.

Assessing changes in extreme convective precipitation from a damage perspective

Science.gov (United States)

Schroeer, K.; Tye, M. R.

2016-12-01

Projected increases in high-intensity short-duration convective precipitation are expected even in regions that are likely to become more arid. Such high intensity precipitation events can trigger hazardous flash floods, debris flows and landslides that put people and local assets at risk. However, the assessment of local scale precipitation extremes is hampered by its high spatial and temporal variability. In addition to which, not only are extreme events rare, but such small scale events are likely to be underreported where they don't coincide with the observation network. Rather than focus solely on the convective precipitation, understanding the characteristics of these extremes which drive damage may be more effective to assess future risks. Two sources of data are used in this study. First, sub-daily precipitation observations over the Southern Alps enable an examination of seasonal and regional patterns in high-intensity convective precipitation and their relationship with weather types. Secondly, reports of private loss and damage on a household scale are used to identify which events are most damaging, or what conditions potentially enhance the vulnerability to these extremes.This study explores the potential added value from including recorded loss and damage data to understand the risks from summertime convective precipitation events. By relating precipitation generating weather types to the severity of damage we hope to develop a mechanism to assess future risks. A further benefit would be to identify from damage reports the likely occurrence of precipitation extremes where no direct observations are available and use this information to validate remotely sensed observations.

Extremely short duration high intensity interval training substantially improves insulin action in young healthy males

DEFF Research Database (Denmark)

Babraj, John A; Vollaard, Niels B J; Keast, Cameron

2009-01-01

BACKGROUND: Traditional high volume aerobic exercise training reduces cardiovascular and metabolic disease risk but involves a substantial time commitment. Extremely low volume high-intensity interval training (HIT) has recently been demonstrated to produce improvements to aerobic function...... cycle sprints per session). Aerobic performance (250-kJ self-paced cycling time trial), and glucose, insulin and NEFA responses to a 75-g oral glucose load (oral glucose tolerance test; OGTT) were determined before and after training. RESULTS: Following 2 weeks of HIT, the area under the plasma glucose......, to substantially improve insulin action in young sedentary subjects is remarkable. This novel time-efficient training paradigm can be used as a strategy to reduce metabolic risk factors in young and middle aged sedentary populations who otherwise would not adhere to time consuming traditional aerobic exercise...

Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

Science.gov (United States)

Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

2016-09-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (PHIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; PHIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. Copyright © 2016 Elsevier Inc. All rights reserved.

Novel All-Extremity High-Intensity Interval Training Improves Aerobic Fitness, Cardiac Function and Insulin Resistance in Healthy Older Adults

Science.gov (United States)

Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M.; Petersen, John W.; Christou, Demetra D.

2016-01-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1 years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4 minutes 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4x/week for 8 weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (PHIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; PHIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. PMID:27346646

Key drivers and economic consequences of high-end climate scenarios: uncertainties and risks

DEFF Research Database (Denmark)

Halsnæs, Kirsten; Kaspersen, Per Skougaard; Drews, Martin

2015-01-01

The consequences of high-end climate scenarios and the risks of extreme events involve a number of critical assumptions and methodological challenges related to key uncertainties in climate scenarios and modelling, impact analysis, and economics. A methodological framework for integrated analysis...... of extreme events increase beyond scaling, and in combination with economic assumptions we find a very wide range of risk estimates for urban precipitation events. A sensitivity analysis addresses 32 combinations of climate scenarios, damage cost curve approaches, and economic assumptions, including risk...... aversion and equity represented by discount rates. Major impacts of alternative assumptions are investigated. As a result, this study demonstrates that in terms of decision making the actual expectations concerning future climate scenarios and the economic assumptions applied are very important...

Coronary arterial Disease associated with arteriosclerosis in lower extremity: Angiographic analysis

International Nuclear Information System (INIS)

Kim, Ji Hye; Chung, Jin Wook; Lee, Seon Kyu; Han, Joon Koo; Park, Jae Hyung; Kim, Jae Seung; Han, Man Chung

1993-01-01

We performed both peripheral and coronary angiographies in 52 patients with an arteriosclerosis in lower extremities. The severity of arteriosclerotic narrowing of the coronary and peripheral arteries were compared on angiographies. An angiographic vascular score(AVS, 0-5) reflecting the number and the degree of stenosis in 12 lower extremity arteries and three major coronary arteries was assigned to each angiogram and the sun of scores in the lower extremity arteries was compared with the incidence of significant coronary artery disease (more than grade 3) and coronary score. Relation of incidence and severity of vascular stenosis and risk factors (diabetes metallitus, hypertension, smoking, and hypercholesterolemia) was also analyzed. Thirty-four of 52 patients (65%) had an angiographically significant coronary artery disease. Thirteen of these 34 patients (38%) had no clinical symptom and sign of the ischemic heart disease. There was no statistically significant difference in the incidence and severity of coronary artery disease between high (more than 30) and low AVS group in lower extremity (p>0.14). All patients had at least one risk factor and 49 of 52 patients (94%) had multiple risk factors. Coronary angiography was normal in there patients with only one risk factors, and angiographically significant coronary artery disease existed in nine of 16 cases (56.3%) with two risk factors. 13 of 17 case (76.5%) with three risk factors, and 12 of 16 cases (75.0%) with all four risk factors. There were no significant correlations between individual risk factors and incidence, severity of arteriosclerosis in coronary and lower extremity arteries. In conclusion, angiographic evaluation of the coronary artery disease in patients with lower extremity arteriosclerosis is necessary because of the high chance of coronary artery disease and difficulty in the prediction of coronary artery disease with a severity of the peripheral arteriosclerosis, presence of various risk

High resolution spectroscopy of six new extreme helium stars

Science.gov (United States)

Heber, U.; Jones, G.; Drilling, J. S.

1986-01-01

High resolution spectra of six newly discovered extreme helium stars are presented. LSS 5121 is shown to be a spectroscopical twin of the hot extreme helium star HD 160641. A preliminary LTE analysis of LSS 3184 yielded an effective temperature of 22,000 K and a surface gravity of log g = 3.2. Four stars form a new subgroup, classified by sharp-lined He I spectra and pronounced O II spectra, and it is conjectured that these lie close to the Eddington limit. The whole group of extreme helium stars apparently is inhomogeneous with respect to luminosity to mass ratio and chemical composition.

Risk Factors and Indications for Readmission Following Lower Extremity Amputation in the ACS-NSQIP

Science.gov (United States)

Curran, Thomas; Zhang, Jennifer Q.; Lo, Ruby C.; Fokkema, Margriet; McCallum, John C.; Buck, Dominique; Darling, Jeremy; Schermerhorn, Marc L.

2014-01-01

BACKGROUND Postoperative readmission, recently identified as a marker of hospital quality in the Affordable Care Act, is associated with increased morbidity, mortality and healthcare costs, yet data on readmission following lower extremity amputation is limited. We evaluated risk factors for readmission and post-discharge adverse events following lower extremity amputation in the ACS-NSQIP. STUDY DESIGN All patients undergoing transmetatarsal (TMA), below-knee (BKA) or above-knee amputation (AKA) in the 2011 – 2012 NSQIP were identified. Independent pre-discharge predictors of 30-day readmission were determined using multivariable logistic regression. Readmission indication and re-interventions, available in the 2012 NSQIP only, were also evaluated. RESULTS We identified 5,732 patients undergoing amputation (TMA: 12%; BKA: 51%; AKA: 37%). Readmission rate was 18%. Post-discharge mortality rate was 5% (TMA: 2%; BKA: 3%; AKA: 8%; preadmission included chronic nursing home residence (OR: 1.3; 95% CI: 1.0–1.7), non-elective surgery (OR: 1.4; 95% CI: 1.1–1.7), prior revascularization/amputation (OR: 1.4; 95% CI: 1.1–1.7), preoperative congestive heart failure (OR: 1.7; 95% CI: 1.2–2.4), and preoperative dialysis (OR: 1.5; 95% CI: 1.2–1.9). Guillotine amputation (OR: .6; 95%CI: .4–.9) and non-home discharge (OR: .7; 95%CI: .6–1.0) were protective of readmission. Wound related complications accounted for 49% of readmissions. CONCLUSIONS Post discharge morbidity, mortality and readmission are common following lower extremity amputation. Closer follow up of high risk patients, optimization of medical comorbidities and aggressive management of wound infection may play a role in decreasing readmission and post discharge adverse events. PMID:24985536

Workshop on extremely high energy density plasmas and their diagnostics

Energy Technology Data Exchange (ETDEWEB)

Ishii, Shozo (ed.)

2001-09-01

Compiled are the papers presented at the workshop on 'Extremely High Energy Density Plasmas and Their Diagnostics' held at National Institute for Fusion Science. The papers cover physics and applications of extremely high-energy density plasmas such as dense z-pinch, plasma focus, and intense pulsed charged beams. Separate abstracts were presented for 7 of the papers in this report. The remaining 25 were considered outside the subject scope of INIS. (author)

Workshop on extremely high energy density plasmas and their diagnostics

International Nuclear Information System (INIS)

Ishii, Shozo

2001-09-01

Compiled are the papers presented at the workshop on 'Extremely High Energy Density Plasmas and Their Diagnostics' held at National Institute for Fusion Science. The papers cover physics and applications of extremely high-energy density plasmas such as dense z-pinch, plasma focus, and intense pulsed charged beams. Separate abstracts were presented for 7 of the papers in this report. The remaining 25 were considered outside the subject scope of INIS. (author)

Extremely-high vacuum pressure measurement by laser ionization

International Nuclear Information System (INIS)

Kokubun, Kiyohide

1991-01-01

Laser ionization method has the very high sensitivity for detecting atoms and molecules. Hurst et al. successfully detected a single Cs atom by means of resonance ionization spectroscopy developed by them. Noting this high sensitivity, the authors have attempted to apply the laser ionization method to measure gas pressure, particularly in the range down to extremely high vacuum. At present, hot cathode ionization gauges are used for measuring gas pressure down to ultrahigh vacuum, however, those have a number of disadvantages. The pressure measurement using lasers does not have such disadvantages. The pressure measurement utilizing the laser ionization method is based on the principle that when laser beam is focused through a lens, the amount of atom or molecule ions generated in the focused space region is proportional to gas pressure. In this paper, the experimental results are presented on the nonresonant multiphoton ionization characteristics of various kinds of gases, the ion detection system with high sensitivity and an extremely high vacuum system prepared for the laser ionization experiment. (K.I.)

Renal transplantation in high cardiovascular risk patients.

Science.gov (United States)

Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

2009-10-01

Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

Extreme vulnerability of smallholder farmers to agricultural risks and climate change in Madagascar.

Science.gov (United States)

Harvey, Celia A; Rakotobe, Zo Lalaina; Rao, Nalini S; Dave, Radhika; Razafimahatratra, Hery; Rabarijohn, Rivo Hasinandrianina; Rajaofara, Haingo; Mackinnon, James L

2014-04-05

Across the tropics, smallholder farmers already face numerous risks to agricultural production. Climate change is expected to disproportionately affect smallholder farmers and make their livelihoods even more precarious; however, there is limited information on their overall vulnerability and adaptation needs. We conducted surveys of 600 households in Madagascar to characterize the vulnerability of smallholder farmers, identify how farmers cope with risks and explore what strategies are needed to help them adapt to climate change. Malagasy farmers are particularly vulnerable to any shocks to their agricultural system owing to their high dependence on agriculture for their livelihoods, chronic food insecurity, physical isolation and lack of access to formal safety nets. Farmers are frequently exposed to pest and disease outbreaks and extreme weather events (particularly cyclones), which cause significant crop and income losses and exacerbate food insecurity. Although farmers use a variety of risk-coping strategies, these are insufficient to prevent them from remaining food insecure. Few farmers have adjusted their farming strategies in response to climate change, owing to limited resources and capacity. Urgent technical, financial and institutional support is needed to improve the agricultural production and food security of Malagasy farmers and make their livelihoods resilient to climate change.

Concussion May Increase the Risk of Subsequent Lower Extremity Musculoskeletal Injury in Collegiate Athletes.

Science.gov (United States)

Herman, Daniel C; Jones, Debi; Harrison, Ashley; Moser, Michael; Tillman, Susan; Farmer, Kevin; Pass, Anthony; Clugston, James R; Hernandez, Jorge; Chmielewski, Terese L

2017-05-01

Laboratory-based studies on neuromuscular control after concussion and epidemiological studies suggest that concussion may increase the risk of subsequent musculoskeletal injury. The purpose of this study was to determine if athletes have an increased risk of lower extremity musculoskeletal injury after return to play from a concussion. Injury data were collected from 2006 to 2013 for men's football and for women's basketball, soccer and lacrosse at a National Collegiate Athletic Association Division I university. Ninety cases of in-season concussion in 73 athletes (52 male, 21 female) with return to play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return to play was reviewed for time-loss injury. The same period was studied in up to two control athletes who had no concussion within the prior year and were matched for sport, starting status and position. Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (45/90 or 50 %) than in the non-concussed athletes (30/148 or 20 %; P relationship between concussion and an increased risk of lower extremity musculoskeletal injury after return to play, and may have implications for current medical practice standards regarding evaluation and management of concussion injuries.

Mitigating the risk of extreme water scarcity and dependency: the case of Jordan

NARCIS (Netherlands)

Schyns, Joseph Franciscus; Hamaideh, A.; Hoekstra, Arjen Ysbert; Mekonnen, Mesfin; Schyns, M.

2015-01-01

Jordan faces great internal water scarcity and pollution, conflict over trans-boundary waters, and strong dependency on external water resources through trade. This paper analyzes these issues and subsequently reviews options to reduce the risk of extreme water scarcity and dependency. Based on

Risk-based water resources planning: Coupling water allocation and water quality management under extreme droughts

Science.gov (United States)

Mortazavi-Naeini, M.; Bussi, G.; Hall, J. W.; Whitehead, P. G.

2016-12-01

The main aim of water companies is to have a reliable and safe water supply system. To fulfil their duty the water companies have to consider both water quality and quantity issues and challenges. Climate change and population growth will have an impact on water resources both in terms of available water and river water quality. Traditionally, a distinct separation between water quality and abstraction has existed. However, water quality can be a bottleneck in a system since water treatment works can only treat water if it meets certain standards. For instance, high turbidity and large phytoplankton content can increase sharply the cost of treatment or even make river water unfit for human consumption purposes. It is vital for water companies to be able to characterise the quantity and quality of water under extreme weather events and to consider the occurrence of eventual periods when water abstraction has to cease due to water quality constraints. This will give them opportunity to decide on water resource planning and potential changes to reduce the system failure risk. We present a risk-based approach for incorporating extreme events, based on future climate change scenarios from a large ensemble of climate model realisations, into integrated water resources model through combined use of water allocation (WATHNET) and water quality (INCA) models. The annual frequency of imposed restrictions on demand is considered as measure of reliability. We tested our approach on Thames region, in the UK, with 100 extreme events. The results show increase in frequency of imposed restrictions when water quality constraints were considered. This indicates importance of considering water quality issues in drought management plans.

Thromboembolic Risk of Endovascular Intervention for Lower Extremity Deep Venous Thrombosis.

Science.gov (United States)

Lindsey, Philip; Echeverria, Angela; Poi, Mun J; Matos, Jesus; Bechara, Carlos F; Cheung, Mathew; Lin, Peter H

2018-05-01

This study evaluated the risk of thromboembolism during endovascular interventions in patients with symptomatic lower extremity deep vein thrombosis (DVT) METHODS: Clinical records of all patients who underwent endovascular interventions for symptomatic lower extremity DVT from 2001 to 2017 were retrospectively analyzed using a prospectively maintained database. Only patients who received an inferior vena cava (IVC) filter were included in the analysis. Trapped intrafilter thrombus was assessed for procedure-related thromboembolism. Clinical outcomes of thrombus management and thromboembolism risk were analyzed. A total 172 patients (mean age 57.4 years, 98 females) who underwent 174 endovascular DVT interventions were included in the analysis. Treatment strategies included thrombolytic therapy (64%), mechanical thrombectomy (n = 86%), pharmacomechanical thrombolysis (51%), balloon angioplasty (98%), and stent placement (28%). Thrombectomy device used included AngioJet (56%), Trellis (19%), and Aspire (11%). Trapped IVC filter thrombus was identified in 58 patients (38%) based on the IVC venogram. No patient developed clinically evident pulmonary embolism (PE). IVC filter retrieval was performed in 98 patients (56%, mean 11.8 months after implantation). Multivariate analysis showed that iliac vein occlusion (P = 0.04) was predictive for procedure-related thromboembolism. Iliac vein thrombotic occlusion is associated with an increased thromboembolic risk in DVT intervention. Retrievable IVC filter should be considered when performing percutaneous thrombectomy in patients with iliac venous occlusion to prevent PE. Copyright © 2017 Elsevier Inc. All rights reserved.

Extremely high frequency RF effects on electronics.

Energy Technology Data Exchange (ETDEWEB)

Loubriel, Guillermo Manuel; Vigliano, David; Coleman, Phillip Dale; Williams, Jeffery Thomas; Wouters, Gregg A.; Bacon, Larry Donald; Mar, Alan

2012-01-01

The objective of this work was to understand the fundamental physics of extremely high frequency RF effects on electronics. To accomplish this objective, we produced models, conducted simulations, and performed measurements to identify the mechanisms of effects as frequency increases into the millimeter-wave regime. Our purpose was to answer the questions, 'What are the tradeoffs between coupling, transmission losses, and device responses as frequency increases?', and, 'How high in frequency do effects on electronic systems continue to occur?' Using full wave electromagnetics codes and a transmission-line/circuit code, we investigated how extremely high-frequency RF propagates on wires and printed circuit board traces. We investigated both field-to-wire coupling and direct illumination of printed circuit boards to determine the significant mechanisms for inducing currents at device terminals. We measured coupling to wires and attenuation along wires for comparison to the simulations, looking at plane-wave coupling as it launches modes onto single and multiconductor structures. We simulated the response of discrete and integrated circuit semiconductor devices to those high-frequency currents and voltages, using SGFramework, the open-source General-purpose Semiconductor Simulator (gss), and Sandia's Charon semiconductor device physics codes. This report documents our findings.

Predicting Sport and Occupational Lower Extremity Injury Risk through Movement Quality Screening: A Systematic Review

Science.gov (United States)

Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L.; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria

2017-01-01

Background Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. Objective To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. Material and methods Five electronic databases were systematically searched. Studies selected included: original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The PRISMA guidelines were followed. Two independent authors assessed the quality [Downs and Black (DB) criteria] and level of evidence (Oxford Centre of Evidence-Based Medicine model). Results Of 4361 potential studies, 17 were included. The majority were low quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3–15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). Four studies considered interrelationships between risk factors, seven reported diagnostic accuracy and none tested an intervention program targeting individuals identified as high-risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Conclusions Future research should focus on high quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating pre-participation screening and LE injury prevention programs through high quality randomized controlled trials targeting individuals at greater risk of injury based upon screening tests with validated test properties. PMID:27935483

PAI-1 4G/5G and MTHFR C677T polymorphisms increased the accuracy of two prediction scores for the risk of acute lower extremity deep vein thrombosis.

Science.gov (United States)

Pop, Tudor Radu; Vesa, Ştefan Cristian; Trifa, Adrian Pavel; Crişan, Sorin; Buzoianu, Anca Dana

2014-01-01

This study investigates the accuracy of two scores in predicting the risk of acute lower extremity deep vein thrombosis. The study included 170 patients [85 (50%) women and 85 (50%) men] who were diagnosed with acute lower extremity deep vein thrombosis (DVT) with duplex ultrasonography. Median age was 62 (52.75; 72) years. The control group consisted of 166 subjects [96 (57.8%) women and 70 (42.2%) men], without DVT, matched for age (± one year) to those in the group with DVT. The patients and controls were selected from those admitted to the internal medicine, cardiology and geriatrics wards within the Municipal Hospital of Cluj-Napoca, Romania, between October 2009 and June 2011. Clinical, demographic and lab data were recorded for each patient. For each patient we calculated the prior risk of DVT using two prediction scores: Caprini and Padua. According to the Padua score only 93 (54.7%) patients with DVT had been at high risk of developing DVT, while 48 (28.9%) of controls were at high risk of developing DVT. When Padua score included PAI-1 4G/5G and MTHFR C677T polymorphisms, the sensitivity increased at 71.7%. Using the Caprini score, we determined that 147 (86.4%) patients with DVT had been at high risk of developing DVT, while 103 (62%) controls were at high risk of developing DVT. A Caprini score higher than 5 was the strongest predictor of acute lower extremity DVT risk. The Caprini prediction score was more sensitive than the Padua score in assessing the high risk of DVT in medical patients. PAI-1 4G/5G and MTHFR C677T polymorphisms increased the sensitivity of Padua score.

Solidification at the High and Low Rate Extreme

Energy Technology Data Exchange (ETDEWEB)

Meco, Halim [Iowa State Univ., Ames, IA (United States)

2004-12-19

The microstructures formed upon solidification are strongly influenced by the imposed growth rates on an alloy system. Depending on the characteristics of the solidification process, a wide range of growth rates is accessible. The prevailing solidification mechanisms, and thus the final microstructure of the alloy, are governed by these imposed growth rates. At the high rate extreme, for instance, one can have access to novel microstructures that are unattainable at low growth rates. While the low growth rates can be utilized for the study of the intrinsic growth behavior of a certain phase growing from the melt. Although the length scales associated with certain processes, such as capillarity, and the diffusion of heat and solute, are different at low and high rate extremes, the phenomena that govern the selection of a certain microstructural length scale or a growth mode are the same. Consequently, one can analyze the solidification phenomena at both high and low rates by using the same governing principles. In this study, we examined the microstructural control at both low and high extremes. For the high rate extreme, the formation of crystalline products and factors that control the microstructure during rapid solidification by free-jet melt spinning are examined in Fe-Si-B system. Particular attention was given to the behavior of the melt pool at different quench-wheel speeds. Since the solidification process takes place within the melt-pool that forms on the rotating quench-wheel, we examined the influence of melt-pool dynamics on nucleation and growth of crystalline solidification products and glass formation. High-speed imaging of the melt-pool, analysis of ribbon microstructure, and measurement of ribbon geometry and surface character all indicate upper and lower limits for melt-spinning rates for which nucleation can be avoided, and fully amorphous ribbons can be achieved. Comparison of the relevant time scales reveals that surface-controlled melt

A water risk index for portfolio exposure to climatic extremes: conceptualization and an application to the mining industry

Science.gov (United States)

Bonnafous, Luc; Lall, Upmanu; Siegel, Jason

2017-04-01

Corporations, industries and non-governmental organizations have become increasingly concerned with growing water risks in many parts of the world. Most of the focus has been on water scarcity and competition for the resource between agriculture, urban users, ecology and industry. However, water risks are multi-dimensional. Water-related hazards include flooding due to extreme rainfall, persistent drought and pollution, either due to industrial operations themselves, or to the failure of infrastructure. Most companies have risk management plans at each operational location to address these risks to a certain design level. The residual risk may or may not be managed, and is typically not quantified at a portfolio scale, i.e. across many sites. Given that climate is the driver of many of these extreme events, and there is evidence of quasi-periodic climate regimes at inter-annual and decadal timescales, it is possible that a portfolio is subject to persistent, multi-year exceedances of the design level. In other words, for a multi-national corporation, it is possible that there is correlation in the climate-induced portfolio water risk across its operational sites as multiple sites may experience a hazard beyond the design level in a given year. Therefore, from an investor's perspective, a need exists for a water risk index that allows for an exploration of the possible space and/or time clustering in exposure across many sites contained in a portfolio. This paper represents a first attempt to develop an index for financial exposure of a geographically diversified, global portfolio to the time-varying risk of climatic extremes using long daily global rainfall datasets derived from climate re-analysis models. Focusing on extreme daily rainfall amounts and using examples from major mining companies, we illustrate how the index can be developed. We discuss how companies can use it to explore their corporate exposure, and what they may need to disclose to investors and

Peripherally inserted central catheters and upper extremity deep vein thrombosis

International Nuclear Information System (INIS)

Ong, B.; Gibbs, H.; Catchpole, I.; Hetherington, R.; Harper, J.

2006-01-01

The purpose of the study was to determine the incidence and risk factors for venous thrombosis in patients with a peripherally inserted central catheter (PICC). A retrospective study of all upper extremity venous duplex scans was carried out in the Vascular Medicine department from year 2000 to 2002 inclusive. A chart review of positive scans was undertaken to identify possible thrombotic risk factors. Of 317 upper extremity venous duplex scans carried out, 115, or 32%, were positive for upper extremity deep vein thrombosis. Three main risk factors were identified - presence of a central line, malignancy and administration of chemotherapy. PICC were the most common central line present. Symptomatic thrombosis occurred in 7% of PICC inserted for chemotherapy compared with 1% of PICC inserted for other reasons. Ten per cent of the patients receiving chemotherapy through a PICC developed a thrombosis. The post-thrombotic syndrome was infrequent following upper extremity deep vein thrombosis. Patients receiving chemotherapy through a PICC are at increased risk of thrombosis. There may be a role for prophylactic low-dose anticoagulation in these high-risk patients

Impacts of Extreme Events on Human Health. Chapter 4

Science.gov (United States)

Bell, Jesse E.; Herring, Stephanie C.; Jantarasami, Lesley; Adrianopoli, Carl; Benedict, Kaitlin; Conlon, Kathryn; Escobar, Vanessa; Hess, Jeremy; Luvall, Jeffrey; Garcia-Pando, Carlos Perez;

Neurodevelopmental problems and extremes in BMI

Directory of Open Access Journals (Sweden)

Nóra Kerekes

2015-07-01

Full Text Available Background. Over the last few decades, an increasing number of studies have suggested a connection between neurodevelopmental problems (NDPs and body mass index (BMI. Attention deficit/hyperactivity disorder (ADHD and autism spectrum disorders (ASD both seem to carry an increased risk for developing extreme BMI. However, the results are inconsistent, and there have been only a few studies of the general population of children.Aims. We had three aims with the present study: (1 to define the prevalence of extreme (low or high BMI in the group of children with ADHD and/or ASDs compared to the group of children without these NDPs; (2 to analyze whether extreme BMI is associated with the subdomains within the diagnostic categories of ADHD or ASD; and (3 to investigate the contribution of genetic and environmental factors to BMI in boys and girls at ages 9 and 12.Method. Parents of 9- or 12-year-old twins (n = 12,496 were interviewed using the Autism—Tics, ADHD and other Comorbidities (A-TAC inventory as part of the Child and Adolescent Twin Study in Sweden (CATSS. Univariate and multivariate generalized estimated equation models were used to analyze associations between extremes in BMI and NDPs.Results. ADHD screen-positive cases followed BMI distributions similar to those of children without ADHD or ASD. Significant association was found between ADHD and BMI only among 12-year-old girls, where the inattention subdomain of ADHD was significantly associated with the high extreme BMI. ASD scores were associated with both the low and the high extremes of BMI. Compared to children without ADHD or ASD, the prevalence of ASD screen-positive cases was three times greater in the high extreme BMI group and double as much in the low extreme BMI group. Stereotyped and repetitive behaviors were significantly associated with high extreme BMIs.Conclusion. Children with ASD, with or without coexisting ADHD, are more prone to have low or high extreme BMIs than

Cognitive Outcomes of Children Born Extremely or Very Preterm Since the 1990s and Associated Risk Factors : A Meta-analysis and Meta-regression

NARCIS (Netherlands)

Twilhaar, E Sabrina; Wade, Rebecca M; de Kieviet, Jorrit F; van Goudoever, Johannes B; van Elburg, Ruurd M; Oosterlaan, Jaap

2018-01-01

Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective: To examine the cognitive abilities of

[Risk factors for lower extremity amputation in patients with diabetic foot].

Science.gov (United States)

Xu, B; Yang, C Z; Wu, S B; Zhang, D; Wang, L N; Xiao, L; Chen, Y; Wang, C R; Tong, A; Zhou, X F; Li, X H; Guan, X H

2017-01-01

Objective: To explore the risk factors for lower extremity amputation in patients with diabetic foot. Methods: The clinical data of 1 771 patients with diabetic foot at the Air Force General Hospital of PLA from November 2001 to April 2015 were retrospectively analyzed. The patients were divided into the non-amputation and amputation groups. Within the amputation group, subjects were further divided into the minor and major amputation subgroups. Binary logistic regression analyses were used to assess the association between risk factors and lower extremity amputation. Results: Among 1 771 patients with diabetic foot, 323 of them (18.24%) were in the amputation group (major amputation: 41; minor amputation: 282) and 1 448 (81.76%) in the non-amputation group. Compared with non-amputation patients, those in the amputation group had a longer hospital stay and higher estimated glomerular filtration rate(eGFR)levels. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-reaction protein (CRP), ESR, ferritin, fibrinogen and WBC levels of the amputation group were higher, while hemoglobin albumin, transferrin, TC, TG, HDL-C and LDL-C were lower than those of the non-amputation group (all P diabetic foot. Conclusion: Wagner's grade, ischemia of lower limbs and infection are closely associated with amputation of diabetic foot patients.

Psychological characteristics in high-risk MSM in China

Directory of Open Access Journals (Sweden)

Chen Guanzhi

2012-01-01

Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

The extreme risk of personal data breaches and the erosion of privacy

Science.gov (United States)

Wheatley, Spencer; Maillart, Thomas; Sornette, Didier

2016-01-01

Personal data breaches from organisations, enabling mass identity fraud, constitute an extreme risk. This risk worsens daily as an ever-growing amount of personal data are stored by organisations and on-line, and the attack surface surrounding this data becomes larger and harder to secure. Further, breached information is distributed and accumulates in the hands of cyber criminals, thus driving a cumulative erosion of privacy. Statistical modeling of breach data from 2000 through 2015 provides insights into this risk: A current maximum breach size of about 200 million is detected, and is expected to grow by fifty percent over the next five years. The breach sizes are found to be well modeled by an extremely heavy tailed truncated Pareto distribution, with tail exponent parameter decreasing linearly from 0.57 in 2007 to 0.37 in 2015. With this current model, given a breach contains above fifty thousand items, there is a ten percent probability of exceeding ten million. A size effect is unearthed where both the frequency and severity of breaches scale with organisation size like s0.6. Projections indicate that the total amount of breached information is expected to double from two to four billion items within the next five years, eclipsing the population of users of the Internet. This massive and uncontrolled dissemination of personal identities raises fundamental concerns about privacy.

Extreme Transients in the High Energy Universe

Science.gov (United States)

Kouveliotou, Chryssa

2013-01-01

The High Energy Universe is rich in diverse populations of objects spanning the entire cosmological (time)scale, from our own present-day Milky Way to the re-ionization epoch. Several of these are associated with extreme conditions irreproducible in laboratories on Earth. Their study thus sheds light on the behavior of matter under extreme conditions, such as super-strong magnetic fields (in excess of 10^14 G), high gravitational potentials (e.g., Super Massive Black Holes), very energetic collimated explosions resulting in relativistic jet flows (e.g., Gamma Ray Bursts, exceeding 10^53 ergs). In the last thirty years, my work has been mostly focused on two apparently different but potentially linked populations of such transients: magnetars (highly magnetized neutron stars) and Gamma Ray Bursts (strongly beamed emission from relativistic jets), two populations that constitute unique astrophysical laboratories, while also giving us the tools to probe matter conditions in the Universe to redshifts beyond z=10, when the first stars and galaxies were assembled. I did not make this journey alone I have either led or participated in several international collaborations studying these phenomena in multi-wavelength observations; solitary perfection is not sufficient anymore in the world of High Energy Astrophysics. I will describe this journey, present crucial observational breakthroughs, discuss key results and muse on the future of this field.

Local likelihood estimation of complex tail dependence structures in high dimensions, applied to US precipitation extremes

KAUST Repository

Camilo, Daniela Castro

2017-10-02

In order to model the complex non-stationary dependence structure of precipitation extremes over the entire contiguous U.S., we propose a flexible local approach based on factor copula models. Our sub-asymptotic spatial modeling framework yields non-trivial tail dependence structures, with a weakening dependence strength as events become more extreme, a feature commonly observed with precipitation data but not accounted for in classical asymptotic extreme-value models. To estimate the local extremal behavior, we fit the proposed model in small regional neighborhoods to high threshold exceedances, under the assumption of local stationarity. This allows us to gain in flexibility, while making inference for such a large and complex dataset feasible. Adopting a local censored likelihood approach, inference is made on a fine spatial grid, and local estimation is performed taking advantage of distributed computing resources and of the embarrassingly parallel nature of this estimation procedure. The local model is efficiently fitted at all grid points, and uncertainty is measured using a block bootstrap procedure. An extensive simulation study shows that our approach is able to adequately capture complex, non-stationary dependencies, while our study of U.S. winter precipitation data reveals interesting differences in local tail structures over space, which has important implications on regional risk assessment of extreme precipitation events. A comparison between past and current data suggests that extremes in certain areas might be slightly wider in extent nowadays than during the first half of the twentieth century.

Local likelihood estimation of complex tail dependence structures in high dimensions, applied to US precipitation extremes

KAUST Repository

Camilo, Daniela Castro; Huser, Raphaë l

2017-01-01

In order to model the complex non-stationary dependence structure of precipitation extremes over the entire contiguous U.S., we propose a flexible local approach based on factor copula models. Our sub-asymptotic spatial modeling framework yields non-trivial tail dependence structures, with a weakening dependence strength as events become more extreme, a feature commonly observed with precipitation data but not accounted for in classical asymptotic extreme-value models. To estimate the local extremal behavior, we fit the proposed model in small regional neighborhoods to high threshold exceedances, under the assumption of local stationarity. This allows us to gain in flexibility, while making inference for such a large and complex dataset feasible. Adopting a local censored likelihood approach, inference is made on a fine spatial grid, and local estimation is performed taking advantage of distributed computing resources and of the embarrassingly parallel nature of this estimation procedure. The local model is efficiently fitted at all grid points, and uncertainty is measured using a block bootstrap procedure. An extensive simulation study shows that our approach is able to adequately capture complex, non-stationary dependencies, while our study of U.S. winter precipitation data reveals interesting differences in local tail structures over space, which has important implications on regional risk assessment of extreme precipitation events. A comparison between past and current data suggests that extremes in certain areas might be slightly wider in extent nowadays than during the first half of the twentieth century.

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

NARCIS (Netherlands)

Bot, S.D.M.; Terwee, C.B.; Windt, D.A.W.M. van der; Beek, A.J. van der; Bouter, L.M.; Dekker, J.

2007-01-01

Objectives: To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods: Three hundred and forty two patients with neck or upper extremity complaints completed self-report

Lower extremity functional tests and risk of injury in division iii collegiate athletes.

Science.gov (United States)

Brumitt, Jason; Heiderscheit, Bryan C; Manske, Robert C; Niemuth, Paul E; Rauh, Mitchell J

2013-06-01

Functional tests have been used primarily to assess an athlete's fitness or readiness to return to sport. The purpose of this prospective cohort study was to determine the ability of the standing long jump (SLJ) test, the single-leg hop (SLH) for distance test, and the lower extremity functional test (LEFT) as preseason screening tools to identify collegiate athletes who may be at increased risk for a time-loss sports-related low back or lower extremity injury. A total of 193 Division III athletes from 15 university teams (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 y) were tested prior to their sports seasons. Athletes performed the functional tests in the following sequence: SLJ, SLH, LEFT. The athletes were then prospectively followed during their sports season for occurrence of low back or LE injury. Female athletes who completed the LEFT in $118 s were 6 times more likely (OR=6.4, 95% CI: 1.3, 31.7) to sustain a thigh or knee injury. Male athletes who completed the LEFT in #100 s were more likely to experience a time-loss injury to the low back or LE (OR=3.2, 95% CI: 1.1, 9.5) or a foot or ankle injury (OR=6.7, 95% CI: 1.5, 29.7) than male athletes who completed the LEFT in 101 s or more. Female athletes with a greater than 10% side-to-side asymmetry between SLH distances had a 4-fold increase in foot or ankle injury (cut point: >10%; OR=4.4, 95% CI: 1.2, 15.4). Male athletes with SLH distances (either leg) at least 75% of their height had at least a 3-fold increase (OR=3.6, 95% CI: 1.2, 11.2 for the right LE; OR=3.6, 95% CI: 1.2, 11.2 for left LE) in low back or LE injury. The LEFT and the SLH tests appear useful in identifying Division III athletes at risk for a low back or lower extremity sports injury. Thus, these tests warrant further consideration as preparticipatory screening examination tools for sport injury in this population. The single-leg hop for distance and the lower extremity functional test, when administered to Division III

Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review.

Science.gov (United States)

Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria

2017-04-01

Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Wave-mixing with high-order harmonics in extreme ultraviolet region

International Nuclear Information System (INIS)

Dao, Lap Van; Dinh, Khuong Ba; Le, Hoang Vu; Gaffney, Naylyn; Hannaford, Peter

2015-01-01

We report studies of the wave-mixing process in the extreme ultraviolet region with two near-infrared driving and controlling pulses with incommensurate frequencies (at 1400 nm and 800 nm). A non-collinear scheme for the two beams is used in order to spatially separate and to characterise the properties of the high-order wave-mixing field. We show that the extreme ultraviolet frequency mixing can be treated by perturbative, very high-order nonlinear optics; the modification of the wave-packet of the free electron needs to be considered in this process

High resolution modelling of extreme precipitation events in urban areas

Science.gov (United States)

Siemerink, Martijn; Volp, Nicolette; Schuurmans, Wytze; Deckers, Dave

2015-04-01

The present day society needs to adjust to the effects of climate change. More extreme weather conditions are expected, which can lead to longer periods of drought, but also to more extreme precipitation events. Urban water systems are not designed for such extreme events. Most sewer systems are not able to drain the excessive storm water, causing urban flooding. This leads to high economic damage. In order to take appropriate measures against extreme urban storms, detailed knowledge about the behaviour of the urban water system above and below the streets is required. To investigate the behaviour of urban water systems during extreme precipitation events new assessment tools are necessary. These tools should provide a detailed and integral description of the flow in the full domain of overland runoff, sewer flow, surface water flow and groundwater flow. We developed a new assessment tool, called 3Di, which provides detailed insight in the urban water system. This tool is based on a new numerical methodology that can accurately deal with the interaction between overland runoff, sewer flow and surface water flow. A one-dimensional model for the sewer system and open channel flow is fully coupled to a two-dimensional depth-averaged model that simulates the overland flow. The tool uses a subgrid-based approach in order to take high resolution information of the sewer system and of the terrain into account [1, 2]. The combination of using the high resolution information and the subgrid based approach results in an accurate and efficient modelling tool. It is now possible to simulate entire urban water systems using extreme high resolution (0.5m x 0.5m) terrain data in combination with a detailed sewer and surface water network representation. The new tool has been tested in several Dutch cities, such as Rotterdam, Amsterdam and The Hague. We will present the results of an extreme precipitation event in the city of Schiedam (The Netherlands). This city deals with

Assessing uncertainty in extreme events: Applications to risk-based decision making in interdependent infrastructure sectors

International Nuclear Information System (INIS)

Barker, Kash; Haimes, Yacov Y.

2009-01-01

Risk-based decision making often relies upon expert probability assessments, particularly in the consequences of disruptive events and when such events are extreme or catastrophic in nature. Naturally, such expert-elicited probability distributions can be fraught with errors, as they describe events which occur very infrequently and for which only sparse data exist. This paper presents a quantitative framework, the extreme event uncertainty sensitivity impact method (EE-USIM), for measuring the sensitivity of extreme event consequences to uncertainties in the parameters of the underlying probability distribution. The EE-USIM is demonstrated with the Inoperability input-output model (IIM), a model with which to evaluate the propagation of inoperability throughout an interdependent set of economic and infrastructure sectors. The EE-USIM also makes use of a two-sided power distribution function generated by expert elicitation of extreme event consequences

Paleoflood Data, Extreme Floods and Frequency: Data and Models for Dam Safety Risk Scenarios

Science.gov (United States)

England, J. F.; Godaire, J.; Klinger, R.

2007-12-01

Extreme floods and probability estimates are crucial components in dam safety risk analysis and scenarios for water-resources decision making. The field-based collection of paleoflood data provides needed information on the magnitude and probability of extreme floods at locations of interest in a watershed or region. The stratigraphic record present along streams in the form of terrace and floodplain deposits represent direct indicators of the magnitude of large floods on a river, and may provide 10 to 100 times longer records than conventional stream gaging records of large floods. Paleoflood data is combined with gage and historical streamflow estimates to gain insights to flood frequency scaling, model extrapolations and uncertainty, and provide input scenarios to risk analysis event trees. We illustrate current data collection and flood frequency modeling approaches via case studies in the western United States, including the American River in California and the Arkansas River in Colorado. These studies demonstrate the integration of applied field geology, hydraulics, and surface-water hydrology. Results from these studies illustrate the gains in information content on extreme floods, provide data- based means to separate flood generation processes, guide flood frequency model extrapolations, and reduce uncertainties. These data and scenarios strongly influence water resources management decisions.

Exome sequencing in schizophrenic patients with high levels of homozygosity identifies novel and extremely rare mutations in the GABA/glutamatergic pathways.

Directory of Open Access Journals (Sweden)

Edoardo Giacopuzzi

Full Text Available Inbreeding is a known risk factor for recessive Mendelian diseases and previous studies have suggested that it could also play a role in complex disorders, such as psychiatric diseases. Recent inbreeding results in the presence of long runs of homozygosity (ROHs along the genome, which are also defined as autozygosity regions. Genetic variants in these regions have two alleles that are identical by descent, thus increasing the odds of bearing rare recessive deleterious mutations due to a homozygous state. A recent study showed a suggestive enrichment of long ROHs in schizophrenic patients, suggesting that recent inbreeding could play a role in the disease. To better understand the impact of autozygosity on schizophrenia risk, we selected, from a cohort of 180 Italian patients, seven subjects with extremely high numbers of large ROHs that were likely due to recent inbreeding and characterized the mutational landscape within their ROHs using Whole Exome Sequencing and, gene set enrichment analysis. We identified a significant overlap (17%; empirical p-value = 0.0171 between genes inside ROHs affected by low frequency functional homozygous variants (107 genes and the group of most promising candidate genes mutated in schizophrenia. Moreover, in four patients, we identified novel and extremely rare damaging mutations in the genes involved in neurodevelopment (MEGF8 and in GABA/glutamatergic synaptic transmission (GAD1, FMN1, ANO2. These results provide insights into the contribution of rare recessive mutations and inbreeding as risk factors for schizophrenia. ROHs that are likely due to recent inbreeding harbor a combination of predisposing low-frequency variants and extremely rare variants that have a high impact on pivotal biological pathways implicated in the disease. In addition, this study confirms that focusing on patients with high levels of homozygosity could be a useful prioritization strategy for discovering new high-impact mutations in

Exome sequencing in schizophrenic patients with high levels of homozygosity identifies novel and extremely rare mutations in the GABA/glutamatergic pathways.

Science.gov (United States)

Giacopuzzi, Edoardo; Gennarelli, Massimo; Minelli, Alessandra; Gardella, Rita; Valsecchi, Paolo; Traversa, Michele; Bonvicini, Cristian; Vita, Antonio; Sacchetti, Emilio; Magri, Chiara

2017-01-01

Inbreeding is a known risk factor for recessive Mendelian diseases and previous studies have suggested that it could also play a role in complex disorders, such as psychiatric diseases. Recent inbreeding results in the presence of long runs of homozygosity (ROHs) along the genome, which are also defined as autozygosity regions. Genetic variants in these regions have two alleles that are identical by descent, thus increasing the odds of bearing rare recessive deleterious mutations due to a homozygous state. A recent study showed a suggestive enrichment of long ROHs in schizophrenic patients, suggesting that recent inbreeding could play a role in the disease. To better understand the impact of autozygosity on schizophrenia risk, we selected, from a cohort of 180 Italian patients, seven subjects with extremely high numbers of large ROHs that were likely due to recent inbreeding and characterized the mutational landscape within their ROHs using Whole Exome Sequencing and, gene set enrichment analysis. We identified a significant overlap (17%; empirical p-value = 0.0171) between genes inside ROHs affected by low frequency functional homozygous variants (107 genes) and the group of most promising candidate genes mutated in schizophrenia. Moreover, in four patients, we identified novel and extremely rare damaging mutations in the genes involved in neurodevelopment (MEGF8) and in GABA/glutamatergic synaptic transmission (GAD1, FMN1, ANO2). These results provide insights into the contribution of rare recessive mutations and inbreeding as risk factors for schizophrenia. ROHs that are likely due to recent inbreeding harbor a combination of predisposing low-frequency variants and extremely rare variants that have a high impact on pivotal biological pathways implicated in the disease. In addition, this study confirms that focusing on patients with high levels of homozygosity could be a useful prioritization strategy for discovering new high-impact mutations in genetically

Is Extremely High Life Satisfaction during Adolescence Advantageous?

Science.gov (United States)

Suldo, Shannon M.; Huebner, E. Scott

2006-01-01

This study examined whether extremely high life satisfaction was associated with adaptive functioning or maladaptive functioning. Six hundred ninety-eight secondary level students completed the Students' Life Satisfaction Scale [Huebner, 1991a, School Psychology International, 12, pp. 231-240], Youth Self-Report of the Child Behavior Checklist…

Assessment of the risk of falling with the use of timed up and go test in the elderly with lower extremity osteoarthritis.

Science.gov (United States)

Zasadzka, Ewa; Borowicz, Adrianna Maria; Roszak, Magdalena; Pawlaczyk, Mariola

2015-01-01

Falling in the elderly results in a significant number of admissions to hospitals and long-term care facilities, especially among patients with lower extremity osteoarthritis (OA). The aim of the study was to assess the risk of falling in adults older than 60 years with OA using timed up and go (TUG) test. A total of 187 patients (aged >60 years) were enrolled in the study. The assessment included: basic activities of daily living (ADLs), lower extremity strength with the use of the 30-second chair stand test (30 CST), and assessment of the risk of falling (TUG test). Pain intensity was evaluated with the numeric rating scale (NRS). The TUG test results were significantly better in younger OA patients (aged 60-69 years), as compared with their older peers (aged 70-79 years; P80 years; Pwomen than men (Pfalls was significantly higher in the group of subjects who scored ≥13.5 when compared to risk of falling, which increases with progressing age, pain, and muscle weakness. It seems prudent to identify individuals at a high risk of falling and to propose an adequate treatment for them.

Forecasting the value-at-risk of Chinese stock market using the HARQ model and extreme value theory

Science.gov (United States)

Liu, Guangqiang; Wei, Yu; Chen, Yongfei; Yu, Jiang; Hu, Yang

2018-06-01

Using intraday data of the CSI300 index, this paper discusses value-at-risk (VaR) forecasting of the Chinese stock market from the perspective of high-frequency volatility models. First, we measure the realized volatility (RV) with 5-minute high-frequency returns of the CSI300 index and then model it with the newly introduced heterogeneous autoregressive quarticity (HARQ) model, which can handle the time-varying coefficients of the HAR model. Second, we forecast the out-of-sample VaR of the CSI300 index by combining the HARQ model and extreme value theory (EVT). Finally, using several popular backtesting methods, we compare the VaR forecasting accuracy of HARQ model with other traditional HAR-type models, such as HAR, HAR-J, CHAR, and SHAR. The empirical results show that the novel HARQ model can beat other HAR-type models in forecasting the VaR of the Chinese stock market at various risk levels.

WHO's health risk assessment of extremely low frequency electric fields

International Nuclear Information System (INIS)

Repacholi, M.H.

2003-01-01

The World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), WHOs scientific collaborating centres (including the UKs National Radiological Protection Board (NRPB) and over 50 participating Member States are participants of WHOs International EMF Project. As part of WHOs health risk assessment process for extremely low frequency fields (ELFs), this workshop was convened by NRPB to assist WHO in evaluating potential health impacts of electrical currents and fields induced by ELF in molecules, cells, tissues and organs of the body. This paper describes the process by which WHO will conduct its health risk assessment. WHO is also trying to provide information on why exposure to ELF magnetic fields seems to be associated with an increased incidence of childhood leukaemia. Are there mechanisms that could lead to this health outcome or does the epidemiological evidence incorporate biases or other factors that need to be further explored? (author)

Cerebral Damage May Be the Primary Risk Factor for Visual Impairment in Preschool Children Born Extremely Premature

DEFF Research Database (Denmark)

Slidsborg, Carina; Bangsgaard, Regitze; Fledelius, Hans Callø

2012-01-01

OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children born......, 3.0-25.2; P visual impairment in children born extremely premature, and cerebral damage may be the primary risk...... participants were identified through the National Birth Register and invited to participate in a clinical examination. The children were evaluated with regard to visual acuity, foveal sequelae, and maximum ROP stage and the presence of global developmental deficits (an indicator for cerebral damage...

Regional-Scale High-Latitude Extreme Geoelectric Fields Pertaining to Geomagnetically Induced Currents

Science.gov (United States)

Pulkkinen, Antti; Bernabeu, Emanuel; Eichner, Jan; Viljanen, Ari; Ngwira, Chigomezyo

2015-01-01

Motivated by the needs of the high-voltage power transmission industry, we use data from the high-latitude IMAGE magnetometer array to study characteristics of extreme geoelectric fields at regional scales. We use 10-s resolution data for years 1993-2013, and the fields are characterized using average horizontal geoelectric field amplitudes taken over station groups that span about 500-km distance. We show that geoelectric field structures associated with localized extremes at single stations can be greatly different from structures associated with regionally uniform geoelectric fields, which are well represented by spatial averages over single stations. Visual extrapolation and rigorous extreme value analysis of spatially averaged fields indicate that the expected range for 1-in-100-year extreme events are 3-8 V/km and 3.4-7.1 V/km, respectively. The Quebec reference ground model is used in the calculations.

A Comparative Analysis of Climate-Risk and Extreme Event-Related Impacts on Well-Being and Health: Policy Implications

Science.gov (United States)

Al-Amin, Abul Quasem; Wiesböck, Laura; Mugabe, Paschal; Aparicio-Effen, Marilyn; Fudjumdjum, Hubert; Chiappetta Jabbour, Charbel Jose

2018-01-01

There are various climate risks that are caused or influenced by climate change. They are known to have a wide range of physical, economic, environmental and social impacts. Apart from damages to the physical environment, many climate risks (climate variability, extreme events and climate-related hazards) are associated with a variety of impacts on human well-being, health, and life-supporting systems. These vary from boosting the proliferation of vectors of diseases (e.g., mosquitos), to mental problems triggered by damage to properties and infrastructure. There is a great variety of literature about the strong links between climate change and health, while there is relatively less literature that specifically examines the health impacts of climate risks and extreme events. This paper is an attempt to address this knowledge gap, by compiling eight examples from a set of industrialised and developing countries, where such interactions are described. The policy implications of these phenomena and the lessons learned from the examples provided are summarised. Some suggestions as to how to avert the potential and real health impacts of climate risks are made, hence assisting efforts to adapt to a problem whose impacts affect millions of people around the world. All the examples studied show some degree of vulnerability to climate risks regardless of their socioeconomic status and need to increase resilience against extreme events. PMID:29438345

A Comparative Analysis of Climate-Risk and Extreme Event-Related Impacts on Well-Being and Health: Policy Implications.

Science.gov (United States)

Filho, Walter Leal; Al-Amin, Abul Quasem; Nagy, Gustavo J; Azeiteiro, Ulisses M; Wiesböck, Laura; Ayal, Desalegn Y; Morgan, Edward A; Mugabe, Paschal; Aparicio-Effen, Marilyn; Fudjumdjum, Hubert; Chiappetta Jabbour, Charbel Jose

2018-02-13

There are various climate risks that are caused or influenced by climate change. They are known to have a wide range of physical, economic, environmental and social impacts. Apart from damages to the physical environment, many climate risks (climate variability, extreme events and climate-related hazards) are associated with a variety of impacts on human well-being, health, and life-supporting systems. These vary from boosting the proliferation of vectors of diseases (e.g., mosquitos), to mental problems triggered by damage to properties and infrastructure. There is a great variety of literature about the strong links between climate change and health, while there is relatively less literature that specifically examines the health impacts of climate risks and extreme events. This paper is an attempt to address this knowledge gap, by compiling eight examples from a set of industrialised and developing countries, where such interactions are described. The policy implications of these phenomena and the lessons learned from the examples provided are summarised. Some suggestions as to how to avert the potential and real health impacts of climate risks are made, hence assisting efforts to adapt to a problem whose impacts affect millions of people around the world. All the examples studied show some degree of vulnerability to climate risks regardless of their socioeconomic status and need to increase resilience against extreme events.

A Comparative Analysis of Climate-Risk and Extreme Event-Related Impacts on Well-Being and Health: Policy Implications

Directory of Open Access Journals (Sweden)

Walter Leal Filho

2018-02-01

Full Text Available There are various climate risks that are caused or influenced by climate change. They are known to have a wide range of physical, economic, environmental and social impacts. Apart from damages to the physical environment, many climate risks (climate variability, extreme events and climate-related hazards are associated with a variety of impacts on human well-being, health, and life-supporting systems. These vary from boosting the proliferation of vectors of diseases (e.g., mosquitos, to mental problems triggered by damage to properties and infrastructure. There is a great variety of literature about the strong links between climate change and health, while there is relatively less literature that specifically examines the health impacts of climate risks and extreme events. This paper is an attempt to address this knowledge gap, by compiling eight examples from a set of industrialised and developing countries, where such interactions are described. The policy implications of these phenomena and the lessons learned from the examples provided are summarised. Some suggestions as to how to avert the potential and real health impacts of climate risks are made, hence assisting efforts to adapt to a problem whose impacts affect millions of people around the world. All the examples studied show some degree of vulnerability to climate risks regardless of their socioeconomic status and need to increase resilience against extreme events.

Extreme Conditioning Programs: Potential Benefits and Potential Risks.

Science.gov (United States)

Knapik, Joseph J

2015-01-01

CrossFit, Insanity, Gym Jones, and P90X are examples of extreme conditioning programs (ECPs). ECPs typically involve high-volume and high-intensity physical activities with short rest periods between movements and use of multiple joint exercises. Data on changes in fitness with ECPs are limited to CrossFit investigations that demonstrated improvements in muscle strength, muscular endurance, aerobic fitness, and body composition. However, no study has directly compared CrossFit or other ECPs to other more traditional forms of aerobic and resistance training within the same investigation. These direct comparisons are needed to more adequately evaluate the effectiveness of ECPs. Until these studies emerge, the comparisons with available literature suggest that improvements in CrossFit, in terms of muscular endurance (push-ups, sit-ups), strength, and aerobic capacity, appear to be similar to those seen in more traditional training programs. Investigations of injuries in ECPs are limited to two observational studies that suggest that the overall injury rate is similar to that seen in other exercise programs. Several cases of rhabdomyolysis and cervical carotid artery dissections have been reported during CrossFit training. The symptoms, diagnosis, and treatment of these are reviewed here. Until more data on ECPs emerge, physical training should be aligned with US Army doctrine. If ECPs are included in exercise programs, trainers should (1) have appropriate training certifications, (2) inspect exercise equipment regularly to assure safety, (3) introduce ECPs to new participants, (4) ensure medical clearance of Soldiers with special health problems before participation in ECPs, (4) tailor ECPs to the individual Soldier, (5) adjust rest periods to optimize recovery and reduce fatigue, (6) monitor Soldiers for signs of overtraining, rhabdomyolysis, and other problems, and (7) coordinate exercise programs with other unit training activities to eliminate redundant activities

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals.

Science.gov (United States)

Choi, Sehoon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog; Han, Seung Hoon

2018-02-01

To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.

Combined Psoas Compartment-Sciatic Block in a Pediatric Patient with High-Risk Cardiopulmonary

Directory of Open Access Journals (Sweden)

Levent Þahin

2013-03-01

Full Text Available There is high potential for complications in cardiopulmonary high-risk patients with valvular heart disease at perioperative period. The operation was planned due to pathological fracture of the femoral shaft of a nine year old male patient weighing 26 kilograms. He had 3o tricuspid insufficiency, 3o mitral insufficiency and pulmonary hypertension in preoperative evaluation. Sciatic nerve block and psoas compartment block was performed to patient for anesthesia and analgesia. In conclusion we think that combined psoas compartment-sciatic nerve block may be a good alternative to other methods of anesthesia in high-risk pediatric patients with cardiopulmonary perspective in lower-extremity surgery.

Protective Alternatives of SMR against Extreme Threat Scenario – A Preliminary Risk Analysis

International Nuclear Information System (INIS)

Shohet, I.M.; Ornai, D.; Gal, E.; Ronen, Y.; Vidra, M.

2014-01-01

The article presents a preliminary risk analysis of the main features in NPP (Nuclear Power Plant) that includes SMR - Small and Modular Reactors, given an extreme threat scenario. A review of the structure and systems of the SMR is followed by systematic definitions and analysis of the threat scenario to which a preliminary risk analysis was carried out. The article outlines the basic events caused by the referred threat scenario, which had led to possible failure mechanisms according to FTA (Fault-Tree-Analysis),critical protective circuits, and todetecting critical topics for the protection and safety of the reactor

Extreme weather events in southern Germany - Climatological risk and development of a large-scale identification procedure

Science.gov (United States)

Matthies, A.; Leckebusch, G. C.; Rohlfing, G.; Ulbrich, U.

2009-04-01

Extreme weather events such as thunderstorms, hail and heavy rain or snowfall can pose a threat to human life and to considerable tangible assets. Yet there is a lack of knowledge about present day climatological risk and its economic effects, and its changes due to rising greenhouse gas concentrations. Therefore, parts of economy particularly sensitve to extreme weather events such as insurance companies and airports require regional risk-analyses, early warning and prediction systems to cope with such events. Such an attempt is made for southern Germany, in close cooperation with stakeholders. Comparing ERA40 and station data with impact records of Munich Re and Munich Airport, the 90th percentile was found to be a suitable threshold for extreme impact relevant precipitation events. Different methods for the classification of causing synoptic situations have been tested on ERA40 reanalyses. An objective scheme for the classification of Lamb's circulation weather types (CWT's) has proved to be most suitable for correct classification of the large-scale flow conditions. Certain CWT's have been turned out to be prone to heavy precipitation or on the other side to have a very low risk of such events. Other large-scale parameters are tested in connection with CWT's to find out a combination that has the highest skill to identify extreme precipitation events in climate model data (ECHAM5 and CLM). For example vorticity advection in 700 hPa shows good results, but assumes knowledge of regional orographic particularities. Therefore ongoing work is focused on additional testing of parameters that indicate deviations of a basic state of the atmosphere like the Eady Growth Rate or the newly developed Dynamic State Index. Evaluation results will be used to estimate the skill of the regional climate model CLM concerning the simulation of frequency and intensity of the extreme weather events. Data of the A1B scenario (2000-2050) will be examined for a possible climate change

High-resolution Sonographic Measurements of Lower Extremity Bursae in Chinese Healthy Young Men

Directory of Open Access Journals (Sweden)

Yong-Yan Gao

2016-01-01

Conclusions: Using HR-US imaging, we were able to analyze lower extremity bursae with high detection rates in healthy young men. The normal ranges of lower extremity bursa dimensions in healthy young men measured by HR-US in this study could be used as reference values for evaluation of bursa abnormalities in the lower extremity.

Extremely high thermal conductivity anisotropy of double-walled carbon nanotubes

Directory of Open Access Journals (Sweden)

Zhaoji Ma

2017-06-01

Full Text Available Based on molecular dynamics simulations, we reveal that double-walled carbon nanotubes can possess an extremely high anisotropy ratio of radial to axial thermal conductivities. The mechanism is basically the same as that for the high thermal conductivity anisotropy of graphene layers - the in-plane strong sp2 bonds lead to a very high intralayer thermal conductivity while the weak van der Waals interactions to a very low interlayer thermal conductivity. However, different from flat graphene layers, the tubular structures of carbon nanotubes result in a diameter dependent thermal conductivity. The smaller the diameter, the larger the axial thermal conductivity but the smaller the radial thermal conductivity. As a result, a DWCNT with a small diameter may have an anisotropy ratio of thermal conductivity significantly higher than that for graphene layers. The extremely high thermal conductivity anisotropy allows DWCNTs to be a promising candidate for thermal management materials.

Mitigating the Risk of Extreme Water Scarcity and Dependency: The Case of Jordan

Directory of Open Access Journals (Sweden)

Joep F. Schyns

2015-10-01

Full Text Available Jordan faces great internal water scarcity and pollution, conflict over trans-boundary waters, and strong dependency on external water resources through trade. This paper analyzes these issues and subsequently reviews options to reduce the risk of extreme water scarcity and dependency. Based on estimates of water footprint, water availability, and virtual water trade, we find that groundwater consumption is nearly double the groundwater availability, water pollution aggravates blue water scarcity, and Jordan’s external virtual water import dependency is 86%. The review of response options yields 10 ingredients for a strategy for Jordan to mitigate the risks of extreme water scarcity and dependency. With respect to these ingredients, Jordan’s current water policy requires a strong redirection towards water demand management. Actual implementation of the plans in the national water strategy (against existing oppositions would be a first step. However, more attention should be paid to reducing water demand by changing the consumption pattern of Jordanian consumers. Moreover, unsustainable exploitation of the fossil Disi aquifer should soon be halted and planned desalination projects require careful consideration regarding the sustainability of their energy supply.

Risk factors for generally reduced productivity--a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms.

Science.gov (United States)

Boström, Maria; Dellve, Lotta; Thomée, Sara; Hagberg, Mats

2008-04-01

This study prospectively assessed the importance of individual conditions and computer use during school or work and leisure time as risk factors for self-reported generally reduced productivity due to musculoskeletal complaints among young adults with musculoskeletal symptoms in the neck or upper extremities. A cohort of 2914 young adults (18-25 years, vocational school and college or university students) responded to an internet-based questionnaire concerning musculoskeletal symptoms related to individual conditions and computer use during school or work and leisure time that possibly affected general productivity. Prevalence ratios (PR) were used to assess prospective risk factors for generally reduced productivity. The selected study sample (N=1051) had reported neck or upper-extremity symptoms. At baseline, 280 of them reported reduced productivity. A follow-up of the 771 who reported no reduced productivity was carried out after 1 year. Risk factors for self-reported generally reduced productivity for those followed-up were symptoms in two or three locations or dimensions for the upper back or neck and the shoulders, arms, wrists, or hands [PR 2.30, 95% confidence interval (95% CI) 1.40-3.78], symptoms persisting longer than 90 days in the shoulders, arms, wrists, or hands (PR 2.50, 95% CI 1.12-5.58), current symptoms in the shoulders, arms, wrists, or hands (PR 1.78, 95% CI 1.10-2.90) and computer use 8-14 hours/week during leisure time (PR 2.32, 95% CI 1.20-4.47). A stronger relationship was found if three or four risk factors were present. For women, a relationship was found between generally reduced productivity and widespread and current symptoms in the upper extremities. The main risk factors for generally reduced productivity due to musculoskeletal symptoms among young adults in this study were chronic symptoms in the upper extremities and widespread symptoms in the neck and upper extremities.

The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity.

Science.gov (United States)

Wang, Ching-Jen; Liu, Hao-Chen; Fu, Te-Hu

2007-02-01

High-energy long bone fractures of the lower extremity are at risk of poor fracture healing and high rate of non-union. Extracorporeal shockwave was shown effective to heal non-union of long bone fracture. However, the effect of shockwave on acute fractures is unknown. The purpose of this study was to investigate the effects of shockwave on acute high-energy fractures of the lower extremity. Between January and October 2004, 56 patients with 59 acute high-energy fractures were enrolled in this study. Patients were randomly divided into two groups with 28 patients with 28 fractures in the study group and 28 patients with 31 fractures in the control group. Both groups showed similar age, gender, type of fracture and follow-up time. Patients in the study group received open reduction and internal fixation and shockwave treatment immediately after surgery on odd-numbered days of the week, whereas, patients in the control group received open reduction and internal fixation without shockwave treatment on even-numbered days of the week. Postoperative managements were similarly performed in both groups including crutch walking with non-weight bearing on the affected limb until fracture healing shown on radiographs. The evaluation parameters included clinical assessments of pain score and weight bearing status of the affected leg and serial radiographs at 3, 6 and 12 months. The primary end-point is the rate of non-union at 12 months, and the secondary end point is the rate of fracture healing at 3, 6 and 12 months. At 12 months, the rate of non-union was 11% for the study group versus 20% for the control group (P fracture healing was noted in the study group than the control group at 3, 6 and 12 months (P fracture healing and decreasing the rate of non-union in acute high-energy fractures of the lower extremity.

Coping with extreme climate events: Institutional flocking

NARCIS (Netherlands)

Koppen, van C.S.A.; Mol, A.P.J.; Tatenhove, van J.P.M.

2010-01-01

The article explores the governance structures that would be needed to cope with extreme and unpredictable climate change. The impacts on the Netherlands of a Gulf Stream collapse in the Northern Atlantic are taken as a case. This hypothetical situation of serious risks and high uncertainties

A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

Science.gov (United States)

Qi, Wei

2017-11-01

Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

Shoe and field surface risk factors for acute lower extremity injuries among female youth soccer players

Science.gov (United States)

O'Kane, John W.; Gray, Kristen E.; Levy, Marni R.; Neradilek, Moni; Tencer, Allan F.; Polissar, Nayak L.; Schiff, Melissa A.

2015-01-01

Objective Describe acute lower extremity injuries and evaluate extrinsic risk factors in female youth soccer Design Nested case-control study Setting Youth soccer clubs in Washington State, USA. Participants Female soccer players (N= 351) ages 11 to 15 years randomly selected from 4 soccer clubs from which 83% of their players were enrolled with complete follow-up for 92% of players. Interventions Injured players were interviewed regarding injury, field surface, shoe type, and position. Uninjured controls, matched on game or practice session, were also interviewed. Main Outcome Measures The association between risk factors and acute lower extremity injury using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). Results One hundred seventy-three acute lower extremity injuries occurred involving primarily the ankle (39.3%), knee (24.9%), and thigh (11.0%). Over half (52.9%) recovered within 1 week, while 30.2% lasted beyond 2 weeks. During practices, those injured were approximately 3-fold ( OR 2.83, 95% CI 1.49-5.31) more likely to play on grass than artificial turf and 2.4-fold (95% CI 1.03-5.96) more likely to wear cleats on grass than other shoe and surface combinations. During games injured players were 89% (95% CI 1.03-4.17) more likely to play defender compared to forward. Conclusions Half of the acute lower extremity injuries affected the ankle or knee. Grass surface and wearing cleats on grass increased training injuries. PMID:26327288

Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

Science.gov (United States)

Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

2014-11-01

Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Risk from drought and extreme heat in Russian wheat production and its relation to atmospheric blocking and teleconnection patterns

Science.gov (United States)

Giannakaki, Paraskevi; Calanca, Pierluigi

2017-04-01

Russia has become one of the leading wheat exporters worldwide. Major breakdowns in Russian wheat production induced by extreme weather events are therefore of high significance not only for the domestic but also for the global market. Wheat production in south-western Russia, the main growing area, suffers in particular from the adverse effects of drought and heat waves. For this reason knowledge of the occurrence of this type of extreme events and of the processes that lead to adverse conditions is of paramount importance for risk management. The negative impacts of heat waves and drought are particularly severe when anomalous conditions persist in time. As an example, a blocking event in summer 2010 resulted in one of the warmest and worst drought conditions in Russia's recent history. The latter caused a decline in Russian wheat production by more than 30%, which in turn prompted the Russian government to issue an export ban that lasted until summer 2011. In view of this, the question of course arises of how much of the negative variations in Russian wheat production levels can be explained by blocking events and other features of the large-scale atmospheric circulation. Specific questions are: how often are blocking events over Russia associated with extreme high temperatures and dry conditions? Which of the teleconnection patterns are correlated with drought and heat stress conditions in the area? Answering these questions can contribute to a develop strategies for agricultural risk management. In this contribution we present results of a study that aims at characterizing the occurrence of adverse weather conditions in south-western Russia in relation to atmospheric blocking and teleconnection patterns such as East Atlantic/Western Russia pattern, the Polar/Eurasia pattern, the North Atlantic Oscillation and the Scandinavia pattern. The analysis relies on weather data for 1980-2014 from 130 stations distributed across the wheat production area. The account

High-resolution stochastic generation of extreme rainfall intensity for urban drainage modelling applications

Science.gov (United States)

Peleg, Nadav; Blumensaat, Frank; Molnar, Peter; Fatichi, Simone; Burlando, Paolo

2016-04-01

Urban drainage response is highly dependent on the spatial and temporal structure of rainfall. Therefore, measuring and simulating rainfall at a high spatial and temporal resolution is a fundamental step to fully assess urban drainage system reliability and related uncertainties. This is even more relevant when considering extreme rainfall events. However, the current space-time rainfall models have limitations in capturing extreme rainfall intensity statistics for short durations. Here, we use the STREAP (Space-Time Realizations of Areal Precipitation) model, which is a novel stochastic rainfall generator for simulating high-resolution rainfall fields that preserve the spatio-temporal structure of rainfall and its statistical characteristics. The model enables a generation of rain fields at 102 m and minute scales in a fast and computer-efficient way matching the requirements for hydrological analysis of urban drainage systems. The STREAP model was applied successfully in the past to generate high-resolution extreme rainfall intensities over a small domain. A sub-catchment in the city of Luzern (Switzerland) was chosen as a case study to: (i) evaluate the ability of STREAP to disaggregate extreme rainfall intensities for urban drainage applications; (ii) assessing the role of stochastic climate variability of rainfall in flow response and (iii) evaluate the degree of non-linearity between extreme rainfall intensity and system response (i.e. flow) for a small urban catchment. The channel flow at the catchment outlet is simulated by means of a calibrated hydrodynamic sewer model.

Asthma in Patients Climbing to High and Extreme Altitudes in the Tibetan Everest Region

NARCIS (Netherlands)

Huismans, Henrike K.; Douma, W. Rob; Kerstjens, Huib A. M.; Renkema, Tineke E. J.

Objectives: The aim of this study was to investigate the behavior of asthma in patients traveling to high and extreme altitudes. Methods: Twenty-four Dutch patients with mild asthma did a trekking at high and extreme altitudes (up to 6410 m = 21030 ft) in the Tibetan Everest region. Asthma symptoms,

Extreme value modelling of Ghana stock exchange index.

Science.gov (United States)

Nortey, Ezekiel N N; Asare, Kwabena; Mettle, Felix Okoe

2015-01-01

Modelling of extreme events has always been of interest in fields such as hydrology and meteorology. However, after the recent global financial crises, appropriate models for modelling of such rare events leading to these crises have become quite essential in the finance and risk management fields. This paper models the extreme values of the Ghana stock exchange all-shares index (2000-2010) by applying the extreme value theory (EVT) to fit a model to the tails of the daily stock returns data. A conditional approach of the EVT was preferred and hence an ARMA-GARCH model was fitted to the data to correct for the effects of autocorrelation and conditional heteroscedastic terms present in the returns series, before the EVT method was applied. The Peak Over Threshold approach of the EVT, which fits a Generalized Pareto Distribution (GPD) model to excesses above a certain selected threshold, was employed. Maximum likelihood estimates of the model parameters were obtained and the model's goodness of fit was assessed graphically using Q-Q, P-P and density plots. The findings indicate that the GPD provides an adequate fit to the data of excesses. The size of the extreme daily Ghanaian stock market movements were then computed using the value at risk and expected shortfall risk measures at some high quantiles, based on the fitted GPD model.

High resolution extremity CT for biomechanics modeling

International Nuclear Information System (INIS)

Ashby, A.E.; Brand, H.; Hollerbach, K.; Logan, C.M.; Martz, H.E.

1995-01-01

With the advent of ever more powerful computing and finite element analysis (FEA) capabilities, the bone and joint geometry detail available from either commercial surface definitions or from medical CT scans is inadequate. For dynamic FEA modeling of joints, precise articular contours are necessary to get appropriate contact definition. In this project, a fresh cadaver extremity was suspended in parafin in a lucite cylinder and then scanned with an industrial CT system to generate a high resolution data set for use in biomechanics modeling

High resolution extremity CT for biomechanics modeling

Energy Technology Data Exchange (ETDEWEB)

Ashby, A.E.; Brand, H.; Hollerbach, K.; Logan, C.M.; Martz, H.E.

1995-09-23

With the advent of ever more powerful computing and finite element analysis (FEA) capabilities, the bone and joint geometry detail available from either commercial surface definitions or from medical CT scans is inadequate. For dynamic FEA modeling of joints, precise articular contours are necessary to get appropriate contact definition. In this project, a fresh cadaver extremity was suspended in parafin in a lucite cylinder and then scanned with an industrial CT system to generate a high resolution data set for use in biomechanics modeling.

Risk Formulations versus Comprehensive Uncertainty Characterizations for Climate Extremes and their Impacts

Science.gov (United States)

Parish, E. S.; Ganguly, A. R.

2009-12-01

Climate extremes—defined inclusively as extreme hydro-metrological events and regional changes in climate patterns at decadal scales—and their impacts on natural, engineered or human systems, represent among the most significant knowledge-gaps in climate prediction and integrated assessments in a post-AR4 world. Risks and uncertainties are related but distinct concepts. However, their relevance to decision-support tools in the context of climate change is indisputable. The opportunities and challenges are presented with case studies developed for stakeholders and policy makers.

Operational early warning platform for extreme meteorological events

Science.gov (United States)

Mühr, Bernhard; Kunz, Michael

2015-04-01

Operational early warning platform for extreme meteorological events Most natural disasters are related to extreme weather events (e.g. typhoons); weather conditions, however, are also highly relevant for humanitarian and disaster relief operations during and after other natural disaster like earthquakes. The internet service "Wettergefahren-Frühwarnung" (WF) provides various information on extreme weather events, especially when these events are associated with a high potential for large damage. The main focus of the platform is on Central Europe, but major events are also monitored worldwide on a daily routine. WF provides high-resolution forecast maps for many weather parameters which allow detailed and reliable predictions about weather conditions during the next days in the affected areas. The WF service became operational in February 2004 and is part of the Center for Disaster Management and Risk Reduction Technology (CEDIM) since 2007. At the end of 2011, CEDIM embarked a new type of interdisciplinary disaster research termed as forensic disaster analysis (FDA) in near real time. In case of an imminent extreme weather event WF plays an important role in CEDIM's FDA group. It provides early and precise information which are always available and updated several times during a day and gives advice and assists with articles and reports on extreme events.

Detection and attribution of extreme weather disasters

Science.gov (United States)

Huggel, Christian; Stone, Dáithí; Hansen, Gerrit

2014-05-01

Single disasters related to extreme weather events have caused loss and damage on the order of up to tens of billions US dollars over the past years. Recent disasters fueled the debate about whether and to what extent these events are related to climate change. In international climate negotiations disaster loss and damage is now high on the agenda, and related policy mechanisms have been discussed or are being implemented. In view of funding allocation and effective risk reduction strategies detection and attribution to climate change of extreme weather events and disasters is a key issue. Different avenues have so far been taken to address detection and attribution in this context. Physical climate sciences have developed approaches, among others, where variables that are reasonably sampled over climatically relevant time periods and related to the meteorological characteristics of the extreme event are examined. Trends in these variables (e.g. air or sea surface temperatures) are compared between observations and climate simulations with and without anthropogenic forcing. Generally, progress has been made in recent years in attribution of changes in the chance of some single extreme weather events to anthropogenic climate change but there remain important challenges. A different line of research is primarily concerned with losses related to the extreme weather events over time, using disaster databases. A growing consensus is that the increase in asset values and in exposure are main drivers of the strong increase of economic losses over the past several decades, and only a limited number of studies have found trends consistent with expectations from climate change. Here we propose a better integration of existing lines of research in detection and attribution of extreme weather events and disasters by applying a risk framework. Risk is thereby defined as a function of the probability of occurrence of an extreme weather event, and the associated consequences

Production processes at extremely high energies

CERN Document Server

Gastmans, R; Wu, Tai Tsun

2013-01-01

The production processes are identified that contribute to the rise of the total cross section in proton-proton scattering at extremely high energies, s->~. At such energies, the scattering can be described by a black disk (completely absorptive) with a radius expanding logarithmically with energy surrounded by a gray fringe (partially absorptive). For the leading term of (lns)^2 in the increasing total cross section, the gray fringe is neglected, and geometrical optics is generalized to production processes. It is known that half of the rise in the total cross section is due to elastic scattering. The other half is found to originate from the production of jets with relatively small momenta in the center-of-mass system.

[Crossing borders. The motivation of extreme sportsmen].

Science.gov (United States)

Opaschowski, H W

2005-08-01

In his article "Crossing borders -- the motivation of extreme sportsmen" the author gets systematically to the bottom of the question of why extreme sportsmen voluntarily take risks and endanger themselves. Within the scope of a representative sampling 217 extreme sportsmen -- from the fields of mountain biking, trekking and free climbing, canoyning, river rafting and deep sea diving, paragliding, parachuting, bungee jumping and survival training -- give information about their personal motives. What fascinates them? The attraction of risk? The search for sensation? Or the drop out of everyday life? And what comes afterwards? Does in the end the whole life become an extreme sport? Fact is: they live extremely, because they want to move beyond well-trodden paths. To escape the boredom of everyday life they are searching for the kick, the thrill, the no-limit experience. It's about calculated risk between altitude flight and deep sea adventure.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China.

Science.gov (United States)

Wang, Xuying; Li, Guoxing; Liu, Liqun; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan

2015-12-21

Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

A spatial assessment framework for evaluating flood risk under extreme climates.

Science.gov (United States)

Chen, Yun; Liu, Rui; Barrett, Damian; Gao, Lei; Zhou, Mingwei; Renzullo, Luigi; Emelyanova, Irina

2015-12-15

Australian coal mines have been facing a major challenge of increasing risk of flooding caused by intensive rainfall events in recent years. In light of growing climate change concerns and the predicted escalation of flooding, estimating flood inundation risk becomes essential for understanding sustainable mine water management in the Australian mining sector. This research develops a spatial multi-criteria decision making prototype for the evaluation of flooding risk at a regional scale using the Bowen Basin and its surroundings in Queensland as a case study. Spatial gridded data, including climate, hydrology, topography, vegetation and soils, were collected and processed in ArcGIS. Several indices were derived based on time series of observations and spatial modeling taking account of extreme rainfall, evapotranspiration, stream flow, potential soil water retention, elevation and slope generated from a digital elevation model (DEM), as well as drainage density and proximity extracted from a river network. These spatial indices were weighted using the analytical hierarchy process (AHP) and integrated in an AHP-based suitability assessment (AHP-SA) model under the spatial risk evaluation framework. A regional flooding risk map was delineated to represent likely impacts of criterion indices at different risk levels, which was verified using the maximum inundation extent detectable by a time series of remote sensing imagery. The result provides baseline information to help Bowen Basin coal mines identify and assess flooding risk when making adaptation strategies and implementing mitigation measures in future. The framework and methodology developed in this research offers the Australian mining industry, and social and environmental studies around the world, an effective way to produce reliable assessment on flood risk for managing uncertainty in water availability under climate change. Copyright © 2015. Published by Elsevier B.V.

Extremely Durable, Flexible Supercapacitors with Greatly Improved Performance at High Temperatures.

Science.gov (United States)

Kim, Sung-Kon; Kim, Hae Jin; Lee, Jong-Chan; Braun, Paul V; Park, Ho Seok

2015-08-25

The reliability and durability of energy storage devices are as important as their essential characteristics (e.g., energy and power density) for stable power output and long lifespan and thus much more crucial under harsh conditions. However, energy storage under extreme conditions is still a big challenge because of unavoidable performance decays and the inevitable damage of components. Here, we report high-temperature operating, flexible supercapacitors (f-SCs) that can provide reliable power output and extreme durability under severe electrochemical, mechanical, and thermal conditions. The outstanding capacitive features (e.g., ∼40% enhancement of the rate capability and a maximum capacitances of 170 F g(-1) and 18.7 mF cm(-2) at 160 °C) are attributed to facilitated ion transport at elevated temperatures. Under high-temperature operation and/or a flexibility test in both static and dynamic modes at elevated temperatures >100 °C, the f-SCs showed extreme long-term stability of 100000 cycles (>93% of initial capacitance value) and mechanical durability after hundreds of bending cycles (at bend angles of 60-180°). Even at 120 °C, the versatile design of tandem serial and parallel f-SCs was demonstrated to provide both desirable energy and power requirements at high temperatures.

Assessing future climatic changes of rainfall extremes at small spatio-temporal scales

DEFF Research Database (Denmark)

Gregersen, Ida Bülow; Sørup, Hjalte Jomo Danielsen; Madsen, Henrik

2013-01-01

Climate change is expected to influence the occurrence and magnitude of rainfall extremes and hence the flood risks in cities. Major impacts of an increased pluvial flood risk are expected to occur at hourly and sub-hourly resolutions. This makes convective storms the dominant rainfall type...... in relation to urban flooding. The present study focuses on high-resolution regional climate model (RCM) skill in simulating sub-daily rainfall extremes. Temporal and spatial characteristics of output from three different RCM simulations with 25 km resolution are compared to point rainfall extremes estimated...... from observed data. The applied RCM data sets represent two different models and two different types of forcing. Temporal changes in observed extreme point rainfall are partly reproduced by the RCM RACMO when forced by ERA40 re-analysis data. Two ECHAM forced simulations show similar increases...

Analysis of extreme events

CSIR Research Space (South Africa)

Khuluse, S

2009-04-01

Full Text Available ) determination of the distribution of the damage and (iii) preparation of products that enable prediction of future risk events. The methodology provided by extreme value theory can also be a powerful tool in risk analysis...

Design, fabrication, and characterization of high-efficiency extreme ultraviolet diffusers

Energy Technology Data Exchange (ETDEWEB)

Naulleau, Patrick P.; Liddle, J. Alexander; Salmassi, Farhad; Anderson, Erik H.; Gullikson, Eric M.

2004-02-19

As the development of extreme ultraviolet (EUV) lithography progresses, interest grows in the extension of traditional optical components to the EUV regime. The strong absorption of EUV by most materials and its extremely short wavelength, however, makes it very difficult to implement many components that are commonplace in the longer wavelength regimes. One such example is the diffuser often implemented with ordinary ground glass in the visible light regime. Here we demonstrate the fabrication of reflective EUV diffusers with high efficiency within a controllable bandwidth. Using these techniques we have fabricated diffusers with efficiencies exceeding 10% within a moderate angular single-sided bandwidth of approximately 0.06 radians.

Bright high-repetition-rate source of narrowband extreme-ultraviolet harmonics beyond 22 eV

Energy Technology Data Exchange (ETDEWEB)

Wang, He [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division; Xu, Yiming [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division; Ulonska, Stefan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division; Robinson, Joseph S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division; Ranitovic, Predrag [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division; Kaindl, Robert A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Materials Sciences Division

2015-06-11

Novel table-top sources of extreme-ultraviolet light based on high-harmonic generation yield unique insight into the fundamental properties of molecules, nanomaterials or correlated solids, and enable advanced applications in imaging or metrology. Extending high-harmonic generation to high repetition rates portends great experimental benefits, yet efficient extreme-ultraviolet conversion of correspondingly weak driving pulses is challenging. In this article, we demonstrate a highly-efficient source of femtosecond extreme-ultraviolet pulses at 50-kHz repetition rate, utilizing the ultraviolet second-harmonic focused tightly into Kr gas. In this cascaded scheme, a photon flux beyond ≈3 × 10¹³ s^-1 is generated at 22.3 eV, with 5 × 10^-5 conversion efficiency that surpasses similar harmonics directly driven by the fundamental by two orders-of-magnitude. The enhancement arises from both wavelength scaling of the atomic dipole and improved spatio-temporal phase matching, confirmed by simulations. Finally, spectral isolation of a single 72-meV-wide harmonic renders this bright, 50-kHz extreme-ultraviolet source a powerful tool for ultrafast photoemission, nanoscale imaging and other applications.

Extreme Weather and Climate: Workshop Report

Science.gov (United States)

Sobel, Adam; Camargo, Suzana; Debucquoy, Wim; Deodatis, George; Gerrard, Michael; Hall, Timothy; Hallman, Robert; Keenan, Jesse; Lall, Upmanu; Levy, Marc;

Achieving Conservation and Equity amidst Extreme Poverty and Climate Risk: The Makira REDD+ Project in Madagascar

Directory of Open Access Journals (Sweden)

Laura Brimont

2015-03-01

Full Text Available Achieving forest conservation together with poverty alleviation and equity is an unending challenge in the tropics. The Makira REDD+ pilot project located in northeastern Madagascar is a well-suited case to explore this challenge in conditions of extreme poverty and climatic vulnerability. We assessed the potential effect of project siting on the livelihoods of the local population and which households would be the most strongly impacted by conservation measures. Farmers living in hilly areas must resort to slash-and-burn agriculture (tavy since a combination of topographic and climatic constraints, such as cyclones, makes permanent rice cultivation very difficult. These are the people who suffer most from conservation-related restriction measures. For practical reasons the project, unfortunately, did not target these farmers. The main focus was on communities with a lower cyclonic risk that are able to practice permanent rice agriculture in the lowlands. To reduce deforestation without violating the principles of equity, REDD+ projects in Madagascar need to better target populations facing high climatic risks and invest in efforts to improve the farmers’ agricultural systems.

Making Energy-Water Nexus Scenarios more Fit-for-Purpose through Better Characterization of Extremes

Science.gov (United States)

Yetman, G.; Levy, M. A.; Chen, R. S.; Schnarr, E.

2017-12-01

Often quantitative scenarios of future trends exhibit less variability than the historic data upon which the models that generate them are based. The problem of dampened variability, which typically also entails dampened extremes, manifests both temporally and spatially. As a result, risk assessments that rely on such scenarios are in danger of producing misleading results. This danger is pronounced in nexus issues, because of the multiple dimensions of change that are relevant. We illustrate the above problem by developing alternative joint distributions of the probability of drought and of human population totals, across U.S. counties over the period 2010-2030. For the dampened-extremes case we use drought frequencies derived from climate models used in the U.S. National Climate Assessment and the Environmental Protection Agency's population and land use projections contained in its Integrated Climate and Land Use Scenarios (ICLUS). For the elevated extremes case we use an alternative spatial drought frequency estimate based on tree-ring data, covering a 555-year period (Ho et al 2017); and we introduce greater temporal and spatial extremes in the ICLUS socioeconomic projections so that they conform to observed extremes in the historical U.S. spatial census data 1790-present (National Historical Geographic Information System). We use spatial and temporal coincidence of high population and extreme drought as a proxy for energy-water nexus risk. We compare the representation of risk in the dampened-extreme and elevated-extreme scenario analysis. We identify areas of the country where using more realistic portrayals of extremes makes the biggest difference in estimate risk and suggest implications for future risk assessments. References: Michelle Ho, Upmanu Lall, Xun Sun, Edward R. Cook. 2017. Multiscale temporal variability and regional patterns in 555 years of conterminous U.S. streamflow. Water Resources Research. . doi: 10.1002/2016WR019632

High-Risk List

Science.gov (United States)

2017-01-01

economy. The World Bank has said that “corruption creates an unfavorable business environment by undermining the operation efficiency of firms and... Bank Began as ‘Ponzi Scheme,’” 11/27/2012. 64 Independent Joint Anti-Corruption Monitoring and Evaluation Committee, Unfinished Business : The Follow...HIGH RISK AREA 7: Oversight 51 HIGH-RISK AREA 8: Strategy and Planning 55 CONCLUSION HIGH RISK LIST I JANUARY 11, 2017 2 EXECUTIVE SUMMARY

Extreme weather events and infectious disease outbreaks.

Science.gov (United States)

McMichael, Anthony J

2015-01-01

Human-driven climatic changes will fundamentally influence patterns of human health, including infectious disease clusters and epidemics following extreme weather events. Extreme weather events are projected to increase further with the advance of human-driven climate change. Both recent and historical experiences indicate that infectious disease outbreaks very often follow extreme weather events, as microbes, vectors and reservoir animal hosts exploit the disrupted social and environmental conditions of extreme weather events. This review article examines infectious disease risks associated with extreme weather events; it draws on recent experiences including Hurricane Katrina in 2005 and the 2010 Pakistan mega-floods, and historical examples from previous centuries of epidemics and 'pestilence' associated with extreme weather disasters and climatic changes. A fuller understanding of climatic change, the precursors and triggers of extreme weather events and health consequences is needed in order to anticipate and respond to the infectious disease risks associated with human-driven climate change. Post-event risks to human health can be constrained, nonetheless, by reducing background rates of persistent infection, preparatory action such as coordinated disease surveillance and vaccination coverage, and strengthened disaster response. In the face of changing climate and weather conditions, it is critically important to think in ecological terms about the determinants of health, disease and death in human populations.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China

Directory of Open Access Journals (Sweden)

Xuying Wang

2015-12-01

Full Text Available Objective: Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. Methods: We collected data from Beijing and Shanghai, China, during 2007–2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. Results: For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0–27, while the hot effects reached the strongest at lag 0–14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34 to extremely low temperature. Conclusion: People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Can Regional Climate Models be used in the assessment of vulnerability and risk caused by extreme events?

Science.gov (United States)

Nunes, Ana

2015-04-01

Extreme meteorological events played an important role in catastrophic occurrences observed in the past over densely populated areas in Brazil. This motived the proposal of an integrated system for analysis and assessment of vulnerability and risk caused by extreme events in urban areas that are particularly affected by complex topography. That requires a multi-scale approach, which is centered on a regional modeling system, consisting of a regional (spectral) climate model coupled to a land-surface scheme. This regional modeling system employs a boundary forcing method based on scale-selective bias correction and assimilation of satellite-based precipitation estimates. Scale-selective bias correction is a method similar to the spectral nudging technique for dynamical downscaling that allows internal modes to develop in agreement with the large-scale features, while the precipitation assimilation procedure improves the modeled deep-convection and drives the land-surface scheme variables. Here, the scale-selective bias correction acts only on the rotational part of the wind field, letting the precipitation assimilation procedure to correct moisture convergence, in order to reconstruct South American current climate within the South American Hydroclimate Reconstruction Project. The hydroclimate reconstruction outputs might eventually produce improved initial conditions for high-resolution numerical integrations in metropolitan regions, generating more reliable short-term precipitation predictions, and providing accurate hidrometeorological variables to higher resolution geomorphological models. Better representation of deep-convection from intermediate scales is relevant when the resolution of the regional modeling system is refined by any method to meet the scale of geomorphological dynamic models of stability and mass movement, assisting in the assessment of risk areas and estimation of terrain stability over complex topography. The reconstruction of past extreme

A comparison of observed extreme water levels at the German Bight elaborated through an extreme value analysis (EVA) with extremes derived from a regionally coupled ocean-atmospheric climate model (MPI-OM)

Science.gov (United States)

Möller, Jens; Heinrich, Hartmut

2017-04-01

As a consequence of climate change atmospheric and oceanographic extremes and their potential impacts on coastal regions are of growing concern for governmental authorities responsible for the transportation infrastructure. Highest risks for shipping as well as for rail and road traffic originate from combined effects of extremes of storm surges and heavy rainfall which sometimes lead to insufficient dewatering of inland waterways. The German Ministry of Transport and digital Infrastructure therefore has tasked its Network of Experts to investigate the possible evolutions of extreme threats for low lands and especially for Kiel Canal, which is an important shortcut for shipping between the North and Baltic Seas. In this study we present results of a comparison of an Extreme Value Analysis (EVA) carried out on gauge observations and values derived from a coupled Regional Ocean-Atmosphere Climate Model (MPI-OM). High water levels at the coasts of the North and Baltic Seas are one of the most important hazards which increase the risk of flooding of the low-lying land and prevents such areas from an adequate dewatering. In this study changes in the intensity (magnitude of the extremes) and duration of extreme water levels (above a selected threshold) are investigated for several gauge stations with data partly reaching back to 1843. Different methods are used for the extreme value statistics, (1) a stationary general Pareto distribution (GPD) model as well as (2) an instationary statistical model for better reproduction of the impact of climate change. Most gauge stations show an increase of the mean water level of about 1-2 mm/year, with a stronger increase of the highest water levels and a decrease (or lower increase) of the lowest water levels. Also, the duration of possible dewatering time intervals for the Kiel-Canal was analysed. The results for the historical gauge station observations are compared to the statistics of modelled water levels from the coupled

Haplotype Analysis Discriminates Genetic Risk for DR3-Associated Endocrine Autoimmunity and Helps Define Extreme Risk for Addison’s Disease

Science.gov (United States)

Baker, Peter R.; Baschal, Erin E.; Fain, Pam R.; Triolo, Taylor M.; Nanduri, Priyaanka; Siebert, Janet C.; Armstrong, Taylor K.; Babu, Sunanda R.; Rewers, Marian J.; Gottlieb, Peter A.; Barker, Jennifer M.; Eisenbarth, George S.

2010-01-01

Context: Multiple autoimmune disorders (e.g. Addison’s disease, type 1 diabetes, celiac disease) are associated with HLA-DR3, but it is likely that alleles of additional genes in linkage disequilibrium with HLA-DRB1 contribute to disease. Objective: The objective of the study was to characterize major histocompatability complex (MHC) haplotypes conferring extreme risk for autoimmune Addison’s disease (AD). Design, Setting, and Participants: Eighty-six 21-hydroxylase autoantibody-positive, nonautoimmune polyendocrine syndrome type 1, Caucasian individuals collected from 1992 to 2009 with clinical AD from 68 families (12 multiplex and 56 simplex) were genotyped for HLA-DRB1, HLA-DQB1, MICA, HLA-B, and HLA-A as well as high density MHC single-nucleotide polymorphism (SNP) analysis for 34. Main Outcome Measures: AD and genotype were measured. Result: Ninety-seven percent of the multiplex individuals had both HLA-DR3 and HLA-B8 vs. 60% of simplex AD patients (P = 9.72 × 10−4) and 13% of general population controls (P = 3.00 × 10−19). The genotype DR3/DR4 with B8 was present in 85% of AD multiplex patients, 24% of simplex patients, and 1.5% of control individuals (P = 4.92 × 10−191). The DR3-B8 haplotype of AD patients had HLA-A1 less often (47%) than controls (81%, P = 7.00 × 10−5) and type 1 diabetes patients (73%, P = 1.93 × 10−3). Analysis of 1228 SNPs across the MHC for individuals with AD revealed a shorter conserved haplotype (3.8) with the loss of the extended conserved 3.8.1 haplotype approximately halfway between HLA-B and HLA-A. Conclusion: Extreme risk for AD, especially in multiplex families, is associated with haplotypic DR3 variants, in particular a portion (3.8) but not all of the conserved 3.8.1 haplotype. PMID:20631027

Censored rainfall modelling for estimation of fine-scale extremes

Science.gov (United States)

Cross, David; Onof, Christian; Winter, Hugo; Bernardara, Pietro

2018-01-01

Reliable estimation of rainfall extremes is essential for drainage system design, flood mitigation, and risk quantification. However, traditional techniques lack physical realism and extrapolation can be highly uncertain. In this study, we improve the physical basis for short-duration extreme rainfall estimation by simulating the heavy portion of the rainfall record mechanistically using the Bartlett-Lewis rectangular pulse (BLRP) model. Mechanistic rainfall models have had a tendency to underestimate rainfall extremes at fine temporal scales. Despite this, the simple process representation of rectangular pulse models is appealing in the context of extreme rainfall estimation because it emulates the known phenomenology of rainfall generation. A censored approach to Bartlett-Lewis model calibration is proposed and performed for single-site rainfall from two gauges in the UK and Germany. Extreme rainfall estimation is performed for each gauge at the 5, 15, and 60 min resolutions, and considerations for censor selection discussed.

Remembering the best and worst of times: memories for extreme outcomes bias risky decisions.

Science.gov (United States)

Madan, Christopher R; Ludvig, Elliot A; Spetch, Marcia L

2014-06-01

When making decisions on the basis of past experiences, people must rely on their memories. Human memory has many well-known biases, including the tendency to better remember highly salient events. We propose an extreme-outcome rule, whereby this memory bias leads people to overweight the largest gains and largest losses, leading to more risk seeking for relative gains than for relative losses. To test this rule, in two experiments, people repeatedly chose between fixed and risky options, where the risky option led equiprobably to more or less than did the fixed option. As was predicted, people were more risk seeking for relative gains than for relative losses. In subsequent memory tests, people tended to recall the extreme outcome first and also judged the extreme outcome as having occurred more frequently. Across individuals, risk preferences in the risky-choice task correlated with these memory biases. This extreme-outcome rule presents a novel mechanism through which memory influences decision making.

Isolated psychosis during exposure to very high and extreme altitude - characterisation of a new medical entity.

Science.gov (United States)

Hüfner, Katharina; Brugger, Hermann; Kuster, Eva; Dünsser, Franziska; Stawinoga, Agnieszka E; Turner, Rachel; Tomazin, Iztok; Sperner-Unterweger, Barbara

2017-12-05

Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity. Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Eighty-three of the episodes collected underwent a cluster analysis to identify similar groups. Ratings were done by two independent, trained researchers (κ values 0.6-1). Findings Cluster 1 included 51% (42/83) episodes without psychosis; cluster 2 22% (18/83) cases with psychosis, plus symptoms of HACE or mental status change from other origins; and cluster 3 28% (23/83) episodes with isolated psychosis. Possible risk factors of psychosis and associated somatic symptoms were analysed between the three clusters and revealed differences regarding the factors 'starvation' (χ2 test, p = 0.002), 'frostbite' (p = 0.024) and 'supplemental oxygen' (p = 0.046). Episodes with psychosis were reversible but associated with near accidents and accidents (p = 0.007, odds ratio 4.44). Episodes of psychosis during exposure to high altitude are frequently reported, but have not been specifically examined or assigned to medical diagnoses. In addition to the risk of suffering from somatic mountain illnesses, climbers and workers at high altitude should be aware of the potential occurrence of psychotic episodes, the associated risks and respective coping strategies.

Characteristics of extreme ultraviolet emission from high-Z plasmas

International Nuclear Information System (INIS)

Ohashi, H.; Higashiguchi, T.; Suzuki, Y.; Kawasaki, M.; Suzuki, C.; Tomita, K.; Nishikino, M.; Fujioka, S.; Endo, A.; Li, B.; Otsuka, T.; Dunne, P.; O'Sullivan, G.

2016-01-01

We demonstrate the extreme ultraviolet (EUV) and soft x-ray sources in the 2 to 7 nm spectral region related to the beyond EUV (BEUV) question at 6.x nm and the water window source based on laser-produced high-Z plasmas. Resonance emission from multiply charged ions merges to produce intense unresolved transition arrays (UTAs), extending below the carbon K edge (4.37 nm). An outline of a microscope design for single-shot live cell imaging is proposed based on high-Z plasma UTA source, coupled to multilayer mirror optics. (paper)

Characteristics of extreme ultraviolet emission from high-Z plasmas

Science.gov (United States)

Ohashi, H.; Higashiguchi, T.; Suzuki, Y.; Kawasaki, M.; Suzuki, C.; Tomita, K.; Nishikino, M.; Fujioka, S.; Endo, A.; Li, B.; Otsuka, T.; Dunne, P.; O'Sullivan, G.

2016-03-01

We demonstrate the extreme ultraviolet (EUV) and soft x-ray sources in the 2 to 7 nm spectral region related to the beyond EUV (BEUV) question at 6.x nm and the water window source based on laser-produced high-Z plasmas. Resonance emission from multiply charged ions merges to produce intense unresolved transition arrays (UTAs), extending below the carbon K edge (4.37 nm). An outline of a microscope design for single-shot live cell imaging is proposed based on high-Z plasma UTA source, coupled to multilayer mirror optics.

Probability modeling of high flow extremes in Yingluoxia watershed, the upper reaches of Heihe River basin

Science.gov (United States)

Li, Zhanling; Li, Zhanjie; Li, Chengcheng

2014-05-01

Probability modeling of hydrological extremes is one of the major research areas in hydrological science. Most basins in humid and semi-humid south and east of China are concerned for probability modeling analysis of high flow extremes. While, for the inland river basin which occupies about 35% of the country area, there is a limited presence of such studies partly due to the limited data availability and a relatively low mean annual flow. The objective of this study is to carry out probability modeling of high flow extremes in the upper reach of Heihe River basin, the second largest inland river basin in China, by using the peak over threshold (POT) method and Generalized Pareto Distribution (GPD), in which the selection of threshold and inherent assumptions for POT series are elaborated in details. For comparison, other widely used probability distributions including generalized extreme value (GEV), Lognormal, Log-logistic and Gamma are employed as well. Maximum likelihood estimate is used for parameter estimations. Daily flow data at Yingluoxia station from 1978 to 2008 are used. Results show that, synthesizing the approaches of mean excess plot, stability features of model parameters, return level plot and the inherent independence assumption of POT series, an optimum threshold of 340m3/s is finally determined for high flow extremes in Yingluoxia watershed. The resulting POT series is proved to be stationary and independent based on Mann-Kendall test, Pettitt test and autocorrelation test. In terms of Kolmogorov-Smirnov test, Anderson-Darling test and several graphical diagnostics such as quantile and cumulative density function plots, GPD provides the best fit to high flow extremes in the study area. The estimated high flows for long return periods demonstrate that, as the return period increasing, the return level estimates are probably more uncertain. The frequency of high flow extremes exhibits a very slight but not significant decreasing trend from 1978 to

Neoadjuvant Interdigitated Chemoradiotherapy Using Mesna, Doxorubicin, and Ifosfamide for Large, High-grade, Soft Tissue Sarcomas of the Extremity: Improved Efficacy and Reduced Toxicity.

Science.gov (United States)

Chowdhary, Mudit; Sen, Neilayan; Jeans, Elizabeth B; Miller, Luke; Batus, Marta; Gitelis, Steven; Wang, Dian; Abrams, Ross A

2018-05-18

Patients with large, high-grade extremity soft tissue sarcoma (STS) are at high risk for both local and distant recurrence. RTOG 95-14, using a regimen of neoadjuvant interdigitated chemoradiotherapy with mesna, doxorubicin, ifosfamide, and dacarbazine followed by surgery and 3 cycles of adjuvant mesna, doxorubicin, ifosfamide, and dacarbazine, demonstrated high rates of disease control at the cost of significant toxicity (83% grade 4, 5% grade 5). As such, this regimen has not been widely adopted. Herein, we report our institutional outcomes utilizing a modified interdigitated chemoradiotherapy regimen, without dacarbazine, and current radiotherapy planning and delivery techniques for high-risk STS. Adults with large (≥5 cm; median, 12.9 cm), grade 3 extremity STS who were prospectively treated as part of our institutional standard of care from 2008 to 2016 are included. Neoadjuvant chemoradiotherapy consisted of 3 cycles of mesna, doxorubicin, and ifosfamide (MAI) and 44 Gy (22 Gy in 11 fractions between cycles of MAI) after which patients underwent surgical resection and received 3 additional cycles of MAI. Twenty-six patients received the MAI treatment protocol. At a median follow-up of 47.3 months, 23 (88.5%) patients are still alive. Three year locoregional recurrence-free survival, disease-free survival, and overall survival are 95.0%, 64.0%, and 95.0%, respectively. There have been no therapy-related deaths or secondary malignancies. The nonhematologic grade 4 toxicity rate was 7.7%. Neoadjuvant interdigitated MAI radiotherapy followed by resection and 3 cycles of adjuvant MAI has resulted in acceptable and manageable toxicity and highly favorable survival in patients at greatest risk for treatment failure.

Rapid Global River Flood Risk Assessment under Climate and Socioeconomic Scenarios: An Extreme Case of Eurasian region

Science.gov (United States)

Kwak, Young-joo; Magome, Jun; Hasegawa, Akira; Iwami, Yoichi

2017-04-01

Causing widespread devastation with massive economic damage and loss of human lives, flood disasters hamper economic growth and accelerate poverty particularly in developing countries. Globally, this trend will likely continue due to increase in flood magnitude and lack of preparedness for extreme events. In line with risk reduction efforts since the early 21st century, the monitors and governors of global river floods should pay attention to international scientific and policy communities for support to facilitate evidence-based policy making with a special interest in long-term changes due to climate change and socio-economic effects. Although advanced hydrological inundation models and risk models have been developed to reveal flood risk, hazard, exposure, and vulnerability at a river basin, it is obviously hard to identify the distribution and locations of continent-level flood risk based on national-level data. Therefore, we propose a methodological possibility for rapid global flood risk assessment with the results from its application to the two periods, i.e., Present (from 1980 to 2004) and Future (from 2075 to 2099). The method is particularly designed to effectively simplify complexities of a hazard area by calculating the differential inundation depth using GFID2M (global flood inundation depth 2-dimension model), despite low data availability. In this research, we addressed the question of which parts in the Eurasian region (8E to 180E, 0N to 60N) can be found as high-risk areas in terms of exposed population and economy in case of a 50-year return period flood. Economic losses were estimated according to the Shared Socioeconomic Pathways (SSP) scenario, and the flood scale was defined using the annual maximum daily river discharge under the extreme conditions of climate change simulated with MRI-AGCM3.2S based on the Representative Concentration Pathways (RCP8.5) emissions scenario. As a preliminary result, the total potential economic loss in the

Sonographically Assessed Intra-Abdominal Fat And Cardiometabolic Risk Factors in Adolescents with Extreme Obesity

Directory of Open Access Journals (Sweden)

Anja Moss

2016-04-01

Full Text Available Objective: The metabolic and cardiovascular risk of obesity is predominantly defined through the amount of intra-abdominal fat (IAF. Regarding this risk and the benefits of weight reduction gender-specific differences have been described. The aim of this study was to examine the gender-specific relationship between IAF assessed via ultrasound and the cardiometabolic risk profile in extremely obese adolescents before and after weight loss. Methods: In 107 consecutively admitted adolescents (n = 59 girls, mean age 15.4 ± 2.6 years boys and 15.1 ± 2.1 years girls, mean BMI z-score 3.2 ± 0.6 boys and 3.5 ± 0.6 girls anthropometric and fasting laboratory chemical parameters were measured before and after an in-patient long-term therapy (mean durance 5.6 ± 2.3 months. IAF was determined by measuring the intra-abdominal depth (IAD via ultrasound. Results: IAD was higher in boys as compared to girls (58.0 ± 22.4 mm vs. 51.3 ± 16.0 mm. IAD values were positively associated with BMI-z scores, waist circumferences, HOMA-IR and serum levels of γGT, hs-CRP and IL-6 in both genders. In boys, but not in girls, IAD was significantly correlated with systolic and diastolic blood pressure, serum levels of triglycerides, ALT as well as adiponectin and HDL-cholesterol. After a marked mean weight loss of -27.1 ± 16.2 kg (-20.1 ± 7.9% in boys and of -20.5 ± 11.5 kg (-17.3 ± 7.1% in girls, IAD decreased by -20.7 ± 16.2 mm (--32.4 ± 16.9% in boys and by -18.4 ± 12,7 mm (-34.3 ± 18.4% in girls, resulting in more pronounced ameliorations of cardiovascular risk factors in boys than in girls. Conclusions: The present study indicates that IAF assessed by ultrasound is a good indicator for the cardiometabolic risk factor profile in extremely obese adolescents. Associations between IAF and risk factors are more pronounced in boys than in girls.

The greenhouse effect and extreme weather

International Nuclear Information System (INIS)

Groenaas, Sigbjoern; Kvamstoe, Nils Gunnar

2002-01-01

The article asserts that an anthropogenic global warming is occurring. This greenhouse effect is expected to cause more occurrences of extreme weather. It is extremely difficult, however, to relate specific weather catastrophes to global warming with certainty, since such extreme weather conditions are rare historically. The subject is controversial. The article also discusses the public debate and the risk of floods

High Energy Ion Acceleration by Extreme Laser Radiation Pressure

Science.gov (United States)

2017-03-14

published in the internationally leading journal Physical Review Letters. We continued to progress this pionee 15.  SUBJECT TERMS ion therapy, heavy ion ...Thomson parabola spectrometer: To separate and provide a measurement of the charge -to-mass ratio and energy spectrum of the different ion species...AFRL-AFOSR-UK-TR-2017-0015 High energy ion acceleration by extreme laser radiation pressure Paul McKenna UNIVERSITY OF STRATHCLYDE VIZ ROYAL COLLEGE

Quantitative methods for stochastic high frequency spatio-temporal and non-linear analysis: Assessing health effects of exposure to extreme ambient temperature

Science.gov (United States)

Liss, Alexander

regionalization method algorithmically forms eight climatically homogeneous regions for Conterminous US from satellite Remote Sensing inputs. The relative risk of hospitalizations due to extreme ambient temperature varied across climatic regions. Difference in regional hospitalization rates suggests presence of an adaptation effect to a prevailing climate. In various climatic regions the hospitalizations peaked earlier than the peak of exposure. This suggests disproportionally high impact of extreme weather events, such as cold spells or heat waves when they occur early in the season. These findings provide an insight into the use of high frequency disjoint data sets for the assessment of the magnitude, timing, synchronization and non-linear properties of adverse health consequences due to exposure to extreme weather events to the elderly in defined climatic regions. These findings assist in the creation of decision support frameworks targeting preventions and adaptation strategies such as improving infrastructure, providing energy assistance, education and early warning notifications for the vulnerable population. This dissertation offers a number of methodological innovations for the assessment of the high frequency spatio-temporal and non-linear impacts of extreme weather events on human health. These innovations help to ensure an improved protection of the elderly population, aid policy makers in the development of efficient disaster prevention strategies, and facilitate more efficient allocation of scarce resources.

High Risk Behaviors in Marine Mammals: Linking Behavioral Responses to Anthropogenic Disturbance to Biological Consequences

Science.gov (United States)

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. High Risk Behaviors in Marine Mammals : Linking...comprehensive evaluation of biological safety zones for diving marine mammals . In this way we intend to identify those marine mammal species or specific...improving the protection of marine mammals during naval operations. OBJECTIVES We are testing the hypothesis that extreme behaviors requiring

Thiazide use is associated with reduced risk for incident lower extremity fractures in men with spinal cord injury.

Science.gov (United States)

Carbone, Laura D; Chin, Amy S; Lee, Todd A; Burns, Stephen P; Svircev, Jelena N; Hoenig, Helen M; Bailey, Lauren; Weaver, Frances M

2014-06-01

To determine the association between thiazide use and lower extremity fractures in patients who are men with a spinal cord injury (SCI). Cohort study from fiscal years 2002 to 2007. Medical centers. Men (N=6969) with an SCI from the Veterans Affairs (VA) Spinal Cord Dysfunction (SCD) Registry, including 1433 users of thiazides and 5536 nonusers of thiazides. Thiazide use versus nonuse. Incident lower extremity fractures. Among the men, 21% in the VA SCD Registry (fiscal years 2002-2007) included in these analyses used thiazide diuretics. There were 832 incident lower extremity fractures over the time period of this study: 110 fractures (7.7%) in 1433 thiazide users and 722 fractures (13%) in 5536 nonusers of thiazides. In unadjusted and adjusted models alike, thiazide use was associated with at least a one-quarter risk reduction in lower extremity fracture at any given point in time (unadjusted: hazard ratio (HR)=.75; 95% confidence interval (CI), .59-.94; adjusted: HR=.74; 95% CI, .58-.95). Thiazide use is common in men with SCI and is associated with a decreased likelihood for lower extremity fractures. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Risk-based damage potential and loss estimation of extreme flooding scenarios in the Austrian Federal Province of Tyrol

Directory of Open Access Journals (Sweden)

M. Huttenlau

2010-12-01

Full Text Available Within the last decades serious flooding events occurred in many parts of Europe and especially in 2005 the Austrian Federal Province of Tyrol was serious affected. These events in general and particularly the 2005 event have sensitised decision makers and the public. Beside discussions pertaining to protection goals and lessons learnt, the issue concerning potential consequences of extreme and severe flooding events has been raised. Additionally to the general interest of the public, decision makers of the insurance industry, public authorities, and responsible politicians are especially confronted with the question of possible consequences of extreme events. Answers thereof are necessary for the implementation of preventive appropriate risk management strategies. Thereby, property and liability losses reflect a large proportion of the direct tangible losses. These are of great interest for the insurance sector and can be understood as main indicators to interpret the severity of potential events. The natural scientific-technical risk analysis concept provides a predefined and structured framework to analyse the quantities of affected elements at risk, their corresponding damage potentials, and the potential losses. Generally, this risk concept framework follows the process steps hazard analysis, exposition analysis, and consequence analysis. Additionally to the conventional hazard analysis, the potential amount of endangered elements and their corresponding damage potentials were analysed and, thereupon, concrete losses were estimated. These took the specific vulnerability of the various individual elements at risk into consideration. The present flood risk analysis estimates firstly the general exposures of the risk indicators in the study area and secondly analyses the specific exposures and consequences of five extreme event scenarios. In order to precisely identify, localize, and characterize the relevant risk indicators of buildings

Extremity x-ray

Science.gov (United States)

... page: //medlineplus.gov/ency/article/003461.htm Extremity x-ray To use the sharing features on this page, ... in the body Risks There is low-level radiation exposure. X-rays are monitored and regulated to provide the ...

[German Language Version and Validation of the Risk-Taking Behaviour Scale (RBS-K) for High-Risk Sports].

Science.gov (United States)

Frühauf, Anika; Niedermeier, Martin; Ruedl, Gerhard; Barlow, Matthew; Woodman, Tim; Kopp, Martin

2017-11-23

Background  High-risk sports, particularly climbing, kayaking and extreme skiing, have become increasingly popular. The most widely used psychological survey instrument with regard to risk behaviour in sports is the Sensation Seeking Model, mostly assessed by the Sensation Seeking Scale (SSS-V). Until recently, the literature discussed risk behaviour solely through this model. However, this scale does not measure risk-taking behaviours. In contrast, the Risk-Taking Behaviour Scale (RBS-K) is a three-item scale that measures risk behaviour in high-risk sports. This study aimed to validate a German language version of the RBS-K. Methods  The RBS-K was translated and back-translated between English and German. High-risk sports participants (n = 2399) completed the German version of the RBS-K. Of those participants, 820 completed the RBS-K in person as part of a field survey and 1579 participated in an online survey. To validate the questionnaire, the SSS-V, accident involvement, age and sex were evaluated. The RBS-K divides the sample into deliberate risk takers (mean + standard deviation) and risk-averse persons (mean - standard deviation). We tested for internal consistency and correlations with SSS-V, age, sex and accident involvement. Group differences were calculated between deliberate risk takers and risk-averse persons. Results  For internal consistency, we obtained a Cronbach's alpha of 0.56 and a McDonald's omega of 0.63. Significant correlations were shown between RBS-K and SSS-V as well as age and sex. Compared to risk-averse persons (n = 643, 26.8 %), deliberate risk takers (n = 319, 13.3 %) scored significantly higher in sensation seeking, were significantly younger and primarily male and had a significantly higher accident involvement. Conclusion  The RBS-K discriminates well for age, sex and accident involvement. Also, correlations between the RBS-K and the well-established SSS-V are acceptable. With regard to the results and its

"RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

OpenAIRE

M. Pourmahabadian; J.N. Saraji; M. Aghabeighi H. Saddeghi-Naeeni

2005-01-01

The strain index (SI) is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE) disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The ai...

Extreme Programming: Maestro Style

Science.gov (United States)

Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

2009-01-01

"Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications.

Science.gov (United States)

McClelland, Erin; Amlôt, Richard; Rogers, M Brooke; Rubin, G James; Tesh, John; Pearce, Julia M

2017-02-01

In recent years, a series of large-scale, high-profile natural disasters and terrorist attacks have demonstrated the need for thorough and effective disaster preparedness. While these extreme events affect communities and societies as a whole, they also carry specific risks for particular population groups. Crises such as Hurricane Katrina and the 2011 earthquake and tsunami disaster in Japan have illustrated the risk of significant and disproportionate morbidity and mortality among older adults during disasters. Age does not necessarily equate to vulnerability, but many physical and psychological consequences of the aging process can increase the risk of adverse outcomes. As the older population grows, so too does the need to ensure that adequate, practical, and appropriate measures exist to offset the specific risks from extreme events associated with this subpopulation. Effective risk and crisis communication plays a key role in mitigating the extent to which older adults are differentially affected during extreme events. By identifying the specific issues affecting older adults, this review highlights important areas for action for practitioners and policy-makers, particularly in the realm of crisis communication. (Disaster Med Public Health Preparedness. 2017;11:127-134).

Value-at-risk estimation with wavelet-based extreme value theory: Evidence from emerging markets

Science.gov (United States)

Cifter, Atilla

2011-06-01

This paper introduces wavelet-based extreme value theory (EVT) for univariate value-at-risk estimation. Wavelets and EVT are combined for volatility forecasting to estimate a hybrid model. In the first stage, wavelets are used as a threshold in generalized Pareto distribution, and in the second stage, EVT is applied with a wavelet-based threshold. This new model is applied to two major emerging stock markets: the Istanbul Stock Exchange (ISE) and the Budapest Stock Exchange (BUX). The relative performance of wavelet-based EVT is benchmarked against the Riskmetrics-EWMA, ARMA-GARCH, generalized Pareto distribution, and conditional generalized Pareto distribution models. The empirical results show that the wavelet-based extreme value theory increases predictive performance of financial forecasting according to number of violations and tail-loss tests. The superior forecasting performance of the wavelet-based EVT model is also consistent with Basel II requirements, and this new model can be used by financial institutions as well.

High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

Science.gov (United States)

Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

2012-12-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

Changing precipitation extremes and flood risk over the conterminous U.S.

Science.gov (United States)

Lettenmaier, D. P.

2017-12-01

On the basis of first principles, precipitation extremes should increase in a warming climate. Effectively, the atmospheric "heat engine" is expected to turn over more rapidly as the climate warms, due to increased water holding capacity of the atmosphere. Most climate models reflect this behavior, and project that precipitation extremes should increase, at roughly the Clausius-Clapyron rate. From a societal standpoint though, changing precipitation extremes in and of themselves aren't necessarily a concern - rather, the question of societal interest is "are and/or will flood extremes change". Flood extremes of course respond to precipitation extremes, but they are affected by a number of other factors, among them being the duration of precipitation relative to catchment size and channel features, storm orientation relative to catchment orientation, soil characteristics, and antecedent hydrologic conditions. Various studies have shown that over both the conterminous U.S. and globally, there have been slight increases in precipitation extremes (i.e., more than would be expected due to chance. On the other hand, evidence for increases in flooding are less pervasive. I review past work in this area, and suggest the nature of studies that might be conducted going forward to better understand the likely signature of changing precipitation extremes on flooding.

A genome-wide analysis of putative functional and exonic variation associated with extremely high intelligence.

Science.gov (United States)

Spain, S L; Pedroso, I; Kadeva, N; Miller, M B; Iacono, W G; McGue, M; Stergiakouli, E; Davey Smith, G; Putallaz, M; Lubinski, D; Meaburn, E L; Plomin, R; Simpson, M A

2016-08-01

Although individual differences in intelligence (general cognitive ability) are highly heritable, molecular genetic analyses to date have had limited success in identifying specific loci responsible for its heritability. This study is the first to investigate exome variation in individuals of extremely high intelligence. Under the quantitative genetic model, sampling from the high extreme of the distribution should provide increased power to detect associations. We therefore performed a case-control association analysis with 1409 individuals drawn from the top 0.0003 (IQ >170) of the population distribution of intelligence and 3253 unselected population-based controls. Our analysis focused on putative functional exonic variants assayed on the Illumina HumanExome BeadChip. We did not observe any individual protein-altering variants that are reproducibly associated with extremely high intelligence and within the entire distribution of intelligence. Moreover, no significant associations were found for multiple rare alleles within individual genes. However, analyses using genome-wide similarity between unrelated individuals (genome-wide complex trait analysis) indicate that the genotyped functional protein-altering variation yields a heritability estimate of 17.4% (s.e. 1.7%) based on a liability model. In addition, investigation of nominally significant associations revealed fewer rare alleles associated with extremely high intelligence than would be expected under the null hypothesis. This observation is consistent with the hypothesis that rare functional alleles are more frequently detrimental than beneficial to intelligence.

The evolution of extreme precipitations in high resolution scenarios over France

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Colin, J.; Déqué, M.; Somot, S.

2009-09-01

Over the past years, improving the modelling of extreme events and their variability at climatic time scales has become one of the challenging issue raised in the regional climate research field. This study shows the results of a high resolution (12 km) scenario run over France with the limited area model (LAM) ALADIN-Climat, regarding the representation of extreme precipitations. The runs were conducted in the framework of the ANR-SCAMPEI national project on high resolution scenarios over French mountains. As a first step, we attempt to quantify one of the uncertainties implied by the use of LAM : the size of the area on which the model is run. In particular, we address the issue of whether a relatively small domain allows the model to create its small scale process. Indeed, high resolution scenarios cannot be run on large domains because of the computation time. Therefore one needs to answer this preliminary question before producing and analyzing such scenarios. To do so, we worked in the framework of a « big brother » experiment. We performed a 23-year long global simulation in present-day climate (1979-2001) with the ARPEGE-Climat GCM, at a resolution of approximately 50 km over Europe (stretched grid). This first simulation, named ARP50, constitutes the « big brother » reference of our experiment. It has been validated in comparison with the CRU climatology. Then we filtered the short waves (up to 200 km) from ARP50 in order to obtain the equivalent of coarse resolution lateral boundary conditions (LBC). We have carried out three ALADIN-Climat simulations at a 50 km resolution with these LBC, using different configurations of the model : * FRA50, run over a small domain (2000 x 2000 km, centered over France), * EUR50, run over a larger domain (5000 x 5000 km, centered over France as well), * EUR50-SN, run over the large domain (using spectral nudging). Considering the facts that ARPEGE-Climat and ALADIN-Climat models share the same physics and dynamics

Brain network characterization of high-risk preterm-born school-age children

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Elda Fischi-Gomez

2016-01-01

Full Text Available Higher risk for long-term cognitive and behavioral impairments is one of the hallmarks of extreme prematurity (EP and pregnancy-associated fetal adverse conditions such as intrauterine growth restriction (IUGR. While neurodevelopmental delay and abnormal brain function occur in the absence of overt brain lesions, these conditions have been recently associated with changes in microstructural brain development. Recent imaging studies indicate changes in brain connectivity, in particular involving the white matter fibers belonging to the cortico-basal ganglia-thalamic loop. Furthermore, EP and IUGR have been related to altered brain network architecture in childhood, with reduced network global capacity, global efficiency and average nodal strength. In this study, we used a connectome analysis to characterize the structural brain networks of these children, with a special focus on their topological organization. On one hand, we confirm the reduced averaged network node degree and strength due to EP and IUGR. On the other, the decomposition of the brain networks in an optimal set of clusters remained substantially different among groups, talking in favor of a different network community structure. However, and despite the different community structure, the brain networks of these high-risk school-age children maintained the typical small-world, rich-club and modularity characteristics in all cases. Thus, our results suggest that brain reorganizes after EP and IUGR, prioritizing a tight modular structure, to maintain the small-world, rich-club and modularity characteristics. By themselves, both extreme prematurity and IUGR bear a similar risk for neurocognitive and behavioral impairment, and the here defined modular network alterations confirm similar structural changes both by IUGR and EP at school age compared to control. Interestingly, the combination of both conditions (IUGR + EP does not result in a worse outcome. In such cases, the alteration

Fabrication of surfaces with extremely high contact angle hysteresis from polyelectrolyte multilayer.

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Wang, Liming; Wei, Jingjing; Su, Zhaohui

2011-12-20

High contact angle hysteresis on polyelectrolyte multilayers (PEMs) ion-paired with hydrophobic perfluorooctanoate anions is reported. Both the bilayer number of PEMs and the ionic strength of deposition solutions have significant influence on contact angle hysteresis: higher ionic strength and greater bilayer number cause increased contact angle hysteresis values. The hysteresis values of ~100° were observed on smooth PEMs and pinning of the receding contact line on hydrophilic defects is implicated as the cause of hysteresis. Surface roughness can be used to further tune the contact angle hysteresis on the PEMs. A surface with extremely high contact angle hysteresis of 156° was fabricated when a PEM was deposited on a rough substrate coated with submicrometer scale silica spheres. It was demonstrated that this extremely high value of contact angle hysteresis resulted from the penetration of water into the rough asperities on the substrate. The same substrate hydrophobized by chemical vapor deposition of 1H,1H,2H,2H-perfluorooctyltriethoxysilane exhibits high advancing contact angle and low hysteresis. © 2011 American Chemical Society

Laser waveform control of extreme ultraviolet high harmonics from solids.

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You, Yong Sing; Wu, Mengxi; Yin, Yanchun; Chew, Andrew; Ren, Xiaoming; Gholam-Mirzaei, Shima; Browne, Dana A; Chini, Michael; Chang, Zenghu; Schafer, Kenneth J; Gaarde, Mette B; Ghimire, Shambhu

2017-05-01

Solid-state high-harmonic sources offer the possibility of compact, high-repetition-rate attosecond light emitters. However, the time structure of high harmonics must be characterized at the sub-cycle level. We use strong two-cycle laser pulses to directly control the time-dependent nonlinear current in single-crystal MgO, leading to the generation of extreme ultraviolet harmonics. We find that harmonics are delayed with respect to each other, yielding an atto-chirp, the value of which depends on the laser field strength. Our results provide the foundation for attosecond pulse metrology based on solid-state harmonics and a new approach to studying sub-cycle dynamics in solids.

Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes.

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Johnson, Samantha; Strauss, Victoria; Gilmore, Camilla; Jaekel, Julia; Marlow, Neil; Wolke, Dieter

2016-12-01

Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hydrologic Extremes and Risk Assessment under Non-stationarity

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Mondal, A.

2015-12-01

In the context of hydrologic designs, robust assessment and communication of risk is crucial to ascertain a sustainable water future. Traditional methods for defining return period, risk or reliability assumes a stationary regime which may no longer be valid because of natural or man-made changes. Reformulations are suggested in recent literature to account for non-stationarity in the definition of hydrologic risk, as time evolves. This study presents a comparative analysis of design levels under non-stationarity based on time varying annual exceedance probabilities, waiting time of a hazardous event, number of hazardous events and probability of failure. A case study application is shown for peak streamflow in the flood-prone delta area of the Krishna River in India where an increasing trend in annual maximum flows are observed owing to persistent silting. Considerable disagreement is found between the design magnitudes of flood obtained by the different definitions of hydrologic risk. Such risk is also found to be highly sensitive to the assumed design life period and projections of trend in that period or beyond. Additionally, some critical points on the assumption of a deterministic non-stationary model for an observed natural process are also discussed. The findings highlight the necessity for a unifying framework for assessment and communication of hydrologic risk under transient hydro-climatic conditions. The concepts can also be extended to other applications such as regional hydrologic frequency analysis or development of precipitation intensity-duration-frequency relationships for infrastructure design.

Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

Energy Technology Data Exchange (ETDEWEB)

Özgen, Ali, E-mail: draliozgen@hotmail.com [Yeditepe University Hospital, Department of Radiology (Turkey); Sanioğlu, Soner [Yeditepe University Hospital, Department of Cardiovascular Surgery (Turkey); Bingöl, Uğur Anıl [Yeditepe University Hospital, Department of Plastic Surgery (Turkey)

2016-08-15

PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatinine levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.

Footwear traction and lower extremity noncontact injury.

Science.gov (United States)

Wannop, John W; Luo, Geng; Stefanyshyn, Darren J

2013-11-01

Football is the most popular high school sport; however, it has the highest rate of injury. Speculation has been prevalent that foot fixation due to high footwear traction contributes to injury risk. Therefore, the purpose of the study was to determine whether a relationship exists between the athlete's specific footwear traction (measured with their own shoes on the field of play) and lower extremity noncontact injury in high school football. For 3 yr, 555 high school football athletes had their footwear traction measured on the actual field of play at the start of the season, and any injury the athletes suffered during a game was recorded. Lower extremity noncontact injury rates, grouped based on the athlete's specific footwear traction (both translational and rotational), were compared. For translational traction, injury rate reached a peak of 23.3 injuries/1000 game exposures within the midrange of translational traction, before decreasing to 5.0 injuries/1000 game exposures in the high range of traction. For rotational traction, there was a steady increase in injury rate as footwear traction increased, starting at 4.2 injuries/1000 game exposures at low traction and reaching 19.2 injuries/1000 game exposures at high traction. A relationship exists between footwear traction and noncontact lower extremity injury, with increases in rotational traction leading to a greater injury rate and increases in translational traction leading to a decrease in injury. It is recommended that athletes consider selecting footwear with the lowest rotational traction values for which no detriment in performance results.

A simple model for prediction postpartum PTSD in high-risk pregnancies.

Science.gov (United States)

Shlomi Polachek, Inbal; Dulitzky, Mordechai; Margolis-Dorfman, Lilia; Simchen, Michal J

2016-06-01

This study aimed to examine the prevalence and possible antepartum risk factors of complete and partial post-traumatic stress disorder (PTSD) among women with complicated pregnancies and to define a predictive model for postpartum PTSD in this population. Women attending the high-risk pregnancy outpatient clinics at Sheba Medical Center completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire regarding demographic variables, history of psychological and psychiatric treatment, previous trauma, previous childbirth, current pregnancy medical and emotional complications, fears from childbirth, and expected pain. One month after delivery, women were requested to repeat the EPDS and complete the Post-traumatic Stress Diagnostic Scale (PDS) via telephone interview. The prevalence rates of postpartum PTSD (9.9 %) and partial PTSD (11.9 %) were relatively high. PTSD and partial PTSD were associated with sadness or anxiety during past pregnancy or childbirth, previous very difficult birth experiences, preference for cesarean section in future childbirth, emotional crises during pregnancy, increased fear of childbirth, higher expected intensity of pain, and depression during pregnancy. We created a prediction model for postpartum PTSD which shows a linear growth in the probability for developing postpartum PTSD when summing these seven antenatal risk factors. Postpartum PTSD is extremely prevalent after complicated pregnancies. A simple questionnaire may aid in identifying at-risk women before childbirth. This presents a potential for preventing or minimizing postpartum PTSD in this population.

Extremely low frequency magnetic fields and health risks

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M.I. Buzdugan

2009-10-01

Full Text Available In a world abounding in artificially created electromagnetic fields, we consider that a new approach regarding their possible harmful effects on living beings becomes mandatory. The paper reviews briefly the results of some epidemiological studies, the ICNIRP (International Committee on Non-Ionizing Radiation Protection Guidelines and the latest document of the SCENIHR (an organism of the European Commission regarding extremely low frequency (ELF magnetic fields. We are convinced that the best conduct that might be adopted on this matter is the policy of the prudential avoidance. Several examples of possible harmful effects determined by extremely low frequency magnetic fields dedicated to building services engineering in residences are presented, along with several methods of mitigating them.

Image-based motion compensation for high-resolution extremities cone-beam CT

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Sisniega, A.; Stayman, J. W.; Cao, Q.; Yorkston, J.; Siewerdsen, J. H.; Zbijewski, W.

2016-03-01

Purpose: Cone-beam CT (CBCT) of the extremities provides high spatial resolution, but its quantitative accuracy may be challenged by involuntary sub-mm patient motion that cannot be eliminated with simple means of external immobilization. We investigate a two-step iterative motion compensation based on a multi-component metric of image sharpness. Methods: Motion is considered with respect to locally rigid motion within a particular region of interest, and the method supports application to multiple locally rigid regions. Motion is estimated by maximizing a cost function with three components: a gradient metric encouraging image sharpness, an entropy term that favors high contrast and penalizes streaks, and a penalty term encouraging smooth motion. Motion compensation involved initial coarse estimation of gross motion followed by estimation of fine-scale displacements using high resolution reconstructions. The method was evaluated in simulations with synthetic motion (1-4 mm) applied to a wrist volume obtained on a CMOS-based CBCT testbench. Structural similarity index (SSIM) quantified the agreement between motion-compensated and static data. The algorithm was also tested on a motion contaminated patient scan from dedicated extremities CBCT. Results: Excellent correction was achieved for the investigated range of displacements, indicated by good visual agreement with the static data. 10-15% improvement in SSIM was attained for 2-4 mm motions. The compensation was robust against increasing motion (4% decrease in SSIM across the investigated range, compared to 14% with no compensation). Consistent performance was achieved across a range of noise levels. Significant mitigation of artifacts was shown in patient data. Conclusion: The results indicate feasibility of image-based motion correction in extremities CBCT without the need for a priori motion models, external trackers, or fiducials.

Quantifying extreme risks in stock markets: A case of former Yugoslavian states

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Saša Žiković

2008-06-01

Full Text Available One of the reasons why investors were not prepared for heavy losses in the stock markets that occurred after the beginning of sub prime mortgage crisis in the US lies in the curious fact that many practitioners were led to believe that there are so many independent agents participating in the stock markets that surely they must act according to Central limit theorem i.e. according to Gaussian distribution. As it turns out the paradigm of normality has let us down once again and reputation of VaR based risk measurement is seriously damaged. An alternative measure that looks very strong at these dire times and quantifi es the losses that might be encountered in the tail is the conditional VaR (CVaR. While VaR represents a loss one expects at a determined confi dence level for a given holding period, CVaR is the loss one expects, provided that the loss is equal to or greater than VaR. In this paper the testing of CVaR models is performed on stock indexes from Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro and Macedonia. Error statistics show that CVaR models are quite successful at capturing extreme losses that occurred in these markets, especially models based on Generalized extreme value distribution and a proposed Hybrid historical simulation CVaR model.

Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

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Vinayak Muralidhar

2016-02-01

Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

Moderate and extreme maternal obesity.

LENUS (Irish Health Repository)

Abdelmaboud, M O

2012-05-01

The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.

Modeling, Forecasting and Mitigating Extreme Earthquakes

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Ismail-Zadeh, A.; Le Mouel, J.; Soloviev, A.

2012-12-01

Recent earthquake disasters highlighted the importance of multi- and trans-disciplinary studies of earthquake risk. A major component of earthquake disaster risk analysis is hazards research, which should cover not only a traditional assessment of ground shaking, but also studies of geodetic, paleoseismic, geomagnetic, hydrological, deep drilling and other geophysical and geological observations together with comprehensive modeling of earthquakes and forecasting extreme events. Extreme earthquakes (large magnitude and rare events) are manifestations of complex behavior of the lithosphere structured as a hierarchical system of blocks of different sizes. Understanding of physics and dynamics of the extreme events comes from observations, measurements and modeling. A quantitative approach to simulate earthquakes in models of fault dynamics will be presented. The models reproduce basic features of the observed seismicity (e.g., the frequency-magnitude relationship, clustering of earthquakes, occurrence of extreme seismic events). They provide a link between geodynamic processes and seismicity, allow studying extreme events, influence of fault network properties on seismic patterns and seismic cycles, and assist, in a broader sense, in earthquake forecast modeling. Some aspects of predictability of large earthquakes (how well can large earthquakes be predicted today?) will be also discussed along with possibilities in mitigation of earthquake disasters (e.g., on 'inverse' forensic investigations of earthquake disasters).

Climate change, variability and extreme events : risk assessment and management strategies in a Peach cultivated area in Italy.

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Alfieri, Silvia Maria; De Lorenzi, Francesca; Basile, Angelo; Bonfante, Antonello; Missere, Daniele; Menenti, Massimo

2014-05-01

Climate change in Mediterranean area is likely to reduce precipitation amounts and to increase temperature thus affecting the timing of development stages and the productivity of crops. Further, extreme weather events are expected to increase in the future leading to significant increase in agricultural risk. Some strategies for effectively managing risks and adapting to climate change involve adjustments to irrigation management and use of different varieties. We quantified the risk on Peach production in an irrigated area of "Emilia Romagna" region ( Italy) taking into account the impact on crop yield due to climate change and variability and to extreme weather events as well as the ability of the agricultural system to modulate this impact (adaptive capacity) through changes in water and crop management. We have focused on climatic events causing insufficient water supply to crops, while taking into account the effect of climate on the duration and timing of phenological stages. Further, extreme maximum and minimum temperature events causing significant reduction of crop yield have been considered using phase-specific critical temperatures. In our study risk was assessed as the product of the probability of a damaging event (hazard), such as drought or extreme temperatures, and the estimated impact of such an event (vulnerability). To estimate vulnerability we took into account the possible options to reduce risk, by combining estimates of the sensitivity of the system (negative impact on crop yield) and its adaptive capacity. The latter was evaluated as the relative improvement due to alternate management options: the use of alternate varieties or the changes in irrigation management. Vulnerability was quantified using cultivar-specific thermal and hydrologic requirements of a set of cultivars determined by experimental data and from scientific literature. Critical temperatures determining a certain reduction of crop yield have been estimated and used to assess

An Extreme Degree of Difficulty: The Educational Demographics of Urban Neighborhood High Schools

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Neild, Ruth Curran; Balfanz, Robert

2006-01-01

Despite the growth of a variety of alternatives to the neighborhood high school, most students in big-city school systems still attend large comprehensive high schools that serve a particular residential area. The authors contend that the extreme concentration of educational need at these schools is often overlooked by policymakers, school reform…

Mortality and morbidity risks vary with birth weight standard deviation score in growth restricted extremely preterm infants.

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Yamakawa, Takuji; Itabashi, Kazuo; Kusuda, Satoshi

2016-01-01

To assess whether the mortality and morbidity risks vary with birth weight standard deviation score (BWSDS) in growth restricted extremely preterm infants. This was a multicenter retrospective cohort study using the database of the Neonatal Research Network of Japan and including 9149 infants born between 2003 and 2010 at <28 weeks gestation. According to the BWSDSs, the infants were classified as: <-2.0, -2.0 to -1.5, -1.5 to -1.0, -1.0 to -0.5, and ≥-0.5. Infants with BWSDS≥-0.5 were defined as non-growth restricted group. After adjusting for covariates, the risks of mortality and some morbidities were different among the BWSDS groups. Compared with non-growth restricted group, the adjusted odds ratio (aOR) for mortality [aOR, 1.69; 95% confidence interval (CI), 1.35-2.12] and chronic lung disease (CLD) (aOR, 1.28; 95% CI, 1.07-1.54) were higher among the infants with BWSDS -1.5 to <-1.0. The aOR for severe retinopathy of prematurity (ROP) (aOR, 1.36; 95% CI, 1.09-1.71) and sepsis (aOR, 1.72; 95% CI, 1.32-2.24) were higher among the infants with BWSDS -2.0 to <-1.5. The aOR for necrotizing enterocolitis (NEC) (aOR, 2.41; 95% CI, 1.64-3.55) was increased at a BWSDS<-2.0. Being growth restricted extremely preterm infants confer additional risks for mortality and morbidities such as CLD, ROP, sepsis and NEC, and these risks may vary with BWSDS. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The extreme condition analyzing for NEMPI shielding of electronic system in high-intensity pulsed radiation diagnosing

International Nuclear Information System (INIS)

Cheng Xiaolei; Liu Fang; Ouyang Xiaoping

2012-01-01

The difficulty for estimating the NEMPI (electromagnetic pulsed interference caused by the nuclear reaction) on the electronic system in high-intensity pulsed radiation diagnosing is analyzed in this article. To solve the difficulty, a method called 'Extreme Condition Analyzing' is presented for estimating the NEMPI conservatively and reliably. Through an extreme condition hypothesizing which could be described as 'Entire Coupling of Electric Field Energy', the E max (maximum electric field intensity which could be endured by the electronic system in the high-intensity pulsed radiation) could be figured out without any other information of the EMP caused by the nuclear reaction. Then a feasibility inspection is introduced, to confirm that the EMPI shielding request according to E max is not too extreme to be achieved. (authors)

Use of a national hospitalization register to identify industrial sectors carrying high risk of severe injuries: a three-year cohort study of more than 900,000 Danish men.

Science.gov (United States)

Baarts, C; Mikkelsen, K L; Hannerz, H; Tüchsen, F

2000-12-01

Data indicates that Denmark has relatively high risks of occupational injuries. We evaluated all injuries resulting in hospitalization by occupation. All gainfully employed men younger than 60 in 1990 were divided into 47 industrial groups and followed using the National Inpatient Registry, for hospitalized injuries 1991-1993. Following ICD-8, injuries were grouped into six categories: head, upper extremities, back, trunk, lower extremities and ruptures, sprains and strains. Standardized industrial hospitalization ratios (SHRs) were calculated and Pearson's independence test was performed for each category. Industrial differences were ascertained for each injury category. The highest associated injury category was upper extremity injuries ranging from SHR = 43 (fire services and salvage corps) to SHR = 209 (slaughterhouse industry). Carpentry, joinery, bricklaying and construction work had significantly high SHRs for all injury categories, whereas administrative work was significantly low throughout. Occupational surveillance systems based on hospitalized injuries can be used to identify high-risk industries, and thereby suggest where to direct prevention efforts. Copyright 2000 Wiley-Liss, Inc.

Relationship of Lower Extremity Muscle Strength with Balance and Lower Extremity Functions in Elderly Women

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Ferdi Başkurt

2018-03-01

Conclusions: Functional score, mobility and balance are related to lower extremity muscle strength in elderly women. Increasing muscle strength will reduce the risk of falls and increase independence.

Adjuvant radiotherapy in high-grade extremity sarcomas

International Nuclear Information System (INIS)

Franca, Carlos Antonio da Silva; Penna, Antonio Belmiro Rodrigues Campbell; Carvalho, Antonio Carlos Pires; Vieira, Sergio Lannes

2010-01-01

Objective: to evaluate the therapies utilized in the authors' institution for management of high-grade extremity sarcomas, analyzing the overall survival rates following multidisciplinary treatment. Materials and methods: retrospective study developed in the period from 1993 to 2007 with 36 patients diagnosed with stages IIb/III, submitted to postoperative external beam radiotherapy, with or without boost dose, utilizing high-dose brachytherapy. Results: thirty-six patients underwent surgery followed by adjuvant external beam radiation therapy. Four patients (11%) received boost dose with brachytherapy, and seven (19%) received chemotherapy. The average dose for radiotherapy was 50 Gy (CI 95%: 47-53 Gy), and the four patients with brachytherapy boost received doses ranging from 16.2 to 35 Gy. Chemotherapy was indicated for seven patients (19%) with positive margins. Fifteen patients (42%) presented local or distant recurrence, and all of them progressed to death. Twenty-one patients (58%) remain with no clinical/radiological evidence of local/distant recurrence. The mean follow-up time was 88 months (IC 95%: 74-102). The overall seven years survival rate was 80%. Conclusion: combined surgery and radiotherapy is an effective treatment with excellent outcomes in cases where brachytherapy is associated, with improved overall survival rates. (author)

Satellite-Enhanced Dynamical Downscaling of Extreme Events

Science.gov (United States)

Nunes, A.

2015-12-01

Severe weather events can be the triggers of environmental disasters in regions particularly susceptible to changes in hydrometeorological conditions. In that regard, the reconstruction of past extreme weather events can help in the assessment of vulnerability and risk mitigation actions. Using novel modeling approaches, dynamical downscaling of long-term integrations from global circulation models can be useful for risk analysis, providing more accurate climate information at regional scales. Originally developed at the National Centers for Environmental Prediction (NCEP), the Regional Spectral Model (RSM) is being used in the dynamical downscaling of global reanalysis, within the South American Hydroclimate Reconstruction Project. Here, RSM combines scale-selective bias correction with assimilation of satellite-based precipitation estimates to downscale extreme weather occurrences. Scale-selective bias correction is a method employed in the downscaling, similar to the spectral nudging technique, in which the downscaled solution develops in agreement with its coarse boundaries. Precipitation assimilation acts on modeled deep-convection, drives the land-surface variables, and therefore the hydrological cycle. During the downscaling of extreme events that took place in Brazil in recent years, RSM continuously assimilated NCEP Climate Prediction Center morphing technique precipitation rates. As a result, RSM performed better than its global (reanalysis) forcing, showing more consistent hydrometeorological fields compared with more sophisticated global reanalyses. Ultimately, RSM analyses might provide better-quality initial conditions for high-resolution numerical predictions in metropolitan areas, leading to more reliable short-term forecasting of severe local storms.

Not all risks are equal: the risk taking inventory for high-risk sports.

Science.gov (United States)

Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

2013-10-01

Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

"RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

Directory of Open Access Journals (Sweden)

M. Pourmahabadian

2005-08-01

Full Text Available The strain index (SI is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The aim of this study was to assess and analyze risk of developing DUE disorders in different jobs as well as hazard classification in an assembling electronic industry through SI method. Also, DUE disorders prevalence, work-related absenteeism and turnover extracted from SI results were compared and assessed by those obtained by Nordic musculoskeletal questionnaire (NMQ. The findings of this study showed that more than 50% of investigated jobs are categorized as "hazardous" and there is a significant difference between SI mean in hazardous and safe jobs (P < 0.0001. In addition, significant difference was found between prevalence of DUE disorders in "safe" and "hazardous" jobs (P < 0.049. But, no significant difference (P = 0.3 was obtained between mean absenteeism in "safe" and hazardous jobs. Also, no significant difference statistically was found between turnover in "safe" and hazardous jobs (X2 = 0.133, P = 1 and high prevalence of DUE disorders is due to low turnover rate of workers.

Shoulder range of motion measures as risk factors for shoulder and elbow injuries in high school softball and baseball players.

Science.gov (United States)

Shanley, Ellen; Rauh, Mitchell J; Michener, Lori A; Ellenbecker, Todd S; Garrison, J Craig; Thigpen, Charles A

2011-09-01

Range of motion deficits in shoulder external rotation (ER), internal rotation (IR), total rotation range of motion (ER + IR), and horizontal adduction (HA) have been retrospectively associated with overhand athletes' arm injuries. The authors expected the incidence of upper extremity injury in high school softball and baseball players with side-to-side shoulder range of motion deficits to be greater than the incidence of upper extremity injury in players with normal shoulder range of motion. Cohort study (prognosis); Level of evidence, 2. High school softball and baseball players (N = 246) participated. Before the start of the season, passive shoulder ER, IR, and HA were assessed at 90° of abduction with the scapula stabilized. Relative risk (RR) was calculated to examine range of motion measure, by categorical criteria, and risk of upper extremity injury. Twenty-seven shoulder and elbow injuries (9 softball, 18 baseball) were observed during the season. The dominant shoulder of all injured players and baseball players displayed a significant decrease in HA (P = .05) and IR (P = .04). The dominant shoulder total rotation of injured baseball players displayed a significant decrease (mean difference = 8.0° ± 0.1°; P = .05) as compared with the dominant shoulder of uninjured baseball players. Players who displayed a decrease of ≥25° of IR in the dominant shoulder were at 4 times greater risk of upper extremity injury compared with players with a .05). There are large mean deficits in shoulder IR and HA between injured and noninjured players, but not in ER or total rotation. Passive shoulder IR loss ≥25° as compared bilaterally was predictive of arm injury. Shoulder range of motion deficits differed between sports and appeared more predictive of injury for baseball players.

The effect of unilateral arm swing motion on lower extremity running mechanics associated with injury risk.

Science.gov (United States)

Agresta, Cristine; Ward, Christian R; Wright, W Geoffrey; Tucker, Carole A

2018-06-01

Many field sports involve equipment that restricts one or both arms from moving while running. Arm swing during running has been examined from a biomechanical and physiologic perspective but not from an injury perspective. Moreover, only bilateral arm swing suppression has been studied with respect to running. The purpose of this study was to determine the influence of running with one arm restrained on lower extremity mechanics associated with running or sport-related injury. Fifteen healthy participants ran at a self-selected speed with typical arm swing, with one arm restrained and with both arms restrained. Lower extremity kinematics and spatiotemporal measures were analysed for all arm swing conditions. Running with one arm restrained resulted in increased frontal plane knee and hip angles, decreased foot strike angle, and decreased centre of mass vertical displacement compared to typical arm swing or bilateral arm swing restriction. Stride length was decreased and step frequency increased when running with one or both arms restrained. Unilateral arm swing restriction induces changes in lower extremity kinematics that are not similar to running with bilateral arm swing restriction or typical arm swing motion. Running with one arm restrained increases frontal plane mechanics associated with risk of knee injury.

Clinical potentials of methylator phenotype in stage 4 high-risk neuroblastoma: an open challenge.

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Barbara Banelli

Full Text Available Approximately 20% of stage 4 high-risk neuroblastoma patients are alive and disease-free 5 years after disease onset while the remaining experience rapid and fatal progression. Numerous findings underline the prognostic role of methylation of defined target genes in neuroblastoma without taking into account the clinical and biological heterogeneity of this disease. In this report we have investigated the methylation of the PCDHB cluster, the most informative member of the "Methylator Phenotype" in neuroblastoma, hypothesizing that if this epigenetic mark can predict overall and progression free survival in high-risk stage 4 neuroblastoma, it could be utilized to improve the risk stratification of the patients, alone or in conjunction with the previously identified methylation of the SFN gene (14.3.3sigma that can accurately predict outcome in these patients. We have utilized univariate and multivariate models to compare the prognostic power of PCDHB methylation in terms of overall and progression free survival, quantitatively determined by pyrosequencing, with that of other markers utilized for the patients' stratification utilizing methylation thresholds calculated on neuroblastoma at stage 1-4 and only on stage 4, high-risk patients. Our results indicate that PCDHB accurately distinguishes between high- and intermediate/low risk stage 4 neuroblastoma in agreement with the established risk stratification criteria. However PCDHB cannot predict outcome in the subgroup of stage 4 patients at high-risk whereas methylation levels of SFN are suggestive of a "methylation gradient" associated with tumor aggressiveness as suggested by the finding of a higher threshold that defines a subset of patients with an extremely severe disease (OS <24 months. Because of the heterogeneity of neuroblastoma we believe that clinically relevant methylation markers should be selected and tested on homogeneous groups of patients rather than on patients at all stages.

Statistics of extremes theory and applications

CERN Document Server

Beirlant, Jan; Segers, Johan; Teugels, Jozef; De Waal, Daniel; Ferro, Chris

2006-01-01

Research in the statistical analysis of extreme values has flourished over the past decade: new probability models, inference and data analysis techniques have been introduced; and new application areas have been explored. Statistics of Extremes comprehensively covers a wide range of models and application areas, including risk and insurance: a major area of interest and relevance to extreme value theory. Case studies are introduced providing a good balance of theory and application of each model discussed, incorporating many illustrated examples and plots of data. The last part of the book covers some interesting advanced topics, including  time series, regression, multivariate and Bayesian modelling of extremes, the use of which has huge potential.  

FURTHER EVIDENCE ON THE “COSTS OF PRIVILEGE”: PERFECTIONISM IN HIGH-ACHIEVING YOUTH AT SOCIOECONOMIC EXTREMES

Science.gov (United States)

LYMAN, EMILY L.; LUTHAR, SUNIYA S.

2015-01-01

This study involved two academically-gifted samples of 11th and 12th grade youth at the socioeconomic status (SES) extremes; one from an exclusive private, affluent school, and the other from a magnet school with low-income students. Negative and positive adjustment outcomes were examined in relation to multiple dimensions of perfectionism including perceived parental pressures to be perfect, personal perfectionistic self-presentation, and envy of peers. The low-income students showed some areas of relative vulnerability, but when large group differences were found, it was the affluent youth who were at a disadvantage, with substantially higher substance use and peer envy. Affluent girls seemed particularly vulnerable, with pronounced elevations in perfectionistic tendencies, peer envy, as well as body dissatisfaction. Examination of risk and protective processes showed that relationships with mothers were associated with students’ distress as well as positive adjustment. Additionally, findings showed links between (a) envy of peers and multiple outcomes (among high SES girls in particular), (b) dimensions of perfectionism in relation to internalizing symptoms, and (c) high extrinsic versus intrinsic values in relation to externalizing symptoms. PMID:26345229

Vulnerabilities to agricultural production shocks: An extreme, plausible scenario for assessment of risk for the insurance sector

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Tobias Lunt

2016-01-01

Full Text Available Climate risks pose a threat to the function of the global food system and therefore also a hazard to the global financial sector, the stability of governments, and the food security and health of the world’s population. This paper presents a method to assess plausible impacts of an agricultural production shock and potential materiality for global insurers. A hypothetical, near-term, plausible, extreme scenario was developed based upon modules of historical agricultural production shocks, linked under a warm phase El Niño-Southern Oscillation (ENSO meteorological framework. The scenario included teleconnected floods and droughts in disparate agricultural production regions around the world, as well as plausible, extreme biotic shocks. In this scenario, global crop yield declines of 10% for maize, 11% for soy, 7% for wheat and 7% for rice result in quadrupled commodity prices and commodity stock fluctuations, civil unrest, significant negative humanitarian consequences and major financial losses worldwide. This work illustrates a need for the scientific community to partner across sectors and industries towards better-integrated global data, modeling and analytical capacities, to better respond to and prepare for concurrent agricultural failure. Governments, humanitarian organizations and the private sector collectively may recognize significant benefits from more systematic assessment of exposure to agricultural climate risk.

Extreme-ultraviolet wavelength and lifetime measurements in highly ionized krypton

CERN Document Server

Kukla, K W; Vogt, C M V; Berry, H G; Dunford, R W; Curtis, L J; Cheng, S

2005-01-01

We have studied the spectrum of highly ionized krypton in the extreme-ultraviolet wavelength region (50-300 Aa), using beam-foil excitation of fast krypton ions at the Argonne ATLAS accelerator facility. We report measurements of transition wavelengths and excited-state lifetimes for n=2 states in the lithiumlike, berylliumlike, and boronlike ions, Kr/sup 31+,32+,33+/. Excited state lifetimes ranging from 10 ps to 3 ns were measured by acquiring time- of-flight-delayed spectra with a position-sensitive multichannel detector.

Flood protection diversification to reduce probabilities of extreme losses.

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Zhou, Qian; Lambert, James H; Karvetski, Christopher W; Keisler, Jeffrey M; Linkov, Igor

2012-11-01

Recent catastrophic losses because of floods require developing resilient approaches to flood risk protection. This article assesses how diversification of a system of coastal protections might decrease the probabilities of extreme flood losses. The study compares the performance of portfolios each consisting of four types of flood protection assets in a large region of dike rings. A parametric analysis suggests conditions in which diversifications of the types of included flood protection assets decrease extreme flood losses. Increased return periods of extreme losses are associated with portfolios where the asset types have low correlations of economic risk. The effort highlights the importance of understanding correlations across asset types in planning for large-scale flood protection. It allows explicit integration of climate change scenarios in developing flood mitigation strategy. © 2012 Society for Risk Analysis.

Study of a pressure measurement method using laser ionization for extremely-high vacuum

International Nuclear Information System (INIS)

Kokubun, Kiyohide

1991-01-01

A method of measuring pressures in the range of extremely-high vacuum (XHV) using the laser ionization has been studied. For this purpose, nonresonant multiphoton ionization of various kinds of gases has been studied, and highly-sensitive ion-detection systems and an extremely-high vacuum equipment were fabricated. These results are presented in detail. Two ion-detection systems were fabricated and tested: the one is based on the pulse-counting method, and the other utilizes the image-processing technique. The former is superior in detecting a few ions or less. The latter was processing technique. The former is superior in detecting a few ions or less. The latter was verified to able to count accurately the number of ions in the range of a few to several hundreds. To obtain the information on residual gases and test our pressure measurement system, an extremely-high vacuum system was fabricated in our own fashion, attained a pressure lower than 1 x 10 -10 Pa, measured with an extractor gauge. The outgassing rate of this vacuum vessel was measured to be 7.8 x 10 -11 Pa·m 3 /s·m 2 . The surface structures and the surface compositions of the raw material, the machined material, and the machined-and-outgased material were studied by SEM and AES. Besides, the pumping characteristics and the residual gases of the XHV system were investigated in detail at each pumping stage. On the course of these studies, the method of pressure measurement using the laser-ionization has been verified to be very effective for measuring pressures in XHV. (J.P.N.)

Longitudinal Regional Brain Development and Clinical Risk Factors in Extremely Preterm Infants.

Science.gov (United States)

Kersbergen, Karina J; Makropoulos, Antonios; Aljabar, Paul; Groenendaal, Floris; de Vries, Linda S; Counsell, Serena J; Benders, Manon J N L

2016-11-01

To investigate third-trimester extrauterine brain growth and correlate this with clinical risk factors in the neonatal period, using serially acquired brain tissue volumes in a large, unselected cohort of extremely preterm born infants. Preterm infants (gestational age regions covering the entire brain. Multivariable regression analysis was used to determine the influence of clinical variables on volumes at both scans, as well as on volumetric growth. MRIs at term equivalent age were available for 210 infants and serial data were available for 131 infants. Growth over these 10 weeks was greatest for the cerebellum, with an increase of 258%. Sex, birth weight z-score, and prolonged mechanical ventilation showed global effects on brain volumes on both scans. The effect of brain injury on ventricular size was already visible at 30 weeks, whereas growth data and volumes at term-equivalent age revealed the effect of brain injury on the cerebellum. This study provides data about third-trimester extrauterine volumetric brain growth in preterm infants. Both global and local effects of several common clinical risk factors were found to influence serial volumetric measurements, highlighting the vulnerability of the human brain, especially in the presence of brain injury, during this period. Copyright © 2016 Elsevier Inc. All rights reserved.

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

Science.gov (United States)

McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

2017-03-01

Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017

Climate Change and Health Risks from Extreme Heat and Air Pollution in the Eastern United States

Science.gov (United States)

Limaye, V.; Vargo, J.; Harkey, M.; Holloway, T.; Meier, P.; Patz, J.

2013-12-01

Climate change is expected to exacerbate health risks from exposure to extreme heat and air pollution through both direct and indirect mechanisms. Directly, warmer ambient temperatures promote biogenic emissions of ozone precursors and favor the formation of ground-level ozone, while an anticipated increase in the frequency of stagnant air masses will allow fine particulates to accumulate. Indirectly, warmer summertime temperatures stimulate energy demand and exacerbate polluting emissions from the electricity sector. Thus, while technological adaptations such as air conditioning can reduce risks from exposures to extreme heat, they can trigger downstream damage to air quality and public health. Through an interdisciplinary modeling effort, we quantify the impacts of climate change on ambient temperatures, summer energy demand, air quality, and public health. The first phase of this work explores how climate change will directly impact the burden of heat-related mortality. Climatic patterns, demographic trends, and epidemiologic risk models suggest that populations in the eastern United States are likely to experience an increasing heat stress mortality burden in response to rising summertime air temperatures. We use North American Regional Climate Change Assessment Program modeling data to estimate mid-century 2-meter air temperatures and humidity across the eastern US from June-August, and quantify how long-term changes in actual and apparent temperatures from present-day will affect the annual burden of heat-related mortality across this region. With the US Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program, we estimate health risks using concentration-response functions, which relate temperature increases to changes in annual mortality rates. We compare mid-century summertime temperature data, downscaled using the Weather Research and Forecasting model, to 2007 baseline temperatures at a 12 km resolution in order to estimate

Neurodevelopmental Outcomes of Extremely Preterm Infants Randomized to Stress Dose Hydrocortisone.

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Nehal A Parikh

Full Text Available To compare the effects of stress dose hydrocortisone therapy with placebo on survival without neurodevelopmental impairments in high-risk preterm infants.We recruited 64 extremely low birth weight (birth weight ≤1000 g infants between the ages of 10 and 21 postnatal days who were ventilator-dependent and at high-risk for bronchopulmonary dysplasia. Infants were randomized to a tapering 7-day course of stress dose hydrocortisone or saline placebo. The primary outcome at follow-up was a composite of death, cognitive or language delay, cerebral palsy, severe hearing loss, or bilateral blindness at a corrected age of 18-22 months. Secondary outcomes included continued use of respiratory therapies and somatic growth.Fifty-seven infants had adequate data for the primary outcome. Of the 28 infants randomized to hydrocortisone, 19 (68% died or survived with impairment compared with 22 of the 29 infants (76% assigned to placebo (relative risk: 0.83; 95% CI, 0.61 to 1.14. The rates of death for those in the hydrocortisone and placebo groups were 31% and 41%, respectively (P = 0.42. Randomization to hydrocortisone also did not significantly affect the frequency of supplemental oxygen use, positive airway pressure support, or need for respiratory medications.In high-risk extremely low birth weight infants, stress dose hydrocortisone therapy after 10 days of age had no statistically significant effect on the incidence of death or neurodevelopmental impairment at 18-22 months. These results may inform the design and conduct of future clinical trials.ClinicalTrials.gov NCT00167544.

A comparative evaluation of risk-adjustment models for benchmarking amputation-free survival after lower extremity bypass.

Science.gov (United States)

Simons, Jessica P; Goodney, Philip P; Flahive, Julie; Hoel, Andrew W; Hallett, John W; Kraiss, Larry W; Schanzer, Andres

2016-04-01

Providing patients and payers with publicly reported risk-adjusted quality metrics for the purpose of benchmarking physicians and institutions has become a national priority. Several prediction models have been developed to estimate outcomes after lower extremity revascularization for critical limb ischemia, but the optimal model to use in contemporary practice has not been defined. We sought to identify the highest-performing risk-adjustment model for amputation-free survival (AFS) at 1 year after lower extremity bypass (LEB). We used the national Society for Vascular Surgery Vascular Quality Initiative (VQI) database (2003-2012) to assess the performance of three previously validated risk-adjustment models for AFS. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL), Finland National Vascular (FINNVASC) registry, and the modified Project of Ex-vivo vein graft Engineering via Transfection III (PREVENT III [mPIII]) risk scores were applied to the VQI cohort. A novel model for 1-year AFS was also derived using the VQI data set and externally validated using the PIII data set. The relative discrimination (Harrell c-index) and calibration (Hosmer-May goodness-of-fit test) of each model were compared. Among 7754 patients in the VQI who underwent LEB for critical limb ischemia, the AFS was 74% at 1 year. Each of the previously published models for AFS demonstrated similar discriminative performance: c-indices for BASIL, FINNVASC, mPIII were 0.66, 0.60, and 0.64, respectively. The novel VQI-derived model had improved discriminative ability with a c-index of 0.71 and appropriate generalizability on external validation with a c-index of 0.68. The model was well calibrated in both the VQI and PIII data sets (goodness of fit P = not significant). Currently available prediction models for AFS after LEB perform modestly when applied to national contemporary VQI data. Moreover, the performance of each model was inferior to that of the novel VQI-derived model

High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

Science.gov (United States)

Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

2017-09-01

High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

Variability of extreme wet events over Malawi

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Libanda Brigadier

2017-01-01

Full Text Available Adverse effects of extreme wet events are well documented by several studies around the world. These effects are exacerbated in developing countries like Malawi that have insufficient risk reduction strategies and capacity to cope with extreme wet weather. Ardent monitoring of the variability of extreme wet events over Malawi is therefore imperative. The use of the Expert Team on Climate Change Detection and Indices (ETCCDI has been recommended by many studies as an effective way of quantifying extreme wet events. In this study, ETCCDI indices were used to examine the number of heavy, very heavy, and extremely heavy rainfall days; daily and five-day maximum rainfall; very wet and extremely wet days; annual wet days and simple daily intensity. The Standard Normal Homogeneity Test (SNHT was employed at 5% significance level before any statistical test was done. Trend analysis was done using the nonparametric Mann-Kendall statistical test. All stations were found to be homogeneous apart from Mimosa. Trend results show high temporal and spatial variability with the only significant results being: increase in daily maximum rainfall (Rx1day over Karonga and Bvumbwe, increase in five-day maximum rainfall (Rx5day over Bvumbwe. Mzimba and Chileka recorded a significant decrease in very wet days (R95p while a significant increase was observed over Thyolo. Chileka was the only station which observed a significant trend (decrease in extremely wet rainfall (R99p. Mzimba was the only station that reported a significant trend (decrease in annual wet-day rainfall total (PRCPTOT and Thyolo was the only station that reported a significant trend (increase in simple daily intensity (SDII. Furthermore, the findings of this study revealed that, during wet years, Malawi is characterised by an anomalous convergence of strong south-easterly and north-easterly winds. This convergence is the main rain bringing mechanism to Malawi.

Flood risk assessment in France: comparison of extreme flood estimation methods (EXTRAFLO project, Task 7)

Science.gov (United States)

Garavaglia, F.; Paquet, E.; Lang, M.; Renard, B.; Arnaud, P.; Aubert, Y.; Carre, J.

2013-12-01

In flood risk assessment the methods can be divided in two families: deterministic methods and probabilistic methods. In the French hydrologic community the probabilistic methods are historically preferred to the deterministic ones. Presently a French research project named EXTRAFLO (RiskNat Program of the French National Research Agency, https://extraflo.cemagref.fr) deals with the design values for extreme rainfall and floods. The object of this project is to carry out a comparison of the main methods used in France for estimating extreme values of rainfall and floods, to obtain a better grasp of their respective fields of application. In this framework we present the results of Task 7 of EXTRAFLO project. Focusing on French watersheds, we compare the main extreme flood estimation methods used in French background: (i) standard flood frequency analysis (Gumbel and GEV distribution), (ii) regional flood frequency analysis (regional Gumbel and GEV distribution), (iii) local and regional flood frequency analysis improved by historical information (Naulet et al., 2005), (iv) simplify probabilistic method based on rainfall information (i.e. Gradex method (CFGB, 1994), Agregee method (Margoum, 1992) and Speed method (Cayla, 1995)), (v) flood frequency analysis by continuous simulation approach and based on rainfall information (i.e. Schadex method (Paquet et al., 2013, Garavaglia et al., 2010), Shyreg method (Lavabre et al., 2003)) and (vi) multifractal approach. The main result of this comparative study is that probabilistic methods based on additional information (i.e. regional, historical and rainfall information) provide better estimations than the standard flood frequency analysis. Another interesting result is that, the differences between the various extreme flood quantile estimations of compared methods increase with return period, staying relatively moderate up to 100-years return levels. Results and discussions are here illustrated throughout with the example

[Risk assessment and risk control for occupational exposure to chemical toxicants from an isophorone nitrile device].

Science.gov (United States)

Wang, Dejun; Fu, Xiaokuan; Kong, Fanling; Sui, Shaofeng; Jiang, Yuanyuan; Du, Yinglin; Zhou, Jingyang

2014-06-01

Risk assessment and risk control for occupational exposure to chemical toxicants were performed on an isophorone nitrile device with an annual production of 5,000 tons, based on improved Singaporean semi-quantitative risk assessment method, with consideration of actual situation in China and in the present project. With the use of engineering analysis and identification of occupational hazards in the improved Singaporean semi-quantitative risk assessment method, hazard rating (HR) and risk assessment were performed on chemical toxicants from an isophorone nitrile device with an annual production of 5,000 tons. The chemical toxicants in the isophorone nitrile device were mainly isophorone, hydrocyanic acid, methanol, phosphoric acid, sodium hydroxide, and sodium cyanide; the HR values were mild hazard (2), extreme hazard (5), mild hazard (2), mild hazard (2), moderate hazard (3), and extreme hazard (5), respectively, and the corresponding exposure rating (ER) values were 2.09, 2.72, 2.76, 1.68, 2.0, and 1.59, respectively. The risk of chemical toxicants in this project was assessed according to the formula Risk = [HR×ER](1/2). Hydrocyanic acid was determined as high risk, sodium hydroxide and sodium cyanide as medium risk, and isophorone, methanol, and phosphoric acid as low risk. Priority in handling of risks was determined by risk rating. The table of risk control measure was established for pre-assessment of occupational hazards. With risk assessment in this study, we concluded that the isophorone nitrile device with 5,000 ton annual production was a high-occupational hazard device. This device is a project of extreme occupational hazard. The improved Singaporean semi-quantitative risk assessment method is a scientific and applicable method, and is especially suitable for pre-evaluation of on-site project with no analogy.

Global patterns of NDVI-indicated vegetation extremes and their sensitivity to climate extremes

International Nuclear Information System (INIS)

Liu Guo; Liu Hongyan; Yin Yi

2013-01-01

Extremes in climate have significant impacts on ecosystems and are expected to increase under future climate change. Extremes in vegetation could capture such impacts and indicate the vulnerability of ecosystems, but currently have not received a global long-term assessment. In this study, a robust method has been developed to detect significant extremes (low values) in biweekly time series of global normalized difference vegetation index (NDVI) from 1982 to 2006 and thus to acquire a global pattern of vegetation extreme frequency. This pattern coincides with vegetation vulnerability patterns suggested by earlier studies using different methods over different time spans, indicating a consistent mechanism of regulation. Vegetation extremes were found to aggregate in Amazonia and in the semi-arid and semi-humid regions in low and middle latitudes, while they seldom occurred in high latitudes. Among the environmental variables studied, extreme low precipitation has the highest slope against extreme vegetation. For the eight biomes analyzed, these slopes are highest in temperate broadleaf forest and temperate grassland, suggesting a higher sensitivity in these environments. The results presented here contradict the hypothesis that vegetation in water-limited semi-arid and semi-humid regions might be adapted to drought and suggest that vegetation in these regions (especially temperate broadleaf forest and temperate grassland) is highly prone to vegetation extreme events under more severe precipitation extremes. It is also suggested here that more attention be paid to precipitation-induced vegetation changes than to temperature-induced events. (letter)

Dairy product consumption and risk of colorectal cancer in an older mediterranean population at high cardiovascular risk.

Science.gov (United States)

Barrubés, Laura; Babio, Nancy; Mena-Sánchez, Guillermo; Toledo, Estefania; Ramírez-Sabio, Judith B; Estruch, Ramón; Ros, Emilio; Fitó, Montserrat; Arós, Fernando; Fiol, Miquel; Santos-Lozano, José Manuel; Serra-Majem, Lluís; Pintó, Xavier; Martínez-González, Miguel Ángel; Sorlí, José Vicente; Basora, Josep; Salas-Salvadó, Jordi

2018-04-16

Prospective studies have reported an inverse association between the consumption of total dairy products and milk and the risk of colorectal cancer (CRC). Nonetheless, there is little and inconsistent evidence regarding subtypes of dairy product and CRC risk. We assessed the associations between the consumption of total dairy products, their different subtypes and CRC risk in older Mediterranean individuals at high cardiovascular risk. We analyzed data from 7,216 men and women (55-80 years) without CRC at baseline from the PREvención con DIeta MEDiterránea study. Individuals were recruited between 2003 and 2009 and followed up until December 2012. At baseline and yearly thereafter, consumption of total and specific dairy products was assessed using a validated 137-item food-frequency questionnaire. Cox proportional hazards ratios (HRs) of CRC incidence were estimated for tertiles of mean consumption of dairy products during the follow-up. During a median [interquartile range] follow-up of 6.0 [4.4-7.3] years, we documented 101 incident CRC cases. In the multivariable-adjusted models, HRs and 95% confidence intervals (CIs) of CRC for the comparison of extreme tertiles of total dairy product and low-fat milk consumption were 0.55 (95% CI: 0.31-0.99; p-trend = 0.037) and 0.54 (95% CI: 0.32-0.92; p-trend = 0.022), respectively. No significant associations with other dairy products (whole-fat and low-fat dairy products; total, low-fat and whole-fat yogurt; cheese; total, low-fat and whole-fat milk; concentrated full-fat dairy products, sugar-enriched dairy products and fermented dairy products) were found. A high consumption of total dairy products and low-fat milk was significantly associated with a reduced CRC risk. © 2018 UICC.

Prenatal screening for psychosocial risks in a high risk-population in Peru using the KINDEX interview.

Science.gov (United States)

Spyridou, Andria; Schauer, Maggie; Ruf-Leuschner, Martina

2016-01-22

Prenatal stress and other prenatal risk factors (e.g. intimate partner violence) have a negative impact on mother's health, fetal development as well as enduring adverse effects on the neuro-cognitive, behavioral and physical health of the child. Mothers of low socio-economic status and especially those living in crime-ridden areas are even more exposed to a host of risk factors. Societies of extreme violence, poverty and inequalities, often present difficulties to provide adequate mental health care to the most needed populations. The KINDEX, a brief standardized instrument that assesses 11 different risk factors was used by midwives to identify pregnant women at-risk, in a suburban area with one of the highest levels of domestic violence in Lima. The instrument was designed to be used by medical staff to identify high-risk child-bearing women and, based on the results, to refer them to the adequate psychological or social support providers. The aim of this study is to assess the feasibility of psychosocial screening using the KINDEX in a Latin American Country for the first time, and to explore the relationship of the KINDEX with thee major risk areas, maternal psychopathology, perceived stress and traumatic experiences. The study was conducted in cooperation with the gynecological department of a general hospital in a suburban area of Lima. Nine midwives conducted interviews using the KINDEX of ninety-five pregnant women attending the gynecological unit of the hospital. From these, forty pregnant women were re-interviewed by a clinical psychologist using established instruments in order to assess the feasibility of the prenatal assessment in public health settings and the relationship of the KINDEX with maternal perceived stress, psychopathology symptoms and trauma load during pregnancy. We found high rates of risk factors in the examined pregnant women comparable with those found in the general population. Significant correlations were found between the KINDEX

Risks of Climate Change with Respect to the Singapore-Malaysia High Speed Rail System

Directory of Open Access Journals (Sweden)

Sazrul Leena Binti Sa’adin

2016-12-01

Full Text Available Warming of the climate system is unequivocal, and many of the observed changes are unprecedented over the past five decades. Globally, the atmosphere and the ocean are becoming increasingly warmer, the amount of ice on the earth is decreasing over the oceans, and the sea level has risen. According to the Intergovernmental Panel on Climate Change, the average increase in global temperature (combined land and surface between the 1850–1900 period and the 2003–2012 period was 0.78 °C (0.72 to 0.85. But should we prepare for such a relatively small change? The importance is not the means of the warming but the considerable likelihood of climate change that could trigger extreme natural hazards. The impact and the risk of climate change associated with railway infrastructure have not been fully addressed in the literature due to the differences in local environmental parameters. On the other hand, the current railway network in Malaysia, over the last decade, has been significantly affected by severe weather conditions such as rainfall, lightning, wind and very high temperatures. Our research findings based on a critical literature review and expert interviews point out the extremes that can lead to asset system failure, degraded operation and ultimately, delays in train services. During flooding, the embankment of the track can be swept away and bridge can be demolished, while during drought, the embankment of the track can suffer from soil desiccation and embankment deterioration; high temperature increases the risk of track buckling and high winds can result in vegetation or foreign object incursion onto the infrastructure as well as exert an additional quasi-static burden. This review is of significant importance for planning and design of the newly proposed high speed rail link between Malaysia and Singapore.

Managing the risk of extreme climate events in Australian major wheat production systems

Science.gov (United States)

Luo, Qunying; Trethowan, Richard; Tan, Daniel K. Y.

2018-06-01

Extreme climate events (ECEs) such as drought, frost risk and heat stress cause significant economic losses in Australia. The risk posed by ECEs in the wheat production systems of Australia could be better managed through the identification of safe flowering (SFW) and optimal time of sowing (TOS) windows. To address this issue, three locations (Narrabri, Roseworthy and Merredin), three cultivars (Suntop and Gregory for Narrabri, Mace for both Roseworthy and Merredin) and 20 TOS at 1-week intervals between 1 April and 12 August for the period from 1957 to 2007 were evaluated using the Agricultural Production System sIMulator (APSIM)-Wheat model. Simulation results show that (1) the average frequency of frost events decreased with TOS from 8 to 0 days (d) across the four cases (the combination of locations and cultivars), (2) the average frequency of heat stress events increased with TOS across all cases from 0 to 10 d, (3) soil moisture stress (SMS) increased with earlier TOS before reaching a plateau and then slightly decreasing for Suntop and Gregory at Narrabri and Mace at Roseworthy while SMS increased with TOS for Mace at Merredin from 0.1 to 0.8, (4) Mace at Merredin had the earliest and widest SFW (216-260) while Mace at Roseworthy had latest SFW (257-280), (5) frost risk and heat stress determine SFW at wetter sites (i.e. Narrabri and Roseworthy) while frost risk and SMS determine SFW at drier site (i.e. Merredin) and (6) the optimal TOS (window) to maximise wheat yield are 6-20 May, 13-27 May and 15 April at Narrabri, Roseworthy and Merredin, respectively. These findings provide important and specific information for wheat growers about the management of ECE risk on farm. Furthermore, the coupling of the APSIM crop models with state-of-the-art seasonal and intra-seasonal climate forecast information provides an important tool for improved management of the risk of ECEs in economically important cropping industries in the foreseeable future.

A metasynthesis of risk perception in women with high risk pregnancies.

Science.gov (United States)

Lee, Suzanne; Ayers, Susan; Holden, Des

2014-04-01

risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Type 2 diabetes risk alleles demonstrate extreme directional differentiation among human populations, compared to other diseases.

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Rong Chen

Full Text Available Many disease-susceptible SNPs exhibit significant disparity in ancestral and derived allele frequencies across worldwide populations. While previous studies have examined population differentiation of alleles at specific SNPs, global ethnic patterns of ensembles of disease risk alleles across human diseases are unexamined. To examine these patterns, we manually curated ethnic disease association data from 5,065 papers on human genetic studies representing 1,495 diseases, recording the precise risk alleles and their measured population frequencies and estimated effect sizes. We systematically compared the population frequencies of cross-ethnic risk alleles for each disease across 1,397 individuals from 11 HapMap populations, 1,064 individuals from 53 HGDP populations, and 49 individuals with whole-genome sequences from 10 populations. Type 2 diabetes (T2D demonstrated extreme directional differentiation of risk allele frequencies across human populations, compared with null distributions of European-frequency matched control genomic alleles and risk alleles for other diseases. Most T2D risk alleles share a consistent pattern of decreasing frequencies along human migration into East Asia. Furthermore, we show that these patterns contribute to disparities in predicted genetic risk across 1,397 HapMap individuals, T2D genetic risk being consistently higher for individuals in the African populations and lower in the Asian populations, irrespective of the ethnicity considered in the initial discovery of risk alleles. We observed a similar pattern in the distribution of T2D Genetic Risk Scores, which are associated with an increased risk of developing diabetes in the Diabetes Prevention Program cohort, for the same individuals. This disparity may be attributable to the promotion of energy storage and usage appropriate to environments and inconsistent energy intake. Our results indicate that the differential frequencies of T2D risk alleles may

[Detecting high risk pregnancy].

Science.gov (United States)

Doret, Muriel; Gaucherand, Pascal

2009-12-20

Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration.

Science.gov (United States)

Onozuka, Daisuke; Hagihara, Akihito

2017-03-15

Although several studies have reported the impacts of extremely high temperatures on cardiovascular diseases, no studies have examined whether variation in out-of-hospital cardiac arrest (OHCA) due to extremely long sunshine duration changes during the summer. We obtained daily data on all cases of OHCA and weather variations for all 47 prefectures of Japan during the summer (June to September) between 2005 and 2014. A distributed lag non-linear model combined with a quasi-Poisson regression model was used to estimate within-summer variation in OHCA due to extremely long sunshine duration for each prefecture. Then, multivariate random-effects meta-analysis was performed to derive overall effect estimates of sunshine duration at the national level. A total of 166,496 OHCAs of presumed cardiac origin met the inclusion criteria. The minimum morbidity percentile (MMP) was the 0th percentile of sunshine duration at the national level. The overall cumulative relative risk (RR) at the 99th percentile vs. the MMP was 1.15 (95% CI: 1.05-1.27) during the summer. The effect of extremely long sunshine duration on OHCA in early summer was acute and did not persist, whereas an identical effect was observed in late summer, but it was delayed and lasted for several days. During summer periods, excessive sunshine duration could increase the risk of OHCA. Timely preventive measures to reduce the OHCA risk due to extremely long sunshine duration are important in early summer, whereas these measures could include a wider time window of several days to reduce the risk in late summer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners

Science.gov (United States)

Kahanov, Leamor; Eberman, Lindsey E; Games, Kenneth E; Wasik, Mitch

2015-01-01

Stress fractures account for between 1% and 20% of athletic injuries, with 80% of stress fractures in the lower extremity. Stress fractures of the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities such as running, military and aerobic exercise and therefore require practitioner expertise in diagnosis and management. Accurate diagnosis for stress fractures is dependent on the anatomical area. Anatomical regions such as the pelvis, sacrum, and metatarsals offer challenges due to difficulty differentiating pathologies with common symptoms. Special tests and treatment regimes, however, are similar among most stress fractures with resolution between 4 weeks to a year. The most difficult aspect of stress fracture treatment entails mitigating internal and external risk factors. Practitioners should address ongoing risk factors to minimize recurrence. PMID:25848327

Is southwestern China experiencing more frequent precipitation extremes?

International Nuclear Information System (INIS)

Liu, Meixian; Xu, Xianli; Wang, Kelin; Sun, Alexander Y; Liu, Wen; Zhang, Xiaoyan

2014-01-01

Climate extremes have and will continue to cause severe damages to buildings and natural environments around the world. A full knowledge of the probability of the climate extremes is important for the management and mitigation of natural hazards. Based on Mann–Kendall trend test and copulas, this study investigated the characteristics of precipitation extremes as well as their implications in southwestern China (Yunnan, Guangxi and Guizhou Province), through analyzing the changing trends and probabilistic characteristics of six indices, including the consecutive dry days, consecutive wet days, annual total wet day precipitation, heavy precipitation days (R25), max 5 day precipitation amount (Rx5) and the rainy days (RDs). Results showed that the study area had generally become drier (regional mean annual precipitation decreased by 11.4 mm per decade) and experienced enhanced precipitation extremes in the past 60 years. Relatively higher risk of drought in Yuanan and flood in Guangxi was observed, respectively. However, the changing trends of the precipitation extremes were not spatially uniform: increasing risk of extreme wet events for Guangxi and Guizhou, and increasing probability of concurrent extreme wet and dry events for Yunnan. Meanwhile, trend analyses of the 10 year return levels of the selected indices implied that the severity of droughts decreased in Yunnan but increased significantly in Guangxi and Guizhou, and the severity of floods increased in Yunnan and Guangxi in the past decades. Hence, the policy-makers need to be aware of the different characterizations and the spatial heterogeneity of the precipitation extremes. (letters)

Recent and future warm extreme events and high-mountain slope stability.

Science.gov (United States)

Huggel, C; Salzmann, N; Allen, S; Caplan-Auerbach, J; Fischer, L; Haeberli, W; Larsen, C; Schneider, D; Wessels, R

2010-05-28

The number of large slope failures in some high-mountain regions such as the European Alps has increased during the past two to three decades. There is concern that recent climate change is driving this increase in slope failures, thus possibly further exacerbating the hazard in the future. Although the effects of a gradual temperature rise on glaciers and permafrost have been extensively studied, the impacts of short-term, unusually warm temperature increases on slope stability in high mountains remain largely unexplored. We describe several large slope failures in rock and ice in recent years in Alaska, New Zealand and the European Alps, and analyse weather patterns in the days and weeks before the failures. Although we did not find one general temperature pattern, all the failures were preceded by unusually warm periods; some happened immediately after temperatures suddenly dropped to freezing. We assessed the frequency of warm extremes in the future by analysing eight regional climate models from the recently completed European Union programme ENSEMBLES for the central Swiss Alps. The models show an increase in the higher frequency of high-temperature events for the period 2001-2050 compared with a 1951-2000 reference period. Warm events lasting 5, 10 and 30 days are projected to increase by about 1.5-4 times by 2050 and in some models by up to 10 times. Warm extremes can trigger large landslides in temperature-sensitive high mountains by enhancing the production of water by melt of snow and ice, and by rapid thaw. Although these processes reduce slope strength, they must be considered within the local geological, glaciological and topographic context of a slope.

Decision Making and Risk Evaluation Frameworks for Extreme Space Weather Events

Science.gov (United States)

Uritskaya, O.; Robinson, R. M.; Pulkkinen, A. A.

2017-12-01

Extreme Space Weather events (ESWE) are in the spotlight nowadays because they can produce a significant impact not only due to their intensity and broad geographical scope, but also because of the widespread levels and the multiple sectors of the economy that could be involved. In the task of evaluation of the ESWE consequences, the most problematic and vulnerable aspect is the determination and calculation of the probability of statistically infrequent events and the subsequent assessment of the economic risks. In this work, we conduct a detailed analysis of the available frameworks of the general Decision-Making Theory in the presence of uncertainty, in the context of their applicability for the numerical estimation of the risks and losses associated with ESWE. The results of our study demonstrate that, unlike the Multiple-criteria decision analysis or Minimax approach to modeling of the possible scenarios for the ESWE effects, which prevail in the literature, the most suitable concept is the Games Against Nature (GAN). It enables an evaluation of every economically relevant aspect of space weather conditions and obtain more detailed results. Choosing the appropriate methods for solving GAN models, i.e. determining the most optimal strategy with a given level of uncertainty, requires estimating the conditional probabilities of Space Weather events for each outcome of possible scenarios of this natural disaster. Due to the specifics of complex natural and economic systems, with which we are dealing in this case, this problem remains unsolved, mainly because of inevitable loss of information at every stage of the decision-making process. The analysis is illustrated by deregulated electricity markets of the USA and Canada, whose power grid systems are known to be perceptive to ESWE. The GAN model is more appropriate in identifying potential risks in economic systems. The proposed approach, when applied to the existing database of Space Weather observations and

INLA goes extreme: Bayesian tail regression for the estimation of high spatio-temporal quantiles

KAUST Repository

Opitz, Thomas; Huser, Raphaë l; Bakka, Haakon; Rue, Haavard

2018-01-01

approach is based on a Bayesian generalized additive modeling framework that is designed to estimate complex trends in marginal extremes over space and time. First, we estimate a high non-stationary threshold using a gamma distribution for precipitation

Measuring Value-at-Risk and Expected Shortfall of crude oil portfolio using extreme value theory and vine copula

Science.gov (United States)

Yu, Wenhua; Yang, Kun; Wei, Yu; Lei, Likun

2018-01-01

Volatilities of crude oil price have important impacts on the steady and sustainable development of world real economy. Thus it is of great academic and practical significance to model and measure the volatility and risk of crude oil markets accurately. This paper aims to measure the Value-at-Risk (VaR) and Expected Shortfall (ES) of a portfolio consists of four crude oil assets by using GARCH-type models, extreme value theory (EVT) and vine copulas. The backtesting results show that the combination of GARCH-type-EVT models and vine copula methods can produce accurate risk measures of the oil portfolio. Mixed R-vine copula is more flexible and superior to other vine copulas. Different GARCH-type models, which can depict the long-memory and/or leverage effect of oil price volatilities, however offer similar marginal distributions of the oil returns.

Riparian responses to extreme climate and land-use change scenarios.

Science.gov (United States)

Fernandes, Maria Rosário; Segurado, Pedro; Jauch, Eduardo; Ferreira, Maria Teresa

2016-11-01

Climate change will induce alterations in the hydrological and landscape patterns with effects on riparian ecotones. In this study we assess the combined effect of an extreme climate and land-use change scenario on riparian woody structure and how this will translate into a future risk of riparian functionality loss. The study was conducted in the Tâmega catchment of the Douro basin. Boosted Regression Trees (BRTs) were used to model two riparian landscape indicators related with the degree of connectivity (Mean Width) and complexity (Area Weighted Mean Patch Fractal Dimension). Riparian data were extracted by planimetric analysis of high spatial-resolution Word Imagery Layer (ESRI). Hydrological, climatic and land-use variables were obtained from available datasets and generated with process-based modeling using current climate data (2008-2014), while also considering the high-end RCP8.5 climate-change and "Icarus" socio-economic scenarios for the 2046-2065 time slice. Our results show that hydrological and land-use changes strongly influence future projections of riparian connectivity and complexity, albeit to diverse degrees and with differing effects. A harsh reduction in average flows may impair riparian zones while an increase in extreme rain events may benefit connectivity by promoting hydrologic dynamics with the surrounding floodplains. The expected increase in broad-leaved woodlands and mixed forests may enhance the riparian galleries by reducing the agricultural pressure on the area in the vicinity of the river. According to our results, 63% of river segments in the Tâmega basin exhibited a moderate risk of functionality loss, 16% a high risk, and 21% no risk. Weaknesses and strengths of the method are highlighted and results are discussed based on a resilience perspective with regard to riparian ecosystems. Copyright © 2016 Elsevier B.V. All rights reserved.

Early neurodevelopmental outcomes of extremely preterm infants.

Science.gov (United States)

Rogers, Elizabeth E; Hintz, Susan R

2016-12-01

Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Extremes in nature

CERN Document Server

Salvadori, Gianfausto; Kottegoda, Nathabandu T

2007-01-01

This book is about the theoretical and practical aspects of the statistics of Extreme Events in Nature. Most importantly, this is the first text in which Copulas are introduced and used in Geophysics. Several topics are fully original, and show how standard models and calculations can be improved by exploiting the opportunities offered by Copulas. In addition, new quantities useful for design and risk assessment are introduced.

Sibling Death after Being Thrown from Window by Brother with Autism: Defenestration, an Emerging High-Risk Behavior

Directory of Open Access Journals (Sweden)

Osman Sabuncuoglu

2015-01-01

Full Text Available Children diagnosed with autistic spectrum disorders (ASD may have serious behavioral problems such as aggression, self-injury, and violence. However, the literature on ASD either overrules any correlation between aggression and ASD or maintains the fact that the efforts to link them have so far been inconclusive. Although severe forms of violence are extremely rare in children with autism, there are a few cases reported in the literature with significant harm to siblings. We hereby report an 8-year-old boy with ASD who caused the death of his sibling by throwing her out of the window. Shared similarities of all defenestration cases indicate a pattern of high-risk behavior threatening the survival of minors. We recommend precautions against this high-risk behavior in children with ASD.

Extreme Environment Circuit Blocks for Spacecraft Power & Propulsion System & Other High Reliability Applications, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Chronos Technology (DIv of FMI, Inc.) proposes to design, fabricate, and deliver a performance proven, and commercially available set of extreme high operating...

Risk perception in women with high-risk pregnancies

OpenAIRE

Lee, S.

2014-01-01

Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

Science.gov (United States)

Andersen, Johan H; Fallentin, Nils; Thomsen, Jane F; Mikkelsen, Sigurd

2011-05-12

To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

Directory of Open Access Journals (Sweden)

Johan H Andersen

Full Text Available BACKGROUND: To summarize systematic reviews that 1 assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS or upper extremity musculoskeletal disorders (UEMSDs, or 2 reported on intervention studies among computer users/or office workers. METHODOLOGY/PRINCIPAL FINDINGS: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. CONCLUSIONS/SIGNIFICANCE: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

Developing high-risk scenarios and countermeasure ideas for mitigation of hazardous materials incidents

International Nuclear Information System (INIS)

Russell, E.R. Sr.

1991-01-01

Kansas State University (KSU) conducted a comprehensive study of the development of a set of prioritized, extreme-risk scenarios, the development of a set of feasible, practical and implementable protective systems, and a report to summarize guidelines on the use of these protective systems to mitigate potential, extreme-risk situations that could occur during the transport of hazardous materials (Hazmat) on our highway system. This paper covers the methodology used to compete the first tow objectives with use of a state's panel. The research study was limited to materials (such as LNG, propane, gasoline, etc.) spilled within the highway system. It focused on potential risks which would result in severe, long-term, permanent, irreparable or catastrophic consequences, and existing technology and state-of-the-art knowledge for development of protective systems to mitigate these consequences. The protective systems within the scope of this study were systems constructed or physically incorporated into the highway system or modifications thereto

Enhancing the Extreme Climate Index (ECI) to monitor climate extremes for an index-based insurance scheme across Africa

Science.gov (United States)

Helmschrot, J.; Malherbe, J.; Chamunorwa, M.; Muthige, M.; Petitta, M.; Calmanti, S.; Cucchi, M.; Syroka, J.; Iyahen, E.; Engelbrecht, F.

2017-12-01

Climate services are a key component of National Adaptation Plan (NAP) processes, which require the analysis of current climate conditions, future climate change scenarios and the identification of adaptation strategies, including the capacity to finance and implement effective adaptation options. The Extreme Climate Facility (XCF) proposed by the African Risk Capacity (ARC) developed a climate index insurance scheme, which is based on the Extreme Climate Index (ECI): an objective, multi-hazard index capable of tracking changes in the frequency or magnitude of extreme weather events, thus indicating possible shifts to a new climate regime in various regions. The main hazards covered by ECI are extreme dry, wet and heat events, with the possibility of adding other region-specific risk events. The ECI is standardized across broad geographical regions, so that extreme events occurring under different climatic regimes in Africa can be compared. Initially developed by an Italian company specialized in Climate Services, research is now conducted at the CSIR and SASSCAL, to verify and further develop the ECI for application in southern African countries, through a project initiated by the World Food Programme (WFP) and ARC. The paper will present findings on the most appropriate definitions of extremely wet and dry conditions in Africa, in terms of their impact across a multitude of sub-regional climates of the African continent. Findings of a verification analysis of the ECI, as determined through vegetation monitoring data and the SASSCAL weather station network will be discussed. Changes in the ECI under climate change will subsequently be projected, using detailed regional projections generated by the CSIR and through the Coordinated Regional Downscaling Experiment (CORDEX). This work will be concluded by the development of a web-based climate service informing African Stakeholders on climate extremes.

Optimization with Extremal Dynamics

International Nuclear Information System (INIS)

Boettcher, Stefan; Percus, Allon G.

2001-01-01

We explore a new general-purpose heuristic for finding high-quality solutions to hard discrete optimization problems. The method, called extremal optimization, is inspired by self-organized criticality, a concept introduced to describe emergent complexity in physical systems. Extremal optimization successively updates extremely undesirable variables of a single suboptimal solution, assigning them new, random values. Large fluctuations ensue, efficiently exploring many local optima. We use extremal optimization to elucidate the phase transition in the 3-coloring problem, and we provide independent confirmation of previously reported extrapolations for the ground-state energy of ±J spin glasses in d=3 and 4

Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

Directory of Open Access Journals (Sweden)

R Kreidy

2009-07-01

Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

Progression of disease preceding lower extremity amputation in Denmark

DEFF Research Database (Denmark)

Jensen, Pia Søe; Petersen, Janne; Kirketerp-Møller, Klaus

2017-01-01

OBJECTIVES: Patients with non-traumatic lower extremity amputation are characterised by high age, multi-morbidity and polypharmacy and long-term complications of atherosclerosis and diabetes. To ensure early identification of patients at risk of amputation, we need to gain knowledge about...... the progression of diseases related to lower extremity amputations during the years preceding the amputation. DESIGN: A retrospective population-based national registry study. SETTING: The study includes data on demographics, diagnoses, surgery, medications and healthcare services from five national registries....... Data were retrieved from 14 years before until 1 year after the amputation. Descriptive statistics were used to describe the progression of diseases and use of medication and healthcare services. PARTICIPANTS: An unselected cohort of patients (≥50 years; n=2883) subjected to a primary non...

[Ultrasound examination for lower extremity deep vein thrombosis].

Science.gov (United States)

Toyota, Kosaku

2014-09-01

Surgery is known to be a major risk factor of vein thrombosis. Progression from lower extremity deep vein thrombosis (DVT) to pulmonary embolism can lead to catastrophic outcome, although the incidence ratio is low. The ability to rule in or rule out DVT is becoming essential for anesthesiologists. Non-invasive technique of ultrasonography is a sensitive and specific tool for the assessment of lower extremity DVT. This article introduces the basics and practical methods of ultrasound examination for lower extremity DVT.

Response of snow-dependent hydrologic extremes to continued global warming

Energy Technology Data Exchange (ETDEWEB)

Diffenbaugh, Noah [Stanford University; Scherer, Martin [Stanford University; Ashfaq, Moetasim [ORNL

2012-01-01

Snow accumulation is critical for water availability in the Northern Hemisphere1,2, raising concern that global warming could have important impacts on natural and human systems in snow-dependent regions1,3. Although regional hydrologic changes have been observed (for example, refs 1,3 5), the time of emergence of extreme changes in snow accumulation and melt remains a key unknown for assessing climate- change impacts3,6,7. We find that the CMIP5 global climate model ensemble exhibits an imminent shift towards low snow years in the Northern Hemisphere, with areas of western North America, northeastern Europe and the Greater Himalaya showing the strongest emergence during the near- termdecadesandat2 Cglobalwarming.Theoccurrenceof extremely low snow years becomes widespread by the late twenty-first century, as do the occurrences of extremely high early-season snowmelt and runoff (implying increasing flood risk), and extremely low late-season snowmelt and runoff (implying increasing water stress). Our results suggest that many snow-dependent regions of the Northern Hemisphere are likely to experience increasing stress from low snow years within the next three decades, and from extreme changes in snow-dominated water resources if global warming exceeds 2 C above the pre-industrial baseline.

An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

Directory of Open Access Journals (Sweden)

Ford KR

2015-08-01

Full Text Available Kevin R Ford,1 Anh-Dung Nguyen,2 Steven L Dischiavi,1 Eric J Hegedus,1 Emma F Zuk,2 Jeffrey B Taylor11Department of Physical Therapy, High Point University, High Point, NC, USA; 2Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USAAbstract: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.Keywords: dynamic lower extremity valgus, hip neuromuscular control, ACL injury rehabilitation, patellofemoral pain, hip muscular activation

STUDY ON IMPACT OF SALINE WATER INUNDATION ON FRESHWATER AQUACULTURE IN SUNDARBAN USING RISK ANALYSIS TOOLS

Directory of Open Access Journals (Sweden)

B.K Chand

2012-11-01

Full Text Available The impact of saline water inundation on freshwater aquaculture was evaluated through risk assessment tools. Fishponds in low-lying areas of Sagar and Basanti block are prone to saline water flooding. Respondents of Sagar block considered events like cyclone and coastal flooding as extreme risk; erratic monsoon, storm surge and land erosion as high risk; temperature rise, sea level rise, hot & extended summer and precipitation as medium risk. Likewise, in Basanti block the respondents rated cyclone as extreme risk; erratic monsoon, storm surge as high risk; temperature rise, hot & extended summer, land erosion, and precipitation as medium risk; coastal flooding and sea level rise as low risk. Fish farmers of Sagar block classified the consequences of saline water flooding like breach of pond embankment and mass mortality of fishes as extreme risk; escape of existing fish stock and diseases as high risk; entry of unwanted species, retardation of growth and deterioration of water quality as medium risk; and damage of pond environment as low risk. Farmers of Basanti block categorised breach of pond dyke, mass mortality of fishes and entry of unwanted species as extreme risk; escape of fish and diseases as high risk; retardation of growth as medium risk; deterioration of water quality and damage of pond environment as low risk. To reduce the threats against saline water ingression, farmers are taking some coping measures like increase in pond dyke height; repair and strengthening of dyke; plantation on dyke; dewatering and addition of fresh water; application of chemicals/ lime/ dung; addition of tree branches in pond for hide outs etc.

Active muscle response contributes to increased injury risk of lower extremity in occupant-knee airbag interaction.

Science.gov (United States)

Nie, Bingbing; Sathyanarayan, Deepak; Ye, Xin; Crandall, Jeff R; Panzer, Matthew B

2018-02-28

Recent field data analysis has demonstrated that knee airbags (KABs) can reduce occupant femur and pelvis injuries but may be insufficient to decrease leg injuries in motor vehicle crashes. An enhanced understanding of the associated injury mechanisms requires accurate assessment of physiological-based occupant parameters, some of which are difficult or impossible to obtain from experiments. This study sought to explore how active muscle response can influence the injury risk of lower extremities during KAB deployment using computational biomechanical analysis. A full-factorial matrix, consisting of 48 finite element simulations of a 50th percentile occupant human model in a simplified vehicle interior, was designed. The matrix included 32 new cases in combination with 16 previously reported cases. The following influencing factors were taken into account: muscle activation, KAB use, KAB design, pre-impact seating position, and crash mode. Responses of 32 lower extremity muscles during emergency braking were replicated using one-dimensional elements of a Hill-type constitutive model, with the activation level determined from inverse dynamics and validated by existing volunteer tests. Dynamics of unfolding and inflating of the KABs were represented using the state-of-the-art corpuscular particle method. Abbreviated Injury Scale (AIS) 2+ injury risks of the knee-thigh-hip (KTH) complex and the tibia were assessed using axial force and resultant bending moments. With all simulation cases being taken together, a general linear model was used to assess factor significance (P systems. Future efforts are recommended on realistic vehicle and restraint environment and advanced modeling strategies toward a full understanding of KAB efficacy.

Extreme conditioning programs and injury risk in a US Army Brigade Combat Team.

Science.gov (United States)

Grier, Tyson; Canham-Chervak, Michelle; McNulty, Vancil; Jones, Bruce H

2013-01-01

Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programs with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC program is a unique physical training program consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programs such as the Ranger Athlete Warrior program and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning program (ECP). To determine if these new programs (ATAC, ECP) had an effect on injury rates and physical fitness. Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new program. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during

Upper extremity golf injuries.

Science.gov (United States)

Cohn, Michael A; Lee, Steven K; Strauss, Eric J

2013-01-01

Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

Assessing Climate Variability using Extreme Rainfall and ...

African Journals Online (AJOL)

user1

extreme frequency); the average intensity of rainfall from extreme events ... frequency and extreme intensity indices, suggesting that extreme events are more frequent and intense during years with high rainfall. The proportion of total rainfall from ...

Extremely Severe Space Weather and Geomagnetically Induced Currents in Regions with Locally Heterogeneous Ground Resistivity

Science.gov (United States)

Fujita, Shigeru; Kataoka, Ryuho; Pulkkinen, Antti; Watari, Shinichi

2016-01-01

Large geomagnetically induced currents (GICs) triggered by extreme space weather events are now regarded as one of the serious natural threats to the modern electrified society. The risk is described in detail in High-Impact, Low-Frequency Event Risk, A Jointly-Commissioned Summary Report of the North American Electric Reliability Corporation and the US Department of Energy's November 2009 Workshop, June 2010. For example, the March 13-14,1989 storm caused a large-scale blackout affecting about 6 million people in Quebec, Canada, and resulting in substantial economic losses in Canada and the USA (Bolduc 2002). Therefore, European and North American nations have invested in GIC research such as the Solar Shield project in the USA (Pulkkinen et al. 2009, 2015a). In 2015, the Japanese government (Ministry of Economy, Trade and Industry, METI) acknowledged the importance of GIC research in Japan. After reviewing the serious damages caused by the 2011 Tohoku-Oki earthquake, METI recognized the potential risk to the electric power grid posed by extreme space weather. During extreme events, GICs can be concerning even in mid- and low-latitude countries and have become a global issue.

Extremely deformable structures

CERN Document Server

2015-01-01

Recently, a new research stimulus has derived from the observation that soft structures, such as biological systems, but also rubber and gel, may work in a post critical regime, where elastic elements are subject to extreme deformations, though still exhibiting excellent mechanical performances. This is the realm of ‘extreme mechanics’, to which this book is addressed. The possibility of exploiting highly deformable structures opens new and unexpected technological possibilities. In particular, the challenge is the design of deformable and bi-stable mechanisms which can reach superior mechanical performances and can have a strong impact on several high-tech applications, including stretchable electronics, nanotube serpentines, deployable structures for aerospace engineering, cable deployment in the ocean, but also sensors and flexible actuators and vibration absorbers. Readers are introduced to a variety of interrelated topics involving the mechanics of extremely deformable structures, with emphasis on ...

Improved Extreme Learning Machine and Its Application in Image Quality Assessment

Directory of Open Access Journals (Sweden)

Li Mao

2014-01-01

Full Text Available Extreme learning machine (ELM is a new class of single-hidden layer feedforward neural network (SLFN, which is simple in theory and fast in implementation. Zong et al. propose a weighted extreme learning machine for learning data with imbalanced class distribution, which maintains the advantages from original ELM. However, the current reported ELM and its improved version are only based on the empirical risk minimization principle, which may suffer from overfitting. To solve the overfitting troubles, in this paper, we incorporate the structural risk minimization principle into the (weighted ELM, and propose a modified (weighted extreme learning machine (M-ELM and M-WELM. Experimental results show that our proposed M-WELM outperforms the current reported extreme learning machine algorithm in image quality assessment.

Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

Directory of Open Access Journals (Sweden)

Nicoleta-Elena Buzatu

2012-05-01

Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

Effects of elevated mean and extremely high temperatures on the physio-ecological characteristics of geographically distinctive populations of Cunninghamia lanceolata

Science.gov (United States)

Zhou, Ting; Jia, Xiaorong; Liao, Huixuan; Peng, Shijia; Peng, Shaolin

2016-12-01

Conventional models for predicting species distribution under global warming scenarios often treat one species as a homogeneous whole. In the present study, we selected Cunninghamia lanceolata (C. lanceolata), a widely distributed species in China, to investigate the physio-ecological responses of five populations under different temperature regimes. The results demonstrate that increased mean temperatures induce increased growth performance among northern populations, which exhibited the greatest germination capacity and largest increase in the overlap between the growth curve and the monthly average temperature. However,tolerance of the southern population to extremely high temperatures was stronger than among the population from the northern region,shown by the best growth and the most stable photosynthetic system of the southern population under extremely high temperature. This result indicates that the growth advantage among northern populations due to increased mean temperatures may be weakened by lower tolerance to extremely high temperatures. This finding is antithetical to the predicted results. The theoretical coupling model constructed here illustrates that the difference in growth between populations at high and low latitudes and altitudes under global warming will decrease because of the frequent occurrence of extremely high temperatures.

The effect of extreme cold temperatures on the risk of death in the two major Portuguese cities

Science.gov (United States)

Antunes, Liliana; Silva, Susana Pereira; Marques, Jorge; Nunes, Baltazar; Antunes, Sílvia

2017-01-01

It is well known that meteorological conditions influence the comfort and human health. Southern European countries, including Portugal, show the highest mortality rates during winter, but the effects of extreme cold temperatures in Portugal have never been estimated. The objective of this study was the estimation of the effect of extreme cold temperatures on the risk of death in Lisbon and Oporto, aiming the production of scientific evidence for the development of a real-time health warning system. Poisson regression models combined with distributed lag non-linear models were applied to assess the exposure-response relation and lag patterns of the association between minimum temperature and all-causes mortality and between minimum temperature and circulatory and respiratory system diseases mortality from 1992 to 2012, stratified by age, for the period from November to March. The analysis was adjusted for over dispersion and population size, for the confounding effect of influenza epidemics and controlled for long-term trend, seasonality and day of the week. Results showed that the effect of cold temperatures in mortality was not immediate, presenting a 1-2-day delay, reaching maximum increased risk of death after 6-7 days and lasting up to 20-28 days. The overall effect was generally higher and more persistent in Lisbon than in Oporto, particularly for circulatory and respiratory mortality and for the elderly. Exposure to cold temperatures is an important public health problem for a relevant part of the Portuguese population, in particular in Lisbon.

Radical prostatectomy for high-risk prostate cancer.

Science.gov (United States)

Yossepowitch, Ofer; Eastham, James A

2008-06-01

Consensus recommendations for the identification and treatment of men whose apparent organ confined prostate cancer has high risk features are lacking. Despite ongoing refinements in surgical technique and improvements in morbidity and functional outcomes, the tradition of steering high-risk patients away from radical prostatectomy (RP) remains steadfast. We performed a medical literature search in English using MEDLINE/PubMed that addressed high risk prostate cancer. We analyzed the literature with respect to the historical evolution of this concept, current risk stratification schemes and treatment guidelines and related short and long term outcomes following RP. Contemporary evidence suggest that patients classified with high-risk prostate cancer by commonly used definitions do not have a uniformly poor prognosis after RP. Many cancers categorized clinically as high risk are actually pathologically confined to the prostate, and most men with such cancers who undergo RP are alive and free of additional therapy long after surgery. RP in the high-risk setting appears to be associated with a similar morbidity as in lower-risk patients. Men with clinically localized high-risk prostate cancer should not be categorically disqualified from local definitive therapy with RP. With careful attention to surgical technique, cancer control rates should improve further, and adverse effects on quality of life after RP should continue to decrease.

To evaluate the differences of risk factors in patients with lower extremity venous disease

International Nuclear Information System (INIS)

Sadikoglu, G.; Ozcakir, A.; Ercan, I.; Ozkaya, G.; Sadikoglu, Y.M.

2007-01-01

To determine whether there is difference between risk factors in patients diagnosed to have clinically documented lower extremity venous disease after confirming the diagnosis radiologically by ultrasonographic and venographic evaluation. This study was performed from January 2002 to January 2005 in Bursa, the fourth biggest city of Turkey situated in the west of country in the Marmara region. The study center is a private imaging center working in conjunction with the Department of Health, which performs diagnostic and therapeutic vascular protocols in the region. Five hundred and fifty-three cases with clinically and radiologically documented diagnoses were evaluated with Multi-Variate Statistical Package 3.13 for the presence of pre-defined clusters of 14 different variables. Other statistical analyses were performed by the Statistical Package for Social sciences, version 13.0. Three different clusters were defined. The variables used to define the clusters were: age, gender, educational level, presence of smoking, amount of smoking (pack/per year), disease symptoms, presence of heart disease and radiologically documented diagnosis. Chronic venous insufficiency and varicose veins are venous system diseases that are most commonly present in association with more than one concomitant risk factors. (author)

Extreme Environment High Temperature Communication Systems, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — The purpose of this project is to develop and demonstrate a communications system capable of operation at extreme temperatures and pressures in hostile and corrosive...

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes.

Science.gov (United States)

Gilbert, Frances C; Burdette, G Trey; Joyner, A Barry; Llewellyn, Tracy A; Buckley, Thomas A

Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Cross-sectional study. Level 3. Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. There were significant associations between concussion and lateral ankle sprain ( P = 0.012), knee injury ( P = 0.002), and lower extremity muscle strain ( P = 0.031). There were also significant associations between reported concussions and knee injury ( P = 0.003), unreported concussions and knee injury ( P = 0.002), and unrecognized concussions and lateral ankle sprain ( P = 0.001) and lower extremity muscle strains ( P = 0.006), with odds ratios ranging from 1.6 to 2.9. There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.

Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities

International Nuclear Information System (INIS)

Oya, Natsuo; Kokubo, Masaki; Mizowaki, Takashi; Shibamoto, Yuta; Nagata, Yasushi; Sasai, Keisuke; Nishimura, Yasumasa; Tsuboyama, Tadao; Toguchida, Junya; Nakamura, Takashi; Hiraoka, Masahiro

2001-01-01

Purpose: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb. Methods and Materials: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months. Results: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4-29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays. Conclusions: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved

The influence of non thermal coherent EMR with low intensity and extremely high frequency on total activity and isoenzyme composition of peroxidase

International Nuclear Information System (INIS)

Nerkararyan, A.V.; Shahinyan, M.A.; Khachatryan, A.V.; Vardevanyan, P.O.

2011-01-01

In this work the influence of non-thermal coherent electromagnetic radiation (EMR) with low intensity and extremely high frequency on intensity of wheat developing germ metabolism has been investigated. Particularly, total activity and isoenzymatic composition of peroxidase of germ cells have been determined during their growth. The role of water in formation of organism response reaction to the external physical field effect has also been investigated. It has been shown, that water appears to be a primary element of extremely high frequency EMR effect on bio system. Extremely high frequency EMR irradiation of germinating seeds and the cultivation of dry seeds and their germs by irradiated water stimulate peroxidase synthesis in germ cells. The redistribution of quantitative composition of peroxidase molecular forms takes place in germ cells effected by EMR with extremely high frequency and low intensity

Return levels of temperature extremes in southern Pakistan

Science.gov (United States)

Zahid, Maida; Blender, Richard; Lucarini, Valerio; Caterina Bramati, Maria

2017-12-01

Southern Pakistan (Sindh) is one of the hottest regions in the world and is highly vulnerable to temperature extremes. In order to improve rural and urban planning, it is useful to gather information about the recurrence of temperature extremes. In this work, return levels of the daily maximum temperature Tmax are estimated, as well as the daily maximum wet-bulb temperature TWmax extremes. We adopt the peaks over threshold (POT) method, which has not yet been used for similar studies in this region. Two main datasets are analyzed: temperatures observed at nine meteorological stations in southern Pakistan from 1980 to 2013, and the ERA-Interim (ECMWF reanalysis) data for the nearest corresponding locations. The analysis provides the 2-, 5-, 10-, 25-, 50-, and 100-year return levels (RLs) of temperature extremes. The 90 % quantile is found to be a suitable threshold for all stations. We find that the RLs of the observed Tmax are above 50 °C at northern stations and above 45 °C at the southern stations. The RLs of the observed TWmax exceed 35 °C in the region, which is considered as a limit of survivability. The RLs estimated from the ERA-Interim data are lower by 3 to 5 °C than the RLs assessed for the nine meteorological stations. A simple bias correction applied to ERA-Interim data improves the RLs remarkably, yet discrepancies are still present. The results have potential implications for the risk assessment of extreme temperatures in Sindh.

Morbidity of a combined modality therapy of I.A. Doxorubicin, neoadjuvant radiotherapy and surgery for locally advanced high grade Soft Tissue Sarcomas (STS) of the extremities

International Nuclear Information System (INIS)

Nijhuis, Paul; Pras, Betty; Sleijfer, Dirk Th.; Molenaar, Ineke M.; Schraffordt, Koops Heimen; Hoekstra, Harald J.

1997-01-01

Purpose/objective: In the early eighties a combined modality therapy of intra-arterial doxorubicin, neo-adjuvant radiotherapy and surgery was introduced as limb-saving treatment for 'unresectable' grade III high grade STS of the extremities. We studied short and long-term morbidity of this combined modality treatment. Materials and methods: Between 1982 and 1986 11 patients, 9 male and 2 female, median age 52 (range 24-70) years, with 'unresectable' grade III STS of the extremities were treated by preoperative i.a. infusion of doxorubicin for three consecutive days (daily dose 20 mg/m 2 ). Within 24 hours after infusion preoperative radiation of the compartment (10 x 350 cGy) was started. After chemo-radiotherapy the tumor was resected. Non-radical resections received additionally 20-30 Gy radiotherapy (9 patients). Results: No local recurrences (median follow-up 110 months); pulmonary metastases in five patients (45%). Local skin toxicity due to doxorubicin in three patients (27%). Preoperative 35 Gy radiotherapy was well tolerated. Limb-saving treatment was possible in ten patients (91%); in one patient an exarticulation of the hip had to be performed. Three of the five long-term survivors (follow-up > 10 years) developed a severe fibrosis of the affected limb (60%). Two severe long-term complications: a stress fracture of the affected femur (91 months after treatment), and a severe radiation-induced motor and sensory neuropathy of the sciatic nerve. Conclusion: The long-term results show a limb-saving rate of 91%, without increasing the risk of a local recurrence. Especially the long-term morbidity is extremely high (60%). This combination therapy should therefore no longer be advocated as a limb-saving treatment modality for these primarily 'unresectable' high grade STS of the extremities

An "Ensemble Approach" to Modernizing Extreme Precipitation Estimation for Dam Safety Decision-Making

Science.gov (United States)

Cifelli, R.; Mahoney, K. M.; Webb, R. S.; McCormick, B.

2017-12-01

To ensure structural and operational safety of dams and other water management infrastructure, water resources managers and engineers require information about the potential for heavy precipitation. The methods and data used to estimate extreme rainfall amounts for managing risk are based on 40-year-old science and in need of improvement. The need to evaluate new approaches based on the best science available has led the states of Colorado and New Mexico to engage a body of scientists and engineers in an innovative "ensemble approach" to updating extreme precipitation estimates. NOAA is at the forefront of one of three technical approaches that make up the "ensemble study"; the three approaches are conducted concurrently and in collaboration with each other. One approach is the conventional deterministic, "storm-based" method, another is a risk-based regional precipitation frequency estimation tool, and the third is an experimental approach utilizing NOAA's state-of-the-art High Resolution Rapid Refresh (HRRR) physically-based dynamical weather prediction model. The goal of the overall project is to use the individual strengths of these different methods to define an updated and broadly acceptable state of the practice for evaluation and design of dam spillways. This talk will highlight the NOAA research and NOAA's role in the overarching goal to better understand and characterizing extreme precipitation estimation uncertainty. The research led by NOAA explores a novel high-resolution dataset and post-processing techniques using a super-ensemble of hourly forecasts from the HRRR model. We also investigate how this rich dataset may be combined with statistical methods to optimally cast the data in probabilistic frameworks. NOAA expertise in the physical processes that drive extreme precipitation is also employed to develop careful testing and improved understanding of the limitations of older estimation methods and assumptions. The process of decision making in the

Client experiences with perinatal healthcare for high-risk and low-risk women

NARCIS (Netherlands)

van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

2018-01-01

Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

Extremely low temperature properties of epoxy GFRP

International Nuclear Information System (INIS)

Kadotani, Kenzo; Nagai, Matao; Aki, Fumitake.

1983-01-01

The examination of fiber-reinforced plastics, that is, plastics such as epoxy, polyester and polyimide reinforced with high strength fibers such as glass, carbon, boron and steel, for extremely low temperature use began from the fuel tanks of rockets. Therafter, the trial manufacture of superconducting generators and extremely low temperature transformers and the manufacture of superconducting magnets for nuclear fusion experimental setups became active, and high performance FRPs have been adopted, of which the extremely low temperature properties have been sufficiently grasped. Recently, the cryostats made of FRPs have been developed, fully utilizing such features of FRPs as high strength, high rigidity, non-magnetic material, insulation, low heat conductivity, light weight and the freedom of molding. In this paper, the mechanical properties at extremely low temperature of the plastic composite materials used as insulators and structural materials for extremely low temperature superconducting equipment is outlined, and in particular, glass fiber-reinforced epoxy laminates are described somewhat in detail. The fracture strain of GFRP at extremely low temperature is about 1.3 times as large as that at room temperature, but at extremely low temperature, clear cracking occurred at 40% of the fracture strain. The linear thermal contraction of GFRP showed remarkable anisotropy. (Kako, I.)

Solving Component Structural Dynamic Failures Due to Extremely High Frequency Structural Response on the Space Shuttle Program

Science.gov (United States)

Frady, Greg; Nesman, Thomas; Zoladz, Thomas; Szabo, Roland

2010-01-01

For many years, the capabilities to determine the root-cause failure of component failures have been limited to the analytical tools and the state of the art data acquisition systems. With this limited capability, many anomalies have been resolved by adding material to the design to increase robustness without the ability to determine if the design solution was satisfactory until after a series of expensive test programs were complete. The risk of failure and multiple design, test, and redesign cycles were high. During the Space Shuttle Program, many crack investigations in high energy density turbomachines, like the SSME turbopumps and high energy flows in the main propulsion system, have led to the discovery of numerous root-cause failures and anomalies due to the coexistences of acoustic forcing functions, structural natural modes, and a high energy excitation, such as an edge tone or shedding flow, leading the technical community to understand many of the primary contributors to extremely high frequency high cycle fatique fluid-structure interaction anomalies. These contributors have been identified using advanced analysis tools and verified using component and system tests during component ground tests, systems tests, and flight. The structural dynamics and fluid dynamics communities have developed a special sensitivity to the fluid-structure interaction problems and have been able to adjust and solve these problems in a time effective manner to meet budget and schedule deadlines of operational vehicle programs, such as the Space Shuttle Program over the years.

Extreme events in total ozone over Arosa – Part 1: Application of extreme value theory

Directory of Open Access Journals (Sweden)

H. E. Rieder

2010-10-01

Full Text Available In this study ideas from extreme value theory are for the first time applied in the field of stratospheric ozone research, because statistical analysis showed that previously used concepts assuming a Gaussian distribution (e.g. fixed deviations from mean values of total ozone data do not adequately address the structure of the extremes. We show that statistical extreme value methods are appropriate to identify ozone extremes and to describe the tails of the Arosa (Switzerland total ozone time series. In order to accommodate the seasonal cycle in total ozone, a daily moving threshold was determined and used, with tools from extreme value theory, to analyse the frequency of days with extreme low (termed ELOs and high (termed EHOs total ozone at Arosa. The analysis shows that the Generalized Pareto Distribution (GPD provides an appropriate model for the frequency distribution of total ozone above or below a mathematically well-defined threshold, thus providing a statistical description of ELOs and EHOs. The results show an increase in ELOs and a decrease in EHOs during the last decades. The fitted model represents the tails of the total ozone data set with high accuracy over the entire range (including absolute monthly minima and maxima, and enables a precise computation of the frequency distribution of ozone mini-holes (using constant thresholds. Analyzing the tails instead of a small fraction of days below constant thresholds provides deeper insight into the time series properties. Fingerprints of dynamical (e.g. ENSO, NAO and chemical features (e.g. strong polar vortex ozone loss, and major volcanic eruptions, can be identified in the observed frequency of extreme events throughout the time series. Overall the new approach to analysis of extremes provides more information on time series properties and variability than previous approaches that use only monthly averages and/or mini-holes and mini-highs.

Improving antenatal risk assessment in women exposed to high risks.

Science.gov (United States)

Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

2015-01-01

Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

Extreme metabolic alkalosis in intensive care.

Science.gov (United States)

Tripathy, Swagata

2009-10-01

Metabolic alkalosis is a commonly seen imbalance in the intensive care unit (ICU). Extreme metabolic alkalemia, however, is less common. A pH greater than 7.65 may carry a high risk of mortality (up to 80%). We discuss the entity of life threatening metabolic alkalemia by means of two illustrative cases - both with a pH greater than 7.65 on presentation. The cause, modalities of managing and complications of this condition is discussed from the point of view of both the traditional method of Henderson and Hasselbalch and the mathematical model based on physiochemical model described by Stewart. Special mention to the pitfalls in managing patients of metabolic alkalosis with concomitant renal compromise is made.

CLASH: EXTREME EMISSION-LINE GALAXIES AND THEIR IMPLICATION ON SELECTION OF HIGH-REDSHIFT GALAXIES

International Nuclear Information System (INIS)

Huang, Xingxing; Wang, Junxian; Shu, Xinwen; Zheng, Wei; Ford, Holland; Lemze, Doron; Moustakas, John; Van der Wel, Arjen; Zitrin, Adi; Frye, Brenda L.; Postman, Marc; Bradley, Larry; Coe, Dan; Bartelmann, Matthias; Benítez, Narciso; Broadhurst, Tom; Donahue, Megan; Infante, Leopoldo

2015-01-01

We utilize the Cluster Lensing And Supernova survey with Hubble observations of 25 clusters to search for extreme emission-line galaxies (EELGs). The selections are carried out in two central bands: F105W (Y 105 ) and F125W (J 125 ), as the flux of the central bands could be enhanced by the presence of [O III] λλ4959, 5007 at redshifts of ∼0.93-1.14 and 1.57-1.79, respectively. The multiband observations help to constrain the equivalent widths (EWs) of emission lines. Thanks to cluster lensing, we are able to identify 52 candidates down to an intrinsic limiting magnitude of 28.5 and to a rest-frame [O III] λλ4959, 5007 EW of ≅ 3700 Å. Our samples include a number of EELGs at lower luminosities that are missed in other surveys, and the extremely high EW can only be found in such faint galaxies. These EELGs can mimic a dropout feature similar to that of high-redshift galaxies and contaminate the color-color selection of high-redshift galaxies when the signal-to-noise ratio is limited or the band coverage is incomplete

CLASH: EXTREME EMISSION-LINE GALAXIES AND THEIR IMPLICATION ON SELECTION OF HIGH-REDSHIFT GALAXIES

Energy Technology Data Exchange (ETDEWEB)

Huang, Xingxing; Wang, Junxian; Shu, Xinwen [CAS Key Laboratory for Research in Galaxies and Cosmology, Department of Astronomy, University of Science and Technology of China, Hefei, Anhui 230026 (China); Zheng, Wei; Ford, Holland; Lemze, Doron [Department of Physics and Astronomy, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 (United States); Moustakas, John [Department of Physics and Astronomy, Siena College, 515 Loudon Road, Loudonville, NY 12211 (United States); Van der Wel, Arjen [Max-Planck Institute for Astronomy, Königstuhl 17, D-69117, Heidelberg (Germany); Zitrin, Adi [Cahill Center for Astronomy and Astrophysics, California Institute of Technology, MS 249-17, Pasadena, CA 91125 (United States); Frye, Brenda L. [Steward Observatory/Department of Astronomy, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721-0065 (United States); Postman, Marc; Bradley, Larry; Coe, Dan [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21208 (United States); Bartelmann, Matthias [Leiden Observatory, Leiden University, P. O. Box 9513, 2300 RA Leiden (Netherlands); Benítez, Narciso [Instituto de Astrofísica de Andalucía (CSIC), C/Camino Bajo de Huétor 24, Granada E-18008 (Spain); Broadhurst, Tom [Department of Theoretical Physics, University of Basque Country UPV/EHU E-Bilbao (Spain); Donahue, Megan [Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); Infante, Leopoldo, E-mail: hxx@mail.ustc.edu.cn [Departamento de Astronoía y Astrofísica, Pontificia Universidad Católica de Chile, V. Mackenna 4860 Santiago 22 (Chile); and others

2015-03-01

We utilize the Cluster Lensing And Supernova survey with Hubble observations of 25 clusters to search for extreme emission-line galaxies (EELGs). The selections are carried out in two central bands: F105W (Y {sub 105}) and F125W (J {sub 125}), as the flux of the central bands could be enhanced by the presence of [O III] λλ4959, 5007 at redshifts of ∼0.93-1.14 and 1.57-1.79, respectively. The multiband observations help to constrain the equivalent widths (EWs) of emission lines. Thanks to cluster lensing, we are able to identify 52 candidates down to an intrinsic limiting magnitude of 28.5 and to a rest-frame [O III] λλ4959, 5007 EW of ≅ 3700 Å. Our samples include a number of EELGs at lower luminosities that are missed in other surveys, and the extremely high EW can only be found in such faint galaxies. These EELGs can mimic a dropout feature similar to that of high-redshift galaxies and contaminate the color-color selection of high-redshift galaxies when the signal-to-noise ratio is limited or the band coverage is incomplete.

[A model list of high risk drugs].

Science.gov (United States)

Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

2013-12-01

«High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Systemic Inflammation during the First Postnatal Month and the Risk of Attention Deficit Hyperactivity Disorder Characteristics among 10 year-old Children Born Extremely Preterm.

Science.gov (United States)

Allred, Elizabeth N; Dammann, Olaf; Fichorova, Raina N; Hooper, Stephen R; Hunter, Scott J; Joseph, Robert M; Kuban, Karl; Leviton, Alan; O'Shea, Thomas Michael; Scott, Megan N

2017-09-01

Although multiple sources link inflammation with attention difficulties, the only human study that evaluated the relationship between systemic inflammation and attention problems assessed attention at age 2 years. Parent and/or teacher completion of the Childhood Symptom Inventory-4 (CSI-4) provided information about characteristics that screen for attention deficit hyperactive disorder (ADHD) among 793 10-year-old children born before the 28th week of gestation who had an IQ ≥ 70. The concentrations of 27 proteins in blood spots obtained during the first postnatal month were measured. 151 children with ADHD behaviors were identified by parent report, while 128 children were identified by teacher report. Top-quartile concentrations of IL-6R, TNF-α, IL-8, VEGF, VEFG-R1, and VEGF-R2 on multiple days were associated with increased risk of ADHD symptoms as assessed by a teacher. Some of this increased risk was modulated by top-quartile concentrations of IL-6R, RANTES, EPO, NT-4, BDNF, bFGF, IGF-1, PIGF, Ang-1, and Ang-2. Systemic inflammation during the first postnatal month among children born extremely preterm appears to increase the risk of teacher-identified ADHD characteristics, and high concentrations of proteins with neurotrophic properties appear capable of modulating this increased risk.

A metasynthesis of risk perception in women with high risk pregnancies

OpenAIRE

Lee, S.; Ayers, S.; Holden, D.

2014-01-01

Introduction: Risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.\\ud \\ud Methods: A systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that rep...

Regional Sea Level Scenarios for Coastal Risk Management: Managing the Uncertainty of Future Sea Level Change and Extreme Water Levels for Department of Defense Coastal Sites Worldwide

Science.gov (United States)

2016-04-01

authors and do not necessarily reflect the view of the authors’ Agencies. MANAGING THE UNCERTAINTY OF FUTURE SEA LEVEL CHANGE AND EXTREME WATER LEVELS FOR...COASTAL RISK MANAGEMENT 2-20 contingent probabilities given their dependence on non-probabilistic emissions futures, have extended the ranges of...flood risk provides confidence in the associated projection as a true minimum value for risk management purposes. The contemporary rate observed by

Relative incidence of phlebitis associated with peripheral intravenous catheters in the lower versus upper extremities.

Science.gov (United States)

Benaya, A; Schwartz, Y; Kory, R; Yinnon, A M; Ben-Chetrit, E

2015-05-01

Peripheral venous access in elderly, hospitalized patients is often challenging. The usual alternative is insertion of a central venous catheter, with associated risk for complications. The purpose of this investigation was to determine the relative incidence of phlebitis secondary to lower as compared to upper extremity intravenous catheters (IVCs) and associated risk factors. A non-randomized, observational, cohort-controlled study was carried out. Consecutive patients receiving a lower extremity IVC were enrolled and compared with patients receiving an upper extremity IVC. Patients were followed from insertion until removal of the IVC. The major endpoint was phlebitis. The incidence of phlebitis secondary to upper extremity IVCs was 3/50 (6 %) compared to 5/53 (9.4 %) in lower extremity IVCs (χ(2) Yates = 0.08, p = 0.776). Age, gender, obesity, diabetes mellitus, site (arm versus leg, left versus right), and size of needle were not found to be risk factors for phlebitis according to univariate analysis. None of the patients developed bloodstream infection. In elderly patients with poor venous access, lower extremity IVCs are a reasonable and low-risk alternative to central venous catheters.

High-Risk Palliative Care Patients' Knowledge and Attitudes about Hereditary Cancer Testing and DNA Banking.

Science.gov (United States)

Quillin, John M; Emidio, Oluwabunmi; Ma, Brittany; Bailey, Lauryn; Smith, Thomas J; Kang, In Guk; Yu, Brandon J; Owodunni, Oluwafemi Patrick; Abusamaan, Mohammed; Razzak, Rab; Bodurtha, Joann N

2017-12-04

Even at the end of life, testing cancer patients for inherited susceptibility may provide life-saving information to their relatives. Prior research suggests palliative care inpatients have suboptimal understanding of genetic importance, and testing may be underutilized in this clinical setting. These conclusions are based on limited research. This study aimed to estimate genetic testing prevalence among high-risk palliative care patients in a National Cancer Institute-designated comprehensive cancer center. We also aimed to understand these patients' understanding of, and attitudes toward, hereditary cancer testing and DNA banking. Palliative care in-patients with cancer completed structured interviews, and their medical records were reviewed. Among patients at high risk for hereditary cancer, we assessed history of genetic testing/DNA banking; and related knowledge and attitudes. Among 24 high-risk patients, 14 (58.3%) said they/their relatives had genetic testing or they had been referred for a genetics consultation. Of the remaining 10 patients, seven (70%) said they would "probably" or "definitely" get tested. Patients who had not had testing were least concerned about the impact of future testing on their family relationships; two (20%) said they were "extremely concerned" about privacy related to genetic testing. Of patients without prior testing, five (50%) said they had heard or read "a fair amount" about genetic testing. No high-risk patients had banked DNA. Overall, 23 (95.8%) said they had heard or read "almost nothing" or "relatively little" about DNA banking. Written materials and clinician discussion were most preferred ways to learn about genetic testing and DNA banking. Overall, this study demonstrates underutilization of genetics services at the end of life continues to be problematic, despite high patient interest.

Recurrent Embolic Strokes of Undetermined Source in a Patient with Extreme Lipoprotein(a Levels

Directory of Open Access Journals (Sweden)

Zachary Bulwa

2016-08-01

Full Text Available Lipoprotein(a is a plasma lipoprotein and known cardiovascular risk factor most recently implicated in the development of high-risk carotid atherosclerotic plaques without significant carotid stenosis. We present a case of a young African-American female with recurrent embolic strokes of undetermined source. After our thorough investigation we identified the link between a small, irregular plaque in the right internal carotid artery and an extremely elevated plasma level of lipoprotein(a as the source of her embolic strokes.

Nitrogen accumulation and partitioning in a High Arctic tundra ecosystem from extreme atmospheric N deposition events

International Nuclear Information System (INIS)

Choudhary, Sonal; Blaud, Aimeric; Osborn, A. Mark; Press, Malcolm C.; Phoenix, Gareth K.

2016-01-01

Arctic ecosystems are threatened by pollution from recently detected extreme atmospheric nitrogen (N) deposition events in which up to 90% of the annual N deposition can occur in just a few days. We undertook the first assessment of the fate of N from extreme deposition in High Arctic tundra and are presenting the results from the whole ecosystem "1"5N labelling experiment. In 2010, we simulated N depositions at rates of 0, 0.04, 0.4 and 1.2 g N m"−"2 yr"−"1, applied as "1"5NH_4"1"5NO_3 in Svalbard (79"°N), during the summer. Separate applications of "1"5NO_3"− and "1"5NH_4"+ were also made to determine the importance of N form in their retention. More than 95% of the total "1"5N applied was recovered after one growing season (~ 90% after two), demonstrating a considerable capacity of Arctic tundra to retain N from these deposition events. Important sinks for the deposited N, regardless of its application rate or form, were non-vascular plants > vascular plants > organic soil > litter > mineral soil, suggesting that non-vascular plants could be the primary component of this ecosystem to undergo measurable changes due to N enrichment from extreme deposition events. Substantial retention of N by soil microbial biomass (70% and 39% of "1"5N in organic and mineral horizon, respectively) during the initial partitioning demonstrated their capacity to act as effective buffers for N leaching. Between the two N forms, vascular plants (Salix polaris) in particular showed difference in their N recovery, incorporating four times greater "1"5NO_3"− than "1"5NH_4"+, suggesting deposition rich in nitrate will impact them more. Overall, these findings show that despite the deposition rates being extreme in statistical terms, biologically they do not exceed the capacity of tundra to sequester pollutant N during the growing season. Therefore, current and future extreme events may represent a major source of eutrophication. - Highlights: • High Arctic tundra demonstrated a

Extreme ultraviolet spectroscopy of highly charged argon ions at the Berlin EBIT

International Nuclear Information System (INIS)

Biedermann, C; Radtke, R; Fussmann, G; Allen, F I

2007-01-01

Extreme ultraviolet radiation from highly charged argon was investigated at the Berlin Electron Beam Ion Trap with a 2 m grazing incidence spectrometer. Lines in the wavelength range 150 to 660 A originating from C-like Ar 12+ to Li-like Ar 15+ ions have been identified and are compared with database information from solar line lists and predictions. Line ratios for the observed resonance, intercombination and forbidden lines offer important diagnostic capabilities for low density, hot plasmas

Social media as a marketing tool for extreme-sport oriented companies

OpenAIRE

Korosuo, Saku

2013-01-01

Marketing in social media has been studied extensively in recent years, but not specifically for extreme-sport oriented companies. Even though most of the extreme-oriented companies are using social media for marketing, only a few pay special attention to its risks and possibilities. The purpose of this study is to identify extreme-sport oriented companies' practices to use social media as a marketing tool. I interviewed eight extreme- oriented companies and athletes. In addition to interview...

Models and Inference for Multivariate Spatial Extremes

KAUST Repository

Vettori, Sabrina

2017-01-01

The development of flexible and interpretable statistical methods is necessary in order to provide appropriate risk assessment measures for extreme events and natural disasters. In this thesis, we address this challenge by contributing

Simulation of the 23 July 2012 Extreme Space Weather Event: What if This Extremely Rare CME Was Earth Directed?

Science.gov (United States)

Ngwira, Chigomezyo M.; Pulkkinen, Antti; Mays, M. Leila; Kuznetsova, Maria M.; Galvin, A. B.; Simunac, Kristin; Baker, Daniel N.; Li, Xinlin; Zheng, Yihua; Glocer, Alex

2013-01-01

Extreme space weather events are known to cause adverse impacts on critical modern day technological infrastructure such as high-voltage electric power transmission grids. On 23 July 2012, NASA's Solar Terrestrial Relations Observatory-Ahead (STEREO-A) spacecraft observed in situ an extremely fast coronal mass ejection (CME) that traveled 0.96 astronomical units (approx. 1 AU) in about 19 h. Here we use the SpaceWeather Modeling Framework (SWMF) to perform a simulation of this rare CME.We consider STEREO-A in situ observations to represent the upstream L1 solar wind boundary conditions. The goal of this study is to examine what would have happened if this Rare-type CME was Earth-bound. Global SWMF-generated ground geomagnetic field perturbations are used to compute the simulated induced geoelectric field at specific ground-based active INTERMAGNET magnetometer sites. Simulation results show that while modeled global SYM-H index, a high-resolution equivalent of the Dst index, was comparable to previously observed severe geomagnetic storms such as the Halloween 2003 storm, the 23 July CME would have produced some of the largest geomagnetically induced electric fields, making it very geoeffective. These results have important practical applications for risk management of electrical power grids.

State-of-the-Art of Extreme Pressure Lubrication Realized with the High Thermal Diffusivity of Liquid Metal.

Science.gov (United States)

Li, Haijiang; Tian, Pengyi; Lu, Hongyu; Jia, Wenpeng; Du, Haodong; Zhang, Xiangjun; Li, Qunyang; Tian, Yu

2017-02-15

Sliding between two objects under very high load generally involves direct solid-solid contact at molecular/atomic level, the mechanism of which is far from clearly disclosed yet. Those microscopic solid-solid contacts could easily lead to local melting of rough surfaces. At extreme conditions, this local melting could propagate to the seizure and welding of the entire interface. Traditionally, the microscopic solid-solid contact is alleviated by various lubricants and additives based on their improved mechanical properties. In this work, we realized the state-of-the-art of extreme pressure lubrication by utilizing the high thermal diffusivity of liquid metal, 2 orders of magnitude higher than general organic lubricants. The extreme pressure lubrication property of gallium based liquid metal (GBLM) was compared with gear oil and poly-α-olefin in a four-ball test. The liquid metal lubricates very well at an extremely high load (10 kN, the maximum capability of a four-ball tester) at a rotation speed of 1800 rpm for a duration of several minutes, much better than traditional organic lubricants which typically break down within seconds at a load of a few kN. Our comparative experiments and analysis showed that this superextreme pressure lubrication capability of GBLM was attributed to the synergetic effect of the ultrafast heat dissipation of GBLM and the low friction coefficient of FeGa 3 tribo-film. The present work demonstrated a novel way of improving lubrication capability by enhancing the lubricant thermal properties, which might lead to mechanical systems with much higher reliability.

Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

Science.gov (United States)

Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

2014-01-21

The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in

Extreme river flow dependence in Northern Scotland

Science.gov (United States)

Villoria, M. Franco; Scott, M.; Hoey, T.; Fischbacher-Smith, D.

2012-04-01

Various methods for the spatial analysis of hydrologic data have been developed recently. Here we present results using the conditional probability approach proposed by Keef et al. [Appl. Stat. (2009): 58,601-18] to investigate spatial interdependence in extreme river flows in Scotland. This approach does not require the specification of a correlation function, being mostly suitable for relatively small geographical areas. The work is motivated by the Flood Risk Management Act (Scotland (2009)) which requires maps of flood risk that take account of spatial dependence in extreme river flow. The method is based on two conditional measures of spatial flood risk: firstly the conditional probability PC(p) that a set of sites Y = (Y 1,...,Y d) within a region C of interest exceed a flow threshold Qp at time t (or any lag of t), given that in the specified conditioning site X > Qp; and, secondly the expected number of sites within C that will exceed a flow Qp on average (given that X > Qp). The conditional probabilities are estimated using the conditional distribution of Y |X = x (for large x), which can be modeled using a semi-parametric approach (Heffernan and Tawn [Roy. Statist. Soc. Ser. B (2004): 66,497-546]). Once the model is fitted, pseudo-samples can be generated to estimate functionals of the joint tails of the distribution of (Y,X). Conditional return level plots were directly compared to traditional return level plots thus improving our understanding of the dependence structure of extreme river flow events. Confidence intervals were calculated using block bootstrapping methods (100 replicates). We report results from applying this approach to a set of four rivers (Dulnain, Lossie, Ewe and Ness) in Northern Scotland. These sites were chosen based on data quality, spatial location and catchment characteristics. The river Ness, being the largest (catchment size 1839.1km2) was chosen as the conditioning river. Both the Ewe (441.1km2) and Ness catchments have

Characterizing and reaching high-risk drinkers using audience segmentation.

Science.gov (United States)

Moss, Howard B; Kirby, Susan D; Donodeo, Fred

2009-08-01

Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZM (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZM audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech

Increasing stress on disaster risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen; Mechler, Reinhard; Botzen, Wouter; Bouwer, Laurens; Pflug, Georg; Rojas, Rodrigo; Ward, Philip

2014-05-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. To date, little is known about such flood hazard interdependencies across regions, and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins and that these correlations can, or should, be used in national to continental scale risk assessment. We present probabilistic trends in continental flood risk, and demonstrate that currently observed extreme flood losses could more than double in frequency by 2050 under future climate change and socioeconomic development. The results demonstrate that accounting for tail dependencies leads to higher estimates of extreme losses than estimates based on the traditional assumption of independence between basins. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Likelihood estimators for multivariate extremes

KAUST Repository

Huser, Raphaë l; Davison, Anthony C.; Genton, Marc G.

2015-01-01

The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

Likelihood estimators for multivariate extremes

KAUST Repository

Huser, Raphaël

2015-11-17

The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

Characterizing the Spatial Contiguity of Extreme Precipitation over the US in the Recent Past

Science.gov (United States)

Touma, D. E.; Swain, D. L.; Diffenbaugh, N. S.

2016-12-01

The spatial characteristics of extreme precipitation over an area can define the hydrologic response in a basin, subsequently affecting the flood risk in the region. Here, we examine the spatial extent of extreme precipitation in the US by defining its "footprint": a contiguous area of rainfall exceeding a certain threshold (e.g., 90th percentile) on a given day. We first characterize the climatology of extreme rainfall footprint sizes across the US from 1980-2015 using Daymet, a high-resolution observational gridded rainfall dataset. We find that there are distinct regional and seasonal differences in average footprint sizes of extreme daily rainfall. In the winter, the Midwest shows footprints exceeding 500,000 sq. km while the Front Range exhibits footprints of 10,000 sq. km. Alternatively, the summer average footprint size is generally smaller and more uniform across the US, ranging from 10,000 sq. km in the Southwest to 100,000 sq. km in Montana and North Dakota. Moreover, we find that there are some significant increasing trends of average footprint size between 1980-2015, specifically in the Southwest in the winter and the Northeast in the spring. While gridded daily rainfall datasets allow for a practical framework in calculating footprint size, this calculation heavily depends on the interpolation methods that have been used in creating the dataset. Therefore, we assess footprint size using the GHCN-Daily station network and use geostatistical methods to define footprints of extreme rainfall directly from station data. Compared to the findings from Daymet, preliminary results using this method show fewer small daily footprint sizes over the US while large footprints are of similar number and magnitude to Daymet. Overall, defining the spatial characteristics of extreme rainfall as well as observed and expected changes in these characteristics allows us to better understand the hydrologic response to extreme rainfall and how to better characterize flood

Resuscitation of newborn in high risk deliveries

International Nuclear Information System (INIS)

Yousaf, U.F.; Hayat, S.

2015-01-01

High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

Using subseasonal-to-seasonal (S2S) extreme rainfall forecasts for extended-range flood prediction in Australia

Science.gov (United States)

White, C. J.; Franks, S. W.; McEvoy, D.

2015-06-01

Meteorological and hydrological centres around the world are looking at ways to improve their capacity to be able to produce and deliver skilful and reliable forecasts of high-impact extreme rainfall and flooding events on a range of prediction timescales (e.g. sub-daily, daily, multi-week, seasonal). Making improvements to extended-range rainfall and flood forecast models, assessing forecast skill and uncertainty, and exploring how to apply flood forecasts and communicate their benefits to decision-makers are significant challenges facing the forecasting and water resources management communities. This paper presents some of the latest science and initiatives from Australia on the development, application and communication of extreme rainfall and flood forecasts on the extended-range "subseasonal-to-seasonal" (S2S) forecasting timescale, with a focus on risk-based decision-making, increasing flood risk awareness and preparedness, capturing uncertainty, understanding human responses to flood forecasts and warnings, and the growing adoption of "climate services". The paper also demonstrates how forecasts of flood events across a range of prediction timescales could be beneficial to a range of sectors and society, most notably for disaster risk reduction (DRR) activities, emergency management and response, and strengthening community resilience. Extended-range S2S extreme flood forecasts, if presented as easily accessible, timely and relevant information are a valuable resource to help society better prepare for, and subsequently cope with, extreme flood events.

Restoring surface fire stabilizes forest carbon under extreme fire weather in the Sierra Nevada

Science.gov (United States)

Daniel J. Krofcheck; Matthew D. Hurteau; Robert M. Scheller; E. Louise Loudermilk

2017-01-01

Climate change in the western United States has increased the frequency of extreme fire weather events and is projected to increase the area burned by wildfire in the coming decades. This changing fire regime, coupled with increased high-severity fire risk from a legacy of fire exclusion, could destabilize forest carbon (C), decrease net ecosystem exchange (...

Legacies from extreme drought increase ecosystem sensitivity to future extremes

Science.gov (United States)

Smith, M. D.; Knapp, A.; Hoover, D. L.; Avolio, M. L.; Felton, A. J.; Wilcox, K. R.

2016-12-01

Climate extremes, such as drought, are increasing in frequency and intensity, and the ecological consequences of these extreme events can be substantial and widespread. Although there is still much to be learned about how ecosystems will respond to an intensification of drought, even less is known about the factors that determine post-drought recovery of ecosystem function. Such knowledge is particularly important because post-drought recovery periods can be protracted depending on the extent to which key plant populations, community structure and biogeochemical processes are affected. These drought legacies may alter ecosystem function for many years post-drought and may impact future sensitivity to climate extremes. We experimentally imposed two extreme growing season droughts in a central US grassland to assess the impacts of repeated droughts on ecosystem resistance (response) and resilience (recovery). We found that this grassland was not resistant to the first extreme drought due to reduced productivity and differential sensitivity of the co-dominant C4 grass (Andropogon gerardii) and C3 forb (Solidago canadensis) species. This differential sensitivity led to a reordering of species abundances within the plant community. Yet, despite this large shift in plant community composition, which persisted post-drought, the grassland was highly resilient post-drought, due to increased abundance of the dominant C4 grass. Because of this shift to increased C4 grass dominance, we expected that previously-droughted grassland would be more resistant to a second extreme drought. However, contrary to these expectations, previously droughted grassland was more sensitive to drought than grassland that had not experienced drought. Thus, our result suggest that legacies of drought (shift in community composition) may increase ecosystem sensitivity to future extreme events.

Climate variability and extremes, interacting with nitrogen storage, amplify eutrophication risk

Science.gov (United States)

Lee, Minjin; Shevliakova, Elena; Malyshev, Sergey; Milly, P.C.D.; Jaffe, Peter R.

2016-01-01

Despite 30 years of basin-wide nutrient-reduction efforts, severe hypoxia continues to be observed in the Chesapeake Bay. Here we demonstrate the critical influence of climate variability, interacting with accumulated nitrogen (N) over multidecades, on Susquehanna River dissolved nitrogen (DN) loads, known precursors of the hypoxia in the Bay. We used the process model LM3-TAN (Terrestrial and Aquatic Nitrogen), which is capable of capturing both seasonal and decadal-to-century changes in vegetation-soil-river N storage, and produced nine scenarios of DN-load distributions under different short-term scenarios of climate variability and extremes. We illustrate that after 1 to 3 yearlong dry spells, the likelihood of exceeding a threshold DN load (56 kt yr−1) increases by 40 to 65% due to flushing of N accumulated throughout the dry spells and altered microbial processes. Our analyses suggest that possible future increases in climate variability/extremes—specifically, high precipitation occurring after multiyear dry spells—could likely lead to high DN-load anomalies and hypoxia.

Association between frontal plane knee control and lower extremity injuries: a prospective study on young team sport athletes

Science.gov (United States)

Pasanen, Kati; Krosshaug, Tron; Vasankari, Tommi; Kannus, Pekka; Heinonen, Ari; Kujala, Urho M; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari

2018-01-01

Background/aim Poor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk. Methods A total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis. Results Athletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee injury (OR 1.49, 95% CI 0.56 to 3.98). The receiver operating characteristic curve analyses indicated poor combined sensitivity and specificity when FPKPA was used as a screening test for lower extremity injuries (area under the curve of 0.59) and ankle injuries (area under the curve of 0.58). Conclusions Athletes displaying a large FPKPA in the SLS test had an elevated risk of acute lower extremity and ankle injuries. However, the SLS test is not sensitive and specific enough to be used as a screening tool for future injury risk. PMID:29387448

The combined risk of extreme tropical cyclone winds and storm surges along the U.S. Gulf of Mexico Coast

Science.gov (United States)

Trepanier, J. C.; Yuan, J.; Jagger, T. H.

2017-03-01

Tropical cyclones, with their nearshore high wind speeds and deep storm surges, frequently strike the United States Gulf of Mexico coastline influencing millions of people and disrupting offshore economic activities. The combined risk of occurrence of tropical cyclone nearshore wind speeds and storm surges is assessed at 22 coastal cities throughout the United States Gulf of Mexico. The models used are extreme value copulas fitted with margins defined by the generalized Pareto distribution or combinations of Weibull, gamma, lognormal, or normal distributions. The statistical relationships between the nearshore wind speed and storm surge are provided for each coastal city prior to the copula model runs using Spearman's rank correlations. The strongest significant relationship between the nearshore wind speed and storm surge exists at Shell Beach, LA (ρ = 0.67), followed by South Padre Island, TX (ρ = 0.64). The extreme value Archimedean copula models for each city then provide return periods for specific nearshore wind speed and storm surge pairs. Of the 22 cities considered, Bay St. Louis, MS, has the shortest return period for a tropical cyclone with at least a 50 ms-1 nearshore wind speed and a 3 m surge (19.5 years, 17.1-23.5). The 90% confidence intervals are created by recalculating the return periods for a fixed set of wind speeds and surge levels using 100 samples of the model parameters. The results of this study can be utilized by policy managers and government officials concerned with coastal populations and economic activity in the Gulf of Mexico.

Projected changes of extreme weather events in the eastern United States based on a high resolution climate modeling system

International Nuclear Information System (INIS)

Gao, Y; Fu, J S; Drake, J B; Liu, Y; Lamarque, J-F

2012-01-01

This study is the first evaluation of dynamical downscaling using the Weather Research and Forecasting (WRF) Model on a 4 km × 4 km high resolution scale in the eastern US driven by the new Community Earth System Model version 1.0 (CESM v1.0). First we examined the global and regional climate model results, and corrected an inconsistency in skin temperature during the downscaling process by modifying the land/sea mask. In comparison with observations, WRF shows statistically significant improvement over CESM in reproducing extreme weather events, with improvement for heat wave frequency estimation as high as 98%. The fossil fuel intensive scenario Representative Concentration Pathway (RCP) 8.5 was used to study a possible future mid-century climate extreme in 2057–9. Both the heat waves and the extreme precipitation in 2057–9 are more severe than the present climate in the Eastern US. The Northeastern US shows large increases in both heat wave intensity (3.05 °C higher) and annual extreme precipitation (107.3 mm more per year). (letter)

Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature.

Science.gov (United States)

Liu, Yang; Hoppe, Brenda O; Convertino, Matteo

2018-04-10

Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure. © 2018 Society for Risk Analysis.

Ultra-high field upper extremity peripheral nerve and non-contrast enhanced vascular imaging.

Directory of Open Access Journals (Sweden)

Shailesh B Raval

Full Text Available The purpose of this study was to explore the efficacy of Ultra-high field [UHF] 7 Tesla [T] MRI as compared to 3T MRI in non-contrast enhanced [nCE] imaging of structural anatomy in the elbow, forearm, and hand [upper extremity].A wide range of sequences including T1 weighted [T1] volumetric interpolate breath-hold exam [VIBE], T2 weighted [T2] double-echo steady state [DESS], susceptibility weighted imaging [SWI], time-of-flight [TOF], diffusion tensor imaging [DTI], and diffusion spectrum imaging [DSI] were optimized and incorporated with a radiofrequency [RF] coil system composed of a transverse electromagnetic [TEM] transmit coil combined with an 8-channel receive-only array for 7T upper extremity [UE] imaging. In addition, Siemens optimized protocol/sequences were used on a 3T scanner and the resulting images from T1 VIBE and T2 DESS were compared to that obtained at 7T qualitatively and quantitatively [SWI was only qualitatively compared]. DSI studio was utilized to identify nerves based on analysis of diffusion weighted derived fractional anisotropy images. Images of forearm vasculature were extracted using a paint grow manual segmentation method based on MIPAV [Medical Image Processing, Analysis, and Visualization].High resolution and high quality signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]-images of the hand, forearm, and elbow were acquired with nearly homogeneous 7T excitation. Measured [performed on the T1 VIBE and T2 DESS sequences] SNR and CNR values were almost doubled at 7T vs. 3T. Cartilage, synovial fluid and tendon structures could be seen with higher clarity in the 7T T1 and T2 weighted images. SWI allowed high resolution and better quality imaging of large and medium sized arteries and veins, capillary networks and arteriovenous anastomoses at 7T when compared to 3T. 7T diffusion weighted sequence [not performed at 3T] demonstrates that the forearm nerves are clearly delineated by fiber tractography. The

Models and Inference for Multivariate Spatial Extremes

KAUST Repository

Vettori, Sabrina

2017-12-07

The development of flexible and interpretable statistical methods is necessary in order to provide appropriate risk assessment measures for extreme events and natural disasters. In this thesis, we address this challenge by contributing to the developing research field of Extreme-Value Theory. We initially study the performance of existing parametric and non-parametric estimators of extremal dependence for multivariate maxima. As the dimensionality increases, non-parametric estimators are more flexible than parametric methods but present some loss in efficiency that we quantify under various scenarios. We introduce a statistical tool which imposes the required shape constraints on non-parametric estimators in high dimensions, significantly improving their performance. Furthermore, by embedding the tree-based max-stable nested logistic distribution in the Bayesian framework, we develop a statistical algorithm that identifies the most likely tree structures representing the data\\'s extremal dependence using the reversible jump Monte Carlo Markov Chain method. A mixture of these trees is then used for uncertainty assessment in prediction through Bayesian model averaging. The computational complexity of full likelihood inference is significantly decreased by deriving a recursive formula for the nested logistic model likelihood. The algorithm performance is verified through simulation experiments which also compare different likelihood procedures. Finally, we extend the nested logistic representation to the spatial framework in order to jointly model multivariate variables collected across a spatial region. This situation emerges often in environmental applications but is not often considered in the current literature. Simulation experiments show that the new class of multivariate max-stable processes is able to detect both the cross and inner spatial dependence of a number of extreme variables at a relatively low computational cost, thanks to its Bayesian hierarchical

Variance swap payoffs, risk premia and extreme market conditions

DEFF Research Database (Denmark)

Rombouts, Jeroen V.K.; Stentoft, Lars; Violante, Francesco

This paper estimates the Variance Risk Premium (VRP) directly from synthetic variance swap payoffs. Since variance swap payoffs are highly volatile, we extract the VRP by using signal extraction techniques based on a state-space representation of our model in combination with a simple economic....... The latter variables and the VRP generate different return predictability on the major US indices. A factor model is proposed to extract a market VRP which turns out to be priced when considering Fama and French portfolios....

Spin-resolved photoelectron spectroscopy using femtosecond extreme ultraviolet light pulses from high-order harmonic generation

Energy Technology Data Exchange (ETDEWEB)

Plötzing, M.; Adam, R., E-mail: r.adam@fz-juelich.de; Weier, C.; Plucinski, L.; Schneider, C. M. [Forschungszentrum Jülich GmbH, Peter Grünberg Institut (PGI-6), 52425 Jülich (Germany); Eich, S.; Emmerich, S.; Rollinger, M.; Aeschlimann, M. [University of Kaiserslautern and Research Center OPTIMAS, 67663 Kaiserslautern (Germany); Mathias, S. [Georg-August-Universität Göttingen, I. Physikalisches Institut, 37077 Göttingen (Germany)

2016-04-15

The fundamental mechanism responsible for optically induced magnetization dynamics in ferromagnetic thin films has been under intense debate since almost two decades. Currently, numerous competing theoretical models are in strong need for a decisive experimental confirmation such as monitoring the triggered changes in the spin-dependent band structure on ultrashort time scales. Our approach explores the possibility of observing femtosecond band structure dynamics by giving access to extended parts of the Brillouin zone in a simultaneously time-, energy- and spin-resolved photoemission experiment. For this purpose, our setup uses a state-of-the-art, highly efficient spin detector and ultrashort, extreme ultraviolet light pulses created by laser-based high-order harmonic generation. In this paper, we present the setup and first spin-resolved spectra obtained with our experiment within an acquisition time short enough to allow pump-probe studies. Further, we characterize the influence of the excitation with femtosecond extreme ultraviolet pulses by comparing the results with data acquired using a continuous wave light source with similar photon energy. In addition, changes in the spectra induced by vacuum space-charge effects due to both the extreme ultraviolet probe- and near-infrared pump-pulses are studied by analyzing the resulting spectral distortions. The combination of energy resolution and electron count rate achieved in our setup confirms its suitability for spin-resolved studies of the band structure on ultrashort time scales.

Excess Mortality Attributable to Extreme Heat in New York City, 1997-2013.

Science.gov (United States)

Matte, Thomas D; Lane, Kathryn; Ito, Kazuhiko

2016-01-01

Extreme heat event excess mortality has been estimated statistically to assess impacts, evaluate heat emergency response, and project climate change risks. We estimated annual excess non-external-cause deaths associated with extreme heat events in New York City (NYC). Extreme heat events were defined as days meeting current National Weather Service forecast criteria for issuing heat advisories in NYC based on observed maximum daily heat index values from LaGuardia Airport. Outcomes were daily non-external-cause death counts for NYC residents from May through September from 1997 to 2013 (n = 337,162). The cumulative relative risk (CRR) of death associated with extreme heat events was estimated in a Poisson time-series model for each year using an unconstrained distributed lag for days 0-3 accommodating over dispersion, and adjusting for within-season trends and day of week. Attributable death counts were computed by year based on individual year CRRs. The pooled CRR per extreme heat event day was 1.11 (95%CI 1.08-1.14). The estimated annual excess non-external-cause deaths attributable to heat waves ranged from -14 to 358, with a median of 121. Point estimates of heat wave-attributable deaths were greater than 0 in all years but one and were correlated with the number of heat wave days (r = 0.81). Average excess non-external-cause deaths associated with extreme heat events were nearly 11-fold greater than hyperthermia deaths. Estimated extreme heat event-associated excess deaths may be a useful indicator of the impact of extreme heat events, but single-year estimates are currently too imprecise to identify short-term changes in risk.

Effects of exercise improves muscle strength and fat mass in patients with high fracture risk: A randomized control trial

Directory of Open Access Journals (Sweden)

Ding-Cheng Chan

2018-07-01

Full Text Available Background: The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX® ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point or fall (≧2 falls in previous year. Methods: Patients were assigned randomized to participate in either IC or LEE group (n = 55 each for 3 months. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise while the LEE group performed machine-based low extremities exercise. Fat free mass, muscle strength, and physical performance were measured at their baseline and 3-months follow-up. Results: Mean age was 73.8 ± 7 years with 69.1% women. Entire cohort demonstrated significant increment in fat free mass, muscle strength (4 indicators and physical performance (3 indicators. However, between group differences were not significant. Conclusion: With regular supervise exercise; both groups are equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required fewer resources and thus more financially feasible in a community setting. Keywords: Bone mineral density, Gender differences, Integrated care, Low extremities exercise, Muscle strength

High-energy roller injuries to the upper extremity.

Science.gov (United States)

Askins, G; Finley, R; Parenti, J; Bush, D; Brotman, S

1986-12-01

Eleven cases of high-energy industrial roller injuries treated between 1980 and 1984 were retrospectively reviewed. The dominant extremity was affected in nine. Six patients sustained fractures and/or dislocations, and three of these patients required fasciotomies for clinical signs of impending compartment syndromes. All fracture/dislocations, with the exception of a scapula fracture, anterior dislocation of a thumb interphalangeal joint, and a fractured coronoid process of the ulna, required open reduction with internal fixation. Three patients required split-thickness skin grafting for extensive skin degloving. Two patients required immediate amputation. Late sequelae included prolonged edema, nutritional depletion, neuroma formation of the superficial branch of the radial nerve, late carpal tunnel syndrome, and partial brachial plexus palsy. Industrial roller injuries continue to be an occupational hazard associated with more severe crushing trauma than the low-energy wringer washer injuries first described by MacCollum (11). Attention must be paid to the treatment of crushed skin, muscle, and nerves, fracture stabilization, nutritional support, and occupational therapy. Concurrent monitoring for signs of a developing compartment syndrome and complications of rhabdomyolysis is essential.

Assessing the importance of spatio-temporal RCM resolution when estimating sub-daily extreme precipitation under current and future climate conditions

DEFF Research Database (Denmark)

Sunyer Pinya, Maria Antonia; Luchner, J.; Onof, C.

2017-01-01

extreme precipitation over Denmark generated by the regional climate model (RCM) HIRHAM-ECEARTH at different spatial resolutions (8, 12, 25 and 50km), three RCM from the RiskChange project at 8km resolution and three RCMs from ENSEMBLES at 25km resolution at temporal aggregations from 1 to 48h...... are more skewed than the observational dataset, which leads to an overestimation by the higher spatial resolution simulations. Nevertheless, in general, under current conditions RCM simulations at high spatial resolution represent extreme events and high-order moments better. The changes projected...

Are recent severe floods in Xiang River basin of China linked with the increase extreme precipitation?

Science.gov (United States)

Cheng, L.; Du, J.

2015-12-01

The Xiang River, a main tributary of the Yangtze River, is subjected to high floods frequently in recent twenty years. Climate change, including abrupt shifts and fluctuations in precipitation is an important factor influencing hydrological extreme conditions. In addition, human activities are widely recognized as another reasons leading to high flood risk. With the effects of climate change and human interventions on hydrological cycle, there are several questions that need to be addressed. Are floods in the Xiang River basin getting worse? Whether the extreme streamflow shows an increasing tendency? If so, is it because the extreme rainfall events have predominant effect on floods? To answer these questions, the article detected existing trends in extreme precipitation and discharge using Mann-Kendall test. Continuous wavelet transform method was employed to identify the consistency of changes in extreme precipitation and discharge. The Pearson correlation analysis was applied to investigate how much degree of variations in extreme discharge can be explained by climate change. The results indicate that slightly upward trends can be detected in both extreme rainfalls and discharge in the upper region of Xiang River basin. For the most area of middle and lower river basin, the extreme rainfalls show significant positive trends, but the extreme discharge displays slightly upward trends with no significance at 90% confidence level. Wavelet transform analysis results illustrate that highly similar patterns of signal changes can be seen between extreme precipitation and discharge in upper section of the basin, while the changes in extreme precipitation for the middle and lower reaches do not always coincide with the extreme streamflow. The correlation coefficients of the wavelet transforms for the precipitation and discharge signals in most area of the basin pass the significance test. The conclusion may be drawn that floods in recent years are not getting worse in

A Generalized Framework for Non-Stationary Extreme Value Analysis

Science.gov (United States)

Ragno, E.; Cheng, L.; Sadegh, M.; AghaKouchak, A.

2017-12-01

Empirical trends in climate variables including precipitation, temperature, snow-water equivalent at regional to continental scales are evidence of changes in climate over time. The evolving climate conditions and human activity-related factors such as urbanization and population growth can exert further changes in weather and climate extremes. As a result, the scientific community faces an increasing demand for updated appraisal of the time-varying climate extremes. The purpose of this study is to offer a robust and flexible statistical tool for non-stationary extreme value analysis which can better characterize the severity and likelihood of extreme climatic variables. This is critical to ensure a more resilient environment in a changing climate. Following the positive feedback on the first version of Non-Stationary Extreme Value Analysis (NEVA) Toolbox by Cheng at al. 2014, we present an improved version, i.e. NEVA2.0. The upgraded version herein builds upon a newly-developed hybrid evolution Markov Chain Monte Carlo (MCMC) approach for numerical parameters estimation and uncertainty assessment. This addition leads to a more robust uncertainty estimates of return levels, return periods, and risks of climatic extremes under both stationary and non-stationary assumptions. Moreover, NEVA2.0 is flexible in incorporating any user-specified covariate other than the default time-covariate (e.g., CO2 emissions, large scale climatic oscillation patterns). The new feature will allow users to examine non-stationarity of extremes induced by physical conditions that underlie the extreme events (e.g. antecedent soil moisture deficit, large-scale climatic teleconnections, urbanization). In addition, the new version offers an option to generate stationary and/or non-stationary rainfall Intensity - Duration - Frequency (IDF) curves that are widely used for risk assessment and infrastructure design. Finally, a Graphical User Interface (GUI) of the package is provided, making NEVA

Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie [Dept. of Radiology, Hangang Scared Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Lee, Eil Seong [Dept.of Radiology, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju (Korea, Republic of)

2011-04-15

A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

Vulnerability of solar energy infrastructure and output to extreme events: Climate change implications (Conference paper)

OpenAIRE

Patt, A.; Pfenninger, S.; Lilliestam, J.

2010-01-01

This paper explores the potential vulnerability of solar energy systems to future extreme event risks as a consequence of climate change. We describe the three main technologies likely to be used to harness sunlight -- thermal heating, photovoltaic (PV), and concentrating solar power (CSP) -- and identify critical extreme event vulnerabilities for each one. We then compare these vulnerabilities with assessments of future changes in extreme event risk levels. We do not identify any vulnerabili...

Medical and psychosocial implications of adolescent extreme obesity - acceptance and effects of structured care, short: Youth with Extreme Obesity Study (YES).

Science.gov (United States)

Wabitsch, Martin; Moss, Anja; Reinehr, Thomas; Wiegand, Susanna; Kiess, Wieland; Scherag, André; Holl, Reinhard; Holle, Rolf; Hebebrand, Johannes

2013-08-29

Prevalence rates of overweight and obesity have increased in German children and adolescents in the last three decades. Adolescents with extreme obesity represent a distinct risk group. On the basis of data obtained by the German Child and Youth Survey (KiGGS) and the German district military offices we estimate that the group of extremely obese adolescents (BMI ≥ 35 kg/m2) currently encompasses approximately 200.000 adolescents aged 14 to 21 yrs. Conventional approaches focusing on weight reduction have largely proven futile for them. In addition, only a small percentage of adolescents with extreme obesity seek actively treatment for obesity while contributing disproportionately strong to health care costs. Because of somatic and psychiatric co-morbidities and social problems adolescents with extreme obesity require special attention within the medical care system. We have initiated the project "Medical and psychosocial implications of adolescents with extreme obesity--acceptance and effects of structured care, short: 'Youths with Extreme Obesity Study (YES)'", which aims at improving the medical care and social support structures for youths with extreme obesity in Germany. We focus on identification of these subjects (baseline examination) and their acceptance of diagnostic and subsequent treatment procedures. In a randomized controlled trial (RCT) we will investigate the effectiveness of a low key group intervention not focusing on weight loss but aimed at the provision of obesity related information, alleviation of social isolation, school and vocational integration and improvement of self-esteem in comparison to a control group treated in a conventional way with focus on weight loss. Interested individuals who fulfill current recommended criteria for weight loss surgery will be provided with a structured preparation and follow-up programs. All subjects will be monitored within a long-term observational study to elucidate medical and psychosocial outcomes

Extremely high efficiency phosphorescent organic light-emitting diodes with horizontal emitting dipoles

Science.gov (United States)

Kim, Kwon-Hyeon; Moon, Chang-Ki; Lee, Jeong-Hwan; Kim, Jang-Joo

2014-10-01

We present the factors influencing the orientation of the phosphorescent dyes in phosphorescent OLEDs. And, we report that an OLED containing a phosphorescent emitter with horizontally oriented dipoles in an exciplex-forming co-host that exhibits an extremely high EQE of 32.3% and power efficiency of 142 lm/W, the highest values ever reported in literature. Furthermore, we experimentally and theoretically correlated the EQE of OLEDs to the PL quantum yield and the horizontal dipole ratio of phosphorescent dyes using three different dyes.

Use of historical information in extreme storm surges frequency analysis

Science.gov (United States)

Hamdi, Yasser; Duluc, Claire-Marie; Deville, Yves; Bardet, Lise; Rebour, Vincent

2013-04-01

The prevention of storm surge flood risks is critical for protection and design of coastal facilities to very low probabilities of failure. The effective protection requires the use of a statistical analysis approach having a solid theoretical motivation. Relating extreme storm surges to their frequency of occurrence using probability distributions has been a common issue since 1950s. The engineer needs to determine the storm surge of a given return period, i.e., the storm surge quantile or design storm surge. Traditional methods for determining such a quantile have been generally based on data from the systematic record alone. However, the statistical extrapolation, to estimate storm surges corresponding to high return periods, is seriously contaminated by sampling and model uncertainty if data are available for a relatively limited period. This has motivated the development of approaches to enlarge the sample extreme values beyond the systematic period. The nonsystematic data occurred before the systematic period is called historical information. During the last three decades, the value of using historical information as a nonsystematic data in frequency analysis has been recognized by several authors. The basic hypothesis in statistical modeling of historical information is that a perception threshold exists and that during a giving historical period preceding the period of tide gauging, all exceedances of this threshold have been recorded. Historical information prior to the systematic records may arise from high-sea water marks left by extreme surges on the coastal areas. It can also be retrieved from archives, old books, earliest newspapers, damage reports, unpublished written records and interviews with local residents. A plotting position formula, to compute empirical probabilities based on systematic and historical data, is used in this communication paper. The objective of the present work is to examine the potential gain in estimation accuracy with the

Kinematic and neuromuscular relationships between lower extremity clinical movement assessments.

Science.gov (United States)

Mauntel, Timothy C; Cram, Tyler R; Frank, Barnett S; Begalle, Rebecca L; Norcross, Marc F; Blackburn, J Troy; Padua, Darin A

2018-06-01

Lower extremity injuries have immediate and long-term consequences. Lower extremity movement assessments can assist with identifying individuals at greater injury risk and guide injury prevention interventions. Movement assessments identify similar movement characteristics and evidence suggests large magnitude kinematic relationships exist between movement patterns observed across assessments; however, the magnitude of the relationships for electromyographic (EMG) measures across movement assessments remains largely unknown. This study examined relationships between lower extremity kinematic and EMG measures during jump landings and single leg squats. Lower extremity three-dimensional kinematic and EMG data were sampled from healthy adults (males = 20, females = 20) during the movement assessments. Pearson correlations examined the relationships of the kinematic and EMG measures and paired samples t-tests compared mean kinematic and EMG measures between the assessments. Overall, significant moderate correlations were observed for lower extremity kinematic (r avg  = 0.41, r range  = 0.10-0.61) and EMG (r avg  = 0.47, r range  = 0.32-0.80) measures across assessments. Kinematic and EMG measures were greater during the jump landings. Jump landings and single leg squats place different demands on the body and necessitate different kinematic and EMG patterns, such that these measures are not highly correlated between assessments. Clinicians should, therefore, use multiple assessments to identify aberrant movement and neuromuscular control patterns so that comprehensive interventions can be implemented.

Ensemble-based evaluation of extreme water levels for the eastern Baltic Sea

Science.gov (United States)

Eelsalu, Maris; Soomere, Tarmo

2016-04-01

The risks and damages associated with coastal flooding that are naturally associated with an increase in the magnitude of extreme storm surges are one of the largest concerns of countries with extensive low-lying nearshore areas. The relevant risks are even more contrast for semi-enclosed water bodies such as the Baltic Sea where subtidal (weekly-scale) variations in the water volume of the sea substantially contribute to the water level and lead to large spreading of projections of future extreme water levels. We explore the options for using large ensembles of projections to more reliably evaluate return periods of extreme water levels. Single projections of the ensemble are constructed by means of fitting several sets of block maxima with various extreme value distributions. The ensemble is based on two simulated data sets produced in the Swedish Meteorological and Hydrological Institute. A hindcast by the Rossby Centre Ocean model is sampled with a resolution of 6 h and a similar hindcast by the circulation model NEMO with a resolution of 1 h. As the annual maxima of water levels in the Baltic Sea are not always uncorrelated, we employ maxima for calendar years and for stormy seasons. As the shape parameter of the Generalised Extreme Value distribution changes its sign and substantially varies in magnitude along the eastern coast of the Baltic Sea, the use of a single distribution for the entire coast is inappropriate. The ensemble involves projections based on the Generalised Extreme Value, Gumbel and Weibull distributions. The parameters of these distributions are evaluated using three different ways: maximum likelihood method and method of moments based on both biased and unbiased estimates. The total number of projections in the ensemble is 40. As some of the resulting estimates contain limited additional information, the members of pairs of projections that are highly correlated are assigned weights 0.6. A comparison of the ensemble-based projection of

Nitrogen accumulation and partitioning in a High Arctic tundra ecosystem from extreme atmospheric N deposition events

Energy Technology Data Exchange (ETDEWEB)

Choudhary, Sonal, E-mail: S.Choudhary@sheffield.ac.uk [Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield S10 2TN (United Kingdom); Management School, University of Sheffield, Conduit Road, Sheffield S10 1FL (United Kingdom); Blaud, Aimeric [Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield S10 2TN (United Kingdom); Osborn, A. Mark [Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield S10 2TN (United Kingdom); School of Applied Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 (Australia); Press, Malcolm C. [School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT (United Kingdom); Manchester Metropolitan University, Manchester, M15 6BH (United Kingdom); Phoenix, Gareth K. [Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield S10 2TN (United Kingdom)

2016-06-01

Arctic ecosystems are threatened by pollution from recently detected extreme atmospheric nitrogen (N) deposition events in which up to 90% of the annual N deposition can occur in just a few days. We undertook the first assessment of the fate of N from extreme deposition in High Arctic tundra and are presenting the results from the whole ecosystem {sup 15}N labelling experiment. In 2010, we simulated N depositions at rates of 0, 0.04, 0.4 and 1.2 g N m{sup −2} yr{sup −1}, applied as {sup 15}NH{sub 4}{sup 15}NO{sub 3} in Svalbard (79{sup °}N), during the summer. Separate applications of {sup 15}NO{sub 3}{sup −} and {sup 15}NH{sub 4}{sup +} were also made to determine the importance of N form in their retention. More than 95% of the total {sup 15}N applied was recovered after one growing season (~ 90% after two), demonstrating a considerable capacity of Arctic tundra to retain N from these deposition events. Important sinks for the deposited N, regardless of its application rate or form, were non-vascular plants > vascular plants > organic soil > litter > mineral soil, suggesting that non-vascular plants could be the primary component of this ecosystem to undergo measurable changes due to N enrichment from extreme deposition events. Substantial retention of N by soil microbial biomass (70% and 39% of {sup 15}N in organic and mineral horizon, respectively) during the initial partitioning demonstrated their capacity to act as effective buffers for N leaching. Between the two N forms, vascular plants (Salix polaris) in particular showed difference in their N recovery, incorporating four times greater {sup 15}NO{sub 3}{sup −} than {sup 15}NH{sub 4}{sup +}, suggesting deposition rich in nitrate will impact them more. Overall, these findings show that despite the deposition rates being extreme in statistical terms, biologically they do not exceed the capacity of tundra to sequester pollutant N during the growing season. Therefore, current and future extreme events

Model of analysis of maximum loads in wind generators produced by extreme winds

International Nuclear Information System (INIS)

Herrera – Sánchez, Omar; Schellong, Wolfgang; González – Fernández, Vladimir

2010-01-01

The use of the wind energy by means of the wind turbines in areas of high risk of occurrence of Hurricanes comes being an important challenge for the designers of wind farm at world for some years. The wind generator is not usually designed to support this type of phenomena, for this reason the areas of high incidence of tropical hurricanes of the planning are excluded, that which, in occasions disables the use of this renewable source of energy totally, either because the country is very small, or because it coincides the area of more potential fully with that of high risk. To counteract this situation, a model of analysis of maxims loads has been elaborated taken place the extreme winds in wind turbines of great behavior. This model has the advantage of determining, in a chosen place, for the installation of a wind farm, the micro-areas with higher risk of wind loads above the acceptable for the standard classes of wind turbines. (author)

Climatic changes of extreme precipitation in Denmark from 1872 to 2100

DEFF Research Database (Denmark)

Arnbjerg-Nielsen, Karsten; Gregersen, Ida Bülow; Sunyer Pinya, Maria Antonia

of climate change impacts from anthropogenic effects can be established based on projections of daily precipitation. These estimates have then been further downscaled to enable urban pluvial inundation calculations using different statistical downscaling and extreme value analysis techniques. . From...... of precipitation extremes. The objective is to establish cities that are resilient to pluvial floods by means of a gradual upgrading of the drainage capacity in combination with a structured risk management approach. Using the regional climate model (RCM) data repositories from PRUDENCE and ENSEMBLES, estimates....... These results are important for the extrapolation to future events. Currently efforts are dedicated to constructing similar models based on outputs from climate models, but the models are complicated due to the fact that the correlation structure of high-resolution precipitation in the climate models deviates...

A trauma-like model of political extremism: psycho-political fault lines in Israel.

Science.gov (United States)

Laor, Nathaniel; Yanay-Shani, Alma; Wolmer, Leo; Khoury, Oula

2010-10-01

This study examines a trauma-like model of potentially violent political extremism among Jewish Israelis. We study the psychosocial characteristics of political extremists that may lie at the root of sociopolitical instability and assess personal (gender, stressful life events, Holocaust family background, and political activism) and psychological parameters (self- and political transcendence, perceived political threats, in/out-group identification ratio) that may predict readiness to engage in destructive political behavior. We examine the ideological zeal of various political groups, the relationship between the latter and perceived political threats, and the predictors of extreme political activism. Results showed that the extreme political poles displayed high level of ideological and morbid transcendence. Right extremists displayed higher perceived threats to physical existence and national identity. Left extremists scored highest on perceived moral integrity threat. Higher perceived threats to national identity and moral integrity, risk, and self-transcendence statistically explain morbid transcendence. When fear conjures up extremely skewed sociopolitical identifications across political boundaries, morbid transcendence may manifest itself in destructive political activity. © 2010 Association for Research in Nervous and Mental Disease.

Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study.

Science.gov (United States)

Johnson, S; Hennessy, E; Smith, R; Trikic, R; Wolke, D; Marlow, N

2009-07-01

To assess academic attainment and special educational needs (SEN) in extremely preterm children in middle childhood. Of 307 extremely preterm (special school. In mainstream schools, 105 (57%) extremely preterm children had SEN (OR 10; 6 to 18) and 103 (55%) required SEN resource provision (OR 10; 6 to 18). Teachers rated 50% of extremely preterm children as having below average attainment compared with 5% of classmates (OR 18; 8 to 41). Extremely preterm children who entered compulsory education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR 2; 1.0 to 3.6). Extremely preterm survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources to access the national curriculum. The prevalence and impact of SEN are likely to increase as these children approach the transition to secondary school.

Evaluation of trends in high temperature extremes in north-western Europe in regional climate models

International Nuclear Information System (INIS)

Min, E; Hazeleger, W; Van Oldenborgh, G J; Sterl, A

2013-01-01

Projections of future changes in weather extremes on the regional and local scale depend on a realistic representation of trends in extremes in regional climate models (RCMs). We have tested this assumption for moderate high temperature extremes (the annual maximum of the daily maximum 2 m temperature, T ann.max ). Linear trends in T ann.max from historical runs of 14 RCMs driven by atmospheric reanalysis data are compared with trends in gridded station data. The ensemble of RCMs significantly underestimates the observed trends over most of the north-western European land surface. Individual models do not fare much better, with even the best performing models underestimating observed trends over large areas. We argue that the inability of RCMs to reproduce observed trends is probably not due to errors in large-scale circulation. There is also no significant correlation between the RCM T ann.max trends and trends in radiation or Bowen ratio. We conclude that care should be taken when using RCM data for adaptation decisions. (letter)

The high-risk plaque initiative

DEFF Research Database (Denmark)

Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

2011-01-01

The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...

Risk Factors for Readmission Following Lower Extremity Bypass in the ACS-NSQIP

Science.gov (United States)

Zhang, Jennifer Q.; Curran, Thomas; McCallum, John C.; Wang, Li; Wyers, Mark C.; Hamdan, Allen D.; Guzman, Raul J.; Schermerhorn, Marc L.

2014-01-01

Objectives Readmission is associated with high mortality, morbidity, and cost. We used the ACS-NSQIP to determine risk factors for readmission following lower extremity bypass (LEB). Methods We identified all patients who received LEB in the 2011 ACS-NSQIP database. Multivariable logistic regression was used to assess independent predictors of 30-day readmission. We also identified our institutional contribution of LEB patients to the ACS-NSQIP from 2005–2011 to determine our institution’s rate of readmission and readmission indications. Results Among 5018 patients undergoing LEB, ACS-NSQIP readmission analysis was performed on 4512, excluding those whose readmission data was unavailable, suffered a death on index admission, or remained in the hospital at 30 days. Overall readmission rate was 18%, and readmission rate of those with NSQIP captured complications was 8%. Multivariable predictors of readmission were dependent functional status (OR 1.40, 95% CI: 1.08–1.79), dyspnea (OR 1.28, 95% CI: 1.02–1.60), cardiac comorbidity (OR 1.46, 95% CI: 1.16–1.84), dialysis dependence (OR 1.44, 95% CI: 1.05–1.97), obesity (OR 1.28, 95% CI: 1.07–1.53), malnutrition (OR 1.42, 95% CI 1.12–1.79), CLI operative indication (OR 1.40, 95% CI: 1.10–1.79), and return to the operating room on index admission (OR 8.0, 95% CI: 6.68–9.60). The most common post-discharge complications occurring in readmitted patients included wound complications (56%), multiple complications (22%), and graft failure (5%). Our institutional data contributed 465 LEB patients to the ACS-NSQIP from 2005–2012, with an overall readmission rate of 14%. Unplanned readmissions related to the original LEB (related unplanned) made up 75% of cases. The remainder 25% included readmissions that were planned staged procedures related to the original LEB (related planned, 11%) and admissions for a completely unrelated reason (unrelated unplanned, 14%). The most common readmission indications included

Sensitivity of UK butterflies to local climatic extremes: which life stages are most at risk?

Science.gov (United States)

McDermott Long, Osgur; Warren, Rachel; Price, Jeff; Brereton, Tom M; Botham, Marc S; Franco, Aldina M A

2017-01-01

There is growing recognition as to the importance of extreme climatic events (ECEs) in determining changes in species populations. In fact, it is often the extent of climate variability that determines a population's ability to persist at a given site. This study examined the impact of ECEs on the resident UK butterfly species (n = 41) over a 37-year period. The study investigated the sensitivity of butterflies to four extremes (drought, extreme precipitation, extreme heat and extreme cold), identified at the site level, across each species' life stages. Variations in the vulnerability of butterflies at the site level were also compared based on three life-history traits (voltinism, habitat requirement and range). This is the first study to examine the effects of ECEs at the site level across all life stages of a butterfly, identifying sensitive life stages and unravelling the role life-history traits play in species sensitivity to ECEs. Butterfly population changes were found to be primarily driven by temperature extremes. Extreme heat was detrimental during overwintering periods and beneficial during adult periods and extreme cold had opposite impacts on both of these life stages. Previously undocumented detrimental effects were identified for extreme precipitation during the pupal life stage for univoltine species. Generalists were found to have significantly more negative associations with ECEs than specialists. With future projections of warmer, wetter winters and more severe weather events, UK butterflies could come under severe pressure given the findings of this study. © 2016 The Authors. Journal of Animal Ecology © 2016 British Ecological Society.

Lower extremity muscle activation during baseball pitching.

Science.gov (United States)

Campbell, Brian M; Stodden, David F; Nixon, Megan K

2010-04-01

The purpose of this study was to investigate muscle activation levels of select lower extremity muscles during the pitching motion. Bilateral surface electromyography data on 5 lower extremity muscles (biceps femoris, rectus femoris, gluteus maximus, vastus medialis, and gastrocnemius) were collected on 11 highly skilled baseball pitchers and compared with individual maximal voluntary isometric contraction (MVIC) data. The pitching motion was divided into 4 distinct phases: phase 1, initiation of pitching motion to maximum stride leg knee height; phase 2, maximum stride leg knee height to stride foot contact (SFC); phase 3, SFC to ball release; and phase 4, ball release to 0.5 seconds after ball release (follow-through). Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38-172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2-4 (23-170% of MVIC). These data indicate a high demand for lower extremity strength and endurance. Specifically, coaches should incorporate unilateral and bilateral lower extremity exercises for strength improvement or maintenance and to facilitate dynamic stabilization of the lower extremities during the pitching motion.

Increasing stress on disaster-risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen C. J. H.; Mechler, Reinhard; Botzen, W. J. Wouter; Bouwer, Laurens M.; Pflug, Georg; Rojas, Rodrigo; Ward, Philip J.

2014-04-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. So far, little is known about such flood hazard interdependencies across regions and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins. We present probabilistic trends in continental flood risk, and demonstrate that observed extreme flood losses could more than double in frequency by 2050 under future climate change and socio-economic development. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Study on extreme high temperature of cooling water in Chinese coastal nuclear power plant

International Nuclear Information System (INIS)

Yu Fan; Jiang Ziying

2012-01-01

In order to protect aquatic life from the harmful effects of thermal discharge, the appropriate water temperature limits or the scope of the mixing zone is a key issue in the regulatory control of the environmental impact of thermal discharge. Based on the sea surface temperature in the Chinese coastal waters, the extreme value of the seawater temperature change was analyzed by using the Gumbel model. The limit of the design temperature rise of cooling water in the outfall is 9 ℃, and the limit of the temperature rise of cooling water in the edge of the mixing zone is 4 ℃. The extreme high temperature of the cooling water in Chinese coastal nuclear power plant is 37 ℃ in the Bohai Sea, Yellow Sea, and is 40 ℃ in East China Sea, South China Sea. (authors)

Neonatal systemic inflammation and the risk of low scores on measures of reading and mathematics achievement at age 10 years among children born extremely preterm.

Science.gov (United States)

Leviton, Alan; Dammann, Olaf; Allred, Elizabeth N; Joseph, Robert M; Fichorova, Raina N; O'Shea, T Michael; Kuban, Karl C K

2018-05-01

Difficulties with reading and math occur more commonly among children born extremely preterm than among children born at term. Reasons for this are unclear. We measured the concentrations of 27 inflammatory-related and neurotrophic/angiogenic proteins (angio-neurotrophic proteins) in multiple blood specimens collected a week apart during the first postnatal month from 660 children born before the 28th week of gestation who at age 10 years had an IQ ≥ 70 and a Wechsler Individual Achievement Test 3rd edition (WIAT-III) assessment. We identified four groups of children, those who had a Z-score ≤ -1 on the Word Reading assessment only, on the Numerical Operations assessment only, on both of these assessments, and on neither, which served as the referent group. We then modeled the risk of each learning limitation associated with a top quartile concentration of each protein, and with high and lower concentrations of multiple proteins. The protein profile of low reading scores was confined to the third and fourth postnatal weeks when increased risks were associated with high concentrations of IL-8 and ICAM-1 in the presence of low concentrations of angio-neurotrophic proteins. The profile of low math scores was very similar, except it did not include ICAM-1. In contrast, the profile of low scores on both assessments was present in each of the first four postnatal weeks. The increased risks associated with high concentrations of TNF-α in the first two weeks and of IL-8 and ICAM-1 in the next two weeks were modulated down by high concentrations of angio-neurotrophic proteins. High concentrations of angio-neurotrophic proteins appear to reduce/moderate the risk of each learning limitation associated with systemic inflammation. The three categories of limitations have protein profiles with some similarities, and yet some differences, too. Copyright © 2018 ISDN. Published by Elsevier Ltd. All rights reserved.

Patients at High-Risk for Surgical Site Infection.

Science.gov (United States)

Mueck, Krislynn M; Kao, Lillian S

Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

Using subseasonal-to-seasonal (S2S extreme rainfall forecasts for extended-range flood prediction in Australia

Directory of Open Access Journals (Sweden)

C. J. White

2015-06-01

Full Text Available Meteorological and hydrological centres around the world are looking at ways to improve their capacity to be able to produce and deliver skilful and reliable forecasts of high-impact extreme rainfall and flooding events on a range of prediction timescales (e.g. sub-daily, daily, multi-week, seasonal. Making improvements to extended-range rainfall and flood forecast models, assessing forecast skill and uncertainty, and exploring how to apply flood forecasts and communicate their benefits to decision-makers are significant challenges facing the forecasting and water resources management communities. This paper presents some of the latest science and initiatives from Australia on the development, application and communication of extreme rainfall and flood forecasts on the extended-range "subseasonal-to-seasonal" (S2S forecasting timescale, with a focus on risk-based decision-making, increasing flood risk awareness and preparedness, capturing uncertainty, understanding human responses to flood forecasts and warnings, and the growing adoption of "climate services". The paper also demonstrates how forecasts of flood events across a range of prediction timescales could be beneficial to a range of sectors and society, most notably for disaster risk reduction (DRR activities, emergency management and response, and strengthening community resilience. Extended-range S2S extreme flood forecasts, if presented as easily accessible, timely and relevant information are a valuable resource to help society better prepare for, and subsequently cope with, extreme flood events.

Assessment of the risk of falling with the use of timed up and go test in the elderly with lower extremity osteoarthritis

Directory of Open Access Journals (Sweden)

Zasadzka E

2015-08-01

Full Text Available Ewa Zasadzka,1 Adrianna Maria Borowicz,1 Magdalena Roszak,2 Mariola Pawlaczyk1 1Department of Geriatric Medicine and Gerontology, Karol Marcinkowski University of Medical Sciences, 2Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland Background: Falling in the elderly results in a significant number of admissions to hospitals and long-term care facilities, especially among patients with lower extremity osteoarthritis (OA.Objective: The aim of the study was to assess the risk of falling in adults older than 60 years with OA using timed up and go (TUG test.Materials and methods: A total of 187 patients (aged >60 years were enrolled in the study. The assessment included: basic activities of daily living (ADLs, lower extremity strength with the use of the 30-second chair stand test (30 CST, and assessment of the risk of falling (TUG test. Pain intensity was evaluated with the numeric rating scale (NRS.Results: The TUG test results were significantly better in younger OA patients (aged 60–69 years, as compared with their older peers (aged 70–79 years; P<0.01 and the oldest group (aged >80 years; P<0.001. Also, the 30 CST results were significantly higher in younger OA patients (P<0.05. Subjects older than 80 years had a significantly worse ADL score (P<0.05 and P<0.001. Pain complaints were reported significantly more frequently by women than men (P<0.05. A correlation between age and the TUG test score (r=0.412; P<0.0004 as well as between the TUG test and the 30 CST scores (r=0.7368; P=0.000 was detected. In the group with the TUG test score of <13.5 seconds, the 30 CST (P<0.0001 and ADL (P<0.003 results were significantly better. A comparison of fallers vs nonfallers revealed that the number of falls was significantly higher in the group of subjects who scored $13.5 when compared to <13.5 (P=0.003. Fallers significantly more often reported pain (P<0.0001, whereas nonfallers had

Extreme temperatures and out-of-hospital coronary deaths in six large Chinese cities.

Science.gov (United States)

Chen, Renjie; Li, Tiantian; Cai, Jing; Yan, Meilin; Zhao, Zhuohui; Kan, Haidong

2014-12-01

The seasonal trend of out-of-hospital coronary death (OHCD) and sudden cardiac death has been observed, but whether extreme temperature serves as a risk factor is rarely investigated. We therefore aimed to evaluate the impact of extreme temperatures on OHCDs in China. We obtained death records of 126,925 OHCDs from six large Chinese cities (Harbin, Beijing, Tianjin, Nanjing, Shanghai and Guangzhou) during the period 2009-2011. The short-term associations between extreme temperature and OHCDs were analysed with time-series methods in each city, using generalised additive Poisson regression models. We specified distributed lag non-linear models in studying the delayed effects of extreme temperature. We then applied Bayesian hierarchical models to combine the city-specific effect estimates. The associations between extreme temperature and OHCDs were almost U-shaped or J-shaped. The pooled relative risks (RRs) of extreme cold temperatures over the lags 0-14 days comparing the 1st and 25th centile temperatures were 1.49 (95% posterior interval (PI) 1.26-1.76); the pooled RRs of extreme hot temperatures comparing the 99th and 75th centile temperatures were 1.53 (95% PI 1.27-1.84) for OHCDs. The RRs of extreme temperature on OHCD were higher if the patients with coronary heart disease were old, male and less educated. This multicity epidemiological study suggested that both extreme cold and hot temperatures posed significant risks on OHCDs, and might have important public health implications for the prevention of OHCD or sudden cardiac death. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Refugee youth, unemployment and extremism: countering the myth

Directory of Open Access Journals (Sweden)

Drew Mikhael

2018-02-01

Full Text Available Refugee youth unemployment has been linked to increased risk of extremism and/or exploitation. Research indicates, however, that unemployment is just one of many factors triggering frustration among young refugees.

Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

Science.gov (United States)

Kristina, S.; Wijaya, B. M.

2017-12-01

This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

Detection and Attribution of Climate Change : From global mean temperature change to climate extremes and high impact weather.

CERN Multimedia

CERN. Geneva

2013-01-01

This talk will describe how evidence has grown in recent years for a human influence on climate and explain how the Fifth Assessment Report of the Intergovernmental Panel on Climate Change concluded that it is extremely likely (>95% probability) that human influence on climate has been the dominant cause of the observed global-mean warming since the mid-20th century. The fingerprint of human activities has also been detected in warming of the ocean, in changes in the global water cycle, in reductions in snow and ice, and in changes in some climate extremes. The strengthening of evidence for the effects of human influence on climate extremes is in line with long-held basic understanding of the consequences of mean warming for temperature extremes and for atmospheric moisture. Despite such compelling evidence this does not mean that every instance of high impact weather can be attributed to anthropogenic climate change, because climate variability is often a major factor in many locations, especially for rain...

Combining quantitative and qualitative breast density measures to assess breast cancer risk.

Science.gov (United States)

Kerlikowske, Karla; Ma, Lin; Scott, Christopher G; Mahmoudzadeh, Amir P; Jensen, Matthew R; Sprague, Brian L; Henderson, Louise M; Pankratz, V Shane; Cummings, Steven R; Miglioretti, Diana L; Vachon, Celine M; Shepherd, John A

2017-08-22

Accurately identifying women with dense breasts (Breast Imaging Reporting and Data System [BI-RADS] heterogeneously or extremely dense) who are at high breast cancer risk will facilitate discussions of supplemental imaging and primary prevention. We examined the independent contribution of dense breast volume and BI-RADS breast density to predict invasive breast cancer and whether dense breast volume combined with Breast Cancer Surveillance Consortium (BCSC) risk model factors (age, race/ethnicity, family history of breast cancer, history of breast biopsy, and BI-RADS breast density) improves identifying women with dense breasts at high breast cancer risk. We conducted a case-control study of 1720 women with invasive cancer and 3686 control subjects. We calculated ORs and 95% CIs for the effect of BI-RADS breast density and Volpara™ automated dense breast volume on invasive cancer risk, adjusting for other BCSC risk model factors plus body mass index (BMI), and we compared C-statistics between models. We calculated BCSC 5-year breast cancer risk, incorporating the adjusted ORs associated with dense breast volume. Compared with women with BI-RADS scattered fibroglandular densities and second-quartile dense breast volume, women with BI-RADS extremely dense breasts and third- or fourth-quartile dense breast volume (75% of women with extremely dense breasts) had high breast cancer risk (OR 2.87, 95% CI 1.84-4.47, and OR 2.56, 95% CI 1.87-3.52, respectively), whereas women with extremely dense breasts and first- or second-quartile dense breast volume were not at significantly increased breast cancer risk (OR 1.53, 95% CI 0.75-3.09, and OR 1.50, 95% CI 0.82-2.73, respectively). Adding continuous dense breast volume to a model with BCSC risk model factors and BMI increased discriminatory accuracy compared with a model with only BCSC risk model factors (C-statistic 0.639, 95% CI 0.623-0.654, vs. C-statistic 0.614, 95% CI 0.598-0.630, respectively; P breasts and fourth

Complex Plasma Research Under Extreme Conditions

International Nuclear Information System (INIS)

Ishihara, Osamu

2008-01-01

Complex plasma research under extreme conditions is described. The extreme conditions include low-dimensionality for self-organized structures of dust particles, dust magnetization in high magnetic field, criticality in phase transition, and cryogenic environment for Coulomb crystals and dust dynamics.

Judging risk behaviour and risk preference: the role of the evaluative connotation of risk terms.

NARCIS (Netherlands)

van Schie, E.C.M.; van der Pligt, J.; van Baaren, K.

1993-01-01

Two experiments investigated the impact of the evaluative connotation of risk terms on the judgment of risk behavior and on risk preference. Exp 1 focused on the evaluation congruence of the risk terms with a general risk norm and with Ss' individual risk preference, and its effects on the extremity

High-resolution projections of mean and extreme precipitations over China through PRECIS under RCPs

Science.gov (United States)

Zhu, Jinxin; Huang, Gordon; Wang, Xiuquan; Cheng, Guanhui; Wu, Yinghui

2018-06-01

The impact of global warming on the characteristics of mean and extreme precipitations over China is investigated by using the Providing REgional Climate Impacts for Studies (PRECIS) model. The PRECIS model was driven by the Hadley Centre Global Environment Model version 2 with Earth System components and coupling (HadGEM2-ES). The results of both models are analyzed in terms of mean precipitation and indices of precipitation extremes (R95p, R99p, SDII, WDF, and CWD) over China at the resolution of 25 km under the Representative Concentration Pathways 4.5 and 8.5 (RCP4.5 and RCP8.5) scenarios for the baseline period (1976-2005) and two future periods (2036-2065 and 2070-2099). With improved resolution, the PRECIS model is able to better represent the fine-scale physical process than HadGEM2-ES. It can provide reliable spatial patterns of precipitation and its related extremes with high correlations to observations. Moreover, there is a notable improvement in temporal patterns simulation through the PRECIS model. The PRECIS model better reproduces the regional annual cycle and frequencies of daily precipitation intensity than its driving GCM. Under RCP4.5 and RCP8.5, both the HadGEM2-ES and the precis project increasing annual precipitation over the entire country for two future periods. Precipitation increase in winter is greater than the increase in summer. The results suggest that increased radiative forcing from RCP4.5 to RCP8.5 would further intensify the magnitude of projected precipitation changes by both PRECIS and HadGEM2-ES. For example, some parts of south China with decreased precipitation under RCP4.5 would expect even less precipitation under RCP8.5; regions (northwest, northcentral and northeast China) with increased precipitation under RCP4.5 would expect more precipitation under RCP8.5. Apart from the projected increase in annual total precipitation, the results also suggest that there will be an increase in the days with precipitation higher than

Statistical techniques for modeling extreme price dynamics in the energy market

International Nuclear Information System (INIS)

Mbugua, L N; Mwita, P N

2013-01-01

Extreme events have large impact throughout the span of engineering, science and economics. This is because extreme events often lead to failure and losses due to the nature unobservable of extra ordinary occurrences. In this context this paper focuses on appropriate statistical methods relating to a combination of quantile regression approach and extreme value theory to model the excesses. This plays a vital role in risk management. Locally, nonparametric quantile regression is used, a method that is flexible and best suited when one knows little about the functional forms of the object being estimated. The conditions are derived in order to estimate the extreme value distribution function. The threshold model of extreme values is used to circumvent the lack of adequate observation problem at the tail of the distribution function. The application of a selection of these techniques is demonstrated on the volatile fuel market. The results indicate that the method used can extract maximum possible reliable information from the data. The key attraction of this method is that it offers a set of ready made approaches to the most difficult problem of risk modeling.

Playground slide-related injuries in preschool children: increased risk of lower extremity injuries when riding on laps.

Science.gov (United States)

Jennissen, Charles A; Koos, Maggie; Denning, Gerene

2018-04-10

The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3-5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person's lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0-58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7-77.4). Decreasing age was associated with a higher likelihood of being identified as sliding down on another person's lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler's fracture of

An Assessment of Direct and Indirect Economic Losses of Climatic Extreme Events

Science.gov (United States)

Otto, C.; Willner, S. N.; Wenz, L.; Levermann, A.

2015-12-01

Risk of extreme weather events like storms, heat extremes, and floods has already risen due to anthropogenic climate change and is likely to increase further under future global warming. Additionally, the structure of the global economy has changed importantly in the last decades. In the process of globalization, local economies have become more and more interwoven forming a complex network. Together with a trend towards lean production, this has resulted in a strong dependency of local manufacturers on global supply and value added chains, which may render the economic network more vulnerable to climatic extremes; outages of local manufacturers trigger indirect losses, which spread along supply chains and can even outstrip direct losses. Accordingly, in a comprehensive climate risk assessment these inter-linkages should be considered. Here, we present acclimate, an agent based dynamic damage propagation model. Its agents are production and consumption sites, which are interlinked by economic flows accounting for the complexity as well as the heterogeneity of the global supply network. Assessing the economic response on the timescale of the adverse event, the model permits to study temporal and spatial evolution of indirect production losses during the disaster and in the subsequent recovery phase of the economy. In this study, we focus on the dynamic economic resilience defined here as the ratio of direct to total losses. This implies that the resilience of the system under consideration is low if the high indirect losses are high. We find and assess a nonlinear dependence of the resilience on the disaster size. Further, we analyze the influence of the network structure upon resilience and discuss the potential of warehousing as an adaptation option.

Using an extended 2D hydrodynamic model for evaluating damage risk caused by extreme rain events: Flash-Flood-Risk-Map (FFRM) Upper Austria

Science.gov (United States)

Humer, Günter; Reithofer, Andreas

2016-04-01

Using an extended 2D hydrodynamic model for evaluating damage risk caused by extreme rain events: Flash-Flood-Risk-Map (FFRM) Upper Austria Considering the increase in flash flood events causing massive damage during the last years in urban but also rural areas [1-4], the requirement for hydrodynamic calculation of flash flood prone areas and possible countermeasures has arisen to many municipalities and local governments. Besides the German based URBAS project [1], also the EU-funded FP7 research project "SWITCH-ON" [5] addresses the damage risk caused by flash floods in the sub-project "FFRM" (Flash Flood Risk Map Upper Austria) by calculating damage risk for buildings and vulnerable infrastructure like schools and hospitals caused by flash-flood driven inundation. While danger zones in riverine flooding are established as an integral part of spatial planning, flash floods caused by overland runoff from extreme rain events have been for long an underrated safety hazard not only for buildings and infrastructure, but man and animals as well. Based on the widespread 2D-model "hydro_as-2D", an extension was developed, which calculates the runoff formation from a spatially and temporally variable precipitation and determines two dimensionally the land surface area runoff and its concentration. The conception of the model is to preprocess the precipitation data and calculate the effective runoff-volume for a short time step of e.g. five minutes. This volume is applied to the nodes of the 2D-model and the calculation of the hydrodynamic model is started. At the end of each time step, the model run is stopped, the preprocessing step is repeated and the hydraulic model calculation is continued. In view of the later use for the whole of Upper Austria (12.000 km²) a model grid of 25x25 m² was established using digital elevation data. Model parameters could be estimated for the small catchment of river Ach, which was hit by an intense rain event with up to 109 mm per hour

Epidemiology of extremity fractures in the Netherlands

NARCIS (Netherlands)

Beerekamp, M. S. H.; de Muinck Keizer, R. J. O.; Schep, N. W. L.; Ubbink, D. T.; Panneman, M. J. M.; Goslings, J. C.

2017-01-01

Insight in epidemiologic data of extremity fractures is relevant to identify people at risk. By analyzing age- and gender specific fracture incidence and treatment patterns we may adjust future policy, take preventive measures and optimize health care management. Current epidemiologic data on

Probabilistic and deterministic risk assessment for extreme objects and ecologically hazardous systems

Directory of Open Access Journals (Sweden)

Yu. V. Veryuzhsky

2003-06-01

Full Text Available The paper include mostly the results of works of the Research Institute for Mechanics of Quickproceeding Processes united in a general research direction - creation of the methodology for risk assessment and risk management for ecologically hazardous systems, consisting of the set of different technological analyzed objects. The elements of system can be characterized by high level of radiation, toxic, explosion, fire and other hazards. The probalistic and deterministic approach for risk assessment, based on mathematical methods of system analysis, non-liner dynamics and computer simulation, has been developed. Branching in problem definition, as well as diversity of factor and criteria for determination of system status, is also taken into account. The risks caused by both objective and subjective factors (including human factor are examined. In many performed studies, the leading structural element, dominating in determination of the system safety, is the structural part of an object. The methodology is implemented for the safety analysis (risk assessment for Chernobyl NPP Shelton Object and other industrial buildings

Mortality associated with extremity injuries compared with other types of trauma

Directory of Open Access Journals (Sweden)

Sanches JEA

2011-04-01

Full Text Available José Eduardo Arantes Sanches1, José Maria Pereira de Godoy3, André Luciano Baitello2, Alceu Gomes Chueire11Departments of Orthopedic and Traumatology, 2Trauma, 3Cardiology and Cardiovascular Surgery, Faculty of Medicine, São Jose do Rio Preto, BrazilBackground: The aim of this study was to evaluate one-month hospital mortality in victims with injuries of the extremities.Methods: All accident victims admitted to the Hospital de Base in São José do Rio Preto, Brazil, during the period from July 2004 to June 2005, were evaluated in an observational study. Patients were classified using the Abbreviated Injury Scale (AIS. Patients with severe injuries of the extremities (AIS 3–4 were compared with those without injuries or with minor extremity injuries (AIS 0–2.Results: A total of 3489 accident victims were evaluated; 3244 (92.98% did not suffer injuries or had minor injuries of the extremities (AIS 0–2 and 245 (7.02% had severe injuries (AIS 3–4. Of the 245 patients with AIS 3–4 extremity injuries, 13 (5.31% patients died, and of those without severe injuries to the extremities, 34 (1.05% died (Fisher’s Exact test P = 0.0000, relative risk 5.063, 95% confidence interval [CI]: 2.707–9.467.Conclusion: Patients with injuries of the extremities are at greater risk of death than accident victims with other types of trauma.Keywords: trauma, extremities, mortality, Brazil

Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

Science.gov (United States)

Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

2010-01-01

Background Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically-defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment; where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions and research efforts. Methods We describe the results of a segmentation analysis of those individuals who self-report consuming five or more drinks per drinking episode at least twice in the last 30-days. The study used the proprietary PRIZM™ audience segmentation database merged with Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top ten of the 66 PRIZM™ audience segments for this risky drinking pattern are described. For five of these segments we provide additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers reside. Results The top ten audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge drinking behavior is referred to as the “Cyber Millenials.” This cluster is characterized as “the nation's tech-savvy singles

High resolution fire risk mapping in Italy

Science.gov (United States)

Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

2014-05-01

The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

Cardiovascular consequences of extreme prematurity: the EPICure study.

Science.gov (United States)

McEniery, Carmel M; Bolton, Charlotte E; Fawke, Joseph; Hennessy, Enid; Stocks, Janet; Wilkinson, Ian B; Cockcroft, John R; Marlow, Neil

2011-07-01

The long-term consequences of extreme prematurity are becoming increasingly important, given recent improvements in neonatal intensive care. The aim of the current study was to examine the cardiovascular consequences of extreme prematurity in 11-year-olds born at or before 25 completed weeks of gestation. Age and sex-matched classmates were recruited as controls. Information concerning perinatal and maternal history was collected, and current anthropometric characteristics were measured in 219 children born extremely preterm and 153 classmates. A subset of the extremely preterm children (n = 68) and classmates (n = 90) then underwent detailed haemodynamic investigations, including measurement of supine blood pressure (BP), aortic pulse wave velocity (aPWV, a measure of aortic stiffness) and augmentation index (AIx, a measure of arterial pressure wave reflections). Seated brachial systolic and diastolic BP were not different between extremely preterm children and classmates (P = 0.3 for both), although there was a small, significant elevation in supine mean and diastolic BP in the extremely preterm children (P prematurity is associated with altered arterial haemodynamics in children, not evident from the examination of brachial BP alone. Moreover, the smaller, preresistance and resistance vessels rather than large elastic arteries appear to be most affected. Children born extremely preterm may be at increased future cardiovascular risk.

High current density ion beam obtained by a transition to a highly focused state in extremely low-energy region

Energy Technology Data Exchange (ETDEWEB)

Hirano, Y., E-mail: y.hirano@aist.go.jp, E-mail: hirano.yoichi@phys.cst.nihon-u.ac.jp [Innovative Plasma Processing Group, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568 (Japan); College of Science and Technologies, Nihon University, Chiyodaku, Tokyo 101-0897 (Japan); Kiyama, S.; Koguchi, H. [Innovative Plasma Processing Group, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568 (Japan); Fujiwara, Y.; Sakakita, H. [Innovative Plasma Processing Group, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568 (Japan); Department of Engineering Mechanics and Energy, University of Tsukuba, Ibaraki 305-8577 (Japan)

2015-11-15

A high current density (≈3 mA/cm{sup 2}) hydrogen ion beam source operating in an extremely low-energy region (E{sub ib} ≈ 150–200 eV) has been realized by using a transition to a highly focused state, where the beam is extracted from the ion source chamber through three concave electrodes with nominal focal lengths of ≈350 mm. The transition occurs when the beam energy exceeds a threshold value between 145 and 170 eV. Low-level hysteresis is observed in the transition when E{sub ib} is being reduced. The radial profiles of the ion beam current density and the low temperature ion current density can be obtained separately using a Faraday cup with a grid in front. The measured profiles confirm that more than a half of the extracted beam ions reaches the target plate with a good focusing profile with a full width at half maximum of ≈3 cm. Estimation of the particle balances in beam ions, the slow ions, and the electrons indicates the possibility that the secondary electron emission from the target plate and electron impact ionization of hydrogen may play roles as particle sources in this extremely low-energy beam after the compensation of beam ion space charge.

ACUTE EFFECTS OF STATIC STRETCHING, DYNAMIC EXERCISES, AND HIGH VOLUME UPPER EXTREMITY PLYOMETRIC ACTIVITY ON TENNIS SERVE PERFORMANCE

Directory of Open Access Journals (Sweden)

Ertugrul Gelen

2012-12-01

Full Text Available The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg performed 4 different warm-up (WU routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice (TRAD; traditional WU and static stretching (TRSS; traditional WU and dynamic exercise (TRDE; and traditional WU and high volume upper extremity plyometric activity (TRPLYP. Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p 0.05. ICCs for ball speed showed strong reliability (0.82 to 0.93 for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players.

Improved Survival With Radiation Therapy in High-Grade Soft Tissue Sarcomas of the Extremities: A SEER Analysis

International Nuclear Information System (INIS)

Koshy, Matthew; Rich, Shayna E.; Mohiuddin, Majid M.

2010-01-01

Purpose: The benefit of radiation therapy in extremity soft tissue sarcomas remains controversial. The purpose of this study was to determine the effect of radiation therapy on overall survival among patients with primary soft tissue sarcomas of the extremity who underwent limb-sparing surgery. Methods and Materials: A retrospective study from the Surveillance, Epidemiology, and End Results (SEER) database that included data from January 1, 1988, to December 31, 2005. A total of 6,960 patients constituted the study population. Overall survival curves were constructed using the Kaplan-Meir method and for patients with low- and high-grade tumors. Hazard ratios were calculated based on multivariable Cox proportional hazards models. Results: Of the cohort, 47% received radiation therapy. There was no significant difference in overall survival among patients with low-grade tumors by radiation therapy. In high-grade tumors, the 3-year overall survival was 73% in patients who received radiation therapy vs. 63% for those who did not receive radiation therapy (p < 0.001). On multivariate analysis, patients with high-grade tumors who received radiation therapy had an improved overall survival (hazard ratio 0.67, 95% confidence interval 0.57-0.79). In patients receiving radiation therapy, 13.5% received it in a neoadjuvant setting. The incidence of patients receiving neoadjuvant radiation did not change significantly between 1988 and 2005. Conclusions: To our knowledge, this is the largest population-based study reported in patients undergoing limb-sparing surgery for soft tissue sarcomas of the extremities. It reports that radiation was associated with improved survival in patients with high-grade tumors.

Gene expression profiles in testis of pigs with extreme high and low levels of androstenone

Directory of Open Access Journals (Sweden)

Bendixen Christian

2007-11-01

Full Text Available Abstract Background: Boar taint is a major obstacle when using uncastrated male pigs for swine production. One of the main compounds causing this taint is androstenone, a pheromone produced in porcine testis. Here we use microarrays to study the expression of thousands of genes simultaneously in testis of high and low androstenone boars. The study allows identification of genes and pathways associated with elevated androstenone levels, which is essential for recognising potential molecular markers for breeding purposes. Results: Testicular tissue was collected from 60 boars, 30 with extreme high and 30 with extreme low levels of androstenone, from each of the two breeds Duroc and Norwegian Landrace. The samples were hybridised to porcine arrays containing 26,877 cDNA clones, detecting 563 and 160 genes that were differentially expressed (p Conclusion: This study contributes to the understanding of the complex genetic system controlling and responding to androstenone levels in pig testis. The identification of new pathways and genes involved in the biosynthesis and metabolism of androstenone is an important first step towards finding molecular markers to reduce boar taint.

Mitigation of houses with extremely high indoor radon concentrations

International Nuclear Information System (INIS)

Jiranek, M.; Neznal, M.

2006-01-01

Full text of publication follows: The paper reports on the experience of the Czech Technical University in dealing with mitigation of houses in which unusually high indoor radon concentrations were found. The whole process of remediation is illustrated by example of an old single-family house that was built in the area formed by highly permeable soils with high radon content in the soil air. T he house has a small cellar located under 1/5 of the ground floor area. Two types of floors, i.e. timber floors and cracked concrete slabs were found in the house. As a result of extremely high radon concentration in the sub-floor region (up to 600 kBq/m 3 ) and leaky structures in contact with soil, radon concentrations around 100 kBq/m 3 in the cellar and up to 60 kBq/m 3 in the living rooms on the ground floor were measured prior to mitigation. Mitigation measures that were carried out in the house consist of reconstruction of timber floors and installation of active soil depressurization. Timber floors were replaced with concrete slab fitted with damp proof membrane, thermal insulation and floor covering. The soil depressurization system was made up of two sections. The first section is composed of the network of perforated pipes inserted in the drainage layer placed under the new floors and four perforated tubes drilled under the existing floors. The soil air from this section is extracted by means of a roof fan installed at the top of the vertical exhaust pipe running inside the living space and terminating above the roof. The second section was designed to withdraw by means of a small fan radon-laden air from the filling in the floor above the cellar and from perforated tubes drilled into the sub-floor region under the rooms adjacent to the cellar. It serves also for the active ventilation of the cellar. Pressure, temperature and radon concentration sensors were installed into the drainage layer during the reconstruction of floors to record variations in these

The importance of risk-aversion as a measurable psychological parameter governing risk-taking behaviour

International Nuclear Information System (INIS)

Thomas, P J

2013-01-01

A utility function with risk-aversion as its sole parameter is developed and used to examine the well-known psychological phenomenon, whereby risk averse people adopt behavioural strategies that are extreme and apparently highly risky. The pioneering work of the psychologist, John W. Atkinson, is revisited, and utility theory is used to extend his mathematical model. His explanation of the psychology involved is improved by regarding risk-aversion not as a discrete variable with three possible states: risk averse, risk neutral and risk confident, but as continuous and covering a large range. A probability distribution is derived, the m otivational density , to describe the process of selecting tasks of different degrees of difficulty. An assessment is then made of practicable methods for measuring risk-aversion

The importance of risk-aversion as a measurable psychological parameter governing risk-taking behaviour

Science.gov (United States)

Thomas, P. J.

2013-09-01

A utility function with risk-aversion as its sole parameter is developed and used to examine the well-known psychological phenomenon, whereby risk averse people adopt behavioural strategies that are extreme and apparently highly risky. The pioneering work of the psychologist, John W. Atkinson, is revisited, and utility theory is used to extend his mathematical model. His explanation of the psychology involved is improved by regarding risk-aversion not as a discrete variable with three possible states: risk averse, risk neutral and risk confident, but as continuous and covering a large range. A probability distribution is derived, the "motivational density", to describe the process of selecting tasks of different degrees of difficulty. An assessment is then made of practicable methods for measuring risk-aversion.

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

Science.gov (United States)

Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

2017-01-01

New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

Current status and issues of external event PSA for extreme natural hazards after Fukushima accident

International Nuclear Information System (INIS)

Choi, In-Kil; Hahm, Daegi; Kim, Min Kyu

2014-01-01

Extreme external events is emerged as significant risk contributor to the nuclear power plants after Fukushima Daiichi accident due to the catastrophic earthquake followed by great tsunami greater than a design basis. This accident shows that the extreme external events have the potential to simultaneously affect redundant and diverse safety systems and thereby induce common cause failure or common cause initiators. The probabilistic risk assessment methodology has been used for the risk assessment and safety improvement against the extreme natural hazards. The earthquake and tsunami hazard is an important issue for the nuclear industry in Korea. In this paper, the role and application of probabilistic safety assessment for the post Fukushima action will be introduced. For the evaluation of the extreme natural hazard, probabilistic seismic and tsunami hazard analysis is being performed for the safety enhancement. The research activity on the external event PSA and its interim results will be introduced with the issues to be solved in the future for the reliability enhancement of the risk analysis results. (authors)

Temporal changes in morality attributed to heat extremes for 57 cities in Northeast Asia.

Science.gov (United States)

Lee, Whanhee; Choi, Hayon Michelle; Kim, Dahye; Honda, Yasushi; Guo, Yue-Liang Leon; Kim, Ho

2018-03-01

Recent studies have reported that heat-related mortality decreased by adaptation during decades. However, since the frequency of extreme heat events is increasing, it is difficult to conclude with certainty that the heat mortality burden is decreasing. To examine temporal changes in mortality attributed to heat extremes in Northeast Asia, we collected temperature and mortality data covering the years 1972-2012 from 57 cities of 3 countries (Taiwan, Korea, and Japan) in Northeast Asia. Poisson regression curves were fitted to the data from each city. The temporal changes in heat-mortality association were estimated with a time-varying distributed lag non-linear model. Heat extremes were defined as temperatures greater than the 97.5th percentiles of city-specific average temperatures. Attributable deaths were calculated considering temporal variations in exposure and relative risk. The estimates were then pooled through meta-analysis. The results show that the mortality risk on extreme heat days declined during the study period in all countries. However, as summer temperatures in Japan have shown more heat extremes over time, the mortality risk attributed to heat increased during 2003-2012 (0.32%) compared with 1972-1981 (0.19%). Thus, to assess the total health burden due to heat extremes related to climate change, public health strategies should focus on the temporal variation in heat-mortality association as well as changes in the distribution of heat extremes overtime. Copyright © 2017 Elsevier B.V. All rights reserved.

Extreme weather is increasing flood-related damage along ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-06-08

Jun 8, 2016 ... IDRC-supported researchers have found changes in weather patterns and in the intensity of extreme weather events are resulting in the ... the design of adaptation policies and risk management scenarios. ... Related articles ...

Spatial analysis and modeling to assess and map current vulnerability to extreme weather events in the Grijalva - Usumacinta watershed, Mexico

International Nuclear Information System (INIS)

Lopez L, D

2009-01-01

One of the major concerns over a potential change in climate is that it will cause an increase in extreme weather events. In Mexico, the exposure factors as well as the vulnerability to the extreme weather events have increased during the last three or four decades. In this study spatial analysis and modeling were used to assess and map settlement and crop systems vulnerability to extreme weather events in the Grijalva - Usumacinta watershed. Sensitivity and coping adaptive capacity maps were constructed using decision models; these maps were then combined to produce vulnerability maps. The most vulnerable area in terms of both settlement and crop systems is the highlands, where the sensitivity is high and the adaptive capacity is low. In lowlands, despite the very high sensitivity, the higher adaptive capacity produces only moderate vulnerability. I conclude that spatial analysis and modeling are powerful tools to assess and map vulnerability. These preliminary results can guide the formulation of adaptation policies to an increasing risk of extreme weather events.

Spatial analysis and modeling to assess and map current vulnerability to extreme weather events in the Grijalva - Usumacinta watershed, Mexico

Energy Technology Data Exchange (ETDEWEB)

Lopez L, D, E-mail: dlopez@centrogeo.org.m [Centro de Investigacion en GeografIa y Geomatica, Ing. Jorge L. Tamayo A.C., Contoy 137, col. Lomas de Padierna, del Tlalpan, Maxico D.F (Mexico)

2009-11-01

One of the major concerns over a potential change in climate is that it will cause an increase in extreme weather events. In Mexico, the exposure factors as well as the vulnerability to the extreme weather events have increased during the last three or four decades. In this study spatial analysis and modeling were used to assess and map settlement and crop systems vulnerability to extreme weather events in the Grijalva - Usumacinta watershed. Sensitivity and coping adaptive capacity maps were constructed using decision models; these maps were then combined to produce vulnerability maps. The most vulnerable area in terms of both settlement and crop systems is the highlands, where the sensitivity is high and the adaptive capacity is low. In lowlands, despite the very high sensitivity, the higher adaptive capacity produces only moderate vulnerability. I conclude that spatial analysis and modeling are powerful tools to assess and map vulnerability. These preliminary results can guide the formulation of adaptation policies to an increasing risk of extreme weather events.

Overweight, Obesity, and Extreme Obesity Among Mississippi Adults, 2001?2010 and 2011?2015

OpenAIRE

Mendy, Vincent L.; Vargas, Rodolfo; Cannon-Smith, Gerri; Payton, Marinelle

2017-01-01

Introduction In 2015, about 1.5 million adults in Mississippi were overweight or obese. Obesity is associated with increased risk for diabetes and cardiovascular problems. We examined trends in the prevalence of overweight, obesity, and extreme obesity from 2001 through 2010 and 2011 through 2015. Methods We used data from the Mississippi Behavioral Risk Factor Surveillance System to analyze trends in the prevalence of overweight, obesity, and extreme obesity among adults from 2001 through 20...

Temperature Extremes, Health, and Human Capital

Science.gov (United States)

Zivin, Joshua Graff; Shrader, Jeffrey

2016-01-01

The extreme temperatures expected under climate change may be especially harmful to children. Children are more vulnerable to heat partly because of their physiological features, but, perhaps more important, because they behave and respond differently than adults do. Children are less likely to manage their own heat risk and may have fewer ways to…

Applying GIS to develop a model for forest fire risk: A case study in Espírito Santo, Brazil.

Science.gov (United States)

Eugenio, Fernando Coelho; dos Santos, Alexandre Rosa; Fiedler, Nilton Cesar; Ribeiro, Guido Assunção; da Silva, Aderbal Gomes; dos Santos, Áureo Banhos; Paneto, Greiciane Gaburro; Schettino, Vitor Roberto

2016-05-15

A forest fire risk map is a basic element for planning and protecting forested areas. The main goal of this study was to develop a statistical model for preparing a forest fire risk map using GIS. Such model is based on assigning weights to nine variables divided into two classes: physical factors of the site (terrain slope, land-use/occupation, proximity to roads, terrain orientation, and altitude) and climatic factors (precipitation, temperature, water deficit, and evapotranspiration). In regions where the climate is different from the conditions of this study, the model will require an adjustment of the variables weights according to the local climate. The study area, Espírito Santo State, exhibited approximately 3.81% low risk, 21.18% moderate risk, 30.10% high risk, 41.50% very high risk, and 3.40% extreme risk of forest fire. The areas classified as high risk, very high and extreme, contemplated a total of 78.92% of heat spots. Copyright © 2016 Elsevier Ltd. All rights reserved.

Warmer and wetter winters: characteristics and implications of an extreme weather event in the High Arctic

International Nuclear Information System (INIS)

Hansen, Brage B; Isaksen, Ketil; Benestad, Rasmus E; Kohler, Jack; Pedersen, Åshild Ø; Loe, Leif E; Coulson, Stephen J; Larsen, Jan Otto; Varpe, Øystein

2014-01-01

One predicted consequence of global warming is an increased frequency of extreme weather events, such as heat waves, droughts, or heavy rainfalls. In parts of the Arctic, extreme warm spells and heavy rain-on-snow (ROS) events in winter are already more frequent. How these weather events impact snow-pack and permafrost characteristics is rarely documented empirically, and the implications for wildlife and society are hence far from understood. Here we characterize and document the effects of an extreme warm spell and ROS event that occurred in High Arctic Svalbard in January–February 2012, during the polar night. In this normally cold semi-desert environment, we recorded above-zero temperatures (up to 7 °C) across the entire archipelago and record-breaking precipitation, with up to 98 mm rainfall in one day (return period of >500 years prior to this event) and 272 mm over the two-week long warm spell. These precipitation amounts are equivalent to 25 and 70% respectively of the mean annual total precipitation. The extreme event caused significant increase in permafrost temperatures down to at least 5 m depth, induced slush avalanches with resultant damage to infrastructure, and left a significant ground-ice cover (∼5–20 cm thick basal ice). The ground-ice not only affected inhabitants by closing roads and airports as well as reducing mobility and thereby tourism income, but it also led to high starvation-induced mortality in all monitored populations of the wild reindeer by blocking access to the winter food source. Based on empirical-statistical downscaling of global climate models run under the moderate RCP4.5 emission scenario, we predict strong future warming with average mid-winter temperatures even approaching 0 °C, suggesting increased frequency of ROS. This will have far-reaching implications for Arctic ecosystems and societies through the changes in snow-pack and permafrost properties. (letter)