Insulin resistance in young adults born small for gestational age (SGA).

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Putzker, Stephanie; Bechtold-Dalla Pozza, Susanne; Kugler, Karl; Schwarz, Hans P; Bonfig, Walter

2014-03-01

This work aimed to assess glucose metabolism and insulin sensitivity in young adults born small for gestational age (SGA) as well as to measure the body composition and adipocytokines of these subjects. A total of 108 out of 342 SGA-born participants were invited for reexamination from the former Bavarian Longitudinal Study (BLS), in which 7505 risk-newborns of the years 1985 to 1986 were prospectively followed. Of these, 76 (34 female/42 male) participants at the age of 19.7±0.5 years were enrolled. Clinical examination and oral glucose tolerance testing (oGTT) was performed with assessment of insulin resistance indices, HbA1c, body mass index (BMI), adipocytokines, and body composition by bioimpedance analysis (BIA). A total of 25 out of 76 (32.9%) patients had abnormal fasting and/or glucose-stimulated insulin levels. Glucose values measured during oGTT showed no abnormalities, except one participant who had impaired glucose tolerance. Homeostasis model assessment insulin resistance index (HOMA-IR) was 1.92±4.2, and insulin sensitivity index by Matsuda (ISI(Matsuda)) showed mean values of 7.85±4.49. HOMA-IR>2.5 was found in 8 patients (10.5%), and 20 patients (26.3%) had an ISI(Matsuda)range for both genders and correlated significantly with BMI (r=0.465, p0.001), but not with adiponectin. Insulin resistance correlated with change in weight-for-height Z-score during the first 3 months of age, indicating that weight gain during that early phase might be a risk factor for the development of insulin resistance in children born SGA. A high percentage of insulin-resistant subjects were reconfirmed in a large German cohort of young adults born SGA. Therefore, regular screening for disturbances in glucose metabolism is recommended in these subjects.

Strapdown Airborne Gravimetry Quality Assessment Method Based on Single Survey Line Data: A Study by SGA-WZ02 Gravimeter

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Wu, Meiping; Cao, Juliang; Zhang, Kaidong; Cai, Shaokun; Yu, Ruihang

2018-01-01

Quality assessment is an important part in the strapdown airborne gravimetry. Root mean square error (RMSE) evaluation method is a classical way to evaluate the gravimetry quality, but classical evaluation methods are preconditioned by extra flight or reference data. Thus, a method, which is able to largely conquer the premises of classical quality assessment methods and can be used in single survey line, has been developed in this paper. According to theoretical analysis, the method chooses the stability of two horizontal attitude angles, horizontal specific force and vertical specific force as the determinants of quality assessment method. The actual data, collected by SGA-WZ02 from 13 flights 21 lines in certain survey, was used to build the model and elaborate the method. To substantiate the performance of the quality assessment model, the model is applied in extra repeat line flights from two surveys. Compared with internal RMSE, standard deviation of assessment residuals are 0.23 mGal and 0.16 mGal in two surveys, which shows that the quality assessment method is reliable and stricter. The extra flights are not necessary by specially arranging the route of flights. The method, summarized from SGA-WZ02, is a feasible approach to assess gravimetry quality using single line data and is also suitable for other strapdown gravimeters. PMID:29373535

Clinical global assessment of nutritional status as predictor of mortality in chronic kidney disease patients.

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Dai, Lu; Mukai, Hideyuki; Lindholm, Bengt; Heimbürger, Olof; Barany, Peter; Stenvinkel, Peter; Qureshi, Abdul Rashid

2017-01-01

The value of subjective global assessment (SGA) as nutritional assessor of protein-energy wasting (PEWSGA) in chronic kidney disease (CKD) patients depends on its mortality predictive capacity. We investigated associations of PEWSGA with markers of nutritional status and all-cause mortality in CKD patients. In 1031 (732 CKD1-5 non-dialysis and 299 dialysis) patients, SGA and body (BMI), lean (LBMI) and fat (FBMI) body mass indices, % handgrip strength (% HGS), serum albumin, and high sensitivity C-reactive protein (hsCRP) were examined at baseline. The five-year all-cause mortality predictive strength of baseline PEWSGA and during follow-up were investigated. PEWSGA was present in 2% of CKD1-2, 16% of CKD3-4, 31% of CKD5 non-dialysis and 44% of dialysis patients. Patients with PEWSGA (n = 320; 31%) had higher hsCRP and lower BMI, LBMI, FBMI, %HGS and serum albumin. But, using receiver operating characteristics-derived cutoffs, these markers could not classify (by kappa statistic) or explain variations of (by multinomial logistic regression analysis) presence of PEWSGA. In generalized linear models, SGA independently predicted mortality after adjustments of multiple confounders (RR: 1.17; 95% CI: 1.11-1.23). Among 323 CKD5 patients who were re-assessed after median 12.6 months, 222 (69%) remained well-nourished, 37 (11%) developed PEWSGA de novo, 40 (12%) improved while 24 (8%) remained with PEWSGA. The latter independently predicted mortality (RR: 1.29; 95% CI: 1.13-1.46). SGA, a valid assessor of nutritional status, is an independent predictor of all-cause mortality both in CKD non-dialysis and dialysis patients that outperforms non-composite nutritional markers as prognosticator.

An application of SGA: How urban resident acts in making traveling decisions

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Long Chenxu

2013-03-01

Full Text Available Purpose: To study how urban resident acts in making traveling decisions.Design/methodology/approach: Simple Genetic Algorithm (SGAFindings: Using SGA to make the model of urban resident's decisions is rational.Research limitations/implications: This study is just about single one and the SGA could be made better.Originality/value: Use SGA to describe urban resident's traveling behavior, and combine the management problem with the AI.

The relationship between bioelectrical impedance phase angle and subjective global assessment in advanced colorectal cancer

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Grutsch James F

2008-06-01

Full Text Available Abstract Background Bioelectrical Impedance (BIA derived phase angle is increasingly being used as an objective indicator of nutritional status in advanced cancer. Subjective Global Assessment (SGA is a subjective method of nutritional status. The objective of this study was to investigate the association between BIA derived phase angle and SGA in advanced colorectal cancer. Methods We evaluated a case series of 73 stages III and IV colorectal cancer patients. Patients were classified as either well-nourished or malnourished using the SGA. BIA was conducted on all patients and phase angle was calculated. The correlation between phase angle and SGA was studied using Spearman correlation coefficient. Receiver Operating Characteristic curves were estimated using the non-parametric method to determine the optimal cut-off levels of phase angle. Results Well-nourished patients had a statistically significantly higher (p = 0.005 median phase angle score (6.12 as compared to those who were malnourished (5.18. The Spearman rank correlation coefficient between phase angle and SGA was found to be 0.33 (p = 0.004, suggesting better nutritional status with higher phase angle scores. A phase angle cut-off of 5.2 was 51.7% sensitive and 79.5% specific whereas a cut-off of 6.0 was 82.8% sensitive and 54.5% specific in detecting malnutrition. Interestingly, a phase angle cut-off of 5.9 demonstrated high diagnostic accuracy in males who had failed primary treatment for advanced colorectal cancer. Conclusion Our study suggests that bioimpedance phase angle is a potential nutritional indicator in advanced colorectal cancer. Further research is needed to elucidate the optimal cut-off levels of phase angle that can be incorporated into the oncology clinic for better nutritional evaluation and management.

Neurodevelopmental consequences of being born SGA

NARCIS (Netherlands)

van Wassenaer, Aleid

2005-01-01

Fetal growth retardation is associated with postnatal growth retardation and cardio-vascular and metabolic problems later on in life. Less well described are the consequences of neurodevelopmental outcome. The term SGA is associated with mild to moderate school problems, still present in late

Evaluation of Nutritional Status of Cancer Patients during Treatment by Patient-Generated Subjective Global Assessment: a Hospital-Based Study.

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Sharma, Dibyendu; Kannan, Ravi; Tapkire, Ritesh; Nath, Soumitra

2015-01-01

Cancer patients frequently experience malnutrition. Cancer and cancer therapy effects nutritional status through alterations in the metabolic system and reduction in food intake. In the present study, fifty seven cancer patients were selected as subjects from the oncology ward of Cachar Cancer Hospital and Research Centre, Silchar, India. Evaluation of nutritional status of cancer patients during treatment was carried out by scored Patient-Generated Subjective Global Assessment (PG-SGA). The findings of PG-SGA showed that 15.8% (9) were well nourished, 31.6% (18) were moderately or suspected of being malnourished and 52.6% (30) were severely malnourished. The prevalence of malnutrition was highest in lip/oral (33.33%) cancer patients. The study showed that the prevalence of malnutrition (84.2%) was high in cancer patients during treatment.

The effect of prenatal maternal cigarette smoking on children's BMI z-score with SGA as a mediator.

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Salahuddin, Meliha; Pérez, Adriana; Ranjit, Nalini; Hoelscher, Deanna M; Kelder, Steven H

2018-02-21

The goal of this study was to assess the effect of prenatal maternal cigarette smoking on children's BMI z-score trajectories, and to evaluate whether small-for-gestational-age (SGA) acts as a potential mediator between prenatal maternal cigarette smoking and child's BMI z-score at 4 years of age. Group-based trajectory modeling (GBTM) methods were employed to describe and classify developmental BMI z-score trajectories (the outcome of interest) in children from 9 months to 4 years of age (n = 5221) in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) study (2001-2005). Further analysis examined whether the identified BMI z-score trajectories varied with the exposure, prenatal maternal cigarette smoking. Mediation analyses were utilized to examine whether being SGA (binary measure) acted as a potential mediator in the relationship between prenatal maternal cigarette smoking and BMI z-score among 4-year-old children. Using GBTM, two BMI z-score trajectory groups were identified: normal BMI z-score (57.8%); and high BMI z-score (42.2%). Children of mothers who smoked cigarettes during pregnancy were 2.1 times (RR 95% CI: 1.1-4.0, P value = 0.023) more at risk of being in the high BMI z-score trajectory group. Prenatal cigarette smoking was positively related to SGA at birth, but SGA was inversely related to BMI z-score at 4 years. The direct effect (0.19, 95% CI: 0.18, 0.19; P value BMI z-score among 4-year-old children was stronger and in the opposite direction of the indirect effect (-0.04, 95% CI: -0.04, -0.04; P value BMI z-score group, as well with SGA. The effects of prenatal smoking on BMI z-score at 4 years appears to act through pathways other than SGA.

A flight test of the strapdown airborne gravimeter SGA-WZ in Greenland

DEFF Research Database (Denmark)

Zhao, Lei; Forsberg, René; Wu, Meiping

2015-01-01

-WZ strapdown airborne gravimeter in Greenland, in an area with good gravity coverage from earlier marine and airborne surveys. An overview of this new system SGA-WZ is given, including system design, sensor performance and data processing. The processing of the SGA-WZ includes a 160 s length finite impulse...

Puberty in growth hormone-treated children born small for gestational age (SGA)

NARCIS (Netherlands)

V.H. Boonstra (Venje); Y. van Pareren; P.G.H. Mulder (Paul); A.C.S. Hokken-Koelega (Anita)

2003-01-01

textabstractSeventy-five small for gestational age (SGA) children were studied in a randomized, double-blind, dose-response GH trial with either 1 or 2 mg GH/m(2).d. Mean (SD) age at the start of GH therapy was 7.3 (2.2) yr. Data were compared with Dutch reference data. In SGA

A Comparison of the Nutritional Risk Screening 2002 Tool With the Subjective Global Assessment Tool to Detect Nutritional Status in Chinese Patients Undergoing Surgery With Gastrointestinal Cancer.

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Chi, Juntao; Yin, Shaohua; Zhu, Yongjian; Gao, Fengli; Song, Xinna; Song, Zhenlan; Lv, Junying; Li, Miaomiao

The objectives of this study were to describe the nutritional status of Chinese patients with gastrointestinal cancer undergoing surgery and to compare the ease of use, diversity, and concordance of the Nutritional Risk Screening 2002 with the Subjective Global Assessment in the same patients. A total of 280 gastrointestinal cancer patients admitted for elective surgery were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) tools within 48 hours of admission from April to October 2012. Related opinions about ease of using the tools were obtained from 10 nurses. The prevalence of patients at nutritional risk with the SGA and NRS 2002 was 33.9% and 53.2% on admission. In the total group, ≤70 age group, and >70 age group, respectively, consistency was observed in 214 (76.4%), 175 (91.1%), and 39 (44.3%); and kappa values were 0.54 (p 70 age group (p nutritional status of patients with gastrointestinal cancer undergoing surgery, but it appeared to detect more patients at nutritional risk in the >70 age group.

Optimized Design of the SGA-WZ Strapdown Airborne Gravimeter Temperature Control System

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Juliang Cao

2015-12-01

Full Text Available The temperature control system is one of the most important subsystems of the strapdown airborne gravimeter. Because the quartz flexible accelerometer based on springy support technology is the core sensor in the strapdown airborne gravimeter and the magnet steel in the electromagnetic force equilibrium circuits of the quartz flexible accelerometer is greatly affected by temperature, in order to guarantee the temperature control precision and minimize the effect of temperature on the gravimeter, the SGA-WZ temperature control system adopts a three-level control method. Based on the design experience of the SGA-WZ-01, the SGA-WZ-02 temperature control system came out with a further optimized design. In 1st level temperature control, thermoelectric cooler is used to conquer temperature change caused by hot weather. The experiments show that the optimized stability of 1st level temperature control is about 0.1 °C and the max cool down capability is about 10 °C. The temperature field is analyzed in the 2nd and 3rd level temperature control using the finite element analysis software ANSYS. The 2nd and 3rd level temperature control optimization scheme is based on the foundation of heat analysis. The experimental results show that static accuracy of SGA-WZ-02 reaches 0.21 mGal/24 h, with internal accuracy being 0.743 mGal/4.8 km and external accuracy being 0.37 mGal/4.8 km compared with the result of the GT-2A, whose internal precision is superior to 1 mGal/4.8 km and all of them are better than those in SGA-WZ-01.

Exon 3-deleted/full-length growth hormone receptor polymorphism genotype frequencies in Spanish short small-for-gestational-age (SGA) children and adolescents (n = 247) and in an adult control population (n = 289) show increased fl/fl in short SGA.

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Audí, Laura; Esteban, Cristina; Carrascosa, Antonio; Espadero, Rosa; Pérez-Arroyo, Annalisa; Arjona, Rosa; Clemente, María; Wollmann, Hartmut; Fryklund, Linda; Parodi, Luis A

2006-12-01

A polymorphism in the human GH receptor gene (d3/fl-GHR) resulting in genomic deletion of exon 3 has been associated with the degree of height increase in response to GH therapy. The objective of the study was to evaluate the frequencies of d3/fl-GHR polymorphism genotypes in control and short small-for-gestational-age (SGA) populations. An adult control population with heights normally distributed (ACPNH) between -2 and +2 sd score (SDS) and a short non-GH-deficient SGA child population were selected. Thirty Spanish hospitals participated in the selection of the short non-GH-deficient SGA children in the setting of a controlled, randomized trial, and one of these hospitals selected the ACPNH. CONTROLS AND PATIENTS: Two hundred eighty-nine adult subjects of both sexes constituted the ACPNH and 247 children and adolescents of both sexes the short SGA patients. Heights and weights were recorded in the ACPNH, and auxologic and biochemical data were recorded at each hospital for the SGA patients; d3/fl-GHR genotypes were determined and data analyzed in a single hospital. In short SGA patients, d3/fl-GHR genotype frequencies were significantly different from those in ACPNH, with a higher frequency of fl/fl genotype (P or=-2 SDS, n = 60). Our data showed significant differences in the frequency distribution of the d3/fl-GHR genotypes between a normally distributed adult height population and short SGA children, with the biologically less active fl/fl genotype being almost twice as frequent in SGA patients. These data suggest that the d3/fl-GHR polymorphism might be considered among the factors that contribute to the phenotypic expression of growth.

An SINS/GNSS Ground Vehicle Gravimetry Test Based on SGA-WZ02

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Ruihang Yu

2015-09-01

Full Text Available In March 2015, a ground vehicle gravimetry test was implemented in eastern Changsha to assess the repeatability and accuracy of ground vehicle SINS/GNSS gravimeter—SGA-WZ02. The gravity system developed by NUDT consisted of a Strapdown Inertial Navigation System (SINS, a Global Navigation Satellite System (GNSS remote station on test vehicle, a GNSS static master station on the ground, and a data logging subsystem. A south-north profile of 35 km along the highway in eastern Changsha was chosen and four repeated available measure lines were obtained. The average speed of a vehicle is 40 km/h. To assess the external ground gravity disturbances, precise ground gravity data was built by CG-5 precise gravimeter as the reference. Under relative smooth conditions, internal accuracy among repeated lines shows an average agreement at the level of 1.86 mGal for half wavelengths about 1.1 km, and 1.22 mGal for 1.7 km. The root-mean-square (RMS of difference between calculated gravity data and reference data is about 2.27 mGal/1.1 km, and 1.74 mGal/1.7 km. Not all of the noises caused by vehicle itself and experiments environments were eliminated in the primary results. By means of selecting reasonable filters and improving the GNSS observation conditions, further developments in ground vehicle gravimetry are promising.

Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia

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Li, Ji; Wang, Chang; Liu, Xiaoliang; Liu, Qiuju; Lin, Hai; Liu, Chunshui; Jin, Fengyan; Yang, Yan; Bai, Ou; Tan, Yehui; Gao, Sujun; Li, Wei

2018-01-01

Abstract To evaluate nutritional status in adult patients with acute leukemia (AL) using patient-generated subjective global assessment (PG-SGA) and to investigate the influence of nutritional status on prognosis. We observationally investigated 68 adult patients with newly diagnosed AL who received PG-SGA at the First Hospital of Jilin University between May 2013 and July 2015. Clinical features, chemotherapy regimens, biochemical indexes, body composition, complete remission (CR) rate, minimal residual disease (MRD), survival time, and side-effects of chemotherapy were compared between patients with and without severe malnutrition. Mean PG-SGA scores of the total patients were 6.1 ± 4.0, and 19 of 68 (27.9%) patients had severe malnutrition (PG-SGA score ≥9). Patients with acute myeloid leukemia (AML) had higher scores than those with acute lymphocytic leukemia (ALL; P = .011) and high-risk patients had higher scores regardless of whether they had AML or ALL (AML, P = .012; ALL, P = .043). Univariate analysis showed that severe malnutrition was correlated with age (P = .041), transferrin (P = .042), Karnofsky Performance Status score (P = .006), and C-reactive protein (CRP) (P = .018). Multivariate analysis demonstrated that severe malnutrition was associated with CRP (hazard ratio [HR] = 1.020, 95% confidence interval [CI]: 1.002–1.039, P = .026). No difference was found in CR rate (P = .831) between patients with and without malnutrition, but those who were severely malnourished had higher MRD (P = .048 in AML patients, P = .036 in ALL patients) and more gastrointestinal side-effects (P = .014). Severe malnutrition was also associated with inferior overall survival (HR = 0.243, 95% CI: 0.063–0.945, P = .041) but not with event-free survival (HR = 0.808, 95% CI: 0.338–1.934, P = .663). Severe malnutrition defined by PG-SGA in adult patients with de novo AL may result in poor outcome

No Weight Catch-Up Growth of SGA Infants Is Associated with Impaired Insulin Sensitivity during the Early Postnatal Period

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Tong-yan Han

2010-01-01

Full Text Available Objective. To investigate the relationship between weight catch-up growth and insulin sensitivity in small for gestational age (SGA infants. Methods. Forty-four singleton SGA subjects met the inclusion criteria and finished-3-month followup. Body weight, length, fasting glucose, and fasting insulin (FI levels were measured at 3 days and 3 months. Insulin sensitivity was evaluated by FI and homeostasis model assessment (HOMA. Results. According to the change of weight Z-score, forty-four subjects were divided into two groups: noncatch-up growth (NCUG and catch-up growth (CUG. By 3 months of age, the body weight, body length and BMI of NCUG group were significantly lower than those of CUG group. The FI and HOMA were significantly higher in NCUG group. The change of weight Z-score during 3 months was inversely related to the HOMA at 3 months. Conclusion. Our data exemplified that no weight catch-up growth during the first 3 months was associated with impaired insulin sensitivity in SGA infants.

Nutritional assessment: comparison of clinical assessment and objective variables for the prediction of length of hospital stay and readmission.

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Jeejeebhoy, Khursheed N; Keller, Heather; Gramlich, Leah; Allard, Johane P; Laporte, Manon; Duerksen, Donald R; Payette, Helene; Bernier, Paule; Vesnaver, Elisabeth; Davidson, Bridget; Teterina, Anastasia; Lou, Wendy

2015-05-01

Nutritional assessment commonly includes multiple nutrition indicators (NIs). To promote efficiency, a minimum set is needed for the diagnosis of malnutrition in the acute care setting. The objective was to compare the ability of different NIs to predict outcomes of length of hospital stay and readmission to refine the detection of malnutrition in acute care. This was a prospective cohort study of 1022 patients recruited from 18 acute care hospitals (academic and community), from 8 provinces across Canada, between 1 July 2010 and 28 February 2013. Participants were patients aged ≥18 y admitted to medical and surgical wards. NIs measured at admission were subjective global assessment (SGA; SGA A = well nourished, SGA B = mild or moderate malnutrition, and SGA C = severe malnutrition), Nutrition Risk Screening (2002), body weight, midarm and calf circumference, serum albumin, handgrip strength (HGS), and patient-self assessment of food intake. Logistic regression determined the independent effect of NIs on the outcomes of length of hospital stay (available for analysis. After we controlled for age, sex, and diagnosis, only SGA C (OR: 2.19; 95% CI: 1.28, 3.75), HGS (OR: 0.98; 95% CI: 0.96, 0.99 per kg of increase), and reduced food intake during the first week of hospitalization (OR: 1.51; 95% CI: 1.08, 2.11) were independent predictors of length of stay. SGA C (OR: 2.12; 95% CI: 1.24, 3.93) and HGS (OR: 0.96; 95% CI: 0.94, 0.98) but not food intake were independent predictors of 30-d readmission. SGA, HGS, and food intake were independent predictors of outcomes for malnutrition. Because food intake in this study was judged days after admission and HGS has a wide range of normal values, SGA is the single best predictor and should be advocated as the primary measure for diagnosis of malnutrition. This study was registered at clinicaltrials.gov as NCT02351661. © 2015 American Society for Nutrition.

Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients.

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Asemi, Zatollah; Soleimani, Alireza; Bahmani, Fereshteh; Shakeri, Hossein; Mazroii, Navid; Abedi, Fatemeh; Fallah, Melika; Mohammadi, Ali Akbar; Esmaillzadeh, Ahmad

2016-02-01

This study was conducted to determine the effects of omega-3 fatty acid plus vitamin E supplementation on subjective global assessment (SGA) score and metabolic profiles in chronic hemodialysis (HD) patients. This randomized double-blind placebo-controlled clinical trial was conducted among 120 chronic HD patients. Participants were randomly divided into four groups to receive: (i) 1250 mg/day omega-3 fatty acid containing 600 mg eicosapentaenoic acid and 300 mg docosahexaenoic acid + vitamin E placebo (n = 30), (ii) 400 IU/day vitamin E + omega-3 fatty acids placebo (n = 30), (iii) 1250 mg omega-3 fatty acids/day + 400 IU/day vitamin E (n = 30), and (iv) omega-3 fatty acids placebo + vitamin E placebo (n = 30) for 12 wk. Fasting blood samples were taken at baseline and after 12-wk intervention to measure metabolic profiles. Patients who received combined omega-3 fatty acids and vitamin E supplements compared with vitamin E, omega-3 fatty acids, and placebo had significantly decreased SGA score (p acids plus vitamin E supplementation for 12 wk among HD patients had beneficial effects on SGA score and metabolic profiles. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Puberty and Pubertal Growth in GH-treated SGA Children: Effects of 2 Years of GnRHa Versus No GnRHa.

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van der Steen, Manouk; Lem, Annemieke J; van der Kaay, Danielle C M; Hokken-Koèelega, Anita C S

2016-05-01

Most studies on puberty in children born small for gestational age (SGA) report height and age at onset of puberty. GH-treated SGA children with an adult height (AH) expectation below -2.5 SDS at onset of puberty can benefit from an additional 2 years of GnRH analog (GnRHa) treatment. There are no data on puberty and growth after discontinuation of GnRHa treatment in GH-treated SGA children. This study aimed to investigate the effects on puberty and pubertal growth of 2 years GnRHa vs no GnRHa in GH-treated SGA children. This was a GH trial involving 76 prepubertal short SGA children (36 girls) treated with GH. Thirty-two children received additional GnRHa for 2 years. Pubertal stages were 3-monthly assessed according to Tanner. Age, bone age, and median height at pubertal onset were lower in girls and boys in the GH/GnRHa group compared with the GH group. In girls and boys treated with GH/GnRHa, pubertal duration after stop of GnRHa treatment was shorter than pubertal duration in those with GH only (40.9 vs 46.7 mo; P = .044; 50.8 vs 57.5 months; P = .006; respectively). Height gain from onset of puberty until AH, including height gain during 2 years of GnRHa treatment, was 25.4 cm in girls and 33.0 cm in boys, which was 6.6 cm more than girls and boys treated with GH only. AH was similar in children treated with GH/GnRHa compared with those with GH only. GH-treated SGA children who start puberty with an AH expectation below -2.5 SDS and are treated with 2 years of GnRHa have a shorter pubertal duration after discontinuation of GnRHa compared with pubertal duration in children treated with GH only. Height gain from onset of puberty until AH is, however, more due to adequate growth during 2 years of GnRHa treatment resulting in a similar AH as children treated with GH only.

Cachexia Stage, Patient-Generated Subjective Global Assessment, Phase Angle, and Handgrip Strength in Patients with Gastrointestinal Cancer.

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Ozorio, Gislaine Aparecida; Barão, Katia; Forones, Nora Manoukian

2017-07-01

The aim of this study was to correlate patients with gastrointestinal cancer, classified according to different stages of cancer cachexia (SCC) as proposed by Fearon, with nutritional assessment tools such as PG-SGA, phase angle (PA), and handgrip strength. One hundred one patients with a mean age of 61.8 ± 12.8 yr, with 58.4% being men were included. 32.6% were malnourished according to the body mass index (BMI). A severe or moderate malnutrition had been diagnosed in 63.3% when assessed using the PG-SGA, 60.4% had decreased handgrip strength, and 57.4% had lower grades of PA. Among the patients in the study, 26% did not have cachexia, 11% had precachexia, 56% cachexia, and 8% refractory cachexia. The PG-SGA, PA, and handgrip strength were associated with cachexia (P ≤ 0.001). An increased risk of death was found in patients with cachexia [RR: 9.1; confidence interval (CI) 95%: 0.1-90.2, P = 0.039], refractory cachexia (RR: 69.4, CI 95%: 4.5-1073.8, P = 0.002), and increased serum C-reactive protein (CRP) levels (P cachexia or refractory cachexia in the first nutritional assessment. Nutritional risk, as determined by PG-SGA, was correlated with PA and handgrip strength. High CRP levels, cachexia, and refractory cachexia were prognostic factors for cancer patients.

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

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Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

2015-06-01

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

Enamel defect of primary dentition in SGA children in relation to onset time of intrauterine growth disturbance

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Willyanti Soewondo Sjarif

2013-06-01

Full Text Available Background: Prenatal disturbances disturb the development of organs resulting in small for gestational age (SGA babies and also causes enamel defects in primary teeth. There are disturbances occur in the beginning of pregnancy causing symmetrical SGA, and asymmetrical type of SGA, where the disturbances occur late in pregnancy. Purpose: This research was to determined differences in severity of enamel defect of primary dentition in small for gestational age children based on the time of intrauterine growth restriction. Methods: This was a clinical epidemiological cohort study. The Ponderal index was used to determine SGA type. The subjects were 129 SGA children aged 9-42 months, 82 with asymmetrical SGA and 47 with symmetrical SGA. Two hundred normal birth weight children were the control group. Intra-oral examinations to determine enamel defect used the FDI modification of the Developmental Defect of Enamel score at 3 months intervals. Statistical t-tests were used to test the difference in severity of enamel defect, and chisquare to find out the difference of Relative Risk Ratio (RRR. Results: The results showed that the enamel defect scores of symmetrical SGA were significantly higher than those with asymmetrical SGA. RRR for severe defect was also significantly higher in symmetrical type for anterior and canines. Conclusion: The study suggested that the severity of enamel defect for infants with symmetrical SGA was higher than those with asymmetrical SGA, indicating that the severity of the defect occurs in the beginning of pregnancy is more severe than in the late pregnancy.Latar belakang: Adanya gangguan prenatal mengganggu perkembangan organ, mengakibatkan terjadinya bayi lahir dengan kecil masa kehamilan (KMK dan defek email pada gigi sulung. Terdapat 2 tipe KMK yaitu tipe simetri; gangguan terjadi pada awal kehamilan; dimana lingkar kepala, berat dan panjang lahir lebih rendah dari normal. Tipe asimetri dimana gangguan terjadi saat

76 FR 11285 - Notice of Funding Opportunity and Solicitation for Grant Applications (SGA) for the Career...

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2011-03-01

... in grant funds authorized by Workforce Investment Act of 1998, Public Law 105-220 to develop and..., for students of different skill levels and at varying academic levels, including students with low... conduct a third-party evaluation of the grant activities with this SGA. The complete SGA and any...

SGA and Turner Syndrome: the impact of growth hormone treatment on physical and mental well-being

NARCIS (Netherlands)

E.M.N. Bannink (Ellen)

2006-01-01

textabstractBy definition, 2.3% of the children is born Small for Gestational Age (SGA), which is a length and/or height < -2 standard deviation (SD). Most children born SGA show catch-up growth during the first years of life. Approximately 10% of them remain short with a height below the normal

Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children.

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Blusková, Zuzana; Koštálová, Ludmila; Celec, Peter; Vitáriušová, Eva; Pribilincová, Zuzana; Maršálková, Marianna; Šemberová, Jana; Kyselová, Tatiana; Hlavatá, Anna; Kovács, László

2014-07-01

Obesity is the major determinant of metabolic syndrome. Being born small for gestational age (SGA) may be co-responsible. We aimed at evaluating the association between 1. obesity and 2. being born SGA and the presence of endocrine-metabolic abnormalities in prepubertal Slovak children. The study included 98 children, aged 3-10.9 years: 36 AGA-born obese children (OB), 31 SGA-born children (SGA) and 31 appropriate for gestational age born non-obese children (AGA). Fasting serum levels of glucose, total cholesterol, LDL, HDL, triglycerides, fT4, TSH, cortisol and insulin were determined. HOMA-IR was calculated. Personal data about birth weight and length and family history were collected. Actual anthropometric measurement was done. In every group, high prevalence of positive family history of metabolic disorder was found. In comparison with AGA children, OB children were taller (plevels and homeostasis model assessment for insulin resistance (HOMA-IR) (pcortisol levels (p=0.069) was noted. SGA-born children were shorter (plevels (plevels (p=0.085) and increased fT4 levels (pobese children and twice more metabolic abnormalities were present in SGA-born children in comparison with AGA-born children. SGA-born children are more prone to developing endocrine-metabolic abnormalities than non-obese children born AGA, but they are at less risk than obese AGA-born children. We should provide specialized care for obese children already in prepubertal age and pay attention to SGA-born children.

Evaluating Photographs as a Replacement for the In-Person Physical Examination of the Scored Patient-Generated Subjective Global Assessment in Elderly Hospital Patients.

Science.gov (United States)

Miller, Michelle; Thomas, Jolene; Suen, Jenni; Ong, De Sheng; Sharma, Yogesh

2018-05-01

Undernourished patients discharged from the hospital require follow-up; however, attendance at return visits is low. Teleconsultations may allow remote follow-up of undernourished patients; however, no valid method to remotely perform physical examination, a critical component of assessing nutritional status, exists. This study aims to compare agreement between photographs taken by trained dietitians and in-person physical examinations conducted by trained dietitians to rate the overall physical examination section of the scored Patient Generated Subjective Global Assessment (PG-SGA). Nested cross-sectional study. Adults aged ≥60 years, admitted to the general medicine unit at Flinders Medical Centre between March 2015 and March 2016, were eligible. All components of the PG-SGA and photographs of muscle and fat sites were collected from 192 participants either in the hospital or at their place of residence after discharge. Validity of photograph-based physical examination was determined by collecting photographic and PG-SGA data from each participant at one encounter by trained dietitians. A dietitian blinded to data collection later assessed de-identified photographs on a computer. Percentage agreement, weighted kappa agreement, sensitivity, and specificity between the photographs and in-person physical examinations were calculated. All data collected were included in the analysis. Overall, the photograph-based physical examination rating achieved a percentage agreement of 75.8% against the in-person assessment, with a weighted kappa agreement of 0.526 (95% CI: 0.416, 0.637; Pexamination by trained dietitians achieved a nearly acceptable percentage agreement, moderate weighted kappa, and fair sensitivity-specificity pair. Methodological refinement before field testing with other personnel may improve the agreement and accuracy of photograph-based physical examination. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights

Increase of long-term 'diabesity' risk, hyperphagia, and altered hypothalamic neuropeptide expression in neonatally overnourished 'small-for-gestational-age' (SGA rats.

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Karen Schellong

Full Text Available BACKGROUND: Epidemiological data have shown long-term health adversity in low birth weight subjects, especially concerning the metabolic syndrome and 'diabesity' risk. Alterations in adult food intake have been suggested to be causally involved. Responsible mechanisms remain unclear. METHODS AND FINDINGS: By rearing in normal (NL vs. small litters (SL, small-for-gestational-age (SGA rats were neonatally exposed to either normal (SGA-in-NL or over-feeding (SGA-in-SL, and followed up into late adult age as compared to normally reared appropriate-for-gestational-age control rats (AGA-in-NL. SGA-in-SL rats displayed rapid neonatal weight gain within one week after birth, while SGA-in-NL growth caught up only at juvenile age (day 60, as compared to AGA-in-NL controls. In adulthood, an increase in lipids, leptin, insulin, insulin/glucose-ratio (all p<0.05, and hyperphagia under normal chow as well as high-energy/high-fat diet, modelling modern 'westernized' lifestyle, were observed only in SGA-in-SL as compared to both SGA-in-NL and AGA-in-NL rats (p<0.05. Lasercapture microdissection (LMD-based neuropeptide expression analyses in single neuron pools of the arcuate hypothalamic nucleus (ARC revealed a significant shift towards down-regulation of the anorexigenic melanocortinergic system (proopiomelanocortin, Pomc in SGA-in-SL rats (p<0.05. Neuropeptide expression within the orexigenic system (neuropeptide Y (Npy, agouti-related-peptide (Agrp and galanin (Gal was not significantly altered. In essence, the 'orexigenic index', proposed here as a neuroendocrine 'net-indicator', was increased in SGA-in-SL regarding Npy/Pomc expression (p<0.01, correlated to food intake (p<0.05. CONCLUSION: Adult SGA rats developed increased 'diabesity' risk only if exposed to neonatal overfeeding. Hypothalamic malprogramming towards decreased anorexigenic activity was involved into the pathophysiology of this neonatally acquired adverse phenotype. Neonatal overfeeding

Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia: A retrospective cohort study.

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Li, Ji; Wang, Chang; Liu, Xiaoliang; Liu, Qiuju; Lin, Hai; Liu, Chunshui; Jin, Fengyan; Yang, Yan; Bai, Ou; Tan, Yehui; Gao, Sujun; Li, Wei

2018-01-01

To evaluate nutritional status in adult patients with acute leukemia (AL) using patient-generated subjective global assessment (PG-SGA) and to investigate the influence of nutritional status on prognosis.We observationally investigated 68 adult patients with newly diagnosed AL who received PG-SGA at the First Hospital of Jilin University between May 2013 and July 2015. Clinical features, chemotherapy regimens, biochemical indexes, body composition, complete remission (CR) rate, minimal residual disease (MRD), survival time, and side-effects of chemotherapy were compared between patients with and without severe malnutrition.Mean PG-SGA scores of the total patients were 6.1 ± 4.0, and 19 of 68 (27.9%) patients had severe malnutrition (PG-SGA score ≥9). Patients with acute myeloid leukemia (AML) had higher scores than those with acute lymphocytic leukemia (ALL; P = .011) and high-risk patients had higher scores regardless of whether they had AML or ALL (AML, P = .012; ALL, P = .043). Univariate analysis showed that severe malnutrition was correlated with age (P = .041), transferrin (P = .042), Karnofsky Performance Status score (P = .006), and C-reactive protein (CRP) (P = .018). Multivariate analysis demonstrated that severe malnutrition was associated with CRP (hazard ratio [HR] = 1.020, 95% confidence interval [CI]: 1.002-1.039, P = .026). No difference was found in CR rate (P = .831) between patients with and without malnutrition, but those who were severely malnourished had higher MRD (P = .048 in AML patients, P = .036 in ALL patients) and more gastrointestinal side-effects (P = .014). Severe malnutrition was also associated with inferior overall survival (HR = 0.243, 95% CI: 0.063-0.945, P = .041) but not with event-free survival (HR = 0.808, 95% CI: 0.338-1.934, P = .663).Severe malnutrition defined by PG-SGA in adult patients with de novo AL may result in poor outcome. Copyright �

Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients.

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Ryu, Seung Wan; Kim, In Ho

2010-07-14

To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients. From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student's t test and one-way analysis of variance. Spearman's rank correlation coefficients were calculated to evaluate the association between the scores and variables. The prevalence of malnutrition at admission was 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status. A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer

Comparison of Dual Energy X-ray Absorptiometry and Bioimpedance in Assessing Body Composition and Nutrition in Peritoneal Dialysis Patients

DEFF Research Database (Denmark)

Popovic, Velena; Zerahn, Bo; Heaf, James Goya

2017-01-01

OBJECTIVE: Peritoneal dialysis (PD) patients are characterized by protein malnutrition and muscle wasting. Reliable, easy, and cheap methods for evaluating nutrition are desirable. Three methods are commonly available: dual-energy X-ray absorptiometry (DXA), bioimpedance (BI), and subjective global...... assessment (SGA).The objective of the study was to compare the previously mentioned methods for assessment of body composition and nutritional status in PD patients. DESIGN: The study is cross-sectional and consisted of 72 PD patients from a single center PD ambulatorium. METHODS: Participants were measured...... in this population. OH might reduce DXA accuracy in PD patients. LTI and ICW may be useful measures to supplement SGA in assessing nutrition....

消化道肿瘤患者术前PG-SGA评分与人体成分的相关性研究%The correlation between PG-SGA and body composition in preoperative patients with digestive tract cancer

Institute of Scientific and Technical Information of China (English)

翟泽民; 郭剑; 张蓓蕾; 张燕忠

2016-01-01

Objective To investigate the correlation between Patient-Generated Subjective Global Assessment (PG-SGA) and the index of body composition in nutritional assessment of patients with digestive tract cancer.Methods The nutritional status of 101 patients with digestive tract cancer were evaluated by Patient-Generated Subjective Global Assessment (PG-SGA), and in the meantime, the body composition was measured by multi-frequency bioelectrical impedance analysis, then take correlation analysis on the result.Results 65 cases were malnutrition, the rate is 64.36%. The incidence of gastric cancer patients with PG-SGA scores more than 4 was 76%, signiifcantly higher than 52.95% of patients with colorectal cancer (P0.05). The correlation between PG-SGA score and body mass, BMI, body fat mass and body fat percentage was higher than other body composition indexes.Conclusions The incidence of malnutrition was high in digestive tract cancer patients especially in gastric cancer patients. The body weight , body fat mass ,lean body mass and other indexes were signiifcantly decreased in the patients with malnutrition. There was a good correlation between PG-SGA score and body composition index, the combination of them can provide a more accurate assessment of preoperative nutritional status in order to provide the exact evidence for nutritional support.%目的探讨患者主观整体评估（PG-SGA）与人体成分指标在消化道肿瘤患者营养评估中的相关性。方法对101例消化道肿瘤患者应用PG-SGA进行术前营养状况评估，同时应用多频生物电阻抗分析法测定人体成分，将结果进行相关性分析。结果术前营养不良（PG-SGA≥4分）患者65例占64.36%。胃癌患者营养不良的发生率为76%，明显高于结直肠癌患者的52.95%（P＜0.05）。营养不良组患者体重、BMI、体脂肪量、体脂百分比、瘦体组织、身体水分含量、细胞外液均低于非营养不良组（P＜0.05�

Patient-Generated Subjective Global Assessment in relation to site, stage of the illness, reason for hospital admission, and mortality in patients with gynecological tumors.

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Rodrigues, Camila Santos; Chaves, Gabriela Villaça

2015-03-01

This study aimed to identify factors related to the illness and to oncological treatment as determinants of the nutritional status of patients with gynecological tumors. This is a retrospective study; the group was composed of 146 women histopathologically shown to have gynecological tumors, at different stages of treatment, and hospitalized at the foremost centers for the prevention and treatment of cancer in Rio de Janeiro. To obtain a nutritional diagnosis, we used the Patient-Generated Subjective Global Assessment (PG-SGA). We did multiple comparisons of the numeric variables between the three PG-SGA nutritional status-classification groups by performing Kruskal-Wallis analysis of variance. We used the Mann-Whitney test to compare numerical variables between two groups. We analyzed the associations between categorical variables by using either the chi-squared (χ (2)) test or Fisher's exact test. Of the women, 62.4 % were found to be at nutritional risk or to have some level of malnourishment, being more associated with the reason for hospital admission and stage disease that properly to the tumor site. The median PG-SGA score was points, with 62.3 % of the group returning 9 or more points. Women diagnosed with endometrial cancer were found to be predominantly well nourished, and those with tumors in the ovary were more frequently diagnosed as being severely malnourished. Our findings support early nutritional intervention in the population identified as being at greater nutritional risk, aiming to minimize the loss of muscle mass and body weight, as well as to improve symptoms management, thus helping to achieve better clinical results.

Anthropometric, biochemical and clinical assessment of malnutrition in Malaysian patients with advanced cirrhosis

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Rampal Sanjay

2010-06-01

Full Text Available Abstract Background There is limited data on the nutritional status of Asian patients with various aetiologies of cirrhosis. This study aimed to determine the prevalence of malnutrition and to compare nutritional differences between various aetiologies. Methodology A cross-sectional study of adult patients with decompensated cirrhosis was conducted. Nutritional status was assessed using standard anthropometry, serum visceral proteins and subjective global assessment (SGA. Results Thirty six patients (mean age 59.8 ± 12.8 years; 66.7% males; 41.6% viral hepatitis; Child-Pugh C 55.6% with decompensated cirrhosis were recruited. Malnutrition was prevalent in 18 (50% patients and the mean caloric intake was low at 15.2 kcal/kg/day. SGA grade C, as compared to SGA grade B, demonstrated significantly lower anthropometric values in males (BMI 18.1 ± 1.6 vs 26.3 ± 3.5 kg/m2, p Conclusion Significant malnutrition in Malaysian patients with advanced cirrhosis is common. Alcoholic cirrhosis may have more malnutrition compared to other aetiologies of cirrhosis.

Correlation between preoperative PG-SGA score and body composition in patients with gastric cancer%胃癌患者术前PG-SGA评分与人体成分的相关性

Institute of Scientific and Technical Information of China (English)

徐东平; 齐玉梅; 张明; 郑平

2017-01-01

目的 探讨胃癌患者术前主观整体评估(PG-SGA)评分与人体成分的相关性.方法 选择天津市第三中心医院2015年6月至2016年10月收治的82例胃癌患者为研究对象,均进行PG-SGA量表评估及人体成分测定,PG-SGA量表得分为0～3分者纳入营养良好组(n=25),4分以上者纳入营养不良组(n=57).比较两组患者人体成分指标,以及PG-SGA评分与人体成分指标的相关性.结果 营养不良组患者的体质量、体质量指数(BMI)、体脂肪量、体脂百分比、瘦体组织、身体水分含量、细胞外液量分别为(51.92±6.85)kg、(18.58±1.92)kg/m2、(13.32±3.15)kg、(14.19±4.05)％、(44.13±4.96)kg、(33.02±2.64)L、(12.27±1.38)L,均明显低于营养良好组的(62.95±11.32)kg、(23.45±1.86)kg/m2、(15.87±3.32)kg、(23.37±3.31)％、(47.18±5.23)kg、(34.75±3.21)L、(13.72±1.37)L,差异均有统计学意义(P<0.05);PG-SGA评分与体质量、BMI、体脂肪量、体脂百分比、蛋白质含量、瘦体组织、体细胞量、骨骼肌量、身体水分含量、细胞外液、细胞内液均呈负相关性(P<0.05).结论 PG-SGA与人体成分指标具有较好的相关性,术前进行PG-SGA评分及人体成分测定对评估胃癌患者的营养状况和营养干预方案的制定具有重要的临床意义.%Objective To investigate the correlation between Patient-Generated Subjective Global Assessment (PG-SGA) score and body composition in patients with gastric cancer before operation. Methods A total of 82 cases of patients with gastric cancer, who admitted to our hospital from June 2015 to October 2016, were selected as the research object. The PG-SGA scale evaluation and determination of body composition were carried out, patients with score of 0-3 points enrolled into the normal nutrition group (n=25), more than 4 points enrolled into the malnutrition group (n=57). The PG-SGA score and human body composition indicators of the two group were compared, and the

Objective and subjective nutritional assessment of patients with cancer in palliative care.

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Kwang, Ang Yee; Kandiah, Mirnalini

2010-03-01

This study aimed to evaluate the nutritional status of patients with cancer in palliative care and to examine the interrelationship between objective and subjective nutritional assessment measures. Patients' nutritional status in a palliative care unit of a Malaysian government hospital and a hospice facility were assessed using anthropometric measurements, weight loss at 1/6 months, and the scored patient-generated subjective global assessment (PG-SGA). Moderate-to-severe malnutrition was observed in a range from 31% to 69% using both measurements. Common nutritional impact symptoms were pain, xerostomia, and anorexia. Patient-generated subjective global assessment scores were significantly correlated with anthropometric measurements (P nutritional status assessment of patients with cancer in palliative care.

Malnutrition in a sample of community-dwelling people with Parkinson's disease.

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Jamie M Sheard

Full Text Available OBJECTIVE: Malnutrition results in poor health outcomes, and people with Parkinson's disease may be more at risk of malnutrition. However, the prevalence of malnutrition in Parkinson's disease is not yet well defined. The aim of this study is to provide an estimate of the extent of malnutrition in community-dwelling people with Parkinson's disease. METHODS: This is a cross-sectional study of people with Parkinson's disease residing within a 2 hour driving radius of Brisbane, Australia. The Subjective Global Assessment (SGA and scored Patient Generated Subjective Global Assessment (PG-SGA were used to assess nutritional status. Body weight, standing or knee height, mid-arm circumference and waist circumference were measured. RESULTS: Nineteen (15% of the participants were moderately malnourished (SGA-B. The median PG-SGA score of the SGA-B group was 8 (4-15, significantly higher than the SGA-A group, U = 1860.5, p<.05. The symptoms most influencing intake were loss of appetite, constipation, early satiety and problems swallowing. CONCLUSIONS: As with other populations, malnutrition remains under-recognised and undiagnosed in people with Parkinson's disease. Regular screening of nutritional status in people with Parkinson's disease by health professionals with whom they have regular contact should occur to identify those who may benefit from further nutrition assessment and intervention.

76 FR 22147 - Solicitation for Grant Applications (SGA); Trade Adjustment Assistance Community College and...

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2011-04-20

... with Section IVB, Part IIIa, of the SGA, which states that the Abstracts will be shared publicly, we... information that can be used to distinguish or trace an individual's identity, such as a name, social security... the application, for DOL to post that redacted version. If an applicant fails to provide a redacted...

What are the most effective methods for assessment of nutritional status in outpatients with gastric and colorectal cancer?

Science.gov (United States)

Abe Vicente, Mariana; Barão, Katia; Silva, Tiago Donizetti; Forones, Nora Manoukian

2013-01-01

To evaluate methods for the identification of nutrition risk and nutritional status in outpatients with colorectal (CRC) and gastric cancer (GC), and to compare the results to those obtained for patients already treated for these cancers. A cross-sectional study was conducted on 137 patients: group 1 (n = 75) consisting of patients with GC or CRC, and group 2 (n = 62) consisting of patients after treatment of GC or CRC under follow up, who were tumor free for a period longer than 3 months. Nutritional status was assessed in these patients using objective methods [body mass index (BMI), phase angle, serum albumin]; nutritional screening tools [Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), Nutritional Risk Index (NRI)], and subjective assessment [Patient-Generated Subjective Global Assessment (PGSGA)]. The sensitivity and specificity of each method was calculated in relation to the PG-SGA used as gold standard. One hundred thirty seven patients participated in the study. Stage IV cancer patients were more common in group 1. There was no difference in BMI between groups (p = 0.67). Analysis of the association between methods of assessing nutritional status and PG-SGA showed that the nutritional screening tools provided more significant results (p nutritional screening tools MUST, NRI and MST were more sensitive than the objective methods. Phase angle measurement was the most sensitive objective method in group 1. The nutritional screening tools showed the best association with PG-SGA and were also more sensitive than the objective methods. The results suggest the combination of MUST and PG-SGA for patients with cancer before and after treatment. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

SSA DISABILITY. SGA Levels Appear to Affect the Work Behavior of Relatively Few Beneficiaries, but More Data Needed

National Research Council Canada - National Science Library

Baucus, Max

2002-01-01

... physical or mental impairment has earnings that exceed the Substantial Gainful Activity (SGA) level, which represents SSA's principal standard for determining whether a disabled individual is able to work...

Audit Of The Prevalence Of Malnutrition Using The Modified Subjective Global Assessment Tool In Maintenance Peritoneal Dialysis Patients In The Top End Renal Service Of The Nortehrn Territory Australia

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Greta Hollis

2012-06-01

Full Text Available The objective of the audit is to determine the prevalence of malnutrition in maintenance peritoneal dialysis (MPD patients in the Top End of the Northern Territory, using the modified Subjective Global Assessment (SGA tool. Methods: The audit was conducted in an outpatients setting. Approximately 75% of PD patients in the Top End Renal service are represented by Aboriginal and Torres Strait Island people. The study population was MPD patients in the Top End Renal Service (TERS of the Northern Territory, from January 1st 2010 to December 31st 2010. Results were compared to malnutrition rates found in the 2008/09 the audit of MPD patients in the TERS. The SGA’s were performed by the renal Dietitian as part of the standard dietetic support of MPD patients. SGA scores were collected from patient medical charts. Results: Patients were classified into one of three categories, based on their SGA score (A Well-nourished; (B Mild- Moderate Malnutrition, (C Severe malnutrition. Malnutrition (B or C was detected in 10% of PD patients, compared to the 2008/09 audit where 76% of MPD patients had some degree of malnutrition. Summary: These results were much lower than malnutrition rates (76% in the MPD patients audited in 2008/09. A number of factors affecting the PD service after the 2008/09 audit could explain the decrease in malnutrition rates including the implementation of free oral nutrition supplements to MPD patients, development of service wide culturally appropriate education resources used in the pre-dialysis and dialysis stage. Future research into the correlation between improved peritonitis rates and decreased malnutrition rates in the population are warranted.

Similar effects of long-term exogenous growth hormone (GH) on bone and muscle parameters: a pQCT study of GH-deficient and small-for-gestational-age (SGA) children.

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Schweizer, Roland; Martin, David D; Haase, Martin; Roth, Johannes; Trebar, Branko; Binder, Gerhard; Schwarze, C Philipp; Ranke, Michael B

2007-11-01

Treatment with GH in short children has focused on height development. Little is known about the concomitant changes in muscle mass, bone structure and bone strength. Muscle area as well as parameters of bone architecture (bone mineral content, BMC; volumetric cortical density, total bone area, TBA; cortical area, cortical thickness, CT; and marrow area) were measured by means of pQCT (Stratec) at 65% of the proximal length of the forearm. The strength-strain index (SSI) was calculated as an indicator of bone strength. Prepubertal children with GHD (mean values: age; 7.2 years; height SDS=-2.9 SDS; GH dose: 30 microg/kg/d) were followed at 0, 6, 12 (n=74) and 24 (n=55) months. Prepubertal children with SGA (mean values: age: 7.1 years; height SDS=-3.4 SDS; GH dose: 55 mug/kg/d) were followed at 0, 6, 12 (n=47) and 24 (n=35) months. Both groups showed a similar increase in height. At GH start, muscle mass and bone characteristics were lower than normal but similar in SGA vs. GHD. Muscle area (mean values, SDS) increased from -3.0 to -1.5 in SGA and from -2.4 to -1.0 in GHD. Bone geometry changed in a biphasic mode, with an increase in total bone area and lowering of bone mineral content (BMC) during the first 12 months, followed by an increase of BMC and CT thereafter. SSI (mean values, mm(3)) improved from 78 to 114 in GHD and from 62 to 101 in SGA after 24 months on GH. The increment in terms of SDS did not reach significance in SGA. SSI correlated positively with muscle area before and during GH treatment. Bone strength and muscle mass are impaired in prepubertal children with GHD and SGA. Exogenous GH can indirectly improve bone structure and strength by inducing an increase in muscle mass. Our findings support the assumption that, in SGA, there is impaired tissue responsiveness to GH.

76 FR 17970 - Notice of Funding Opportunity and Solicitation for Grant Applications (SGA) for the Young Parents...

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2011-03-31

... Solicitation for Grant Applications (SGA) for the Young Parents Demonstration AGENCY: Employment and Training... of 2010 to support applicants in providing intensive mentoring services to low- income young parents (both mothers and fathers, and expectant parents ages 16 to 24) participating in workforce development...

Low-birth-weight, but not catch-up growth, correlates with insulin resistance and resistin level in SGA infants at 12 months.

Science.gov (United States)

Giapros, Vasileios; Vavva, Efthymia; Siomou, Ekaterini; Kolios, Georgios; Tsabouri, Sofia; Cholevas, Vasileios; Bairaktari, Eleni; Tzoufi, Meropi; Challa, Anna

2017-08-01

To investigate the insulin resistance status in SGA infants at 12 months and its relationship with auxological and metabolic parameters. One group of 45 SGA and one of 50 appropriate for gestational age infants were followed from birth to the end of the first year of life. At 12 months, skinfold thickness, waist circumference, and blood levels of glucose, insulin, adiponectin, leptin, resistin, visfatin, retinol-binding protein 4, IGFs, lipids profile were determined, and the HOMA-IR index was calculated. The SGAs had increased insulin (5.2 ± 2.7 versus 2.9 ± 2.4 μIU/ml, p = 0.012) and HOMA-IR (1.09 ± 0.9 versus 0.59 ± 0.55, p = 0.016). In multiple regression, insulin resistance indices were independently correlated with low-birth-weight (β = -2.92, p = 0.015 for insulin, β = -2.98, p = 0.011 for HOMA-IR) but not with catch-up growth in either height or weight or any other metabolic parameter. Resistin was higher in the SGAs (5.1 ± 2.1 versus 3.9 ± 2.1 ng/ml, p = 0.03) and independently correlated with low-birth-weight but not insulin resistance. Resistin was negatively correlated with total cholesterol (R = -0.33, p = 0.007) and positively with lipoprotein(a) (R = 0.49, p = 0.001). Low-birth-weight, but not catch-up growth or adiposity tissue hormones, was correlated with insulin resistance at 12 months in non-obese SGA infants. The higher resistin in SGA infants and its correlation with total cholesterol and lipoprotein(a) need further clarification.

[Nutritional assessment and perioperative nutritional support in gastric cancer patients].

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Seo, Kyung Won; Yoon, Ki Young

2013-04-01

Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

Assessment of nutritional status using abridged scored patient-generated subjective global assessment in cancer patient

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Simin Shahvazi

2017-01-01

Conclusion: According to the high prevalence of cancers and increasing growth of them in recent years with regard to outpatient treatment development for cancer patients, using the abPG-SGA standard questionnaire by nutritionist or nurses can be effective to detect malnourished patients and reduce complications caused by disease.

Added value of cerebro-placental ratio and uterine artery Doppler at routine third trimester screening as a predictor of SGA and FGR in non-selected pregnancies.

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Rial-Crestelo, M; Martinez-Portilla, R J; Cancemi, A; Caradeux, J; Fernandez, L; Peguero, A; Gratacos, E; Figueras, Francesc

2018-03-04

The objective of this study is to determine the added value of cerebroplacental ratio (CPR) and uterine Doppler velocimetry at third trimester scan in an unselected obstetric population to predict smallness and growth restriction. We constructed a prospective cohort study of women with singleton pregnancies attended for routine third trimester screening (32 +0 -34 +6 weeks). Fetal biometry and fetal-maternal Doppler ultrasound examinations were performed by certified sonographers. The CPR was calculated as a ratio of the middle cerebral artery to the umbilical artery pulsatility indices. Both attending professionals and patients were blinded to the results, except in cases of estimated fetal weight < p10. The association between third trimester Doppler parameters and small for gestational age (SGA) (birth weight <10th centile) and fetal growth restriction (FGR) (birth weight below the third centile) was assessed by logistic regression, where the basal comparison was a model comprising maternal characteristics and estimated fetal weight (EFW). A total of 1030 pregnancies were included. The mean gestational age at scan was 33 weeks (SD 0.6). The addition of CPR and uterine Doppler to maternal characteristics plus EFW improved the explained uncertainty of the predicting models for SGA (15 versus 10%, p < .001) and FGR (12 versus 8%, p = .03). However, the addition of CPR and uterine Doppler to maternal characteristics plus EFW only marginally improved the detection rates for SGA (38 versus 34% for a 10% of false positives) and did not change the predictive performance for FGR. The added value of CPR and uterine Doppler at 33 weeks of gestation for detecting defective growth is poor.

Validation of screening tools to assess appetite among geriatric patients.

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Hanisah, R; Suzana, S; Lee, F S

2012-07-01

Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special

The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery.

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Lohsiriwat, V

2014-11-01

The aim of the present study was to evaluate the effects of preoperative nutritional status on the short-term outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery. This prospective observational study included 149 patients who underwent elective resection of colorectal cancer with ERAS from January 2011 to January 2014 in a university hospital. Subjective global assessment (SGA) was used to determine preoperative nutritional status. Primary outcomes included the length of postoperative stay, postoperative morbidity, gastrointestinal recovery, and 30-day readmission. The patients were divided into 3 groups according to the SGA classification. There were 96 patients (64.4 %) in SGA-A (well-nourished), 48 (32.2 %) in SGA-B (mild to moderately malnourished), and 5 (3.4 %) in SGA-C (severely malnourished). Patients in SGA-A had the median length of postoperative stay of 4 days (range 2-23), which was significantly shorter compared to SGA-B (5 days; range 2-16; p recovery of gastrointestinal function, and prolonged length of hospital stay.

Assessing the nutritional status of hospitalized elderly

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Abd Aziz NAS

2017-10-01

Full Text Available Nur Adilah Shuhada Abd Aziz, Nur Islami Mohd Fahmi Teng, Mohd Ramadan Abdul Hamid, Nazrul Hadi Ismail Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia Purpose: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.Methods: A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA”, “Geriatric Nutrition Risk Index (GNRI”, and “Subjective Global Assessment (SGA”.Results: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.Conclusion: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future. Keywords: malnutrition in elderly

Customized vs INTERGROWTH-21st standards for the assessment of birthweight and stillbirth risk at term.

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Francis, Andre; Hugh, Oliver; Gardosi, Jason

2018-02-01

Fetal growth abnormalities are linked to stillbirth and other adverse pregnancy outcomes, and use of the correct birthweight standard is essential for accurate assessment of growth status and perinatal risk. Two competing, conceptually opposite birthweight standards are currently being implemented internationally: customized gestation-related optimal weight (GROW) and INTERGROWTH-21 st . We wanted to compare their performance when applied to a multiethnic international cohort, and evaluate their usefulness in the assessment of stillbirth risk at term. We analyzed routinely collected maternity data from 10 countries with a total of 1.25 million term pregnancies in their respective main ethnic groups. The 2 standards were applied to determine small for gestational age (SGA) and large for gestational age (LGA) rates, with associated relative risk and population-attributable risk of stillbirth. The customized standard (GROW) was based on the term optimal weight adjusted for maternal height, weight, parity, and ethnic origin, while INTERGROWTH-21 st was a fixed standard derived from a multiethnic cohort of low-risk pregnancies. The customized standard showed an average SGA rate of 10.5% (range 10.1-12.7) and LGA rate of 9.5% (range 7.3-9.9) for the set of cohorts. In contrast, there was a wide variation in SGA and LGA rates with INTERGROWTH-21 st , with an average SGA rate of 4.4% (range 3.1-16.8) and LGA rate of 20.6% (range 5.1-27.5). This variation in INTERGROWTH-21 st SGA and LGA rates was correlated closely (R = ±0.98) to the birthweights predicted for the 10 country cohorts by the customized method to derive term optimal weight, suggesting that they were mostly due to physiological variation in birthweight. Of the 10.5% of cases defined as SGA according to the customized standard, 4.3% were also SGA by INTERGROWTH-21 st and had a relative risk of 3.5 (95% confidence interval, 3.1-4.1) for stillbirth. A further 6.3% (60% of the whole customized SGA) were not SGA

Markers of disease severity are associated with malnutrition in Parkinson's disease.

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Jamie M Sheard

Full Text Available OBJECTIVE: In Parkinson's disease (PD, commonly reported risk factors for malnutrition in other populations commonly occur. Few studies have explored which of these factors are of particular importance in malnutrition in PD. The aim was to identify the determinants of nutritional status in people with Parkinson's disease (PWP. METHODS: Community-dwelling PWP (>18 years were recruited (n = 125; 73M/52F; Mdn 70 years. Self-report assessments included Beck's Depression Inventory (BDI, Spielberger Trait Anxiety Inventory (STAI, Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT, Modified Constipation Assessment Scale (MCAS and Freezing of Gait Questionnaire (FOG-Q. Information about age, PD duration, medications, co-morbid conditions and living situation was obtained. Addenbrooke's Cognitive Examination (ACE-R, Unified Parkinson's Disease Rating Scale (UPDRS II and UPDRS III were performed. Nutritional status was assessed using the Subjective Global Assessment (SGA as part of the scored Patient-Generated Subjective Global Assessment (PG-SGA. RESULTS: Nineteen (15% were malnourished (SGA-B. Median PG-SGA score was 3. More of the malnourished were elderly (84% vs. 71% and had more severe disease (H&Y: 21% vs. 5%. UPDRS II and UPDRS III scores and levodopa equivalent daily dose (LEDD/body weight (mg/kg were significantly higher in the malnourished (Mdn 18 vs. 15; 20 vs. 15; 10.1 vs. 7.6 respectively. Regression analyses revealed older age at diagnosis, higher LEDD/body weight (mg/kg, greater UPDRS III score, lower STAI score and higher BDI score as significant predictors of malnutrition (SGA-B. Living alone and higher BDI and UPDRS III scores were significant predictors of a higher log-adjusted PG-SGA score. CONCLUSIONS: In this sample of PWP, the rate of malnutrition was higher than that previously reported in the general community. Nutrition screening should occur regularly in those with more severe disease and depression. Community

GAR Global Risk Assessment

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Maskrey, Andrew; Safaie, Sahar

2015-04-01

Disaster risk management strategies, policies and actions need to be based on evidence of current disaster loss and risk patterns, past trends and future projections, and underlying risk factors. Faced with competing demands for resources, at any level it is only possible to priorities a range of disaster risk management strategies and investments with adequate understanding of realised losses, current and future risk levels and impacts on economic growth and social wellbeing as well as cost and impact of the strategy. The mapping and understanding of the global risk landscape has been greatly enhanced by the latest iteration of the GAR Global Risk Assessment and the objective of this submission is to present the GAR global risk assessment which contributed to Global Assessment Report (GAR) 2015. This initiative which has been led by UNISDR, was conducted by a consortium of technical institutions from around the world and has covered earthquake, cyclone, riverine flood, and tsunami probabilistic risk for all countries of the world. In addition, the risks associated with volcanic ash in the Asia-Pacific region, drought in various countries in sub-Saharan Africa and climate change in a number of countries have been calculated. The presentation will share thee results as well as the experience including the challenges faced in technical elements as well as the process and recommendations for the future of such endeavour.

Increment of absolute neutrophil count in the third trimester and increased risk of small-for-gestational-age birth: Hirakata Risk Associated with Pregnancy Assessment Research (HIRAPAR).

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Harita, Nobuko; Kariya, Masatoshi; Hayashi, Tomoshige; Sato, Kyoko Kogawa; Nakamura, Kimihiko; Endo, Ginji; Narimoto, Katsuhiko

2012-09-01

Small-for-gestational-age (SGA) infants, who have growth restriction, have higher perinatal morbidity and mortality. Excessive inflammatory reaction such as neutrophil activation has been observed in pregnant women whose offspring had restricted fetal growth, but the association between white blood cell (WBC) counts and SGA birth has not yet been assessed. We therefore examined the association of WBC count and its change with the risk of SGA birth. We enrolled 2356 pregnant women who had full-term singleton delivery at a private maternity hospital in Hirakata, Japan. SGA was defined as under the 10th percentile of birthweight for gestational age, baby sex, and mother's parity according to the Japanese neonatal anthropometric charts renewed in 2010. Blood samples were measured in the first and third trimesters. We performed multiple logistic regression analysis to assess associations between total and differential WBC counts and SGA birth. Women with SGA birth tended to have higher total WBC count in the third trimester compared with women who did not have SGA birth. This tendency was not observed for total WBC count in the first trimester. After adjustment for age, height, body mass index at entry, smoking habit, weekly gestational weight gain, and pregnancy-induced hypertension, higher total WBC count in the third trimester was associated with an increased risk of SGA birth. Total WBC count in the first trimester did not show any significant association with SGA birth. The ratio of total WBC count in the third trimester to that in the first trimester was associated with SGA birth; the odds ratio for 1 unit increase was 3.02 (95% CI: 1.54-5.92). Regarding differential WBC counts in the third trimester, neutrophil count but not lymphocyte count was associated positively with SGA birth. Higher total WBC and absolute neutrophil counts in the third trimester were associated with SGA birth. In addition, greater ratio of increase in total WBC counts during pregnancy

Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

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White, Susan W.; Smith, Laura A.; Schry, Amie R.

2014-01-01

Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer.

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Maurício, Sílvia Fernandes; da Silva, Jacqueline Braga; Bering, Tatiana; Correia, Maria Isabel Toulson Davisson

2013-04-01

The association between nutritional status and inflammation was assessed in patients with colorectal cancer and to verify their association with complications during anticancer treatment. The agreement between the Subjective Global Assessment (SGA) and different nutritional assessment methods was also evaluated. A cross-sectional, prospective, and descriptive study was performed. The nutritional status was defined by the SGA and the severity of inflammation was defined by the Glasgow Prognostic Score (GPS). The complications were classified using the Common Toxicity Criteria, version 3. Anthropometric measurements such as body mass index, triceps skinfold, midarm circumference, midarm muscle area, and adductor pollicis muscle thickness were also performed, as were handgrip strength and phase angle. The chi-square test, Fisher exact test, Spearman correlation coefficient, independent t test, analysis of variance, Gabriel test, and κ index were used for the statistical analysis. P cancer (60.4 ± 14.3 y old) were included. The nutritional status according to the SGA was associated with the GPS (P nutritional assessment methods with the SGA, there were statistically significant differences. Malnutrition is highly prevalent in patients with colorectal cancer. The nutritional status was associated with the GPS. Copyright © 2013 Elsevier Inc. All rights reserved.

Diagnostic test accuracy of nutritional tools used to identify undernutrition in patients with colorectal cancer: a systematic review.

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Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bath-Hextall, Fiona; Kirkpatrick, Pamela

2015-05-15

and negative predictive values. In addition, the positive likelihood ratio (sensitivity/ [1 - specificity]) and negative likelihood ratio (1 - sensitivity)/ specificity), were also calculated and presented in this review to provide information about the likelihood that a given test result would be expected when the target condition is present compared with the likelihood that the same result would be expected when the condition is absent. Not all trials reported true positive, true negative, false positive and false negative rates, therefore these rates were calculated based on the data in the published papers. A two-by-two truth table was reconstructed for each study, and sensitivity, specificity, positive predictive value, negative predictive value positive likelihood ratio and negative likelihood ratio were calculated for each study. A summary receiver operator characteristics curve was constructed to determine the relationship between sensitivity and specificity, and the area under the summary receiver operator characteristics curve which measured the usefulness of a test was calculated. Meta-analysis was not considered appropriate, therefore data was synthesized in a narrative summary. 1. One study evaluated the Malnutrition Screening Tool against the reference standard Patient-Generated Subjective Global Assessment. The sensitivity was 56% and the specificity 84%. The positive likelihood ratio was 3.100, negative likelihood ratio was 0.59, the diagnostic odds ratio (CI 95%) was 5.20 (1.09-24.90) and the Area Under the Curve (AUC) represents only a poor to fair diagnostic test accuracy. A total of two studies evaluated the diagnostic accuracy of Malnutrition Universal Screening Tool (MUST) (index test) compared to both Subjective Global Assessment (SGA) (reference standard) and PG-SGA (reference standard) in patients with colorectal cancer. In MUST vs SGA the sensitivity of the tool was 96%, specificity was 75%, LR+ 3.826, LR- 0.058, diagnostic OR (CI 95%) 66

Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction.

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Caradeux, J; Eixarch, E; Mazarico, E; Basuki, T R; Gratacós, E; Figueras, F

2018-02-01

Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was to compare second- to third-trimester longitudinal growth assessment to cross-sectional evaluation in the third trimester for the prediction of small-for-gestational age (SGA) and late FGR in low-risk singleton pregnancy. This was a prospective cohort study of 2696 unselected consecutive low-risk singleton pregnancies scanned at 21 ± 2 and 32 ± 2 weeks. For cross-sectional growth assessment, abdominal circumference (AC) measurements were transformed to z-values according the 21st-INTERGROWTH standards. Longitudinal growth assessment was performed by calculating the AC z-velocity and the second- to third-trimester AC conditional growth centile. Longitudinal assessment was compared with cross-sectional assessment at 32 weeks. Association of cross-sectional and longitudinal evaluations with SGA and late FGR was assessed by logistic regression analysis. Predictive performance was determined by receiver-operating characteristics curve analysis. In total, 210 (7.8%) newborns were classified as SGA and 103 (3.8%) as late FGR. Neither longitudinal measurement improved the association with SGA or late FGR provided by cross-sectional evaluation of AC z-score at 32 weeks. Areas under the curves of AC z-velocity and conditional AC growth were significantly smaller than those of cross-sectional AC z-scores (P third trimester has a low predictive capacity for SGA and late FGR in low-risk singleton pregnancy compared with cross-sectional growth evaluation. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

The relationship between baseline nutritional status with subsequent parenteral nutrition and clinical outcomes in cancer patients undergoing hyperthermic intraperitoneal chemotherapy.

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Vashi, Pankaj G; Gupta, Digant; Lammersfeld, Carolyn A; Braun, Donald P; Popiel, Brenten; Misra, Subhasis; Brown, Komen C

2013-08-14

The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising treatment option for selected patients with peritoneal carcinomatosis. This retrospective study investigated the relationship between baseline nutritional assessment with subsequent parenteral nutritional (PN) and clinical outcomes in cancer patients undergoing CRS and HIPEC. A consecutive series of 60 patients undergoing CRS and HIPEC at our institution between January 2009 and May 2011. Subjective Global Assessment (SGA) was used to assess nutritional status. Patients were classified preoperatively as: well nourished (SGA-A), mildly-moderately malnourished (SGA-B), and severely malnourished (SGA-C). For PN, patients were divided into 2 groups: those who received PN (PN+) and those who did not receive PN (PN-). The primary outcomes of interest were length of stay (LOS), postoperative complications, ECOG performance status (PS) and survival. LOS was calculated as the number of days in the hospital post surgery. Performance status was measured on a scale of 0-4. Survival was calculated from the date of first visit to the date of death/last contact. Of 60 patients, 19 were males and 41 females. The mean age at presentation was 50.3 years. The most common cancer types were colorectal (n = 24) and gynecologic (n = 19) with the majority of patients (n = 47) treated previously before coming to our institution. 33 patients were SGA-A, 22 SGA-B and 5 SGA-C prior to surgery. Of a total of 60 patients, 31 received PN. Mean LOS for the entire cohort was 16.2 days (SD = 9.8). Mean LOS for preoperative SGA-A, SGA-B and SGA-C were 15.0, 15.2 and 27.8 days respectively (ANOVA p = 0.02). Overall incidence of complications was 26.7% (16/60). Complications were recorded in 9 of 33 (27.3%) preoperative SGA-A patients and 7 of 27 (25.9%) SGA-B + C patients (p = 0.91). The median overall survival was 17.5 months (95% CI = 13.0 to 22

Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients.

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Seo, Seung Hee; Kim, Sung-Eun; Kang, Yoon-Koo; Ryoo, Baek-Yeol; Ryu, Min-Hee; Jeong, Jae Ho; Kang, Shin Sook; Yang, Mihi; Lee, Jung Eun; Sung, Mi-Kyung

2016-11-18

Malnutrition in gastrectomized patients receiving chemotherapy is associated with the susceptibility to chemotherapy-related adverse events. This study evaluated pre-operative nutritional status-related indices associated with adverse events in post-operation gastric cancer patients receiving chemotherapy. Medical records of 234 gastrectomized patients under adjuvant tegafur/gimeracil/oteracil chemotherapy with extended lymph node dissection were analyzed. Nutritional status assessment included Patient-Generated Subjective Global Assessment (PG-SGA), body weight, body mass index, serum albumin concentration, and Nutrition Risk Index (NRI). Chemotherapy-originated adverse events were determined using Common Terminology Criteria for Adverse Events. PG-SGA indicated 59% of the patients were malnourished, and 27.8% of the patients revealed serious malnutrition with PG-SGA score of ≥9. Fifteen % of patients lost ≥10% of the initial body weight, 14.5% of the patients had hypoalbuminemia (cancer patients.

Quality of life and nutritional status among cancer patients on chemotherapy.

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Vergara, Nunilon; Montoya, Jose Enrique; Luna, Herdee Gloriane; Amparo, Jose Roberto; Cristal-Luna, Gloria

2013-07-01

Malnutrition is prevalent among cancer patients, and maybe correlated with altered quality of life. The objective of this study is to determine wether quality of life among cancer patients on chemotherapy at the National Kidney and Transplant Institute- Cancer Unit differs from patients with normal nutrition based on the Subjective Global Assessment scale. A cross sectional study was conducted among cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute-Cancer Unit from January to May 2011. Demographic profile, performance status by Eastern Cooperative Oncology Group performance scale, nutritional status assessment by Subjective Global Assessment, and quality of life assessment by the European Organization for Research and Treatment of Cancer QoL-30 core module were obtained. Descriptive statistics and ANOVA were performed for analysis of quality of life parameters and nutritional status. A total of 97 subjects were included in this study, 66 subjects (68.04%) were females and 31 (31.96%) were males. Mean age was 54.55 ± 11.14 years, while mean performance status by the Eastern Cooperative Oncology Group classification was 0.88 ± 0.83 with a range of 0-3. According to the Subjective Global Assessment, there were 58 patients with SGA A, classified to have adequate nutrition, and 39 patients (40.21%) were considered malnourished. Among these 39 patients, 32 were classified SGA-B (moderately malnourished) and 7 were classified SGA C (severely malnourished) mean global quality of life was 68.73 ± 19.05. Results from ANOVA test revealed that patients were statistically different across the Subjective Global Assessment groups according to global quality of life (p<0.001), physical (p<0.001), role (p<0.001), emotional (p<0.001), and cognitive functioning (p<0.001); fatigue (p<0.001), nausea and vomiting (p<0.001), pain (p<0.001), insomnia (p<0.001), and appetite loss (p<0.001). GLOBAL QUALITY OF LIFE AND ITS PARAMETERS: physical state

Quality of Life and Nutritional Status Among Cancer Patients on Chemotherapy

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Nunilon Vergara

2013-07-01

Full Text Available Objectives: Malnutrition is prevalent among cancer patients, and maybe correlated with altered quality of life. The objective of this study is to determine whether quality of life among cancer patients on chemotherapy at the National Kidney and Transplant Institute- Cancer Unit differs from patients with normal nutrition based on the Subjective Global Assessment scale.Methods: A cross sectional study was conducted among cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute-Cancer Unit from January to May 2011. Demographic profile, performance status by Eastern Cooperative Oncology Group performance scale, nutritional status assessment by Subjective Global Assessment, and quality of life assessment by the European Organization for Research and Treatment of Cancer QoL-30 core module were obtained. Descriptive statistics and ANOVA were performed for analysis of quality of life parameters and nutritional status.Results: A total of 97 subjects were included in this study, 66 subjects (68.04% were females and 31 (31.96% were males. Mean age was 54.55 ± 11.14 years, while mean performance status by the Eastern Cooperative Oncology Group classification was 0.88 ± 0.83 with a range of 0-3. According to the Subjective Global Assessment, there were 58 patients with SGA A, classified to have adequate nutrition, and 39 patients (40.21% were considered malnourished. Among these 39 patients, 32 were classified SGA-B (moderately malnourished and 7 were classified SGA C (severely malnourished mean global quality of life was 68.73 ± 19.05. Results from ANOVA test revealed that patients were statistically different across the Subjective Global Assessment groups according to global quality of life (p<0.001, physical (p<0.001, role (p<0.001, emotional (p<0.001, and cognitive functioning (p<0.001; fatigue (p<0.001, nausea and vomiting (p<0.001, pain (p<0.001, insomnia (p<0.001, and appetite loss (p<0.001.Conclusion: Global

The evolution of global disaster risk assessments: from hazard to global change

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Peduzzi, Pascal

2013-04-01

The perception of disaster risk as a dynamic process interlinked with global change is a fairly recent concept. It gradually emerged as an evolution from new scientific theories, currents of thinking and lessons learned from large disasters since the 1970s. The interest was further heighten, in the mid-1980s, by the Chernobyl nuclear accident and the discovery of the ozone layer hole, both bringing awareness that dangerous hazards can generate global impacts. The creation of the UN International Decade for Natural Disaster Reduction (IDNDR) and the publication of the first IPCC report in 1990 reinforced the interest for global risk assessment. First global risk models including hazard, exposure and vulnerability components were available since mid-2000s. Since then increased computation power and more refined datasets resolution, led to more numerous and sophisticated global risk models. This article presents a recent history of global disaster risk models, the current status of researches for the Global Assessment Report on Disaster Risk Reduction (GAR 2013) and future challenges and limitations for the development of next generation global disaster risk models.

The Adaptation Gap Report. Towards Global Assessment

DEFF Research Database (Denmark)

2017-01-01

The Paris Agreement, adopted in 2015, established the global goal on adaptation of enhancing adaptive capacity, strengthening resilience and reducing vulnerability to climate change, with a view to contributing to sustainable development and ensuring an adequate adaptation response in the context...... Change (UNFCCC) to prepare for the implementation of the Paris Agreement. In contrast to previous Adaptation Gap Reports, the 2017 report focuses on issues relating to frameworks, comprising concepts, methodologies and data, rather than on assessing a particular dimension of the adaptation gap. Future...... extensive external review. The Paris Agreement’s global goal on adaptation provides a new starting point and impetus for assessing progress on adaptation at the global level, but additional information is required for assessing such progress. The global goal on adaptation provides a collective vision...

Global Mercury Assessment 2013

International Development Research Centre (IDRC) Digital Library (Canada)

mercury pollution. This summary report and the accompanying. Technical Background Report for the Global. Mercury Assessment 2013 are developed in response to Decision 25/5, paragraph ... The use of different pollution control technologies in different ...... vegetation, snow, freshwater, and seawater. One of the largest ...

Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries: Individual Participant Data Meta-Analysis and Population Attributable Fraction.

Science.gov (United States)

Kozuki, Naoko; Katz, Joanne; Lee, Anne C C; Vogel, Joshua P; Silveira, Mariangela F; Sania, Ayesha; Stevens, Gretchen A; Cousens, Simon; Caulfield, Laura E; Christian, Parul; Huybregts, Lieven; Roberfroid, Dominique; Schmiegelow, Christentze; Adair, Linda S; Barros, Fernando C; Cowan, Melanie; Fawzi, Wafaie; Kolsteren, Patrick; Merialdi, Mario; Mongkolchati, Aroonsri; Saville, Naomi; Victora, Cesar G; Bhutta, Zulfiqar A; Blencowe, Hannah; Ezzati, Majid; Lawn, Joy E; Black, Robert E

2015-11-01

Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. The specific aims of this study were to estimate the association between short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. We conducted an individual participant data meta-analysis with the use of data sets from 12 population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each of these studies, we individually calculated RRs between height exposure categories of < 145 cm, 145 to < 150 cm, and 150 to < 155 cm (reference: ≥ 155 cm) and outcomes of SGA, preterm birth, and their combination categories. SGA was defined with the use of both the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) birth weight standard and the 1991 US birth weight reference. The associations were then meta-analyzed. All short stature categories were statistically significantly associated with term SGA, preterm appropriate-for-gestational-age (AGA), and preterm SGA births (reference: term AGA). When using the INTERGROWTH-21st standard to define SGA, women < 145 cm had the highest adjusted risk ratios (aRRs) (term SGA-aRR: 2.03; 95% CI: 1.76, 2.35; preterm AGA-aRR: 1.45; 95% CI: 1.26, 1.66; preterm SGA-aRR: 2.13; 95% CI: 1.42, 3.21). Similar associations were seen for SGA defined by the US reference. Annually, 5.5 million term SGA (18.6% of the global total), 550,800 preterm AGA (5.0% of the global total), and 458,000 preterm SGA (16.5% of the global total) births may be associated

The evaluation of preoperative nutritional status in patients undergoing thoracic surgery.

Science.gov (United States)

Trufă, D I; Arhire, Lidia Iuliana; Niţă, Otilia; Gherasim, Andreea; Niţă, G; Graur, Mariana

2014-01-01

The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools. . We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iaşi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002). After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance. Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.

U.S. Global Change Research Program National Climate Assessment Global Change Information System

Science.gov (United States)

Tilmes, Curt

2012-01-01

The program: a) Coordinates Federal research to better understand and prepare the nation for global change. b) Priori4zes and supports cutting edge scientific work in global change. c) Assesses the state of scientific knowledge and the Nation s readiness to respond to global change. d) Communicates research findings to inform, educate, and engage the global community.

Combined evaluation of nutrition and hydration in dialysis patients with bioelectrical impedance vector analysis (BIVA).

Science.gov (United States)

Piccoli, Antonio; Codognotto, Marta; Piasentin, Paola; Naso, Agostino

2014-08-01

Body hydration changes continuously in hemodialysis patients. The Subjective Global Assessment (SGA) is used for the nutritional evaluation but it does not allow a direct evaluation of hydration. Bioelectrical impedance vector analysis (BIVA) is very sensitive to hydration. The potential of the combined evaluation of hydration and nutrition with SGA and BIVA is still lacking. Observational cross-sectional study on 130 (94 Male) uremic patients undergoing chronic hemodialysis three times a week. Nutritional status was evaluated with the SGA. Each subject was classified as SGA-A (normal nutritional status), SGA-B (moderate malnutrition), or SGA-C (severe malnutrition). Body hydration was evaluated with BIVA. The two vector components resistance (R) and reactance (Xc) were normalized by the subject's height and standardized as bivariate Z-score, i.e. Z(R) and Z(Xc). Undernutrition influenced impedance vector distribution both before and after a dialysis session. In pre-dialysis, the mean vector of SGA A was inside the 50% tolerance ellipse. In SGA B and C, Z(R) was increased and Z(Xc) decreased, indicating a progressive loss of soft tissue mass. Fluid removal with dialysis increased both Z(R) and Z(Xc) in SGA A and B but not in C. With ROC curve analysis on the slope of increase, we found the cutoff value of 27.8° below which undernutrition was present, either moderate or severe. The area under the ROC curve was 77.7° (95% CI 69.5-84.5, P hydration in each SGA category can be detected with BIVA. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Drinking-water exposure to a mixture of nitrate and low-dose atrazine metabolites and small-for-gestational age (SGA) babies: a historic cohort study.

Science.gov (United States)

Migeot, V; Albouy-Llaty, M; Carles, C; Limousi, F; Strezlec, S; Dupuis, A; Rabouan, S

2013-04-01

Groundwater, surface water and drinking water are contaminated by nitrates and atrazine, an herbicide. They are present as a mixture in drinking water and with their endocrine-disrupting activity, they may alter fetal growth. To study an association between drinking-water atrazine metabolites/nitrate mixture exposure and small-for-gestational-age(SGA). A historic cohort study based on birth records and drinking-water nitrate and pesticide measurements in Deux-Sèvres (France) between 2005 and 2009 was carried out. Exposure to drinking-water atrazine metabolites/nitrate mixture was divided into 6 classes according to the presence or absence of atrazine metabolites and to terciles of nitrate concentrations in each trimester of pregnancy. Regression analysis of SGA by mixture exposure at second trimester was subsequently conducted. We included 11,446 woman-neonate couples of whom 37.0% were exposed to pesticides, while 99.9% of the women were exposed to nitrates. Average nitrate concentration was from 0 to 63.30 mg/L. In the second trimester of pregnancy, the risk of SGA was different with mixture exposure when drinking-water atrazine metabolites, mainly 2 hydroxyatrazine and desethylatrazine, were present and nitrate dose exposure increased: compared to single first tercile of nitrate concentration exposure, single second tercile exposure OR was 1.74 CI 95% [1.10; 2.75] and atrazine metabolites presence in the third tercile of nitrate concentration exposure OR was 0.87 CI 95% [0.45;1.67]. It is possible that the association found at the second trimester of exposure with regard to birth weight may likewise be observed before birth, with regard to the estimated fetal weight, and that it might change in the event that the atrazine metabolites dose were higher or the nitrate dose lower. It would appear necessary to further explore the variability of effects. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Transparent Global Seismic Hazard and Risk Assessment

Science.gov (United States)

Smolka, Anselm; Schneider, John; Pinho, Rui; Crowley, Helen

2013-04-01

Vulnerability to earthquakes is increasing, yet advanced reliable risk assessment tools and data are inaccessible to most, despite being a critical basis for managing risk. Also, there are few, if any, global standards that allow us to compare risk between various locations. The Global Earthquake Model (GEM) is a unique collaborative effort that aims to provide organizations and individuals with tools and resources for transparent assessment of earthquake risk anywhere in the world. By pooling data, knowledge and people, GEM acts as an international forum for collaboration and exchange, and leverages the knowledge of leading experts for the benefit of society. Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, open tools and models for seismic hazard and risk assessment. Guided by the needs and experiences of governments, companies and citizens at large, they work in continuous interaction with the wider community. A continuously expanding public-private partnership constitutes the GEM Foundation, which drives the collaborative GEM effort. An integrated and holistic approach to risk is key to GEM's risk assessment platform, OpenQuake, that integrates all above-mentioned contributions and will become available towards the end of 2014. Stakeholders worldwide will be able to calculate, visualise and investigate earthquake risk, capture new data and to share their findings for joint learning. Homogenized information on hazard can be combined with data on exposure (buildings, population) and data on their vulnerability, for loss assessment around the globe. Furthermore, for a true integrated view of seismic risk, users can add social vulnerability and resilience indices to maps and estimate the costs and benefits

Assessing the Risk of Having Small for Gestational Age Newborns Among Lebanese Underweight and Normal Pre-pregnancy Weight Women.

Science.gov (United States)

Rafei, Rym El; Abbas, Hussein A; Alameddine, Hind; Bizri, Ayah Al; Melki, Imad; Yunis, Khalid A

2018-01-01

Introduction It has been established that underweight women with low gestational weight gain (GWG) are at a higher risk of having Small for Gestational Age (SGA) newborns. However, the association remains poorly studied in Middle Eastern societies exhibiting different ethnic groups, genetic predisposing factors along with differences in nutritional food intake during pregnancy. The aim of this study is to assess the risk of having a SGA newborn among underweight and normal weight BMI women while studying the role of GWG in this association. Methods This is a retrospective cross-sectional study of 62,351 singleton pregnancies from the National Collaborative Perinatal Neonatal Network between 2001 and 2009 from 27 hospitals across Lebanon. Women who had underweight and normal pre-pregnancy BMI were included. Results A total of 8.6% newborns were SGA and 6.6% of women were underweight. Among women with normal and underweight pre-pregnancy BMI, 8.6 and 12.4% had SGA births respectively. Overall, the adjusted OR of having SGA newborns was significantly higher among underweight women (OR = 1.448; 95%CI = 1.287-1.630) compared to normal pre-pregnancy BMI. Below normal weight gain significantly increased the odds of SGA for both normal and underweight pre-pregnancy BMI women, with adjusted ORs of 1.535 (95% CI = 1.418-1.661) and 1.970 (95%CI = 1.515-2.560) respectively. Discussion Higher risks of SGA newborns in underweight and normal BMI women with low GWG were observed. In addition, normal weight gain couldn't protect underweight women of having risk for SGA newborns. Hence, all pregnant women should be encouraged to maintain healthy BMI before pregnancy and attain adequate GWG.

Psychosocial factors, lifestyle, and fetal growth: the added value of both pre- and post-natal assessments.

Science.gov (United States)

Dejin-Karlsson, Elisabeth; Ostergren, Per-Olof

2003-09-01

Psychosocial resources as well as lifestyle habits during pregnancy have been shown to effect the risk of having a small-for-gestational-age (SGA) child. Most previous studies are based on a single assessment of these exposures, which does not take into account the possibility of different effects during early and late stages of pregnancy. The impact of psychosocial and lifestyle factors on the risk of giving birth to an SGA child (as measured by ultrasound) was examined among 747 nulliparous Swedish women who completed both a prenatal baseline, and a post-partum assessment. Those registering low social participation on both assessments showed increased risk of giving birth to an SGA infant (OR = 2.44 and 95% CI: 1.06-5.66), while at one assessment (OR = 1.70 and 95% CI: 0.74-3.91). Maternal smoking confirmed by both or one assessments yielded an OR = 2.72 and 95% CI: 1.37-5.39 and OR = 1.60 and 95% CI: 0.58-4.46, respectively. During early pregnancy, poor instrumental support, maternal smoking, or passive smoking yielded increased risks of SGA, adjusted for confounding (OR = 2.39 and 95% CI: 1.11-5.17; OR = 2.38 and 95% CI: 1.27-4.49; OR = 2.92 and 95% CI: 1.17-7.32, respectively). In late pregnancy, only maternal smoking yielded a significant association (OR = 2.34 and 95% CI: 1.24-4.41). Scheduling repeated assessments of psychosocial resources and lifestyle factors during pregnancy yielded additional information. The findings suggest that there can be differential effects of such exposures depending on gestational stage. This information is of importance when designing appropriate intervention strategies for maternal health services as well as for public health relevant policy formulation (e.g. regarding exposure to environmental tobacco during pregnancy).

A framework for global river flood risk assessments

NARCIS (Netherlands)

Winsemius, H.C.; van Beek, L.P.H.|info:eu-repo/dai/nl/14749799X; Jongman, B.; Ward, P.J.; Bouwman, A.

2013-01-01

There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and

The selective glycine uptake inhibitor org 25935 as an adjunctive treatment to atypical antipsychotics in predominant persistent negative symptoms of schizophrenia: results from the GIANT trial.

Science.gov (United States)

Schoemaker, Joep H; Jansen, Wim T; Schipper, Jacques; Szegedi, Armin

2014-04-01

Using a selective glycine uptake inhibitor as adjunctive to second-generation antipsychotic (SGA) was hypothesized to ameliorate negative and/or cognitive symptoms in subjects with schizophrenia. Subjects with predominant persistent negative symptoms (previously stabilized ≥3 months on an SGA) were enrolled in a randomized, placebo-controlled trial to investigate adjunctive treatment with Org 25935, a selective inhibitor of type 1 glycine transporter, over 12 weeks in a flexible dose design. Org 25935 was tested at 4 to 8 mg twice daily and 12 to 16 mg twice daily versus placebo. Primary efficacy outcome was mean change from baseline in Scale for Assessment of Negative Symptoms composite score. Secondary efficacy end points were Positive and Negative Syndrome Scale total and subscale scores, depressive symptoms (Calgary Depression Scale for Schizophrenia), global functioning (Global Assessment of Functioning scale), and cognitive measures using a computerized battery (Central Nervous System Vital Signs). Responder rates were assessed post hoc. A total of 215 subjects were randomized, of which 187 (87%) completed the trial. Both dose groups of Org 25935 did not differ significantly from placebo on Scale for Assessment of Negative Symptoms, Positive and Negative Syndrome Scale (total or subscale scores), Global Assessment of Functioning, or the majority of tested cognitive domains. Org 25935 was generally well tolerated within the tested dose range, with no meaningful effects on extrapyramidal symptoms and some reports of reversible visual adverse effects. Org 25935 did not differ significantly from placebo in reducing negative symptoms or improving cognitive functioning when administered as adjunctive treatment to SGA. In our study population, Org 25935 appeared to be well tolerated in the tested dose ranges.

A new birthweight reference in Guangzhou, southern China, and its comparison with the global reference.

Science.gov (United States)

He, Jian-Rong; Xia, Hui-Min; Liu, Yu; Xia, Xiao-Yan; Mo, Wei-Jian; Wang, Ping; Cheng, Kar Keung; Leung, Gabriel M; Feng, Qiong; Schooling, C Mary; Qiu, Xiu

2014-12-01

To formulate a new birthweight reference for different gestational ages in Guangzhou, southern China, and compare it with the currently used reference in China and the global reference. All singleton live births of more than 26 weeks' gestational age recorded in the Guangzhou Perinatal Health Care and Delivery Surveillance System for the years 2009, 2010 and 2011 (n=510 837) were retrospectively included in the study. In addition, the study sample was supplemented by all singleton live births (n=3538) at gestational ages 26-33 weeks from 2007 and 2008. We used Gaussian mixture models and robust regression to exclude outliers of birth weight and then applied Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to generate smoothed percentile curves separately for gender and parity. Of infants defined as small for gestational age (SGA) in the new reference, 15.3-47.7% (depending on gestational age) were considered appropriate for gestational age (AGA) by the currently used reference of China. Of the infants defined as SGA by the new reference, 9.2% with gestational ages 34-36 weeks and 14.3% with 37-41 weeks were considered AGA by the global reference. At the 50th centile line, the new reference curve was similar to that of the global reference for gestational ages 26-33 weeks and above the global reference for 34-40 weeks. The new birthweight reference based on birthweight data for neonates in Guangzhou, China, differs from the reference currently used in China and the global reference, and appears to be more relevant to the local population. 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.

Assessing the decennial, reassessing the global

DEFF Research Database (Denmark)

Manners, Ian James

2013-01-01

in global politics by rethinking the nature of power and actorness in a globalizing, multilateralizing and multipolarizing era. To do this, the article assesses the past decade in terms of normative power engagement, internationalization and comparison. The article then argues that rethinking power...... and actorness involves reassessing global theory and pouvoir normatif in action. The article concludes by setting out three ways of developing the NPA in its second decade: macro-approach, meso-characterization and micro-analysis. Following the suggestion of Emanuel Adler, Barry Buzan and Tim Dunne, the article...

A prospective study of nutritional status in immunoglobulin light chain amyloidosis

DEFF Research Database (Denmark)

Sattianayagam, PT; Lane, T; Fox, Z

2013-01-01

Weight loss is common in systemic immunoglobulin light chain amyloidosis but there are limited data on the impact of nutritional status on outcome. Using the Patient-Generated Subjective Global Assessment (PG-SGA) score, we prospectively examined nutritional status in 110 consecutive newly-diagno...

A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study).

Science.gov (United States)

Marshall, Skye; Craven, Dana; Kelly, Jaimon; Isenring, Elizabeth

2017-10-12

Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community. A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. There were 6412 records identified, of which 104 potentially eligible records were screened via full text. Eight papers were included; two which evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six which evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95% CI: 1.55-2.39]; P < 0.00001; n = 2013 participants; n = 4 studies; I 2 : 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P = 0.01; n = 4046 participants; n = 3 studies; I 2 :89%). Due to the small number of studies identified and no evaluation of the predictive validity of tools other than

A framework for global river flood risk assessments

Science.gov (United States)

Winsemius, H. C.; Van Beek, L. P. H.; Jongman, B.; Ward, P. J.; Bouwman, A.

2013-05-01

There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and socio-economic changes. The framework's goal is to establish flood hazard and impact estimates at a high enough resolution to allow for their combination into a risk estimate, which can be used for strategic global flood risk assessments. The framework estimates hazard at a resolution of ~ 1 km2 using global forcing datasets of the current (or in scenario mode, future) climate, a global hydrological model, a global flood-routing model, and more importantly, an inundation downscaling routine. The second component of the framework combines hazard with flood impact models at the same resolution (e.g. damage, affected GDP, and affected population) to establish indicators for flood risk (e.g. annual expected damage, affected GDP, and affected population). The framework has been applied using the global hydrological model PCR-GLOBWB, which includes an optional global flood routing model DynRout, combined with scenarios from the Integrated Model to Assess the Global Environment (IMAGE). We performed downscaling of the hazard probability distributions to 1 km2 resolution with a new downscaling algorithm, applied on Bangladesh as a first case study application area. We demonstrate the risk assessment approach in Bangladesh based on GDP per capita data, population, and land use maps for 2010 and 2050. Validation of the hazard estimates has been performed using the Dartmouth Flood Observatory database. This was done by comparing a high return period flood with the maximum observed extent, as well as by comparing a time series of a single event with Dartmouth imagery of the event. Validation of modelled damage estimates was performed using observed damage estimates from the EM

A framework for global river flood risk assessments

Directory of Open Access Journals (Sweden)

H. C. Winsemius

2013-05-01

Full Text Available There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and socio-economic changes. The framework's goal is to establish flood hazard and impact estimates at a high enough resolution to allow for their combination into a risk estimate, which can be used for strategic global flood risk assessments. The framework estimates hazard at a resolution of ~ 1 km2 using global forcing datasets of the current (or in scenario mode, future climate, a global hydrological model, a global flood-routing model, and more importantly, an inundation downscaling routine. The second component of the framework combines hazard with flood impact models at the same resolution (e.g. damage, affected GDP, and affected population to establish indicators for flood risk (e.g. annual expected damage, affected GDP, and affected population. The framework has been applied using the global hydrological model PCR-GLOBWB, which includes an optional global flood routing model DynRout, combined with scenarios from the Integrated Model to Assess the Global Environment (IMAGE. We performed downscaling of the hazard probability distributions to 1 km2 resolution with a new downscaling algorithm, applied on Bangladesh as a first case study application area. We demonstrate the risk assessment approach in Bangladesh based on GDP per capita data, population, and land use maps for 2010 and 2050. Validation of the hazard estimates has been performed using the Dartmouth Flood Observatory database. This was done by comparing a high return period flood with the maximum observed extent, as well as by comparing a time series of a single event with Dartmouth imagery of the event. Validation of modelled damage estimates was performed using observed damage estimates from

Nutritional status in patients with hepatitis C

International Nuclear Information System (INIS)

Ismail, F.W.; Khan, R.A.; Kamani, L.; Shah, H.A.; Jafri, W.

2012-01-01

To assess the nutritional status via the SGA (subjective global assessment) screening tool of patients at all stages of hepatitis C virus (HCV) liver disease. Study Design: Descriptive study. Place and Duration of Study: Out-patient Clinics of the Aga Khan University Hospital, Karachi, conducted from October 2009 to January 2011. Methodology: Patients with hepatitis C virus infection and their HCV-negative attendants were enrolled from the outpatient clinics, and categorized into 4 groups of 100 patients each: healthy controls (HC), those with chronic hepatitis C infection (CHC), compensated cirrhotics (CC) and decompensated cirrhotics (DC). The validated subjective global assessment (SGA) tool was used to assess nutritional status. Results: A total of 400 patients were enrolled. Most of the patients in the HC group were class 'A' (best nutritional status). In contrast, the majority (64%) in the DC group were in the class 'C' (worst status). The compensated cirrhosis (CC) group showed that 90% of patients were malnourished, while 98% of all patients were malnourished in the DC group, predominantly class 'C'. Most importantly, 14% of patients with chronic hepatitis C (CHC) also scored a 'B' on the SGA; which when compared to HC was statistically significant (p=0.005). As the groups progressed in their disease from CHC to DC, the transition in nutritional status from 'A' to 'C' between groups was statistically significant. Conclusion: Malnutrition occurs early in the course of HCV, and progresses relentlessly throughout the spectrum of HCV disease. (author)

Linking global scenarios to national assessments: Experiences from the Resources Planning Act (RPA) Assessment

Science.gov (United States)

Linda L. Langner; Peter J. Ince

2012-01-01

The Resources Planning Act (RPA) Assessment provides a nationally consistent analysis of the status and trends of the Nation's renewable forest resources. A global scenario approach was taken for the 2010 RPA Assessment to provide a shared world view of potential futures. The RPA Assessment scenarios were linked to the global scenarios and climate projections used...

Association Between Nutritional Status, Inflammatory Condition, and Prognostic Indexes with Postoperative Complications and Clinical Outcome of Patients with Gastrointestinal Neoplasia.

Science.gov (United States)

Costa, Milena Damasceno de Souza; Vieira de Melo, Camila Yandara Sousa; Amorim, Ana Carolina Ribeiro de; Cipriano Torres, Dilênia de Oliveira; Dos Santos, Ana Célia Oliveira

2016-10-01

The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

Global assessments of the state of the marine environment: Contemporary initiatives

International Nuclear Information System (INIS)

Bewers, J.M.; Boelens, R.G.V.

1999-01-01

A large number of assessments of regional marine areas have been conducted in recent years for a variety of purposes. Periodic reviews of the state of the marine environment have been undertaken by the United Nations Joint Group of Experts on the Scientific Aspects of Marine Environmental Protection (GESAMP). The most recent of these global assessments was published in 1990. The international adoption of a Global Programme of Action for the Protection of the Marine Environment from Land-Based Activities in 1995 has led to additional demand for regional assessments and a global review. The regional assessments are either completed or in train largely through mechanisms associated with the UNEP Regional Seas Programme. The global assessment has been assigned to GESAMP and incorporated into its plans for the preparation of a new global review to be completed in the year 2002. The Intergovernmental Oceanographic Commission, (IOC) the Scientific Committee for Oceanic Research (SCOR) and the Scientific Committee on Problems of the Environment (SCOPE) are collaborating in a review of ocean science. The Global Environment Facility (GEF) recently approved funding for a 'Global International Waters Assessment' (GIWA) partly as a means of determining priorities within its International Waters Portfolio. This paper outlines the nature of, and contemporary activities within, these various assessments. (author)

Psychomotor and intellectual development (Neurocognitive Function) of children born small for gestational age (SGA). Transversal and longitudinal study.

Science.gov (United States)

Puga, Beatriz; Puga, Paloma Gil; de Arriba, Antonio; Armendariz, Yolanda; Labarta, Jose I; Longas, Angel Ferrandez

2009-02-01

Although much is now known about the effects of intrauterine growth retardation (IUGR) on children born SGA with regard to anthropometric and biochemical parameters and their treatment, there are still many gaps associated with its impact on neurocognitive functions. In our experience published several years ago, IUGR has a negative effect on neurocognitive development, regardless of whether these children showed evidence of catch-up growth or not or of the socio-economic conditions that might contribute to the situation. We have now accumulated a large number of cases, many of whom have been followed longitudinally, some for up to 7 years, many having been treated with GH from the time when this therapy was first approved by the EMA. Apart from the cases mentioned, other confounding factors such as gestational age, Apgar score, neonatal comorbidity and the possible effects of GH treatment have also been included. In addition and using our own reference standards, we now present our experience, which confirms what we had already noted in the past, that IUGR is in itself a condition that often causes psychomotorintellectual impairment, may be extremely severe and tends to worsen. This negative impact of IUGR on neurocognitive development does not depend on how the child grows,spontaneous growth is better and when growth is not altered by GH therapy. Later studies will be able to confirm whether early treatment with GH throughout the 2nd year of life, or an early specific stimulation programme, or the sum of both, can improve the neurocognitive development of these children. IUGR prevention, acting on causal factors that are partly avoidable such as smoking, working conditions and stress during pregnancy (see the corresponding article in this supplement) proves once again to be the best way to stop this negative impact on the IQ of many children born SGA.

Status Gizi sebagai Prediktor Kualitas Hidup Pasien Kanker Kepala dan Leher

Directory of Open Access Journals (Sweden)

Fuadiyah Nila Kurniasari

2015-06-01

In Indonesia cancer is the seventh cause of mortality. The prevalence of the Head and Neck Cancer (HNC in Indonesia is high (4,7/100.000. Cancer patients have high risk for weight loss and malnutrition, where nutritional status affects quality of life and comfortable feeling in cancer patients. Determining the nutritional status indicators can be used to predict the quality of life of patients with head and neck cancer. The study was observational with cross sectional design in Saiful Anwar Hospital, Malang in November 2010 – January 2011. Subjects were HNC patients that met inclusion criteria (n=45. Nutritional status was determined with 3 methods, which are body mass index (BMI, subjective global assessment (SGA, and dietary intake assessment. Interview, weight and height measurement and physical examination were held to collect data. Chi square and linier regression analysis were used to get data analysis. There was a significant correlation between SGA of category A (β1=30,631; p=0.001, intake of protein (β2=0,344; p=0.009, body mass index (β3=-1,533; p=0.028, and SGA of category B (β4=13,353; p=0.039 with quality of life of head and neck in cancer patients. Intake of energy was represented from intake of protein whereby both were mutually supportive. There was no correlation between intake of vitamin A and quality of life (β5=0,000; p=0.907.The nutritional status can be used as a predictor for determining the quality of life scores of head and neck cancer patients, with the formula is: quality of life of HNC patients =47.1+30.6(if SGAA +0.3(protein intake (g -1.5(BMI (kg/m2 +13.3(if SGAB. Nutritional status was assessed by BMI, intake of protein, and SGA can be used to predict the quality of life scores in head and neck of cancer patients, where SGA is the most influential factor in determining the quality of life of patients with head and neck cancer. Keywords: body mass index, intake of energy, protein, vitamin A, subjective global assessment, quality

Comparison of methods for identifying small-for-gestational-age infants at risk of perinatal mortality among obese mothers: a hospital-based cohort study.

Science.gov (United States)

Hinkle, S N; Sjaarda, L A; Albert, P S; Mendola, P; Grantz, K L

2016-11-01

To assess differences in small-for-gestational age (SGA) classifications for the detection of neonates with increased perinatal mortality risk among obese women and subsequently assess the association between prepregnancy body mass index (BMI) status and SGA. Hospital-based cohort. Twelve US clinical centres (2002-08). A total of 114 626 singleton, nonanomalous pregnancies. Data were collected using electronic medical record abstraction. Relative risks (RR) with 95% CI were estimated. SGA trends (birthweight < 10th centile) classified using population-based (SGA POP ), intrauterine (SGA IU ) and customised (SGA CUST ) references were assessed. The SGA-associated perinatal mortality risk was estimated among obese women. Using the SGA method most associated with perinatal mortality, the association between prepregnancy BMI and SGA was estimated. The overall perinatal mortality prevalence was 0.55% and this increased significantly with increasing BMI (P < 0.01). Among obese women, SGA IU detected the highest proportion of perinatal mortality cases (2.49%). Perinatal mortality was 5.32 times (95% CI 3.72-7.60) more likely among SGA IU neonates than non-SGA IU neonates. This is in comparison with the 3.71-fold (2.49-5.53) and 4.81-fold (3.41-6.80) increased risk observed when SGA POP and SGA CUST were used, respectively. Compared with women of normal weight, overweight women (RR = 0.82, 95% CI 0.78-0.86) and obese women (RR = 0.80; 95% CI 0.75-0.83) had a lower risk for delivering an SGA IU neonate. Among obese women, the intrauterine reference best identified neonates at risk of perinatal mortality. Based on SGA IU , SGA is less common among obese women but these SGA babies are at a high risk of death and remain an important group for surveillance. SGA is less common among obese women but these SGA babies are at a high risk of death. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Estado nutricional y mortalidad en neumonía de la comunidad Nutritional status and mortality in community acquired pneumonia

Directory of Open Access Journals (Sweden)

María Soledad Rodríguez-Pecci

2010-04-01

Full Text Available Las neumonías constituyen una causa mayor de morbimortalidad, y entre los factores de riesgo se incluye el estado nutricional. En el presente estudio se analizó la relación entre malnutrición y mortalidad en Neumonía Aguda de la Comunidad (NAC y se utilizó la Escala de Evaluación Global Subjetiva (EGS como método de valoración del estado nutricional de los pacientes con NAC. En este estudio prospectivo observacional se incluyeron en forma consecutiva 98 pacientes con NAC que requirieron hospitalización, de octubre de 2004 a septiembre de 2006. Se registraron características clínicas, bacteriológicas y de laboratorio y se evaluó nutricionalmente a cada paciente utilizando la EGS. El seguimiento se realizó hasta el alta médica, derivación o muerte. La persistencia de tos o fiebre, la presencia de derrame pleural, neoplasias o larga hospitalización se asociaron a peor pronóstico. La mortalidad aumentó proporcionalmente con el grado de desnutrición. Treinta y dos pacientes (32.65% fueron clasificados como categoría EGS-A; 44 (44.90% como EGS-B, y 22 (22.45% como EGS-C. Fallecieron 3 de 32 EGS-A (9.37%, 8 de 44 EGS-B (18.18% y 10 de 22 EGS-C. El riesgo de muerte fue significativamente mayor en el grupo EGS-C que en el EGS-A; OR = 6.085 (CI95% 1.071- 34.591 p = 0.042. Considerando la muerte como variable de egreso, la categoría EGS-A mostró el mayor valor predictivo negativo (0.906, y EGS-C el mayor valor predictivo positivo (0.455. La EGS realizada al ingreso fue un instrumento útil para identificar el estado nutricional y un buen pronosticador de riesgo de muerte en NAC.Pneumonias are a major cause of morbidity and mortality and their prognosis depends on many factors including nutritional status. This study analyzed the relationship between malnutrition and the risk of death in Community Acquired Pneumonia (CAP patients. This is a prospective observational study. The Subjective Global Assessment (SGA was used as a screening

The Children's Global Assessment Scale (CGAS) and Global Assessment of Psychosocial Disability (GAPD) in clinical practice--substance and reliability as judged by intraclass correlations

DEFF Research Database (Denmark)

Dyrborg, J; Larsen, F W; Nielsen, S

2000-01-01

Studies on the inter-rater reliability on the Children's Global Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD) involving different subgroups of 145 outpatients from 4 to 16 years of age showed fair to substantial intraclass correlations of 0.59 to 0.90. Raters...

Assessing students' communication skills: validation of a global rating.

Science.gov (United States)

Scheffer, Simone; Muehlinghaus, Isabel; Froehmel, Annette; Ortwein, Heiderose

2008-12-01

Communication skills training is an accepted part of undergraduate medical programs nowadays. In addition to learning experiences its importance should be emphasised by performance-based assessment. As detailed checklists have been shown to be not well suited for the assessment of communication skills for different reasons, this study aimed to validate a global rating scale. A Canadian instrument was translated to German and adapted to assess students' communication skills during an end-of-semester-OSCE. Subjects were second and third year medical students at the reformed track of the Charité-Universitaetsmedizin Berlin. Different groups of raters were trained to assess students' communication skills using the global rating scale. Validity testing included concurrent validity and construct validity: Judgements of different groups of raters were compared to expert ratings as a defined gold standard. Furthermore, the amount of agreement between scores obtained with this global rating scale and a different instrument for assessing communication skills was determined. Results show that communication skills can be validly assessed by trained non-expert raters as well as standardised patients using this instrument.

A global probabilistic tsunami hazard assessment from earthquake sources

Science.gov (United States)

Davies, Gareth; Griffin, Jonathan; Lovholt, Finn; Glimsdal, Sylfest; Harbitz, Carl; Thio, Hong Kie; Lorito, Stefano; Basili, Roberto; Selva, Jacopo; Geist, Eric L.; Baptista, Maria Ana

2017-01-01

Large tsunamis occur infrequently but have the capacity to cause enormous numbers of casualties, damage to the built environment and critical infrastructure, and economic losses. A sound understanding of tsunami hazard is required to underpin management of these risks, and while tsunami hazard assessments are typically conducted at regional or local scales, globally consistent assessments are required to support international disaster risk reduction efforts, and can serve as a reference for local and regional studies. This study presents a global-scale probabilistic tsunami hazard assessment (PTHA), extending previous global-scale assessments based largely on scenario analysis. Only earthquake sources are considered, as they represent about 80% of the recorded damaging tsunami events. Globally extensive estimates of tsunami run-up height are derived at various exceedance rates, and the associated uncertainties are quantified. Epistemic uncertainties in the exceedance rates of large earthquakes often lead to large uncertainties in tsunami run-up. Deviations between modelled tsunami run-up and event observations are quantified, and found to be larger than suggested in previous studies. Accounting for these deviations in PTHA is important, as it leads to a pronounced increase in predicted tsunami run-up for a given exceedance rate.

An assessement of global energy resource economic potentials

International Nuclear Information System (INIS)

Mercure, Jean-François; Salas, Pablo

2012-01-01

This paper presents an assessment of global economic energy potentials for all major natural energy resources. This work is based on both an extensive literature review and calculations using natural resource assessment data. Economic potentials are presented in the form of cost-supply curves, in terms of energy flows for renewable energy sources, or fixed amounts for fossil and nuclear resources, with strong emphasis on uncertainty, using a consistent methodology that allow direct comparisons to be made. In order to interpolate through available resource assessment data and associated uncertainty, a theoretical framework and a computational methodology are given based on statistical properties of different types of resources, justified empirically by the data, and used throughout. This work aims to provide a global database for natural energy resources ready to integrate into models of energy systems, enabling to introduce at the same time uncertainty over natural resource assessments. The supplementary material provides theoretical details and tables of data and parameters that enable this extensive database to be adapted to a variety of energy systems modelling frameworks. -- Highlights: ► Global energy potentials for all major energy resources are reported. ► Theory and methodology for calculating economic energy potentials is given. ► An uncertainty analysis for all energy economic potentials is carried out.

Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

Science.gov (United States)

Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung; Kim, Soon-Kyung

2015-10-01

Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.

Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

Science.gov (United States)

Erdim, Aylin; Aktan, Ahmet Özdemir

2017-01-01

This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

Assessment of the Pre-operative Nutritional Status of Patients who were Scheduled for Elective Surgery and Determination of Nutritional Support Requirements

Directory of Open Access Journals (Sweden)

Bahri Özer

2016-12-01

Full Text Available Aim: We aimed to evaluate the nutritional status with clinical, antropometric and laboratory methods in patients who were scheduled for elective surgery. Methods: Retrospective evaluation of 90 patients in a period of 4 years was performed. Patients with tumors (group 1 were compared with controls (group 2 in regard to nutritional status. Student t-test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results: The mean age of patients in group 1 (3 males, 8 females and group 2 (35 males, 44 females was 62.8±11.0 and 47.7±16.2 years, respectively. The mean body mass index (BMI was 30.1±6.6. Triceps thickness and circumference of the upper mid-arm were 2.2±0.8 and 28.6±4.2 cm, respectively. All patients had a Subjective Global Assessment (SGA score A, but two patients were classified as having moderate nutritional risk according to Nutritional Risk Screening (NRS 2002. The mean length of hospital stay was 2.6±2.4 days. Complications were observed in four patients of group 2 and in two patients of group 1. Gender, SGA score, albumin, prealbumin, BMI, triceps thickness, circumference of the upper mid-arm and complication rates were statistically similar between the groups. There was a statistically significant difference in age, NRS 2002, gastrointestinal system findings, length of hospital stay, sedimentation and fasting blood glucose levels between the groups. Conclusion: Patients with nutritional risk can be detected using the NRS 2002. Nutritional support was necessary in 2% of all cases and in 18% of group 1 patients. However, advantages of antropometric measurements, biochemical tests, BMI and SGA could not be shown.

Is Nutrition Specific Quality of Life Associated With Nutritional Status?

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Feasel-Aklilu, Sarah; Marcus, Andrea; Parrott, J Scott; Peters, Emily; Byham-Gray, Laura

2018-04-06

The study purpose was to explore the relationship between nutritional status, as measured by Subjective Global Assessment (SGA), and Health Related Quality of Life measured using the Nutrition Specific Quality of Life (NS-QoL), tool among participants on maintenance hemodialysis (MHD). The study aim was to determine if NS-QoL may be an adjuvant tool for detecting changes in nutritional status among patients on MHD. This is a cross-sectional, secondary analysis of data from a multi-center study. Participants were adult (>18) men and women on MHD (n = 145) recruited from 3 institutions in the Northeastern United States. Statistical tests were conducted to determine the relationship between key demographic characteristics (age, sex, dialysis vintage, gender, and ethnicity) and SGA and NS-QoL. Spearman's correlation examined the relationship between the independent variable, SGA and the dependent variable, NS-QoL. A univariate general linear model was conducted to adjust for confounding variables. The relationship between overall SGA score and composite NS-QoL score. The sample consisted of 85 men (58.6%), with a mean age of 55.3 ± 11.9 years, who were largely African-American (84.1%) and non-Hispanic (77.2%). Mean SGA score was 5.5 ± 1.0, and the mean NS-QoL composite score was 9.51 ± 3.77. No key demographic characteristics had a statistically significant relationship with SGA, whereas sex (P nutritional status. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Focus: Assessing the regional impacts of global warming

International Nuclear Information System (INIS)

Woo, Mingko

1992-01-01

Five studies are presented which assess the impacts of global warming on physical, economic, and social systems in Canada. A study on the use of climatic change scenarios to estimate ecoclimatic impacts was carried out. These scenarios may include synthetic scenarios produced from historical data, global climate model (GCM) simulations, and hybrid scenarios. The advantages and drawbacks of various scenarios are discussed along with the criteria for selecting impact assessment models. An examination of water resources in the Great Lakes and the Saskatchewan River subbasin uses case studies of two areas that have experienced wide hydrological variations due to climatic variability in order to determine the impacts of global warming scenarios on net basin supply. Problems of developing regional models are discussed and results of projected changes in net basin supply are presented for GCM-based simulations and hypothetical warming scenarios. A study of the impacts of climate warming on transportation and the regional economy in northern Canada uses stochastic models to provide examples of how Mackenzie River barge traffic will be affected. The economic impacts of the resultant lengthened shipping season are outlined under three scenarios. The implications of climatic change on Ontario agriculture are assessed according to GCM scenarios. Results are presented for crop yields and production as well as land resource suitability. Finally, sociocultural implications of global warming on the Arctic and the Inuit are summarized, with reference to a past warming episode occurring around the year 1000. 45 refs., 4 figs., 3 tabs

Nutritional status of Vietnamese outpatients with chronic obstructive pulmonary disease.

Science.gov (United States)

Hogan, D; Lan, L T T; Diep, D T N; Gallegos, D; Collins, P F

2017-02-01

Nutritional screening and assessment is not currently part of routine clinical practice in Vietnam. Therefore, the present study aimed to investigate the utility of the commonly used methods for identifying malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). A cross-sectional pilot study and a larger retrospective study were carried out in outpatients with COPD who were attending a respiratory clinic in Ho Chi Minh City, Vietnam. Routine clinical data were collected [body mass index (BMI), forced expiratory volume in 1 s (FEV 1 )]. Nutritional screening and assessment were performed using the Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) as the gold standard to diagnose malnutrition. In total, 393 outpatients had documented BMI and 29 were prospectively assessed using SGA: males, n = 25; females, n = 4; mean (SD) age 69.7 (9.6) years; mean (SD) BMI 21.0 (3.4) kg m -2 ; mean (SD) FEV 1 percentage predicted 57.0% (19.7%). Malnutrition risk was identified in 20.7% (n = 6) of patients using the MST (38% sensitivity; 94% specificity). However, 45% (n = 13) were diagnosed as malnourished using the SGA (31% mild/moderate; 14% severe). All malnourished patients not identified by the MST had evidence of muscle wasting. BMI had a strong negative correlation with muscle wasting as assessed using the SGA (r = -0.857, n = 28; P Vietnamese outpatients with COPD. A BMI threshold of <21 kg m -2 appears to represent a useful and pragmatic cut-off point for identifying outpatients requiring comprehensive nutritional assessment and support. © 2016 The British Dietetic Association Ltd.

International Global Crop Condition Assessments in the framework of GEOGLAM

Science.gov (United States)

Becker-Reshef, I.; Justice, C. O.; Vermote, E.; Whitcraft, A. K.; Claverie, M.

2013-12-01

The Group on Earth Observations (partnership of governments and international organizations) developed the Global Agricultural Monitoring (GEOGLAM) initiative in response to the growing calls for improved agricultural information. The goal of GEOGLAM is to strengthen the international community's capacity to produce and disseminate relevant, timely and accurate forecasts of agricultural production at national, regional and global scales through the use of Earth observations. This initiative is designed to build on existing agricultural monitoring initiatives at national, regional and global levels and to enhance and strengthen them through international networking, operationally focused research, and data/method sharing. GEOGLAM was adopted by the G20 as part of the action plan on food price volatility and agriculture and is being implemented through building on the extensive GEO Agricultural Community of Practice (CoP) that was initiated in 2007 and includes key national and international agencies, organizations, and universities involved in agricultural monitoring. One of the early GEOGLAM activities is to provide harmonized global crop outlooks that offer timely qualitative consensus information on crop status and prospects. This activity is being developed in response to a request from the G-20 Agricultural Market Information System (AMIS) and is implemented within the global monitoring systems component of GEOGLAM. The goal is to develop a transparent, international, multi-source, consensus assessment of crop growing conditions, status, and agro-climatic conditions, likely to impact global production. These assessments are focused on the four primary crop types (corn, wheat, soy and rice) within the main agricultural producing regions of the world. The GEOGLAM approach is to bring together international experts from global, regional and national monitoring systems that can share and discuss information from a variety of independent complementary sources in

Personality Assessment of Global Talent: Conceptual and Methodological Issues

Science.gov (United States)

van de Vijver, Fons J. R.

2008-01-01

The recruitment of managers who will operate in a culturally heterogeneous context (as expatriate managers, managers in a global company, or managers of a multicultural workforce) is increasingly important in an age of globalization. This article describes conceptual and methodological issues in the assessment of such managers, notably in the…

Accuracy and Utility of Estimating Lean Body Mass and Nutritional Status in Patients with Chronic Kidney Disease on Long-Term Hemodialysis Using Anthropometric Skinfold Thickness Measurements.

Science.gov (United States)

Leong, Khai Gene; Chee, Jia Lian; Karahalios, Amalia; Skelley, Annabelle; Wong, Kim

2018-01-01

Malnutrition is common in patients on hemodialysis (prevalence of 30% to 50%) and is associated with higher mortality. Lean body mass (LBM) assessment is an accurate way of assessing nutritional status. The dual-energy X-ray absorptiometry (DEXA) scan is a reliable method in assessing body compositions and LBM; however, it is expensive and largely inaccessible. Anthropometric skinfold thickness measurement (ASFM) is useful in assessing LBM. It is cheaper and accessible, but underutilized clinically. The subjective global score (SGA) is a well-established method of assessing nutritional status. All three methods of assessing nutritional status were compared. In this pilot observational study, there was a significant correlation between LBM% estimated by DEXA and ASFM (mean difference -1.46% [95% CI -4.09 to 1.18]; LOA -14.0 to 11.1). Nutritional status by SGA could only detect those severely malnourished when using LBM% by ASFM as comparison. Our study demonstrated that ASFM is a useful method of assessing LBM and nutritional status, which can be easily utilized clinically. Copyright© by the American Nephrology Nurses Association.

Global mineral resource assessment: porphyry copper assessment of Mexico: Chapter A in Global mineral resource assessment

Science.gov (United States)

Hammarstrom, Jane M.; Robinson, Gilpin R.; Ludington, Steve; Gray, Floyd; Drenth, Benjamin J.; Cendejas-Cruz, Francisco; Espinosa, Enrique; Pérez-Segura, Efrén; Valencia-Moreno, Martín; Rodríguez-Castañeda, José Luis; Vásquez-Mendoza, Rigobert; Zürcher, Lukas

2010-01-01

Mineral resource assessments provide a synthesis of available information about distributions of mineral deposits in the Earth’s crust. A probabilistic mineral resource assessment of undiscovered resources in porphyry copper deposits in Mexico was done as part of a global mineral resource assessment. The purpose of the study was to (1) delineate permissive areas (tracts) for undiscovered porphyry copper deposits within 1 km of the surface at a scale of 1:1,000,000; (2) provide a database of known porphyry copper deposits and significant prospects; (3) estimate numbers of undiscovered deposits within those permissive tracts; and (4) provide probabilistic estimates of amounts of copper (Cu), molybdenum (Mo), gold (Au), and silver (Ag) that could be contained in undiscovered deposits for each permissive tract. The assessment was conducted using a three-part form of mineral resource assessment based on mineral deposit models (Singer, 1993). Delineation of permissive tracts primarily was based on distributions of mapped igneous rocks related to magmatic arcs that formed in tectonic settings associated with subduction boundary zones. Using a GIS, map units were selected from digital geologic maps based on lithology and age to delineate twelve permissive tracts associated with Jurassic, Laramide (~90 to 34 Ma), and younger Tertiary magmatic arcs. Stream-sediment geochemistry, mapped alteration, regional aeromagnetic data, and exploration history were considered in conjunction with descriptive deposit models and grade and tonnage models to guide estimates.

Assessment of Global Wind Energy Resource Utilization Potential

Science.gov (United States)

Ma, M.; He, B.; Guan, Y.; Zhang, H.; Song, S.

2017-09-01

Development of wind energy resource (WER) is a key to deal with climate change and energy structure adjustment. A crucial issue is to obtain the distribution and variability of WER, and mine the suitable location to exploit it. In this paper, a multicriteria evaluation (MCE) model is constructed by integrating resource richness and stability, utilization value and trend of resource, natural environment with weights. The global resource richness is assessed through wind power density (WPD) and multi-level wind speed. The utilizable value of resource is assessed by the frequency of effective wind. The resource stability is assessed by the coefficient of variation of WPD and the frequency of prevailing wind direction. Regression slope of long time series WPD is used to assess the trend of WER. All of the resource evaluation indicators are derived from the atmospheric reanalysis data ERA-Interim with spatial resolution 0.125°. The natural environment factors mainly refer to slope and land-use suitability, which are derived from multi-resolution terrain elevation data 2010 (GMTED 2010) and GlobalCover2009. Besides, the global WER utilization potential map is produced, which shows most high potential regions are located in north of Africa. Additionally, by verifying that 22.22 % and 48.8 9% operational wind farms fall on medium-high and high potential regions respectively, the result can provide a basis for the macroscopic siting of wind farm.

Influencia del método de evaluación de la prevalencia de la desnutrición hospitalaria : una comparación entre dos períodos

OpenAIRE

Beghetto, Mariur Gomes; Koglin, Gabriela; Mello, Elza Daniel de

2010-01-01

There is no consensus on the best method to assess the nutritional status of hospitalized adults although many methods are available. This study evaluated the prevalence of malnutrition in adults at different times of hospitalization (admission, 7th, 14th, 21st, and 28th days) in two years (2002 and 2006). All patients were submitted to anthropometric assessment, Subjective Global Assessment (SGA), determination of serum albumin, and lymphocyte count. There were no differences in prevalence o...

Intimate Partner Violence, Small for Gestational Age Birth and Cigarette Smoking in the Pregnancy Risk Assessment Monitoring System.

Science.gov (United States)

Alhusen, Jeanne L; Geller, Ruth; Jellig, Jerry; Budhathoki, Chakra; Decker, Michele

2018-04-01

Exposure to intimate partner violence (IPV) in the perinatal period is associated with obstetric complications, poor maternal mental health, neonatal complications, and increased risk of infant mortality and morbidity. Less is known about how IPV may influence small for gestational age (SGA) birth. Data were obtained for 231,081 United States mothers who delivered neonates from 2004 to 2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2-9 months after delivery. Weighted descriptive statistics and multivariate logistic regression models were used. IPV in the year before or during pregnancy was related to SGA bivariately (odds ratio 1.39, 95% confidence interval [CI] 1.28, 1.51), and after adjustment for demographic and obstetric factors, this association attenuated after further adjustment for perinatal smoking patterns, (adjusted odds ratio [aOR] 1.06, 95% CI 0.97, 1.15). Compared with nonabused women, women experiencing perinatal IPV were more than twice as likely to smoke before pregnancy (aOR 2.34, 95% CI 2.19, 2.49), and nearly 1.5 times as likely to report sustained smoking into the last 3 months of pregnancy (aOR 1.45, 95% CI 1.32, 1.59). In turn, among prepregnancy smokers, sustained smoking was associated with delivery of a SGA neonate (aOR 1.87, 95% CI 1.72, 2.03), fully attenuating the association of perinatal IPV with SGA. Women who experienced perinatal IPV were significantly more likely to smoke prepregnancy and sustain smoking into the last 3 months of pregnancy. Through behavioral and physiological pathways, smoking cessation may be uniquely challenging for women experiencing IPV, yet critical to address clinically to mitigate risk for SGA.

Global Energy Assessment. Toward a Sustainable Future

Energy Technology Data Exchange (ETDEWEB)

Johansson, T B; Nakicenovic, N; Patwardhan, A; Gomez-Echeverri, L [eds.

2012-11-01

The Global Energy Assessment (GEA) brings together over 300 international researchers to provide an independent, scientifically based, integrated and policy-relevant analysis of current and emerging energy issues and options. It has been peer-reviewed anonymously by an additional 200 international experts. The GEA assesses the major global challenges for sustainable development and their linkages to energy; the technologies and resources available for providing energy services; future energy systems that address the major challenges; and the policies and other measures that are needed to realize transformational change toward sustainable energy futures. The GEA goes beyond existing studies on energy issues by presenting a comprehensive and integrated analysis of energy challenges, opportunities and strategies, for developing, industrialized and emerging economies. This volume is an invaluable resource for energy specialists and technologists in all sectors (academia, industry and government) as well as policymakers, development economists and practitioners in international organizations and national governments.

The process of developing policy based on global environmental risk assessment

International Nuclear Information System (INIS)

Fisk, D.J.

1995-01-01

A brief presentation is given on developing policy based on a global environmental risk assessment. The author looks at the global warming issue as if it were a formal problem in risk assessment. He uses that framework to make one or two suggestions as to how the interaction of policy and research might evolve as the climate convention progresses

Global assessment of human losses due to earthquakes

Science.gov (United States)

Silva, Vitor; Jaiswal, Kishor; Weatherill, Graeme; Crowley, Helen

2014-01-01

Current studies have demonstrated a sharp increase in human losses due to earthquakes. These alarming levels of casualties suggest the need for large-scale investment in seismic risk mitigation, which, in turn, requires an adequate understanding of the extent of the losses, and location of the most affected regions. Recent developments in global and uniform datasets such as instrumental and historical earthquake catalogues, population spatial distribution and country-based vulnerability functions, have opened an unprecedented possibility for a reliable assessment of earthquake consequences at a global scale. In this study, a uniform probabilistic seismic hazard assessment (PSHA) model was employed to derive a set of global seismic hazard curves, using the open-source software OpenQuake for seismic hazard and risk analysis. These results were combined with a collection of empirical fatality vulnerability functions and a population dataset to calculate average annual human losses at the country level. The results from this study highlight the regions/countries in the world with a higher seismic risk, and thus where risk reduction measures should be prioritized.

Accountability for Early Childhood Education (Assessing Global Functioning).

Science.gov (United States)

Cassel, Russell N.

1995-01-01

Discusses the pacing of learning activity, knowledge of progress in student learning, teacher role, accountability in learning, feedback on knowledge of success, the global functioning assessment concept, and the mother surrogate. (RS)

Integrated assessment of the global warming problem. A decision-analytical approach

International Nuclear Information System (INIS)

Van Lenthe, J.; Hendrickx, L.; Vlek, C.A.J.

1995-01-01

The project on the title subject aims at developing a policy-oriented methodology for the integrated assessment of the global warming problem. Decision analysis in general and influence diagrams in particular appear to constitute an appropriate integrated assessment methodology. The influence-diagram approach is illustrated at a preliminary integrated modeling of the global warming problem. In next stages of the research, attention will be shifted from the methodology of integrated assessment to the contents of integrated models. 4 figs., 5 refs

Seismic and wind vulnerability assessment for the GAR-13 global risk assessment

OpenAIRE

Yamín Lacouture, Luis Eduardo; Hurtado Chaparro, Alvaro Ivan; Barbat Barbat, Horia Alejandro; Cardona Arboleda, Omar Dario

2014-01-01

A general methodology to evaluate vulnerability functions suitable for a probabilistic global risk assessment is proposed. The methodology is partially based in the methodological approach of the Multi-hazard Loss Estimation Methodology (Hazus) developed by the Federal Emergency Management Agency (FEMA). The vulnerability assessment process considers the resolution, information and limitations established for both the hazard and exposure models adopted. Seismic and wind vulnerability function...

High-resolution assessment of global technical and economic hydropower potential

NARCIS (Netherlands)

Gernaat, David E.H.J.; Bogaart, Patrick W.; Vuuren, van Detlef P.; Biemans, Hester; Niessink, Robin

2017-01-01

Hydropower is the most important renewable energy source to date, providing over 72% of all renewable electricity globally. Yet, only limited information is available on the global potential supply of hydropower and the associated costs. Here we provide a high-resolution assessment of the technical

Assessing global resource utilization efficiency in the industrial sector

International Nuclear Information System (INIS)

Rosen, Marc A.

2013-01-01

Designing efficient energy systems, which also meet economic, environmental and other objectives and constraints, is a significant challenge. In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement. Energy analysis alone is inadequate, e.g., it yields energy efficiencies that do not provide limits to efficiency. To obtain meaningful and useful efficiencies for energy systems, and to clarify losses, exergy analysis is a beneficial and useful tool. Here, the global industrial sector and industries within it are assessed by using energy and exergy methods. The objective is to improve the understanding of the efficiency of global resource use in the industrial sector and, with this information, to facilitate the development, prioritization and ultimate implementation of rational improvement options. Global energy and exergy flow diagrams for the industrial sector are developed and overall efficiencies for the global industrial sector evaluated as 51% based on energy and 30% based on exergy. Consequently, exergy analysis indicates a less efficient picture of energy use in the global industrial sector than does energy analysis. A larger margin for improvement exists from an exergy perspective, compared to the overly optimistic margin indicated by energy. - Highlights: ► The global industrial sector and its industries are assessed by using energy and exergy methods. ► Global industrial sector efficiencies are evaluated as 51% based on energy and 30% based on exergy. ► Exergy analysis shows global industrial energy to be less efficient than does energy analysis. ► A misleadingly low margin for efficiency improvement is indicated by energy analysis. ► A significant and rational margin for efficiency improvement exists from an exergy perspective

Global warming and the challenge of international cooperation: an interdisciplinary assessment

International Nuclear Information System (INIS)

Bryner, G.C.

1992-01-01

The book aims to explore the nature of potential climatic change. It seeks to assess the scientific, economic legal and political issues related to the threat of global warming from an interdisciplinary perspective. The seven chapters have the following titles: the challenge of global warming; global warming and ozone depletion - certainties and uncertainties; consequences of global climate change for Earth's biosphere; global energy use and global warming; problems and prospects of institutionalizing ecological interdependence in a world of local independence; political institutions and climate change; and policy options for responding to the threat of global warming. Six chapters are abstracted separately. 158 refs

A neonatal piglet model for investigating brain and cognitive development in small for gestational age human infants.

Directory of Open Access Journals (Sweden)

Emily C Radlowski

Full Text Available The piglet was investigated as a potential model for studying brain and cognitive deficits associated with being born small for gestational age (SGA. Naturally farrowed SGA (0.7-1.0 kg BW and average for gestational age (AGA, 1.3-1.6 kg BW piglets were obtained on postnatal day (PD 2, placed in individual cages, and provided a nutritionally adequate milk replacer diet (285 ml/kg/d. Beginning at PD14, performance in a spatial T-maze task was assessed. At PD28, piglets were anesthetized for magnetic resonance (MR imaging to assess brain structure (voxel-based morphometry, connectivity (diffusion-tensor imaging and metabolites in the hippocampus and corpus callosum (proton MR spectroscopy. Piglets born SGA showed compensatory growth such that BW of SGA and AGA piglets was similar (P>0.05, by PD15. Birth weight affected maze performance, with SGA piglets taking longer to reach criterion than AGA piglets (p<0.01. Total brain volume of SGA and AGA piglets was similar (P<0.05, but overall, SGA piglets had less gray matter than AGA piglets (p<0.01 and tended to have a smaller internal capsule (p = 0.07. Group comparisons between SGA and AGA piglets defined 9 areas (≥ 20 clusters where SGA piglets had less white matter (p<0.01; 2 areas where SGA piglets had more white matter (p<0.01; and 3 areas where SGA piglets had more gray matter (p<0.01. The impact of being born SGA on white matter was supported by a lower (p<0.04 fractional anisotropy value for SGA piglets, suggesting reduced white matter development and connectivity. None of the metabolites measured were different between groups. Collectively, the results show that SGA piglets have spatial learning deficits and abnormal development of white matter. As learning deficits and abnormalities in white matter are common in SGA human infants, the piglet is a tractable translational model that can be used to investigate SGA-associated cognitive deficits and potential interventions.

Beyond offshoring: assess your company's global potential.

Science.gov (United States)

Farrell, Diana

2004-12-01

In the past few years, companies have become aware that they can slash costs by offshoring: moving jobs to lower-wage locations. But this practice is just the tip of the iceberg in terms of how globalization can transform industries, according to research by the McKinsey Global Institute (MGI). The institute's yearlong study suggests that by streamlining their production processes and supply chains globally, rather than just nationally or regionally, companies can lower their costs-as we've seen in the consumer-electronics and PC industries. Companies can save as much as 70% of their total costs through globalization--50% from offshoring, 5% from training and business-task redesign, and 15% from process improvements. But they don't have to stop there. The cost reductions make it possible to lower prices and expand into new markets, attracting whole new classes of customers. To date, however, few businesses have recognized the full scope of performance improvements that globalization makes possible, much less developed sound strategies for capturing those opportunities. In this article, Diana Farrell, director of MGI, offers a step-by-step approach to doing both things. Among her suggestions: Assess where your industry falls along the globalization spectrum, because not all sectors of the economy face the same challenges and opportunities at the same time. Also, pay attention to production, regulatory, and organizational barriers to globalization. If any of these can be changed, size up the cost-saving (and revenue-generating) opportunities that will emerge for your company as a result of those changes. Farrell also defines the five stages of globalization-market entry, product specialization, value chain disaggregation, value chain reengineering, and the creation of new markets-and notes the different levers for cutting costs and creating value that companies can use in each phase.

ASSESSMENT OF THE BUSINESS ENVIRONMENT FOR DEVELOPMENT OF GLOBAL MARKETING STRATEGY

Directory of Open Access Journals (Sweden)

V. Savelyev

2014-03-01

Full Text Available The article concerns with essence of assessment of the business environment and specific directions of analysis during the working out of global marketing strategy. The classification of the global marketing environment researches and tasks sequence in the context of the decisions made on each stage of global marketing strategy is proposed.

Integrated assessment of the global warming problem: A decision-analytical approach

International Nuclear Information System (INIS)

Van Lenthe, J.; Hendrickx, L.; Vlek, C.A.J.

1994-12-01

The multi-disciplinary character of the global warming problem asks for an integrated assessment approach for ordering and combining the various physical, ecological, economical, and sociological results. The Netherlands initiated their own National Research Program (NRP) on Global Air Pollution and Climate Change (NRP). The first phase (NRP-1) identified the integration theme as one of five central research themes. The second phase (NRP-2) shows a growing concern for integrated assessment issues. The current two-year research project 'Characterizing the risks: a comparative analysis of the risks of global warming and of relevant policy options, which started in September 1993, comes under the integrated assessment part of the Dutch NRP. The first part of the interim report describes the search for an integrated assessment methodology. It starts with emphasizing the need for integrated assessment at a relatively high level of aggregation and from a policy point of view. The conclusion will be that a decision-analytical approach might fit the purpose of a policy-oriented integrated modeling of the global warming problem. The discussion proceeds with an account on decision analysis and its explicit incorporation and analysis of uncertainty. Then influence diagrams, a relatively recent development in decision analysis, are introduced as a useful decision-analytical approach for integrated assessment. Finally, a software environment for creating and analyzing complex influence diagram models is discussed. The second part of the interim report provides a first, provisional integrated modeling of the global warming problem, emphasizing on the illustration of the decision-analytical approach. Major problem elements are identified and an initial problem structure is developed. The problem structure is described in terms of hierarchical influence diagrams. At some places the qualitative structure is filled with quantitative data

The New European Society for Clinical Nutrition and Metabolism Definition of Malnutrition: Application for Nutrition Assessment and Prediction of Morbimortality in an Emergency Service.

Science.gov (United States)

Fink, Jaqueline da Silva; Marcadenti, Aline; Rabito, Estela Iraci; Silva, Flávia Moraes

2017-03-01

Recently, the European Society for Clinical Nutrition and Metabolism (ESPEN) provided novel consensus criteria for malnutrition diagnosis. This study aimed to evaluate the applicability of this instrument in combination with different nutrition screening tools (1) to identify malnutrition and (2) to predict morbidity and mortality in hospitalized patients. Observational prospective study in 750 adults admitted to the emergency service of a tertiary public hospital. Subjective Global Assessment (SGA-reference method) and the new ESPEN criteria were used to assess nutrition status of patients, who were initially screened for nutrition risk using 4 different tools. Outcome measures included length of hospital stay, occurrence of infection, and incidence of death during hospitalization, analyzed by logistic regression. There was a lack of agreement between the SGA and ESPEN definition of malnutrition, regardless of the nutrition screening tool applied previously (κ = -0.050 to 0.09). However, when Malnutrition Screening Tool and Nutritional Risk Screening-2002 (NRS-2002) were used as the screening tool, malnourished patients according to ESPEN criteria showed higher probability of infection (relative risk [RR], 1.54; 95% confidence interval [CI], 1.02-2.31 and RR, 2.06; 95% CI, 1.37-3.10, respectively), and when the NRS-2002 was used, the risk for death was 2.7 times higher (hazard ratio, 2.69; 95% CI, 1.07-6.81) in malnourished patients than in well-nourished patients. Although the new ESPEN criteria had a poor diagnostic value, it seems to be a prognostic tool among hospitalized patients, especially when used in combination with the NRS-2002.

Developing an International Assessment of Global Competence

Science.gov (United States)

Piacentini, Mario

2017-01-01

In 2014, an international, interdisciplinary group of experts came together under the auspices of the PISA Governing Board to consider a novel question: can an international assessment evaluate, the global competence of 15-year-old students? The experts recognized the need for data to understand how well students are prepared for life in…

Balancing Attended and Global Stimuli in Perceived Video Quality Assessment

DEFF Research Database (Denmark)

You, Junyong; Korhonen, Jari; Perkis, Andrew

2011-01-01

. This paper proposes a quality model based on the late attention selection theory, assuming that the video quality is perceived via two mechanisms: global and local quality assessment. First we model several visual features influencing the visual attention in quality assessment scenarios to derive......The visual attention mechanism plays a key role in the human perception system and it has a significant impact on our assessment of perceived video quality. In spite of receiving less attention from the viewers, unattended stimuli can still contribute to the understanding of the visual content...... an attention map using appropriate fusion techniques. The global quality assessment as based on the assumption that viewers allocate their attention equally to the entire visual scene, is modeled by four carefully designed quality features. By employing these same quality features, the local quality model...

Tropospheric Ozone Assessment Report: Assessment of global-scale model performance for global and regional ozone distributions, variability, and trends

Directory of Open Access Journals (Sweden)

P. J. Young

2018-01-01

Full Text Available The goal of the Tropospheric Ozone Assessment Report (TOAR is to provide the research community with an up-to-date scientific assessment of tropospheric ozone, from the surface to the tropopause. While a suite of observations provides significant information on the spatial and temporal distribution of tropospheric ozone, observational gaps make it necessary to use global atmospheric chemistry models to synthesize our understanding of the processes and variables that control tropospheric ozone abundance and its variability. Models facilitate the interpretation of the observations and allow us to make projections of future tropospheric ozone and trace gas distributions for different anthropogenic or natural perturbations. This paper assesses the skill of current-generation global atmospheric chemistry models in simulating the observed present-day tropospheric ozone distribution, variability, and trends. Drawing upon the results of recent international multi-model intercomparisons and using a range of model evaluation techniques, we demonstrate that global chemistry models are broadly skillful in capturing the spatio-temporal variations of tropospheric ozone over the seasonal cycle, for extreme pollution episodes, and changes over interannual to decadal periods. However, models are consistently biased high in the northern hemisphere and biased low in the southern hemisphere, throughout the depth of the troposphere, and are unable to replicate particular metrics that define the longer term trends in tropospheric ozone as derived from some background sites. When the models compare unfavorably against observations, we discuss the potential causes of model biases and propose directions for future developments, including improved evaluations that may be able to better diagnose the root cause of the model-observation disparity. Overall, model results should be approached critically, including determining whether the model performance is acceptable for

Prevalence and prognostic significance of malnutrition in chronic renal insufficiency.

Science.gov (United States)

Lawson, J A; Lazarus, R; Kelly, J J

2001-01-01

Malnutrition is present in a significant proportion of patients commencing dialysis. However, the prevalence and prognostic significance of malnutrition within the chronic renal insufficiency (CRI) population before the initiation of dialysis is poorly characterized. The aim of this study was to determine the prevalence and prognostic significance of malnutrition in an unselected group of patients with CRI. Cohort analytic study. Ambulatory care practice of a university teaching hospital. Fifty patients with CRI (serum creatinine concentration > or = 1.7 mg/dL) were enrolled. Patients with a recent acute illness, nephrotic syndrome, intercurrent steroid therapy, gastrointestinal disease, or other severe organ failure that may have independently influenced nutritional status were excluded. At baseline, patients had a nutritional assessment consisting of subjective global assessment (SGA), measurement of body mass index (BMI), midarm circumference (MAC), serum albumin concentration, total lymphocyte count, and single frequency bioelectrical impedance analysis. Patients received standard medical care and were followed prospectively at quarterly intervals for 12 months. At baseline assessment, 28% of patients had evidence of malnutrition by SGA criteria. The malnourished group of patients had a significantly lower creatinine clearance (18.9 +/- 9.8 v 36.5 +/- 14.0 mL/min/1.73 m(2), mean +/- SD, P renal failure. These data suggest that SGA provides a useful means of assessing nutritional status and is helpful in identifying patients with increased risk of morbidity and mortality in the setting of CRI.

Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review [Formula: see text].

Science.gov (United States)

Lew, Charles Chin Han; Yandell, Rosalie; Fraser, Robert J L; Chua, Ai Ping; Chong, Mary Foong Fong; Miller, Michelle

2017-07-01

Malnutrition is associated with poor clinical outcomes among hospitalized patients. However, studies linking malnutrition with poor clinical outcomes in the intensive care unit (ICU) often have conflicting findings due in part to the inappropriate diagnosis of malnutrition. We primarily aimed to determine whether malnutrition diagnosed by validated nutrition assessment tools such as the Subjective Global Assessment (SGA) or Mini Nutritional Assessment (MNA) is independently associated with poorer clinical outcomes in the ICU and if the use of nutrition screening tools demonstrate a similar association. PubMed, CINAHL, Scopus, and Cochrane Library were systematically searched for eligible studies. Search terms included were synonyms of malnutrition, nutritional status, screening, assessment, and intensive care unit. Eligible studies were case-control or cohort studies that recruited adults in the ICU; conducted the SGA, MNA, or used nutrition screening tools before or within 48 hours of ICU admission; and reported the prevalence of malnutrition and relevant clinical outcomes including mortality, length of stay (LOS), and incidence of infection (IOI). Twenty of 1168 studies were eligible. The prevalence of malnutrition ranged from 38% to 78%. Malnutrition diagnosed by nutrition assessments was independently associated with increased ICU LOS, ICU readmission, IOI, and the risk of hospital mortality. The SGA clearly had better predictive validity than the MNA. The association between malnutrition risk determined by nutrition screening was less consistent. Malnutrition is independently associated with poorer clinical outcomes in the ICU. Compared with nutrition assessment tools, the predictive validity of nutrition screening tools were less consistent.

Validation of a global assessment of arthroscopic skills in a cadaveric knee model.

Science.gov (United States)

Slade Shantz, Jesse A; Leiter, Jeff R; Collins, John B; MacDonald, Peter B

2013-01-01

The purpose of this study was to determine whether a global assessment of arthroscopic skills was valid for blinded assessment of cadaveric diagnostic knee arthroscopy. A global skills assessment for arthroscopy was created using a published theory of the development of expertise. Faculty surgeons, fellows, and residents were consented and enrolled in this institutional review board-approved validation study. All participants were oriented to the equipment and procedures for diagnostic arthroscopy of the knee. After reviewing the anatomic structures to be visualized, participants were allowed 10 minutes to complete a diagnostic arthroscopy of the knee. The hands and arthroscopic view were recorded during this attempt. Resident participants completed a second filmed diagnostic arthroscopy 1 week after the initial attempt. Five blinded reviewers watched the synchronized videos and assessed arthroscopic skills with a procedure-specific checklist and the newly developed global skills assessment. The agreement between reviewers was determined by intraclass correlation coefficient. Internal consistency was determined with Cronbach's α. Test-retest reliability was measured by correlating repeated arthroscopies by residents. The ability of the global assessment to discriminate skill levels was determined with between-group Mann-Whitney U tests. The agreement between global assessment scores was strong (I.C.C. = 0.80, 95% C.I. 0.68-0.92). The internal consistency of evaluations was excellent (Cronbach's α = 0.97), and the test-retest reliability was strong (r = 0.52). The global assessment score was shown to be able to discriminate between skill levels by an analysis of variance indicating the difference in means among the various levels of training (P Assessment of Arthroscopic Skills is a useful adjunct to arthroscopic educators and learners and could be used for in-training evaluations. The Objective Assessment of Arthroscopic Skills is an instrument that can be

Global Assessment of Bisphenol A in the Environment

Directory of Open Access Journals (Sweden)

Jone Corrales

2015-07-01

Full Text Available Because bisphenol A (BPA is a high production volume chemical, we examined over 500 peer-reviewed studies to understand its global distribution in effluent discharges, surface waters, sewage sludge, biosolids, sediments, soils, air, wildlife, and humans. Bisphenol A was largely reported from urban ecosystems in Asia, Europe, and North America; unfortunately, information was lacking from large geographic areas, megacities, and developing countries. When sufficient data were available, probabilistic hazard assessments were performed to understand global environmental quality concerns. Exceedances of Canadian Predicted No Effect Concentrations for aquatic life were >50% for effluents in Asia, Europe, and North America but as high as 80% for surface water reports from Asia. Similarly, maximum concentrations of BPA in sediments from Asia were higher than Europe. Concentrations of BPA in wildlife, mostly for fish, ranged from 0.2 to 13 000 ng/g. We observed 60% and 40% exceedences of median levels by the US Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey in Europe and Asia, respectively. These findings highlight the utility of coordinating global sensing of environmental contaminants efforts through integration of environmental monitoring and specimen banking to identify regions for implementation of more robust environmental assessment and management programs.

Assessing tourism's global environmental impact 1900–2050

NARCIS (Netherlands)

Gössling, Stefan; Peeters, Paul

2015-01-01

This paper pioneers the assessment of tourism's total global resource use, including its fossil fuel consumption, associated CO₂ emissions, fresh water, land, and food use. As tourism is a dynamic growth system, characterized by rapidly increasing tourist numbers, understanding its

Global Water Scarcity Assessment under Post-SRES Scenarios

Science.gov (United States)

Hanasaki, N.; Fujimori, S.

2011-12-01

A large number of future projections contributed to the fourth Assessment Report of IPCC were based on Special Report on Emission Scenarios (SRES). Processes toward the fifth Assessment Report are under way, and post-SRES scenarios, called Shared Socio-economic Pathways (SSP) are being prepared. One of the key challenges of SSP is provision of detailed socio-economic scenarios compared to SRES for impact, adaptation and vulnerability studies. In this study, a comprehensive global water scarcity assessment was conducted, using a state of the art global water resources model H08 (Hanasaki et al., 2008a, 2008b, 2010). We used a prototype of SSP developed by National Institute for Environmental Studies, Japan. Two sets of socio economic scenarios and two sets of climate scenarios were prepared to run H08 for the period 2001-2100. Socio-economic scenarios include Business As Usual and High Mitigation Capacity. Climate scenarios include Reference and Mitigation which stabilizes green house gas concentration at a certain level. We analyzed the simulation results of four combinations, particularly focusing on the sensitivity of socio-economic scenarios to major water resources indices.

An integrated model for the assessment of global water resources – Part 2: Applications and assessments

Directory of Open Access Journals (Sweden)

N. Hanasaki

2008-07-01

Full Text Available To assess global water resources from the perspective of subannual variation in water availability and water use, an integrated water resources model was developed. In a companion report, we presented the global meteorological forcing input used to drive the model and six modules, namely, the land surface hydrology module, the river routing module, the crop growth module, the reservoir operation module, the environmental flow requirement module, and the anthropogenic withdrawal module. Here, we present the results of the model application and global water resources assessments. First, the timing and volume of simulated agriculture water use were examined because agricultural use composes approximately 85% of total consumptive water withdrawal in the world. The estimated crop calendar showed good agreement with earlier reports for wheat, maize, and rice in major countries of production. In major countries, the error in the planting date was ±1 mo, but there were some exceptional cases. The estimated irrigation water withdrawal also showed fair agreement with country statistics, but tended to be underestimated in countries in the Asian monsoon region. The results indicate the validity of the model and the input meteorological forcing because site-specific parameter tuning was not used in the series of simulations. Finally, global water resources were assessed on a subannual basis using a newly devised index. This index located water-stressed regions that were undetected in earlier studies. These regions, which are indicated by a gap in the subannual distribution of water availability and water use, include the Sahel, the Asian monsoon region, and southern Africa. The simulation results show that the reservoir operations of major reservoirs (>1 km³ and the allocation of environmental flow requirements can alter the population under high water stress by approximately −11% to +5% globally. The integrated model is applicable to

Use of Subjective Global Assessment, Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 to evaluate the nutritional status of non-critically ill patients on parenteral nutrition.

Science.gov (United States)

Badia-Tahull, M B; Cobo-Sacristán, S; Leiva-Badosa, E; Miquel-Zurita, M E; Méndez-Cabalerio, N; Jódar-Masanés, R; Llop-Talaverón, J

2014-02-01

To evaluate the nutritional status of non-critically ill digestive surgery patients at the moment of parenteral nutrition initiation using three different nutritional test tools and to study their correlation. To study the association between the tests and the clinical and laboratory parameters used in the follow-up of PN treatment. Prospective study over 4 months. Anthropometric and clinical variables were recorded. Results of Subjective Global Assessment; Patient-Generated Subjective Global Assessment; and Nutritional Risk Screening 2002 were compared applying kappa test. Relationship between the clinical and laboratory parameters with Subjective Global Assessment was studied by multinominal regression and with the other two tests by multiple linear regression models. Age and sex were included as adjustment variables. Malnutrition in 45 studied patients varied from 51% to 57%. Subjective Global Assessment correlated well with Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 (κ = 0531 p = 0.000). The test with the greatest correlation with the clinical and analytical variables was the Nutritional Risk Screening 2002. Worse nutritional state in this test was associated with worse results in albumin (B = -0.087; CI = -0.169/-0.005], prealbumin (B = -0.005; CI = [-0.011/-0.001]), C-reactive protein (B = 0.006;CI = [0.001/ 0.011]) and leukocytes (B = 0.134; CI = [0.031/0.237]) at the en of parenteral nutrition treatment. Half of the digestive surgery patients were at malnutritional risk at the moment of initiating parenteral nutrition. Nutritional Risk Screening 2002 was the test with best association with the parameters used in the clinical follow-up of parenteral nutrition treated patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Peripheral parenteral nutrition: an option for patients with an indication for short-term parenteral nutrition La nutrición parenteral periférica, alternativa para los pacientes con indicación de nutrición parenteral durante poco tiempo

OpenAIRE

M. I. T. D. Correia; J. Guimarâes; L. Cirino de Mattos; K. C. Araújo Gurgel; E. B. Cabral

2004-01-01

Objective: The aim of this study was to examine and describe our experience with the use of peripheral parenteral nutrition (PPN). Methods: Patients with an indication for parenteral nutrition for less than 15 days received it via a peripheral vein via a short, 20 or 22 gauge French polyurethane catheter. Parenteral nutrition had a final osmolality of 993 mOsm/l and was administered by infusion pump. The nutritional status of patients was assessed by the Subjective Global Assessment (SGA) tec...

Environmental Engineering Curricula assessment in the global world

Science.gov (United States)

Caporali, Enrica; Catelani, Marcantonio; Manfrida, Giampaolo; Valdiserri, Juna

2014-05-01

Environmental engineers are technicians with specific expertise on the sustainability of human presence in the environment. Among other global dilemmas, to the environmental engineers it is often demanded to be able in developing systematic, innovative solutions in order to simultaneously meet water and energy needs, to build resilience to natural and technological disasters, to more accurately gauge and manage countries' greenhouse gas emissions. The general objectives of the Environmental Engineers are to establish actions of environmental sustainability as well as to verify progress toward global goals or international commitments. The globalization of challenges and problems to be faced, leads, in general, to the globalization of the engineering profession. In particular, since the environmental issues are without boundaries, and many and different are the involved professions and the competences, the environmental engineer must have a multidisciplinary and interdisciplinary approach to adequately answer to the demand of technical innovative knowledge at global scale. The environmental engineers, more and more, are involved in international projects were the effective collaboration requires not only the capacity to communicate in a common technical language, but also the assurance of an adequate and common level of technical competences, knowledge and understanding. The Europe-based EUR ACE system, currently operated by ENAEE - European Network for Accreditation of Engineering Education, can represent the proper framework and accreditation system in order to provide a set of measures to assess the quality of engineering degree programmes in Europe and abroad. In the global frame of the knowledge triangle: education-innovation-research, the accreditation and quality assurance of engineering curricula in Europe is discussed with reference to the Environmental engineering curricula, of the 1st and 2nd cycle, based on the European Credit Transfer System and in

Assessing flood risk at the global scale: model setup, results, and sensitivity

International Nuclear Information System (INIS)

Ward, Philip J; Jongman, Brenden; Weiland, Frederiek Sperna; Winsemius, Hessel C; Bouwman, Arno; Ligtvoet, Willem; Van Beek, Rens; Bierkens, Marc F P

2013-01-01

Globally, economic losses from flooding exceeded $19 billion in 2012, and are rising rapidly. Hence, there is an increasing need for global-scale flood risk assessments, also within the context of integrated global assessments. We have developed and validated a model cascade for producing global flood risk maps, based on numerous flood return-periods. Validation results indicate that the model simulates interannual fluctuations in flood impacts well. The cascade involves: hydrological and hydraulic modelling; extreme value statistics; inundation modelling; flood impact modelling; and estimating annual expected impacts. The initial results estimate global impacts for several indicators, for example annual expected exposed population (169 million); and annual expected exposed GDP ($1383 billion). These results are relatively insensitive to the extreme value distribution employed to estimate low frequency flood volumes. However, they are extremely sensitive to the assumed flood protection standard; developing a database of such standards should be a research priority. Also, results are sensitive to the use of two different climate forcing datasets. The impact model can easily accommodate new, user-defined, impact indicators. We envisage several applications, for example: identifying risk hotspots; calculating macro-scale risk for the insurance industry and large companies; and assessing potential benefits (and costs) of adaptation measures. (letter)

Local to global: a collaborative approach to volcanic risk assessment

Science.gov (United States)

Calder, Eliza; Loughlin, Sue; Barsotti, Sara; Bonadonna, Costanza; Jenkins, Susanna

2017-04-01

Volcanic risk assessments at all scales present challenges related to the multitude of volcanic hazards, data gaps (hazards and vulnerability in particular), model representation and resources. Volcanic hazards include lahars, pyroclastic density currents, lava flows, tephra fall, ballistics, gas dispersal and also earthquakes, debris avalanches, tsunamis and more ... they can occur in different combinations and interact in different ways throughout the unrest, eruption and post-eruption period. Volcanoes and volcanic hazards also interact with other natural hazards (e.g. intense rainfall). Currently many hazards assessments consider the hazards from a single volcano but at national to regional scales the potential impacts of multiple volcanoes over time become important. The hazards that have the greatest tendency to affect large areas up to global scale are those transported in the atmosphere: volcanic particles and gases. Volcanic ash dispersal has the greatest potential to directly or indirectly affect the largest number of people worldwide, it is currently the only volcanic hazard for which a global assessment exists. The quantitative framework used (primarily at a regional scale) considers the hazard at a given location from any volcano. Flow hazards such as lahars and floods can have devastating impacts tens of kilometres from a source volcano and lahars can be devastating decades after an eruption has ended. Quantitative assessment of impacts is increasingly undertaken after eruptions to identify thresholds for damage and reduced functionality. Some hazards such as lava flows could be considered binary (totally destructive) but others (e.g. ash fall) have varying degrees of impact. Such assessments are needed to enhance available impact and vulnerability data. Currently, most studies focus on physical vulnerability but there is a growing emphasis on social vulnerability showing that it is highly variable and dynamic with pre-eruption socio

Assessment in the global context: From ozone to ecosystems

CSIR Research Space (South Africa)

Scholes, B

2017-10-01

Full Text Available This presentation discusses the assessment in the global context: From ozone to ecosystems. Process to evaluate the status of knowledge on complex problems relevant to societies. A key element of the contemporary science-policy interface....

An Approach for Assessing the Benefits of IT Investments in Global Supply Chains

DEFF Research Database (Denmark)

Betz, Michaela; Henningsson, Stefan

2016-01-01

-duced by the technology as an isolated product. In contrast, research on global supply chains has shown that benefits generated from IT investments in this domain are typically generated by the coor-dinated use of many stakeholders and by technologies producing complimentary effects in systemic relationships......This paper develops and demonstrates a novel approach for ex-ante assessment of business benefits from IT investments in global supply chains. Extant IT assessment approaches are typically based on the assumption that benefit realization from IT investments involves a single stakeholder and are pro....... The assessment approach in this paper brings the contingent inter-organizational and technological dependencies of IT investments to the forefront of the assessment. It provides actors in industries relating to global supply chains the means to better apprehend the possible benefits from an IT investment...

Integrated assessment models of global climate change

International Nuclear Information System (INIS)

Parson, E.A.; Fisher-Vanden, K.

1997-01-01

The authors review recent work in the integrated assessment modeling of global climate change. This field has grown rapidly since 1990. Integrated assessment models seek to combine knowledge from multiple disciplines in formal integrated representations; inform policy-making, structure knowledge, and prioritize key uncertainties; and advance knowledge of broad system linkages and feedbacks, particularly between socio-economic and bio-physical processes. They may combine simplified representations of the socio-economic determinants of greenhouse gas emissions, the atmosphere and oceans, impacts on human activities and ecosystems, and potential policies and responses. The authors summarize current projects, grouping them according to whether they emphasize the dynamics of emissions control and optimal policy-making, uncertainty, or spatial detail. They review the few significant insights that have been claimed from work to date and identify important challenges for integrated assessment modeling in its relationships to disciplinary knowledge and to broader assessment seeking to inform policy- and decision-making. 192 refs., 2 figs

Open Source Tools for Assessment of Global Water Availability, Demands, and Scarcity

Science.gov (United States)

Li, X.; Vernon, C. R.; Hejazi, M. I.; Link, R. P.; Liu, Y.; Feng, L.; Huang, Z.; Liu, L.

2017-12-01

Water availability and water demands are essential factors for estimating water scarcity conditions. To reproduce historical observations and to quantify future changes in water availability and water demand, two open source tools have been developed by the JGCRI (Joint Global Change Research Institute): Xanthos and GCAM-STWD. Xanthos is a gridded global hydrologic model, designed to quantify and analyze water availability in 235 river basins. Xanthos uses a runoff generation and a river routing modules to simulate both historical and future estimates of total runoff and streamflows on a monthly time step at a spatial resolution of 0.5 degrees. GCAM-STWD is a spatiotemporal water disaggregation model used with the Global Change Assessment Model (GCAM) to spatially downscale global water demands for six major enduse sectors (irrigation, domestic, electricity generation, mining, and manufacturing) from the region scale to the scale of 0.5 degrees. GCAM-STWD then temporally downscales the gridded annual global water demands to monthly results. These two tools, written in Python, can be integrated to assess global, regional or basin-scale water scarcity or water stress. Both of the tools are extensible to ensure flexibility and promote contribution from researchers that utilize GCAM and study global water use and supply.

Nutritional status and related factors of patients with advanced gastrointestinal cancer.

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Zhang, Liyan; Lu, Yuhan; Fang, Yu

2014-04-14

The scored Patient-Generated Subjective Global Assessment (PG-SGA) is considered to be the most appropriate tool for detecting malnutrition in cancer patients. In particular, malignant tumours derived from the gastrointestinal tract may impair nutrient intake and absorption and cause malnutrition. We carried out a cross-sectional study to assess the nutritional status and related factors of patients with gastrointestinal cancer. Nutritional status was determined using the scored PG-SGA in patients (n 498) with advanced gastrointestinal cancer admitted to the Gastrointestinal Medical Oncology Unit at Beijing Cancer Hospital between 1 August 2012 and 28 February 2013. The possible related factors including age, sex, hospitalisation frequency and pathology were explored. We found that 98% of the patients required nutrition intervention and 54% of the patients required improved nutrition-related symptom management and/or urgent nutritional support (PG-SGA score ≥9). Factors related to malnutrition were age (r 0.103, Pcancer had a lower risk of malnutrition than patients with other types of gastrointestinal cancer (F=35.895, Pnutritional status of gastrointestinal patients, especially those at a higher risk of malnutrition, such as elderly patients, those hospitalised for the first time, male patients and those with other types of gastrointestinal cancer except rectal cancer. The nutritional status of these patients should be evaluated and they should be given proper nutrition education and nutritional support in a timely manner.

Nutritional status of vegetarians on maintenance haemodialysis.

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Wu, Tai-Te; Chang, Chieh-Ying; Hsu, Wei-Min; Wang, I-Kwan; Hsu, Chih-Hao; Cheng, Shu-Hwa; Liang, Chih-Chia; Chang, Chiz-Tzung; Huang, Chiu-Ching

2011-08-01

Vegetarian diets have long been thought of as beneficial to health. However, vegetarian diets are often low in protein, which is contradictory to the high protein diet guideline for uraemia patients. The purpose of the study was to investigate the impact of a vegetarian diet on the nutritional status of haemodialysis (HD) patients. Patients on chronic HD for over 6 months were included in the study. The normalized protein catabolic rate (nPCR) was used to reflect daily protein intake. Biochemical markers of nutrition, anthropometric parameters, subjective global assessment (SGA) and functional activity of daily living were assessed to evaluate the nutritional status of vegetarians on chronic HD. Nineteen out of 318 HD patients were vegetarians. The nPCR was lower in the vegetarian group (1.20 ± 0.24 vs 1.10 ± 0.29 g/kg per day, non-Veg vs Veg, P strength evaluated by the hand-grip test, SGA and activities of daily living were similar in vegetarians and non-vegetarians. The present study revealed that HD patients on vegetarian diets might have a smaller BMI, but SGA and function of daily activities were similar to those of the non-vegetarians. The haematocrit of vegetarians can be maintained with a higher erythropoietin dose. © 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.

Birth weight and long-term metabolic outcomes: does the definition of smallness matter?

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Verkauskiene, R; Figueras, F; Deghmoun, S; Chevenne, D; Gardosi, J; Levy-Marchal, M

2008-01-01

To establish the role of individual definition of smallness at birth in the association between birth weight and long-term metabolic outcomes. Lipid profile and oral glucose tolerance test were performed in young adults (22 years) born either small (SGA) or appropriate for gestational age (AGA). AGA/SGA were defined by both population-based and customized methods adjusting for individual maternal/pregnancy characteristics. 825 individuals were classified as AGA and 575 as SGA by both methods, 131 were SGA by the population-based method only (SGA(pop)) and 22 were SGA by the customized method only (SGA(cust)). SGA(cust) subjects had higher total cholesterol and triglyceride levels and lower high-density lipoprotein cholesterol concentrations than SGA(pop) and AGA subjects, however, insignificantly when adjusted for age, gender and body mass index. The homeostasis model assessment for insulin resistance (HOMA-IR) index was higher in the SGA(cust) (p = 0.05) and SGA(pop) (p = 0.02) versus the AGA group. Controlling for the HOMA-IR index, the insulinogenic index was significantly lower in the SGA(cust) versus SGA(pop) (p = 0.001) and AGA (p = 0.003) groups. In SGA(cust) individuals, the HOMA-IR index was clearly shifted to higher, while the insulinogenic index to lower tertiles of AGA distribution; SGA(pop) subjects had the HOMA-IR and insulinogenic index predominantly in the highest tertiles. Individualized birth weight standards allow to better identify subjects who failed to reach their genetic potential of intrauterine growth and are at higher risk of metabolic disturbances and impaired insulin secretion later in life. Copyright 2008 S. Karger AG, Basel.

Nutritional assessment of cancer patients in Tehran, Iran.

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Khoshnevis, N; Ahmadizar, F; Alizadeh, M; Akbari, M E

2012-01-01

Weight loss and malnutrition are common among cancer patients, these two factors greatly affecting survival and quality of life during treatment. Since cancer is becoming increasingly common in the world and in order to provide better treatment measures, it is important to identify and prevent side effects. The present study has been conducted in 2010 on a sample of cancer patients in the oncology center of Shahid Beheshti University of Medical Sciences to determine the prevalence rates of malnutrition and the factors affecting it. The PG-SGA standard questionnaire was administered to 416 cancer patients to evaluate their nutrition status and determine the frequency of each malnutrition stage. Correlations and ANOVA tests were used to analyze the relationship between factors and weight loss and how they might affect the development of malnutrition. The prevalence of malnutrition among the patients was 53.1% out of which 29.1% had moderate and 24% had severe malnutrition. The most common factors inducing nutritional symptoms were depression and anorexia. Some 35 % of the patients had over 5% weight loss in the last mouth. The average PG-SGA score was 10.1 with 49 being the highest. 46.1 percent of the patients scored over 9 (requiring critical nutrient intervention). Malnutrition has a high correlation with weight loss, activity limitations, nutritional symptoms, and cancer stage, but low correlation with treatment and pathologic type. Malnutrition has a high prevalence in Iranian cancer patients and has a close relationship with mortality, morbidity and treatment-related problems and also quality of life. Therefore, periodical assessment by PG-SGA to detect malnutrition in patients should be made so that appropriate nutritional interventions can be provided.

Longitudinal changes and correlations of bioimpedance and anthropometric measurements in pregnancy: Simple possible bed-side tools to assess pregnancy evolution.

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Piuri, Gabriele; Ferrazzi, Enrico; Bulfoni, Camilla; Mastricci, Luciana; Di Martino, Daniela; Speciani, Attilio Francesco

2017-12-01

The aim of this study was to assess longitudinal changes of bioimpedance analysis compared with anthropometric measurements in low-risk pregnant woman recruited in the first trimester and to observe possible differences in these indices in women who developed high-risk pregnancies. Bioimpedance indices for the three trimesters of pregnancies were calculated separately for uneventful pregnancies delivered of newborns > the 10th centile. These findings were compared with anthropometric measurements. Data of women who developed hypertensive disorders of pregnancy (HDP) or delivered SGA newborns were calculated and compared. Significantly longitudinal increases were observed in these pregnancies for total body water (TBW), free fat mass, fat mass, and extra-cellular water. These increases were paralleled body mass index (BMI), skinfolds, and waist measurements. The correlations between these two sets of findings were poor. Women who developed HDP with AGA fetuses showed significantly different bioimpedance from normal cases. TBW indices were highly significantly different since the first trimester. In pregnancies delivered of SGA newborns, these indices were opposite of the values observed in patients with HDP-AGA, TBW in these patients was significantly reduced compared with normal pregnancies. The bioelectrical impedance is a fast, simple, noninvasive way to assess the TBW content in pregnancy. Our findings are in agreement with the hypothesis that bioimpedance might help to identify early in gestation patients at risk of developing different clinical phenotypes of hypertensive disease of pregnancy and SGA fetuses.

Reduced genetic influence on childhood obesity in small for gestational age children

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Han Dug Yeo

2013-01-01

Full Text Available Abstract Background Children born small-for-gestational-age (SGA are at increased risk of developing obesity and metabolic diseases later in life, a risk which is magnified if followed by accelerated postnatal growth. We investigated whether common gene variants associated with adult obesity were associated with increased postnatal growth, as measured by BMI z-score, in children born SGA and appropriate for gestational age (AGA in the Auckland Birthweight Collaborative. Methods A total of 37 candidate SNPs were genotyped on 547 European children (228 SGA and 319 AGA. Repeated measures of BMI (z-score were used for assessing obesity status, and results were corrected for multiple testing using the false discovery rate. Results SGA children had a lower BMI z-score than non-SGA children at assessment age 3.5, 7 and 11 years. We confirmed 27 variants within 14 obesity risk genes to be individually associated with increasing early childhood BMI, predominantly in those born AGA. Conclusions Genetic risk variants are less important in influencing early childhood BMI in those born SGA than in those born AGA, suggesting that non-genetic or environmental factors may be more important in influencing childhood BMI in those born SGA.

Framework for e-learning assessment in dental education: a global model for the future.

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Arevalo, Carolina R; Bayne, Stephen C; Beeley, Josie A; Brayshaw, Christine J; Cox, Margaret J; Donaldson, Nora H; Elson, Bruce S; Grayden, Sharon K; Hatzipanagos, Stylianos; Johnson, Lynn A; Reynolds, Patricia A; Schönwetter, Dieter J

2013-05-01

The framework presented in this article demonstrates strategies for a global approach to e-curricula in dental education by considering a collection of outcome assessment tools. By combining the outcomes for overall assessment, a global model for a pilot project that applies e-assessment tools to virtual learning environments (VLE), including haptics, is presented. Assessment strategies from two projects, HapTEL (Haptics in Technology Enhanced Learning) and UDENTE (Universal Dental E-learning), act as case-user studies that have helped develop the proposed global framework. They incorporate additional assessment tools and include evaluations from questionnaires and stakeholders' focus groups. These measure each of the factors affecting the classical teaching/learning theory framework as defined by Entwistle in a standardized manner. A mathematical combinatorial approach is proposed to join these results together as a global assessment. With the use of haptic-based simulation learning, exercises for tooth preparation assessing enamel and dentine were compared to plastic teeth in manikins. Equivalence for student performance for haptic versus traditional preparation methods was established, thus establishing the validity of the haptic solution for performing these exercises. Further data collected from HapTEL are still being analyzed, and pilots are being conducted to validate the proposed test measures. Initial results have been encouraging, but clearly the need persists to develop additional e-assessment methods for new learning domains.

Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

Science.gov (United States)

Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

2015-10-01

Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

Assessing Climate Change Impacts on Global Hydropower

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Aanund Killingtveit

2012-02-01

Full Text Available Currently, hydropower accounts for close to 16% of the world’s total power supply and is the world’s most dominant (86% source of renewable electrical energy. The key resource for hydropower generation is runoff, which is dependent on precipitation. The future global climate is uncertain and thus poses some risk for the hydropower generation sector. The crucial question and challenge then is what will be the impact of climate change on global hydropower generation and what are the resulting regional variations in hydropower generation potential? This paper is a study that aims to evaluate the changes in global hydropower generation resulting from predicted changes in climate. The study uses an ensemble of simulations of regional patterns of changes in runoff, computed from global circulation models (GCM simulations with 12 different models. Based on these runoff changes, hydropower generation is estimated by relating the runoff changes to hydropower generation potential through geographical information system (GIS, based on 2005 hydropower generation. Hydropower data obtained from EIA (energy generation, national sites, FAO (water resources and UNEP were used in the analysis. The countries/states were used as computational units to reduce the complexities of the analysis. The results indicate that there are large variations of changes (increases/decreases in hydropower generation across regions and even within regions. Globally, hydropower generation is predicted to change very little by the year 2050 for the hydropower system in operation today. This change amounts to an increase of less than 1% of the current (2005 generation level although it is necessary to carry out basin level detailed assessment for local impacts which may differ from the country based values. There are many regions where runoff and hydropower generation will increase due to increasing precipitation, but also many regions where there will be a decrease. Based on this

Multi-hazard national-level risk assessment in Africa using global approaches

Science.gov (United States)

Fraser, Stuart; Jongman, Brenden; Simpson, Alanna; Murnane, Richard

2016-04-01

In recent years Sub-Saharan Africa has been characterized by unprecedented opportunity for transformation and sustained growth. However, natural disasters such as droughts, floods, cyclones, earthquakes, landslides, volcanic eruptions and extreme temperatures cause significant economic and human losses, and major development challenges. Quantitative disaster risk assessments are an important basis for governments to understand disaster risk in their country, and to develop effective risk management and risk financing solutions. However, the data-scarce nature of many Sub-Saharan African countries as well as a lack of financing for risk assessments has long prevented detailed analytics. Recent advances in globally applicable disaster risk modelling practices and data availability offer new opportunities. In December 2013 the European Union approved a € 60 million contribution to support the development of an analytical basis for risk financing and to accelerate the effective implementation of a comprehensive disaster risk reduction. The World Bank's Global Facility for Disaster Reduction and Recovery (GFDRR) was selected as the implementing partner of the Program for Result Area 5: the "Africa Disaster Risk Assessment and Financing Program." As part of this effort, the GFDRR is overseeing the production of national-level multi-hazard risk profiles for a range of countries in Sub-Saharan Africa, using a combination of national and global datasets and state-of-the-art hazard and risk assessment methodologies. In this presentation, we will highlight the analytical approach behind these assessments, and show results for the first five countries for which the assessment has been completed (Kenya, Uganda, Senegal, Niger and Ethiopia). The presentation will also demonstrate the visualization of the risk assessments into understandable and visually attractive risk profile documents.

Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment

Science.gov (United States)

Mackey, Tim K.; Liang, Bryan A.; York, Peter; Kubic, Thomas

2015-01-01

Counterfeit medicines are a global public health risk. We assess counterfeit reports involving the legitimate supply chain using 2009–2011 data from the Pharmaceutical Security Institute Counterfeit Incident System (PSI CIS) database that uses both open and nonpublic data sources. Of the 1,510 identified CIS reports involving counterfeits, 27.6% reported China as the source country of the incident/detection. Further, 51.3% were reported as counterfeit but the specific counterfeit subcategory was not known or verifiable. The most prevalent therapeutic category was anti-infectives (21.1%) with most reports originating from health-related government agencies. Geographically, Asian and Latin American regions and, economically, middle-income markets were most represented. A total of 127 (64.8%) of a total of 196 countries had no legitimate supply chain CIS counterfeit reports. Improvements in surveillance, including detection of security breaches, data collection, analysis, and dissemination are urgently needed to address public health needs to combat the global counterfeit medicines trade. PMID:25897059

Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study

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Prashant Paul Verghese

2018-01-01

Full Text Available Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients. The study was carried out based on daily documentation. The primary outcome was the nutritional status of medical Patients at admission to the adult ICU. The tests for statistical analysis used were independent t test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis. Results: Out of the 200 patients in our study, 45%, 48.5% and 9% of patients had mild, moderate and severe malnutrition, respectively, corresponding to subjective global assessment (SGA rating A,B and C, respectively. The most common reasons for non-attainment of daily feeding goals were delayed feed procurement (17.57%, and feeds being held for procedures (16.36%. The overall mean length of ICU stay was 8.63 ± 7.26 days, and the ICU mortality rate was 47.5% (95/200. Patients with SGA rating B and C at admission had higher risk of mortality in the ICU, with an adjusted odds ratio of 3.54 (95% confidence interval [CI]- 1.71–7.33, P = 0.001 and 11.11 (95% CI-2.26–54.66, P = 0.003, respectively. Conclusion: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.

Initial Assessment of Cyclone Global Navigation Satellite System (CYGNSS) Observations

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McKague, D. S.; Ruf, C. S.

2017-12-01

The NASA Cyclone Global Navigation Satellite System (CYNSS) mission provides high temporal resolution observations of cyclones from a constellation of eight low-Earth orbiting satellites. Using the relatively new technique of Global Navigation Satellite System reflectometry (GNSS-R), all-weather observations are possible, penetrating even deep convection within hurricane eye walls. The compact nature of the GNSS-R receivers permits the use of small satellites, which in turn enables the launch of a constellation of satellites from a single launch vehicle. Launched in December of 2016, the eight CYGNSS satellites provide 25 km resolution observations of mean square slope (surface roughness) and surface winds with a 2.8 hour median revisit time from 38 S to 38 N degrees latitude. In addition to the calibration and validation of CYGNSS sea state observations, the CYGNSS science team is assessing the ability of the mission to provide estimates of cyclone size, intensity, and integrated kinetic energy. With its all-weather ability and high temporal resolution, the CYGNSS mission will add significantly to our ability to monitor cyclone genesis and intensification and will significantly reduce uncertainties in our ability to estimate cyclone intensity, a key variable in predicting its destructive potential. Members of the CYGNSS Science Team are also assessing the assimilation of CYGNSS data into hurricane forecast models to determine the impact of the data on forecast skill, using the data to study extra-tropical cyclones, and looking at connections between tropical cyclones and global scale weather, including the global hydrologic cycle. This presentation will focus on the assessment of early on-orbit observations of cyclones with respect to these various applications.

Inequality measures perform differently in global and local assessments: An exploratory computational experiment

Science.gov (United States)

Chiang, Yen-Sheng

2015-11-01

Inequality measures are widely used in both the academia and public media to help us understand how incomes and wealth are distributed. They can be used to assess the distribution of a whole society-global inequality-as well as inequality of actors' referent networks-local inequality. How different is local inequality from global inequality? Formalizing the structure of reference groups as a network, the paper conducted a computational experiment to see how the structure of complex networks influences the difference between global and local inequality assessed by a selection of inequality measures. It was found that local inequality tends to be higher than global inequality when population size is large; network is dense and heterophilously assorted, and income distribution is less dispersed. The implications of the simulation findings are discussed.

Comparison of INTERGROWTH-21 and Fenton growth standards to assess size at birth and extrauterine growth in very preterm infants.

Science.gov (United States)

Tuzun, Funda; Yucesoy, Ebru; Baysal, Bora; Kumral, Abdullah; Duman, Nuray; Ozkan, Hasan

2018-09-01

This study aimed to compare the recently published prescriptive INTERGROWTH-21st standards with commonly used intrauterine based Fenton growth standards in terms of birth size classification and extrauterine growth restriction (EUGR) incidence in a sample of very preterm infants. The anthropometric measures of preterm infants born before 32 weeks of gestation at the Dokuz Eylul University Hospital during the period from January 2012 to February 2016 were obtained at birth, at the 36th gestational weeks or at the time of discharge. Birth and growth data were presented as percentiles according to the two reference standards. A total of 248 infants with mean gestational age of 29.1 ± 2.1 weeks were included. The small for gestational age (SGA) rate was significantly higher (12 versus 15%, p = .004) and the EUGR rate was significantly lower (40.2 versus 31.5%, p Fentons'. Twenty-four per cent of the infants who were accepted as SGA according to the INTERGROWTH-21st standards were appropriate for gestational age (AGA) according to the Fenton preterm growth charts. However, these newly identified SGA infants according to the Intergrowth-21st standards did not have increased risks of early morbidities. Furthermore, 77% of the cases who had EUGR due to the Fenton standards were categorized as EUGR when evaluated using the INTERGROWTH-21st standards. Results indicated that almost one out of every five cases assessed as EUGR according to Fenton standards was within the normal interval according to Intergrowth standards. On the contrary, one out of every four cases assessed as SGA according to the INTERGROWTH-21st standards was within the normal interval according to Fentons'. These differences observed with INTERGROWTH-21st standards may affect in-hospital and postdischarge nutrition plan of these vulnerable infants. However, new standards are needed to be evaluated against currently used ones before they are implemented and further studies should be conducted

Global Aquaculture Performance Index (GAPI: The First Global Environmental Assessment of Marine Fish Farming

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Jenna M.S. Stoner

2013-09-01

Full Text Available “Sustainable” is among the most sought after of all seafood product adjectives. Ironically it is also one of the most poorly defined and understood. The Global Aquaculture Performance Index (GAPI is the first tool to assess environmental performance of global marine aquaculture production, permitting direct comparison of disparate species, production methods and jurisdictions. Clear patterns emerge from this analysis; significant variation of environmental performance is driven by the species being farmed, significant room for improvement exists across the entire sector, the worst performing players are also the fastest growing, particularly within Asia, and perhaps most importantly, this work highlights the potential trap awaiting policy makers who focus too narrowly on farm production efficiency alone as a solution to diminishing seafood availability.

Methods for global sensitivity analysis in life cycle assessment

NARCIS (Netherlands)

Groen, Evelyne A.; Bokkers, Eddy; Heijungs, Reinout; Boer, de Imke J.M.

2017-01-01

Purpose: Input parameters required to quantify environmental impact in life cycle assessment (LCA) can be uncertain due to e.g. temporal variability or unknowns about the true value of emission factors. Uncertainty of environmental impact can be analysed by means of a global sensitivity analysis to

CUTOFF POINT OF THE PHASE ANGLE IN PRE-RADIOTHERAPY CANCER PATIENTS.

Science.gov (United States)

Souza Thompson Motta, Rachel; Alves Castanho, Ivany; Guillermo Coca Velarde, Luis

2015-11-01

malnutrition is a common complication for cancer patients. The phase angle (PA), direct measurement of bioelectrical impedance analysis (BIA), has been considered a predictor of body cell mass and prognostic indicator. Cutoff points for phase angle (PA) associated with nutritional risk in cancer patients have not been determined yet. assess the possibility of determining the cutoff point for PA to identify nutritional risk in pre-radiotherapy cancer patients. sample group: Patients from both genders diagnosed with cancer and sent for ambulatory radiotherapy. body mass index (BMI), percentage of weight loss (% WL), mid-arm circumference (MAC), triceps skinfold thickness (TST), mid-arm muscle circumference (MAMC), mid-arm muscle area (MAMA), score and categorical assessment obtained using the Patient-Generated Subjective Global Assessment (PG-SGA) form, PA and standardized phase angle (SPA). Kappa coefficient was used to test the degree of agreement between the diagnoses of nutritional risk obtained from several different methods of nutritional assessment. Cutoff points for the PA through anthropometric indicators and PG-SGA were determined by using Receiver Operating Characteristic (ROC) curves, and patient survival was analyzed with the Cox regression method. the cutoff points with the greatest discriminatory power were those obtained from BMI (5.2) and the categorical assessment of PG-SGA (5.4). The diagnosis obtained using these cutoff points showed a significant association with risk of death for the patients in the sample group. we recommend using the cutoff point 5.2 for the PA as a criterion for identifying nutritional risk in pre-radiotherapy cancer patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The Global Seismic Hazard Assessment Program (GSHAP - 1992/1999

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D. Giardini

1999-06-01

Full Text Available The United Nations, recognizing natural disasters as a major threat to human life and development, designed the 1990-1999 period as the International Decade for Natural Disaster Reduction (UN/IDNDR; UN Res. 42/169/ 1987. Among the IDNDR Demonstration Projects is the Global Seismic Hazard Assessment Program (GSHAP, launched in 1992 by the International Lithosphere Program (ILP and implemented in the 1992-1999 period. In order to mitigate the risk associated to the recurrence of earthquakes, the GSHAP promoted a regionally coordinated, homogeneous approach to seismic hazard evaluation. To achieve a global dimension, the GSHAP established initially a mosaic of regions and multinational test areas, then expanded to cover whole continents and finally the globe. The GSHAP Global Map of Seismic Hazard integrates the results obtained in the regional areas and depicts Peak-Ground-Acceleration (PGA with 10% chance of exceedance in 50 years, corresponding to a return period of 475 years. All regional results and the Global Map of Seismic Hazard are published in 1999 and available on the GSHAP homepage on http://seismo.ethz.ch/GSHAP/.

A multi-model assessment of the co-benefits of climate mitigation for global air quality

NARCIS (Netherlands)

Rao, Shilpa; Klimont, Zbigniew; Leitao, Joana; Riahi, Keywan; van Dingenen, Rita; Aleluia Reis, Lara; Calvin, Katherine; Dentener, Frank; Drouet, Laurent; Fujimori, Shinichiro; Harmsen, Mathijs; Luderer, Gunnar; Heyes, Chris; Strefler, Jessica; Tavoni, Massimo; van Vuuren, Detlef P.

2016-01-01

We present a model comparison study that combines multiple integrated assessment models with a reduced-form global air quality model to assess the potential co-benefits of global climate mitigation policies in relation to the World Health Organization (WHO) goals on air quality and health. We

Ultrasound assessment of placental function: the effectiveness of placental biometry in a low-risk population as a predictor of a small for gestational age neonate.

LENUS (Irish Health Repository)

McGinty, Patricia

2012-07-01

The aims of the study were to establish reference ranges for placental length and thickness in a low-risk obstetric population and to assess the likelihood of a small for gestational age (SGA) neonate on the basis of placental length at 18-24 weeks\\' gestation.

Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

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Henrica M A de Bie

Full Text Available Intrauterine growth restriction (IUGR can lead to infants being born small for gestational age (SGA. SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI.18 children born appropriate for gestational age (AGA and 34 SGA born children (18 with and 16 without postnatal catch-up growth participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning. A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes.Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA.This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

Science.gov (United States)

de Bie, Henrica M A; de Ruiter, Michiel B; Ouwendijk, Mieke; Oostrom, Kim J; Wilke, Marko; Boersma, Maria; Veltman, Dick J; Delemarre-van de Waal, Henriette A

2015-01-01

Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI). 18 children born appropriate for gestational age (AGA) and 34 SGA born children (18 with and 16 without postnatal catch-up growth) participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning). A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes. Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA. This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

Kidney transplantation fails to provide adequate growth in children with chronic kidney disease born small for gestational age.

Science.gov (United States)

Franke, Doris; Steffens, Rena; Thomas, Lena; Pavičić, Leo; Ahlenstiel, Thurid; Pape, Lars; Gellermann, Jutta; Müller, Dominik; Querfeld, Uwe; Haffner, Dieter; Živičnjak, Miroslav

2017-03-01

Children with chronic kidney disease are frequently born small for gestational age (SGA) and prone to disproportionately short stature. It is unclear how SGA affects growth after kidney transplantation (KTx). Linear growth (height, sitting height, and leg length) was prospectively investigated in a cohort of 322 pediatric KTx recipients, with a mean follow-up of 4.9 years. Sitting height index (ratio of sitting height to total body height) was used to assess body proportions. Predictors of growth outcome in KTx patients with (n = 94) and without (n = 228) an SGA history were evaluated by the use of linear mixed-effects models. Mean z-scores for all linear body dimensions were lower in SGA compared with non-SGA patients (p deficit and degree of body disproportion (p growth during childhood. Pubertal trunk growth was diminished in SGA patients, and the pubertal growth spurt of legs was delayed in both groups, resulting in further impairment of adult height, which was more frequently reduced in SGA than in non-SGA patients (50 % vs 18 %, p growth hormone treatment in the pre-transplant period, preemptive KTx, transplant function, and control of metabolic acidosis were the only potentially modifiable correlates of post-transplant growth in SGA groups. By contrast, living related KTx, steroid exposure, and degree of anemia proved to be correlates in non-SGA only. In children born SGA, growth outcome after KTx is significantly more impaired and affected by different clinical parameters compared with non-SGA patients.

Effort in Multitasking: Local and Global Assessment of Effort.

Science.gov (United States)

Kiesel, Andrea; Dignath, David

2017-01-01

When performing multiple tasks in succession, self-organization of task order might be superior compared to external-controlled task schedules, because self-organization allows optimizing processing modes and thus reduces switch costs, and it increases commitment to task goals. However, self-organization is an additional executive control process that is not required if task order is externally specified and as such it is considered as time-consuming and effortful. To compare self-organized and externally controlled task scheduling, we suggest assessing global subjective and objectives measures of effort in addition to local performance measures. In our new experimental approach, we combined characteristics of dual tasking settings and task switching settings and compared local and global measures of effort in a condition with free choice of task sequence and a condition with cued task sequence. In a multi-tasking environment, participants chose the task order while the task requirement of the not-yet-performed task remained the same. This task preview allowed participants to work on the previously non-chosen items in parallel and resulted in faster responses and fewer errors in task switch trials than in task repetition trials. The free-choice group profited more from this task preview than the cued group when considering local performance measures. Nevertheless, the free-choice group invested more effort than the cued group when considering global measures. Thus, self-organization in task scheduling seems to be effortful even in conditions in which it is beneficiary for task processing. In a second experiment, we reduced the possibility of task preview for the not-yet-performed tasks in order to hinder efficient self-organization. Here neither local nor global measures revealed substantial differences between the free-choice and a cued task sequence condition. Based on the results of both experiments, we suggest that global assessment of effort in addition to

The impact of delayed maternity on foetal growth in Spain: An assessment by population attributable fraction.

Science.gov (United States)

Varea, Carlos; Terán, José Manuel; Bernis, Cristina; Bogin, Barry

2017-09-18

Delayed childbearing is considered a risk factor for maternal-foetal health. As in other higher-income countries, in Spain age at maternity has steadily increased during the last two decades. To quantify the impact of the delay in the age at maternity on small for gestational age (SGA) categories of maternity and parity. Primipara 35-39 years old mothers have the highest PAF p in the three categories of SGA, with the maximum value for SGA maternity is a significant adjusted risk factor for SGA, contributing to the increase of its prevalence. However, results also suggest a limited clinical impact of delayed maternity on foetal growth. Positive changes in maternal profile associated with the shift in maternal age might contribute to explain the limited impact of mothers aged 35 years and older on negative birth outcome in Spain. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt.

Science.gov (United States)

Nour-Eldein, Hebatallah; Abdelsalam, Shimaa A; Nasr, Gamila M; Abdelwahed, Hassan A

2013-01-01

The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aiming to improve CV prevention service. The current study is a cross-sectional descriptive analytic. Sixty-five family physicians were asked to respond to, validated anonymous questionnaire to collect data about characteristics of family physicians, their awareness, attitude, current use, barriers, and recommendations of global CV risk assessment. Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis. Awareness of guidelines of global CV risk assessment was relatively higher regarding the American guidelines (30.8%) than that recommended by World Health Organization (WHO) for Egypt (20.2%). 50.8% of participants had favorable attitude. There was statistical significant relationship between attitude scores and physician characteristics; age (P = 0.003), qualification (P = 0.001) and number of patients seen per week (P = 0.009). Routine use of global CV risk assessment tools was reported only (23%) by family physicians. Relative higher attitude scores than use of global CV risk assessment tools in practice. The most frequent barriers were related to lack of resources and shortage in training/skills and the raised suggestions were towards training.

Climate Prediction Center(CPC)Global Tropics Hazards and Benefits Assessment

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Global Tropics Hazards and Benefits Assessment (GTH) is an outlook product for the areas in the Tropics. Forecasts for the Week-1 and Week-2 period are given for...

Development of Authentic Assessment instruments for Critical Thinking skills in Global Warming with a Scientific Approach

Directory of Open Access Journals (Sweden)

R. Surya Damayanti

2017-12-01

Full Text Available This study aims to develop an authentic assessment instrument to measure critical thinking skills in global warming learning and to describe the suitability, easiness, and usefulness of the use instruments which are developed base on the teacher’s opinion.   The development design is carried out by Borg & Gall (2003 development model, which is conducted with seven stages: information gathering stage, planning stage, product development stage, product test stage, product revision stage, field trial stage, and final product. The test subjects are students and teachers in SMA Lampung Tengah by using purposive sampling technique.  Global warming learning using authentic assessment consists of a series of learning activities, including observing, discussing, exploring, associating and communicating.  The results show the authentic assessment techniques global warming to measure and cultivate critical thinking skills consisting of written tests, performance, portfolios, projects, and attitudes.  The developed assessment model meets content and constructs validity, and effectively improves students' critical thinking skills and has a high level of suitability, easiness, and usefulness well-being. The assessment techniques are used in global warming learning are performance assessment techniques, portfolios, projects, products, and attitude that together contribute to the improvement of critical thinking skills on 97,4% of global warming learning.

Assessing global resource utilization efficiency in the industrial sector.

Science.gov (United States)

Rosen, Marc A

2013-09-01

Designing efficient energy systems, which also meet economic, environmental and other objectives and constraints, is a significant challenge. In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement. Energy analysis alone is inadequate, e.g., it yields energy efficiencies that do not provide limits to efficiency. To obtain meaningful and useful efficiencies for energy systems, and to clarify losses, exergy analysis is a beneficial and useful tool. Here, the global industrial sector and industries within it are assessed by using energy and exergy methods. The objective is to improve the understanding of the efficiency of global resource use in the industrial sector and, with this information, to facilitate the development, prioritization and ultimate implementation of rational improvement options. Global energy and exergy flow diagrams for the industrial sector are developed and overall efficiencies for the global industrial sector evaluated as 51% based on energy and 30% based on exergy. Consequently, exergy analysis indicates a less efficient picture of energy use in the global industrial sector than does energy analysis. A larger margin for improvement exists from an exergy perspective, compared to the overly optimistic margin indicated by energy. Copyright © 2012 Elsevier B.V. All rights reserved.

QUANTITATIVE MEASUREMENT AND ASSESSMENT OF THE EFFECTS OF GLOBALIZATION OF COMPANIES AND MARKETS

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N. Kovtun

2015-10-01

Full Text Available The results of improving the author’s methodology linked with the assessment of companies’ and markets’ globalization level were presented in this paper. Based on the analysis of the global companies’ and global markets’ features referred to in scientific literature, the specifications which can be used to determine the globalization level of companies and markets were suggested. In addition, the globalization level of the largest top-ten companies (according to the rating of Forbes Global 2000 Leading Companies in 2015 was identified as well as that of corresponding industry markets: auto and truck manufacturers, major banks, software and programming, large department stores (retailers, telecommunication services, electronics producers, electronics, oil and gas operations.

To create a consensus on malnutrition diagnostic criteria: A report from the Global Leadership Initiative on Malnutrition (GLIM) meeting at the ESPEN Congress 2016.

Science.gov (United States)

Cederholm, Tommy; Jensen, Gordon L

2017-02-01

During the ESPEN Congress in Copenhagen, Denmark (September 2016) representatives of the 4 largest global PEN-societies from Europe (ESPEN), USA (ASPEN), Asia (PENSA) and Latin America (FELANPE), and from national PEN-societies around the world met to continue the conversation on how to diagnose malnutrition that started during the Clinical Nutrition Week, Austin, USA (February 2016). Current thinking on diagnostic approaches was shared; ESPEN suggested a grading approach that could encompass various types of signs, symptoms and etiologies to support diagnosis. ASPEN emphasized where the parties agree; i.e. that the three major published approaches (ESPEN, ASPEN/AND and Subjective Global Assessment (SGA)) all propose weight loss as a key indicator for malnutrition. FELANPE suggested that the anticipated consensus approach needs to prioritize a diagnostic methodology that is available for everybody since resources differ globally. PENSA highlighted that BMI varies by ethnicity/race, and that sarcopenia/muscle mass evaluation is important for the diagnosis of malnutrition. A Core Working Committee of the Global Leadership Initiative on Malnutrition (GLIM) has been established (comprised of two representatives each from the 4 largest PEN-societies) that will lead consensus development in collaboration with a larger Working Group with broad global representation, using e-mail, telephone conferences, and face-to-face meetings during the up-coming ASPEN and ESPEN Congresses. Transparency and external input will be sought. Objectives include: 1. Consensus development around evidence-based criteria for broad application. 2. Promotion of global dissemination of the consensus criteria. 3. Seeking adoption by the World Health Organization (WHO) and the International Classification of Diseases (ICD). Copyright © 2017 American Society for Parenteral and Enteral Nutrition, Elsevier Ltd, European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All

The relationship between nutritional status and handgrip strength in adult cancer patients: a cross-sectional study.

Science.gov (United States)

Alkan, Şenay Burçin; Artaç, Mehmet; Rakıcıoğlu, Neslişah

2018-02-09

Malnutrition is a common complication in head, neck and lung cancer patients, particularly in cases of gastrointestinal system (GIS) cancer. Therefore, an assessment of malnutrition is crucial for early nutritional interventions. It was conducted as a cross-sectional study to evaluate nutritional status of adult cancer patients. The nutritional status of 104 cancer patients (52 GIS and 52 non-GIS cancer cases) using a Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength, certain anthropometric measurements and food consumption in and outside of the hospital were assessed. The percentages of malnutrition were 64.6 and 64.3% in the male patients with and without GIS cancer, respectively. They were 61.9 and 45.8% in the female patients with GIS and without GIS cancer, respectively. However, no significant difference was found between these two groups according to the malnutrition classification, PG-SGA score, handgrip strength and other anthropometric measurements (p > 0.05). The daily energy and protein intakes (per body weight) of the female patients in the hospital were significantly lower than those outside (p Cancer patients could be provided with nutritional education, and arrangements could be made with hospital nutritional services in order to prevent malnutrition.

Association of nutritional status and functional capacity in gastrointestinal cancer patients.

Science.gov (United States)

Pérez-Cruz, Elizabeth; Camacho-Limas, Christian Patricio

To determine the nutritional status and its association with functional capacity in patients with digestive tract cancer. We retrospectively studied all adult patients hospitalized who were diagnosed as having a cancer of the digestive tract. Nutritional status and functional capacity were assessed. Descriptive statistic and odds ratio were used to determine the association in SPSS 14.0. 57 patients were included, 96% had weight loss. Using subjective global assessment (SGA) as a method of screening, 82.5% of the patients were found malnutrition and by biochemical and immunological test 82% and 65% respectively. Functional capacity was assessed by Karnofsky index, finding that 75.5% of the patients have some activity limitation. Results show an association between malnutrition by SGA and limitation in functional capacity (c2 = 1.56; p = 0.212; OR: 2.46; 95% confidence interval [95% CI]: 0.581-10.465). In addition, we observe an association between the total lymphocyte count and limitation in functional capacity (χ2 = 6.94; p = 0.008; OR: 5.23; 95% CI: 1.441-19.025). Malnutrition in patients with digestive tract cancer was associated with limitation in functional capacity. Copyright: © 2017 SecretarÍa de Salud

Assessing Compatibility of Direct Detection Data: Halo-Independent Global Likelihood Analyses

CERN Document Server

Gelmini, Graciela B.

2016-10-18

We present two different halo-independent methods utilizing a global maximum likelihood that can assess the compatibility of dark matter direct detection data given a particular dark matter model. The global likelihood we use is comprised of at least one extended likelihood and an arbitrary number of Poisson or Gaussian likelihoods. In the first method we find the global best fit halo function and construct a two sided pointwise confidence band, which can then be compared with those derived from the extended likelihood alone to assess the joint compatibility of the data. In the second method we define a "constrained parameter goodness-of-fit" test statistic, whose $p$-value we then use to define a "plausibility region" (e.g. where $p \\geq 10\\%$). For any halo function not entirely contained within the plausibility region, the level of compatibility of the data is very low (e.g. $p < 10 \\%$). As an example we apply these methods to CDMS-II-Si and SuperCDMS data, assuming dark matter particles with elastic s...

Risk Assessment Method for Offshore Structure Based on Global Sensitivity Analysis

Directory of Open Access Journals (Sweden)

Zou Tao

2012-01-01

Full Text Available Based on global sensitivity analysis (GSA, this paper proposes a new risk assessment method for an offshore structure design. This method quantifies all the significances among random variables and their parameters at first. And by comparing the degree of importance, all minor factors would be negligible. Then, the global uncertainty analysis work would be simplified. Global uncertainty analysis (GUA is an effective way to study the complexity and randomness of natural events. Since field measured data and statistical results often have inevitable errors and uncertainties which lead to inaccurate prediction and analysis, the risk in the design stage of offshore structures caused by uncertainties in environmental loads, sea level, and marine corrosion must be taken into account. In this paper, the multivariate compound extreme value distribution model (MCEVD is applied to predict the extreme sea state of wave, current, and wind. The maximum structural stress and deformation of a Jacket platform are analyzed and compared with different design standards. The calculation result sufficiently demonstrates the new risk assessment method’s rationality and security.

Effects of oral nutritional supplementation in the management of malnutrition in hospital and post-hospital discharged patients in India: a randomised, open-label, controlled trial.

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Huynh, D T T; Devitt, A A; Paule, C L; Reddy, B R; Marathe, P; Hegazi, R A; Rosales, F J

2015-08-01

Hospital malnutrition is a significant problem that still remains under-recognised and under-treated in India. The present study assessed the effects of oral nutritional supplementation (ONS) in conjunction with dietary counselling versus dietary counselling (control) alone in malnourished patients when given in hospital and post-hospital discharge. The present study was conducted in nine private and four public hospitals. Patients from various medical wards were screened for malnutrition using modified Subjective Global Assessment (mSGA) and randomised to control (n = 106) or ONS (n = 106) for 12 weeks. Two servings (460 mL) of ONS were prescribed daily, providing 432 kcal, 16 g of protein and 28 micronutrients. The primary outcome was weight gain over 12 weeks. Other outcomes included change in body mass index (BMI), serum pre-albumin, albumin and C-reactive protein levels, energy and nutrient intakes, and handgrip strength at weeks 4, 8 and 12, as well as mSGA score at week 12. The mean age of patients was 39 years. Fifty-five percent were males and 90.3% were moderately malnourished (mSGA score B) at baseline. At week 12, ONS significantly improved certain parameters compared to control: weight (2.0 versus 0.9 kg; P energy intake per day (560 versus 230 kcal; P energy intake and weight in malnourished Indian patients. Those patients with poorer functional status at baseline demonstrated the most benefit. © 2014 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

Objectives for Stakeholder Engagement in Global Environmental Assessments

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Jennifer Garard

2017-09-01

Full Text Available Global environmental assessments (GEAs are among the most large-scale, formalized processes for synthesizing knowledge at the science–policy–society interface. The successful engagement of diverse stakeholders in GEAs is often described as a crucial mechanism for increasing their legitimacy, salience and credibility. However, the diversity of perspectives on the more precise objectives for stakeholder engagement remains largely unclear. The aims of this study are to categorize and characterize the diversity of perspectives on objectives for stakeholder engagement in GEAs; to explore differences in perspectives within and between different stakeholder groups and categories; and to test whether the more practical prioritization and selection of objectives in GEAs can be linked to deliberative policy learning as a higher-level rationale for stakeholder engagement. For these purposes, we conduct a grounded theory analysis and a keyword analysis of interview material and official GEA documents relating to two GEAs: UN Environment’s Fifth Global Environment Outlook and the Working Group III contribution to the Intergovernmental Panel on Climate Change Fifth Assessment Report. Based on the analysis, we identify six categories of objectives and present as hypotheses promising ways forward for prioritizing and characterizing objectives for stakeholder engagement in GEAs, as well as potential reasons for the differences between perspectives on objectives. This study draws attention to the need for future GEA processes to have more explicit discussions on the objectives for stakeholder engagement, as well as the importance of moving towards increasingly deliberative and inclusive assessment processes more broadly.

Replacement of chlorofluorocarbons at the DOE gaseous diffusion plants: An assessment of global impacts

International Nuclear Information System (INIS)

Socolof, M.L.; McCold, L.N.; Saylor, R.E.

1997-01-01

Three gaseous diffusion plants (GDPs) for enriching uranium maintain a large inventory of chlorofluorocarbon-114 (CFC-114) as a coolant. To address the continued use of CFC-114, an ozone-depleting substance, the US Department of Energy (DOE) considered introducing perfluorocarbons (PFCs) by the end of 1995. These PFCs would not contribute to stratospheric ozone depletion but would be larger contributors to global warming than would CFC-114. The paper reports the results of an assessment of the global impacts of four alternatives for modifying GDP coolant system operations over a three-year period beginning in 1996. The overall contribution of GDP coolant releases to impacts on ozone depletion and global warming were quantified by parameters referred to as ozone-depletion impact and global-warming impact. The analysis showed that these parameters could be used as surrogates for predicting global impacts to all resources and could provide a framework for assessing environmental impacts of a permanent coolant replacement, eliminating the need for subsequent resource-specific analyses

An Improved Global Wind Resource Estimate for Integrated Assessment Models: Preprint

Energy Technology Data Exchange (ETDEWEB)

Eurek, Kelly [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sullivan, Patrick [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gleason, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hettinger, Dylan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lopez, Anthony [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-02-01

This paper summarizes initial steps to improving the robustness and accuracy of global renewable resource and techno-economic assessments for use in integrated assessment models. We outline a method to construct country-level wind resource supply curves, delineated by resource quality and other parameters. Using mesoscale reanalysis data, we generate estimates for wind quality, both terrestrial and offshore, across the globe. Because not all land or water area is suitable for development, appropriate database layers provide exclusions to reduce the total resource to its technical potential. We expand upon estimates from related studies by: using a globally consistent data source of uniquely detailed wind speed characterizations; assuming a non-constant coefficient of performance for adjusting power curves for altitude; categorizing the distance from resource sites to the electric power grid; and characterizing offshore exclusions on the basis of sea ice concentrations. The product, then, is technical potential by country, classified by resource quality as determined by net capacity factor. Additional classifications dimensions are available, including distance to transmission networks for terrestrial wind and distance to shore and water depth for offshore. We estimate the total global wind generation potential of 560 PWh for terrestrial wind with 90% of resource classified as low-to-mid quality, and 315 PWh for offshore wind with 67% classified as mid-to-high quality. These estimates are based on 3.5 MW composite wind turbines with 90 m hub heights, 0.95 availability, 90% array efficiency, and 5 MW/km2 deployment density in non-excluded areas. We compare the underlying technical assumption and results with other global assessments.

Nutritional status assessment in colorectal cancer patients qualified to systemic treatment

OpenAIRE

Ziętarska, Monika; Krawczyk-Lipiec, Joanna; Kraj, Leszek; Zaucha, Renata; Małgorzewicz, Sylwia

2017-01-01

Aim of the study Cancer is usually associated with impaired nutritional status, which is one of the factors contributing to the deterioration of the results of surgery, chemotherapy, or radiotherapy. The aim of this study was the assessment of the nutritional status of patients with CRC qualified to chemotherapy. Material and methods Seventy-five persons aged 40–86 years with colorectal cancer were examined. To evaluate the nutritional status NRS 2002, SGA, SCRINIO Working Group classificatio...

Nutritional status assessment in colorectal cancer patients qualified to systemic treatment

OpenAIRE

Monika Ziętarska; Joanna Krawczyk-Lipiec; Leszek Kraj; Renata Zaucha; Sylwia Małgorzewicz

2017-01-01

Aim of the study . Cancer is usually associated with impaired nutritional status, which is one of the factors contributing to the deterioration of the results of surgery, chemotherapy, or radiotherapy. The aim of this study was the assessment of the nutritional status of patients with CRC qualified to chemotherapy. Material and methods : Seventy-five persons aged 40–86 years with colorectal cancer were examined. To evaluate the nutritional status NRS 2002, SGA, SCRINIO Working Group...

[Oral nutritional supplementation in hematologic patients].

Science.gov (United States)

Peñalva, A; San Martín, A; Rosselló, J; Pérez-Portabella, C; Palacios, A; Julià, A; Planas, M

2009-01-01

Hematological patients often present anorexia which along with other secondary effects from the chemotherapy and/or radiotherapy treatments compromise their nutritional status. Oral supplementation can aid to fulfill the energy and protein requirements of these patients. Nevertheless, the use of commercial nutritional supplements normally available, is limited by its poor intake. To evaluate the degree of fulfillment of the prescribed supplements and fulfillment of energy requirements, as well as the development of nutritional status in hematological patients hospitalized for treatment with chemotherapy and/or radiotherapy. Prospective, randomized and open study of inpatients at the hematological ward. Patients were randomized sequentially and they were assigned into 3 different nutritional interventions providing: Group 1 (G1), a flavored supplement; Group 2 (G2): a non flavored (neutral) supplement and Group 3 (G3): "kitchen" foods as supplements. Need and amount of nutritional supplements were provided according to the oral intake previously analyzed. Nutritional assessment (at admission and discharge) was based in the Subjective Global Assessment test (SGA), Risk Nutritional Index (RNI) and percentage of lost weight. Both fulfillment of supplement intake and achievement of energetic requirements were analyzed. 125 patients of 51.3 +/- 16.8 years; 45% men and 55% women. 54% lymphoma, 33% leukemia, 8% myeloma and others 4%. Length of stay (LOS): 7.0 +/- 3.6 d. The nutritional assessment done by SGA showed significant negative changes in G2 and G3 (G1: 30% developed malnutrition and 28% improved their nutritional status, p = NS; G2: 50% developed malnutrition against 7% whom improved their nutritional status, p = 0.002; y G3: 37% developed malnutrition against 21% whom improved their nutritional status, p = 0.02). According to RNI, patients evolved negatively from their nutritional state but no significant differences were found within groups (G1, from 81% of

Impact of nutritional status on the quality of life of advanced cancer patients in hospice home care.

Science.gov (United States)

Shahmoradi, Negar; Kandiah, Mirnalini; Peng, Loh Su

2009-01-01

Cancer patients frequently experience malnutrition and this is an important factor in impaired quality of life. This cross-sectional study examined the association between global quality of life and its various subscales with nutritional status among 61 (33 females and 28 males) advanced cancer patients cared for by selected hospices in peninsular Malaysia. The Patient Generated-Subjective Global Assessment (PG-SGA) and the Hospice Quality of Life Index (HQLI) were used to assess nutritional status and quality of life, respectively. Nine (14.7%) patients were well-nourished, 32 (52.5%) were moderately or suspected of being malnourished while 20 (32.8%) of them were severely malnourished. The total HQLI mean score for these patients was 189.9-/+51.7, with possible scores ranging from 0 to 280. The most problem areas in these patients were in the domain of functional well-being and the least problems were found in the social/spiritual domain. PG-SGA scores significantly correlated with total quality of life scores (r2= 0.38, pnutritional status exhibited a lower quality of life. Advanced cancer patients with poor nutritional status have a diminished quality of life. These findings suggest that there is a need for a comprehensive nutritional intervention for improving nutritional status and quality of life in terminally ill cancer patients under hospice care.

Evaluation of nutritional indicators and body composition in patients with advanced liver disease enrolled for liver transplantation.

Science.gov (United States)

Vulcano, Daniela Salate Biagioni; Carvalhaes, Maria Antonieta de Barros Leite; Bakonyi Neto, Alexandre

2013-10-01

Malnutrition is prevalent in patients with advanced liver disease (LD) related to multifactorial causes. Fluid retention can underestimate the nutritional status based on anthropometric measures. We evaluated nutritional indicators and body composition (BC) in patients with liver cirrhosis and correlated them with LD severity. Forty three patients with LD enrolled for liver transplantation were evaluated by Anthropometric measures, subjective evaluation (Global Assessment of Nutritional Status - SGA) and biochemical indicators. Single-frequency electrical bioimpedance (SFE-BIA) was used to evaluate body composition (BC). It measured resistance (R), reactance (Xc) and the phase angle (PA). LD severity was estimated by Child-Pugh and Meld criteria (Model for End-Stage Liver Disease). Child-Pugh index between patients was 7.11 ± 1.70 and Meld was 12.23 ± 4.22. Arm Circumference, Arm Muscle Circumference and Arm Muscle Area, SGA, hemoglobin, hematocrit and albumin showed better correlation with disease severity. Xc and PA showed correlation both with Meld and Child-Pugh score when BC were evaluated. PA was depleted in 55.8% of the patients. Diagnosis of malnutrition varied according to the method. Global assessment of nutritional status showed better correlation with disease severity than with objective methods. Single-frequency electrical bioimpedance for body composition analysis in cirrhotic patients must be cautiously used; however, primary vectors seems to be valid and promising in clinical practice.

Phytase Production by Aspergillus niger CFR 335 and Aspergillus ficuum SGA 01 through Submerged and Solid-State Fermentation

Science.gov (United States)

Shivanna, Gunashree B.; Venkateswaran, Govindarajulu

2014-01-01

Fermentation is one of the industrially important processes for the development of microbial metabolites that has immense applications in various fields. This has prompted to employ fermentation as a major technique in the production of phytase from microbial source. In this study, a comparison was made between submerged (SmF) and solid-state fermentations (SSF) for the production of phytase from Aspergillus niger CFR 335 and Aspergillus ficuum SGA 01. It was found that both the fungi were capable of producing maximum phytase on 5th day of incubation in both submerged and solid-state fermentation media. Aspergillus niger CFR 335 and A. ficuum produced a maximum of 60.6 U/gds and 38 U/gds of the enzyme, respectively, in wheat bran solid substrate medium. Enhancement in the enzyme level (76 and 50.7 U/gds) was found when grown in a combined solid substrate medium comprising wheat bran, rice bran, and groundnut cake in the ratio of 2 : 1 : 1. A maximum of 9.6 and 8.2 U/mL of enzyme activity was observed in SmF by A. niger CFR 335 and A.ficuum, respectively, when grown in potato dextrose broth. PMID:24688383

Towards a Global Water Scarcity Risk Assessment Framework: Incorporation of Probability Distributions and Hydro-Climatic Variability

Science.gov (United States)

Veldkamp, T. I. E.; Wada, Y.; Aerts, J. C. J. H.; Ward, P. J.

2016-01-01

Changing hydro-climatic and socioeconomic conditions increasingly put pressure on fresh water resources and are expected to aggravate water scarcity conditions towards the future. Despite numerous calls for risk-based water scarcity assessments, a global-scale framework that includes UNISDR's definition of risk does not yet exist. This study provides a first step towards such a risk based assessment, applying a Gamma distribution to estimate water scarcity conditions at the global scale under historic and future conditions, using multiple climate change and population growth scenarios. Our study highlights that water scarcity risk, expressed in terms of expected annual exposed population, increases given all future scenarios, up to greater than 56.2% of the global population in 2080. Looking at the drivers of risk, we find that population growth outweigh the impacts of climate change at global and regional scales. Using a risk-based method to assess water scarcity, we show the results to be less sensitive than traditional water scarcity assessments to the use of fixed threshold to represent different levels of water scarcity. This becomes especially important when moving from global to local scales, whereby deviations increase up to 50% of estimated risk levels.

Lithium Resources and Production: Critical Assessment and Global Projections

Directory of Open Access Journals (Sweden)

Steve H. Mohr

2012-03-01

Full Text Available This paper critically assesses if accessible lithium resources are sufficient for expanded demand due to lithium battery electric vehicles. The ultimately recoverable resources (URR of lithium globally were estimated at between 19.3 (Case 1 and 55.0 (Case 3 Mt Li; Best Estimate (BE was 23.6 Mt Li. The Mohr 2010 model was modified to project lithium supply. The Case 1 URR scenario indicates sufficient lithium for a 77% maximum penetration of lithium battery electric vehicles in 2080 whereas supply is adequate to beyond 2200 in the Case 3 URR scenario. Global lithium demand approached a maximum of 857 kt Li/y, with a 100% penetration of lithium vehicles, 3.5 people per car and 10 billion population.

Invited review: A position on the Global Livestock Environmental Assessment Model (GLEAM).

Science.gov (United States)

MacLeod, M J; Vellinga, T; Opio, C; Falcucci, A; Tempio, G; Henderson, B; Makkar, H; Mottet, A; Robinson, T; Steinfeld, H; Gerber, P J

2018-02-01

The livestock sector is one of the fastest growing subsectors of the agricultural economy and, while it makes a major contribution to global food supply and economic development, it also consumes significant amounts of natural resources and alters the environment. In order to improve our understanding of the global environmental impact of livestock supply chains, the Food and Agriculture Organization of the United Nations has developed the Global Livestock Environmental Assessment Model (GLEAM). The purpose of this paper is to provide a review of GLEAM. Specifically, it explains the model architecture, methods and functionality, that is the types of analysis that the model can perform. The model focuses primarily on the quantification of greenhouse gases emissions arising from the production of the 11 main livestock commodities. The model inputs and outputs are managed and produced as raster data sets, with spatial resolution of 0.05 decimal degrees. The Global Livestock Environmental Assessment Model v1.0 consists of five distinct modules: (a) the Herd Module; (b) the Manure Module; (c) the Feed Module; (d) the System Module; (e) the Allocation Module. In terms of the modelling approach, GLEAM has several advantages. For example spatial information on livestock distributions and crops yields enables rations to be derived that reflect the local availability of feed resources in developing countries. The Global Livestock Environmental Assessment Model also contains a herd model that enables livestock statistics to be disaggregated and variation in livestock performance and management to be captured. Priorities for future development of GLEAM include: improving data quality and the methods used to perform emissions calculations; extending the scope of the model to include selected additional environmental impacts and to enable predictive modelling; and improving the utility of GLEAM output.

Combined Influence of Gestational Weight Gain and Estimated Fetal Weight on Risk Assessment for Small- or Large-for-Gestational-Age Birth Weight: A Prospective Cohort Study.

Science.gov (United States)

Pugh, Sarah J; Hinkle, Stefanie N; Kim, Sungduk; Albert, Paul S; Newman, Roger; Grobman, William A; Wing, Deborah A; Grantz, Katherine L

2018-04-01

To evaluate the frequency with which gestational weight gain and estimated fetal weight do not track across gestation and to assess the risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight as a function of tracking. This study included a pregnancy cohort (2009-2013) of 2438 women from 4 racial/ethnic groups in the United States. We calculated race- and trimester-specific gestational weight gain and estimated fetal weight z scores. The prevalence of how often gestational weight gain and estimated fetal weight did not or did directly track was examined by grouping z scores into measure-specific categories (1 SD) and then examining 2-measure combinations. Trimester-specific relative risks for SGA and LGA births were estimated with a gestational weight gain and estimated fetal weight z score interaction. We estimated coefficients for selected gestational weight gain and estimated fetal weight values (-1 SD, 0 SD, and +1 SD) compared with the referent of 0 SD for both measures. Small and large for gestational age were calculated as birth weight below the 10th and at or above the 90th percentiles, respectively. Gestational weight gain and estimated fetal weight were within 1 SD 55.5%, 51.5%, and 48.2% of the time in the first, second, and third trimesters, respectively. There was no significant interaction between gestational weight gain and estimated fetal weight on the risk of SGA in the first and second trimesters (interaction term P = .48; P = .79). In the third trimester, there was a significant interaction (P = .002), resulting in a 71% (95% confidence interval, 1.45-2.02) increased risk of SGA when estimated fetal weight was low and gestational weight gain was high. These relationships were similar for the risk of LGA. Deviations in either measure, even in the presence of average gestational weight gain or estimated fetal weight, still suggest an increased risk of SGA and LGA. © 2017 by the American Institute of

Global ex-situ crop diversity conservation and the Svalbard Global Seed Vault: assessing the current status.

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Ola T Westengen

Full Text Available Ex-situ conservation of crop diversity is a global concern, and the development of an efficient and sustainable conservation system is a historic priority recognized in international law and policy. We assess the completeness of the safety duplication collection in the Svalbard Global Seed Vault with respect to data on the world's ex-situ collections as reported by the Food and Agriculture Organization of the United Nations. Currently, 774,601 samples are deposited at Svalbard by 53 genebanks. We estimate that more than one third of the globally distinct accessions of 156 crop genera stored in genebanks as orthodox seeds are conserved in the Seed Vault. The numbers of safety duplicates of Triticum (wheat, Sorghum (sorghum, Pennisetum (pearl millet, Eleusine (finger millet, Cicer (chickpea and Lens (lentil exceed 50% of the estimated numbers of distinct accessions in global ex-situ collections. The number of accessions conserved globally generally reflects importance for food production, but there are significant gaps in the safety collection at Svalbard in some genera of high importance for food security in tropical countries, such as Amaranthus (amaranth, Chenopodium (quinoa, Eragrostis (teff and Abelmoschus (okra. In the 29 food-crop genera with the largest number of accessions stored globally, an average of 5.5 out of the ten largest collections is already represented in the Seed Vault collection or is covered by existing deposit agreements. The high coverage of ITPGRFA Annex 1 crops and of those crops for which there is a CGIAR mandate in the current Seed Vault collection indicates that existence of international policies and institutions are important determinants for accessions to be safety duplicated at Svalbard. As a back-up site for the global conservation system, the Seed Vault plays not only a practical but also a symbolic role for enhanced integration and cooperation for conservation of crop diversity.

Global ex-situ crop diversity conservation and the Svalbard Global Seed Vault: assessing the current status.

Science.gov (United States)

Westengen, Ola T; Jeppson, Simon; Guarino, Luigi

2013-01-01

Ex-situ conservation of crop diversity is a global concern, and the development of an efficient and sustainable conservation system is a historic priority recognized in international law and policy. We assess the completeness of the safety duplication collection in the Svalbard Global Seed Vault with respect to data on the world's ex-situ collections as reported by the Food and Agriculture Organization of the United Nations. Currently, 774,601 samples are deposited at Svalbard by 53 genebanks. We estimate that more than one third of the globally distinct accessions of 156 crop genera stored in genebanks as orthodox seeds are conserved in the Seed Vault. The numbers of safety duplicates of Triticum (wheat), Sorghum (sorghum), Pennisetum (pearl millet), Eleusine (finger millet), Cicer (chickpea) and Lens (lentil) exceed 50% of the estimated numbers of distinct accessions in global ex-situ collections. The number of accessions conserved globally generally reflects importance for food production, but there are significant gaps in the safety collection at Svalbard in some genera of high importance for food security in tropical countries, such as Amaranthus (amaranth), Chenopodium (quinoa), Eragrostis (teff) and Abelmoschus (okra). In the 29 food-crop genera with the largest number of accessions stored globally, an average of 5.5 out of the ten largest collections is already represented in the Seed Vault collection or is covered by existing deposit agreements. The high coverage of ITPGRFA Annex 1 crops and of those crops for which there is a CGIAR mandate in the current Seed Vault collection indicates that existence of international policies and institutions are important determinants for accessions to be safety duplicated at Svalbard. As a back-up site for the global conservation system, the Seed Vault plays not only a practical but also a symbolic role for enhanced integration and cooperation for conservation of crop diversity.

The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

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Gianpaolo Maso

2014-01-01

Full Text Available The antenatal condition of small for gestational age (SGA is significantly associated with perinatal morbidity and mortality and it is known that there are significant differences in birth weight and fetal size among different populations. The aim of our study was to assess the impact on outcomes of the diagnosis of SGA according to Bangladeshi and European antenatal growth charts in Sri Lankan population. The estimated fetal weight before delivery was retrospectively reviewed according to Bangladeshi and European growth references. Three groups were identified: Group 1-SGA according to Bangladeshi growth chart; Group 2-SGA according to European growth chart but not having SGA according to Bangladeshi growth chart; Group 3-No SGA according to both charts. There was a difference in prevalence of SGA between Bangladeshi and European growth charts: 12.7% and 51.7%, respectively. There were statistically significant higher rates in emergency cesarean section, fetal distress in labour, and intrauterine death (P<0.001 in Group 1 compared with Group, 2 and 3. No differences of outcomes occurred between Groups 2 and 3. Our study demonstrated that only cases diagnosed as SGA according to population-based growth charts are at risk of adverse outcome. The use of inappropriate prenatal growth charts might lead to misdiagnosis and potential unnecessary interventions.

Nutritional requirements and feeding recommendations for small for gestational age infants.

Science.gov (United States)

Tudehope, David; Vento, Maximo; Bhutta, Zulfiqar; Pachi, Paulo

2013-03-01

We define the small for gestational age (SGA) infant as an infant born ≥ 35 weeks' gestation and milk for SGA infants because it meets most of their nutritional requirements and provides short- and long-term benefits. Several distinct patterns of intrauterine growth restriction are identified among the heterogeneous grouping of SGA infants; each varies with regard to neonatal morbidities, requirements for neonatal management, postnatal growth velocities, neurodevelopmental progress, and adult health outcomes. There is much we do not know about nutritional management of the SGA infant. We need to identify and define: infants who have "true" growth restriction and are at high risk for adverse metabolic outcomes in later life; optimal growth velocity and "catch-up" growth rates that are conducive with life-long health and well being; global approaches to management of hypoglycemia; and an optimal model for postdischarge care. Large, rigorously conducted trials are required to determine whether aggressive feeding of SGA infants results in improved nutritional rehabilitation, growth, and neurodevelopmental outcomes. Before birth, maternal supplementation with specific nutrients reduces the rate and severity of growth restriction and may prevent nutrient deficiency states if infants are born SGA. After birth, the generally accepted goal is to provide enough nutrients to achieve postnatal growth similar to that of a normal fetus. In addition, we recommend SGA infants be allowed to "room in" with their mothers to promote breastfeeding, mother-infant attachment, and skin-to-skin contact to assist with thermoregulation. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

Global assessment of the economics of land degradation and improvement

Science.gov (United States)

Nkonya, Ephraim

2017-04-01

Land degradation—defined by the Millennium Ecosystem Assessment report as the long-term loss of ecosystems services—is a global problem, negatively affecting the livelihoods and food security of billions of people. Intensifying efforts, mobilizing more investments and strengthening the policy commitment for addressing land degradation at the global level needs to be supported by a careful evaluation of the costs and benefits of action versus costs of inaction against land degradation. Consistent with the definition of land degradation, we adopt the Total Economic Value (TEV) approach to determine the costs of land degradation and use remote sensing data and global statistical databases in our analysis. The results show that the annual costs of land degradation due to land use and land cover change (LUCC) are about US231 billion per year or about 0.41 % of the global GDP of US56.49 trillion in 2007. Contrary to past global land degradation assessment studies, land degradation is severe in both tropical and temperate countries. However, the losses from LUCC are especially high in Sub-Saharan Africa, which accounts for 26 % of the total global costs of land degradation due to LUCC. However, the local tangible losses (mainly provisioning services) account only for 46 % of the total cost of land degradation and the rest of the cost is due to the losses of ecosystem services (ES) accruable largely to beneficiaries other than the local land users. These external ES losses include carbon sequestration, biodiversity, genetic information and cultural services. This implies that the global community bears the largest cost of land degradation, which suggests that efforts to address land degradation should be done bearing in mind that the global community,as a whole, incurs larger losses than the local communities experiencing land degradation. The cost of soil fertility mining due to using land degrading management practices on maize, rice and wheat is estimated to be

Integrating Global Open Geo-Information for Major Disaster Assessment: A Case Study of the Myanmar Flood

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Suju Li

2017-07-01

Full Text Available Major disasters typically impact large areas, cause considerable damages, and result in significant human and economic losses. The timely and accurate estimation of impacts and damages is essential to better understand disaster conditions and to support emergency response operations. Geo-information drawn from various sources at multi spatial-temporal scales can be used for disaster assessments through a synthesis of hazard, exposure, and post disaster information based on pertinent approaches. Along with the increased availability of open sourced data and cooperation initiatives, more global scale geo-information, including global land cover datasets, has been produced and can be integrated with other information for disaster dynamic damage assessment (e.g., impact estimation immediately after a disaster occurs, physical damage assessment during the emergency response stage, and comprehensive assessment following an emergency response. Residential areas and arable lands affected by the flood disaster occurring from July to August 2015 in Myanmar were assessed based on satellite images, GlobeLand30 data, and other global open sourced information as a study case. The results show that integrating global open geo-information could serve as a practical and efficient means of assessing damage resulting from major disasters worldwide, especially at the early emergency response stage.

Vanishing twins: a predictor of small-for-gestational age in IVF singletons

DEFF Research Database (Denmark)

Pinborg, Anja; Lidegaard, Ojvind; Freiesleben, Nina la Cour

2007-01-01

The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.......The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons....

Global approach of mean service satisfaction assessment

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Ahmed Dooguy Kora

2014-01-01

Full Text Available A theoretical expression for mobile service satisfaction assessment has been proposed. Mobile networks users’ satisfaction is a major concern for the operators and regulators. Therefore a certain level of network qualification is required to be offered to consumers by operators thanks to the decisions initiated by the regulation authority. For the assessment of the level of satisfaction, several methodologies and tools (measuring and monitoring have emerged. Ranking in two broad categories, namely the objective and subjective methods, both have advantages as well as disadvantages. This Letter has proposed a unified approach to evaluate more objectively users’ level of satisfaction of a service based on the most common network key performance indicators (KPIs rate following the different methods. This approach's main advantage is that it has taken advantages of the different positive aspects of the existing methods and outperformed their limitations thanks to the introduced concept of global KPI. In addition, the size of samples according to each method has been considered. A mean service satisfaction theoretical expression has been proposed to regulation authority, consumers association and operators as common base of service satisfaction assessment.

Global assessment of promising forest management practices for sequestration of carbon

International Nuclear Information System (INIS)

Winjum, J.K.; Dixon, R.K.; Schroeder, P.E.

1991-01-01

In the 1980s, forests covered an estimated 4.08 billion hectares and contained a carbon pool of 1,400 gigatonnes, or 64% of the total terrestrial pool. Forest biomass productivity per unit of land can be enhanced by proper management practices and it is suggested that by implementing such practices, forests could store more carbon globally and thereby slow the increase in atmospheric CO 2 . Currently, only about 10% of world forests are managed at an active level. An assessment is presented of the amount of carbon that could be sequestered globally by implementing the practices of reforestation, afforestation, natural regeneration, silviculture, and agroforestry. The assessment is based on the development of a global database on managed forest and agroforestry systems. For each of the above five practices, the database contains information on carbon sequestered per hectare, implementation costs, and estimates of the amount of land technically suitable for such practices throughout the world. Results are presented for each practice in the boreal, temperate, and tropical regions. Preliminary estimates show that promising forestry and agroforestry practices could sequester, over a 50-y period, ca 50-100 gigatonnes of carbon at a cost of $170-340 million. This would be a significant contribution as a mitigating measure regarding atmospheric CO 2 buildup and projections for global warming, at present rates of anthropogenic carbon emissions (300-400 gigatonnes carbon over 50 y). 19 refs., 2 figs., 4 tabs

Stem cell engineering a WTEC global assessment

CERN Document Server

Loring, Jeanne; McDevitt, Todd; Palecek, Sean; Schaffer, David; Zandstra, Peter

2014-01-01

This book describes a global assessment of stem cell engineering research, achieved through site visits by a panel of experts to leading institutes, followed by dedicated workshops. The assessment made clear that engineers and the engineering approach with its quantitative, system-based thinking can contribute much to the progress of stem cell research and development. The increased need for complex computational models and new, innovative technologies, such as high-throughput screening techniques, organ-on-a-chip models and in vitro tumor models require an increasing involvement of engineers and physical scientists. Additionally, this book will show that although the US is still in a leadership position in stem cell engineering, Asian countries such as Japan, China and Korea, as well as European countries like the UK, Germany, Sweden and the Netherlands are rapidly expanding their investments in the field. Strategic partnerships between countries could lead to major advances of the field and scalable expansi...

Limitless Learning: Assessing Social Media Use for Global Workplace Learning

Science.gov (United States)

Breunig, Karl Joachim

2016-01-01

Purpose: This empirical paper aims to assess how social media can foster workplace learning within a globally dispersed project environment. In general, there are few studies on the use of social media in organizations, and many of these emphasize on issues related to knowledge transfer. Although learning traditionally has been as acquisition of…

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment.

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Aline Guttmann

Full Text Available In cluster detection of disease, the use of local cluster detection tests (CDTs is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps.

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment

Science.gov (United States)

Guttmann, Aline; Li, Xinran; Feschet, Fabien; Gaudart, Jean; Demongeot, Jacques; Boire, Jean-Yves; Ouchchane, Lemlih

2015-01-01

In cluster detection of disease, the use of local cluster detection tests (CDTs) is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC) is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps. PMID:26086911

Porphyry copper assessment of Southeast Asia and Melanesia: Chapter D in Global mineral resource assessment

Science.gov (United States)

Hammarstrom, Jane M.; Bookstrom, Arthur A.; Dicken, Connie L.; Drenth, Benjamin J.; Ludington, Steve; Robinson, Gilpin R.; Setiabudi, Bambang Tjahjono; Sukserm, Wudhikarn; Sunuhadi, Dwi Nugroho; Wah, Alexander Yan Sze; Zientek, Michael L.

2013-01-01

The U.S. Geological Survey collaborated with member countries of the Coordinating Committee for Geoscience Programmes in East and Southeast Asia (CCOP) on an assessment of the porphyry copper resources of Southeast Asia and Melanesia as part of a global mineral resource assessment. The region hosts world-class porphyry copper deposits and underexplored areas that are likely to contain undiscovered deposits. Examples of known porphyry copper deposits include Batu Hijau and Grasberg in Indonesia; Panguna, Frieda River, and Ok Tedi in Papua New Guinea; and Namosi in Fiji.

Global assessment of onshore wind power resources considering the distance to urban areas

International Nuclear Information System (INIS)

Silva Herran, Diego; Dai, Hancheng; Fujimori, Shinichiro; Masui, Toshihiko

2016-01-01

This study assessed global onshore wind power resources considering the distance to urban areas in terms of transmission losses and costs, and visibility (landscape impact) restrictions. Including this factor decreased the economic potential considerably depending on the level of supply cost considered (at least 37% and 16% for an economic potential below 10 and 14 US cents/kWh, respectively). Its importance compared to other factors was secondary below 15 US cents/kWh. At higher costs it was secondary only to land use, and was more important than economic and technical factors. The impact of this factor was mixed across all regions of the world, given the heterogeneity of wind resources in remote and proximal areas. Regions where available resources decreased the most included the European Union, Japan, Southeast Asia, the Middle East, and Africa. The supply cost chosen to evaluate the economic potential and uncertainties influencing the estimation of distance to the closest urban area are critical for the assessment. Neglecting the restrictions associated with integration into energy systems and social acceptability resulted in an overestimation of global onshore wind resources. These outcomes are fundamental for global climate policies because they help to clarify the limits of wind energy resource availability. - Highlights: • Global onshore wind resources were assessed including the distance to urban areas. • We evaluate the impact of transmission losses and cost, and visibility restrictions. • The distance to urban areas' impact was considerable, depending on the supply cost. • This factor's importance was secondary to economic, land use, and technical factors. • Neglecting this factor resulted in an overestimation of global wind resources.

Effectiveness of slow motion video compared to real time video in ...

African Journals Online (AJOL)

Objective measures of canine gait quality via force plates, pressure mats or kinematic analysis are considered superior to subjective gait assessment (SGA). Despite research demonstrating that SGA does not accurately detect subtle lameness, it remains the most commonly performed diagnostic test for detecting lameness ...

Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

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Patrick Harris

2015-01-01

Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

Porphyry copper assessment of western Central Asia: Chapter N in Global mineral resource assessment

Science.gov (United States)

Berger, Byron R.; Mars, John L.; Denning, Paul; Phillips, Jeffrey D.; Hammarstrom, Jane M.; Zientek, Michael L.; Dicken, Connie L.; Drew, Lawrence J.; with contributions from Alexeiev, Dmitriy; Seltmann, Reimar; Herrington, Richard J.

2014-01-01

The U.S. Geological Survey conducted an assessment of resources associated with porphyry copper deposits in the western Central Asia countries of Kyrgyzstan, Uzbekistan, Kazakhstan, and Tajikistan and the southern Urals of Kazakhstan and Russia as part of a global mineral resource assessment. The purpose of the study was to (1) delineate permissive areas (tracts) for undiscovered porphyry copper deposits; (2) compile a database of known porphyry copper deposits and significant prospects; (3) where data permit, estimate numbers of undiscovered deposits within those permissive tracts; and (4) provide probabilistic estimates the amounts of copper (Cu), molybdenum (Mo), gold (Au), and silver (Ag) that could be contained in those undiscovered deposits.

Graphical Methodology of Global Pollution Index for the Environmental Impact Assessment Using Two Environmental Components

OpenAIRE

Corneliu Cojocaru; Diana Mariana Cocârţă; Irina Aura Istrate; Igor Creţescu

2017-01-01

One of the applied methods for environmental impact assessment is the index of global pollution (IGP) proposed by Rojanschi in 1991. This methodology enables the global estimation for the ecosystem state affected more or less by human activities. Unfortunately, Rojanschi’s method has a limitation; it can be applied only if at least three environmental components are considered. Frequently, many environmental impact assessment applications rely on analysis of only two environmental components....

Global assessment of ocean carbon export by combining satellite observations and food-web models

Science.gov (United States)

Siegel, D. A.; Buesseler, K. O.; Doney, S. C.; Sailley, S. F.; Behrenfeld, M. J.; Boyd, P. W.

2014-03-01

The export of organic carbon from the surface ocean by sinking particles is an important, yet highly uncertain, component of the global carbon cycle. Here we introduce a mechanistic assessment of the global ocean carbon export using satellite observations, including determinations of net primary production and the slope of the particle size spectrum, to drive a food-web model that estimates the production of sinking zooplankton feces and algal aggregates comprising the sinking particle flux at the base of the euphotic zone. The synthesis of observations and models reveals fundamentally different and ecologically consistent regional-scale patterns in export and export efficiency not found in previous global carbon export assessments. The model reproduces regional-scale particle export field observations and predicts a climatological mean global carbon export from the euphotic zone of 6 Pg C yr-1. Global export estimates show small variation (typically model parameter values. The model is also robust to the choices of the satellite data products used and enables interannual changes to be quantified. The present synthesis of observations and models provides a path for quantifying the ocean's biological pump.

Pyrosequencing of the bacteria associated with Platygyra carnosus corals with skeletal growth anomalies reveals differences in bacterial community composition in apparently healthy and diseased tissues

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Jenny Chun-Yee Ng

2015-10-01

Full Text Available Corals are rapidly declining globally due to coral diseases. Skeletal growth anomalies (SGA or coral tumors are a group of coral diseases that affect coral reefs worldwide, including Hong Kong waters in the Indo-Pacific region. To better understand how bacterial communities may vary in corals with SGA, for the first time, we examined the bacterial composition associated with the apparently healthy and the diseased tissues of SGA-affected Platgyra carnosus using 16S ribosomal rRNA gene pyrosequencing. Taxonomic analysis revealed Proteobacteria, Bacteroidetes, Cyanobacteria, and Actinobacteria as the main phyla in both the apparently healthy and the diseased tissues. A significant difference in the bacterial community composition was observed between the two conditions at the OTU level. Diseased tissues were associated with higher abundances of Acidobacteria and Gemmatimonadetes, and a lower abundance of Spirochaetes. Several OTUs belonging to Rhodobacteraceae, Rhizobiales, Gammaproteobacteria, and Cytophaga-Flavobacterium-Bacteroidetes (CFB were strongly associated with the diseased tissues. These groups of bacteria may contain potential pathogens involved with the development of SGA or opportunistic secondary or tertiary colonizers that proliferated upon the health-compromised coral host. We suggest that these bacterial groups to be further studied based on inoculation experiments and testing of Koch’s postulates in efforts to understand the etiology and progression of SGA.

Differential effect of assisted reproductive technology and small-for-gestational age on fetal cardiac remodeling.

Science.gov (United States)

Valenzuela-Alcaraz, B; Crispi, F; Cruz-Lemini, M; Bijnens, B; García-Otero, L; Sitges, M; Balasch, J; Gratacós, E

2017-07-01

Fetuses conceived by assisted reproductive technology (ART) and those that are small-for-gestational age (SGA) show cardiovascular remodeling in utero; however, these two conditions are often associated. We aimed to evaluate the differential effect of ART and SGA on fetal cardiac remodeling. This was a prospective cohort study of term singleton pregnancies seen at our department between April 2011 and September 2013. The cohort was divided according to fetal growth and mode of conception into the following four groups: 102 appropriate-for-gestational-age (AGA) fetuses conceived spontaneously (controls), 72 AGA fetuses conceived by ART (ART-AGA), 31 SGA fetuses conceived by ART (ART-SGA) and 28 SGA fetuses conceived naturally (Spont-SGA). SGA was defined as birth weight Fetal echocardiography was performed at 28-32 weeks to assess cardiac dimensions, geometry and function. ART fetuses had dilated atria (mean left atrium-to-heart area ratio: controls, 15 ± 2.7%; ART-AGA, 18 ± 4.1%; Spont-SGA, 14 ± 3.7%) and more globular ventricles (left ventricular sphericity index: controls, 1.77 ± 0.2; ART-AGA, 1.68 ± 0.2; Spont-SGA, 1.72 ± 0.2), with normally sized hearts. In contrast, SGA fetuses had enlarged hearts (cardiothoracic ratio: controls, 24 ± 3%; ART-AGA, 24 ± 4%; Spont-SGA, 29 ± 6%), preserved atrial size, more globular and concentric hypertrophic ventricles (left ventricle relative wall thickness: controls, 0.48 ± 0.17; ART-AGA, 0.54 ± 0.13; Spont-SGA, 0.63 ± 0.23). Both ART and SGA fetuses had decreased longitudinal motion (tricuspid annular ring displacement: controls, 6.5 ± 0.8 mm; ART-AGA, 5.5 ± 0.7 mm; Spont-SGA, 5.9 ± 0.6 mm) and impaired relaxation (left isovolumetric relaxation time: controls, 47.0 ± 7.3 ms; ART-AGA, 50.0 ± 7.9 ms; Spont-SGA, 49.5 ± 9.3 ms). ART-SGA fetuses presented a combination of features from both ART and SGA groups. SGA and conception with ART

The assessment of Global Precipitation Measurement estimates over the Indian subcontinent

Science.gov (United States)

Murali Krishna, U. V.; Das, Subrata Kumar; Deshpande, Sachin M.; Doiphode, S. L.; Pandithurai, G.

2017-08-01

Accurate and real-time precipitation estimation is a challenging task for current and future spaceborne measurements, which is essential to understand the global hydrological cycle. Recently, the Global Precipitation Measurement (GPM) satellites were launched as a next-generation rainfall mission for observing the global precipitation characteristics. The purpose of the GPM is to enhance the spatiotemporal resolution of global precipitation. The main objective of the present study is to assess the rainfall products from the GPM, especially the Integrated Multi-satellitE Retrievals for the GPM (IMERG) data by comparing with the ground-based observations. The multitemporal scale evaluations of rainfall involving subdaily, diurnal, monthly, and seasonal scales were performed over the Indian subcontinent. The comparison shows that the IMERG performed better than the Tropical Rainfall Measuring Mission (TRMM)-3B42, although both rainfall products underestimated the observed rainfall compared to the ground-based measurements. The analyses also reveal that the TRMM-3B42 and IMERG data sets are able to represent the large-scale monsoon rainfall spatial features but are having region-specific biases. The IMERG shows significant improvement in low rainfall estimates compared to the TRMM-3B42 for selected regions. In the spatial distribution, the IMERG shows higher rain rates compared to the TRMM-3B42, due to its enhanced spatial and temporal resolutions. Apart from this, the characteristics of raindrop size distribution (DSD) obtained from the GPM mission dual-frequency precipitation radar is assessed over the complex mountain terrain site in the Western Ghats, India, using the DSD measured by a Joss-Waldvogel disdrometer.

A global water scarcity assessment under Shared Socio-economic Pathways – Part 1: Water use

Directory of Open Access Journals (Sweden)

N. Hanasaki

2013-07-01

Full Text Available A novel global water scarcity assessment for the 21st century is presented in a two-part paper. In this first paper, water use scenarios are presented for the latest global hydrological models. The scenarios are compatible with the socio-economic scenarios of the Shared Socio-economic Pathways (SSPs, which are a part of the latest set of scenarios on global change developed by the integrated assessment, the IAV (climate change impact, adaptation, and vulnerability assessment, and the climate modeling community. The SSPs depict five global situations based on substantially different socio-economic conditions during the 21st century. Water use scenarios were developed to reflect not only quantitative socio-economic factors, such as population and electricity production, but also key qualitative concepts such as the degree of technological change and overall environmental consciousness. Each scenario consists of five factors: irrigated area, crop intensity, irrigation efficiency, and withdrawal-based potential industrial and municipal water demands. The first three factors are used to estimate the potential irrigation water demand. All factors were developed using simple models based on a literature review and analysis of historical records. The factors are grid-based at a spatial resolution of 0.5° × 0.5° and cover the whole 21st century in five-year intervals. Each factor shows wide variation among the different global situations depicted: the irrigated area in 2085 varies between 2.7 × 106 and 4.5 × 106 km2, withdrawal-based potential industrial water demand between 246 and 1714 km3 yr−1, and municipal water between 573 and 1280 km3 yr−1. The water use scenarios can be used for global water scarcity assessments that identify the regions vulnerable to water scarcity and analyze the timing and magnitude of scarcity conditions.

Global assessment of internal audit competence: Does one size fi t all?

African Journals Online (AJOL)

Data from the Institute of Internal Auditors' (IIA's) latest global Common Body of Knowledge ... Australia consistently indicated different perceptions of the levels of ... Australia's need for a country-specifi c internal audit competency assessment.

Assessment of global phase uncertainty in case-control studies

Directory of Open Access Journals (Sweden)

van Houwelingen Hans C

2009-09-01

Full Text Available Abstract Background In haplotype-based candidate gene studies a problem is that the genotype data are unphased, which results in haplotype ambiguity. The measure 1 quantifies haplotype predictability from genotype data. It is computed for each individual haplotype, and for a measure of global relative efficiency a minimum value is suggested. Alternatively, we developed methods directly based on the information content of haplotype frequency estimates to obtain global relative efficiency measures: and based on A- and D-optimality, respectively. All three methods are designed for single populations; they can be applied in cases only, controls only or the whole data. Therefore they are not necessarily optimal for haplotype testing in case-control studies. Results A new global relative efficiency measure was derived to maximize power of a simple test statistic that compares haplotype frequencies in cases and controls. Application to real data showed that our proposed method gave a clear and summarizing measure for the case-control study conducted. Additionally this measure might be used for selection of individuals, who have the highest potential for improving power by resolving phase ambiguity. Conclusion Instead of using relative efficiency measure for cases only, controls only or their combined data, we link uncertainty measure to case-control studies directly. Hence, our global efficiency measure might be useful to assess whether data are informative or have enough power for estimation of a specific haplotype risk.

Reporter-Based Synthetic Genetic Array Analysis: A Functional Genomics Approach for Investigating Transcript or Protein Abundance Using Fluorescent Proteins in Saccharomyces cerevisiae.

Science.gov (United States)

Göttert, Hendrikje; Mattiazzi Usaj, Mojca; Rosebrock, Adam P; Andrews, Brenda J

2018-01-01

Fluorescent reporter genes have long been used to quantify various cell features such as transcript and protein abundance. Here, we describe a method, reporter synthetic genetic array (R-SGA) analysis, which allows for the simultaneous quantification of any fluorescent protein readout in thousands of yeast strains using an automated pipeline. R-SGA combines a fluorescent reporter system with standard SGA analysis and can be used to examine any array-based strain collection available to the yeast community. This protocol describes the R-SGA methodology for screening different arrays of yeast mutants including the deletion collection, a collection of temperature-sensitive strains for the assessment of essential yeast genes and a collection of inducible overexpression strains. We also present an alternative pipeline for the analysis of R-SGA output strains using flow cytometry of cells in liquid culture. Data normalization for both pipelines is discussed.

Nutritional status of cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute.

Science.gov (United States)

Montoya, J E; Domingo, F; Luna, C A; Berroya, R M; Catli, C A; Ginete, J K; Sanchez, O S; Juat, N J; Tiangco, B J; Jamias, J D

2010-11-01

Malnutrition is common among cancer patients. This study aimed to determine the overall prevalence of malnutrition among patients undergoing chemotherapy and to determine the predictors of malnutrition among cancer patients. A cross-sectional study was conducted on 88 cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute, Philippines, from October to November 2009. Subjective Global Assessment (SGA), anthropometric data and demographic variables were obtained. Descriptive statistics, ANOVA and logistic regression analysis were performed between the outcome and variables. A total of 88 cancer patients were included in the study. The mean age of the patients was 55.7 +/- 14.8 years. The mean duration of illness was 9.7 +/- 8.7 months and the mean body mass index (BMI) was 22.9 kg/m2. The mean Karnofsky performance status was 79.3. 29.55 percent of the patients had breast cancer as the aetiology of their illness. 38 patients (43.2 percent) had SGA B and four (4.5 percent) had SGA C, giving a total malnutrition prevalence of 47.7 percent. The patients were statistically different with regard to their cancer stage (p is less than 0.001), weight (p is 0.01), BMI (p is 0.004), haemoglobin level (p is 0.001) and performance status by Karnofsky score (p is less than 0.001), as evaluated by ANOVA. Logistic regression analysis showed that cancer stage and Karnofsky performance score were predictors of malnutrition. About 47.7 percent of cancer patients suffer from malnutrition, as classified by SGA. Only cancer stage and Karnofsky performance status scoring were predictive of malnutrition in this select group of patients.

Assessment of global cloud datasets from satellites: Project and database initiated by the GEWEX radiation panel

OpenAIRE

Stubenrauch , C.J.; Rossow , W.B.; Kinne , S.; Ackerman , S.; Cesana , G.; Chepfer , H.; Di Girolamo , L.; Getzewich , B.; Guignard , A.; Heidinger , A.; Maddux , B.C.; Menzel , W.P.; Minnis , P.; Pearl , C.; Platnick , S.

2013-01-01

International audience; The Global Energy and Water Cycle Experiment (GEWEX) Radiation Panel initiated the GEWEX Cloud Assessment in 2005 to compare available, global, long-term cloud data products with the International Satellite Cloud Climatology Project (ISCCP). The GEWEX Cloud Assessment database included cloud properties retrieved from different satellite sensor measurements, taken at various local times and over various time periods. The relevant passive satellite sensors measured radia...

Assessing historical rate changes in global tsunami occurrence

Science.gov (United States)

Geist, E.L.; Parsons, T.

2011-01-01

The global catalogue of tsunami events is examined to determine if transient variations in tsunami rates are consistent with a Poisson process commonly assumed for tsunami hazard assessments. The primary data analyzed are tsunamis with maximum sizes >1m. The record of these tsunamis appears to be complete since approximately 1890. A secondary data set of tsunamis >0.1m is also analyzed that appears to be complete since approximately 1960. Various kernel density estimates used to determine the rate distribution with time indicate a prominent rate change in global tsunamis during the mid-1990s. Less prominent rate changes occur in the early- and mid-20th century. To determine whether these rate fluctuations are anomalous, the distribution of annual event numbers for the tsunami catalogue is compared to Poisson and negative binomial distributions, the latter of which includes the effects of temporal clustering. Compared to a Poisson distribution, the negative binomial distribution model provides a consistent fit to tsunami event numbers for the >1m data set, but the Poisson null hypothesis cannot be falsified for the shorter duration >0.1m data set. Temporal clustering of tsunami sources is also indicated by the distribution of interevent times for both data sets. Tsunami event clusters consist only of two to four events, in contrast to protracted sequences of earthquakes that make up foreshock-main shock-aftershock sequences. From past studies of seismicity, it is likely that there is a physical triggering mechanism responsible for events within the tsunami source 'mini-clusters'. In conclusion, prominent transient rate increases in the occurrence of global tsunamis appear to be caused by temporal grouping of geographically distinct mini-clusters, in addition to the random preferential location of global M >7 earthquakes along offshore fault zones.

Cerebral MRI findings in very-low-birth-weight and small-for-gestational-age children at 15 years of age

International Nuclear Information System (INIS)

Skranes, Jon S.; Brubakk, Ann-Mari; Martinussen, Marit; Smevik, Olaug; Myhr, Gunnar; Indredavik, Marit; Vik, Torstein

2005-01-01

A high prevalence of abnormal cerebral MRI findings has been reported in low-birth-weight children. To compare MRI findings in very-low-birth-weight (VLBW) and term small-for-gestational-age (SGA) children with controls in early adolescence. Cerebral MRI was used to examine 55 VLBW, 54 SGA and 66 controls at 15 years of age. The MR images were qualitatively assessed, and size of ventricles, white-matter and grey-matter abnormalities were reported. The VLBW teenagers had a higher prevalence of various MRI abnormalities than SGA children and controls. Dilation of the ventricular system, especially of the occipital horns, was found in 82% of the VLBW group, in 19% of the SGA group and in 21% of controls. White-matter reduction was found in 53% of the VLBW, in 6% of the SGA and in 2% of controls. Corpus callosum thinning was found in 47% of the VLBW, in 2% of the SGA and in 6% of controls. Periventricular gliosis was found in 29% of the VLBW, in 4% of the SGA and in 8% of controls. Cerebral MRI pathology in white matter is a common finding in VLBW teenagers. The findings may indicate minor perinatal PVL with resulting loss of white-matter tissue and ventricular dilation. (orig.)

Successful global assessments and monitoring: The roles of the international community and the United States

International Nuclear Information System (INIS)

Lund, H.G.

1991-01-01

Successful global assessments and monitoring of natural resources requires teamwork between participating nations and the international communities charged with the responsibility for collecting and disseminating information. In an attempt to identify emerging information needs and to promote coordination, the International Union of Forestry Research Organizations (IUFRO) and other national and international groups held a major conference and workshop in Venice, Italy, on global monitoring last September. The results of the meeting and subsequent events in Montreal indicated a need for more aggressive leadership at the international level and more cooperation at the national level. This paper reports on the outcome of the Venice conference and list some things that the international community and the United States must do to make global assessments and monitoring a reality

Genetic Markers of Insulin Sensitivity and Insulin Secretion Are Associated With Spontaneous Postnatal Growth and Response to Growth Hormone Treatment in Short SGA Children

DEFF Research Database (Denmark)

Jensen, Rikke Beck; Thankamony, Ajay; Day, Felix

2015-01-01

with spontaneous postnatal weight gain (regression coefficient [B]: 0.12 SD scores per allele; 95% confidence interval [CI], 0.01-0.23; P = .03) and also in response to GH therapy with first-year height velocity (B: 0.18 cm/y per allele; 95% CI, 0.02-0.35; P = .03) and change in IGF-1 (B: 0.17 SD scores per allele......PURPOSE: The wide heterogeneity in the early growth and metabolism of children born small for gestational age (SGA), both before and during GH therapy, may reflect common genetic variations related to insulin secretion or sensitivity. METHOD: Combined multiallele single nucleotide polymorphism......; 95% CI, 0.00-0.32; P = .03). The association with first-year height velocity was independent of reported predictors of response to GH therapy (adjusted P = .04). The insulin secretion allele score (GS-InSec) was positively associated with spontaneous postnatal height gain (B: 0.15; 95% CI, 0...

An Assessment of Global Oral Health Education in U.S. Dental Schools.

Science.gov (United States)

Sung, Janet; Gluch, Joan I

2017-02-01

Dental schools need to produce graduates who are adequately prepared to respond to the complex needs and challenges of the increasingly diverse and interconnected world in which they will practice dentistry. To enhance discussions about the coverage of global oral health competencies in dental education, the aims of this study were to assess how global health education is currently incorporated into predoctoral dental training in the U.S. and which global oral health competencies are being covered. Surveys were emailed to all 64 accredited U.S. dental schools during the 2015-16 academic year. Respondents from 52 schools completed the survey (response rate 81%). The results showed that social determinants of oral diseases and conditions, how to identify barriers to use of oral health services, and how to work with patients who have limited dental health literacy were covered in the greatest number of responding schools' curricula. Key areas of global health curricula that were covered rarely included global dental infrastructure, data collection design, and horizontal and vertical programming approaches to health improvement. Despite current dialogue on the addition of global oral health competencies to dental curricula, only 41% of the responding schools were currently planning to expand their global oral health education. Based on these results, the authors conclude that it may be most feasible for dental schools to add recommended global oral health competencies to their curricula by incorporating didactic content into already established courses.

The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

Science.gov (United States)

Ruane, Alex; Rosenzweig, Cynthia; Elliott, Joshua; Antle, John

2015-01-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIPs community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPsSSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate changes impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIPs 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

Science.gov (United States)

Ruane, A. C.; Rosenzweig, C.; Antle, J. M.; Elliott, J. W.

2015-12-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIP's community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPs/SSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate change's impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIP's 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

Assessments of global drivers of vaccine hesitancy in 2014-Looking beyond safety concerns.

Directory of Open Access Journals (Sweden)

Melanie Marti

Full Text Available Vaccine hesitancy has become the focus of growing attention and concern globally despite overwhelming evidence of the value of vaccines in preventing disease and saving the lives of millions of individuals every year. Measuring vaccine hesitancy and its determinants worldwide is important in order to understand the scope of the problem and for the development of evidence-based targeted strategies to reduce hesitancy. Two indicators to assess vaccine hesitancy were developed to capture its nature and scope at the national and subnational level to collect data in 2014: 1 The top 3 reasons for not accepting vaccines according to the national schedule in the past year and whether the response was opinion- or assessment-based and 2 Whether an assessment (or measurement of the level of confidence in vaccination had taken place at national or subnational level in the previous 5 years. The most frequently cited reasons for vaccine hesitancy globally related to (1 the risk-benefit of vaccines, (2 knowledge and awareness issues, (3 religious, cultural, gender or socio-economic factors. Major issues were fear of side effects, distrust in vaccination and lack of information on immunization or immunization services. The analysis revealed that 29% of all countries had done an assessment of the level of confidence in their country, suggesting that vaccine confidence was an issue of importance. Monitoring vaccine hesitancy is critical because of its influence on the success of immunization programs. To our knowledge, the proposed indicators provide the first global snapshot of reasons driving vaccine hesitancy and depicting its widespread nature, as well as the extent of assessments conducted by countries.

Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries

DEFF Research Database (Denmark)

Kozuki, Naoko; Katz, Joanne; Lee, Anne Cc

2015-01-01

BACKGROUND: Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. OBJECTIVES: The specific aims of this study were to estimate the association between...... short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. METHODS: We conducted an individual participant data meta-analysis with the use of data sets from 12...... population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each...

Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians

Directory of Open Access Journals (Sweden)

Shillinglaw Benjamin

2012-01-01

Full Text Available Abstract Background Global coronary heart disease (CHD risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US physicians' awareness, use, and attitudes regarding global CHD risk assessment in clinical practice, and how these vary by provider specialty. Methods Using a web-based survey of US family physicians, general internists, and cardiologists, we examined awareness of tools available to calculate CHD risk, method and use of CHD risk assessment, attitudes towards CHD risk assessment, and frequency of using CHD risk assessment to guide recommendations of aspirin, lipid-lowering and blood pressure (BP lowering therapies for primary prevention. Characteristics of physicians indicating they use CHD risk assessments were compared in unadjusted and adjusted analyses. Results A total of 952 physicians completed the questionnaire, with 92% reporting awareness of tools available to calculate CHD global risk. Among those aware of such tools, over 80% agreed that CHD risk calculation is useful, improves patient care, and leads to better decisions about recommending preventive therapies. However, only 41% use CHD risk assessment in practice. The most commonly reported barrier to CHD risk assessment is that it is too time consuming. Among respondents who calculate global CHD risk, 69% indicated they use it to guide lipid lowering therapy recommendations; 54% use it to guide aspirin therapy recommendations; and 48% use it to guide BP lowering therapy. Only 40% of respondents who use global CHD risk routinely tell patients their risk. Use of a personal digital assistant or smart phone was associated with reported use of CHD risk assessment (adjusted OR 1.58; 95% CI 1.17-2.12. Conclusions Reported awareness of tools to calculate global CHD risk appears high, but the majority of physicians in this sample do not

Assessing the vertical structure of baroclinic tidal currents in a global model

Science.gov (United States)

Timko, Patrick; Arbic, Brian; Scott, Robert

2010-05-01

Tidal forcing plays an important role in many aspects of oceanography. Mixing, transport of particulates and internal wave generation are just three examples of local phenomena that may depend on the strength of local tidal currents. Advances in satellite altimetry have made an assessment of the global barotropic tide possible. However, the vertical structure of the tide may only be observed by deployment of instruments throughout the water column. Typically these observations are conducted at pre-determined depths based upon the interest of the observer. The high cost of such observations often limits both the number and the length of the observations resulting in a limit to our knowledge of the vertical structure of tidal currents. One way to expand our insight into the baroclinic structure of the ocean is through the use of numerical models. We compare the vertical structure of the global baroclinic tidal velocities in 1/12 degree HYCOM (HYbrid Coordinate Ocean Model) to a global database of current meter records. The model output is a subset of a 5 year global simulation that resolves the eddying general circulation, barotropic tides and baroclinic tides using 32 vertical layers. The density structure within the simulation is both vertically and horizontally non-uniform. In addition to buoyancy forcing the model is forced by astronomical tides and winds. We estimate the dominant semi-diurnal (M2), and diurnal (K1) tidal constituents of the model data using classical harmonic analysis. In regions where current meter record coverage is adequate, the model skill in replicating the vertical structure of the dominant diurnal and semi-diurnal tidal currents is assessed based upon the strength, orientation and phase of the tidal ellipses. We also present a global estimate of the baroclinic tidal energy at fixed depths estimated from the model output.

Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

International Nuclear Information System (INIS)

Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

2013-01-01

Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences. (letter)

Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

Science.gov (United States)

Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

2013-09-01

Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences.

Antenatal and postnatal growth and 5-year cognitive outcome in very preterm infants.

Science.gov (United States)

Leppänen, Marika; Lapinleimu, Helena; Lind, Annika; Matomäki, Jaakko; Lehtonen, Liisa; Haataja, Leena; Rautava, Päivi

2014-01-01

To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. Very low birth weight (growth was determined as a z score change between measurement points. Cognitive development was assessed at 5 years of age with the Wechsler Preschool and Primary Scales of Intelligence-Revised. The association between growth and full-scale IQ (FSIQ) was studied. Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different.

Global sensitivity analysis in wind energy assessment

Science.gov (United States)

Tsvetkova, O.; Ouarda, T. B.

2012-12-01

Wind energy is one of the most promising renewable energy sources. Nevertheless, it is not yet a common source of energy, although there is enough wind potential to supply world's energy demand. One of the most prominent obstacles on the way of employing wind energy is the uncertainty associated with wind energy assessment. Global sensitivity analysis (SA) studies how the variation of input parameters in an abstract model effects the variation of the variable of interest or the output variable. It also provides ways to calculate explicit measures of importance of input variables (first order and total effect sensitivity indices) in regard to influence on the variation of the output variable. Two methods of determining the above mentioned indices were applied and compared: the brute force method and the best practice estimation procedure In this study a methodology for conducting global SA of wind energy assessment at a planning stage is proposed. Three sampling strategies which are a part of SA procedure were compared: sampling based on Sobol' sequences (SBSS), Latin hypercube sampling (LHS) and pseudo-random sampling (PRS). A case study of Masdar City, a showcase of sustainable living in the UAE, is used to exemplify application of the proposed methodology. Sources of uncertainty in wind energy assessment are very diverse. In the case study the following were identified as uncertain input parameters: the Weibull shape parameter, the Weibull scale parameter, availability of a wind turbine, lifetime of a turbine, air density, electrical losses, blade losses, ineffective time losses. Ineffective time losses are defined as losses during the time when the actual wind speed is lower than the cut-in speed or higher than the cut-out speed. The output variable in the case study is the lifetime energy production. Most influential factors for lifetime energy production are identified with the ranking of the total effect sensitivity indices. The results of the present

Can we (actually) assess global risk?

Science.gov (United States)

Di Baldassarre, Giuliano

2013-04-01

The evaluation of the dynamic interactions of the different components of global risk (e.g. hazard, exposure, vulnerability or resilience) is one of the main challenges in risk assessment and management. In state-of-the-art approaches for the analysis of risk, natural and socio-economic systems are typically treated separately by using different methods. In flood risk studies, for instance, physical scientists typically focus on the study of the probability of flooding (i.e. hazard), while social scientists mainly examine the exposure, vulnerability or resilience to flooding. However, these different components are deeply interconnected. Changes in flood hazard might trigger changes in vulnerability, and vice versa. A typical example of these interactions is the so-called "levee effect", whereby heightening levees to reduce the probability of flooding often leads to increase the potential adverse consequences of flooding as people often perceive that flood risk was completely eliminated once the levee was raised. These interconnections between the different components of risk remain largely unexplored and poorly understood. This lack of knowledge is of serious concern as it limits our ability to plan appropriate risk prevention measures. To design flood control structures, for example, state-of-the-art models can indeed provide quantitative assessments of the corresponding risk reduction associated to the lower probability of flooding. Nevertheless, current methods cannot estimate how, and to what extent, such a reduction might trigger a future increase of the potential adverse consequences of flooding (the aforementioned "levee effect"). Neither can they evaluate how the latter might (in turn) lead to the requirement of additional flood control structures. Thus, while many progresses have been made in the static assessment of flood risk, more inter-disciplinary research is required for the development of methods for dynamic risk assessment, which is very much

Assessment of global expected warming contribution to desertification process development in Kazakhstan

International Nuclear Information System (INIS)

Dolgih, S.A.; Eserkepova, I.B.; Shamen, A.M.

1997-01-01

Assessment of moistening condition change in Kazakhstan and its role in processes of desertification at global expected climate warming are cited. Results of numerical experiments by models of common circulation of atmosphere have been used in capacity of potential regional climate change characteristics. (author)

Are Local Food Chains More Sustainable than Global Food Chains? Considerations for Assessment

Directory of Open Access Journals (Sweden)

Gianluca Brunori

2016-05-01

Full Text Available This paper summarizes the main findings of the GLAMUR project which starts with an apparently simple question: is “local” more sustainable than “global”? Sustainability assessment is framed within a post-normal science perspective, advocating the integration of public deliberation and scientific research. The assessment spans 39 local, intermediate and global supply chain case studies across different commodities and countries. Assessment criteria cover environmental, economic, social, health and ethical sustainability dimensions. A closer view of the food system demonstrates a highly dynamic local–global continuum where actors, while adapting to a changing environment, establish multiple relations and animate several chain configurations. The evidence suggests caution when comparing “local” and “global” chains, especially when using the outcomes of the comparison in decision-making. Supply chains are analytical constructs that necessarily—and arbitrarily—are confined by system boundaries, isolating a set of elements from an interconnected whole. Even consolidated approaches, such as Life Cycle Assessment (LCA, assess only a part of sustainability attributes, and the interpretation may be controversial. Many sustainability attributes are not yet measurable and “hard” methodologies need to be complemented by “soft” methodologies which are at least able to identify critical issues and trade-offs. Aware of these limitations, our research shows that comparing local and global chains, with the necessary caution, can help overcome a priori positions that so far have characterized the debate between “localists” and “globalists”. At firm level, comparison between “local” and “global” chains could be useful to identify best practices, benchmarks, critical points, and errors to avoid. As sustainability is not a status to achieve, but a never-ending process, comparison and deliberation can be the basis of a �

A framework for assessing global change risks to forest carbon stocks in the United States

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Christopher W. Woodall; Grant M. Domke; Karin L. Riley; Christopher M. Oswalt; Susan J. Crocker; Gary W. Yohe

2013-01-01

Among terrestrial environments, forests are not only the largest long-term sink of atmospheric carbon (C), but are also susceptible to global change themselves, with potential consequences including alterations of C cycles and potential C emission. To inform global change risk assessment of forest C across large spatial/temporal scales, this study constructed and...

Correction of systematic bias in ultrasound dating in studies of small-for-gestational-age birth: an example from the Iowa Health in Pregnancy Study.

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Harland, Karisa K; Saftlas, Audrey F; Wallis, Anne B; Yankowitz, Jerome; Triche, Elizabeth W; Zimmerman, M Bridget

2012-09-01

The authors examined whether early ultrasound dating (≤20 weeks) of gestational age (GA) in small-for-gestational-age (SGA) fetuses may underestimate gestational duration and therefore the incidence of SGA birth. Within a population-based case-control study (May 2002-June 2005) of Iowa SGA births and preterm deliveries identified from birth records (n = 2,709), the authors illustrate a novel methodological approach with which to assess and correct for systematic underestimation of GA by early ultrasound in women with suspected SGA fetuses. After restricting the analysis to subjects with first-trimester prenatal care, a nonmissing date of the last menstrual period (LMP), and early ultrasound (n = 1,135), SGA subjects' ultrasound GA was 5.5 days less than their LMP GA, on average. Multivariable linear regression was conducted to determine the extent to which ultrasound GA predicted LMP dating and to correct for systematic misclassification that results after applying standard guidelines to adjudicate differences in these measures. In the unadjusted model, SGA subjects required a correction of +1.5 weeks to the ultrasound estimate. With adjustment for maternal age, smoking, and first-trimester vaginal bleeding, standard guidelines for adjudicating differences in ultrasound and LMP dating underestimated SGA birth by 12.9% and overestimated preterm delivery by 8.7%. This methodological approach can be applied by researchers using different study populations in similar research contexts.

Scored patient-generated Subjective Global Assessment: Length of hospital stay and mortality in cancer patients

Directory of Open Access Journals (Sweden)

Alexsandro Ferreira dos SANTOS

Full Text Available ABSTRACT Objective To determine the association of a scored patient-generated Subjective Global Assessment with mortality and length of hospital stay in cancer patients. Methods Cross-sectional study carried out between July and September 2014 using secondary data collection using data from 366 medical records of patients admitted to a hospital recognized as a cancer center of excellence. The present study included patients with hospital stay over than or equal three days and minimum age of 20 years. The patient-generated Subjective Global Assessment scores were calculated and compared with the patients’ clinical and anthropometric characteristics and outcomes (death and long length of stay in hospital. Results Of the 366 patients evaluated, 36.0% were malnourished. The presence of malnutrition, according to the scored patient-generated Subjective Global Assessment, was statistically associated with the presence of metastasis (52.4%. On the other hand, malnutrition, according to the body mass index in adults (55.8% and in older elderly patients (54.2%, was associated with death (55.0%. The adjusted logistic regression model showed that the following factors were associated with prolonged hospitalization: early nutritional screening, presence of severe malnutrition, radiotherapy and chemotherapy, and surgical procedures. As for mortality, the associated factors were: male reproductive system tumor, presence of metastasis, clinical treatment, prolonged hospitalization, and the presence of some degree of malnutrition. Conclusion The patient-generated Subjective Global Assessment score is an important risk marker of prolonged hospitalization and mortality rates. It is a useful tool capable of circumventing significant biases in the nutritional evaluation of cancer patients.

Petascale Diagnostic Assessment of the Global Portfolio Rainfall Space Missions' Ability to Support Flood Forecasting

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Reed, P. M.; Chaney, N.; Herman, J. D.; Wood, E. F.; Ferringer, M. P.

2015-12-01

This research represents a multi-institutional collaboration between Cornell University, The Aerospace Corporation, and Princeton University that has completed a Petascale diagnostic assessment of the current 10 satellite missions providing rainfall observations. Our diagnostic assessment has required four core tasks: (1) formally linking high-resolution astrodynamics design and coordination of space assets with their global hydrological impacts within a Petascale "many-objective" global optimization framework, (2) developing a baseline diagnostic evaluation of a 1-degree resolution global implementation of the Variable Infiltration Capacity (VIC) model to establish the required satellite observation frequencies and coverage to maintain acceptable global flood forecasts, (3) evaluating the limitations and vulnerabilities of the full suite of current satellite precipitation missions including the recently approved Global Precipitation Measurement (GPM) mission, and (4) conceptualizing the next generation spaced-based platforms for water cycle observation. Our team exploited over 100 Million hours of computing access on the 700,000+ core Blue Waters machine to radically advance our ability to discover and visualize key system tradeoffs and sensitivities. This project represents to our knowledge the first attempt to develop a 10,000 member Monte Carlo global hydrologic simulation at one degree resolution that characterizes the uncertain effects of changing the available frequencies of satellite precipitation on drought and flood forecasts. The simulation—optimization components of the work have set a theoretical baseline for the best possible frequencies and coverages for global precipitation given unlimited investment, broad international coordination in reconfiguring existing assets, and new satellite constellation design objectives informed directly by key global hydrologic forecasting requirements. Our research poses a step towards realizing the integrated

Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases.

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Liu, Peng; Wang, Boshi; Yan, Xia; Cai, Jingjing; Wang, Yu

2016-12-01

To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases. This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People's Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms. After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT. Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment

Global Water Cycle Agreement in the Climate Models Assessed in the IPCC AR4

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Waliser, D.; Seo, K. -W.; Schubert, S.; Njoku, E.

2007-01-01

This study examines the fidelity of the global water cycle in the climate model simulations assessed in the IPCC Fourth Assessment Report. The results demonstrate good model agreement in quantities that have had a robust global observational basis and that are physically unambiguous. The worst agreement occurs for quantities that have both poor observational constraints and whose model representations can be physically ambiguous. In addition, components involving water vapor (frozen water) typically exhibit the best (worst) agreement, and fluxes typically exhibit better agreement than reservoirs. These results are discussed in relation to the importance of obtaining accurate model representation of the water cycle and its role in climate change. Recommendations are also given for facilitating the needed model improvements.

Assessing the environmental impacts of freshwater thermal pollution from global power generation in LCA.

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Raptis, Catherine E; Boucher, Justin M; Pfister, Stephan

2017-02-15

Freshwater heat emissions from power plants with once-through cooling systems constitute one of many environmental pressures related to the thermoelectric power industry. The objective of this work was to obtain high resolution, operational characterization factors (CF) for the impact of heat emissions on ecosystem quality, and carry out a comprehensive, spatially, temporally and technologically differentiated damage-based environmental assessment of global freshwater thermal pollution. The aggregation of CFs on a watershed level results in 12.5% lower annual impacts globally and even smaller differences for the most crucial watersheds and months, so watershed level CFs are recommended when the exact emission site within the basin is unknown. Long-range impacts account for almost 90% of the total global impacts. The Great Lakes, several Mississippi subbasins, the Danube, and the Yangtze are among the most thermally impacted watersheds globally, receiving heat emissions from predominantly coal-fuelled and nuclear power plants. Globally, over 80% of the global annual impacts come from power plants constructed during or before the 1980s. While the impact-weighted mean age of the power plants in the Mississippi ranges from 38 to 51years, in Chinese watersheds including the Yangtze, the equivalent range is only 15 to 22years, reflecting a stark contrast in thermal pollution mitigation approaches. With relatively high shares of total capacity from power plants with once-through freshwater cooling, and tracing a large part of the Danube, 1kWh of net electricity mix is the most impactful in Hungary, Bulgaria and Serbia. Monthly CFs are provided on a grid cell level and on a watershed level for use in Life Cycle Assessment. The impacts per generating unit are also provided, as part of our effort to make available a global dataset of thermoelectric power plant emissions and impacts. Copyright © 2016 Elsevier B.V. All rights reserved.

Spatial assessment of land degradation through key ecosystem services: The role of globally available data.

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Cerretelli, Stefania; Poggio, Laura; Gimona, Alessandro; Yakob, Getahun; Boke, Shiferaw; Habte, Mulugeta; Coull, Malcolm; Peressotti, Alessandro; Black, Helaina

2018-07-01

Land degradation is a serious issue especially in dry and developing countries leading to ecosystem services (ESS) degradation due to soil functions' depletion. Reliably mapping land degradation spatial distribution is therefore important for policy decisions. The main objectives of this paper were to infer land degradation through ESS assessment and compare the modelling results obtained using different sets of data. We modelled important physical processes (sediment erosion and nutrient export) and the equivalent ecosystem services (sediment and nutrient retention) to infer land degradation in an area in the Ethiopian Great Rift Valley. To model soil erosion/retention capability, and nitrogen export/retention capability, two datasets were used: a 'global' dataset derived from existing global-coverage data and a hybrid dataset where global data were integrated with data from local surveys. The results showed that ESS assessments can be used to infer land degradation and identify priority areas for interventions. The comparison between the modelling results of the two different input datasets showed that caution is necessary if only global-coverage data are used at a local scale. In remote and data-poor areas, an approach that integrates global data with targeted local sampling campaigns might be a good compromise to use ecosystem services in decision-making. Copyright © 2018. Published by Elsevier B.V.

Biomass Assessment. Assessment of global biomass potentials and their links to food, water, biodiversity, energy demand and economy. Inventory and analysis of existing studies. Supporting document

International Nuclear Information System (INIS)

Dornburg, V.; Faaij, A.; Verweij, P.; Banse, M.; Van Diepen, K.; Van Keulen, H.; Langeveld, H.; Meeusen, M.; Van de Ven, G.; Wester, F.; Alkemade, R.; Ten Brink, B.; Van den Born, G.J.; Van Oorschot, M.; Ros, J.; Smout, F.; Van Vuuren, D.; Van den Wijngaart, R.; Aiking, H.; Londo, M.; Mozaffarian, H.; Smekens, K.; Lysen, E.

2008-01-01

This supporting document contains the result from the inventory phase of the biomass assessment of global biomass potentials and their links to food, water, biodiversity, energy demand and economy. This study provides a comprehensive assessment of global biomass potential estimates, focusing on the various factors affecting these potentials, such as food supplies, water use, biodiversity, energy demands and agro-economics

Changes in Nutritional and Functional Status in Longer Stay Patients Admitted to a Geriatric Evaluation and Management Unit.

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Whitley, A; Skliros, E; Graven, C; McIntosh, R; Lasry, C; Newsome, C; Bowie, A

2017-01-01

Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. A prospective, observational study. Two GEM units at St Vincent's Hospital Melbourne, Australia. Patients admitted to the GEM units who stayed longer than 21 days were included in the study. Patients were assessed on admission and prior to discharge using the Subjective Global Assessment (SGA), Functional Independence Measure (FIM) motor domain and the Modified Elderly Mobility Scale (MEMS). Fifty-nine patients (Mean age 84.0 ± 7 years) met the required length of stay and were included in the study. Fifty-four per cent (n=32) were malnourished on admission (SGA B/C) and 44% (n=26) were malnourished on discharge. Twenty-two per cent (n=13) improved SGA category, 75% remained stable (n=44) and 3% deteriorated (n=2) from admission to discharge. Total Motor FIM scores significantly increased from admission to discharge in both the improved (pnutritional status groups. Subjects who improved in nutritional status had a significantly higher MEMS score at discharge (pnutritional status at the time of discharge. Improvement in nutritional status was associated with greater improvement in mobility scores. Further studies are required to investigate the effectiveness of nutrition interventions, which will inform models of care aiming to optimise nutritional, functional, and associated clinical outcomes in patients admitted to GEM units.

Assessing the Effects of Corporate Social Responsibility Standards in Global Value Chains

DEFF Research Database (Denmark)

Lund-Thomsen, Peter

This paper considers the issue of corporate social responsibility (CSR) standard impact assessment in global value chains. CSR standards have proliferated in recent years, and several studies have attempted to assess their effects on local producers, workers, and the environment in developing...... countries. However, much less attention has been paid to the “dark side” of impact assessment – the ethical and political dilemmas that arise in the process of carrying out impact studies. This paper addresses this gap in literature, arguing that impact assessments of CSR standards may do more harm than...... good to the intended beneficiaries - developing country firms, farmers, workers, and communities - unless these ethical and political dilemmas are given serious consideration....

Treatment patterns in Medicaid patients with schizophrenia initiated on a first- or second-generation long-acting injectable versus oral antipsychotic

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Pilon D

2017-03-01

Full Text Available Dominic Pilon,1 Kruti Joshi,2 Neeta Tandon,2 Marie-Hélène Lafeuille,1 Rhiannon L Kamstra,1 Bruno Emond,1 Patrick Lefebvre2 1Groupe d’analyse, Ltée, Montréal, QC, Canada; 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA Background: Poor antipsychotic (AP adherence is a key issue in patients with schizophrenia. First-generation antipsychotic (FGA and second-generation antipsychotic (SGA long-acting injectable therapies (LAI may improve adherence compared to oral antipsychotics (OAP. The objective of the study was to compare treatment adherence and persistence in Medicaid patients with schizophrenia initiated on first-generation long-acting injectable therapies (FGA-LAI or second-generation long-acting injectable therapies (SGA-LAI versus OAP.Methods: Adults with schizophrenia initiated on FGA-LAI, SGA-LAI, or OAP on or after January 2010 were identified using a six-state Medicaid database (January 2009– March 2015. Outcomes were assessed during the 12 months following treatment initiation. Index medication adherence was assessed using the proportion of days covered ≥80%, while persistence was assessed as no gap of ≥30, ≥60, or ≥90 days between days of supply. Outcomes were compared between FGA/SGA-LAI and OAP cohorts using chi-squared tests and adjusted odds ratios (OR.Results: During follow-up, AP polypharmacy was more common in FGA-LAI patients (N=1,089; 36%; P=0.029 and less common in SGA-LAI patients (N=2,209; 27%; P<0.001 versus OAP patients (N=20,478; 33%. After adjustment, SGA-LAI patients had 24% higher odds of adherence at 12 months (OR: 1.24; P<0.001, in contrast to FGA-LAI patients who had 48% lower odds of adherence (OR: 0.52; P<0.001 relative to OAP patients. SGA-LAI patients were more likely to be persistent (no gap ≥60 days at 12 months than OAP patients (37% vs 30%; P<0.001, but not FGA-LAI patients (31% vs 30%; P=0.776. In comparison to OAP patients, SGA-LAI patients had 46% higher adjusted odds of

Porphyry copper assessment of northeast Asia: Far East Russia and northeasternmost China: Chapter W in Global mineral resource assessment

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Mihalasky, Mark J.; Ludington, Stephen; Alexeiev, Dmitriy V.; Frost, Thomas P.; Light, Thomas D.; Briggs, Deborah A.; Hammarstrom, Jane M.; Wallis, John C.; Bookstrom, Arthur A.; Panteleyev, Andre

2015-01-01

The U.S. Geological Survey assesses resources (mineral, energy, water, environmental, and biologic) at regional, national, and global scales to provide science in support of land management and decision making. Mineral resource assessments provide a synthesis of available information about where mineral deposits are known and suspected to be in the Earth’s crust, which commodities may be present, and estimates of amounts of resources in undiscovered deposits.

Assessing and managing freshwater ecosystems vulnerable to global change

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Angeler, David G.; Allen, Craig R.; Birge, Hannah E.; Drakare, Stina; McKie, Brendan G.; Johnson, Richard K.

2014-01-01

Freshwater ecosystems are important for global biodiversity and provide essential ecosystem services. There is consensus in the scientific literature that freshwater ecosystems are vulnerable to the impacts of environmental change, which may trigger irreversible regime shifts upon which biodiversity and ecosystem services may be lost. There are profound uncertainties regarding the management and assessment of the vulnerability of freshwater ecosystems to environmental change. Quantitative approaches are needed to reduce this uncertainty. We describe available statistical and modeling approaches along with case studies that demonstrate how resilience theory can be applied to aid decision-making in natural resources management. We highlight especially how long-term monitoring efforts combined with ecological theory can provide a novel nexus between ecological impact assessment and management, and the quantification of systemic vulnerability and thus the resilience of ecosystems to environmental change.

Assessment of climate change scenarios for Saudi Arabia using data from global climate models

International Nuclear Information System (INIS)

Husain, T.; Chowdhury, S.

2009-01-01

This study assesses available scientific information and data to predict changes in the climatic parameters in Saudi Arabia for understanding the impacts for mitigation and/or adaptation. Meteorological data from 26 synoptic stations were analyzed in this study. Various climatic change scenarios were reviewed and A 2 and B 2 climatic scenario families were selected. In order to assess long-term global impact, global climatic models were used to simulate changes in temperature, precipitation, relative humidity, solar radiation, and wind circulation. Using global climate model (GCM), monthly time series data was retrieved for Longitude 15 o N to 35 o N and 32.5 o E to 60 o E covering the Kingdom of Saudi Arabia from 1970 to 2100 for all grids. Taking averages of 1970 to 2003 as baseline, change in temperature, relative humidity and precipitation were estimated for the base period. A comparative evaluation was performed for predictive capabilities of these models for temperature, precipitation and relative humidity. Available meteorological data from 1970 to 2003 was used to determine trends. This paper discusses the inconsistency in these parameters for decision-making and recommends future studies by linking global climate models with a suitable regional climate modeling tool. (author)

Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

DEFF Research Database (Denmark)

Creutzig, Felix; Corbera, Esteve; Bolwig, Simon

2013-01-01

-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across......Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods...... these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences...

UNITED STATES DEPARTMENT OF TRANSPORTATION GLOBAL POSITIONING SYSTEM (GPS) ADJACENT BAND COMPATIBILITY ASSESSMENT

Science.gov (United States)

2018-04-01

The goal of the U.S. Department of Transportation (DOT) Global Positioning System (GPS) Adjacent Band Compatibility Assessment is to evaluate the maximum transmitted power levels of adjacent band radiofrequency (RF) systems that can be tolerated by G...

Tailoring Global Data to Guide Corporate Investments in Biodiversity, Environmental Assessments and Sustainability

Directory of Open Access Journals (Sweden)

Joseph Kiesecker

2013-10-01

Full Text Available Companies make significant investments in environmental impacts assessments, biodiversity action plans, life-cycle assessments, and environmental management systems, but guidance on where and when these tools can be best used, and how they may scale-up to inform corporation-wide planning, is sorely lacking. A major barrier to informed environmental decision-making within companies, especially in data poor regions of the world, is the difficulty accessing, analyzing, and interpreting biodiversity information. To address this shortcoming, we analyzed nine publicly available environmental datasets, and created five globally-relevant metrics associated with biodiversity: habitat intactness, habitat protection, species richness (globally and biome normalized, and threatened species. We demonstrate how packaging these metrics within an open-source, web-based mapping tool can facilitate corporations in biodiversity prioritization of their sites (or their supply chains, ultimately guiding potential investments in the environment.

AgMIP 1.5°C Assessment: Mitigation and Adaptation at Coordinated Global and Regional Scales

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Rosenzweig, C.

2016-12-01

The AgMIP 1.5°C Coordinated Global and Regional Integrated Assessments of Climate Change and Food Security (AgMIP 1.5 CGRA) is linking site-based crop and livestock models with similar models run on global grids, and then links these biophysical components with economics models and nutrition metrics at regional and global scales. The AgMIP 1.5 CGRA assessment brings together experts in climate, crop, livestock, economics, nutrition, and food security to define the 1.5°C Protocols and guide the process throughout the assessment. Scenarios are designed to consistently combine elements of intertwined storylines of future society including socioeconomic development (Shared Socioeconomic Pathways), greenhouse gas concentrations (Representative Concentration Pathways), and specific pathways of agricultural sector development (Representative Agricultural Pathways). Shared Climate Policy Assumptions will be extended to provide additional agricultural detail on mitigation and adaptation strategies. The multi-model, multi-disciplinary, multi-scale integrated assessment framework is using scenarios of economic development, adaptation, mitigation, food policy, and food security. These coordinated assessments are grounded in the expertise of AgMIP partners around the world, leading to more consistent results and messages for stakeholders, policymakers, and the scientific community. The early inclusion of nutrition and food security experts has helped to ensure that assessment outputs include important metrics upon which investment and policy decisions may be based. The CGRA builds upon existing AgMIP research groups (e.g., the AgMIP Wheat Team and the AgMIP Global Gridded Crop Modeling Initiative; GGCMI) and regional programs (e.g., AgMIP Regional Teams in Sub-Saharan Africa and South Asia), with new protocols for cross-scale and cross-disciplinary linkages to ensure the propagation of expert judgment and consistent assumptions.

U.S. Geological Survey assessment of global potash production and resources—A significant advancement for global development and a sustainable future.

Science.gov (United States)

Cocker, Mark D.; Orris, Greta J.; Wynn, Jeff

2016-01-01

During the past 15 yr, the global requirement for fertilizers has grown considerably, mainly due to demand by a larger and wealthier world population for more and higher-quality food. The demand and price for potash as a primary fertilizer ingredient have increased in tandem, because of the necessity to increase the quantity and quality of food production on the decreasing amount of available arable land. The primary sources of potash are evaporates, which occur mainly in marine salt basins and a few brine-bearing continental basins. World potash resources are large, but distribution is inequitable and not presently developed in countries where population and food requirements are large and increasing. There is no known substitute for potash in fertilizer, so knowledge of the world’s potash resources is critical for a sustainable future. The U.S. Geological Survey recently completed a global assessment of evaporite-hosted potash resources, which included a geographic information system–based inventory of known potash resources. This assessment included permissive areas or tracts for undiscovered resources at a scale of 1:1,000,000. Assessments of undiscovered potash resources were conducted for a number of the world’s evaporite-hosted potash basins. The data collected provide a major advance in our knowledge of global potash resources that did not exist prior to this study. The two databases include: (1) potash deposits and occurrences, and (2) potash tracts (basins that contain these deposits and occurrences and potentially undiscovered potash deposits). Data available include geology, mineralogy, grade, tonnage, depth, thickness, areal extent, and structure, as well as numerous pertinent references.

Chemotherapy-Related Toxicity, Nutritional Status and Quality of Life in Precachectic Oncologic Patients with, or without, High Protein Nutritional Support. A Prospective, Randomized Study.

Science.gov (United States)

Ziętarska, Monika; Krawczyk-Lipiec, Joanna; Kraj, Leszek; Zaucha, Renata; Małgorzewicz, Sylwia

2017-10-11

Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. The aim of the study was to determine whether nutritional support with high protein (ONS) in adult oncologic patients in the first step of cancer cachexia-asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. A total of 114 persons aged 40-84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group) and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening), SGA (Subjective Global Assessment), SCRINIO (SCReenIng the Nutritional status In Oncology) Working Group classification, VAS (Visual Analog Scale) for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy) questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group) score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed (increased appetite VAS, p = 0.05; increased points in SGA, p = 0.015, and

SGA-WZ: A New Strapdown Airborne Gravimeter

Directory of Open Access Journals (Sweden)

Kaidong Zhang

2012-07-01

Full Text Available Inertial navigation systems and gravimeters are now routinely used to map the regional gravitational quantities from an aircraft with mGal accuracy and a spatial resolution of a few kilometers. However, airborne gravimeter of this kind is limited by the inaccuracy of the inertial sensor performance, the integrated navigation technique and the kinematic acceleration determination. As the GPS technique developed, the vehicle acceleration determination is no longer the limiting factor in airborne gravity due to the cancellation of the common mode acceleration in differential mode. A new airborne gravimeter taking full advantage of the inertial navigation system is described with improved mechanical design, high precision time synchronization, better thermal control and optimized sensor modeling. Apart from the general usage, the Global Positioning System (GPS after differentiation is integrated to the inertial navigation system which provides not only more precise altitude information along with the navigation aiding, but also an effective way to calculate the vehicle acceleration. Design description and test results on the performance of the gyroscopes and accelerations will be emphasized. Analysis and discussion of the airborne field test results are also given.

Global guidance on environmental life cycle impact assessment indicators: Progress and case study

DEFF Research Database (Denmark)

Frischknecht, Rolf; Fantke, Peter; Tschümperlin, Laura

2016-01-01

Purpose The life cycle impact assessment (LCIA) guidance flagship project of the United Nations Environment Programme (UNEP)/Society of Environmental Toxicology and Chemistry (SETAC) Life Cycle Initiative aims at providing global guidance and building scientific consensus on environmental LCIA in...

Assessments in the Global Peace Operations Initiative: A Systems Engineering Approach

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2014-06-01

police unit GCC GPOI Coordination Committee GIG GPOI Implementation Guide GPOI Global Peace Operations Initiative GRC GPOI Regional Committee G8...degree necessary to build a coherent assessments framework. The GPOI Implementation Guide ( GIG ) begins by alluding to what the program intended to...elements and associated interactions fully observed and understood. Using the U.S. economy as an example, Driscoll (2011) illustrates the common

Multi-model global assessment of subseasonal prediction skill of atmospheric rivers

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Deflorio, M. J.

2017-12-01

Atmospheric rivers (ARs) are global phenomena that are characterized by long, narrow plumes of water vapor transport. They are most often observed in the midlatitudes near climatologically active storm track regions. Because of their frequent association with floods, landslides, and other hydrological impacts on society, there is significant incentive at the intersection of academic research, water management, and policymaking to understand the skill with which state-of-the-art operational weather models can predict ARs weeks-to-months in advance. We use the newly assembled Subseasonal-to-Seasonal (S2S) database, which includes extensive hindcast records of eleven operational weather models, to assess global prediction skill of atmospheric rivers on S2S timescales. We develop a metric to assess AR skill that is suitable for S2S timescales by counting the total number of AR days which occur over each model and observational grid cell during a 2-week time window. This "2-week AR occurrence" metric is suitable for S2S prediction skill assessment because it does not consider discrete hourly or daily AR objects, but rather a smoothed representation of AR occurrence over a longer period of time. Our results indicate that several of the S2S models, especially the ECMWF model, show useful prediction skill in the 2-week forecast window, with significant interannual variation in some regions. We also present results from an experimental forecast of S2S AR prediction skill using the ECMWF and NCEP models.

The German hospital malnutrition study.

Science.gov (United States)

Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert

2006-08-01

Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.

A clinical audit of the nutritional status and need for nutrition support amongst head and neck cancer patients treated with radiotherapy

Directory of Open Access Journals (Sweden)

E Jeffery

2012-01-01

Full Text Available Radiotherapy is an effective treatment for head and neck cancers but patients often experience side effects which lead to weight loss. Nutrition intervention in the form of counselling or oral nutrition support (ONS is frequently needed for these patients. For some patients, tube feeding is required to minimise weight loss during treatment.MethodData was collected on 48 patients who received radiotherapy to the head and neck region over a nine-month period (June 2009–March 2010. Retrospective data collection was commenced in July 2010. Each patient’s Diet Therapy Department record was reviewed. Main outcome measures were: 1 type of nutrition support; 2 percentage weight change during treatment; and 3 Patient-Generated Subjective Global Assessment Global (PG-SGA rating.ResultsOn initial assessment 28 (77.8% patients were classified as well nourished using the PG-SGA. Mean weight loss during radiotherapy was 5.74%. Risk factors for the need for ONS and enteral nutrition support (ENS were older age, presence of nutrition impact symptoms, high-risk tumour sites, advanced disease and chemotherapy. No significant difference was shown in weight loss between ONS and ENS groups.ConclusionThis study identified the need for early dietetic intervention for high nutritional risk groups of head and neck cancer patients to prevent significant weight loss. Pre-treatment nutritional status did not influence weight loss during treatment. ONS alone cannot prevent significant weight loss in patients with multiple nutrition impact symptoms. Early enteral feeding should be considered in this group of patients.

Economic filters for evaluating porphyry copper deposit resource assessments using grade-tonnage deposit models, with examples from the U.S. Geological Survey global mineral resource assessment: Chapter H in Global mineral resource assessment

Science.gov (United States)

Robinson, Gilpin R.; Menzie, W. David

2012-01-01

An analysis of the amount and location of undiscovered mineral resources that are likely to be economically recoverable is important for assessing the long-term adequacy and availability of mineral supplies. This requires an economic evaluation of estimates of undiscovered resources generated by traditional resource assessments (Singer and Menzie, 2010). In this study, simplified engineering cost models were used to estimate the economic fraction of resources contained in undiscovered porphyry copper deposits, predicted in a global assessment of copper resources. The cost models of Camm (1991) were updated with a cost index to reflect increases in mining and milling costs since 1989. The updated cost models were used to perform an economic analysis of undiscovered resources estimated in porphyry copper deposits in six tracts located in North America. The assessment estimated undiscovered porphyry copper deposits within 1 kilometer of the land surface in three depth intervals.

Assessment of global motor performance and gross and fine motor skills of infants attending day care centers.

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Souza, Carolina T; Santos, Denise C C; Tolocka, Rute E; Baltieri, Letícia; Gibim, Nathália C; Habechian, Fernanda A P

2010-01-01

To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

A global assessment of market accessibility and market influence for global environmental change studies

Energy Technology Data Exchange (ETDEWEB)

Verburg, Peter H [Institute for Environmental Studies, Amsterdam Global Change Institute, VU University Amsterdam, De Boelelaan 1087, 1081 HV Amsterdam (Netherlands); Ellis, Erle C [Department of Geography and Environmental Systems, University of Maryland, Baltimore County, Baltimore, MD 21250 (United States); Letourneau, Aurelien, E-mail: Peter.Verburg@ivm.vu.nl [UMR 5175 Centre d' Ecologie Fonctionnelle and Evolutive, Centre National de la Recherche Scientifique, 1919 Route de Mende, 34293 Montpellier cedex 5 (France)

2011-07-15

Markets influence the global patterns of urbanization, deforestation, agriculture and other land use systems. Yet market influence is rarely incorporated into spatially explicit global studies of environmental change, largely because consistent global data are lacking below the national level. Here we present the first high spatial resolution gridded data depicting market influence globally. The data jointly represent variations in both market strength and accessibility based on three market influence indices derived from an index of accessibility to market locations and national level gross domestic product (purchasing power parity). These indices show strong correspondence with human population density while also revealing several distinct and useful relationships with other global environmental patterns. As market influence grows, the need for high resolution global data on market influence and its dynamics will become increasingly important to understanding and forecasting global environmental change.

A global assessment of market accessibility and market influence for global environmental change studies

Science.gov (United States)

Verburg, Peter H.; Ellis, Erle C.; Letourneau, Aurelien

2011-07-01

Markets influence the global patterns of urbanization, deforestation, agriculture and other land use systems. Yet market influence is rarely incorporated into spatially explicit global studies of environmental change, largely because consistent global data are lacking below the national level. Here we present the first high spatial resolution gridded data depicting market influence globally. The data jointly represent variations in both market strength and accessibility based on three market influence indices derived from an index of accessibility to market locations and national level gross domestic product (purchasing power parity). These indices show strong correspondence with human population density while also revealing several distinct and useful relationships with other global environmental patterns. As market influence grows, the need for high resolution global data on market influence and its dynamics will become increasingly important to understanding and forecasting global environmental change.

A global assessment of market accessibility and market influence for global environmental change studies

International Nuclear Information System (INIS)

Verburg, Peter H; Ellis, Erle C; Letourneau, Aurelien

2011-01-01

Markets influence the global patterns of urbanization, deforestation, agriculture and other land use systems. Yet market influence is rarely incorporated into spatially explicit global studies of environmental change, largely because consistent global data are lacking below the national level. Here we present the first high spatial resolution gridded data depicting market influence globally. The data jointly represent variations in both market strength and accessibility based on three market influence indices derived from an index of accessibility to market locations and national level gross domestic product (purchasing power parity). These indices show strong correspondence with human population density while also revealing several distinct and useful relationships with other global environmental patterns. As market influence grows, the need for high resolution global data on market influence and its dynamics will become increasingly important to understanding and forecasting global environmental change.

Challenges and Opportunities for Integrating Social Science Perspectives into Climate and Global Change Assessments

Science.gov (United States)

Larson, E. K.; Li, J.; Zycherman, A.

2017-12-01

Integration of social science into climate and global change assessments is fundamental for improving understanding of the drivers, impacts and vulnerability of climate change, and the social, cultural and behavioral challenges related to climate change responses. This requires disciplinary and interdisciplinary knowledge as well as integrational and translational tools for linking this knowledge with the natural and physical sciences. The USGCRP's Social Science Coordinating Committee (SSCC) is tasked with this challenge and is working to integrate relevant social, economic and behavioral knowledge into processes like sustained assessments. This presentation will discuss outcomes from a recent SSCC workshop, "Social Science Perspectives on Climate Change" and their applications to sustained assessments. The workshop brought academic social scientists from four disciplines - anthropology, sociology, geography and archaeology - together with federal scientists and program managers to discuss three major research areas relevant to the USGCRP and climate assessments: (1) innovative tools, methods, and analyses to clarify the interactions of human and natural systems under climate change, (2) understanding of factors contributing to differences in social vulnerability between and within communities under climate change, and (3) social science perspectives on drivers of global climate change. These disciplines, collectively, emphasize the need to consider socio-cultural, political, economic, geographic, and historic factors, and their dynamic interactions, to understand climate change drivers, social vulnerability, and mitigation and adaptation responses. They also highlight the importance of mixed quantitative and qualitative methods to explain impacts, vulnerability, and responses at different time and spatial scales. This presentation will focus on major contributions of the social sciences to climate and global change research. We will discuss future directions for

The influence of INS VNTR class III allele on auxological parameters, glucose, insulin, lipids, and adipocytokines secretion in prepubertal children born small for gestational age.

Science.gov (United States)

Stawerska, Renata; Szałapska, Małgorzata; Borowiec, Maciej; Antosik, Karolina; Młynarski, Wojciech; Lewiński, Andrzej

2016-01-01

The insulin gene variable number of tandem repeats (INS VNTR) class III allele has been implicated in lower birth weight, obesity, and insulin resistance. We assessed its influence on birth weight in the Polish population and on the current body mass and metabolic profile in prepubertal children born small for gestational age (SGA). DNA for genotyping of INS VNTR was available for 123 subjects born SGA and 132 born appropriate for gestational age (AGA). We identified two alleles: class I and class III. Next, in 112 prepubertal (aged: 6.8 ± 1.38 years) SGA children, the auxological measurements, fasting serum C-peptide, triglycerides, cholesterol, ghrelin, leptin, adiponectin, resistin, cortisol, and insulin-like growth factor type I (IGF-I) concentrations, as well as glucose and insulin during oral glucose tolerance test (OGTT), were assessed and insulin resistance indices were calculated. The results were analysed depending on INS VNTR variants. The occurrence of individual INS VNTR variants were similar in the SGA and AGA groups. In prepubertal SGA children, we did not observe any statistical differences as regards birth weight, body mass, lipids, or adipocytokine concentrations among I/I, I/III, and III/III class groups. The concentration of insulin in 120' of OGTT was significantly higher in class III homozygous than in class I homozygous individuals. Variant INS VNTR class III was shown not to be associated in any essential way with birth weight in the Polish population. Among prepubertal SGA children, the presence of INS VNTR class III is related to higher insulin secretion during OGTT. (Endokrynol Pol 2016; 67 (6): 585-591).

Unrecorded alcohol use: a global modelling study based on nominal group assessments and survey data.

Science.gov (United States)

Probst, Charlotte; Manthey, Jakob; Merey, Aaron; Rylett, Margaret; Rehm, Jürgen

2018-01-27

Alcohol use is among the most important risk factors for burden of disease globally. An estimated quarter of the total alcohol consumed globally is unrecorded. However, due partly to the challenges associated with its assessment, evidence concerning the magnitude of unrecorded alcohol use is sparse. This study estimated country-specific proportions of unrecorded alcohol used in 2015. A statistical model was developed for data prediction using data on the country-specific proportion of unrecorded alcohol use from nominal group expert assessments and secondary, nationally representative survey data and country-level covariates. Estimates were calculated for the country level, for four income groups and globally. A total of 129 participants from 49 countries were included in the nominal group expert assessments. The survey data comprised 66 538 participants from 16 countries. Experts completed a standardized questionnaire assessing the country-specific proportion of unrecorded alcohol. In the national surveys, the number of standard drinks of total and unrecorded alcohol use was assessed for the past 7 days. Based on predictions for 167 countries, a population-weighted average of 27.9% [95% confidence interval (CI) = 10.4-44.9%] of the total alcohol consumed in 2015 was unrecorded. The proportion of unrecorded alcohol was lower in high (9.4%, 95% CI = 2.4-16.4%) and upper middle-income countries (18.3%, 95% CI = 9.0-27.6%) and higher in low (43.1%, 95% CI = 26.5-59.7%) and lower middle-income countries (54.4%, 95% CI = 38.1-70.8%). This corresponded to 0.9 (high-income), 1.2 (upper middle-income), 3.2 (lower middle-income) and 1.8 (low-income) litres of unrecorded alcohol per capita. A new method for modelling the country-level proportion of unrecorded alcohol use globally showed strong variation among geographical regions and income groups. Lower-income countries were associated with a higher proportion of unrecorded alcohol than higher-income countries

Using beryllium-7 to assess cross-tropopause transport in global models

Energy Technology Data Exchange (ETDEWEB)

Liu, Hongyu [National Institute of Aerospace, Hampton, VA (United States); Considine, David B. [NASA Langley Research Center, Hampton, VA (United States); Horowitz, Larry W. [NOAA Geophysical Fluid and Dynamics Laboratory, Princeton, NJ (United States); and others

2016-07-01

We use the Global Modeling Initiative (GMI) modeling framework to assess the utility of cosmogenic beryllium-7 ({sup 7}Be), a natural aerosol tracer, for evaluating cross-tropopause transport in global models. The GMI chemical transport model (CTM) was used to simulate atmospheric {sup 7}Be distributions using four different meteorological data sets (GEOS1-STRAT DAS, GISS II{sup '} GCM, fvGCM, and GEOS4-DAS), featuring significantly different stratosphere-troposphere exchange (STE) characteristics. The simulations were compared with the upper troposphere and/or lower stratosphere (UT/LS) {sup 7}Be climatology constructed from ∝ 25 years of aircraft and balloon data, as well as climatological records of surface concentrations and deposition fluxes. Comparison of the fraction of surface air of stratospheric origin estimated from the {sup 7}Be simulations with observationally derived estimates indicates excessive cross-tropopause transport at mid-latitudes in simulations using GEOS1-STRAT and at high latitudes using GISS II{sup '} meteorological data. These simulations also overestimate {sup 7}Be deposition fluxes at mid-latitudes (GEOS1-STRAT) and at high latitudes (GISS II{sup '}), respectively. We show that excessive cross-tropopause transport of {sup 7}Be corresponds to overestimated stratospheric contribution to tropospheric ozone. Our perspectives on STE in these meteorological fields based on {sup 7}Be simulations are consistent with previous modeling studies of tropospheric ozone using the same meteorological fields. We conclude that the observational constraints for {sup 7}Be and observed {sup 7}Be total deposition fluxes can be used routinely as a first-order assessment of cross-tropopause transport in global models.

Geothermal energy in deep aquifers : A global assessment of the resource base for direct heat utilization

NARCIS (Netherlands)

Limberger, J.|info:eu-repo/dai/nl/371572037; Boxem, T.; Pluymaekers, Maarten; Bruhn, David; Manzella, Adelle; Calcagno, Philippe; Beekman, F.|info:eu-repo/dai/nl/123556856; Cloetingh, S.|info:eu-repo/dai/nl/069161836; van Wees, J.-D.

In this paper we present results of a global resource assessment for geothermal energy within deep aquifers for direct heat utilization. Greenhouse heating, spatial heating, and spatial cooling are considered in this assessment. We derive subsurface temperatures from geophysical data and apply a

Geothermal energy in deep aquifers: A global assessment of the resource base for direct heat utilization

NARCIS (Netherlands)

Limberger, J.; Boxem, T.; Pluymaekers, M.; Bruhn, D.; Manzella, A.; Calcagno, P.; Beekman, F.; Cloetingh, S.; Wees, J.D. van

2018-01-01

In this paper we present results of a global resource assessment for geothermal energy within deep aquifers for direct heat utilization. Greenhouse heating, spatial heating, and spatial cooling are considered in this assessment. We derive subsurface temperatures from geophysical data and apply a

Graphical Methodology of Global Pollution Index for the Environmental Impact Assessment Using Two Environmental Components

Directory of Open Access Journals (Sweden)

Corneliu Cojocaru

2017-04-01

Full Text Available One of the applied methods for environmental impact assessment is the index of global pollution (IGP proposed by Rojanschi in 1991. This methodology enables the global estimation for the ecosystem state affected more or less by human activities. Unfortunately, Rojanschi’s method has a limitation; it can be applied only if at least three environmental components are considered. Frequently, many environmental impact assessment applications rely on analysis of only two environmental components. Therefore, this work aimed to develop a new graphical method to extend Rojanschi’s approach for the case of two environmental components. The proposed method avoids the average value of evaluation grades and uses only the graphical correspondence for calculation of the index of global pollution. A right-angle triangle graph methodology was proposed, where bases represented the values of evaluation grades. Thus, for the case of two environmental components, the index of global pollution was calculated as the relation between the ideal and real ecosystem states represented by the ratio between areas of external and enclosed right triangles. The developed graphical method was tested and validated for real case studies: the environmental impact assessment from a refinery located on the Romanian Black Sea Coast considering Air and Water environmental components and from a coal-fired thermoelectric power plant from Eastern Romania regarding Air and Soil environmental components. In this way, it was provided a reliable and faster tool to be used for the pollution characterization of human-derived chemicals for better decisions in risk management.

A new score for screening of malnutrition in patients with inoperable gastric adenocarcinoma.

Science.gov (United States)

Esfahani, Ali; Somi, Mohammad Hossein; Asghari Jafarabadi, Mohammad; Ostadrahimi, Alireza; Ghayour Nahand, Mousa; Fathifar, Zahra; Doostzadeh, Akram; Ghoreishi, Zohreh

2017-06-01

Malnutrition is common in patients with gastric cancer. Early identification of malnourished patients results in improving quality of life. We aimed to assess the nutritional status of patients with inoperable gastric adenocarcinoma (IGA) and finding a precise malnutrition screening score for these patients before the onset of chemotherapy. Nutritional status was assessed using patient generated subjective global assessment (PG-SGA), visceral proteins, and high-sensitivity C reactive protein. Tumor markers of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA-125) and CA 19-9 and their association with nutritional status were assessed. Then a new score for malnutrition screening was defined. Seventy-one patients with IGA completed the study. Malnourished and well-nourished patients (based on PG-SGA) were statistically different regarding albumin, prealbumin and CA-125. The best cut-off value for prealbumin for prediction of malnutrition was determined at 0.20 mg/dl and using known cut-off values for albumin (3.5 g/dl) and CA-125 (35 U/ml), a new score was defined for malnutrition screening named MS-score. According to MS-score, 92% of the patients had malnutrition and it could predict malnutrition with 96.8% sensitivity, 50% specificity and accuracy of 91.4%. MS-score has been suggested as an available and easy-to-use tool for malnutrition screening in patients with IGA. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessment of Global Mercury Deposition through Litterfall.

Science.gov (United States)

Wang, Xun; Bao, Zhengduo; Lin, Che-Jen; Yuan, Wei; Feng, Xinbin

2016-08-16

There is a large uncertainty in the estimate of global dry deposition of atmospheric mercury (Hg). Hg deposition through litterfall represents an important input to terrestrial forest ecosystems via cumulative uptake of atmospheric Hg (most Hg(0)) to foliage. In this study, we estimate the quantity of global Hg deposition through litterfall using statistical modeling (Monte Carlo simulation) of published data sets of litterfall biomass production, tree density, and Hg concentration in litter samples. On the basis of the model results, the global annual Hg deposition through litterfall is estimated to be 1180 ± 710 Mg yr(-1), more than two times greater than the estimate by GEOS-Chem. Spatial distribution of Hg deposition through litterfall suggests that deposition flux decreases spatially from tropical to temperate and boreal regions. Approximately 70% of global Hg(0) dry deposition occurs in the tropical and subtropical regions. A major source of uncertainty in this study is the heterogeneous geospatial distribution of available data. More observational data in regions (Southeast Asia, Africa, and South America) where few data sets exist will greatly improve the accuracy of the current estimate. Given that the quantity of global Hg deposition via litterfall is typically 2-6 times higher than Hg(0) evasion from forest floor, global forest ecosystems represent a strong Hg(0) sink.

Prediction of Small for Gestational Age Infants in Healthy Nulliparous Women Using Clinical and Ultrasound Risk Factors Combined with Early Pregnancy Biomarkers.

Directory of Open Access Journals (Sweden)

Lesley M E McCowan

Full Text Available Most small for gestational age pregnancies are unrecognised before birth, resulting in substantial avoidable perinatal mortality and morbidity. Our objective was to develop multivariable prediction models for small for gestational age combining clinical risk factors and biomarkers at 15±1 weeks' with ultrasound parameters at 20±1 weeks' gestation.Data from 5606 participants in the Screening for Pregnancy Endpoints (SCOPE cohort study were divided into Training (n = 3735 and Validation datasets (n = 1871. The primary outcomes were All-SGA (small for gestational age with birthweight <10th customised centile, Normotensive-SGA (small for gestational age with a normotensive mother and Hypertensive-SGA (small for gestational age with an hypertensive mother. The comparison group comprised women without the respective small for gestational age phenotype. Multivariable analysis was performed using stepwise logistic regression beginning with clinical variables, and subsequent additions of biomarker and then ultrasound (biometry and Doppler variables. Model performance was assessed in Training and Validation datasets by calculating area under the curve.633 (11.2% infants were All-SGA, 465(8.2% Normotensive-SGA and 168 (3% Hypertensive-SGA. Area under the curve (95% Confidence Intervals for All-SGA using 15±1 weeks' clinical variables, 15±1 weeks' clinical+ biomarker variables and clinical + biomarkers + biometry /Doppler at 20±1 weeks' were: 0.63 (0.59-0.67, 0.64 (0.60-0.68 and 0.69 (0.66-0.73 respectively in the Validation dataset; Normotensive-SGA results were similar: 0.61 (0.57-0.66, 0.61 (0.56-0.66 and 0.68 (0.64-0.73 with small increases in performance in the Training datasets. Area under the curve (95% Confidence Intervals for Hypertensive-SGA were: 0.76 (0.70-0.82, 0.80 (0.75-0.86 and 0.84 (0.78-0.89 with minimal change in the Training datasets.Models for prediction of small for gestational age, which combine biomarkers, clinical and

Assessing compatibility of direct detection data: halo-independent global likelihood analyses

Energy Technology Data Exchange (ETDEWEB)

Gelmini, Graciela B. [Department of Physics and Astronomy, UCLA,475 Portola Plaza, Los Angeles, CA 90095 (United States); Huh, Ji-Haeng [CERN Theory Division,CH-1211, Geneva 23 (Switzerland); Witte, Samuel J. [Department of Physics and Astronomy, UCLA,475 Portola Plaza, Los Angeles, CA 90095 (United States)

2016-10-18

We present two different halo-independent methods to assess the compatibility of several direct dark matter detection data sets for a given dark matter model using a global likelihood consisting of at least one extended likelihood and an arbitrary number of Gaussian or Poisson likelihoods. In the first method we find the global best fit halo function (we prove that it is a unique piecewise constant function with a number of down steps smaller than or equal to a maximum number that we compute) and construct a two-sided pointwise confidence band at any desired confidence level, which can then be compared with those derived from the extended likelihood alone to assess the joint compatibility of the data. In the second method we define a “constrained parameter goodness-of-fit” test statistic, whose p-value we then use to define a “plausibility region” (e.g. where p≥10%). For any halo function not entirely contained within the plausibility region, the level of compatibility of the data is very low (e.g. p<10%). We illustrate these methods by applying them to CDMS-II-Si and SuperCDMS data, assuming dark matter particles with elastic spin-independent isospin-conserving interactions or exothermic spin-independent isospin-violating interactions.

AgMIP Coordinated Global and Regional Assessments for 1.5°C and 2.0°C

Science.gov (United States)

Rosenzweig, C.

2017-12-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has developed novel methods for Coordinated Global and Regional Assessments (CGRA) of agriculture and food security in a changing world. The present study performs a proof-of-concept of the CGRA to demonstrate advantages and challenges of the framework. This effort responds to the request by UNFCCC for the implications of limiting global temperature increases to 1.5°C and 2.0°C above pre-industrial conditions. The protocols for the 1.5°C/2.0°C assessment establish explicit and testable linkages across disciplines and scales, connecting outputs and inputs from the Shared Socio-economic Pathways (SSPs), Representative Agricultural Pathways (RAPs), HAPPI and CMIP5 ensemble scenarios, global gridded crop models, global agricultural economic models, site-based crop models, and within-country regional economic models. CGRA results show that at the global scale, mixed areas of positive and negative simulated yield changes, with declines in some breadbasket regions led to overall declines in productivity at both 1.5°C and 2.0°C. These projected global yield changes resulted in increases in prices of major commodities in a global economic model. Simulations for 1.5°C and 2.0°C using site-based crop models had mixed results depending on region and crop, but with more negative effects on productivity at 2.0°C than at 1.5°C for the most part. In conjunction with price changes from the global economics models, these productivity declines resulted generally in small positive effects on regional farm livelihoods, showing that farming systems should continue to be viable under high mitigation scenarios. CGRA protocols focus on how mitigation actions and effects differ across scales, with main mechanisms studied in the integrated assessment models being policies and technologies that reduce direct non-CO2 emissions from agriculture, reduce CO2 emissions from land use change and forest sink enhancement

Global warming impact assessment of a crop residue gasification project—A dynamic LCA perspective

International Nuclear Information System (INIS)

Yang, Jin; Chen, Bin

2014-01-01

Highlights: • A dynamic LCA is proposed considering time-varying factors. • Dynamic LCA is used to highlight GHG emission hotspots of gasification projects. • Indicators are proposed to reflect GHG emission performance. • Dynamic LCA alters the static LCA results. • Crop residue gasification project has high GHG abatement potential. - Abstract: Bioenergy from crop residues is one of the prevailing sustainable energy sources owing to the abundant reserves worldwide. Amongst a wide variety of energy conversion technologies, crop residue gasification has been regarded as promising owing to its higher energy efficiency than that of direct combustion. However, prior to large-scale application of crop residue gasification, the lifetime environmental performance should be investigated to shed light on sustainable strategies. As traditional static life cycle assessment (LCA) does not include temporal information for dynamic processes, we proposed a dynamic life cycle assessment approach, which improves the static LCA approach by considering time-varying factors, e.g., greenhouse gas characterization factors and energy intensity. As the gasification project can reduce greenhouse gas (GHG) discharge compared with traditional direct fuel combustion, trade-offs between the benefits of global warming mitigation and the impact on global warming of crop residue gasification should be considered. Therefore, indicators of net global warming mitigation benefit and global warming impact mitigation period are put forward to justify the feasibility of the crop residue gasification project. The proposed dynamic LCA and indicators were then applied to estimate the life cycle global warming impact of a crop residue gasification system in China. Results show that the crop residue gasification project has high net global warming mitigation benefit and a short global warming impact mitigation period, indicating its prominent potential in alleviating global warming impact. During

An assessment of global meteorological droughts based on HAPPI experiments

Science.gov (United States)

Liu, Wenbin; Sun, Fubao; Lim, Wee Ho; Zhang, Jie

2017-04-01

Droughts caused water shortages could lead to serious consequences on the socioeconomic and environmental well-being. In the context of changing climate, droughts monitoring, attributions and impact assessments have been performed using observations (e.g., Sun et al., 2012; Zhang et al., 2016) and climate model projections (e.g., Liu et al., 2016, 2017); with expectation that such scientific knowledge would feed into long-term adaptation and mitigation plans to tackle potentially unfavorable future drought impacts in a warming world. Inspired by the 2015 Paris Agreement, the HAPPI (Half a degree Additional warming, Projections, Prognosis and Impacts) experiments were set up to better inform international policymakers about the socioeconomic and environmental impacts under less severe global warming conditions. This study aims to understand the potential shift in meteorological droughts from the past into the future on a global scale. Based on the HAPPI data, we evaluate the change in drought related indices (i.e., PET/P, PDSI) from the past to the future scenarios (1.5 and 2 degrees Celsius warming). Here we present some early results (MIROC5 as demonstration) on identified hotspots and discuss the differences in severity of droughts between these warming worlds and associated consequences. References: Liu W, and Sun F, 2017. Projecting and attributing future changes of evaporative demand over China in CMIP5 climate models, Journal of Hydrometeorology, doi: 10.1175/JHM-D-16-0204.1 Liu W, and Sun F, 2016. Assessing estimates of evaporative demand in climate models using observed pan evaporation over China. Journal of Geophysical Research-Atmosphere 121, 8329-8349 Zhang J, Sun F, Xu J, Chen Y, Sang Y, -F, and Liu C, 2016. Dependence of trends in and sensitivity of drought over China (1961-2013) on potential evaporation model. Geophysical Research Letters 43, 206-213 Sun F, Roderick M, Farquhar G, 2012. Changes in the variability of global land precipitation

Aqueduct: an interactive tool to empower global water risk assessment

Science.gov (United States)

Reig, Paul; Gassert, Francis

2013-04-01

The Aqueduct Water Risk Atlas (Aqueduct) is a publicly available, global database and interactive tool that maps indicators of water related risks for decision makers worldwide. Aqueduct makes use of the latest geo-statistical modeling techniques to compute a composite index and translate the most recently available hydrological data into practical information on water related risks for companies, investors, and governments alike. Twelve global indicators are grouped into a Water Risk Framework designed in response to the growing concerns from private sector actors around water scarcity, water quality, climate change, and increasing demand for freshwater. The Aqueduct framework includes indicators of water stress, variability in supply, storage, flood, drought, groundwater, water quality and social conflict, addressing both spatial and temporal variation in water hazards. It organizes indicators into three categories of risk that bring together multiple dimensions of water related risk into comprehensive aggregated scores, which allow for dynamic weighting to capture users' unique exposure to water hazards. All information is compiled into an online, open access platform, from which decision-makers can view indicators, scores, and maps, conduct global risk assessments, and export data and shape files for further analysis. Companies can use this tool to evaluate their exposure to water risks across operations and supply chains, investors to assess water-related risks in their portfolio, and public-sector actors to better understand water security. Additionally, the open nature of the data and maps allow other organizations to build off of this effort with new research, for example in the areas of water-energy or water-food relationships. This presentation will showcase the Aqueduct Water Risk Atlas online tool and the features and functionalities it offers, as well as explain how it can be used for both private and public sector applications. The session will

Geothermal energy in deep aquifers : A global assessment of the resource base for direct heat utilization

NARCIS (Netherlands)

Limberger, Jon; Boxem, Thijs; Pluymaekers, Maarten; Bruhn, D.F.; Manzella, Adele; Calcagno, Philippe; Beekman, Fred; Cloetingh, S.A.P.L.; van Wees, Jan Diederik

2018-01-01

In this paper we present results of a global resource assessment for geothermal energy within deep aquifers for direct heat utilization. Greenhouse heating, spatial heating, and spatial cooling are considered in this assessment. We derive subsurface temperatures from geophysical data and apply a

Mapping Priorities to Focus Cropland Mapping Activities: Fitness Assessment of Existing Global, Regional and National Cropland Maps

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François Waldner

2015-06-01

Full Text Available Timely and accurate information on the global cropland extent is critical for applications in the fields of food security, agricultural monitoring, water management, land-use change modeling and Earth system modeling. On the one hand, it gives detailed location information on where to analyze satellite image time series to assess crop condition. On the other hand, it isolates the agriculture component to focus food security monitoring on agriculture and to assess the potential impacts of climate change on agricultural lands. The cropland class is often poorly captured in global land cover products due to its dynamic nature and the large variety of agro-systems. The overall objective was to evaluate the current availability of cropland datasets in order to propose a strategic planning and effort distribution for future cropland mapping activities and, therefore, to maximize their impact. Following a very comprehensive identification and collection of national to global land cover maps, a multi-criteria analysis was designed at the country level to identify the priority areas for cropland mapping. As a result, the analysis highlighted priority regions, such as Western Africa, Ethiopia, Madagascar and Southeast Asia, for the remote sensing community to focus its efforts. A Unified Cropland Layer at 250 m for the year 2014 was produced combining the fittest products. It was assessed using global validation datasets and yields an overall accuracy ranging from 82%–94%. Masking cropland areas with a global forest map reduced the commission errors from 46% down to 26%. Compared to the GLC-Share and the International Institute for Applied Systems Analysis-International Food Policy Research Institute (IIASA-IFPRI cropland maps, significant spatial disagreements were found, which might be attributed to discrepancies in the cropland definition. This advocates for a shared definition of cropland, as well as global validation datasets relevant for the

Thrombotic risk assessment in APS: the Global APS Score (GAPSS).

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Sciascia, S; Bertolaccini, M L

2014-10-01

Recently, we developed a risk score for antiphospholipid syndrome (APS) (Global APS Score or GAPSS). This score derived from the combination of independent risk factors for thrombosis and pregnancy loss, taking into account the antiphospholipid antibodies (aPL) profile (criteria and non-criteria aPL), the conventional cardiovascular risk factors, and the autoimmune antibodies profile. We demonstrate that risk profile in APS can be successfully assessed, suggesting that GAPSS can be a potential quantitative marker of APS-related clinical manifestations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

A global assessment of market accessibility and market influence for global environmental change studies

NARCIS (Netherlands)

Verburg, P.H.; Ellis, E.C.; Letourneau, A.

2011-01-01

Markets influence the global patterns of urbanization, deforestation, agriculture and other land use systems. Yet market influence is rarely incorporated into spatially explicit global studies of environmental change, largely because consistent global data are lacking below the national level. Here

Extracting information from an ensemble of GCMs to reliably assess future global runoff change

NARCIS (Netherlands)

Sperna Weiland, F.C.; Beek, L.P.H. van; Weerts, A.H.; Bierkens, M.F.P.

2011-01-01

Future runoff projections derived from different global climate models (GCMs) show large differences. Therefore, within this study the, information from multiple GCMs has been combined to better assess hydrological changes. For projections of precipitation and temperature the Reliability ensemble

Flood damage curves for consistent global risk assessments

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de Moel, Hans; Huizinga, Jan; Szewczyk, Wojtek

2016-04-01

Assessing potential damage of flood events is an important component in flood risk management. Determining direct flood damage is commonly done using depth-damage curves, which denote the flood damage that would occur at specific water depths per asset or land-use class. Many countries around the world have developed flood damage models using such curves which are based on analysis of past flood events and/or on expert judgement. However, such damage curves are not available for all regions, which hampers damage assessments in those regions. Moreover, due to different methodologies employed for various damage models in different countries, damage assessments cannot be directly compared with each other, obstructing also supra-national flood damage assessments. To address these problems, a globally consistent dataset of depth-damage curves has been developed. This dataset contains damage curves depicting percent of damage as a function of water depth as well as maximum damage values for a variety of assets and land use classes (i.e. residential, commercial, agriculture). Based on an extensive literature survey concave damage curves have been developed for each continent, while differentiation in flood damage between countries is established by determining maximum damage values at the country scale. These maximum damage values are based on construction cost surveys from multinational construction companies, which provide a coherent set of detailed building cost data across dozens of countries. A consistent set of maximum flood damage values for all countries was computed using statistical regressions with socio-economic World Development Indicators from the World Bank. Further, based on insights from the literature survey, guidance is also given on how the damage curves and maximum damage values can be adjusted for specific local circumstances, such as urban vs. rural locations, use of specific building material, etc. This dataset can be used for consistent supra

Funding for malaria control 2006–2010: A comprehensive global assessment

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Pigott David M

2012-07-01

Full Text Available Abstract Background The last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world. As the ongoing climate of financial uncertainty places strains on investment in global health, there is an increasing need to audit the origin, recipients and geographical distribution of funding for malaria control relative to populations at risk of the disease. Methods A comprehensive review of malaria control funding from international donors, bilateral sources and national governments was undertaken to reconstruct total funding by country for each year 2006 to 2010. Regions at risk from Plasmodium falciparum and/or Plasmodium vivax transmission were identified using global risk maps for 2010 and funding was assessed relative to populations at risk. Those nations with unequal funding relative to a regional average were identified and potential explanations highlighted, such as differences in national policies, government inaction or donor neglect. Results US$8.9 billion was disbursed for malaria control and elimination programmes over the study period. Africa had the largest levels of funding per capita-at-risk, with most nations supported primarily by international aid. Countries of the Americas, in contrast, were supported typically through national government funding. Disbursements and government funding in Asia were far lower with a large variation in funding patterns. Nations with relatively high and low levels of funding are discussed. Conclusions Global funding for malaria control is substantially less than required. Inequity in funding is pronounced in some regions particularly when considering the distinct goals of malaria control and malaria elimination. Efforts to sustain and increase international investment in malaria control should be informed by evidence-based assessment of funding equity.

Changes in the prescription pattern of antipsychotics for schizophrenic outpatients after the implementation of a global budgeting program

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Hsien-Jane Chiu

2014-06-01

Conclusion: We concluded that the GB implementation reduced SGA expenditures significantly. The extent of influence varied among hospitals (i.e., public versus private, medical versus psychiatric centers, which was most likely caused by financial factors.

Global assessment of extinction risk to populations of Sockeye salmon Oncorhynchus nerka.

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Peter S Rand

Full Text Available BACKGROUND: Concern about the decline of wild salmon has attracted the attention of the International Union for the Conservation of Nature (IUCN. The IUCN applies quantitative criteria to assess risk of extinction and publishes its results on the Red List of Threatened Species. However, the focus is on the species level and thus may fail to show the risk to populations. The IUCN has adapted their criteria to apply to populations but there exist few examples of this type of assessment. We assessed the status of sockeye salmon Oncorhynchus nerka as a model for application of the IUCN population-level assessments and to provide the first global assessment of the status of an anadromous Pacific salmon. METHODS/PRINCIPAL FINDINGS: We found from demographic data that the sockeye salmon species is not presently at risk of extinction. We identified 98 independent populations with varying levels of risk within the species' range. Of these, 5 (5% are already extinct. We analyzed the risk for 62 out of 93 extant populations (67% and found that 17 of these (27% are at risk of extinction. The greatest number and concentration of extinct and threatened populations is in the southern part of the North American range, primarily due to overfishing, freshwater habitat loss, dams, hatcheries, and changing ocean conditions. CONCLUSIONS/SIGNIFICANCE: Although sockeye salmon are not at risk at the species-level, about one-third of the populations that we analyzed are at risk or already extinct. Without an understanding of risk to biodiversity at the level of populations, the biodiversity loss in salmon would be greatly underrepresented on the Red List. We urge government, conservation organizations, scientists and the public to recognize this limitation of the Red List. We also urge recognition that about one-third of sockeye salmon global population diversity is at risk of extinction or already extinct.

Joint Effects of Structural Racism and Income Inequality on Small-for-Gestational-Age Birth

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Wallace, Maeve E.; Liu, Danping; Grantz, Katherine L.

2015-01-01

Objectives. We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. Methods. Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor’s or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. Results. Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. Conclusions. High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur. PMID:26066964

Joint Effects of Structural Racism and Income Inequality on Small-for-Gestational-Age Birth.

Science.gov (United States)

Wallace, Maeve E; Mendola, Pauline; Liu, Danping; Grantz, Katherine L

2015-08-01

We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor's or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur.

Spatiotemporal models of global soil organic carbon stock to support land degradation assessments at regional and global scales: limitations, challenges and opportunities

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Hengl, Tomislav; Heuvelink, Gerard; Sanderman, Jonathan; MacMillan, Robert

2017-04-01

There is an increasing interest in fitting and applying spatiotemporal models that can be used to assess and monitor soil organic carbon stocks (SOCS), for example, in support of the '4 pourmille' initiative aiming at soil carbon sequestration towards climate change adaptation and mitigation and UN's Land Degradation Neutrality indicators and similar degradation assessment projects at regional and global scales. The land cover mapping community has already produced several spatiotemporal data sets with global coverage and at relatively fine resolution e.g. USGS MODIS land cover annual maps for period 2000-2014; European Space Agency land cover maps at 300 m resolution for the year 2000, 2005 and 2010; Chinese GlobeLand30 dataset available for years 2000 and 2010; Columbia University's WRI GlobalForestWatch with deforestation maps at 30 m resolution for the period 2000-2016 (Hansen et al. 2013). These data sets can be used for land degradation assessment and scenario testing at global and regional scales (Wei et al 2014). Currently, however, no compatible global spatiotemporal data sets exist on status of soil quality and/or soil health (Powlson et al. 2013). This paper describes an initial effort to devise and evaluate a procedure for mapping spatio-temporal changes in SOC stocks using a complete stack of soil forming factors (climate, relief, land cover, land use, lithology and living organisms) represented mainly through remote sensing based time series of Earth images. For model building we used some 75,000 geo-referenced soil profiles and a stacks space-time covariates (land cover, land use, biomass, climate) at two standard resolutions: (1) 10 km resolution with data available for period 1920-2014 and (2) 1000 m resolution with data available for period 2000-2014. The initial results show that, although it is technically feasible to produce space time estimates of SOCS that demonstrate the procedure, the estimates are relatively uncertain (<45% of variation

Comparison of secondhand smoke exposure measures during pregnancy in the development of a clinical prediction model for small-for-gestational-age among non-smoking Chinese pregnant women.

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Xie, Chuanbo; Wen, Xiaozhong; Niu, Zhongzheng; Ding, Peng; Liu, Tao; He, Yanhui; Lin, Jianmiao; Yuan, Shixin; Guo, Xiaoling; Jia, Deqin; Chen, Weiqing

2015-10-01

To compare predictive values of small-for-gestational-age (SGA) by different measures for secondhand smoke (SHS) exposure during pregnancy and to develop and validate a prediction model for SGA using SHS exposure along with sociodemographic and pregnancy factors. We compared the predictability of different measures of SHS exposure during pregnancy for SGA among 545 Chinese pregnant women, and then used the optimal SHS measure along with other clinically available factors to develop and validate a prediction model for SGA. We fit logistic regression models to predict SGA by single measures of SHS exposure (self-report, serum cotinine and CYP2A6*4) and different combinations (self-report+cotinine, cotinine+CYP2A6*4, self-report+CYP2A6*4 and self-report+cotinine+CYP2A6*4). We found that self-reported SHS exposure alone predicted SGA (area under the receiver operating characteristic curve or area under the receiver operating curve (AUROC), 0.578) better than the other two single measures (cotinine, 0.547; CYP2A6*4, 0.529) or as accurately as combined SHS measures (0.545-0.584). The final prediction model that contained self-reported SHS exposure, prepregnancy body mass index, gestational weight gain velocity during the second and third trimesters, gestational diabetes, gestational hypertension and the third-trimester biparietal diameter Z-score could predict SGA fairly accurately (AUROC, 0.698). Self-reported SHS exposure at peribirth performs better in predicting SGA than a single measure of serum cotinine at the same time, although repeated biochemical cotinine assessments throughout pregnancy may be optimal. Our simple prediction model is fairly accurate and can be potentially used in routine prenatal care. 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.

Blood pressure and heart rate during stress in children born small for gestational age.

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Pirojsakul, Kwanchai; Thanapinyo, Apinya; Nuntnarumit, Pracha

2017-06-01

Increased sympathetic nervous system activity has been proposed as a potential mechanism for the blood pressure (BP) elevation seen in individuals born small for gestational age (SGA). This study was carried out to detect the changes in BP and heart rate (HR) in children born SGA during exposure to stress and to assess for changes in urinary catecholamine excretion. Nineteen children aged 6-14 years born SGA and 17 age- and gender-matched healthy controls were included in the study. The stress test included a mathematical test and venipuncture. BP and HR were monitored during the test. Spot urine samples were collected at baseline and after the stress test to determine dopamine, epinephrine and norepinephrine levels. At baseline, there was no difference in BP and HR between the SGA and control groups, but mean urinary norepinephrine levels were slightly higher in the SGA group (55.7 ± 16.1 vs. 43.4 ± 3.8 mcg/gCr; P = 0.10). Compared to the control group, mean maximal HR increase was higher in the SGA group (31.3 ± 3.1 vs. 19.2 ± 3.8%; P = 0.008), and mean duration of maximal HR to baseline HR was longer (186 ± 23 vs. 97 ± 13 s, respectively; P = 0.003). There was a significant negative correlation between birth weight and maximal HR increase (r = -0.497, P = 0.003). Children born SGA showed significantly greater increases in HR and significantly longer periods of tachycardia during exposure to stress than did healthy controls. The rise in HR was inversely correlated with birth weight. These findings suggest that children born SGA have a greater increase in sympathetic response when exposed to stress than do healthy individuals.

Designing a global assessment of climate change on inland fishes and fisheries: knowns and needs

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Paukert, Craig P.; Lynch, Abigail J.; Beard, T. Douglas; Chen, Yushun; Cooke, Steven J.; Cooperman, Michael S.; Cowx, Ian G.; Infante, Dana M.; Ibengwe, Lilian; Myers, Bonnie; Nguyen, Phu Hoa; Winfield, Ian J.

2017-01-01

To date, there are few comprehensive assessments of how climate change affects inland finfish, fisheries, and aquaculture at a global scale, but one is necessary to identify research needs and commonalities across regions and to help guide decision making and funding priorities. Broadly, the consequences of climate change on inland fishes will impact global food security, the livelihoods of people who depend on inland capture and recreational fisheries. However, understanding how climate change will affect inland fishes and fisheries has lagged behind marine assessments. Building from a North American inland fisheries assessment, we convened an expert panel from seven countries to provide a first-step to a framework for determining how to approach an assessment of how climate change may affect inland fishes, capture fisheries, and aquaculture globally. Starting with the small group helped frame the key questions (e.g., who is the audience? What is the best approach and spatial scale?). Data gaps identified by the group include: the tolerances of inland fisheries to changes in temperature, stream flows, salinity, and other environmental factors linked to climate change, and the adaptive capacity of fishes and fisheries to adjust to these changes. These questions are difficult to address, but long-term and large-scale datasets are becoming more readily available as a means to test hypotheses related to climate change. We hope this perspective will help researchers and decision makers identify research priorities and provide a framework to help sustain inland fish populations and fisheries for the diversity of users around the globe.

How do glacier inventory data aid global glacier assessments and projections?

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Hock, R.

2017-12-01

Large-scale glacier modeling relies heavily on datasets that are collected by many individuals across the globe, but managed and maintained in a coordinated fashion by international data centers. The Global Terrestrial Network for Glaciers (GTN-G) provides the framework for coordinating and making available a suite of data sets such as the Randolph Glacier Inventory (RGI), the Glacier Thickness Dataset or the World Glacier Inventory (WGI). These datasets have greatly increased our ability to assess global-scale glacier mass changes. These data have also been vital for projecting the glacier mass changes of all mountain glaciers in the world outside the Greenland and Antarctic ice sheet, a total >200,000 glaciers covering an area of more than 700,000 km2. Using forcing from 8 to 15 GCMs and 4 different emission scenarios, global-scale glacier evolution models project multi-model mean net mass losses of all glaciers between 7 cm and 24 cm sea-level equivalent by the end of the 21st century. Projected mass losses vary greatly depending on the choice of the forcing climate and emission scenario. Insufficiently constrained model parameters likely are an important reason for large differences found among these studies even when forced by the same emission scenario, especially on regional scales.

THE EVOLUTION OF ECONOMIC GLOBALIZATION DURING THE CURRENT GLOBAL CRISIS

OpenAIRE

Sabina Tuca

2013-01-01

The current economic crisis constitutes a serious test for the process of globalization. The purpose of this study is to analyze the influence of the current global crisis on economic globalization. To assess the impact of the current crisis on economic globalization, this paper examines the KOF Index of Globalization, before and during the crisis. The findings generally support the idea that economic globalization has been, in fact, weakened, after the onset of the current crisis. However, t...

Application of First Trimester Screening in the Prognostication of Small for Gestational Age

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Reza Saeidi

2018-05-01

Full Text Available Background: Fetal growth restriction is defined as the failure of the fetus to achieve its full growth potential. The present study aimed to investigate the application of first trimester screening in the prediction of small for gestational age (SGA.Methods: This cohort study was conducted on the consecutive and unselected women with singleton pregnancies undergoing routine first-trimester examinations in a health center affiliated to Neyshabur University of Medical Sciences in Razavi Khorasan Iran during February 2014-March 2016. Subjects received a first-trimester visit by a physician, which included the entry of basic maternal characteristics, medical history, measurement of maternal weight and height, ultrasound examination for fetal anatomy, and measurement of crown-rump length to assess gestational age.Results: SGA was significantly correlated with maternal age, parity, and body mass index. Furthermore, a significant association was observed between SGA and smoking habits in the mothers.Conclusion: According to the results, first trimester screening was a useful method for the prediction of SGA.

Beyond the global assessment of functioning: learning from Virginia Apgar.

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Dimsdale, Joel E; Jeste, Dilip V; Patterson, Thomas L

2010-01-01

The Global Assessment of Functioning (GAF) scale is widely used in psychiatry, yet it has certain drawbacks. The authors seek to generate further discussion and research around developing an improved successor to the GAF. The authors used the Apgar scale as a template for constructing a possible successor to the GAF. Consulting with 16 colleagues, they selected 5 domains that were felt to be central to functioning in psychiatric patients. Psychiatrists in diverse clinical settings then completed both a GAF and a Psychiatric Apgar scale on 40 patients. The two scales were found to agree significantly. Use of the Psychiatric Apgar, however, provides clearer guidance about assessing functioning. The GAF was a brilliant addition to psychiatric practice. As we develop the next Diagnostic and Statistical Manual, it is pertinent to ask whether the GAF approach could be optimized even further by applying the lessons of Virginia Apgar.

Global and 3D spatial assessment of neuroinflammation in rodent models of Multiple Sclerosis.

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Shashank Gupta

Full Text Available Multiple Sclerosis (MS is a progressive autoimmune inflammatory and demyelinating disease of the central nervous system (CNS. T cells play a key role in the progression of neuroinflammation in MS and also in the experimental autoimmune encephalomyelitis (EAE animal models for the disease. A technology for quantitative and 3 dimensional (3D spatial assessment of inflammation in this and other CNS inflammatory conditions is much needed. Here we present a procedure for 3D spatial assessment and global quantification of the development of neuroinflammation based on Optical Projection Tomography (OPT. Applying this approach to the analysis of rodent models of MS, we provide global quantitative data of the major inflammatory component as a function of the clinical course. Our data demonstrates a strong correlation between the development and progression of neuroinflammation and clinical disease in several mouse and a rat model of MS refining the information regarding the spatial dynamics of the inflammatory component in EAE. This method provides a powerful tool to investigate the effect of environmental and genetic forces and for assessing the therapeutic effects of drug therapy in animal models of MS and other neuroinflammatory/neurodegenerative disorders.

Perioperative nutritional status changes in gastrointestinal cancer patients.

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Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Lee, Jae Gil; Noh, Sung Hoon

2013-11-01

The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (pgastric cancer patients, postoperative severe malnourishment increased significantly (p60, pgastric cancer (pgastric cancer, and open surgery remained significant as risk factors of severe malnutrition. The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.

Assessing global vegetation activity using spatio-temporal Bayesian modelling

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Mulder, Vera L.; van Eck, Christel M.; Friedlingstein, Pierre; Regnier, Pierre A. G.

2016-04-01

This work demonstrates the potential of modelling vegetation activity using a hierarchical Bayesian spatio-temporal model. This approach allows modelling changes in vegetation and climate simultaneous in space and time. Changes of vegetation activity such as phenology are modelled as a dynamic process depending on climate variability in both space and time. Additionally, differences in observed vegetation status can be contributed to other abiotic ecosystem properties, e.g. soil and terrain properties. Although these properties do not change in time, they do change in space and may provide valuable information in addition to the climate dynamics. The spatio-temporal Bayesian models were calibrated at a regional scale because the local trends in space and time can be better captured by the model. The regional subsets were defined according to the SREX segmentation, as defined by the IPCC. Each region is considered being relatively homogeneous in terms of large-scale climate and biomes, still capturing small-scale (grid-cell level) variability. Modelling within these regions is hence expected to be less uncertain due to the absence of these large-scale patterns, compared to a global approach. This overall modelling approach allows the comparison of model behavior for the different regions and may provide insights on the main dynamic processes driving the interaction between vegetation and climate within different regions. The data employed in this study encompasses the global datasets for soil properties (SoilGrids), terrain properties (Global Relief Model based on SRTM DEM and ETOPO), monthly time series of satellite-derived vegetation indices (GIMMS NDVI3g) and climate variables (Princeton Meteorological Forcing Dataset). The findings proved the potential of a spatio-temporal Bayesian modelling approach for assessing vegetation dynamics, at a regional scale. The observed interrelationships of the employed data and the different spatial and temporal trends support

Birth weight and postnatal growth in preterm born children are associated with cortisol in early infancy, but not at age 8 years.

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Ruys, Charlotte A; van der Voorn, Bibian; Lafeber, Harrie N; van de Lagemaat, Monique; Rotteveel, Joost; Finken, Martijn J J

2017-08-01

Preterm birth has been associated with altered hypothalamic-pituitary-adrenal (HPA-) axis activity as well as cardiometabolic diseases and neurodevelopmental impairments later in life. We assessed cortisol from term age to age 8 y in children born preterm, to explore the development of HPA-axis activity in association with intrauterine and early-postnatal growth until 6 mo. corrected age. In 152 children born at a gestational age ≤32 wks. and/or with a birth weight ≤1,500g, random serum cortisol was assessed at term age (n=150), 3 mo. (n=145) and 6 mo. corrected age (n=144), and age 8 y (n=59). Salivary cortisol was assessed at age 8 y (n=75): prior to bedtime, at awakening, 15min after awakening, and before lunch. Cortisol was analyzed in association with birth weight-standard deviation score (SDS), being born small for gestational age (SGA), and combinations of intrauterine and postnatal growth: appropriate for gestational age (AGA) with or without growth restriction (AGA GR+ or AGA GR-) at 6 mo. corrected age, and SGA with or without catch-up growth (SGA CUG+ or SGA CUG-) at 6 mo. corrected age. Cross-sectional associations at all time points were analyzed using linear regression, and longitudinal associations were analyzed using generalized estimating equations. Longitudinally, birth weight-SDS was associated with cortisol (β [95%CI]): lower cortisol over time was seen in infants with a birth weight ≤-2 SDS (-50.69 [-94.27; -7.11], p=0.02), infants born SGA (-29.70 [-60.58; 1.19], p=0.06), AGA GR+ infants (-55.10 [-106.02; -4.17], p=0.03) and SGA CUG- infants (-61.91 [-104.73; -19.10], p=0.01). In cross-sectional analyses at age 8 y, no associations were found between either serum or salivary cortisol and birth weight-SDS, SGA-status, or growth from birth to 6 mo. corrected age. In children born preterm, poor intrauterine and postnatal growth were associated with lower cortisol in early infancy, but not at age 8 y. Even though HPA-axis activity no longer

Objective structured assessment of nontechnical skills: Reliability of a global rating scale for the in-training assessment in the operating room.

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Dedy, Nicolas J; Szasz, Peter; Louridas, Marisa; Bonrath, Esther M; Husslein, Heinrich; Grantcharov, Teodor P

2015-06-01

Nontechnical skills are critical for patient safety in the operating room (OR). As a result, regulatory bodies for accreditation and certification have mandated the integration of these competencies into postgraduate education. A generally accepted approach to the in-training assessment of nontechnical skills, however, is lacking. The goal of the present study was to develop an evidence-based and reliable tool for the in-training assessment of residents' nontechnical performance in the OR. The Objective Structured Assessment of Nontechnical Skills tool was designed as a 5-point global rating scale with descriptive anchors for each item, based on existing evidence-based frameworks of nontechnical skills, as well as resident training requirements. The tool was piloted on scripted videos and refined in an iterative process. The final version was used to rate residents' performance in recorded OR crisis simulations and during live observations in the OR. A total of 37 simulations and 10 live procedures were rated. Interrater agreement was good for total mean scores, both in simulation and in the real OR, with intraclass correlation coefficients >0.90 in all settings for average and single measures. Internal consistency of the scale was high (Cronbach's alpha = 0.80). The Objective Structured Assessment of Nontechnical Skills global rating scale was developed as an evidence-based tool for the in-training assessment of residents' nontechnical performance in the OR. Unique descriptive anchors allow for a criterion-referenced assessment of performance. Good reliability was demonstrated in different settings, supporting applications in research and education. Copyright © 2015 Elsevier Inc. All rights reserved.

Chemotherapy-Related Toxicity, Nutritional Status and Quality of Life in Precachectic Oncologic Patients with, or without, High Protein Nutritional Support. A Prospective, Randomized Study

Directory of Open Access Journals (Sweden)

Monika Ziętarska

2017-10-01

Full Text Available Background: Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. Objectives: The aim of the study was to determine whether nutritional support with high protein (ONS in adult oncologic patients in the first step of cancer cachexia—asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. Materials and Methods: A total of 114 persons aged 40–84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening, SGA (Subjective Global Assessment, SCRINIO (SCReenIng the Nutritional status In Oncology Working Group classification, VAS (Visual Analog Scale for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Results: Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed

A global call for action to include gender in research impact assessment.

Science.gov (United States)

Ovseiko, Pavel V; Greenhalgh, Trisha; Adam, Paula; Grant, Jonathan; Hinrichs-Krapels, Saba; Graham, Kathryn E; Valentine, Pamela A; Sued, Omar; Boukhris, Omar F; Al Olaqi, Nada M; Al Rahbi, Idrees S; Dowd, Anne-Maree; Bice, Sara; Heiden, Tamika L; Fischer, Michael D; Dopson, Sue; Norton, Robyn; Pollitt, Alexandra; Wooding, Steven; Balling, Gert V; Jakobsen, Ulla; Kuhlmann, Ellen; Klinge, Ineke; Pololi, Linda H; Jagsi, Reshma; Smith, Helen Lawton; Etzkowitz, Henry; Nielsen, Mathias W; Carrion, Carme; Solans-Domènech, Maite; Vizcaino, Esther; Naing, Lin; Cheok, Quentin H N; Eckelmann, Baerbel; Simuyemba, Moses C; Msiska, Temwa; Declich, Giovanna; Edmunds, Laurel D; Kiparoglou, Vasiliki; Buchan, Alison M J; Williamson, Catherine; Lord, Graham M; Channon, Keith M; Surender, Rebecca; Buchan, Alastair M

2016-07-19

Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

Uncertainty propagation in life cycle assessment of biodiesel versus diesel: global warming and non-renewable energy.

Science.gov (United States)

Hong, Jinglan

2012-06-01

Uncertainty information is essential for the proper use of life cycle assessment and environmental assessments in decision making. To investigate the uncertainties of biodiesel and determine the level of confidence in the assertion that biodiesel is more environmentally friendly than diesel, an explicit analytical approach based on the Taylor series expansion for lognormal distribution was applied in the present study. A biodiesel case study demonstrates the probability that biodiesel has a lower global warming and non-renewable energy score than diesel, that is 92.3% and 93.1%, respectively. The results indicate the level of confidence in the assertion that biodiesel is more environmentally friendly than diesel based on the global warming and non-renewable energy scores. Copyright © 2011 Elsevier Ltd. All rights reserved.

Small-for-gestational age and preterm birth across generations: a population-based study of Illinois births.

Science.gov (United States)

Castrillio, Stephanie M; Rankin, Kristin M; David, Richard J; Collins, James W

2014-12-01

Small for gestational age (weight for gestational age mothers (1956-1976) with appended US census income information. Former SGA White mothers (N = 8,993) had a twofold greater infant SGA frequency than former non-SGA White mothers (N = 101,312); 14.4 versus 6.9 %, RR = 2.1 (2.0-2.2). Former SGA African American (N = 4,861) mothers had a SGA birth frequency of 25.7 % compared to 16.1 % for former non-SGA mothers (N = 28,090); RR = 1.5 (1.5-1.6). The adjusted (controlling for maternal age, education, marital status, parity, prenatal care usage, cigarette smoking, and hypertension) RR (95 % CI) of infant SGA for former SGA (compared to non-SGA) White and African-American mothers equaled 2.0 (1.9-2.1 and 1.5 (1.5-1.6), respectively. The adjusted RR (95 % CI) of infant preterm birth for former preterm (compared to term) White and African-American mothers were 1.1 (1.0-1.2). The findings were minimally changed among mothers with a lifelong residence in impoverished or affluent neighborhoods. In both races, approximately 8 % of SGA births were attributable to maternal SGA. There is a transgenerational association of SGA but not preterm birth among non-Hispanic Whites and African-Americans. In both races, a similar proportion of SGA births are attributable to maternal SGA.

Malnutrition in hospitalized patients: results from La Rioja.

Science.gov (United States)

Martín Palmero, Ángela; Serrano Pérez, Andra; Chinchetru Ranedo, Mª José; Cámara Balda, Alejandro; Martínez de Salinas Santamarí, Mª Ángeles; Villar García, Gonzalo; Marín Lizárraga, Mª Del Mar

2017-03-30

There is a high malnutrition prevalence in hospitalized patients. To determine the malnutrition prevalence in hospitalized patients of La Rioja Community (Spain) when evaluated with different screening/ evaluation tools and its relationship with hospital stay and mortality. Cross sectional observational study of hospitalized adult patients (age > 18 years old) from medical and surgical departments that underwent within 72 h of their admission a nutritional screening with Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening (NRS) 2002, Controlling Nutritional Status (CONUT) y Subjective Global Assessment (SGA). 384 patients (273 medical and 111 surgical) were evaluated. Almost fifty percent of them were considered malnourished independently of the screening/assessment tool used. High concordance was found between SGA and NRS-2002 (k = 0.758). Malnourished patients had a longer hospital stay than those well-nourished (9.29 vs. 7.10 days; p = 0.002), used a greater number of medicines (9.2 vs. 7.4; p = 0.001) and underwent a higher number of diagnostic tests (16.4 vs. 12.5; p = 0,002). Half of the hospitalized patients in the medical and surgical department of La Rioja are malnourished. This is associated with a longer hospital stay, higher use of medicines, diagnostics tests and greater mortality. Malnutrition could be detected with easy screening tools to treat it appropriately.

Assessment of undiscovered sandstone copper deposits of the Kodar-Udokan area, Russia: Chapter M in Global mineral resource assessment

Science.gov (United States)

Zientek, Michael L.; Chechetkin, Vladimir S.; Parks, Heather L.; Box, Stephen E.; Briggs, Deborah A.; Cossette, Pamela M.; Dolgopolova, Alla; Hayes, Timothy S.; Seltmann, Reimar; Syusyura, Boris; Taylor, Cliff D.; Wintzer, Niki E.

2014-01-01

Mineral resource assessments integrate and synthesize available information as a basis for estimating the location, quality, and quantity of undiscovered mineral resources. This probabilistic mineral resource assessment of undiscovered sandstone copper deposits within Paleoproterozoic metasedimentary rocks of the Kodar-Udokan area in Russia is a contribution to a global assessment led by the U.S. Geological Survey (USGS). The purposes of this study are to (1) delineate permissive areas (tracts) to indicate where undiscovered sandstone-hosted copper deposits may occur within 2 km of the surface, (2) provide a database of known sandstone copper deposits and significant prospects, (3) estimate numbers of undiscovered deposits within these permissive tracts at several levels of confidence, and (4) provide probabilistic estimates of amounts of copper (Cu) and mineralized rock that could be contained in undiscovered deposits within each tract. The workshop for the assessment, held in October 2009, used a three-part form of mineral resource assessment as described by Singer (1993) and Singer and Menzie (2010).

Global optimization of maintenance and surveillance testing based on reliability and probabilistic safety assessment. Research project

International Nuclear Information System (INIS)

Martorell, S.; Serradell, V.; Munoz, A.; Sanchez, A.

1997-01-01

Background, objective, scope, detailed working plan and follow-up and final product of the project ''Global optimization of maintenance and surveillance testing based on reliability and probabilistic safety assessment'' are described

Assessing climate change impacts, benefits of mitigation, and uncertainties on major global forest regions under multiple socioeconomic and emissions scenarios

Science.gov (United States)

John B Kim; Erwan Monier; Brent Sohngen; G Stephen Pitts; Ray Drapek; James McFarland; Sara Ohrel; Jefferson Cole

2016-01-01

We analyze a set of simulations to assess the impact of climate change on global forests where MC2 dynamic global vegetation model (DGVM) was run with climate simulations from the MIT Integrated Global System Model-Community Atmosphere Model (IGSM-CAM) modeling framework. The core study relies on an ensemble of climate simulations under two emissions scenarios: a...

Assessment of Global Emissions, Local Emissions and Immissions of Different Heating Systems

Directory of Open Access Journals (Sweden)

Georg Erdmann

2009-08-01

Full Text Available This paper assesses and compares existing and new technologies for space heating in Germany (e.g., heat pumps, and solar thermal and wood pellet systems in terms of their environmental impacts. The various technologies were analyzed within the context of the new German legislation. The assessment was carried out on three levels: 1. Global emissions: a life cycle assessment was carried out in order to find the global environmental footprint of the various technologies; 2. Local emissions: the effects of local emissions on human health were analyzed; and 3. Immissions: the immissions were evaluated for the various technologies using a dispersion calculation. A special feature of this study is the substitution of frequently used database emission values by values obtained from field studies and our own measurements. The results show large differences between the different technologies: while electric heat pumps performed quite well in most categories, wood pellet systems performed the best with respect to climate change. The latter, however, are associated with high impacts in other environmental impact categories and on a local scale. The promotion of some technologies (especially systems based on fuel oil, a mixture of fuel oil and rapeseed oil, or a mixture of natural gas and biomethane by the newly introduced German legislation is doubtful. In terms of the immissions of wood pellet systems, it can be concluded that, even for extremely unfavorable meteorological conditions, the regulatory limits are not exceeded and the heating systems have a negligible influence on the total PM load in the ambient air.

Global guidance on environmental life cycle impact assessment indicators: impacts of climate change, fine particulate matter formation, water consumption and land use

DEFF Research Database (Denmark)

Jolliet, Olivier; Antón, Assumpció; Boulay, Anne-Marie

2018-01-01

of water consumption on human health assesses the DALYs from malnutrition caused by lack of water for irrigated food production. Land use impacts: CFs representing global potential species loss from land use are proposed as interim recommendation suitable to assess biodiversity loss due to land use......Purpose: Guidance is needed on best-suited indicators to quantify and monitor the man-made impacts on human health, biodiversity and resources. Therefore, the UNEP-SETAC Life Cycle Initiative initiated a global consensus process to agree on an updated overall life cycle impact assessment (LCIA...... are recommended: (a) The global warming potential 100 years (GWP 100) represents shorter term impacts associated with rate of change and adaptation capacity, and (b) the global temperature change potential 100 years (GTP 100) characterizes the century-scale long term impacts, both including climate-carbon cycle...

The assessment of the transformation of global tectonic plate models and the global terrestrial reference frames using the Velocity Decomposition Analysis

Science.gov (United States)

Ampatzidis, Dimitrios; König, Rolf; Glaser, Susanne; Heinkelmann, Robert; Schuh, Harald; Flechtner, Frank; Nilsson, Tobias

2016-04-01

The aim of our study is to assess the classical Helmert similarity transformation using the Velocity Decomposition Analysis (VEDA). The VEDA is a new methodology, developed by GFZ for the assessment of the reference frames' temporal variation and it is based on the separation of the velocities into two specified parts: The first is related to the reference system choice (the so called datum effect) and the latter one which refers to the real deformation of the terrestrial points. The advantage of the VEDA is its ability to detect the relative biases and reference system effects between two different frames or two different realizations of the same frame, respectively. We apply the VEDA for the assessment between several modern tectonic plate models and the recent global terrestrial reference frames.

Acquired and Participatory Competencies in Health Professions Education: Definition and Assessment in Global Health.

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Eichbaum, Quentin

2017-04-01

Many health professions education programs in high-income countries (HICs) have adopted a competency-based approach to learning. Although global health programs have followed this trend, defining and assessing competencies has proven problematic, particularly in resource-constrained settings of low- and middle-income countries (LMICs) where HIC students and trainees perform elective work. In part, this is due to programs failing to take sufficient account of local learning, cultural, and health contexts.A major divide between HIC and LMIC settings is that the learning contexts of HICs are predominantly individualist, whereas those of LMICs are generally collectivist. Individualist cultures view learning as something that the individual acquires independent of context and can possess; collectivist cultures view learning as arising dynamically from specific contexts through group participation.To bridge the individualist-collectivist learning divide, the author proposes that competencies be classified as either acquired or participatory. Acquired competencies can be transferred across contexts and assessed using traditional psychometric approaches; participatory competencies are linked to contexts and require alternative assessment approaches. The author proposes assessing participatory competencies through the approach of self-directed assessment seeking, which includes multiple members of the health care team as assessors.The proposed classification of competencies as acquired or participatory may apply across health professions. The author suggests advancing participatory competencies through mental models of sharing. In global health education, the author recommends developing three new competency domains rooted in participatory learning, collectivism, and sharing: resourceful learning; transprofessionalism and transformative learning; and social justice and health equity.

Glass vs. Plastic: Life Cycle Assessment of Extra-Virgin Olive Oil Bottles across Global Supply Chains

Directory of Open Access Journals (Sweden)

Riccardo Accorsi

2015-03-01

Full Text Available The environmental impacts of global food supply chains are growing with the need for their measurement and management. This paper explores the operations of a global supply chain for extra-virgin olive oil (EVOO according to a life cycle assessment (LCA methodology. The LCA assessment methodology is applied to determine the environmental impact categories associated with the bottled EVOO life cycle, focusing on packaging decisions. The proposed analysis identifies the greatest environmental stressors of the EVOO supply chain, thereby supporting strategic and operative decisions toward more efficient and environmentally-friendly operations management and packaging choices. This paper quantifies the environmental categories of the impacts of global warming potential, ozone layer depletion, non-renewable energy use, acidification, eutrophication and photochemical smog, for the observed EVOO supply chain, given alternative packaging configurations, i.e., a glass bottle vs. a plastic bottle. The observed system includes the supply of EVOO, the EVOO processing and bottling, the supply of packaging, the distribution of final products to customers, the end-of-life (EOL treatments regarding the management, recycling and the disposal of waste across a global supply chain. The findings from the LCA highlight the potential of PET bottles in reducing the environmental impact of EVOO supply chains and identifies hotspots of discussion for policy-makers, EVOO producers and consumers.

Magnetic resonance imaging assessed inflammation in the wrist is associated with patient-reported physical impairment, global assessment of disease activity and pain in early rheumatoid arthritis

DEFF Research Database (Denmark)

Glinatsi, Daniel; Baker, Joshua F; Hetland, Merete L

2017-01-01

metacarpophalangeal joints in the analyses did not strengthen the associations between MRI pathology and PROs. CONCLUSIONS: MRI-assessed inflammation, but not damage, in early RA wrists is associated with patient-reported physical impairment, global assessment of disease activity and pain and influences the physical...

Alternative "global warming" metrics in life cycle assessment: a case study with existing transportation data.

Science.gov (United States)

Peters, Glen P; Aamaas, Borgar; T Lund, Marianne; Solli, Christian; Fuglestvedt, Jan S

2011-10-15

The Life Cycle Assessment (LCA) impact category "global warming" compares emissions of long-lived greenhouse gases (LLGHGs) using Global Warming Potential (GWP) with a 100-year time-horizon as specified in the Kyoto Protocol. Two weaknesses of this approach are (1) the exclusion of short-lived climate forcers (SLCFs) and biophysical factors despite their established importance, and (2) the use of a particular emission metric (GWP) with a choice of specific time-horizons (20, 100, and 500 years). The GWP and the three time-horizons were based on an illustrative example with value judgments and vague interpretations. Here we illustrate, using LCA data of the transportation sector, the importance of SLCFs relative to LLGHGs, different emission metrics, and different treatments of time. We find that both the inclusion of SLCFs and the choice of emission metric can alter results and thereby change mitigation priorities. The explicit inclusion of time, both for emissions and impacts, can remove value-laden assumptions and provide additional information for impact assessments. We believe that our results show that a debate is needed in the LCA community on the impact category "global warming" covering which emissions to include, the emission metric(s) to use, and the treatment of time.

Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF) in Serbia.

Science.gov (United States)

Stojkov, Svetlana; Tadić, Ivana; Crnjanski, Tatjana; Krajnović, Dušanka

2016-09-01

Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF). The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1) had the lowest score (average value 2.98), while the cluster Management and Organizational Competency (KK2) had the highest score (average value 3.15). The competence Recognition of the Diagnosis and Patient Counseling (K8), which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively) among the all evaluated competencies. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

Can we Observe and Assess Whether the Global Hydrological Cycle is "Intensifying"?

Science.gov (United States)

Wood, E. F.; Sheffield, J.

2012-12-01

There is controversy over whether the hydrological cycle is "intensifying" (or "accelerating"), and if so how and where? Resolving this critical question is a central goal of both national (e.g. NASA's Energy and Water cycle Study: NEWS) and international (WCRP Global Energy and Water cycle Experiment: GEWEX) programs. Its resolution has significant implications for understanding changes in hydroclimatic states and variability, and in future water security at regional to global scales. Over the last decade a number of papers have addressed trends and change in specific water cycle variables with results that can best be described as inconclusive, regardless of the conclusions of specific papers. In this presentation a number of recent studies will be reviewed for their consistency in assessing whether collectively one can make conclusions regarding how the hydrologic cycle is changing. The presentation will also demonstrate a pathway for analyzing where to observe for the detection of change based on a NASA-supported, global, 1983-2009, terrestrial water cycle Earth System Data Record project being led by the author. Initial results will be presented and a discussion presented on the extent that the proposed strategy can be used to detect change in the terrestrial hydrological cycle.

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester.

Science.gov (United States)

Miranda, J; Rodriguez-Lopez, M; Triunfo, S; Sairanen, M; Kouru, H; Parra-Saavedra, M; Crovetto, F; Figueras, F; Crispi, F; Gratacós, E

2017-11-01

To compare the performance of third-trimester screening, based on estimated fetal weight centile (EFWc) vs a combined model including maternal baseline characteristics, fetoplacental ultrasound and maternal biochemical markers, for the prediction of small-for-gestational-age (SGA) neonates and late-onset fetal growth restriction (FGR). This was a nested case-control study within a prospective cohort of 1590 singleton gestations undergoing third-trimester (32 + 0 to 36 + 6 weeks' gestation) evaluation. Maternal baseline characteristics, mean arterial pressure, fetoplacental ultrasound and circulating biochemical markers (placental growth factor (PlGF), lipocalin-2, unconjugated estriol and inhibin A) were assessed in all women who subsequently delivered a SGA neonate (n = 175), defined as birth weight < 10 th centile according to customized standards, and in a control group (n = 875). Among SGA cases, those with birth weight < 3 rd centile and/or abnormal uterine artery pulsatility index (UtA-PI) and/or abnormal cerebroplacental ratio (CPR) were classified as FGR. Logistic regression predictive models were developed for SGA and FGR, and their performance was compared with that obtained using EFWc alone. In SGA cases, EFWc, CPR Z-score and maternal serum concentrations of unconjugated estriol and PlGF were significantly lower, while mean UtA-PI Z-score and lipocalin-2 and inhibin A concentrations were significantly higher, compared with controls. Using EFWc alone, 52% (area under receiver-operating characteristics curve (AUC), 0.82 (95% CI, 0.77-0.85)) of SGA and 64% (AUC, 0.86 (95% CI, 0.81-0.91)) of FGR cases were predicted at a 10% false-positive rate. A combined screening model including a-priori risk (maternal characteristics), EFWc, UtA-PI, PlGF and estriol (with lipocalin-2 for SGA) achieved a detection rate of 61% (AUC, 0.86 (95% CI, 0.83-0.89)) for SGA cases and 77% (AUC, 0.92 (95% CI, 0.88-0.95)) for FGR. The combined model for the

The Global Streamflow Indices and Metadata Archive (GSIM) - Part 2: Quality control, time-series indices and homogeneity assessment

Science.gov (United States)

Gudmundsson, Lukas; Do, Hong Xuan; Leonard, Michael; Westra, Seth

2018-04-01

This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM), which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a) describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate), Part 2 introduces a set of quality controlled time-series indices representing (i) the water balance, (ii) the seasonal cycle, (iii) low flows and (iv) floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470" target="_blank">https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

Assessment of global grey water footprint of major food crops

Science.gov (United States)

Yang, Hong; Liu, Wenfeng; Antonelli, Marta

2016-04-01

Agricultural production is one of the major sources of water pollution in the world. This is closely related to the excess application of fertilizers. Leaching of N and P to water bodies has caused serious degradation of water quality in many places. With the persistent increase in the demand for agricultural products, agricultural intensification evident during the past decades will continue in the future. This will lead to further increase in fertilizer application and consequently water pollution. Grey water footprint is a measure of the intensity of water pollution caused by water use for human activities. It is defined as the volume of water that is required to assimilate a load of pollutants to a freshwater body, based on natural background concentrations and water quality standards. This study conducts a global assessment of grey water footprint for major cereal crops, wheat, maize and rice. A crop model, Python-based EPIC (PEPIT), is applied to quantify the leaching of N and P from the fertilizer application in the three crops on a global scale with 0.5 degree spatial resolution. The hotspots of leaching are identified. The results suggest that, based on the definition and method of grey water footprint proposed by the World Water Footprint Network, the grey water footprint in many parts of the world has exceeded their total water resources availability. This indicates the seriousness of water pollution caused by agricultural production. However, the situation may also call for the development of a realistic measurement of grey water footprint which is more pertinent to water resources management. This paper proposes some alternatives in measuring grey water footprint and also discusses incorporation of grey water footprint assessment into water policy formulation and river basins plan development.

Global constitutionalism, applied to global health governance: uncovering legitimacy deficits and suggesting remedies.

Science.gov (United States)

Ooms, Gorik; Hammonds, Rachel

2016-12-03

Global constitutionalism is a way of looking at the world, at global rules and how they are made, as if there was a global constitution, empowering global institutions to act as a global government, setting rules which bind all states and people. This essay employs global constitutionalism to examine how and why global health governance, as currently structured, has struggled to advance the right to health, a fundamental human rights obligation enshrined in the International Covenant on Economic, Social and Cultural Rights. It first examines the core structure of the global health governance architecture, and its evolution since the Second World War. Second, it identifies the main constitutionalist principles that are relevant for a global constitutionalism assessment of the core structure of the global health governance architecture. Finally, it applies these constitutionalist principles to assess the core structure of the global health governance architecture. Leading global health institutions are structurally skewed to preserve high incomes countries' disproportionate influence on transnational rule-making authority, and tend to prioritise infectious disease control over the comprehensive realisation of the right to health. A Framework Convention on Global Health could create a classic division of powers in global health governance, with WHO as the law-making power in global health governance, a global fund for health as the executive power, and the International Court of Justice as the judiciary power.

Security Components of Globalization

Directory of Open Access Journals (Sweden)

Florin Iftode

2015-05-01

Full Text Available The objective of this paper is our intention to present what are the main connections between globalization and international security. In terms of global security we can perceive the globalization as a process by which global state is represented by the UN, with a single world system, represented by major security organizations and with global effects. We will present from the beginning the main theoretical aspects that define the phenomenon of globalization, and then our contribution in assessing the implications of this phenomenon on the regional and global security. The results of our research are materialized in the last part of the paper. They emphasize the personal assessments on how the phenomenon of globalization has direct effect on global security. When talking about government, we think of norms, rules and decisionmaking procedures in the management of international life. The value that we add to the new scientific interpretation of the definition of globalization is represented, primarily, by the valuable bibliographic used resources and the original approach on the concept that refers to the links between globalization and security. This article may be, at any time, a starting point in an interesting research direction in the field of global security.

GLOBOX : A spatially differentiated global fate, intake and effect model for toxicity assessment in LCA

NARCIS (Netherlands)

Wegener Sleeswijk, Anneke; Heijungs, Reinout

GLOBOX is a model for the calculation of spatially differentiated LCA toxicity characterisation factors on a global scale. It can also be used for human and environmental risk assessment. The GLOBOX model contains equations for the calculation of fate, intake and effect factors, and equations for

Investigating maternal risk factors as potential targets of intervention to reduce socioeconomic inequality in small for gestational age: a population-based study.

Science.gov (United States)

Hayward, Irene; Malcoe, Lorraine Halinka; Cleathero, Lesley A; Janssen, Patricia A; Lanphear, Bruce P; Hayes, Michael V; Mattman, Andre; Pampalon, Robert; Venners, Scott A

2012-06-13

The major aim of this study was to investigate whether maternal risk factors associated with socioeconomic status and small for gestational age (SGA) might be viable targets of interventions to reduce differential risk of SGA by socioeconomic status (socioeconomic SGA inequality) in the metropolitan area of Vancouver, Canada. This study included 59,039 live, singleton births in the Vancouver Census Metropolitan Area (Vancouver) from January 1, 2006 to September 17, 2009. To identify an indicator of socioeconomic SGA inequality, we used hierarchical logistic regression to model SGA by area-level variables from the Canadian census. We then modelled SGA by area-level average income plus established maternal risk factors for SGA and calculated population attributable SGA risk percentages (PAR%) for each variable. Associations of maternal risk factors for SGA with average income were investigated to identify those that might contribute to SGA inequality. Finally, we estimated crude reductions in the percentage and absolute differences in SGA risks between highest and lowest average income quintiles that would result if interventions on maternal risk factors successfully equalized them across income levels or eliminated them altogether. Average income produced the most linear and statistically significant indicator of socioeconomic SGA inequality with 8.9% prevalence of SGA in the lowest income quintile compared to 5.6% in the highest. The adjusted PAR% of SGA for variables were: bottom four quintiles of height (51%), first birth (32%), bottom four quintiles of average income (14%), oligohydramnios (7%), underweight or hypertension, (6% each), smoking (3%) and placental disorder (1%). Shorter height, underweight and smoking during pregnancy had higher prevalence in lower income groups. Crude models assuming equalization of risk factors across income levels or elimination altogether indicated little potential change in relative socioeconomic SGA inequality and reduction

Type 2 diabetes gene TCF7L2 polymorphism is not associated with fetal and postnatal growth in two birth cohort studies

Directory of Open Access Journals (Sweden)

Hofman Albert

2009-07-01

Full Text Available Abstract Background An inverse association between birth weight and the risk of developing type 2 diabetes (T2D in adulthood has been reported. This association may be explained by common genetic variants related to insulin secretion and resistance, since insulin is the most important growth factor in fetal life. The objective of this study was to examine whether T2D gene polymorphism TCF7L2 rs7903146 is associated with growth patterns from fetal life until infancy. Methods This study was performed in two independent birth cohort studies, one prospective population-based (Generation R, and one of subjects born small-for-gestational-age (SGA cohort. Fetal growth was assessed by ultrasounds in second and third trimesters of pregnancy in Generation R. Growth in infancy was assessed in both cohorts at birth and at 6, 12 and 24 months postnatally. TCF7L2 genotype was determined in 3,419 subjects in Generation R and in 566 subjects in the SGA cohort. Results Minor allele frequency did not differ significantly (p = 0.47 between Generation R (T-allele: 28.7% and the SGA cohort (T-allele: 29.8%. No differences at birth were found in gestational age or size (head circumference, length, weight between the genotypes in either cohort. TCF7L2 genotype was also not associated with any pre- or postnatal growth characteristic in either Generation R or the SGA cohort. Conclusion We found no evidence for an association between TCF7L2 genotype and fetal and early postnatal growth. Furthermore, this TCF7L2 polymorphism was not associated with an increased risk of SGA.

Exploring Global Exposure Factors Resources for Use in Consumer Exposure Assessments

Science.gov (United States)

Zaleski, Rosemary T.; Egeghy, Peter P.; Hakkinen, Pertti J.

2016-01-01

This publication serves as a global comprehensive resource for readers seeking exposure factor data and information relevant to consumer exposure assessment. It describes the types of information that may be found in various official surveys and online and published resources. The relevant exposure factors cover a broad range, including general exposure factor data found in published compendia and databases and resources about specific exposure factors, such as human activity patterns and housing information. Also included are resources on exposure factors related to specific types of consumer products and the associated patterns of use, such as for a type of personal care product or a type of children’s toy. Further, a section on using exposure factors for designing representative exposure scenarios is included, along with a look into the future for databases and other exposure science developments relevant for consumer exposure assessment. PMID:27455300

Accuracy assessment of the global TanDEM-X Digital Elevation Model with GPS data

Science.gov (United States)

Wessel, Birgit; Huber, Martin; Wohlfart, Christian; Marschalk, Ursula; Kosmann, Detlev; Roth, Achim

2018-05-01

The primary goal of the German TanDEM-X mission is the generation of a highly accurate and global Digital Elevation Model (DEM) with global accuracies of at least 10 m absolute height error (linear 90% error). The global TanDEM-X DEM acquired with single-pass SAR interferometry was finished in September 2016. This paper provides a unique accuracy assessment of the final TanDEM-X global DEM using two different GPS point reference data sets, which are distributed across all continents, to fully characterize the absolute height error. Firstly, the absolute vertical accuracy is examined by about three million globally distributed kinematic GPS (KGPS) points derived from 19 KGPS tracks covering a total length of about 66,000 km. Secondly, a comparison is performed with more than 23,000 "GPS on Bench Marks" (GPS-on-BM) points provided by the US National Geodetic Survey (NGS) scattered across 14 different land cover types of the US National Land Cover Data base (NLCD). Both GPS comparisons prove an absolute vertical mean error of TanDEM-X DEM smaller than ±0.20 m, a Root Means Square Error (RMSE) smaller than 1.4 m and an excellent absolute 90% linear height error below 2 m. The RMSE values are sensitive to land cover types. For low vegetation the RMSE is ±1.1 m, whereas it is slightly higher for developed areas (±1.4 m) and for forests (±1.8 m). This validation confirms an outstanding absolute height error at 90% confidence level of the global TanDEM-X DEM outperforming the requirement by a factor of five. Due to its extensive and globally distributed reference data sets, this study is of considerable interests for scientific and commercial applications.

Assessing the evolving fragility of the global food system

Science.gov (United States)

Puma, Michael J.; Bose, Satyajit; Chon, So Young; Cook, Benjamin I.

2015-02-01

The world food crisis in 2008 highlighted the susceptibility of the global food system to price shocks. Here we use annual staple food production and trade data from 1992-2009 to analyse the changing properties of the global food system. Over the 18 year study period, we show that the global food system is relatively homogeneous (85% of countries have low or marginal food self-sufficiency) and increases in complexity, with the number of global wheat and rice trade connections doubling and trade flows increasing by 42 and 90%, respectively. The increased connectivity and flows within these global trade networks suggest that the global food system is vulnerable to systemic disruptions, especially considering the tendency for exporting countries to switch to non-exporting states during times of food scarcity in the global markets. To test this hypothesis, we superimpose continental-scale disruptions on the wheat and rice trade networks. We find greater absolute reductions in global wheat and rice exports along with larger losses in network connectivity as the networks evolve due to disruptions in European wheat and Asian rice production. Importantly, our findings indicate that least developed countries suffer greater import losses in more connected networks through their increased dependence on imports for staple foods (due to these large-scale disturbances): mean (median) wheat losses as percentages of staple food supply are 8.9% (3.8%) for 1992-1996, increasing to 11% (5.7%) for 2005-2009. Over the same intervals, rice losses increase from 8.2% (2.2%) to 14% (5.2%). Our work indicates that policy efforts should focus on balancing the efficiency of international trade (and its associated specialization) with increased resilience of domestic production and global demand diversity.

Assessing the evolving fragility of the global food system

International Nuclear Information System (INIS)

Puma, Michael J; Bose, Satyajit; Chon, So Young; Cook, Benjamin I

2015-01-01

The world food crisis in 2008 highlighted the susceptibility of the global food system to price shocks. Here we use annual staple food production and trade data from 1992–2009 to analyse the changing properties of the global food system. Over the 18 year study period, we show that the global food system is relatively homogeneous (85% of countries have low or marginal food self-sufficiency) and increases in complexity, with the number of global wheat and rice trade connections doubling and trade flows increasing by 42 and 90%, respectively. The increased connectivity and flows within these global trade networks suggest that the global food system is vulnerable to systemic disruptions, especially considering the tendency for exporting countries to switch to non-exporting states during times of food scarcity in the global markets. To test this hypothesis, we superimpose continental-scale disruptions on the wheat and rice trade networks. We find greater absolute reductions in global wheat and rice exports along with larger losses in network connectivity as the networks evolve due to disruptions in European wheat and Asian rice production. Importantly, our findings indicate that least developed countries suffer greater import losses in more connected networks through their increased dependence on imports for staple foods (due to these large-scale disturbances): mean (median) wheat losses as percentages of staple food supply are 8.9% (3.8%) for 1992–1996, increasing to 11% (5.7%) for 2005–2009. Over the same intervals, rice losses increase from 8.2% (2.2%) to 14% (5.2%). Our work indicates that policy efforts should focus on balancing the efficiency of international trade (and its associated specialization) with increased resilience of domestic production and global demand diversity. (letter)

Assessing the Evolving Fragility of the Global Food System

Science.gov (United States)

Puma, Michael Joseph; Bose, Satyajit; Chon, So Young; Cook, Benjamin I.

2015-01-01

The world food crisis in 2008 highlighted the susceptibility of the global food system to price shocks. Here we use annual staple food production and trade data from 1992-2009 to analyse the changing properties of the global food system. Over the 18-year study period, we show that the global food system is relatively homogeneous (85 of countries have low or marginal food self-sufficiency) and increases in complexity, with the number of global wheat and rice trade connections doubling and trade flows increasing by 42 and 90, respectively. The increased connectivity and flows within these global trade networks suggest that the global food system is vulnerable to systemic disruptions, especially considering the tendency for exporting countries to switch to non-exporting states during times of food scarcity in the global markets. To test this hypothesis, we superimpose continental-scale disruptions on the wheat and rice trade networks. We find greater absolute reductions in global wheat and rice exports along with larger losses in network connectivity as the networks evolve due to disruptions in European wheat and Asian rice production. Importantly, our findings indicate that least developed countries suffer greater import losses in more connected networks through their increased dependence on imports for staple foods (due to these large-scale disturbances): mean (median) wheat losses as percentages of staple food supply are 8.9 (3.8) for 1992-1996, increasing to 11 (5.7) for 20052009. Over the same intervals, rice losses increase from 8.2 (2.2) to 14 (5.2). Our work indicates that policy efforts should focus on balancing the efficiency of international trade (and its associated specialization) with increased resilience of domestic production and global demand diversity.

Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF in Serbia

Directory of Open Access Journals (Sweden)

Stojkov Svetlana

2016-01-01

Full Text Available Background/Aim. Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF. The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. Methods. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. Results. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1 had the lowest score (average value 2.98, while the cluster Management and Organizational Competency (KK2 had the highest score (average value 3.15. The competence Recognition of the Diagnosis and Patient Counseling (K8, which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively among the all evaluated competencies. Conclusion. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

Integrated assessment of global water scarcity over the 21st century under multiple climate change mitigation policies

Energy Technology Data Exchange (ETDEWEB)

Hejazi, Mohamad I.; Edmonds, James A.; Clarke, Leon E.; Kyle, G. Page; Davies, Evan; Chaturvedi, Vaibhav; Wise, Marshall A.; Patel, Pralit L.; Eom, Jiyong; Calvin, Katherine V.

2014-08-01

Water scarcity conditions over the 21st century both globally and regionally are assessed in the context of climate change and climate mitigation policies, by estimating both water availability and water demand within the Global Change Assessment Model (GCAM), a leading community integrated assessment model of energy, agriculture, climate, and water. To quantify changes in future water availability, a new gridded water-balance global hydrologic model – namely, the Global Water Availability Model (GWAM) – is developed and evaluated. Global water demands for six major demand sectors (irrigation, livestock, domestic, electricity generation, primary energy production, and manufacturing) are modeled in GCAM at the regional scale (14 geopolitical regions, 151 sub-regions) and then spatially downscaled to 0.5 o x 0.5o resolution to match the scale of GWAM. Using a baseline scenario (i.e., no climate change mitigation policy) with radiative forcing reaching 8.8 W/m2 (equivalent to the SRES A1Fi emission scenario) and three climate policy scenarios with increasing mitigation stringency of 7.7, 5.5, and 4.2 W/m2 (equivalent to the SRES A2, B2, and B1 emission scenarios, respectively), we investigate the effects of emission mitigation policies on water scarcity. Two carbon tax regimes (a universal carbon tax (UCT) which includes land use change emissions, and a fossil fuel and industrial emissions carbon tax (FFICT) which excludes land use change emissions) are analyzed. The baseline scenario results in more than half of the world population living under extreme water scarcity by the end of the 21st century. Additionally, in years 2050 and 2095, 36% (28%) and 44% (39%) of the global population, respectively, is projected to live in grid cells (in basins) that will experience greater water demands than the amount of available water in a year (i.e., the water scarcity index (WSI) > 1.0). When comparing the climate policy scenarios to the baseline scenario while maintaining

Nutritional status assessment in colorectal cancer patients qualified to systemic treatment

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Monika Ziętarska

2017-06-01

Full Text Available Aim of the study . Cancer is usually associated with impaired nutritional status, which is one of the factors contributing to the deterioration of the results of surgery, chemotherapy, or radiotherapy. The aim of this study was the assessment of the nutritional status of patients with CRC qualified to chemotherapy. Material and methods : Seventy-five persons aged 40–86 years with colorectal cancer were examined. To evaluate the nutritional status NRS 2002, SGA, SCRINIO Working Group classification, VAS scale for appetite, and FAACT questionnaire were used. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were made. Results : The results indicate that 75% of patients present pre-cachexia status based on SCRINIO Working Group classification. According to both NRS-2002 and SGA, 73.3% of patients were moderately malnourished and 2.7% were severely malnourished. 37.0% of patients had moderate appetite and 6.0% (n = 5 had poor appetite. The Karnofsky score indicates the state of normal activity, and minor signs and symptoms of the disease among most of the patients. A statistically significant positive correlation was found between the VAS and the Karnofsky score (R = 0,4; p < 0.05. The FACCT average score (78.5 indicates a reduction in the quality of life of the patients in all aspects of functioning. Conclusions : Evaluation of the baseline nutritional status of patients with CRC should be a part of routine clinical practice. Because of the high incidence of confirmed pre-cachexia, this group of patients also requires early adequate nutrition intervention.

Preoperative assessment of gastric artery in patients with gastric cancer by CT angiography on 64-slice spiral CT

International Nuclear Information System (INIS)

Tang Lei; Zhang Xiaopeng; Sun Yingshi; Cao Kun; Qi Liping; Cui Yong; Wang Ning

2010-01-01

Objective: To evaluate the efficacy of different three-dimensional CTA methods on 64-slice sprial CT in the preoperative assessment of gastric arteries and their variations. Methods: Sixty-six consecutive patients with gastric cancer who underwent 64-slice spiral CT examinations preoperatively were retrospectively studied. To get the STS-MIP images, the thickness of slab was adjusted according to the inner diameter of targeted blood vessels and their cross-layer distribution. After four weeks, the AVVR images of all cases was got by the auto-vessel technique. The demonstration rates and origins of the direct and indirect feeding arteries were analyzed on AVVR and STS-MIP. McNemar tests were used to compare the detection rates of gastric feeding arteries by STS-MIP and AVVR. The relationship between CT value and display rate of vessels was analyzed using independent-samples t test. The variations of blood vessels were analyzed. Results: The display rate of indirect feeding arteries were all 100% (66/66) by STS-MIP and AVVR. The display rates of left gastric artery (LGA) and right gastroepiploic artery (RGEA) were 98.5% (65/66), 100.0% (66/66) and 97.0% (64/66), 100.0% (66/66) by STS-MIP and AVVR respectively. The display rates of right artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (PGA) by AVVR were lower than those of STS-MIP with statistical significances [RGA: 68.2% (45/66) vs. 98.5% (65/66), P<0.01; LGEA: 53.0% (35/66) vs. 97.0% (64/66), P<0.01; SGA: 7.6%(5/66) vs. 59.1% (39/66), P<0.01; PGA: 18.2% (12/66) vs. 63.6% (42/66), P<0.01]. The demonstration rates of LGEA, RGEA and SGA increased accompanied with the increasing of CT value in celiac axis (LGEA: 35 cases displayed with mean CT value of (272 ± 44) HU, 31 cases did not display with mean CT value of (229 ± 42) HU, t=4.043, P<0.01; RGEA: 64 cases

A vertically resolved, global, gap-free ozone database for assessing or constraining global climate model simulations

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G. E. Bodeker

2013-02-01

Full Text Available High vertical resolution ozone measurements from eight different satellite-based instruments have been merged with data from the global ozonesonde network to calculate monthly mean ozone values in 5° latitude zones. These ''Tier 0'' ozone number densities and ozone mixing ratios are provided on 70 altitude levels (1 to 70 km and on 70 pressure levels spaced ~ 1 km apart (878.4 hPa to 0.046 hPa. The Tier 0 data are sparse and do not cover the entire globe or altitude range. To provide a gap-free database, a least squares regression model is fitted to the Tier 0 data and then evaluated globally. The regression model fit coefficients are expanded in Legendre polynomials to account for latitudinal structure, and in Fourier series to account for seasonality. Regression model fit coefficient patterns, which are two dimensional fields indexed by latitude and month of the year, from the N-th vertical level serve as an initial guess for the fit at the N + 1-th vertical level. The initial guess field for the first fit level (20 km/58.2 hPa was derived by applying the regression model to total column ozone fields. Perturbations away from the initial guess are captured through the Legendre and Fourier expansions. By applying a single fit at each level, and using the approach of allowing the regression fits to change only slightly from one level to the next, the regression is less sensitive to measurement anomalies at individual stations or to individual satellite-based instruments. Particular attention is paid to ensuring that the low ozone abundances in the polar regions are captured. By summing different combinations of contributions from different regression model basis functions, four different ''Tier 1'' databases have been compiled for different intended uses. This database is suitable for assessing ozone fields from chemistry-climate model simulations or for providing the ozone boundary conditions for global climate model simulations that do not

Managing Identifiers for Elements of Provenance of the Third National Climate Assessment in the Global Change Information System (Invited)

Science.gov (United States)

Tilmes, C.; Aulenbach, S.; Duggan, B.; Goldstein, J.

2013-12-01

A Federal Advisory Committee (The "National Climate Assessment and Development Advisory Committee" or NCADAC) has overseen the development of a draft climate report that after extensive review will be considered by the Federal Government in the Third National Climate Assessment (NCA). This comprehensive report (1) Integrates, evaluates, and interprets the findings of the Program and discusses the scientific uncertainties associated with such findings; (2) Analyzes the effects of global change on the natural environment, agriculture, energy production and use, land and water resources, transportation, human health and welfare, human social systems, and biological diversity; and (3) Analyzes current trends in global change, both human-induced and natural, and projects major trends for the subsequent 25 to 100 years. The U.S. Global Change Program (USGCRP), composed of the 13 federal agencies most concerned with global change, is building a Global Change Information System (GCIS) that will ultimately organize access to all of the research, data, and information about global change from across the system. A prototype of the system has been constructed that captures and presents all of the elements of provenance of the NCA through a coherent data model and friendly front end web site. This work will focus on the globally unique and persistent identifiers used to reference and organize those items. These include externally referenced items, such as DOIs used by scientific journal publishers for research articles or by agencies as dataset identifiers, as well as our own internal approach to identifiers, our overall data model and experiences managing persistent identifiers within the GCIS.

Postdischarge growth assessment in very low birth weight infants.

Science.gov (United States)

Park, Joon-Sik; Han, Jungho; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min-Soo; Park, Kook-In; Namgung, Ran

2017-03-01

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months ( P =0.045 for weight and P =0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months ( P <0.001 for weight and P =0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards ( P <0.001). Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

Integrated assessment of global climate change with learning-by-doing and energy-related research and development

International Nuclear Information System (INIS)

Mueller-Fuerstenberger, Georg; Stephan, Gunter

2007-01-01

This paper presents a small-scale version of an Integrated Assessment Model (IAM) of global climate change, which is based on a global, regionally differentiated computable general equilibrium (CGE) model with endogenous technological change. This model can be viewed as a basic framework for analyzing a broad range of economic issues related to climate change, in particular since technological change is represented in two ways: on the one hand, there is learning-by-doing (LbD) in non-fossil energy supply technologies, and on the other hand there is research and development (R and D)-driven energy-saving technical progress in production. Computational experiments are added for illustrating the role of technological innovation in a world both with and without cooperation in the solution of the global climate problem

Assessment of global DNA methylation in the first trimester fetal tissues exposed to maternal cigarette smoking

DEFF Research Database (Denmark)

Fa, Svetlana; Larsen, Trine Vilsbøll; Bilde, Katrine

2016-01-01

to exposures with an epigenetic impact. We have assessed the influence of maternal cigarette smoking during the first trimester for fetal global DNA methylation. METHODS AND RESULTS: We analyzed the human fetal intestines and livers as well as the placentas from the first trimester pregnancies. Global DNA......AIMS: Maternal cigarette smoking during pregnancy increases the risk of negative health consequences for the exposed child. Epigenetic mechanisms constitute a likely link between the prenatal exposure to maternal cigarette smoking and the increased risk in later life for diverse pathologies....... Maternal smoking induces gene-specific DNA methylation alterations as well as global DNA hypermethylation in the term placentas and hypomethylation in the cord blood. Early pregnancy represents a developmental time where the fetal epigenome is remodeled and accordingly can be expected to be highly prone...

Assessment of global industrial-age anthropogenic arsenic contamination.

Science.gov (United States)

Han, Fengxiang X; Su, Yi; Monts, David L; Plodinec, M John; Banin, Amos; Triplett, Glover E

2003-09-01

Arsenic, a carcinogenic trace element, threatens not only the health of millions of humans and other living organisms, but also global sustainability. We present here, for the first time, the global industrial-age cumulative anthropogenic arsenic production and its potential accumulation and risks in the environment. In 2000, the world cumulative industrial-age anthropogenic arsenic production was 4.53 million tonnes. The world-wide coal and petroleum industries accounted for 46% of global annual gross arsenic production, and their overall contribution to industrial-age gross arsenic production was 27% in 2000. Global industrial-age anthropogenic As sources (as As cumulative production) follow the order: As mining production>As generated from coal>As generated from petroleum. The potential industrial-age anthropogenic arsenic input in world arable surface in 2000 was 2.18 mg arsenic kg(-1), which is 1.2 times that in the lithosphere. The development of substitute materials for arsenic applications in the agricultural and forestry industries and controls of arsenic emissions from the coal industry may be possible strategies to significantly decrease arsenic pollution sources and dissipation rates into the environment.

Assessing historical global sulfur emission patterns for the period 1850--1990

Energy Technology Data Exchange (ETDEWEB)

Lefohn, A.S. [A.S.L. and Associates, Helena, MT (United States); Husar, J.D.; Husar, R.B. [Washington Univ., St. Louis, MO (United States). Center for Air Pollution Impact and Trend Analysis; Brimblecombe, P. [Univ. of East Anglia, Norwich (United Kingdom)

1996-07-19

Anthropogenic sulfur dioxide emissions from energy-producing and metal production activities have become an important factor in better understanding the relationship between humans and the environment. Concerns about (1) acid rain effects on the environment and (2) anthropogenic aerosols affecting possible global change have prompted interest in the transformation and fate of sulfur in the environment. One step in assessing the importance of sulfur emissions is the development of a reliable regional emission inventory of sulfur as a function of time. The objective of this research effort was to create a homogeneous database for historical sulfur emission estimates for the world. The time from 1850--1990 was selected to include the period of industrialization form the time the main production of fuels and minerals began until the most recent year for which complete production data exist. This research effort attempts to correct some of the deficiencies associated with previous global sulfur emission estimates by (1) identifying those production activities that resulted in sulfur emissions by country and (2) calculating historical emission trends by country across years. An important component of this study was the comparison of the sulfur emission results with those of previous studies.

Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort.

Science.gov (United States)

Desthieux, Carole; Molto, Anna; Granger, Benjamin; Saraux, Alain; Fautrel, Bruno; Gossec, Laure

2016-09-01

To assess patient-physician discordance in global assessment of disease activity in early axial spondyloarthritis (axSpA) over time and determinants of discordance. DESIR (Devenir des Spondyloarthropathies Indifférenciées Récentes) is a French, multicentre, longitudinal cohort of patients with early inflammatory back pain suggestive of axSpA. Patient global assessment (PGA) and physician global assessment (PhGA) were rated with a 0-10 numerical rating scale, every 6 months during 2 years then at 3 years. Discordance was defined by the absolute difference |PGA-PhGA|≥3 (range 0-10) and was analysed at each visit. Determinants of (PGA-PhGA) were assessed at the visit level by a generalised linear mixed model. A total of 702 patients were analysed at baseline (401 with complete data over 3 years): mean age 33.8±8.6 years, 379 (54.0%) female, mean symptom duration 18.1±10.5 months. Mean PGA values were always higher than mean PhGA values with a mean absolute difference of 1.8 points. At baseline, 202 (28.8%) patients had discordance mainly by PGA>PhGA; over 3 years the frequency of discordance was stable (range 25.5-28.8%). Discordance was not stable at the patient level, 118 (29.4%) patients were discordant once and 88 (22.0%) twice, and only 92 (22.9%) more than twice. Determinants of (PGA-PhGA) were spine pain (β=0.24, ppatient characteristic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Global impact of Danish drama series

DEFF Research Database (Denmark)

Jensen, Pia Majbritt

2016-01-01

In recent years Danish TV series have experienced a global export boom. This article maps the regional and global export patterns over the last fifteen years in order to assess the international impact of Danish TV drama.......In recent years Danish TV series have experienced a global export boom. This article maps the regional and global export patterns over the last fifteen years in order to assess the international impact of Danish TV drama....

Going Global? Internationalizing Australian Universities in a Time of Global Crisis.

Science.gov (United States)

Welch, Anthony

2002-01-01

Analyzes the past decade's internationalization of Australian universities against a backdrop of increasing globalization, particularly the expansion of global capitalism. Examines international student flows, faculty, and programs, assessing the relative presence of internationalization (mutuality and reciprocal cultural relations) versus…

Assessing water resources in Azerbaijan using a local distributed model forced and constrained with global data

Science.gov (United States)

Bouaziz, Laurène; Hegnauer, Mark; Schellekens, Jaap; Sperna Weiland, Frederiek; ten Velden, Corine

2017-04-01

In many countries, data is scarce, incomplete and often not easily shared. In these cases, global satellite and reanalysis data provide an alternative to assess water resources. To assess water resources in Azerbaijan, a completely distributed and physically based hydrological wflow-sbm model was set-up for the entire Kura basin. We used SRTM elevation data, a locally available river map and one from OpenStreetMap to derive the drainage direction network at the model resolution of approximately 1x1 km. OpenStreetMap data was also used to derive the fraction of paved area per cell to account for the reduced infiltration capacity (c.f. Schellekens et al. 2014). We used the results of a global study to derive root zone capacity based on climate data (Wang-Erlandsson et al., 2016). To account for the variation in vegetation cover over the year, monthly averages of Leaf Area Index, based on MODIS data, were used. For the soil-related parameters, we used global estimates as provided by Dai et al. (2013). This enabled the rapid derivation of a first estimate of parameter values for our hydrological model. Digitized local meteorological observations were scarce and available only for limited time period. Therefore several sources of global meteorological data were evaluated: (1) EU-WATCH global precipitation, temperature and derived potential evaporation for the period 1958-2001 (Harding et al., 2011), (2) WFDEI precipitation, temperature and derived potential evaporation for the period 1979-2014 (by Weedon et al., 2014), (3) MSWEP precipitation (Beck et al., 2016) and (4) local precipitation data from more than 200 stations in the Kura basin were available from the NOAA website for a period up to 1991. The latter, together with data archives from Azerbaijan, were used as a benchmark to evaluate the global precipitation datasets for the overlapping period 1958-1991. By comparing the datasets, we found that monthly mean precipitation of EU-WATCH and WFDEI coincided well

Tropospheric Ozone Assessment Report: Database and Metrics Data of Global Surface Ozone Observations

Directory of Open Access Journals (Sweden)

Martin G. Schultz

2017-10-01

Full Text Available In support of the first Tropospheric Ozone Assessment Report (TOAR a relational database of global surface ozone observations has been developed and populated with hourly measurement data and enhanced metadata. A comprehensive suite of ozone data products including standard statistics, health and vegetation impact metrics, and trend information, are made available through a common data portal and a web interface. These data form the basis of the TOAR analyses focusing on human health, vegetation, and climate relevant ozone issues, which are part of this special feature. Cooperation among many data centers and individual researchers worldwide made it possible to build the world's largest collection of 'in-situ' hourly surface ozone data covering the period from 1970 to 2015. By combining the data from almost 10,000 measurement sites around the world with global metadata information, new analyses of surface ozone have become possible, such as the first globally consistent characterisations of measurement sites as either urban or rural/remote. Exploitation of these global metadata allows for new insights into the global distribution, and seasonal and long-term changes of tropospheric ozone and they enable TOAR to perform the first, globally consistent analysis of present-day ozone concentrations and recent ozone changes with relevance to health, agriculture, and climate. Considerable effort was made to harmonize and synthesize data formats and metadata information from various networks and individual data submissions. Extensive quality control was applied to identify questionable and erroneous data, including changes in apparent instrument offsets or calibrations. Such data were excluded from TOAR data products. Limitations of 'a posteriori' data quality assurance are discussed. As a result of the work presented here, global coverage of surface ozone data for scientific analysis has been significantly extended. Yet, large gaps remain in the surface

The Global Streamflow Indices and Metadata Archive (GSIM – Part 2: Quality control, time-series indices and homogeneity assessment

Directory of Open Access Journals (Sweden)

L. Gudmundsson

2018-04-01

Full Text Available This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM, which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate, Part 2 introduces a set of quality controlled time-series indices representing (i the water balance, (ii the seasonal cycle, (iii low flows and (iv floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

Effect of Bifidobacterium breve M-16V supplementation on faecal bifidobacteria in growth restricted very preterm infants - analysis from a randomised trial.

Science.gov (United States)

Patole, Sanjay K; Keil, Anthony D; Nathan, Elizabeth; Doherty, Dorota; Esvaran, Meera; Simmer, Karen N; Conway, Patricia

2016-12-01

Gut development, function and colonisation are impaired in animal models of prematurity with intrauterine growth restriction (IUGR). The effect of Bifidobacterium breve (B. breve) supplementation on faecal bifidobacteria in small for gestational age (SGA: birth weight breve M-16V supplementation effect on faecal bifidobacteria in preterm (breve counts between SGA versus non-SGA infants [probiotic: 7 (33%) versus 22 (42%), p = 0.603; placebo: 1 (6%) versus 1 (2%), p = 0.429]. B. breve counts did not differ between SGA and non-SGA infants in response to treatment (p = 0.589), after adjusting for baseline count (p breve M-16V supplementation was not significantly different in preterm (<33 weeks) SGA versus non-SGA infants.

Factoring stream turbulence into global assessments of nitrogen pollution.

Science.gov (United States)

Grant, Stanley B; Azizian, Morvarid; Cook, Perran; Boano, Fulvio; Rippy, Megan A

2018-03-16

The discharge of excess nitrogen to streams and rivers poses an existential threat to both humans and ecosystems. A seminal study of headwater streams across the United States concluded that in-stream removal of nitrate is controlled primarily by stream chemistry and biology. Reanalysis of these data reveals that stream turbulence (in particular, turbulent mass transfer across the concentration boundary layer) imposes a previously unrecognized upper limit on the rate at which nitrate is removed from streams. The upper limit closely approximates measured nitrate removal rates in streams with low concentrations of this pollutant, a discovery that should inform stream restoration designs and efforts to assess the effects of nitrogen pollution on receiving water quality and the global nitrogen cycle. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Integrated regional assessment of global climatic change. Lessons from the Mackenzie Basin Impact Study (MBIS)

International Nuclear Information System (INIS)

Cohen, Stewart J.

1996-01-01

This paper outlines the potential role integrated regional assessments of global climatic change scenarios could play in building better links between science and related policy concerns. The concept is illustrated through description of an ongoing case study from Canada-the Mackenzie Basin Impact Study (MBIS). As part of the Government of Canada's Green Plan, the Global Warming Science Program includes a study of regional impacts of global warming scenarios in the Mackenzie Basin, located in northwestern Canada. The MBIS is a six-year program focussing on potential climate-induced changes in the land and water resource base, and the implications of four scenarios of global climatic change on land use and economic policies in this region. These policy issues include interjurisdictional water management, sustainability of native lifestyles, economic development opportunities (agriculture, forestry, tourism, etc.), sustainability of ecosystems and infrastructure maintenance. MBIS is due to be completed in 1997. MBIS represents an attempt to address regional impacts by incorporating a 'family of integrators' into the study framework, and by directly involving stakeholders in planning and research activities. The experience in organizing and carrying out this project may provide some lessons for others interested in organizing regional or country studies

Global assessment of internal audit competence

African Journals Online (AJOL)

kirstam

of Accountants (IFAC) and the Global Accounting Alliance (GAA), adhere to the requirements as set out in the international education standards published by IFAC. (GAA 2015). These education standards emphasise the importance of competency- based professional development in the accounting and auditing professions ...

Regional to Global Assessments of Phytoplankton Dynamics From The SeaWiFS Mission

Science.gov (United States)

Siegel, David; Behrenfeld, Michael; Maritorena, Stephanie; McClain, Charles R.; Antoine, David; Bailey, Sean W.; Bontempi, Paula S.; Boss, Emmanuel S.; Dierssen, Heidi M.; Doney, Scott C.;

DNA methylation of IGF2DMR and H19 is associated with fetal and infant growth: the generation R study.

Directory of Open Access Journals (Sweden)

Marieke I Bouwland-Both

Full Text Available Changes in epigenetic programming of embryonic growth genes during pregnancy seem to affect fetal growth. Therefore, in a population-based prospective birth cohort in the Netherlands, we examined associations between fetal and infant growth and DNA methylation of IGF2DMR, H19 and MTHFR. For this study, we selected 69 case children born small-for-gestational age (SGA, birth weight <-2SDS and 471 control children. Fetal growth was assessed with serial ultrasound measurements. Information on birth outcomes was retrieved from medical records. Infant weight was assessed at three and six months. Methylation was assessed in DNA extracted from umbilical cord white blood cells. Analyses were performed using linear mixed models with DNA methylation as dependent variable. The DNA methylation levels of IGF2DMR and H19 in the control group were, median (90% range, 53.6% (44.5-61.6 and 30.0% (25.6-34.2 and in the SGA group 52.0% (43.9-60.9 and 30.5% (23.9-32.9, respectively. The MTHFR region was found to be hypomethylated with limited variability in the control and SGA group, 2.5% (1.4-4.0 and 2.4% (1.5-3.8, respectively. SGA was associated with lower IGF2DMR DNA methylation (β = -1.07, 95% CI -1.93; -0.21, P-value = 0.015, but not with H19 methylation. A weight gain in the first three months after birth was associated with lower IGF2DMR DNA methylation (β = -0.53, 95% CI -0.91; -0.16, P-value = 0.005. Genetic variants in the IGF2/H19 locus were associated with IGF2DMR DNA methylation (P-value<0.05, but not with H19 methylation. Furthermore, our results suggest a possibility of mediation of DNA methylation in the association between the genetic variants and SGA. To conclude, IGF2DMR and H19 DNA methylation is associated with fetal and infant growth.

Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes

Science.gov (United States)

Li, Xiuhong; Eiden, Rina D.; Epstein, Leonard H.; Shenassa, Edmond D.; Xie, Chuanbo; Wen, Xiaozhong

2016-01-01

Objectives It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups. Methods Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001–2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders. Results Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score. Conclusions Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y. PMID:27501456

Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes.

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Xiuhong Li

Full Text Available It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups.Children born SGA (N = 1050 from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001-2007 was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders.Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06] and math (-2.22 [-3.61, -0.84] scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44], but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]. Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG had lower mean reading (-4.81 [-8.50, -1.12] and math (-2.95 [-5.51, -0.38] scores. These differences were not mediated by Apgar score.Multiple-birth SGA subgroups (vs. singleton SGA or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain have poorer cognitive development up to 5 y.

Assessment of the Climate Paris Agreement in the light of a Global Standard of Transparency

International Nuclear Information System (INIS)

Tabau, Anne-Sophie

2016-01-01

Reactions to the Paris Agreement oscillate between political enthusiasm, given the diplomatic challenge that was taken-up, and activist disappointment, considering the emergency and scale of transformations to undertake to tackle climate change. The legal analysis of the COP21, its results and prospects they open however needs to be done in the light of dispassionate criteria. The one proposed in this paper uses a global standard of transparency. The reading grid offered thus enables to locate the Paris Agreement in the context of a global and complex governance; two features that the theory of global administrative law aims to better understand, from an empirical but also a prescriptive approaches. This assessment shows that the balance between transparency and opacity, intelligibility, effectiveness or efficiency is both delicate to establish and unstable. If the way the cursor was positioned under the Paris Agreement may seem unsatisfactory in many respects, it must not be forgotten that it is intended to evolve

Assessing the Impact of Land Use and Land Cover Change on Global Water Resources

Science.gov (United States)

Batra, N.; Yang, Y. E.; Choi, H. I.; Islam, A.; Charlotte, D. F.; Cai, X.; Kumar, P.

2007-12-01

Land use and land cover changes (LULCC) significantly modify the hydrological regime of the watersheds, affecting water resources and environment from regional to global scale. This study seeks to advance and integrate water and energy cycle observation, scientific understanding, and human impacts to assess future water availability. To achieve the research objective, we integrate and interpret past and current space based and in situ observations into a global hydrologic model (GHM). GHM is developed with enhanced spatial and temporal resolution, physical complexity, hydrologic theory and processes to quantify the impact of LULCC on physical variables: surface runoff, subsurface flow, groundwater, infiltration, ET, soil moisture, etc. Coupled with the common land model (CLM), a 3-dimensional volume averaged soil-moisture transport (VAST) model is expanded to incorporate the lateral flow and subgrid heterogeneity. The model consists of 11 soil-hydrology layers to predict lateral as well as vertical moisture flux transport based on Richard's equations. The primary surface boundary conditions (SBCs) include surface elevation and its derivatives, land cover category, sand and clay fraction profiles, bedrock depth and fractional vegetation cover. A consistent global GIS-based dataset is constructed for the SBCs of the model from existing observational datasets comprising of various resolutions, map projections and data formats. Global ECMWF data at 6-hour time steps for the period 1971 through 2000 is processed to get the forcing data which includes incoming longwave and shortwave radiation, precipitation, air temperature, pressure, wind components, boundary layer height and specific humidity. Land use land cover data, generated using IPCC scenarios for every 10 years from 2000 to 2100 is used for future assessment on water resources. Alterations due to LULCC on surface water balance components: ET, groundwater recharge and runoff are then addressed in the study. Land

Performance on naturalistic virtual reality tasks depends on global cognitive functioning as assessed via traditional neurocognitive tests.

Science.gov (United States)

Oliveira, Jorge; Gamito, Pedro; Alghazzawi, Daniyal M; Fardoun, Habib M; Rosa, Pedro J; Sousa, Tatiana; Picareli, Luís Felipe; Morais, Diogo; Lopes, Paulo

2017-08-14

This investigation sought to understand whether performance in naturalistic virtual reality tasks for cognitive assessment relates to the cognitive domains that are supposed to be measured. The Shoe Closet Test (SCT) was developed based on a simple visual search task involving attention skills, in which participants have to match each pair of shoes with the colors of the compartments in a virtual shoe closet. The interaction within the virtual environment was made using the Microsoft Kinect. The measures consisted of concurrent paper-and-pencil neurocognitive tests for global cognitive functioning, executive functions, attention, psychomotor ability, and the outcomes of the SCT. The results showed that the SCT correlated with global cognitive performance as measured with the Montreal Cognitive Assessment (MoCA). The SCT explained one third of the total variance of this test and revealed good sensitivity and specificity in discriminating scores below one standard deviation in this screening tool. These findings suggest that performance of such functional tasks involves a broad range of cognitive processes that are associated with global cognitive functioning and that may be difficult to isolate through paper-and-pencil neurocognitive tests.

Increased prevalence of malnutrition and reduced lean body mass in overweight/obese kidney transplant recipients

Directory of Open Access Journals (Sweden)

Sylwia Małgorzewicz

2012-06-01

Full Text Available Overweight and obesity are common in subjects after kidney transplantation. On the other hand, features of malnutrition are also frequently recognized in this group of patients. The aim of the study was to evaluate the prevalence of both abnormalities in a cohort of stable kidney recipients and to assess whether obesity precludes malnutrition in transplanted patients. We also investigated associations between the nutritional status, graft function and adipokines concentrations. The study was performed in 80 prevalent kidney transplant patients and in a control group which consisted of 23 healthy volunteers. Body composition (% of fat, lean body mass (LBM, water content was measured by multifrequency bioelectrical impedance (Body Composition Manager. Nutritional status was determined by a 7–point Subjective Global Assessment (SGA, anthropometric measurements and s-albumin concentration. C–reactive protein (CRP, Il–6 and plasminogen activator inhibitor–1 (PAI–1 were used as markers of inflammatory status. Concentration of leptin, adiponectin and visfatin were measured by ELISA. Results: Mean age was 52.4±13.9 years (45 men and 35 women. Diabetes mellitus was present in 29% (n=23 of them. Mean time after transplantation (transplantation vintage was 82.5±56.5 months (median=73 months. Mean eGFR was 41.7±14.9 ml/min (4 points MDRD, BMI was 25.7±4.2. Overweight was present in 41% of the patients and obesity in 14%. On the basis of SGA evaluation, signs of malnutrition were observed in 48% of the subjects. Malnutrition was present in 64% (21/33 of the overweight patients and in 91% (10/11 of the obese patients. Transplantation vintage was directly associated with fat mass and inversely associated with LBM. Malnourished patients (SGA had a longer transplantation vintage. Adiponectin levels were significantly lower in transplanted patients as compared to controls. In multivariate analysis, leptin was an independent predictor of serum

Comparison of Quality of Life and Nutritional Status in Gastric Cancer Patients Undergoing Gastrectomies.

Science.gov (United States)

Lim, Hee-Sook; Cho, Gyu-Seok; Park, Yoon-Hyung; Kim, Soon-Kyung

2015-07-01

The aim of this study was to compare the quality of life (QoL) depending on the postoperative survival period or nutritional status in gastric cancer patients. Surviving gastric cancer patients (n = 222) after the gastrectomy were included in the study at Soonchunhyang University Bucheon Hospital from April 2010 to August 2012. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and a gastric cancer-specific module, the EORTC QLQ-STO22, were used to assess the QoL. The postoperative survival period of the patients fell into two groups; the less-than-1-year group or the more-than-1-year group, and the nutritional status of the patients fell into three groups by a score of patient generated-subjective global assessment (SGA)-A, B, and C. As a result, the rate of malnutrition was 34.5% in the less-than-1-year group and 19.8% in the more-than-1-year group, respectively. Score for the fatigue (p = 0.006), loss of appetite (p = 0.002), reflux (p = 0.027) and body image (p = 0.004) in which the QoL was significantly lower in the less-than-1-year group than in the more-than-1-year group. The score of QoL according to the nutritional status of all subjects, overall health status (p = 0.043), physical functioning (p = 0.016), fatigue (p = 0.006), pain (p = 0.028), loss of appetite (p = 0.017), reflux (p = 0.003), eating restriction (p = 0.002), anxiety (p = 0.010), and body image (p = 0.001) was significantly lower in the SGA-C group than in other SGA groups. These results suggest that the nutritional status of the gastrectomy patients with stomach cancer may impact on their QoL. It is necessary to to develop nutritional intervention to improve QoL in gastric cancer patients with postoperative malnutrition.

Prenatal exposure to endocrine disrupting chemicals and risk of being born small for gestational age: Pooled analysis of seven European birth cohorts.

Science.gov (United States)

Govarts, Eva; Iszatt, Nina; Trnovec, Tomas; de Cock, Marijke; Eggesbø, Merete; Palkovicova Murinova, Lubica; van de Bor, Margot; Guxens, Mònica; Chevrier, Cécile; Koppen, Gudrun; Lamoree, Marja; Hertz-Picciotto, Irva; Lopez-Espinosa, Maria-Jose; Lertxundi, Aitana; Grimalt, Joan O; Torrent, Maties; Goñi-Irigoyen, Fernando; Vermeulen, Roel; Legler, Juliette; Schoeters, Greet

2018-06-01

There is evidence that endocrine disrupting chemicals (EDCs) have developmental effects at environmental concentrations. We investigated whether some EDCs are associated with the adverse birth outcome Small for Gestational Age (SGA). We used PCB 153, p,p'-DDE, HCB, PFOS and PFOA measured in maternal, cord blood or breast milk samples of 5446 mother-child pairs (subset of 693 for the perfluorinated compounds) from seven European birth cohorts (1997-2012). SGA infants were those with birth weight below the 10th percentile for the norms defined by gestational age, country and infant's sex. We modelled the association between measured or estimated cord serum EDC concentrations and SGA using multiple logistic regression analyses. We explored effect modification by child's sex and maternal smoking during pregnancy. Among the 5446 newborns, 570 (10.5%) were SGA. An interquartile range (IQR) increase in PCB 153 was associated with a modestly increased risk of SGA (odds ratio (OR) of 1.05 [95% CI: 1.04-1.07]) that was stronger in girls (OR of 1.09 [95% CI: 1.04-1.14]) than in boys (OR of 1.03 [95% CI: 1.03-1.04]) (p-interaction = 0.025). For HCB, we found a modestly increased odds of SGA in girls (OR of 1.04 [95% CI: 1.01-1.07] per IQR increase), and an inverse association in boys (OR of 0.90 [95% CI: 0.85-0.95]) (p-interaction = 0.0003). Assessment of the HCB-sex-smoking interaction suggested that the increased odds of SGA associated with HCB exposure was only in girls of smoking mothers (OR of 1.18 [95% CI: 1.11-1.25]) (p-interaction = 0.055). Higher concentrations of PFOA were associated with greater risk of SGA (OR of 1.64 [95% CI: 0.97-2.76]). Elevated PFOS levels were associated with increased odds of SGA in newborns of mothers who smoked during pregnancy (OR of 1.63 [95% CI: 1.02-2.59]), while an inverse association was found in those of non-smoking mothers (OR of 0.66 [95% CI: 0.61-0.72]) (p-interaction = 0.0004). No significant associations were

Assessment of competence for caesarean section with global rating scale

International Nuclear Information System (INIS)

Qureshi, R.N.; Ali, S.K.

2013-01-01

Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents' independent performance of Caesarean Section. Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case. Results: The observations per faculty ranged from 1-8 (mean 4.07+- 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, 4 (5%). Mean time required for observation of the surgery was 43.81+-14.28 (range: 20-90) with a mode of 45 min. Mean aggregate rating on all items showed gradual progression with the year of residency. The assessment tool had an internal consistency reliability (Cronbach's alpha) of 0.9097 with low inter-rater reliability. Conclusion: The evaluation tool was found to be reliable and valid for evaluating a resident's competence for performing Caesarean Section. Training of the assessors is required for a better inter-rater agreement. (author)

The effect of additive manufacturing on global energy demand : An assessment using a bottom-up approach

NARCIS (Netherlands)

Verhoef, L.A.; Budde, Bart; Chockalingam, Cindhuja; García Nodar, Brais; van Wijk, A.J.M.

2018-01-01

The effect of disruptive technologies unrelated to the energy sector, such as additive manufacturing (AM), tends to be overlooked in energy scenarios. The present research assessed the potential effect of AM on the global energy demand in four energy scenarios for 2050 with extended versus

Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly.

Science.gov (United States)

Poulia, Kalliopi-Anna; Yannakoulia, Mary; Karageorgou, Dimitra; Gamaletsou, Maria; Panagiotakos, Demosthenes B; Sipsas, Nikolaos V; Zampelas, Antonis

2012-06-01

Malnutrition in the elderly is a multifactorial problem, more prevalent in hospitals and care homes. The absence of a gold standard in evaluating nutritional risk led us to evaluate the efficacy of six nutritional screening tools used in the elderly. Two hundred forty eight elderly patients (129 men, 119 female women, aged 75.2 ± 8.5 years) were examined. Nutritional screening was performed on admission using the following tools: Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), Subjective Global Assessment (SGA), Mini Nutritional Assessment - Screening Form (MNA-SF), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated. Nutritional risk and/or malnutrition varied greatly, ranging from 47.2 to 97.6%, depending on the nutritional screening tool used. MUST was the most valid screening tool (validity coefficient = 0.766, CI 95%: 0.690-0.841), while SGA was in better agreement with the combined index (κ = 0.707, p = 0.000). NRS 2002 although was the highest in sensitivity (99.4%), it was the lowest in specificity (6.1%) and positive predictive value (68.2%). MUST seem to be the most valid in the evaluation of the risk for malnutrition in the elderly upon admission to the hospital. NRS 2002 was found to overestimate nutritional risk in the elderly. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Two Decades of Global Mindset Research

DEFF Research Database (Denmark)

Bujac, Andreea Ioana; Kuada, John Ernest

2016-01-01

This chapter presents the results of a systematic review of 28 papers that have studied the global mindset orientation in the period 1995-2014. The review traces the development of the global mindset construct in order to provide scholars and practitioners with an analytical assessment of the exi...... of the existing research on this topic. The findings suggest that the existing knowledge of global mindset can be divided under two research themes: global mindset and leadership, and global mindset and internationalization.......This chapter presents the results of a systematic review of 28 papers that have studied the global mindset orientation in the period 1995-2014. The review traces the development of the global mindset construct in order to provide scholars and practitioners with an analytical assessment...

A new climate dataset for systematic assessments of climate change impacts as a function of global warming

Directory of Open Access Journals (Sweden)

J. Heinke

2013-10-01

Full Text Available In the ongoing political debate on climate change, global mean temperature change (ΔTglob has become the yardstick by which mitigation costs, impacts from unavoided climate change, and adaptation requirements are discussed. For a scientifically informed discourse along these lines, systematic assessments of climate change impacts as a function of ΔTglob are required. The current availability of climate change scenarios constrains this type of assessment to a narrow range of temperature change and/or a reduced ensemble of climate models. Here, a newly composed dataset of climate change scenarios is presented that addresses the specific requirements for global assessments of climate change impacts as a function of ΔTglob. A pattern-scaling approach is applied to extract generalised patterns of spatially explicit change in temperature, precipitation and cloudiness from 19 Atmosphere–Ocean General Circulation Models (AOGCMs. The patterns are combined with scenarios of global mean temperature increase obtained from the reduced-complexity climate model MAGICC6 to create climate scenarios covering warming levels from 1.5 to 5 degrees above pre-industrial levels around the year 2100. The patterns are shown to sufficiently maintain the original AOGCMs' climate change properties, even though they, necessarily, utilise a simplified relationships between ΔTglob and changes in local climate properties. The dataset (made available online upon final publication of this paper facilitates systematic analyses of climate change impacts as it covers a wider and finer-spaced range of climate change scenarios than the original AOGCM simulations.

Use of human patient simulation and the situation awareness global assessment technique in practical trauma skills assessment.

Science.gov (United States)

Hogan, Michael P; Pace, David E; Hapgood, Joanne; Boone, Darrell C

2006-11-01

Situation awareness (SA) is defined as the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future. This construct is vital to decision making in intense, dynamic environments. It has been used in aviation as it relates to pilot performance, but has not been applied to medical education. The most widely used objective tool for measuring trainee SA is the Situation Awareness Global Assessment Technique (SAGAT). The purpose of this study was to design and validate SAGAT for assessment of practical trauma skills, and to compare SAGAT results to traditional checklist style scoring. Using the Human Patient Simulator, we designed SAGAT for practical trauma skills assessment based on Advanced Trauma Life Support objectives. Sixteen subjects (four staff surgeons, four senior residents, four junior residents, and four medical students) participated in three scenarios each. They were assessed using SAGAT and traditional checklist assessment. A questionnaire was used to assess possible confounding factors in attaining SA and overall trainee satisfaction. SAGAT was found to show significant difference (analysis of variance; p level of training lending statistical support to construct validity. SAGAT was likewise found to display reliability (Cronbach's alpha 0.767), and significant scoring correlation with traditional checklist performance measures (Pearson's coefficient 0.806). The questionnaire revealed no confounding factors and universal satisfaction with the human patient simulator and SAGAT. SAGAT is a valid, reliable assessment tool for trauma trainees in the dynamic clinical environment created by human patient simulation. Information provided by SAGAT could provide specific feedback, direct individualized teaching, and support curriculum change. Introduction of SAGAT could improve the current assessment model for practical trauma education.

Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study.

Directory of Open Access Journals (Sweden)

Myriam Bickle Graz

Full Text Available Whether being small for gestational age (SGA increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial.to study the impact of SGA (birthweight < percentile 10 on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old.This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ. Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy. The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment.342/515 (76% premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04, but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions.In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone

Wastewater Treatment Energy Recovery Potential For Adaptation To Global Change: An Integrated Assessment

Science.gov (United States)

Breach, Patrick A.; Simonovic, Slobodan P.

2018-04-01

Approximately 20% of wastewaters globally do not receive treatment, whereas wastewater discharges are projected to increase, thereby leading to excessive water quality degradation of surface waters on a global scale. Increased treatment could help alleviate water quality issues by constructing more treatment plants; however, in many areas there exist economic constraints. Energy recovery methods including the utilization of biogas and incineration of biosolids generated during the treatment process may help to alleviate treatment costs. This study explores the potential for investments in energy recovery from wastewater to increase treatment levels and thus improve surface water quality. This was done by examining the relationships between nutrient over-enrichment, wastewater treatment, and energy recovery at a global scale using system dynamics simulation as part of the ANEMI integrated assessment model. The results show that a significant amount of energy can be recovered from wastewater, which helps to alleviate some of the costs of treatment. It was found that wastewater treatment levels could be increased by 34%, helping to offset the higher nutrient loading from a growing population with access to improved sanitation. The production of renewable natural gas from biogas was found to have the potential to prolong the depletion of natural gas resources used to produce electricity and heat. It is recommended that agricultural nutrient discharges be better managed to help reduce nutrient over-enrichment on global scale. To increase the utility of the simulation, a finer spatial scale should be used to consider regional treatment, economic, and water quality characteristics.

Assessment of Global Forecast Ocean Assimilation Model (FOAM) using new satellite SST data

Science.gov (United States)

Ascione Kenov, Isabella; Sykes, Peter; Fiedler, Emma; McConnell, Niall; Ryan, Andrew; Maksymczuk, Jan

2016-04-01

There is an increased demand for accurate ocean weather information for applications in the field of marine safety and navigation, water quality, offshore commercial operations, monitoring of oil spills and pollutants, among others. The Met Office, UK, provides ocean forecasts to customers from governmental, commercial and ecological sectors using the Global Forecast Ocean Assimilation Model (FOAM), an operational modelling system which covers the global ocean and runs daily, using the NEMO (Nucleus for European Modelling of the Ocean) ocean model with horizontal resolution of 1/4° and 75 vertical levels. The system assimilates salinity and temperature profiles, sea surface temperature (SST), sea surface height (SSH), and sea ice concentration observations on a daily basis. In this study, the FOAM system is updated to assimilate Advanced Microwave Scanning Radiometer 2 (AMSR2) and the Spinning Enhanced Visible and Infrared Imager (SEVIRI) SST data. Model results from one month trials are assessed against observations using verification tools which provide a quantitative description of model performance and error, based on statistical metrics, including mean error, root mean square error (RMSE), correlation coefficient, and Taylor diagrams. A series of hindcast experiments is used to run the FOAM system with AMSR2 and SEVIRI SST data, using a control run for comparison. Results show that all trials perform well on the global ocean and that largest SST mean errors were found in the Southern hemisphere. The geographic distribution of the model error for SST and temperature profiles are discussed using statistical metrics evaluated over sub-regions of the global ocean.

Nitrogen fertilization raises CO2 efflux from inorganic carbon: A global assessment.

Science.gov (United States)

Zamanian, Kazem; Zarebanadkouki, Mohsen; Kuzyakov, Yakov

2018-03-25

Nitrogen (N) fertilization is an indispensable agricultural practice worldwide, serving the survival of half of the global population. Nitrogen transformation (e.g., nitrification) in soil as well as plant N uptake releases protons and increases soil acidification. Neutralizing this acidity in carbonate-containing soils (7.49 × 10 9  ha; ca. 54% of the global land surface area) leads to a CO 2 release corresponding to 0.21 kg C per kg of applied N. We here for the first time raise this problem of acidification of carbonate-containing soils and assess the global CO 2 release from pedogenic and geogenic carbonates in the upper 1 m soil depth. Based on a global N-fertilization map and the distribution of soils containing CaCO 3 , we calculated the CO 2 amount released annually from the acidification of such soils to be 7.48 × 10 12  g C/year. This level of continuous CO 2 release will remain constant at least until soils are fertilized by N. Moreover, we estimated that about 273 × 10 12  g CO 2 -C are released annually in the same process of CaCO 3 neutralization but involving liming of acid soils. These two CO 2 sources correspond to 3% of global CO 2 emissions by fossil fuel combustion or 30% of CO 2 by land-use changes. Importantly, the duration of CO 2 release after land-use changes usually lasts only 1-3 decades before a new C equilibrium is reached in soil. In contrast, the CO 2 released by CaCO 3 acidification cannot reach equilibrium, as long as N fertilizer is applied until it becomes completely neutralized. As the CaCO 3 amounts in soils, if present, are nearly unlimited, their complete dissolution and CO 2 release will take centuries or even millennia. This emphasizes the necessity of preventing soil acidification in N-fertilized soils as an effective strategy to inhibit millennia of CO 2 efflux to the atmosphere. Hence, N fertilization should be strictly calculated based on plant-demand, and overfertilization should be avoided not only

Bibliometric analysis of global environmental assessment research in a 20-year period

Energy Technology Data Exchange (ETDEWEB)

Li, Wei, E-mail: weili@bnu.edu.cn; Zhao, Yang

2015-01-15

Based on the samples of 113,468 publications on environmental assessment (EA) from the past 20 years, we used a bibliometric analysis to study the literature in terms of trends of growth, subject categories and journals, international collaboration, geographic distribution of publications, and scientific research issues. By applying thresholds to network centralities, a core group of countries can be distinguished as part of the international collaboration network. A frequently used keywords analysis found that the priority in assessment would gradually change from project environmental impact assessment (EIA) to strategic environmental assessment (SEA). Decision-theoretic approaches (i.e., environmental indicator selection, life cycle assessment, etc.), along with new technologies and methods (i.e., the geographic information system and modeling) have been widely applied in the EA research field over the past 20 years. Hot spots such as “biodiversity” and “climate change” have been emphasized in current EA research, a trend that will likely continue in the future. The h-index has been used to evaluate the research quality among countries all over the world, while the improvement of developing countries' EA systems is becoming a popular research topic. Our study reveals patterns in scientific outputs and academic collaborations and serves as an alternative and innovative way of revealing global research trends in the EA research field.

Bibliometric analysis of global environmental assessment research in a 20-year period

International Nuclear Information System (INIS)

Li, Wei; Zhao, Yang

2015-01-01

Based on the samples of 113,468 publications on environmental assessment (EA) from the past 20 years, we used a bibliometric analysis to study the literature in terms of trends of growth, subject categories and journals, international collaboration, geographic distribution of publications, and scientific research issues. By applying thresholds to network centralities, a core group of countries can be distinguished as part of the international collaboration network. A frequently used keywords analysis found that the priority in assessment would gradually change from project environmental impact assessment (EIA) to strategic environmental assessment (SEA). Decision-theoretic approaches (i.e., environmental indicator selection, life cycle assessment, etc.), along with new technologies and methods (i.e., the geographic information system and modeling) have been widely applied in the EA research field over the past 20 years. Hot spots such as “biodiversity” and “climate change” have been emphasized in current EA research, a trend that will likely continue in the future. The h-index has been used to evaluate the research quality among countries all over the world, while the improvement of developing countries' EA systems is becoming a popular research topic. Our study reveals patterns in scientific outputs and academic collaborations and serves as an alternative and innovative way of revealing global research trends in the EA research field

A multi-model assessment of the co-benefits of climate mitigation for global air quality

Energy Technology Data Exchange (ETDEWEB)

Rao, Shilpa; Klimont, Zbigniew; Leitao, Joana; Riahi, Keywan; van Dingenen, Rita; Reis, Lara Aleluia; Calvin, Katherine; Dentener, Frank; Drouet, Laurent; Fujimori, Shinichiro; Harmsen, Mathijs; Luderer, Gunnar; Heyes, Chris; Strefler, Jessica; Tavoni, Massimo; van Vuuren, Detlef P.

2016-12-01

The recent International Panel on Climate change (IPCC) report identifies significant co-benefits from climate policies on near-term ambient air pollution and related human health outcomes [1]. This is increasingly relevant for policy making as the health impacts of air pollution are a major global concern- the Global Burden of Disease (GBD) study identifies outdoor air pollution as the sixth major cause of death globally [2]. Integrated assessment models (IAMs) are an effective tool to evaluate future air pollution outcomes across a wide range of assumptions on socio-economic development and policy regimes. The Representative Concentration Pathways (RCPs) [3] were the first set of long-term global scenarios developed across multiple integrated assessment models that provided detailed estimates of a number of air pollutants until 2100. However these scenarios were primarily designed to cover a defined range of radiative forcing outcomes and thus did not specifically focus on the interactions of long-term climate goals on near-term air pollution impacts. More recently, [4] used the RCP4.5 scenario to evaluate the co-benefits of global GHG reductions on air quality and human health in 2030. [5-7] have further examined the interactions of more diverse pollution control regimes with climate policies. This paper extends the listed studies in a number of ways. Firstly it uses multiple IAMs to look into the co-benefits of a global climate policy for ambient air pollution under harmonized assumptions on near-term air pollution control. Multi-model frameworks have been extensively used in the analysis of climate change mitigation pathways, and the structural uncertainties regarding the underlying mechanisms (see for example [8-10]. This is to our knowledge the first time that a multi-model evaluation has been specifically designed and applied to analyze the co-benefits of climate change policy on ambient air quality, thus enabling a better understanding of at a detailed

A global and high-resolution assessment of the green, blue and grey water footprint of wheat

NARCIS (Netherlands)

Mekonnen, Mesfin; Hoekstra, Arjen Ysbert

2010-01-01

The aim of this study is to estimate the green, blue and grey water footprint of wheat in a spatially-explicit way, both from a production and consumption perspective. The assessment is global and improves upon earlier research by taking a high-resolution approach, estimating the water footprint of

Pollution exposure on marine protected areas: A global assessment.

Science.gov (United States)

Partelow, Stefan; von Wehrden, Henrik; Horn, Olga

2015-11-15

Marine protected areas (MPAs) face many challenges in their aim to effectively conserve marine ecosystems. In this study we analyze the extent of pollution exposure on the global fleet of MPAs. This includes indicators for current and future pollution and the implications for regionally clustered groups of MPAs with similar biophysical characteristics. To cluster MPAs into characteristic signature groups, their bathymetry, baseline biodiversity, distance from shore, mean sea surface temperature and mean sea surface salinity were used. We assess the extent at which each signature group is facing exposure from multiple pollution types. MPA groups experience similar pollution exposure on a regional level. We highlight how the challenges that MPAs face can be addressed through governance at the appropriate scale and design considerations for integrated terrestrial and marine management approaches within regional level networks. Furthermore, we present diagnostic social-ecological indicators for addressing the challenges facing unsuccessful MPAs with practical applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conversion of Exogenous Cholesterol into Glycoalkaloids in Potato Shoots, Using Two Methods for Sterol Solubilisation

Science.gov (United States)

Petersson, Erik V.; Nahar, Nurun; Dahlin, Paul; Broberg, Anders; Tröger, Rikard; Dutta, Paresh C.; Jonsson, Lisbeth; Sitbon, Folke

2013-01-01

Steroidal glycoalkaloids (SGA) are toxic secondary metabolites naturally occurring in the potato, as well as in certain other Solanaceous plant species, such as tomato, eggplant and pepper. To investigate the steroidal origin of SGA biosynthesis, cut potato shoots were fed cholesterol labelled with deuterium (D) in the sterol ring structure (D5- or D6-labelled), or side chain (D7-labelled), and analysed after three or five weeks. The labelled cholesterol and presence of D-labelled SGA were analysed by GC-MS and LC-MS/MS, respectively. When feeding D-labelled cholesterol solubilised in Tween-80, labelled cholesterol in free form became present in both leaves and stems, although the major part was recovered as steryl esters. Minor amounts of D-labelled SGA (α-solanine and α-chaconine) were identified in cholesterol-treated shoots, but not in blank controls, or in shoots fed D6-27-hydroxycholesterol. Solubilising the labelled cholesterol in methyl-β-cyclodextrin instead of Tween-80 increased the levels of labelled SGA up to 100-fold, and about 1 mole% of the labelled cholesterol was recovered as labelled SGA in potato leaves. Both side chain and ring structure D labels were retained in SGA, showing that the entire cholesterol molecule is converted to SGA. However, feeding side chain D7-labelled cholesterol resulted in D5-labelled SGA, indicating that two hydrogen atoms were released during formation of the SGA nitrogen-containing ring system. Feeding with D7-sitosterol did not produce any labelled SGA, indicating that cholesterol is a specific SGA precursor. In conclusion, we have demonstrated a superior performance of methyl-β-cyclodextrin for delivery of cholesterol in plant tissue feeding experiments, and given firm evidence for cholesterol as a specific sterol precursor of SGA in potato. PMID:24349406

Effects of size at birth, childhood growth patterns and growth hormone treatment on leukocyte telomere length.

Directory of Open Access Journals (Sweden)

Carolina C J Smeets

Full Text Available Small size at birth and rapid growth in early life are associated with increased risk of cardiovascular disease in later life. Short children born small for gestational age (SGA are treated with growth hormone (GH, inducing catch-up in length. Leukocyte telomere length (LTL is a marker of biological age and shorter LTL is associated with increased risk of cardiovascular disease.To investigate whether LTL is influenced by birth size, childhood growth and long-term GH treatment.We analyzed LTL in 545 young adults with differences in birth size and childhood growth patterns. Previously GH-treated young adults born SGA (SGA-GH were compared to untreated short SGA (SGA-S, SGA with spontaneous catch-up to a normal body size (SGA-CU, and appropriate for gestational age with a normal body size (AGA-NS. LTL was measured using a quantitative PCR assay.We found a positive association between birth length and LTL (p = 0.04, and a trend towards a positive association between birth weight and LTL (p = 0.08, after adjustments for gender, age, gestational age and adult body size. Weight gain during infancy and childhood and fat mass percentage were not associated with LTL. Female gender and gestational age were positively associated with LTL, and smoking negatively. After adjustments for gender, age and gestational age, SGA-GH had a similar LTL as SGA-S (p = 0.11, SGA-CU (p = 0.80, and AGA-NS (p = 0.30.Larger size at birth is positively associated with LTL in young adulthood. Growth patterns during infancy and childhood are not associated with LTL. Previously GH-treated young adults born SGA have similar LTL as untreated short SGA, SGA with spontaneous catch-up and AGA born controls, indicating no adverse effects of GH-induced catch-up in height on LTL.

Global corporate workplaces implementing new global workplace standards in a local context

CERN Document Server

Hodulak, Martin

2017-01-01

In recent years, multinational corporations were increasingly engaged in the development of standardized global workplace models. For their implementation and feasibility, it is decisive as how these standards fit the diverse regional workplace cultures. This topic was pursued in the course of a research project, comparing established workplaces in Germany, USA and Japan against global workplace standards of multinational corporations. The analysis confirmed the expected differences among local workplaces and on the other hand a predominant mainstream among global corporate workplace standards. Conspicuous however, are the fundamental differences between local models and corporate standards. For the implementation of global standards in local context, this implies multiple challenges on cultural, organizational and spatial level. The analysis findings provide information for assessing current projects and pinpointing optimization measures. The analysis framework further provides a tool to uncover and assess n...

Assessing the Global Extent of Rivers Observable by SWOT

Science.gov (United States)

Pavelsky, T.; Durand, M. T.; Andreadis, K.; Beighley, E.; Allen, G. H.; Miller, Z.

2013-12-01

Flow of water through rivers is among the key fluxes in the global hydrologic cycle and its knowledge would advance the understanding of flood hazards, water resources management, ecology, and climate. However, gauges providing publicly accessible measurements of river stage or discharge remain sparse in many regions. The Surface Water and Ocean Topography (SWOT) satellite mission is a joint project of NASA and the French Centre National d'Etudes Spatiales (CNES) that would provide the first high-resolution images of simultaneous terrestrial water surface height, inundation extent, and ocean surface elevation. Among SWOT's primary goals is the direct observation of variations in river water surface elevation and, where possible, estimation of river discharge from SWOT measurements. The mission science requirements specify that rivers wider than 100 m would be observed globally, with a goal of observing rivers wider than 50m. However, the extent of anticipated SWOT river observations remains fundamentally unknown because no high-resolution, global dataset of river widths exists. Here, we estimate the global extent of rivers wider than 50 m-100 m thresholds using established relationships among river width, discharge, and drainage area. We combine a global digital elevation model with in situ river discharge data to estimate the global extent of SWOT-observable rivers, and validate these estimates against satellite-derived measurements of river width in two large river basins (the Yukon and the Ohio). We then compare the extent of SWOT-observed rivers with the current publicly-available, global gauge network included in the Global Runoff Data Centre (GRDC) database to examine the impact of SWOT on the availability of river observation over continental and global scales. Results suggest that if SWOT observes 100 m wide rivers, river basins with areas greater than 50,000 km2 will commonly be measured. If SWOT could observe 50 m wide rivers, then most 10,000 km2 basins

Assessment of land use change in the coterminous United States and Alaska for global assessment of forest loss conducted by the food and agricultural organization of the United Nations

Science.gov (United States)

Tanushree Biswas; Mike Walterman; Paul Maus; Kevin A. Megown; Sean P. Healey; Kenneth Brewer

2012-01-01

The Food and Agricultural Organization (FAO) of the United Nations conducted a global assessment for forest change in 2010 using satellite imagery from 1990, 2000, and 2005. The U.S. Forest Service was responsible for assessing forest change in the United States. A polygon-based, stratified sampling design developed by FAO was used to assess change in forest area...

A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

Science.gov (United States)

Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

2015-04-01

Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight project midwives visited daily three government hospitals in Lima, Peru and identified cases and matched controls based on hospital, gestational age, and inter-gestational period. Mothers were interviewed and clinical chart extractions were completed. Factors associated with risk of SGA were assessed by their adjusted odds ratios (aOR) from conditional logistic regression. Exposure to an overlap of breastfeeding during late pregnancy was not associated with an increased risk of having a SGA newborn [aOR=0.58, 95% confidence interval (CI): 0.10-3.30]. However, increased risk was associated with having a previous low-birthweight birth (aOR=6.53; 95% CI: 1.43-29.70) and a low intake of animal source foods (power are needed to definitively examine this possible association and clarify whether there are other risks to the new baby, the toddler and the pregnant woman. © 2012 Blackwell Publishing Ltd.

Assessment of human-natural system characteristics influencing global freshwater supply vulnerability

Science.gov (United States)

Padowski, Julie C.; Gorelick, Steven M.; Thompson, Barton H.; Rozelle, Scott; Fendorf, Scott

2015-10-01

Global freshwater vulnerability is a product of environmental and human dimensions, however, it is rarely assessed as such. Our approach identifies freshwater vulnerability using four broad categories: endowment, demand, infrastructure, and institutions, to capture impacts on natural and managed water systems within the coupled human-hydrologic environment. These categories are represented by 19 different endogenous and exogenous characteristics affecting water supply vulnerability. By evaluating 119 lower per capita income countries (Yemen and Djibouti nearly as vulnerable. Surprising similarities in vulnerability were also found among geographically disparate nations such as Vietnam, Sri Lanka, and Guatemala. Determining shared patterns of freshwater vulnerability provides insights into why water supply vulnerabilities are manifested in human-water systems at the national scale.

Free Global Dsm Assessment on Large Scale Areas Exploiting the Potentialities of the Innovative Google Earth Engine Platform

Science.gov (United States)

Nascetti, A.; Di Rita, M.; Ravanelli, R.; Amicuzi, M.; Esposito, S.; Crespi, M.

2017-05-01

The high-performance cloud-computing platform Google Earth Engine has been developed for global-scale analysis based on the Earth observation data. In particular, in this work, the geometric accuracy of the two most used nearly-global free DSMs (SRTM and ASTER) has been evaluated on the territories of four American States (Colorado, Michigan, Nevada, Utah) and one Italian Region (Trentino Alto- Adige, Northern Italy) exploiting the potentiality of this platform. These are large areas characterized by different terrain morphology, land covers and slopes. The assessment has been performed using two different reference DSMs: the USGS National Elevation Dataset (NED) and a LiDAR acquisition. The DSMs accuracy has been evaluated through computation of standard statistic parameters, both at global scale (considering the whole State/Region) and in function of the terrain morphology using several slope classes. The geometric accuracy in terms of Standard deviation and NMAD, for SRTM range from 2-3 meters in the first slope class to about 45 meters in the last one, whereas for ASTER, the values range from 5-6 to 30 meters. In general, the performed analysis shows a better accuracy for the SRTM in the flat areas whereas the ASTER GDEM is more reliable in the steep areas, where the slopes increase. These preliminary results highlight the GEE potentialities to perform DSM assessment on a global scale.

FREE GLOBAL DSM ASSESSMENT ON LARGE SCALE AREAS EXPLOITING THE POTENTIALITIES OF THE INNOVATIVE GOOGLE EARTH ENGINE PLATFORM

Directory of Open Access Journals (Sweden)

A. Nascetti

2017-05-01

Full Text Available The high-performance cloud-computing platform Google Earth Engine has been developed for global-scale analysis based on the Earth observation data. In particular, in this work, the geometric accuracy of the two most used nearly-global free DSMs (SRTM and ASTER has been evaluated on the territories of four American States (Colorado, Michigan, Nevada, Utah and one Italian Region (Trentino Alto- Adige, Northern Italy exploiting the potentiality of this platform. These are large areas characterized by different terrain morphology, land covers and slopes. The assessment has been performed using two different reference DSMs: the USGS National Elevation Dataset (NED and a LiDAR acquisition. The DSMs accuracy has been evaluated through computation of standard statistic parameters, both at global scale (considering the whole State/Region and in function of the terrain morphology using several slope classes. The geometric accuracy in terms of Standard deviation and NMAD, for SRTM range from 2-3 meters in the first slope class to about 45 meters in the last one, whereas for ASTER, the values range from 5-6 to 30 meters. In general, the performed analysis shows a better accuracy for the SRTM in the flat areas whereas the ASTER GDEM is more reliable in the steep areas, where the slopes increase. These preliminary results highlight the GEE potentialities to perform DSM assessment on a global scale.

Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

LENUS (Irish Health Repository)

Shahdadpuri, R

2012-02-01

The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation.

Science.gov (United States)

Hung, Yun-Chi; Bauer, Judith; Horsley, Pamela; Waterhouse, Mary; Bashford, John; Isenring, Elisabeth

2013-06-01

This pilot exploratory study aimed to describe the changes in nutritional status, body composition, quality of life (QoL), and physical activity levels (PAL) of cancer patients undergoing high-dose conditioning and autologous peripheral blood stem cell transplantation (PBSCT) at pre-admission, hospital discharge, and at 100 days post-transplantation, and to examine if changes in these parameters are interrelated. Twenty-four patients (56.2 ± 12.9 years; 7 females, 17 males) were recruited from an Australian transplant center. Assessment was prospectively conducted at pre-admission, hospital discharge, and 100 days post-transplantation using the scored patient-generated subjective global assessment, air displacement plethysmography, EORTC QLQ-C30 (version 3), and the international physical activity questionnaire. At discharge, nutritional status deteriorated (patient-generated subjective global assessment (PG-SGA) median, +8.0; interquartile range, 6.0-13.0; p body mass (LBM; -2.2 kg, CI 95% -3.0, -1.4; p < 0.001), and decrease in QoL (-10.6, CI 95% -24.1, 2.9; p = 0.117); the proportion of patients with high PAL decreased (p = 0.012). By 100 days post-transplantation, all patients were well-nourished; however, LBM remained lower -1.0 kg (CI 95% -1.9, -0.1; p = 0.028). Change in nutritional status (PG-SGA score) was associated with weight (r = -0.46; p = 0.039) and fat mass (r = -0.57; p = 0.013). Change in QoL was associated with nutritional reservoir (i.e., fat; r = 0.54; p = 0.024); QoL was consistently higher for patients with high PAL. High-dose conditioning and autologous PBSCT is associated with deterioration in nutritional status, QoL and PAL, with LBM remaining below baseline levels at 100 days post-transplantation. A nutrition and exercise intervention program post-hospital discharge may be beneficial for these patients.

Assessing the Impact of Stricter Alcohol Advertising Standards: The Case of Beam Global Spirits.

Science.gov (United States)

Ross, Craig S; Sparks, Alicia; Jernigan, David H

2016-08-01

Reducing youth exposure to alcohol advertising is a global health priority. In most countries around the world, the alcohol industry is given the opportunity to regulate itself with respect to advertising practices. Generally, the alcohol industry self-regulations are lax, allowing youth to be disproportionately exposed to alcohol advertising. However, Beam Global Spirits and Wine (Beam) voluntarily adopted more restrictive advertising standards in the United States in 2007. This study assessed Beam's compliance with their new standard and estimates its effect on youth exposure and advertising costs. We found that Beam's compliance with its more restrictive standards was imperfect, but never-the-less, we estimated that youth exposure to alcohol advertising was reduced compared to other spirits brands. Beam's more restrictive standards did not increase their advertising costs and therefore other alcohol companies should consider adopting similar standards around the world.

China's "energy revolution": measuring the status quo, modelling regional dynamics and assessing global impacts

DEFF Research Database (Denmark)

Mischke, Peggy

As the world's largest economy in transition, China plays a growing role in global energy markets, clean technology deployment and climate change negotiations. The Chinese president Xi Jinping called in June 2014 for an “energy revolution” of the country’s “energy production and consumption habits......, expanded and applied in this regard. The theories underlying this research are stemming from various scientific disciplines, such as energy and power engineering, macro- and energy-economics, and power project finance. Cross-cutting aspects are the harmonization of Chinese and international energy...... top-down and bottom-up global energy planning tools to model future regional dynamics of China's energy sector; and (v) an assessment of electricity generation costs of the first operational concentrated solar power technologies in China. The results of this thesis are relevant for a broad scientific...

Evaluation process of global environmental impact: assessment guidelines

International Nuclear Information System (INIS)

Memon, A.R.; Mahar, R.B.

2001-01-01

In developed and developing countries, the EIA (Environmental Impact Assessment) is becoming mandatory for the approval of Industrial projects and projects of Environmental hazards. The approving authority of each country has its own guidelines to get projects approved and make project proponents responsible to submit Environmental Impact Statement for the its detailed assessment. In this paper authors have studied an existing EIA Global guidelines and its evaluation process of altogether 40 countries from four continents, Asia, Pacific/Middle East, Europe, Australia and America/Canada. This evaluation process is recorded in the tabulation form and it has been formulated stage wise in which stage one highlights the inception of EIA guidelines of each country and stage two and three gives implementation process. The inception stage of guidelines gives an idea that when EIA was started and an implementation stages provide all information that when EIA become a part of legislation that provide an opportunity to the reader to understand the decision making process for project approvals. The main objective of writing EIA guidelines is to monitor the sustain ability of various types of the projects under different sectoral guidelines, therefore Projects related with different Sectors have been chosen and a detailed record in tabulation form gives an idea to understand the interaction of these guidelines. To make this paper more comprehensive, authors have gone thorough the sectoral guidelines of altogether 64 countries and studied 21 sector oriented project fields. These are of Agriculture/Irrigation, Biodiversity, Coastal/Marine, Community Participation, Extractive industries, Fisheries, Forestry, Hazard Risk, Health, Human settlement, Industry, Multi sectorial, Ports and Harbors, Power, refugees/resettlement, Social, Strategies/Planning, Tourism/Recreational, transportation, Waste Pollution and Wetlands/Water resources. (author)

Non-communicable diseases and global health governance: enhancing global processes to improve health development.