WorldWideScience

Sample records for global severity index

  1. Joint spatiotemporal variability of global sea surface temperatures and global Palmer drought severity index values

    Science.gov (United States)

    Apipattanavis, S.; McCabe, G.J.; Rajagopalan, B.; Gangopadhyay, S.

    2009-01-01

    Dominant modes of individual and joint variability in global sea surface temperatures (SST) and global Palmer drought severity index (PDSI) values for the twentieth century are identified through a multivariate frequency domain singular value decomposition. This analysis indicates that a secular trend and variability related to the El Niño–Southern Oscillation (ENSO) are the dominant modes of variance shared among the global datasets. For the SST data the secular trend corresponds to a positive trend in Indian Ocean and South Atlantic SSTs, and a negative trend in North Pacific and North Atlantic SSTs. The ENSO reconstruction shows a strong signal in the tropical Pacific, North Pacific, and Indian Ocean regions. For the PDSI data, the secular trend reconstruction shows high amplitudes over central Africa including the Sahel, whereas the regions with strong ENSO amplitudes in PDSI are the southwestern and northwestern United States, South Africa, northeastern Brazil, central Africa, the Indian subcontinent, and Australia. An additional significant frequency, multidecadal variability, is identified for the Northern Hemisphere. This multidecadal frequency appears to be related to the Atlantic multidecadal oscillation (AMO). The multidecadal frequency is statistically significant in the Northern Hemisphere SST data, but is statistically nonsignificant in the PDSI data.

  2. Palmer Drought Severity Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  3. The reliability of three psoriasis assessment tools: Psoriasis area and severity index, body surface area and physician global assessment.

    Science.gov (United States)

    Bożek, Agnieszka; Reich, Adam

    2017-08-01

    A wide variety of psoriasis assessment tools have been proposed to evaluate the severity of psoriasis in clinical trials and daily practice. The most frequently used clinical instrument is the psoriasis area and severity index (PASI); however, none of the currently published severity scores used for psoriasis meets all the validation criteria required for an ideal score. The aim of this study was to compare and assess the reliability of 3 commonly used assessment instruments for psoriasis severity: the psoriasis area and severity index (PASI), body surface area (BSA) and physician global assessment (PGA). On the scoring day, 10 trained dermatologists evaluated 9 adult patients with plaque-type psoriasis using the PASI, BSA and PGA. All the subjects were assessed twice by each physician. Correlations between the assessments were analyzed using the Pearson correlation coefficient. Intra-class correlation coefficient (ICC) was calculated to analyze intra-rater reliability, and the coefficient of variation (CV) was used to assess inter-rater variability. Significant correlations were observed among the 3 scales in both assessments. In all 3 scales the ICCs were > 0.75, indicating high intra-rater reliability. The highest ICC was for the BSA (0.96) and the lowest one for the PGA (0.87). The CV for the PGA and PASI were 29.3 and 36.9, respectively, indicating moderate inter-rater variability. The CV for the BSA was 57.1, indicating high inter-rater variability. Comparing the PASI, PGA and BSA, it was shown that the PGA had the highest inter-rater reliability, whereas the BSA had the highest intra-rater reliability. The PASI showed intermediate values in terms of interand intra-rater reliability. None of the 3 assessment instruments showed a significant advantage over the other. A reliable assessment of psoriasis severity requires the use of several independent evaluations simultaneously.

  4. Global Ecosystem Restoration Index

    DEFF Research Database (Denmark)

    Fernandez, Miguel; Garcia, Monica; Fernandez, Nestor

    2015-01-01

    The Global ecosystem restoration index (GERI) is a composite index that integrates structural and functional aspects of the ecosystem restoration process. These elements are evaluated through a window that looks into a baseline for degraded ecosystems with the objective to assess restoration...

  5. Towards a Flood Severity Index

    Science.gov (United States)

    Kettner, A.; Chong, A.; Prades, L.; Brakenridge, G. R.; Muir, S.; Amparore, A.; Slayback, D. A.; Poungprom, R.

    2017-12-01

    Flooding is the most common natural hazard worldwide, affecting 21 million people every year. In the immediate moments following a flood event, humanitarian actors like the World Food Program need to make rapid decisions ( 72 hrs) on how to prioritize affected areas impacted by such an event. For other natural disasters like hurricanes/cyclones and earthquakes, there are industry-recognized standards on how the impacted areas are to be classified. Shake maps, quantifying peak ground motion, from for example the US Geological Survey are widely used for assessing earthquakes. Similarly, cyclones are tracked by Joint Typhoon Warning Center (JTWC) and Global Disaster Alert and Coordination System (GDACS) who release storm nodes and tracks (forecasted and actual), with wind buffers and classify the event according to the Saffir-Simpson Hurricane Wind Scale. For floods, the community is usually able to acquire unclassified data of the flood extent as identified from satellite imagery. Most often no water discharge hydrograph is available to classify the event into recurrence intervals simply because there is no gauging station, or the gauging station was unable to record the maximum discharge due to overtopping or flood damage. So, the question remains: How do we methodically turn a flooded area into classified areas of different gradations of impact? Here, we present a first approach towards developing a global applicable flood severity index. The flood severity index is set up such that it considers relatively easily obtainable physical parameters in a short period of time like: flood frequency (relating the current flood to historical events) and magnitude, as well as land cover, slope, and where available pre-event simulated flood depth. The scale includes categories ranging from very minor flooding to catastrophic flooding. We test and evaluate the postulated classification scheme against a set of past flood events. Once a severity category is determined, socio

  6. The Localized Scleroderma Skin Severity Index and Physician Global Assessment of Disease Activity: A Work in Progress Toward Development of Localized Scleroderma Outcome Measures

    Science.gov (United States)

    ARKACHAISRI, THASCHAWEE; VILAIYUK, SOAMARAT; LI, SUZANNE; O’NEIL, KATHLEEN M.; POPE, ELENA; HIGGINS, GLORIA C.; PUNARO, MARILYNN; RABINOVICH, EGLA C.; ROSENKRANZ, MARGALIT; KIETZ, DANIEL A.; ROSEN, PAUL; SPALDING, STEVEN J.; HENNON, TERESA R.; TOROK, KATHRYN S.; CASSIDY, ELAINE; MEDSGER, THOMAS A.

    2013-01-01

    Objective To develop and evaluate a Localized Scleroderma (LS) Skin Severity Index (LoSSI) and global assessments’ clinimetric property and effect on quality of life (QOL). Methods A 3-phase study was conducted. The first phase involved 15 patients with LS and 14 examiners who assessed LoSSI [surface area (SA), erythema (ER), skin thickness (ST), and new lesion/extension (N/E)] twice for inter/intrarater reliability. Patient global assessment of disease severity (PtGA-S) and Children’s Dermatology Life Quality Index (CDLQI) were collected for intrarater reliability evaluation. The second phase was aimed to develop clinical determinants for physician global assessment of disease activity (PhysGA-A) and to assess its content validity. The third phase involved 2 examiners assessing LoSSI and PhysGA-A on 27 patients. Effect of training on improving reliability/validity and sensitivity to change of the LoSSI and PhysGA-A was determined. Results Interrater reliability was excellent for ER [intraclass correlation coefficient (ICC) 0.71], ST (ICC 0.70), LoSSI (ICC 0.80), and PhysGA-A (ICC 0.90) but poor for SA (ICC 0.35); thus, LoSSI was modified to mLoSSI. Examiners’ experience did not affect the scores, but training/practice improved reliability. Intrarater reliability was excellent for ER, ST, and LoSSI (Spearman’s rho = 0.71–0.89) and moderate for SA. PtGA-S and CDLQI showed good intrarater agreement (ICC 0.63 and 0.80). mLoSSI correlated moderately with PhysGA-A and PtGA-S. Both mLoSSI and PhysGA-A were sensitive to change following therapy. Conclusion mLoSSI and PhysGA-A are reliable and valid tools for assessing LS disease severity and show high sensitivity to detect change over time. These tools are feasible for use in routine clinical practice. They should be considered for inclusion in a core set of LS outcome measures for clinical trials. PMID:19833758

  7. 2012 Global Energy Competitiveness Index

    International Nuclear Information System (INIS)

    Lorot, Pascal; Lauriano do Rego, Wilfrid

    2012-01-01

    The 2012 Global Energy Competitiveness Index, a survey jointly conducted by Institut Choiseul and KPMG, is the first of its kind. It ranks 146 countries, grouping them into 5 categories ranging from the best performers to under-performers. The first edition of this annual study ranks the countries surveyed not only by continent but also according to the quality of their energy mix, electricity access and availability levels and the compatibility of their energy policies with environmental challenges. The governing bodies of the countries in the panel (relevant ministries and regulatory authorities) can gain much from this decision-making support tool that fosters dialogue on energy-related issues. The targeted audience also includes industry professionals, NGOs, international organisations and other economic players such as banks, consulting firms and specialist commercial law firms commercial law firms. Europe is by far the best performing continent ahead of the best performing continent, ahead of the Americas and Americas and even further ahead of Asia/Oceania and Africa. Generally speaking, the Nordic countries are among the best performers: Norway, Canada, Iceland, Denmark, Sweden and Finland rank, in this order, in the global Top 10. Four EU countries are among the global Top 10 (Denmark, Sweden, Finland and France) and five others (the United Kingdom, Austria, Germany, Slovakia and Spain) are in the Top 20. Surprisingly, Colombia stood out as the fifth most competitive country in terms of energy. Its outstanding performance is due to a strong energy mix (ranked second worldwide) and an energy strategy compatible with today's key environmental challenges. The apparent domination of Northern-hemisphere countries needs to be considered in conjunction with the results achieved by the other Seeming domination of be considered in conjunction with the results achieved by the other countries with regard to their energy mix and the environmental compatibility of

  8. Frontier differences and the global malmquist index

    DEFF Research Database (Denmark)

    Asmild, Mette

    2015-01-01

    This chapter reviews different ways of comparing the efficiency frontiers for subgroups within a data set, specifically program efficiency, the metatechnology (or technology gap) ratio and the global frontier difference index. The latter is subsequently used to define a global Malmquist index...

  9. A real-time Global Warming Index.

    Science.gov (United States)

    Haustein, K; Allen, M R; Forster, P M; Otto, F E L; Mitchell, D M; Matthews, H D; Frame, D J

    2017-11-13

    We propose a simple real-time index of global human-induced warming and assess its robustness to uncertainties in climate forcing and short-term climate fluctuations. This index provides improved scientific context for temperature stabilisation targets and has the potential to decrease the volatility of climate policy. We quantify uncertainties arising from temperature observations, climate radiative forcings, internal variability and the model response. Our index and the associated rate of human-induced warming is compatible with a range of other more sophisticated methods to estimate the human contribution to observed global temperature change.

  10. A discussion on disease severity index values: using the disease severity index for null hypothesis testing

    Science.gov (United States)

    A disease severity index (DSI) is a single number for summarizing a large amount of information on disease severity. It has been used to indicate the performance of a cultivar in regard to disease resistance at a particular location, to relate disease severity to yield loss, to determine the effecti...

  11. Severe Malnutrition: A Global Approach.

    Science.gov (United States)

    Pelletier, Jean-Gerard

    1993-01-01

    This report examines the immediate and underlying causes of malnutrition in the developing world. The first section discusses the effects of malnutrition on childhood development and examines the efficacy of nutritional rehabilitation. The second section addresses the medical effects of severe malnutrition, including the onset of ponderostatural…

  12. What's Wrong with the Global Slavery Index?

    Directory of Open Access Journals (Sweden)

    Anne T Gallagher

    2017-04-01

    Full Text Available The Global Slavery Index (GSI, which has been produced by the Walk Free Foundation in 2013, 2014 and 2016, seeks to calculate the number of victims of human trafficking (or ‘modern slavery’ in each country and to assess and rank government responses. Using the latest iteration of the Index, this article examines each of the three elements (vulnerability measurement; prevalence measurement and response measurement, making some preliminary findings about the quality of the methodology and its application under each heading. It concludes with a consideration of two broader issues: (i the conspicuous lack of critical engagement with the Index; and (ii what the Index reveals about the changing face of anti-trafficking/anti-slavery work—most particularly, the growing involvement of metrics-focused strategic philanthropy in defining the ‘problem’ and directing responses.

  13. Geographic analysis of road accident severity index in Nigeria.

    Science.gov (United States)

    Iyanda, Ayodeji E

    2018-05-28

    Before 2030, deaths from road traffic accidents (RTAs) will surpass cerebrovascular disease, tuberculosis, and HIV/AIDS. Yet, there is little knowledge on the geographic distribution of RTA severity in Nigeria. Accident Severity Index is the proportion of deaths that result from a road accident. This study analysed the geographic pattern of RTA severity based on the data retrieved from Federal Road Safety Corps (FRSC). The study predicted a two-year data from a historic road accident data using exponential smoothing technique. To determine spatial autocorrelation, global and local indicators of spatial association were implemented in a geographic information system. Results show significant clusters of high RTA severity among states in the northeast and the northwest of Nigeria. Hence, the findings are discussed from two perspectives: Road traffic law compliance and poor emergency response. Conclusion, the severity of RTA is high in the northern states of Nigeria, hence, RTA remains a public health concern.

  14. Comprehensive evaluation of global energy interconnection development index

    Science.gov (United States)

    Liu, Lin; Zhang, Yi

    2018-04-01

    Under the background of building global energy interconnection and realizing green and low-carbon development, this article constructed the global energy interconnection development index system which based on the current situation of global energy interconnection development. Through using the entropy method for the weight analysis of global energy interconnection development index, and then using gray correlation method to analyze the selected countries, this article got the global energy interconnection development index ranking and level classification.

  15. Validation and simplification of Fournier's gangrene severity index.

    Science.gov (United States)

    Lin, Tsung-Yen; Ou, Chien-Hui; Tzai, Tzong-Shin; Tong, Yat-Ching; Chang, Chien-Chen; Cheng, Hong-Lin; Yang, Wen-Horng; Lin, Yung-Ming

    2014-07-01

    To validate the predictive value of Fournier's Gangrene Severity Index in patients with Fournier gangrene and to facilitate patient mortality risk-stratification by simplifying the Fournier's Gangrene Severity Index. From January 1989 to December 2011, 85 male patients with clinically-documented Fournier's gangrene undergoing intensive treatment and with complete medical records were recruited. The demographic information and nine parameters of Fournier's Gangrene Severity Index were compared between survivors and non-survivors. The parameters that showed a significant difference between the two groups were selected to generate a simplified scoring index. Of the 85 patients recruited, 16 patients died of the disease with mortality rate of 18.8%. The Fournier's Gangrene Severity Index score at initial diagnosis was significantly higher in non-survivors than in survivors. Of the nine parameters of Fournier's Gangrene Severity Index, the scores of serum creatinine level, hematocrit level and serum potassium level were significantly different between the two groups. However, the mean body temperatures, heart rate, respiration rate, white blood cell count, serum sodium and bicarbonate levels were non-significantly different. Of the 12 patients with chronic kidney disease or end-stage renal disease, 10 died of severe sepsis. A simplified scoring index including parameters of creatinine, hematocrit and potassium was generated, which provided sensitivity and specificity of 87% and 77% in predicting patient mortality, respectively. The predictive values of this simplified Fournier's Gangrene Severity Index were shown to be non-inferior to Fournier's Gangrene Severity Index in our patients. The simplified Fournier's Gangrene Severity Index is easy to use at initial diagnosis, and offers a way to compare outcomes in different clinical populations. © 2014 The Japanese Urological Association.

  16. Global Strain in Severe Aortic Valve Stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K

    2012-01-01

    Score, history with ischemic heart disease and ejection fraction. CONCLUSIONS: -In patients with symptomatic severe aortic stenosis undergoing AVR reduced GLS provides important prognostic information beyond standard risk factors. Clinical Trial Registration-URL: http://www.clinicaltrial.gov. Unique identifier......BACKGROUND: -Global longitudinal systolic strain (GLS) is often reduced in aortic stenosis despite normal ejection fraction. The importance of reduced preoperative GLS on long-term outcome after aortic valve replacement (AVR) is unknown. METHODS AND RESULTS: -A total of 125 patients with severe...... and mortality. In a stepwise cox model with forward selection GLS was the sole independent predictor HR=1.13 (95% confidence interval 1.02-1.25), p=0.04. Comparing the overall log likelihood χ(2) of the predictive power of the multivariable model containing GLS was statistically superior to models based on Euro...

  17. Spatial Analysis of Accident Spots Using Weighted Severity Index ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Spatial Analysis of Accident Spots Using Weighted Severity Index (WSI) and ... pedestrians avoiding the use of pedestrian bridges/aid even when they are available. ..... not minding an unforeseen obstruction, miscalculations and wrong break.

  18. CERN featured as leader in Global Innovation Index

    CERN Multimedia

    Anaïs Rassat, KT group

    2016-01-01

    The Global Innovation Index 2016 report is a leading reference on innovation and uses CERN as an example of a highly successful regional initiative.   The Global Innovation Index 2016 (GII) report highlights CERN’s successful innovation initiatives. (Image: GII) Read more here.

  19. Global Solar UV Index (invited paper)

    International Nuclear Information System (INIS)

    Repacholi, M.H.

    2000-01-01

    Excessive solar ultraviolet (UV) radiation exposure produces a significant burden of disease to the skin, eyes and immune system. Effective programmes for the reduction of UV exposure are needed to reduce this disease burden and the associated health care costs. The UV index is seen as an effective tool for communicating important protection information to the public through its use in media news and weather information. The index is described and it is suggested that universally common messages should be associated with its ranges. (author)

  20. A Risk Severity Index for industrial plants and sites

    International Nuclear Information System (INIS)

    Planas, E.; Arnaldos, J.; Silvetti, B.; Vallee, Agnes; Casal, J.

    2006-01-01

    A risk index (Risk Severity Index, S) has been devised to allow the assessment of the risk level originated by a given installation or site over the affected zone. A set of threshold levels for thermal radiation, toxic concentration and overpressure, together with the probabilities and frequencies associated to critical events and their effects have been the basis for calculating the values of S. A computer tool has been designed to perform a quick calculation of the diverse Risk Severity Indexes (for a critical event, for a dangerous phenomenon, for a type of effect and for the whole installation) and to plot a map of the risk severity levels around the site. The methodology has been applied to diverse test cases and it has proved to be useful for risk assessment, for comparative studies and for land use planning

  1. Empirical scaling law connecting persistence and severity of global terrorism

    Science.gov (United States)

    Gao, Jianbo; Fang, Peng; Liu, Feiyan

    2017-09-01

    Terrorism and counterterrorism have both been evolving rapidly. From time to time, there have been debates on whether the new terrorism is evolutionary or revolutionary. Such debate often becomes more heated after major terrorist activities, such as the terrorist attacks on September 11, 2001 and the November 13, 2015 coordinated Paris terror attack. Using country-wide terrorism data since 1970, we show that there exist scaling laws governing the continuity and persistence of world-wide terrorism, with the long-term scaling parameter for each country closely related to its yearly global terrorism index. This suggests that the new terrorism is more accurately considered evolutionary. It is further shown that the imbalance in the seesaw of terrorism and counterterrorism is not only responsible for the scaling behavior found here, but also provides new means of quantifying the severity of the global terrorism.

  2. The development of a flash flood severity index

    Science.gov (United States)

    Schroeder, Amanda J.; Gourley, Jonathan J.; Hardy, Jill; Henderson, Jen J.; Parhi, Pradipta; Rahmani, Vahid; Reed, Kimberly A.; Schumacher, Russ S.; Smith, Brianne K.; Taraldsen, Matthew J.

    2016-10-01

    Flash flooding is a high impact weather event that requires clear communication regarding severity and potential hazards among forecasters, researchers, emergency managers, and the general public. Current standards used to communicate these characteristics include return periods and the United States (U.S.) National Weather Service (NWS) 4-tiered river flooding severity scale. Return periods are largely misunderstood, and the NWS scale is limited to flooding on gauged streams and rivers, often leaving out heavily populated urban corridors. To address these shortcomings, a student-led group of interdisciplinary researchers came together in a collaborative effort to develop an impact-based Flash Flood Severity Index (FFSI). The index was proposed as a damage-based, post-event assessment tool, and preliminary work toward the creation of this index has been completed and presented here. Numerous case studies were analyzed to develop the preliminary outline for the FFSI, and three examples of such cases are included in this paper. The scale includes five impact-based categories ranging from Category 1 very minor flooding to Category 5 catastrophic flooding. Along with the numerous case studies used to develop the initial outline of the scale, empirical data in the form of semi-structured interviews were conducted with multiple NWS forecasters across the country and their responses were analyzed to gain more perspective on the complicated nature of flash flood definitions and which tools were found to be most useful. The feedback from these interviews suggests the potential for acceptance of such an index if it can account for specific challenges.

  3. The Global Solar UV Index used in the United Kingdom

    International Nuclear Information System (INIS)

    New, C.; Driscoll, C.M.H.; Kitchen, K.; Miners, B.

    2000-01-01

    Weather forecast bulletins on television, radio and in the newspapers in the UK now include advice about the strength of the ultraviolet (UV) radiation from the sun in terms of the Global Solar UV Index. A numerical scale of 1 to 20 is used to quote the Index for anywhere in the world and the Index addresses all ethnic groups. The Index replaces the sunburn warning system. The daily UV Index is calculated by the Met. Office from documented UV radiation levels and current atmospheric data and takes into account cloud cover forecast. Armed with the knowledge of the UV Index the public will be able to assess their personal risk of sun damage at home or abroad depending on their natural skin colour. Four categories of skin colour are identified with the Index; white skin that sunburns easily, white skin that tans readily, brown skin and black skin. A colour-coded rating from low to very high is used to identify personal risk with these skin colour categories. The Global UV Index forms an important part of the 'Sun Safety Code' developed by health organisations within the UK. (author)

  4. The Global Solar UV Index used in the United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    New, C.; Driscoll, C.M.H.; Kitchen, K.; Miners, B

    2000-07-01

    Weather forecast bulletins on television, radio and in the newspapers in the UK now include advice about the strength of the ultraviolet (UV) radiation from the sun in terms of the Global Solar UV Index. A numerical scale of 1 to 20 is used to quote the Index for anywhere in the world and the Index addresses all ethnic groups. The Index replaces the sunburn warning system. The daily UV Index is calculated by the Met. Office from documented UV radiation levels and current atmospheric data and takes into account cloud cover forecast. Armed with the knowledge of the UV Index the public will be able to assess their personal risk of sun damage at home or abroad depending on their natural skin colour. Four categories of skin colour are identified with the Index; white skin that sunburns easily, white skin that tans readily, brown skin and black skin. A colour-coded rating from low to very high is used to identify personal risk with these skin colour categories. The Global UV Index forms an important part of the 'Sun Safety Code' developed by health organisations within the UK. (author)

  5. Cost per severe accident as an index for severe accident consequence assessment and its applications

    International Nuclear Information System (INIS)

    Silva, Kampanart; Ishiwatari, Yuki; Takahara, Shogo

    2014-01-01

    The Fukushima Accident emphasizes the need to integrate the assessments of health effects, economic impacts, social impacts and environmental impacts, in order to perform a comprehensive consequence assessment of severe accidents in nuclear power plants. “Cost per severe accident” is introduced as an index for that purpose. The calculation methodology, including the consequence analysis using level 3 probabilistic risk assessment code OSCAAR and the calculation method of the cost per severe accident, is proposed. This methodology was applied to a virtual 1,100 MWe boiling water reactor. The breakdown of the cost per severe accident was provided. The radiation effect cost, the relocation cost and the decontamination cost were the three largest components. Sensitivity analyses were carried out, and parameters sensitive to cost per severe accident were specified. The cost per severe accident was compared with the amount of source terms, to demonstrate the performance of the cost per severe accident as an index to evaluate severe accident consequences. The ways to use the cost per severe accident for optimization of radiation protection countermeasures and for estimation of the effects of accident management strategies are discussed as its applications. - Highlights: • Cost per severe accident is used for severe accident consequence assessment. • Assessments of health, economic, social and environmental impacts are included. • Radiation effect, relocation and decontamination costs are important cost components. • Cost per severe accident can be used to optimize radiation protection measures. • Effects of accident management can be estimated using the cost per severe accident

  6. Relationship between the stuttering severity index and speech rate

    Directory of Open Access Journals (Sweden)

    Claudia Regina Furquim de Andrade

    Full Text Available CONTEXT: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints. OBJECTIVE: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate. DESIGN: Cross-sectional study. SETTING: Fluency and Fluency Disorders Investigation Laboratory, Faculdade de Medicina da Universidade de São Paulo. PARTICIPANTS: Seventy adults with stuttering diagnosis. MAIN MEASUREMENTS: A speech sample from each participant containing at least 200 fluent syllables was videotaped and analyzed according to a stuttering severity index test and speech rate parameters. RESULTS: The results obtained in this study indicate that the stuttering severity and the speech rate present significant variation, i.e., the more severe the stuttering is, the lower the speech rate in words and syllables per minute. DISCUSSION AND CONCLUSION: The results suggest that speech rate is an important indicator of fluency levels and should be incorporated in the assessment and treatment of stuttering. This study represents a first attempt to identify the possible subtypes of developmental stuttering. DEFINITION: Objective tests that quantify diseases are important in their diagnosis, treatment and prognosis.

  7. Predicting global variation in infectious disease severity

    DEFF Research Database (Denmark)

    Jensen, Per Moestrup; de Fine Licht, Henrik Hjarvard

    2016-01-01

    demographic and population data. Results: Birth rates were the best predictor for mumps and malaria CFR. For tuberculosis CFR death rates were the best predictor and for leptospirosis population density was a significant predictor. Conclusions and implications: CFR predictors differed among diseases according...... and leptospirosis and assessed these for association with a range of population characteristics, such as crude birth and death rates, median age of the population, mean body mass index, proportion living in urban areas and tuberculosis vaccine coverage. We then tested this predictive model on Danish his- torical...... have the opposite effect. Accordingly changes in CFR may occur in parallel with demographic transitions. Methodology: We explored the predictability of CFR using data obtained from the World Health Organization (WHO) disease databases for four human diseases: mumps, malaria, tuberculosis...

  8. Healthcare hashtag index development: Identifying global impact in social media.

    Science.gov (United States)

    Pinho-Costa, Luís; Yakubu, Kenneth; Hoedebecke, Kyle; Laranjo, Liliana; Reichel, Christofer Patrick; Colon-Gonzalez, Maria Del C; Neves, Ana Luísa; Errami, Hassna

    2016-10-01

    Create an index of global reach for healthcare hashtags and tweeters therein, filterable by topic of interest. For this proof-of-concept study we focused on the field of Primary Care and Family Medicine. Six hashtags were selected based on their importance, from the ones included in the 'Healthcare Hashtag Project'. Hashtag Global Reach (HGR) was calculated using the additive aggregation of five weighted, normalized indicator variables: number of impressions, tweets, tweeters, user locations, and user languages. Data were obtained for the last quarter of 2014 and first quarter of 2015 using Symplur Signals. Topic-specific HGR were calculated for the top 10 terms and for sets of quotes mapped after a thematic analysis. Individual Global Reach, IGR, was calculated across hashtags as additive indexes of three indicators: replies, retweets and mentions. Using the HGR score we were able to rank six selected hashtags and observe their performance throughout the study period. We found that #PrimaryCare and #FMRevolution had the highest HGR score in both quarters; interestingly, #FMChangeMakers experienced a marked increase in its global visibility during the study period. "Health Policy" was the commonest theme, while "Care", "Family" and "Health" were the most common terms. This is the first study describing an altmetric hashtag index. Assuming analytical soundness, the Index might prove generalizable to other healthcare hashtags. If released as a real-time business intelligence tool with customizable settings, it could aid publishing and strategic decisions by netizens, organizations, and analysts. IGR could also serve to augment academic evaluation and professional development. Our study demonstrates the feasibility of using an index on the global reach of healthcare hashtags and tweeters. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Oxygen saturation index and severity of hypoxic respiratory failure.

    Science.gov (United States)

    Rawat, Munmun; Chandrasekharan, Praveen K; Williams, Ashley; Gugino, Sylvia; Koenigsknecht, Carmon; Swartz, Daniel; Ma, Chang Xing; Mathew, Bobby; Nair, Jayasree; Lakshminrusimha, Satyan

    2015-01-01

    The oxygenation index (OI = mean airway pressure, MAP × FiO2 × 100 : PaO2) is used to assess the severity of hypoxic respiratory failure (HRF) and persistent pulmonary hypertension of the newborn (PPHN). An indwelling arterial line or arterial punctures are necessary to obtain PaO2 for the calculation of OI. Oxygenation can be continuously and noninvasively assessed using pulse oximetry. The use of the oxygen saturation index (OSI = MAP × FiO2 × 100 : SpO2) can be an alternate method of assessing the severity of HRF. To evaluate the correlation between OSI and OI in the following: (1) neonates with HRF and (2) a lamb model of meconium aspiration syndrome. Human neonates: a retrospective chart review of 74 ventilated late preterm/term neonates with indwelling arterial access and SpO2 values in the first 24 h of life was conducted. OSI and OI were calculated and correlated. Lamb model: arterial blood gases were drawn and preductal SpO2 was documented in 40 term newborn lambs with asphyxia and meconium aspiration. OI and OSI were calculated and correlated with pulmonary vascular resistance (PVR). Mean values of OSI and OI showed a correlation coefficient of 0.952 in neonates (mean value of 308 observations in 74 neonates) and 0.948 in lambs (mean value of 743 observations in 40 lambs). In lambs, with increasing PVR, there was a decrease in OI and OSI. OSI correlates significantly with OI in infants with HRF. This noninvasive measure may be used to assess the severity of HRF and PPHN in neonates without arterial access. © 2015 S. Karger AG, Basel

  10. Psychometric evaluation of the ostomy complication severity index.

    Science.gov (United States)

    Pittman, Joyce; Bakas, Tamilyn; Ellett, Marsha; Sloan, Rebecca; Rawl, Susan M

    2014-01-01

    The purpose of this study was to evaluate the psychometric properties of a new instrument to measure incidence and severity of ostomy complications early in the postoperative period. 71 participants were enrolled, most were men (52%), white (96%), and married or partnered (55%). The mean age of participants was 57 ± 15.09 years (mean ± SD). Fifty-two participants (84%) experienced at least 1 ostomy complication in the 60-day postoperative period. The research setting was 3 acute care settings within a large healthcare system in the Midwestern United States. We developed an evidence-based conceptual model to guide development and evaluation of a new instrument, the Pittman Ostomy Complication Severity Index (OCSI). The OCSI format includes Likert-like scale with 9 individual items scored 0 to 3 and a total score computed by summing the individual items. Higher scores indicate more severe ostomy complications. This study consisted of 2 phases: (1) an expert review, conducted to establish content validity; and (2) a prospective, longitudinal study design, to examine psychometric properties of the instrument. A convenience sample of 71 adult patients who underwent surgery to create a new fecal ostomy was recruited from 3 hospitals. Descriptive analyses, content validity indices, interrater reliability testing, and construct validity testing were employed. Common complications included leakage (60%), peristomal moisture-associated dermatitis (50%), stomal pain (42%), retraction (39%), and bleeding (32%). The OCSI demonstrated acceptable evidence of content validity index (CVI = 0.9) and interrater reliability for individual items (k = 0.71-1.0), as well as almost perfect agreement for total scores among raters (ICC = 0.991, P ≤ .001). Construct validity of the OCSI was supported by significant correlations among variables in the conceptual model (complications, risk factors, stoma care self-efficacy, and ostomy adjustment). OCSI demonstrated acceptable validity and

  11. Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis

    DEFF Research Database (Denmark)

    Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva

    2006-01-01

    We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....

  12. Etiology, clinical profile, severity and outcome of acute pancreatitis in relation to bed side index for severity of acute pancreatitis bisap and CT severity index [CTSI] scores

    Directory of Open Access Journals (Sweden)

    Bezwada Srinivasa Rao, Matta SreeVani, V.Sarat Chandra

    2014-11-01

    Full Text Available Background: Acute pancreatitis is an inflammatory process of the pancreas with involvement of regional tissues or remote organ systems and with potentially devastating consequences. Early prediction of outcome of acute pancreatitis within 24 hrs by clinically based bed Side Index of Severity of Acute Pancreatitis [BISAP] Score and radiological based CT Severity Index [CTSI] later on being useful in initiation of early treatment, assessing severity, to prevent morbidity and mortality. In those who survive, it can progress to chronic pancreatitis resulting in malabsorption and permanent diabetes. Aim: The aim was to study aetiology, clinical profile, severity, outcome of acute pancreatitis in relation to BISAP Score and CTSI. Materials and Methods: This was an observational and prospective study. The present study enrolled 55 patients who were diagnosed as acute pancreatitis and patients with chronic pancreatitis were excluded from the study. Vital data like pulse rate, blood Pressure, temperature, respiratory rate, conscious level using Glasgow coma scale, serum amylase, lipase, Chest x-ray, US abdomen and CT abdomen [both CECT & NCCT] were done. BISAP Score was obtained at the time of presentation or within 24 hours of presentation and radiological based CT Severity Index [CTSI] was calculated using the Balthazar grading system and Necrosis Scoring system to assess the severity, morbidity and mortality. The results: In this study, the most common aetiology being alcohol intake followed by gall stones. BISAP Score 3 had organ dysfunction and Score 4 had 100% mortality. The relation between CTSI score and Organ dysfunction showed increased organic dysfunction and higher mortality with higher CTSI Scores. p value < 0.0001 was calculated using Pearson Chi-square test and found to be statistically significant. Conclusions: Both BISAP and CTSI scores had positive correlation with morbidity and mortality.

  13. Photographic Documentation and Hand Eczema Severity Index for Severity Assessment of Hand Eczema

    DEFF Research Database (Denmark)

    Zabludovska, Kristine; Ibler, Kristina S; Jemec, Gregor B E

    2017-01-01

    .003), respectively, and major worsening, r = 0.41 (P = 0.021). With respect to minor changes, no statistically significant correlations were found (P > 0.05). CONCLUSIONS: In patients with mild HE, photographic assessment was found useful for major and moderate changes only. Further studies would need......BACKGROUND: Hand eczema (HE) is a fluctuating disease, and an objective assessment of HE severity is coveted. OBJECTIVES: This study was undertaken to test the association between Hand Eczema Severity Index (HECSI) score and panel scores of photographs taken by dermatologists. METHODS: A total...... were engaged in blinded evaluation of photographs. RESULTS: The highest correlation coefficients between delta HECSI scores and delta panel scores of photographs in the first and second evaluation rounds were found for moderate improvement and moderate worsening, rs = -0.46 (P = 0.009) and 0.52 (P = 0...

  14. On indexes and subject matter of “global competitiveness”

    Directory of Open Access Journals (Sweden)

    A. V. Korotkov

    2017-01-01

    Full Text Available The aim of the research is to analyze the subject matter of a country’s competitiveness and to characterize statistical indexes of competitiveness known in the international practice from the perspective of a more elaborated theory of market competition. This aim follows from the identified problems. First, there are no generally accepted interpretation and joint understanding of competition and competitiveness at country level. Even the international organizations giving estimations of global competitiveness disagree on definitions of competitiveness. Secondly, there is no relation to the theory of market competition in the available source materials on competitiveness of the country without original methodology. Thirdly, well-known statistical indexes of global competitiveness do not have enough theoretical justification and differ in sets of factors. All this highlights the incompleteness of the methodology and methodological support of studying competitiveness at country level.Materials and methods. The research is based on the methodology of statistics, economic theory and marketing. The authors followed the basic principle of statistical methodology – requirement of continuous combination of qualitative and quantitative analysis, when the research begins and ends with qualitative analysis. A most important section of statistical methodology is widely used – construction of statistical indexes. In the course of the analysis, a method of statistical classifications is applied. A significant role in the present research is given to the method of generalizing and analogue method, realizing that related terms should mean similar and almost similar contents. Modeling of competition and competitiveness is widely used in the present research, which made it possible to develop a logical model of competition following from the competition theory.Results. Based on the definitions’ survey the analysis of the subject matter of global

  15. Reliability of the Emergency Severity Index: Meta-analysis

    Directory of Open Access Journals (Sweden)

    Amir Mirhaghi

    2015-01-01

    Full Text Available Objectives: Although triage systems based on the Emergency Severity Index (ESI have many advantages in terms of simplicity and clarity, previous research has questioned their reliability in practice. Therefore, the aim of this meta-analysis was to determine the reliability of ESI triage scales. Methods: This metaanalysis was performed in March 2014. Electronic research databases were searched and articles conforming to the Guidelines for Reporting Reliability and Agreement Studies were selected. Two researchers independently examined selected abstracts. Data were extracted in the following categories: version of scale (latest/older, participants (adult/paediatric, raters (nurse, physician or expert, method of reliability (intra/inter-rater, reliability statistics (weighted/unweighted kappa and the origin and publication year of the study. The effect size was obtained by the Z-transformation of reliability coefficients. Data were pooled with random-effects models and a meta-regression was performed based on the method of moments estimator. Results: A total of 19 studies from six countries were included in the analysis. The pooled coefficient for the ESI triage scales was substantial at 0.791 (95% confidence interval: 0.787‒0.795. Agreement was higher with the latest and adult versions of the scale and among expert raters, compared to agreement with older and paediatric versions of the scales and with other groups of raters, respectively. Conclusion: ESI triage scales showed an acceptable level of overall reliability. However, ESI scales require more development in order to see full agreement from all rater groups. Further studies concentrating on other aspects of reliability assessment are needed.

  16. Dysphonia Severity Index in Typically Developing Indian Children.

    Science.gov (United States)

    Pebbili, Gopi Kishore; Kidwai, Juhi; Shabnam, Srushti

    2017-01-01

    Dysphonia is a variation in an individual's quality, pitch, or loudness from the voice characteristics typical of a speaker of similar age, gender, cultural background, and geographic location. Dysphonia Severity Index (DSI) is a recognized assessment tool based on a weighted combination of maximum phonation time, highest frequency, lowest intensity, and jitter (%) of an individual. Although dysphonia in adults is accurately evaluated using DSI, standard reference values for school-age children have not been studied. This study aims to document the DSI scores in typically developing children (8-12 years). A total of 42 typically developing children (8-12 years) without complaint of voice problem on the day of testing participated in the study. DSI was computed by substituting the raw scores of substituent parameters: maximum phonation time, highest frequency, lowest intensity, and jitter% using various modules of CSL 4500 software. The average DSI values obtained in children were 2.9 (1.23) and 3.8 (1.29) for males and females, respectively. DSI values are found to be significantly higher (P = 0.027) for females than those for males in Indian children. This could be attributed to the anatomical and behavioral differences among females and males. Further, pubertal changes set in earlier for females approximating an adult-like physiology, thereby leading to higher DSI values in them. The mean DSI value obtained for male and female Indian children can be used as a preliminary reference data against which the DSI values of school-age children with dysphonia can be compared. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index.

    Science.gov (United States)

    Chung, Ka-Fai; Kan, Katherine Ka-Ki; Yeung, Wing-Fai

    2011-05-01

    To compare the psychometric properties of the Chinese versions of Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS) and Sleep Quality Index (SQI) for assessment and screening of insomnia in adolescents. This is a school-based survey of 1516 adolescents aged 12-19 years. Sleep-wake habit questionnaire, ISI, AIS, SQI, Epworth Sleepiness Scale (ESS) and 12-item General Health Questionnaire (GHQ-12) were administered. Insomnia Interview Schedule was used to assess the severity of insomnia symptoms and DSM-IV-TR diagnosis of insomnia. The Cronbach's alpha of ISI, AIS and SQI were 0.83, 0.81 and 0.65, respectively, and the 2-week test-retest reliability were 0.79, 0.80 and 0.72. All three scales had a 2-factor structure, and their scores were significantly correlated with sleep-wake variables, ESS and GHQ-12 scores, smoking and drinking habits, and academic performance. The areas under curve of ISI, AIS and SQI for detecting clinical insomnia were 0.85, 0.80 and 0.85, respectively. The optimal cut-offs for ISI, AIS and SQI were a total score of nine (sensitivity/specificity: 0.87/0.75), seven (sensitivity/specificity: 0.78/0.74) and five (sensitivity/specificity: 0.83/0.79), respectively. The Chinese versions of ISI, AIS and SQI are reliable and valid instruments. The ISI and AIS appear to have better psychometric properties than the SQI. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. The essentials of a global index for cognitive function

    Directory of Open Access Journals (Sweden)

    Antony Joseph Mathew

    2017-09-01

    Full Text Available Cognition is comprised of the faculties: perception, creativity, intuition, and ratiocination. Optimal levels of cognition are needed for independent functioning and balanced living. With an aging population that continues to grow, dietary supplements that tilt the balance towards maintenance of cognition are being marketed for vulnerable populations facing these challenges. Randomized clinical trials provide the causal inference necessary to define the efficacy of emerging nutraceuticals. Cognition testing, in particular, requires a battery of tests that encompass all brain regions involved in cognition so as to provide endpoints necessary for product validation. The lack of well controlled studies for comparison analyses, limited sample sizes, ambiguous dosages, and poor cognitive measures result in data that cannot be compared across studies to determine the efficacy of supplements claiming to enhance cognition. Clinical trials for the nutraceutical industry should consider the multifaceted nature of supplements, where clinical endpoints must be comprehensive while remaining feasible. Combining endpoints of cognition with physiological biomarkers of immunity and metabolism to arrive at a global index for cognitive health may be necessary for claim substantiation in order to fully justify and scientifically validate improvements in cognitive health. The issues and needs of a global index will be discussed here.

  19. Higher body mass index associated with severe early childhood caries.

    Science.gov (United States)

    Davidson, Katherine; Schroth, Robert J; Levi, Jeremy A; Yaffe, Aaron B; Mittermuller, Betty-Anne; Sellers, Elizabeth A C

    2016-08-20

    Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC. Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC. Analysis was restricted to children ≥ 24 months of age. Parents completed a questionnaire and heights and weights were recorded. BMI scores and age and gender adjusted BMI z-scores and percentiles were calculated. A p-value ≤ 0.05 was significant. Two hundred thirty-five children were included (141 with S-ECC and 94 caries-free). The mean age was 43.3 ± 12.8 months and 50.2 % were male. Overall, 34.4 % of participants were overweight or obese. Significantly more children with S-ECC were classified as overweight or obese when compared to caries-free children (p = 0.038) and had significantly higher mean BMI z-scores than caries-free children (0.78 ± 1.26 vs. 0.22 ± 1.36, p = 0.002). Those with S-ECC also had significantly higher BMI percentiles (69.0 % ± 29.2 vs. 56.8 % ± 31.7, p = 0.003). Multiple linear regression analyses revealed that BMI z-scores were significantly and independently associated with S-ECC and annual household income as were BMI percentiles. Children with S-ECC in our sample had significantly higher BMI z-scores than caries-free peers.

  20. Global Food Security Index Studies and Satellite Information

    Science.gov (United States)

    Medina, T. A.; Ganti-Agrawal, S.; Joshi, D.; Lakhankar, T.

    2017-12-01

    Food yield is equal to the total crop harvest per unit cultivated area. During the elapsed time of germination and frequent harvesting, both human and climate related effects determine a country's' contribution towards global food security. Each country across the globe's annual income per capita was collected to then determine nine countries for further studies. For a location to be chosen, its income per capita needed to be considered poor, uprising or wealthy. Both physical land cover and regional climate helped categorize potential parameters thought to be studied. Once selected, Normalized Difference Vegetation Index (NDVI) data was collected for Ethiopia, Liberia, Indonesia, United States, Norway, Russia, Kuwait and Saudi Arabia over the recent 16 years for approximately every 16 days starting from early in the year 2000. Software languages such as Geographic Information System (GIS), MatLab and Excel were used to determine how population size, income and deforestation directly determines agricultural yields. Because of high maintenance requirements for large harvests when forest areas are cleared, they often have a reduction in soil quality, requiring fertilizer use to produce sufficient crop yields. Total area and vegetation index of each country is to be studied, to determine crop and deforestation percentages. To determine how deforestation impacts future income and crop yield predictions of each country studied. By using NDVI results a parameter is to be potentially found that will help define an index, to create an equation that will determine a country's annual income and ability to provide for their families and themselves.

  1. TAX HAVENS IN THE GLOBAL FINANCIAL CENTERS INDEX

    Directory of Open Access Journals (Sweden)

    Ana-Maria GEAMÃNU

    2014-04-01

    Full Text Available Previously scrutinized for adopting harmful fiscal measures, tax havens have progressively adhered to the internationally agreed principles of transparency and exchange of information for tax purposes promoted by the Organization for Economic Cooperation and Development (OECD. In this respect, important amendments have been made to both their tax and commercial legislation. Their main competitive advantage remains the favorable fiscal systems characterized by 0% tax rates which have favored the development of well established financial services sectors. The aim of this paper is to analyze the fiscal framework offered by six former tax haven jurisdictions: Monaco, Jersey, Guernsey, Cayman Islands, Isle of Man and British Virgin Islands, which occupy high ranks in the Global Financial Centers Index. The results come to emphasize the importance of these jurisdictions’ tax systems in the development of strong financial sectors.

  2. Correlation Between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis Treated with Ustekinumab

    DEFF Research Database (Denmark)

    Hesselvig, Jeanette Halskou; Egeberg, Alexander; Loft, Nikolai Dyrberg

    2018-01-01

    Monitoring of biological treatment efficacy for psoriasis is based on clinical evaluation and patient's quality of life. However, long-term correlation between Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in real life has not been studied in patients treated...

  3. Damage severity estimation from the global stiffness decrease

    International Nuclear Information System (INIS)

    Nitescu, C; Gillich, G R; Manescu, T; Korka, Z I; Abdel Wahab, M

    2017-01-01

    In actual damage detection methods, localization and severity estimation can be treated separately. The severity is commonly estimated using fracture mechanics approach, with the main disadvantage of involving empirically deduced relations. In this paper, a damage severity estimator based on the global stiffness reduction is proposed. This feature is computed from the deflections of the intact and damaged beam, respectively. The damage is always located where the bending moment achieves maxima. If the damage is positioned elsewhere on the beam, its effect becomes lower, because the stress is produced by a diminished bending moment. It is shown that the global stiffness reduction produced by a crack is the same for all beams with a similar cross-section, regardless of the boundary conditions. One mathematical relation indicating the severity and another indicating the effect of removing damage from the beam. Measurements on damaged beams with different boundary conditions and cross-sections are carried out, and the location and severity are found using the proposed relations. These comparisons prove that the proposed approach can be used to accurately compute the severity estimator. (paper)

  4. A winter severity index for the state of Maine.

    Science.gov (United States)

    2009-01-01

    Winter maintenance in the Sate of Maine consumes around twenty percent of the Bureau of : Maintenance and Operations budget each year. Costs are directly related to the length and severity : of a winter season. In addition, the cost of materials and ...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. How severe space weather can disrupt global supply chains

    Science.gov (United States)

    Schulte in den Bäumen, H.; Moran, D.; Lenzen, M.; Cairns, I.; Steenge, A.

    2014-10-01

    Coronal mass ejections (CMEs) strong enough to create electromagnetic effects at latitudes below the auroral oval are frequent events that could soon have substantial impacts on electrical grids. Modern society's heavy reliance on these domestic and international networks increases our susceptibility to such a severe space-weather event. Using a new high-resolution model of the global economy, we simulate the economic impact of strong CMEs for three different planetary orientations. We account for the economic impacts within the countries directly affected, as well as the post-disaster economic shock in partner economies linked by international trade. For a 1989 Quebec-like event, the global economic impacts would range from USD 2.4 to 3.4 trillion over a year. Of this total economic shock, about 50% would be felt in countries outside the zone of direct impact, leading to a loss in global Gross Domestic Product (GDP) of 3.9 to 5.6%. The global economic damage is of the same order as wars, extreme financial crisis and estimated for future climate change.

  7. The impact of global warming on the Southern Oscillation Index

    Energy Technology Data Exchange (ETDEWEB)

    Power, Scott B.; Kociuba, Greg [Bureau of Meteorology, Centre for Australian Weather and Climate Research, Melbourne (Australia)

    2011-11-15

    The Southern Oscillation Index (SOI) - a measure of air pressure difference across the Pacific Ocean, from Tahiti in the south-east to Darwin in the west - is one of the world's most important climatic indices. The SOI is used to track and predict changes in both the El Nino-Southern Oscillation phenomenon, and the Walker Circulation (WC). During El Nino, for example, the WC weakens and the SOI tends to be negative. Climatic variations linked to changes in the WC have a profound influence on climate, ecosystems, agriculture, and societies in many parts of the world. Previous research has shown that (1) the WC and the SOI weakened in recent decades and that (2) the WC in climate models tends to weaken in response to elevated atmospheric greenhouse gas concentrations. Here we examine changes in the SOI and air pressure across the Pacific in the observations and in numerous WCRP/CMIP3 climate model integrations for both the 20th and 21st centuries. The difference in mean-sea level air pressure (MSLP) between the eastern and western equatorial Pacific tends to weaken during the 21st century, consistent with previous research. Here we show that this primarily arises because of an increase in MSLP in the west Pacific and not a decline in the east. We also show, in stark contrast to expectations, that the SOI actually tends to increase during the 21st century, not decrease. Under global warming MSLP tends to increase at both Darwin and Tahiti, but tends to rise more at Tahiti than at Darwin. Tahiti lies in an extensive region where MSLP tends to rise in response to global warming. So while the SOI is an excellent indicator of interannual variability in both the equatorial MSLP gradient and the WC, it is a highly misleading indicator of long-term equatorial changes linked to global warming. Our results also indicate that the observed decline in the SOI in recent decades has been driven by natural, internally generated variability. The externally forced signal in the

  8. Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease: the DOSE Index.

    Science.gov (United States)

    Jones, Rupert C; Donaldson, Gavin C; Chavannes, Niels H; Kida, Kozui; Dickson-Spillmann, Maria; Harding, Samantha; Wedzicha, Jadwiga A; Price, David; Hyland, Michael E

    2009-12-15

    Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a multicomponent disease with systemic consequences and effects on quality of life. Single measures such as lung function provide a limited reflection of how the disease affects patients. Composite measures have the potential to account for many of the facets of COPD. To derive and validate a multicomponent assessment tool of COPD severity that is applicable to all patients and health care settings. The index was derived using data from 375 patients with COPD in primary care. Regression analysis led to a model explaining 48% of the variance in health status as measured by the Clinical COPD Questionnaire with four components: dyspnea (D), airflow obstruction (O), smoking status (S), and exacerbation frequency (E). The DOSE Index was validated in cross-sectional and longitudinal samples in various health care settings in Holland, Japan, and the United Kingdom. The DOSE Index correlated with health status in all data sets. A high DOSE Index score (> or = 4) was associated with a greater risk of hospital admission (odds ratio, 8.3 [4.1-17]) or respiratory failure (odds ratio, 7.8 [3.4-18.3]). The index predicted exacerbations in the subsequent year (P Index is a simple, valid tool for assessing the severity of COPD. The index is related to a range of clinically important outcomes such as health care consumption and predicts future events.

  9. Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people.

    Science.gov (United States)

    Yu, Doris S F

    2010-10-01

    This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0.81, with item-to-total correlations in the range of 0.34-0.67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. © 2010 The

  10. Interval Changes in Myocardial Performance Index Predict Outcome in Severe Sepsis.

    Science.gov (United States)

    Nizamuddin, Junaid; Mahmood, Feroze; Tung, Avery; Mueller, Ariel; Brown, Samuel M; Shaefi, Shahzad; O'Connor, Michael; Talmor, Daniel; Shahul, Sajid

    2017-06-01

    Septic cardiomyopathy is a well-described consequence of septic shock and is associated with increased sepsis-related mortality. The myocardial performance index (MPI), a parameter derived from echocardiographic tissue Doppler measurements, allows for a more sensitive assessment of global cardiac function than do traditional metrics for cardiac function. The authors hypothesized that changes in left ventricular MPI in patients with severe sepsis would be associated with a higher 90-day mortality. Prospective, observational study. Intensive care units of a tertiary medical center. The study comprised 47 patients admitted with new diagnoses of severe sepsis or septic shock. All patients underwent transthoracic echocardiograms with assessment of MPI at enrollment and 24 hours later. Hemodynamic data and information on sepsis-related mortality were collected. In the primary analysis, the association between change in MPI from enrollment to 24 hours and sepsis-related 90-day mortality was assessed. Of the 47 patients enrolled, 30 demonstrated an improvement in MPI from 0 to 24 hours ("improved" group), and MPI worsened in the remaining 17 patients ("worsened" group). Despite no significant differences in ejection fraction or severity of illness, the median MPI at enrollment in the "improved" group was higher than baseline values in the "worsened" group (p = 0.005). A worsening MPI over the 24-hour study interval was associated with increased mortality at 90 days (p = 0.04), which remained significant (hazard ratio 3.72; 95% confidence interval 1.12-12.41; p = 0.03) after adjusting for severity of illness (Acute Physiology and Chronic Health Evaluation II score), intravenous fluids, and vasopressor use. In patients admitted to the intensive care unit with a diagnosis of severe sepsis or septic shock, a worsening MPI during the first 24 hours after intensive care unit admission was associated with higher 90-day mortality. Copyright © 2017 Elsevier Inc. All rights

  11. Development of a global Agricultural Stress Index System (ASIS) based on remote sensing data

    Science.gov (United States)

    Van Hoolst, R.

    2016-12-01

    According to the 2012 IPCC SREX report, extreme drought events are projected to become more frequent and intense in several regions of the world. Wide and timely monitoring systems are required to mitigate the impact of agricultural drought. Therefore, FAO's Global Information and Early Warning System (GIEWS) and the Climate, Energy and Tenure Division (NRC) have established the `Agricultural Stress Index System' (ASIS). The ASIS is a remote sensing application that provides early warnings of agricultural drought at a global scale. The ASIS has first been designed and described by Rojas et al. (2011). This study focused on the African continent and was based on the back processing of low resolution data of the NOAA-satellites. In the current setup, developed by VITO (Flemish Institute for Technological Research), the system operates in Near Real Time using data from the METOP-AVHRR sensor. The Agricultural Stress Index (ASI) is the percentage of agricultural area affected by drought in the course of the growing season within a given administrative unit. The start and end of the growing season are derived per pixel from the long term NDVI average of SPOT-VEGETATION. The Global Administrative Unit Layer (GAUL) defines the administrative boundaries at level 0, 1 and 2. A global cropland and grassland map eliminates non-agricultural areas. Temperature and NDVI anomalies are used as drought indicators and calculated at a per pixel base. The ASIS aggregates this information and produces every dekad global maps to highlight hotspots of drought stress. New developments are ongoing to strengthen the ASIS to produce country specific outputs, improve existing drought indicators and estimate production deficits using a probabilistic approach.

  12. Prediction of monthly average global solar radiation based on statistical distribution of clearness index

    International Nuclear Information System (INIS)

    Ayodele, T.R.; Ogunjuyigbe, A.S.O.

    2015-01-01

    In this paper, probability distribution of clearness index is proposed for the prediction of global solar radiation. First, the clearness index is obtained from the past data of global solar radiation, then, the parameters of the appropriate distribution that best fit the clearness index are determined. The global solar radiation is thereafter predicted from the clearness index using inverse transformation of the cumulative distribution function. To validate the proposed method, eight years global solar radiation data (2000–2007) of Ibadan, Nigeria are used to determine the parameters of appropriate probability distribution for clearness index. The calculated parameters are then used to predict the future monthly average global solar radiation for the following year (2008). The predicted values are compared with the measured values using four statistical tests: the Root Mean Square Error (RMSE), MAE (Mean Absolute Error), MAPE (Mean Absolute Percentage Error) and the coefficient of determination (R"2). The proposed method is also compared to the existing regression models. The results show that logistic distribution provides the best fit for clearness index of Ibadan and the proposed method is effective in predicting the monthly average global solar radiation with overall RMSE of 0.383 MJ/m"2/day, MAE of 0.295 MJ/m"2/day, MAPE of 2% and R"2 of 0.967. - Highlights: • Distribution of clearnes index is proposed for prediction of global solar radiation. • The clearness index is obtained from the past data of global solar radiation. • The parameters of distribution that best fit the clearness index are determined. • Solar radiation is predicted from the clearness index using inverse transformation. • The method is effective in predicting the monthly average global solar radiation.

  13. Global lightning and severe storm monitoring from GPS orbit

    Energy Technology Data Exchange (ETDEWEB)

    Suszcynsky, D. M. (David M.); Jacobson, A. R.; Linford, J (Justin); Pongratz, M. B. (Morris B.); Light, T. (Tracy E.); Shao, X. (Xuan-Min)

    2004-01-01

    Over the last few decades, there has been a growing interest to develop and deploy an automated and continuously operating satellite-based global lightning mapper [e.g. Christian et al., 1989; Weber et al., 1998; Suszcynsky et al., 2000]. Lightning is a direct consequence of the electrification and breakdown processes that take place during the convective stages of thunderstorm development. Satellite-based lightning mappers are designed to exploit this relationship by using lightning detection as a proxy for remotely identifying, locating and characterizing strong convective activity on a global basis. Global lightning and convection mapping promises to provide users with (1) an enhanced global severe weather monitoring and early warning capability [e.g. Weber et al., 1998] (2) improved ability to optimize aviation flight paths around convective cells, particularly over oceanic and remote regions that are not sufficiently serviced by existing weather radar [e.g. Weber et al., 1998], and (3) access to regional and global proxy data sets that can be used for scientific studies and as input into meteorological forecast and global climatology models. The physical foundation for satellite-based remote sensing of convection by way of lightning detection is provided by the basic interplay between the electrical and convective states of a thundercloud. It is widely believed that convection is a driving mechanism behind the hydrometeor charging and transport that produces charge separation and lightning discharges within thunderclouds [e.g. see chapter 3 in MacGorman and Rust, 1998]. Although cloud electrification and discharge processes are a complex function of the convective dynamics and microphysics of the cloud, the fundamental relationship between convection and electrification is easy to observe. For example, studies have shown that the strength of the convective process within a thundercell can be loosely parameterized (with large variance) by the intensity of the

  14. Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

    DEFF Research Database (Denmark)

    Jander, Nikolaus; Gohlke-Bärwolf, Christa; Bahlmann, Edda

    2014-01-01

    To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are......To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are...

  15. Global Insights Based on the Multidimensional Energy Poverty Index (MEPI

    Directory of Open Access Journals (Sweden)

    Mark Howells

    2013-05-01

    Full Text Available Energy access metrics are needed to track the progress towards providing sustainable energy for all. This paper presents advancements in the development of the Multidimensional Energy Poverty Index (MEPI, as well as results and analysis for a number of developing countries. The MEPI is a composite index designed to shed light on energy poverty by assessing the services that modern energy provides. The index captures both the incidence and intensity of energy poverty. It provides valuable insights–allowing the analysis of determinants of energy poverty–and, subsequently insights into policy efficacy. Building on previous work, this paper presents results obtained as a result of both increased data availability and enhanced methodology. Specifically, this analysis (i includes an increased number of countries, and (ii tracks the evolution of energy poverty over time of energy poverty in selected countries is reported.

  16. PASI (Psoriasis Area and Severity Index in the evaluation of the clinical manifestations of psoriasis

    Directory of Open Access Journals (Sweden)

    A. A. Kubanov

    2016-01-01

    Full Text Available Psoriasis is one of the most prevalent chronic inflammatory skin diseases. The severity of its clinical manifestations can vary greatly. Objective assessment of psoriasis severity is required to select an adequate therapy. One of the simplest and most consistent methods used to determine psoriasis severity is to calculate the PASI (Psoriasis Area and Severity Index. This index is based on the doctor’s determination of the sum of indices showing the intensity of the main symptoms of psoriasis: erythema, infiltration and peeling in view of the affected skin area. The PASI can also be used to assess the efficacy of treatment for psoriasis patients.

  17. Mercurious Oil Index (MOI) : A new indicator for the global oil price

    OpenAIRE

    Leeuw, de, J.; Dorsman, A.B.; Nelissen, R.

    2008-01-01

    “The” price of oil does not exist. This paper describes the development of a (new) oil index, the Mercurious Oil Index (MOI). This index can be seen as an indicator for the global price of oil. We will discuss why this index is a reliable global price reference, and why it is superior to and more useful than the existing indices and/or benchmarks. Indices are very helpful instruments for the tracking and prediction of markets, to measure performance or sentiment and to form a solid basis on w...

  18. The Economic Crisis and Several Effects on Global Economy

    Directory of Open Access Journals (Sweden)

    Florina BRAN

    2011-01-01

    Full Text Available The main mechanism of profit making is not production according to the outcomes of several analyses of the current economic crisis. This mechanism is circulation and exchange. Starting with this observation the paper goes through a number of aspects regarding the relation between crisis and economy at global level. These aspects consist in the recent financial turmoil; who pays for the crisis; stabilizing the financial sector; recession and the financial crisis; the internationalization of the crisis; commodities and the ecological crisis; an end to neo-liberalism; what should socialists demand. We notice and comment on how important current development in the wake of the banking crisis is for the transmission of that crisis to the rest of the economy and its interaction with the more general economic crisis now emerging. It was concluded that there are good chances that the current economic order to be broken. The future shape of the order will depend more on vision of managers than on the influence of the so called objective factors.

  19. Global oncofertility index-data gap slows progress

    NARCIS (Netherlands)

    Roo, S.F. de; Rashedi, A.S.; Beerendonk, C.C.M.; Anazodo, A.; Man, A.M. de; Nelen, W.L.D.M.; Woodruff, T.K.

    2017-01-01

    The number of pediatric and young adult cancer survivors is increasing globally due to earlier diagnostics and expansion of targeted chemo- and biological-based therapeutics. As a consequence, cancer-related infertility and reproductive hormone loss is of increasing concern for both male and female

  20. Development of a Global Lifelong Learning Index for Future Education

    Science.gov (United States)

    Kim, JuSeuk

    2016-01-01

    Since the transition from industrial society to a knowledge-based society, the source of national competitiveness is also changing. In this context, lifelong education has become a new competitive strategy for countries. This study broadly consists of three steps. Step I features a theoretical review of global lifelong learning indices and a…

  1. A Computer Adaptive Testing Version of the Addiction Severity Index-Multimedia Version (ASI-MV): The Addiction Severity CAT

    Science.gov (United States)

    Butler, Stephen F.; Black, Ryan A.; McCaffrey, Stacey A.; Ainscough, Jessica; Doucette, Ann M.

    2017-01-01

    The purpose of this study was to develop and validate a computer adaptive testing (CAT) version of the Addiction Severity Index-Multimedia Version (ASI-MV®), the Addiction Severity CAT. This goal was accomplished in four steps. First, new candidate items for Addiction Severity CAT domains were evaluated after brainstorming sessions with experts in substance abuse treatment. Next, this new item bank was psychometrically evaluated on a large non-clinical (n =4419) and substance abuse treatment sample (n =845). Based on these results, final items were selected and calibrated for the creation of the Addiction Severity CAT algorithms. Once the algorithms were developed for the entire assessment, a fully functioning prototype of an Addiction Severity CAT was created. CAT simulations were conducted and optimal termination criteria were selected for the Addiction Severity CAT algorithms. Finally, construct validity of the CAT algorithms was evaluated by examining convergent/discriminant validity and sensitivity to change. The Addiction Severity CAT was determined to be valid, sensitive to change, and reliable. Further, the Addiction Severity CAT’s time of administration was found to be significantly less than the average time of administration for the ASI-MV composite scores. This study represents the initial validation of an IRT-based Addiction Severity CAT, and further exploration of the Addiction Severity CAT is needed. PMID:28230387

  2. A computer adaptive testing version of the Addiction Severity Index-Multimedia Version (ASI-MV): The Addiction Severity CAT.

    Science.gov (United States)

    Butler, Stephen F; Black, Ryan A; McCaffrey, Stacey A; Ainscough, Jessica; Doucette, Ann M

    2017-05-01

    The purpose of this study was to develop and validate a computer adaptive testing (CAT) version of the Addiction Severity Index-Multimedia Version (ASI-MV), the Addiction Severity CAT. This goal was accomplished in 4 steps. First, new candidate items for Addiction Severity CAT domains were evaluated after brainstorming sessions with experts in substance abuse treatment. Next, this new item bank was psychometrically evaluated on a large nonclinical (n = 4,419) and substance abuse treatment (n = 845) sample. Based on these results, final items were selected and calibrated for the creation of the Addiction Severity CAT algorithms. Once the algorithms were developed for the entire assessment, a fully functioning prototype of an Addiction Severity CAT was created. CAT simulations were conducted, and optimal termination criteria were selected for the Addiction Severity CAT algorithms. Finally, construct validity of the CAT algorithms was evaluated by examining convergent and discriminant validity and sensitivity to change. The Addiction Severity CAT was determined to be valid, sensitive to change, and reliable. Further, the Addiction Severity CAT's time of completion was found to be significantly less than the average time of completion for the ASI-MV composite scores. This study represents the initial validation of an Addiction Severity CAT based on item response theory, and further exploration of the Addiction Severity CAT is needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Vegetation Index and Phenology (VIP) Vegetation Indices Monthly Global 0.05Deg CMG V004

    Data.gov (United States)

    National Aeronautics and Space Administration — The NASA Making Earth System Data Records for Use in Research Environments (MEaSUREs) Vegetation Index and Phenology (VIP) global datasets were created using...

  4. Auroral Electrojet Index Designed to Provide a Global Measure, Hourly Intervals, of Auroral Zone Magnetic Activity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Auroral Electrojet (AE) index is designed to provide a global quantitative measure of auroral zone magnetic activity produced by enhanced ionospheric currents...

  5. Hemodynamic comparison of mild and severe preeclampsia: concept of stroke systemic vascular resistance index.

    Science.gov (United States)

    Scardo, J; Kiser, R; Dillon, A; Brost, B; Newman, R

    1996-01-01

    Our purpose was to compare baseline hemodynamic parameters of mild and severe preeclampsia. Patients admitted to the Medical University Labor and Delivery Unit with the diagnosis of preeclampsia who had not received prior antihypertensive or magnesium sulfate therapy were recruited for noninvasive hemodynamic monitoring with thoracic electrical bioimpedance. After stabilization in the lateral recumbent position, hemodynamic monitoring was begun. Baseline hemodynamic parameters, mean arterial pressure (MAP), heart rate (HR), systemic vascular resistance index (SVRI), cardiac index (CI), and stroke index (SI) were recorded. Stroke systemic vascular resistance index (SSVRI), the resistance imposed by vasculature on each beat of the heart, was calculated for each patient by multiplying SVRI by HR. For statistical analysis, unpaired Student's t-tests (two-tailed) were utilized (P preclampsia appears to be a more intensely vasoconstricted state than mild preeclampsia. Although CI is inversely proportional to SVRI, increased HR in severe preeclampsia prevents this expected decrease in cardiac output.

  6. Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

    Directory of Open Access Journals (Sweden)

    Carlos Polanco

    2013-01-01

    Full Text Available A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010 taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts.

  7. Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

    Science.gov (United States)

    Castañón-González, Jorge Alberto; Macías, Alejandro E.; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián

    2013-01-01

    A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts. PMID:24069063

  8. Analysis and Research on Several Global Subdivision Grids

    Directory of Open Access Journals (Sweden)

    SONG Shuhua

    2016-12-01

    Full Text Available In order to solve the problem that lacking of an unified organization frame about global remote sensing satellite image data, this paper introduces serval global subdivision grids as the unified organization frame for remote sensing image. Based on the characteristics of remote sensing image data, this paper analyzes and summarizes the design principles and difficulties of the organization frame. Based on analysis and comparison with these grids, GeoSOT is more suitable as the unified organization frame for remote sensing image. To provide a reference for the global remote sensing image organization.

  9. The Global Index of Vegetation-Plot Databases 1 (GIVD): a new resource for vegetation science

    NARCIS (Netherlands)

    Dengler, J.; Jansen, F.; Glockler, F.; Schaminee, J.H.J.

    2011-01-01

    Question: How many vegetation plot observations (relevés) are available in electronic databases, how are they geographically distributed, what are their properties and how might they be discovered and located for research and application? Location: Global. Methods: We compiled the Global Index of

  10. Representation of geographic terrain surface using global indexing

    DEFF Research Database (Denmark)

    Kolar, Jan

    2004-01-01

    . Unlike cartographic maps, 3D models can capture the geometry of geographic features without flattening the environment, without cartographic projection?can avoid geometric distortion. More interestingly, however, 3D models can be composed into a single model spanning the whole world; it can be navigated...... visually in order to access information and data in the same geometric space as we navigate ourselves in our real environment.   This article attempts to narrow down the overhead of problems in visualization of 3D geographic information and intends to identify fundamental issues common to other systems......A global 3D geographic model a feasible solution for its visualization and management remains a challenging vision. The existence of a reusable platform would provide an unprecedented potential for development of applications related to geography and facilitate comprehension of geographic data...

  11. Proposing melasma severity index: A new, more practical, office-based scoring system for assessing the severity of melasma

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2016-01-01

    Full Text Available Background: Melasma Area and Severity Index (MASI, the scoring system in melasma, needs to be refined. Aims and Objectives: To propose a more practical scoring system, named as Melasma Severity Index (MSI, for assessing the disease severity and treatment response in melasma. Materials and Methods: Four dermatologists were trained to calculate MASI and also the proposed MSI scores. For MSI, the formula used was 0.4 (a × p 2 l + 0.4 (a × p 2 r + 0.2 (a × p 2 n where "a" stands for area, "p" for pigmentation, "l" for left face, "r" for right face, and "n" for nose. On a single day, 30 enrolled patients were randomly examined by each trained dermatologist and their MASI and MSI scores were calculated. Next, each rater re-examined every 6 th patient for repeat MASI and MSI scoring to assess intra- and inter-rater reliability of MASI and MSI scores. Validity was assessed by comparing the individual scores of each rater with objective data from mexameter and ImageJ software. Results: Inter-rater reliability, as assessed by intraclass correlation coefficient, was significantly higher for MSI (0.955 as compared to MASI (0.816. Correlation of scores with objective data by Spearman′s correlation revealed higher rho values for MSI than for MASI for all raters. Limitations: Sample population belonged to a single ethnic group. Conclusions: MSI is simpler and more practical scoring system for melasma.

  12. Relationships between interplanetary quantities and the global auroral electrojet index

    International Nuclear Information System (INIS)

    Meloni, A.; Wolfe, A.; Lanzerotti, L.J.

    1982-01-01

    We have studied, using linear cross correlation and multilinear regression analyses, statistical relations between the magnetospheric auroral electrojet intensity index AE and various parameters characterizing the interplanetary plasma and magnetic field. We also consider the recently proposed epsilon parameter as an independent variable. The analyses were carried out separately for twenty-eight days in mid 1975 and for each of five individual magnetic storm intervals that have been previously discussed extensively in the literature. We find that when the interplanetary data set is not distinguished as to the direction of the north-south component B/sub z/, the interplanetary electric field -VB/sub z/ carried to the front of the magnetosphere correlates with AE substantially better than does epsilon. Considering only data during which B/sub z/ is negative gives a slightly better correlation of epsilon with AE than of the electric field with AE. The correlations are valid for the specific storm periods as well as for the unrestricted twenty-eight days of data. Our results suggest that the physical processes involved in energy transfer to the nightside magnetosphere depend upon the direction of the north-south component of the interplanetary magnetic field: the interplanetary electric field plays an important role during northward B/sub z/ and the epsilon parameter and the electric field both provide an indication of energy transfer and substorm activity during southward B/sub z/

  13. Psychometric Characteristics of the Teen Addiction Severity Index-Two (T-ASI-2)

    Science.gov (United States)

    Brodey, Benjamin B.; McMullin, Darcy; Kaminer, Yifrah; Winters, Ken C.; Mosshart, Edward; Rosen, Craig S.; Brodey, Inger S.

    2008-01-01

    The Teen Addiction Severity Index-Two (T-ASI-2) was developed as an extension of the T-ASI to assess the severity of substance abuse and related problems among adolescents (N = 371) 12-19 years of age. The T-ASI-2 consists of 18 domains that assess current use of alcohol, tobacco, marijuana, and other drugs, as well as mental health service…

  14. The Addiction Severity Index: Reliability and validity in a Dutch alcoholic population

    NARCIS (Netherlands)

    Dejong, C.A.J.; Willems, J.C.E.W.; Schippers, G.M.; Hendriks, V.M.

    1995-01-01

    The Addiction Severity Index (ASI) was evaluated for its psychometric qualities in a Dutch alcoholic population admitted to an addiction treatment center in the Netherlands. Its factorial structure in this population was found to be consistent with the established six factor structure of the ASI.

  15. The extremity function index (EFI), a disability severity measure for neuromuscular diseases : psychometric evaluation

    NARCIS (Netherlands)

    Bos, Isaac; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Joannes

    2017-01-01

    OBJECTIVE: To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease

  16. Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study

    NARCIS (Netherlands)

    Storm-Versloot, M. N.; Ubbink, D. T.; Chin a Choi, V.; Luitse, J. S. K.

    2009-01-01

    Objectives: To compare inter and intra-observer agreement of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI). Methods: 50 representative emergency department (ED) scenarios derived from actual cases were presented to 18 ED nurses from three different hospitals. Eight of

  17. The relationship between the Nasality Severity Index 2.0 and perceptual judgments of hypernasality.

    NARCIS (Netherlands)

    K. Bettens; Anke Luyten; F. Wuyts; M. de Bodt; K. van Lierde; Y. Maryn

    2016-01-01

    PURPOSE: The Nasality Severity Index 2.0 (NSI 2.0) forms a new, multiparametric approach in the identification of hypernasality. The present study aimed to investigate the correlation between the NSI 2.0 scores and the perceptual assessment of hypernasality. METHOD: Speech samples of 35 patients,

  18. Sensitivity of the Addiction Severity Index physical and sexual assault items: preliminary findings on gender differences

    NARCIS (Netherlands)

    Langeland, W.; van den Brink, W.; Draijer, N.; Hartgers, C.

    2001-01-01

    Evaluation of the Addiction Severity Index (ASI) as a screen for identifying sexual and physical assault histories. The sensitivity and specificity of the ASI assault items were examined in 146 alcoholic patients with the assault questions of the Composite International Diagnostic Interview

  19. Hyperemic stenosis resistance index for evaluation of functional coronary lesion severity

    NARCIS (Netherlands)

    Meuwissen, Martijn; Siebes, Maria; Chamuleau, Steven A. J.; van Eck-Smit, Berthe L. F.; Koch, Karel T.; de Winter, Robbert J.; Tijssen, Jan G. P.; Spaan, Jos A. E.; Piek, Jan J.

    2002-01-01

    Background-Both coronary blood flow velocity reserve (CFVR) and myocardial fractional flow reserve (FFR) are used to evaluate the hemodynamic severity of coronary lesions. However, discordant results between CFVR and FFR have been observed in 25%, to 30% of intermediate coronary lesions. An index of

  20. Development and validation of the Dyspnea Index (DI): a severity index for upper airway-related dyspnea.

    Science.gov (United States)

    Gartner-Schmidt, Jackie L; Shembel, Adrianna C; Zullo, Thomas G; Rosen, Clark A

    2014-11-01

    To (1) develop and validate the Dyspnea Index (DI); (2) quantify severity of symptoms in upper airway dyspnea; and (3) validate the DI as an outcome measure. Survey development and validation. Three hundred sixty-nine participants were recruited for different phases of the study. Two hundred participants with chief complaints of dyspnea were given a 41-item questionnaire addressing common symptoms of dyspnea related to the upper airway. The questions were then reduced based on principal component analysis (PCA) and internal consistency resulting in a 10-item questionnaire. Cognitive interviews were conducted with 15 participants. Test-retest reliability and discriminant validity were measured from 51 participants. The DI was further validated by administering the index to 57 healthy controls (HC). Validation of the DI as a treatment outcome tool occurred with 46 participants' pre- and post-treatment scores. PCA revealed that only a single factor was being measured in both the original 41- and 10-item questionnaires. Additional cognitive interviewing suggested that no modification was needed to the DI. Test-retest reliability was r = 0.83. Discriminant validity was r = 0.62. The Mann-Whitney test demonstrated significant differences between healthy/symptomatic participants. Scores from the HC cohort resulted in a mean of 3.12 (SEM = 0.484; SD = 3.65) for the normative values. The DI is an effective and efficient instrument to quantify patients' symptoms of upper airway dyspnea. It is a statistically robust index, with significant reliability and validity, and can be dependably used as a treatment outcome measure. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Bioimpedance index for measurement of total body water in severely malnourished children

    DEFF Research Database (Denmark)

    Girma, Tsinuel; Kæstel, Pernille; Workeneh, Netsanet

    2016-01-01

    BACKGROUND & OBJECTIVES: Restoration of body composition indicates successful management of severe acute malnutrition (SAM). Bioimpedance (BI) index (height(2)/resistance) is used to predict total body water (TBW) but its performance in SAM, especially with oedema, requires further investigation....... SUBJECTS/METHODS: Children with SAM (mid-arm circumference ...Hzs. Pre- and post-deuterium dose saliva samples were analysed using isotope-ratio mass spectrometry. TBW was regressed on H(2)/Z. Xc and R were height (H)-indexed, and Xc/H plotted against R/H. RESULTS: Thirty five children (16 non-oedematous and 19 oedematous) with median (interquartile range) age of 42...

  2. Construction of prediction intervals for Palmer Drought Severity Index using bootstrap

    Science.gov (United States)

    Beyaztas, Ufuk; Bickici Arikan, Bugrayhan; Beyaztas, Beste Hamiye; Kahya, Ercan

    2018-04-01

    In this study, we propose an approach based on the residual-based bootstrap method to obtain valid prediction intervals using monthly, short-term (three-months) and mid-term (six-months) drought observations. The effects of North Atlantic and Arctic Oscillation indexes on the constructed prediction intervals are also examined. Performance of the proposed approach is evaluated for the Palmer Drought Severity Index (PDSI) obtained from Konya closed basin located in Central Anatolia, Turkey. The finite sample properties of the proposed method are further illustrated by an extensive simulation study. Our results revealed that the proposed approach is capable of producing valid prediction intervals for future PDSI values.

  3. Association of body mass index with symptom severity and quality of life in patients with fibromyalgia.

    Science.gov (United States)

    Kim, Chul-Hyun; Luedtke, Connie A; Vincent, Ann; Thompson, Jeffrey M; Oh, Terry H

    2012-02-01

    To examine the association between body mass index (BMI) and symptom severity and quality of life (QOL) in patients with fibromyalgia. We assessed BMI status and its association with symptom severity and QOL in 888 patients with fibromyalgia who were seen in a fibromyalgia treatment program and who completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form 36 (SF-36) health survey. The BMI distribution of nonobese (BMI fibromyalgia-related symptoms with worse FIQ total scores (P fibromyalgia, severe obesity (BMI ≥35.0 kg/m(2)) is associated with higher levels of fibromyalgia symptoms and lower levels of QOL. Copyright © 2012 by the American College of Rheumatology.

  4. Global Redistributive Obligations in the Face of Severe Poverty

    DEFF Research Database (Denmark)

    Axelsen, David Vestergaard

    ? In the debate on global justice, a number of theorists argue that this discrepancy can indeed be justified (so-called anti-cosmopolitans). Thus, to bring us closer to answer regarding our redistributive obligations towards foreigners, I analyze and evaluate such arguments. My critical examination reveals...... comprehensive obligations to foreigners and compatriots simultaneously. Thus, even if we are duty-bound to redistribute comprehensively to compatriots, this does not entail that we could not also do so towards non-compatriots. Hence, their arguments are incomplete. Thirdly, I show that anti...

  5. Droughts in a warming climate: A global assessment of Standardized precipitation index (SPI) and Reconnaissance drought index (RDI)

    Science.gov (United States)

    Asadi Zarch, Mohammad Amin; Sivakumar, Bellie; Sharma, Ashish

    2015-07-01

    Both drought and aridity indicate imbalance in water availability. While drought is a natural temporal hazard, aridity is a constant climatic feature. This paper investigates the changes in drought characteristics across different aridity zones with and without consideration of potential evapotranspiration (PET), as a means to better assess drought in a warming climate. Two drought indexes are employed: (1) Standardized precipitation index (SPI), which is solely based on precipitation; and (2) Reconnaissance drought index (RDI), which, in addition to precipitation, takes PET into account. The two indexes are first employed to observed precipitation and PET data for the period 1960-2009 from the CRU (Climate Research Unit, University of East Anglia) TS 3.1 database. The results indicate that although all the aridity zones experience both downward and upward drought trends, no significant trend is found over large parts of the zones. However, the agreement between SPI and RDI reduces from the hyper-arid zone on one extreme toward the humid zone on the other. In the three more humid zones (i.e. semi-arid, sub-humid, and humid), the indexes exhibit different trends, with RDI showing more decreasing trends (i.e. becoming drier). While SPI generally shows more drought prone areas than RDI for the pre-1998 period, the opposite is observed for the post-1998 period. Given the known changes to PET in observed records, and also expected increases as global warming intensifies, these results suggest that RDI will be consistently different to the SPI as global warming intensifies. This hypothesis is further tested for historic and future climate projections from the CSIRO (Commonwealth Scientific and Industrial Research Organisation, Australia) Mk3.6 global climate model (GCM), with use of the fifth phase of the Coupled Model Intercomparison Project (CMIP5) and RCP8.5 (Representative Concentration Pathways). In this case, PET is calculated using FAO56-PM model for assessment of

  6. Evidence for increasingly variable Palmer Drought Severity Index in the United States since 1895.

    Science.gov (United States)

    Rayne, Sierra; Forest, Kaya

    2016-02-15

    Annual and summertime trends towards increasingly variable values of the Palmer Drought Severity Index (PDSI) over a sub-decadal period (five years) were investigated within the contiguous United States between 1895 and the present. For the contiguous United States as a whole, there is a significant increasing trend in the five-year running minimum-maximum ranges for the annual PDSI (aPDSI5 yr(min|max, range)). During this time frame, the average aPDSI5 yr(min|max, range) has increased by about one full unit, indicating a substantial increase in drought variability over short time scales across the United States. The end members of the running aPDSI5 yr(min|max, range) highlight even more rapid changes in the drought index variability within the past 120 years. This increasing variability in the aPDSI5 yr(min|max, range) is driven primarily by changes taking place in the Pacific and Atlantic Ocean coastal climate regions, climate regions which collectively comprise one-third the area of the contiguous United States. Similar trends were found for the annual and summertime Palmer Hydrological Drought Index (PHDI), the Palmer Modified Drought Index (PMDI), and the Palmer Z Index (PZI). Overall, interannual drought patterns in the contiguous United States are becoming more extreme and difficult to predict, posing a challenge to agricultural and other water-resource related planning efforts. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Association of Body Mass Index with Asthma Severity and Pulmonary Function among Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Rasuol Nasiri Kalmarzi

    2016-09-01

    Full Text Available Background Asthma is a chronic inflammatory disease in respiratory system and obesity is another inflammatory disease which incidence rate is increasing. Although, many studies have been conducted on severity of asthma and its relationship with obesity, but different results have been obtained. This study aimed to determine a relationship between asthma severity, Body Mass Index (BMI and pulmonary function in Kurdistan province, Iran. Materials and Methods: In this cross sectional study 90 asthmatic patients referred to referral hospital in Kurdistan, North West of Iran, were selected by simple random method. BMI was calculated by dividing weight by height.Pulmonary Function Test (PFT and bronchial-stimulation-test were used for confirmation and investigation of asthma severity. Data were analyzed using SPSS-15 and Chi-square and spearman correlation coefficient tests. Results: Relationship between BMI and severity of asthma (mild, medium and severe was evaluated, there was a relationship and positive relationship between them (P

  8. 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....

  9. The Addiction Severity Index: Reliability and validity in a Dutch alcoholic population

    OpenAIRE

    Dejong, C.A.J.; Willems, J.C.E.W.; Schippers, G.M.; Hendriks, V.M.

    1995-01-01

    The Addiction Severity Index (ASI) was evaluated for its psychometric qualities in a Dutch alcoholic population admitted to an addiction treatment center in the Netherlands. Its factorial structure in this population was found to be consistent with the established six factor structure of the ASI. Reliability analysis revealed that the homogeneity of the subscales was acceptable with the exception of the Alcohol Scale. The six subscales were not highly intercorrelated. The results of this stud...

  10. The Q* Index: A Useful Global Measure of Dementia Screening Test Accuracy

    Directory of Open Access Journals (Sweden)

    A.J. Larner

    2015-06-01

    Full Text Available Background/Aims: Single, global or unitary, indicators of test diagnostic performance have intuitive appeal for clinicians. The Q* index, the point in receiver operating characteristic (ROC curve space closest to the ideal top left-hand corner and where test sensitivity and specificity are equal, is one such measure. Methods: Datasets from four pragmatic accuracy studies which examined the Mini-Mental State Examination, Addenbrooke's Cognitive Examination-Revised, Montreal Cognitive Assessment, Test Your Memory test, and Mini-Addenbrooke's Cognitive Examination were examined to calculate and compare the Q* index, the maximal correct classification accuracy, and the maximal Youden index, as well as the sensitivity and specificity at these cutoffs. Results: Tests ranked similarly for the Q* index and the area under the ROC curve (AUC ROC. The Q* index cutoff was more sensitive (and less specific than the maximal correct classification accuracy cutoff, and less sensitive (and more specific than the maximal Youden index cutoff. Conclusion: The Q* index may be a useful global parameter summarising the test accuracy of cognitive screening instruments, facilitating comparison between tests, and defining a possible test cutoff value. As the point of equal sensitivity and specificity, its use may be more intuitive and appealing for clinicians than AUC ROC.

  11. Distribution of Severity of Injury/Illness Index according to ICD-10 groups

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Dahl, Michael; Rostgaard-Knudsen, Martin

    OBJECTIVE: In our area patients seen by the Prehospital Emergency Physician (PEP) are all classified according to the Severity of Injury/Illness Index (SIII) groups 0 to 7. This classification enables the evaluation of the optimal use of the PEP and focus on education. The PEP should only......, dispatches a PEP for major injury and severe medical conditions. For 72 months we extracted data regarding six main groups of diagnosis according to the ICD-10-system: Metabolic diseases, Diseases of the Central Nervous System (CNS), Diseases of the circulatory system, Diseases of the respiratory system...

  12. Drought severity in intensive agricultural areas by means of the EDI index

    Science.gov (United States)

    Procházková, Petra; Chuchma, Filip; Středa, Tomáš

    2016-12-01

    The aim of this work was the evaluation of drought severity development in the Czech Republic for the period 1971-2015 by the means of the Effective Drought Index (EDI). Annual values of the EDI index were determined using the method of effective precipitation for 14 localities spread throughout the Czech Republic (Central Europe). The seven categories were created according to obtained index values for the drought conditions determination for years during the period 1971-2015 through the percentile method. The annual index values were compared with acquired 2nd, 15th, 45th, 55th, 85th and 98th percentiles. Both the years with precipitation unfavourable conditions: 1972, 1973, 1984, 1990, 1991, 1992, 1993 and 2015 and the years with precipitation favourable conditions: 1977, 1987, 1995, 2001, 2002 and 2010 were determined. Precipitation conditions in the growing season from 61st to 180th day of the year were also analysed. This evaluation was conducted during the period 1971-2015 through the ten-day index values which were compared with acquired 2nd, 15th, 45th, 55th, 85th and 98th percentiles. Dry growing seasons occurred in 1973, 1974, 1976 and 1993. Wet growing seasons occurred in 1987, 2006 and 2010. Trend analysis of annual index values was performed through the Mann-Kendall test. Highly statistically significant increasing linear trends (P < 0.01) were found for four localities (Uherský Ostroh, Vysoká, Znojmo-Oblekovice and Žatec); statistically significant increasing trends (P < 0.05) were found for three localities (Brno-Chrlice, Lednice and Lípa). Based on the extrapolation of the trend, a slightly higher effective precipitation can be expected during the year in a substantial part of the country. However, these findings do not necessarily mean an optimal supply of agricultural land with water. Precipitation exhibits considerable unevenness of distribution through time. Given the increasing evapotranspiration demands of the environment their

  13. Facial Angiofibroma Severity Index (FASI): reliability assessment of a new tool developed to measure severity and responsiveness to therapy in tuberous sclerosis-associated facial angiofibroma.

    Science.gov (United States)

    Salido-Vallejo, R; Ruano, J; Garnacho-Saucedo, G; Godoy-Gijón, E; Llorca, D; Gómez-Fernández, C; Moreno-Giménez, J C

    2014-12-01

    Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Topical sirolimus has recently been suggested as a potential treatment for TSC-associated facial angiofibroma (FA). To validate a reproducible scale created for the assessment of clinical severity and treatment response in these patients. We developed a new tool, the Facial Angiofibroma Severity Index (FASI) to evaluate the grade of erythema and the size and extent of FAs. In total, 30 different photographs of patients with TSC were shown to 56 dermatologists at each evaluation. Three evaluations using the same photographs but in a different random order were performed 1 week apart. Test and retest reliability and interobserver reproducibility were determined. There was good agreement between the investigators. Inter-rater reliability showed strong correlations (> 0.98; range 0.97-0.99) with inter-rater correlation coefficients (ICCs) for the FASI. The global estimated kappa coefficient for the degree of intra-rater agreement (test-retest) was 0.94 (range 0.91-0.97). The FASI is a valid and reliable tool for measuring the clinical severity of TSC-associated FAs, which can be applied in clinical practice to evaluate the response to treatment in these patients. © 2014 British Association of Dermatologists.

  14. Global Age Watch Index 2015, London, 2015, ch 8 Western Europe, North America and Australasia

    NARCIS (Netherlands)

    de Bruijn, J.G.M.

    2015-01-01

    The world’s population is ageing. As fertility declines and life expectancy increases, the proportion of people aged 60 and over is projected to grow in all regions of the world. Yet people’s experiences of later life vary enormously depending on where they live. The Global AgeWatch Index assesses

  15. Psoriasis area severity index (pasi) and the dermatology life quality index (dlqi): the correlation between disease severity and quality of life in patients of psoriasis

    International Nuclear Information System (INIS)

    Khan, S.A.; Shaikh, Z.I.

    2017-01-01

    To determine the correlation between Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in patients of psoriasis. Study Design: Cross sectional study. Place and Duration of Study: Both outdoor and indoor patients of Dermatology Department, Military Hospital (MH) Rawalpindi for duration of 6 months i.e. from 6th Oct 2014 to 5th Apr 2014 were selected. Material and Methods: A total of 155 patients of chronic plaque psoriasis diagnosed clinically, ranging from 20 to 80 years of age and of either gender were included in the study. A careful history and clinical examination was done and for each case PASI and DLQI were calculated and registered in the designed proforma. Data were entered and analyzed in SPSS version-17.0. Mean and standard deviations were calculated for quantitative variables like age, PASI and DLQI. Frequencies and percentages were calculated for qualitative variables like gender. Pearson's correlation coefficient (r) (+1,-1) was calculated between mean PASI and mean DLQI. A p-value <0.05 was considered as significant. Stratification was done for age and gender and post stratification correlation was calculated. Results: Out of 155 patients studied, 110 (70.97%) were males and 45 (29.03%) were females. Ages of the patients ranged from 20-80 years (mean age 49.5 +- 15.6 years). Mean PASI score was 27.92 +- 5.83 and DLQ1 was 11.46 +- 4.22. The value of Pearson correlation coefficient (r) was 0.1324 which showed weak correlation between PASI and DLQ1 with p-value of 0.100. Weak correlation (r=-0.3394) in age 51-80 years while very weak correlation (r=-0.0651) in age 20-50 years was noted. PASI and DLQ1 showed weak correlation in males (r=0.132) and in females (r=0.461). Conclusion: This study concluded that there is a weak correlation between PASI and DLQI.

  16. Combined Versus Detailed Evaluation Components in Medical Student Global Rating Indexes

    Directory of Open Access Journals (Sweden)

    Kim L. Askew

    2015-11-01

    Full Text Available Introduction: To determine if there is any correlation between any of the 10 individual components of a global rating index on an emergency medicine (EM student clerkship evaluation form. If there is correlation, to determine if a weighted average of highly correlated components loses predictive value for the final clerkship grade. Methods: This study reviewed medical student evaluations collected over two years of a required fourth-year rotation in EM. Evaluation cards, comprised of a detailed 10-part evaluation, were completed after each shift. We used a correlation matrix between evaluation category average scores, using Spearman’s rho, to determine if there was any correlation of the grades between any of the 10 items on the evaluation form. Results: A total of 233 students completed the rotation over the two-year period of the study. There were strong correlations (>0.80 between assessment components of medical knowledge, history taking, physical exam, and differential diagnosis. There were also strong correlations between assessment components of team rapport, patient rapport, and motivation. When these highly correlated were combined to produce a four-component model, linear regression demonstrated similar predictive power in terms of final clerkship grade (R2 =0.71, CI95=0.65–0.77 and R2 =0.69, CI95=0.63–0.76 for the full and reduced models respectively. Conclusion: This study revealed that several components of the evaluation card had a high degree of correlation. Combining the correlated items, a reduced model containing four items (clinical skills, interpersonal skills, procedural skills, and documentation was as predictive of the student’s clinical grade as the full 10-item evaluation. Clerkship directors should be aware of the performance of their individual global rating scales when assessing medical student performance, especially if attempting to measure greater than four components.

  17. 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.

  18. The Addiction Severity Index: reliability and validity in a Dutch alcoholic population.

    Science.gov (United States)

    DeJong, C A; Willems, J C; Schippers, G M; Hendriks, V M

    1995-04-01

    The Addiction Severity Index (ASI) was evaluated for its psychometric qualities in a Dutch alcoholic population admitted to an addiction treatment center in The Netherlands. Its factorial structure in this population was found to be consistent with the established six factor structure of the ASI. Reliability analysis revealed that the homogeneity of the subscales was acceptable with the exception of the Alcohol Scale. The six subscales were not highly intercorrelated. The results of this study indicate that the ASI is a useful instrument for the assessment of several problems associated with alcoholism. However, the Alcohol Scale appears to be limited as a diagnostic and research instrument in the field of inpatient treatment of alcohol dependence in The Netherlands.

  19. Correlation of endoscopic severity of gastroesophageal reflux disease (gerd) with body mass index (bmi)

    International Nuclear Information System (INIS)

    Zafar, S.; Haq, I.U.; Butt, A.R.; Shafiq, F.; Huda, G.; Mirza, G.; Rehman, A.U.

    2007-01-01

    To assess the correlation of endoscopic severity of Gastroesophageal Reflux Disease (GERD) with Body Mass Index (BMI). This study was conducted on 203 patients, who presented with upper GI symptoms. Patients who fulfilled the symptom criteria were referred for endoscopy. Classification of GERD was done according to LA Grading classification system. Body mass index (BMI) was calculated as Body Weight (BW) in kilograms (kg) divided by the square of the body height (BH) in meter (m2). Patient data was analyzed using SPSS 12 software. Statistical evaluation was done using non-parametric Wilcoxon's-sign Rank test. P-value <0.05 was considered to be statistically significant. Distribution of GERD was as follows: GERD-A subjects 65 (32%), GERD B subjects 72 (35.4%), GERD-C subjects 23 (11.3%), GERD-D subjects 10 (4.92%), while Non-Erosive Reflux Disease (NERD) was present in 33 subjects (16.2%). Mean BMI was 27+5.02SD (range of 18.2-38.3). BMI of patients having NERD was in normal range but patients who were having advanced disease i.e. Grade C-D were in obese range of BMI, while those who were having LA grade A-B were in overweight BMI range. When regrouped as mild GERD (grade A-B) and NERD versus severe GERD (grade C-D), there was a strong significant correlation between severity of GERD and BMI, as detected by Wilcoxon's signed Rank test (p=0.001). Higher BMI seems to be associated with higher degree of endoscopic GERD severity. (author)

  20. Assessing Agricultural Drought in the Anthropocene: A Modified Palmer Drought Severity Index

    Directory of Open Access Journals (Sweden)

    Mingzhi Yang

    2017-09-01

    Full Text Available In the current human-influenced era, drought is initiated by natural and human drivers, and human activities are as integral to drought as meteorological factors. In large irrigated agricultural regions with high levels of human intervention, where the natural farmland soil moisture has usually been changed significantly by high-frequency irrigation, the actual severity of agricultural drought is distorted in traditional drought indices. In this work, an agricultural drought index that considering irrigation processes based on the Palmer drought severity index (IrrPDSI was developed to interpret the real agricultural drought conditions in irrigated regions, with a case study in the Haihe River Basin in northeast China. The water balance model in the original PDSI was revised by an auto-irrigation threshold method combined with a local irrigation schedule. The auto-irrigation setting of the index was used by taking irrigation quotas during specific growth stages of specific crops (wheat–corn into consideration. A series of weekly comparative analyses are as follows: (1 The soil moisture analyses showed that soil moisture values calculated by the modified water balance model were close to the real values; (2 The statistical analyses indicated that most of the stations in the study area based on IrrPDSI had nearly normal distributed values; (3 The time series and spatial analyses showed that the results of the IrrPDSI-reported dry-wet evaluation were more consistent with documented real conditions. All the results revealed that IrrPDSI performed well when used to assess agricultural drought. This work has direct significance for agricultural drought management in large irrigated areas heavily disturbed by human activity.

  1. Validation of exhaled volatile organic compounds analysis using electronic nose as index of COPD severity

    Directory of Open Access Journals (Sweden)

    Finamore P

    2018-05-01

    Full Text Available Panaiotis Finamore,1 Claudio Pedone,1 Simone Scarlata,1 Alessandra Di Paolo,1 Simone Grasso,2 Marco Santonico,2 Giorgio Pennazza,2 Raffaele Antonelli Incalzi1 1Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy; 2Unit of Electronics for Sensor Systems, Campus Bio-Medico di Roma University, Rome, Italy Aim: Six-minute walking test distance (6MWD and body mass index, obstruction, dyspnea and exercise (BODE index are measures of functional status in COPD patients, but require space, time and patient’s compliance. Exhaled volatile organic compounds (VOCs analysis via electronic nose is a quick and easy method that has already been used to discriminate COPD phenotypes. The aim of this study is to evaluate whether VOCs analysis can predict functional status and its variation over time in COPD patients.Methods: A monocentric prospective study with 1 year of follow-up was carried out. All patients underwent pulmonary function tests, arterial gas analysis, bioimpedance analysis, 6-minute walking test, and VOCs collection. Exhaled breath was collected with Pneumopipe® and analyzed using BIONOTE electronic nose. Outcomes prediction was performed by k-fold cross-validated partial least square discriminant analysis: accuracy, sensitivity and specificity as well as Cohen’s kappa for agreement were calculated.Results: We enrolled 63 patients, 60.3% men, with a mean age of 71 (SD: 8 years, median BODE index of 1 (interquartile range: 0–3 and mean 6MWD normalized by squared height (n6MWD of 133.5 (SD: 42 m/m2. The BIONOTE predicted baseline BODE score (dichotomized as BODE score <3 or ≥3 with an accuracy of 86% and quartiles of n6MWD with an accuracy of 79%. n6MWD decline more than the median value after 1 year was predicted with an accuracy of 86% by BIONOTE, 52% by Global Initiative for Chronic Obstructive Lung Disease (GOLD class and 78% by combined BIONOTE and GOLD class.Conclusion: Exhaled VOCs analysis identifies classes of BODE

  2. Impact of Hospital Variables on Case Mix Index as a Marker of Disease Severity

    Science.gov (United States)

    Mendez, Carmen M.; Harrington, Darrell W.; Christenson, Peter

    2014-01-01

    Abstract Case mix index (CMI) has become a standard indicator of hospital disease severity in the United States and internationally. However, CMI was designed to calculate hospital payments, not to track disease severity, and is highly dependent on documentation and coding accuracy. The authors evaluated whether CMI varied by characteristics affecting hospitals' disease severity (eg, trauma center or not). The authors also evaluated whether CMI was lower at public hospitals than private hospitals, given the diminished financial resources to support documentation enhancement at public hospitals. CMI data for a 14-year period from a large public database were analyzed longitudinally and cross-sectionally to define the impact of hospital variables on average CMI within and across hospital groups. Between 1996 and 2007, average CMI declined by 0.4% for public hospitals, while rising significantly for private for-profit (14%) and nonprofit (6%) hospitals. After the introduction of the Medicare Severity Diagnosis Related Group (MS-DRG) system in 2007, average CMI increased for all 3 hospital types but remained lowest in public vs. private for-profit or nonprofit hospitals (1.05 vs. 1.25 vs. 1.20; P<0.0001). By multivariate analysis, teaching hospitals, level 1 trauma centers, and larger hospitals had higher average CMI, consistent with a marker of disease severity, but only for private hospitals. Public hospitals had lower CMI across all subgroups. Although CMI had some characteristics of a disease severity marker, it was lower across all strata for public hospitals. Hence, caution is warranted when using CMI to adjust for disease severity across public vs. private hospitals. (Population Health Management 2014;17:28–34) PMID:23965045

  3. Human Development Inequality Index and Cancer Pattern: a Global Distributive Study.

    Science.gov (United States)

    Rezaeian, Shahab; Khazaei, Salman; Khazaei, Somayeh; Mansori, Kamyar; Sanjari Moghaddam, Ali; Ayubi, Erfan

    2016-01-01

    This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

  4. Apportioning global and non-global components of mercury deposition through (210)Pb indexing.

    Science.gov (United States)

    Lamborg, Carl H; Engstrom, Daniel R; Fitzgerald, William F; Balcom, Prentiss H

    2013-03-15

    Our previous work has documented a correlation between Hg concentrations and (210)Pb activity measured in wet deposition that might be used to help apportion sources of Hg in precipitation. Here we present the results of a 27-month precipitation collection effort using co-located samplers for Hg and (210)Pb designed to assess this hypothesis. Study sites were located on the east and west coasts of North America, in the continental interior, and on the Florida Peninsula. Relatively high variability in Hg/(210)Pb ratios was found at all sites regionally and seasonally (e.g., overall: 0.99-9.13ngdpm(-1)). The ratio of average volume-weighted Hg concentrations and (210)Pb activities showed consistent trends (higher in impacted area), with Glacier Bay in southeast Alaska, exhibiting the lowest value. Assuming that Glacier Bay represents a benchmark for a site with no regional contribution, we estimate less than 50% of the Hg input was "global" at the Seattle and Florida sites. Differences in Hg/(210)Pb in wet deposition could be due to either a regional/local source contribution of Hg, or a regional/local enhancement in the removal of Hg from the atmosphere (i.e., oxidants), however, this approach is not capable of discerning between these two possibilities. Thus, this method of source apportionment represents an estimate of the maximal amount of Hg contributed by regional sources and may be limited in regions of deep convective mixing. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Generating Global Leaf Area Index from Landsat: Algorithm Formulation and Demonstration

    Science.gov (United States)

    Ganguly, Sangram; Nemani, Ramakrishna R.; Zhang, Gong; Hashimoto, Hirofumi; Milesi, Cristina; Michaelis, Andrew; Wang, Weile; Votava, Petr; Samanta, Arindam; Melton, Forrest; hide

    2012-01-01

    This paper summarizes the implementation of a physically based algorithm for the retrieval of vegetation green Leaf Area Index (LAI) from Landsat surface reflectance data. The algorithm is based on the canopy spectral invariants theory and provides a computationally efficient way of parameterizing the Bidirectional Reflectance Factor (BRF) as a function of spatial resolution and wavelength. LAI retrievals from the application of this algorithm to aggregated Landsat surface reflectances are consistent with those of MODIS for homogeneous sites represented by different herbaceous and forest cover types. Example results illustrating the physics and performance of the algorithm suggest three key factors that influence the LAI retrieval process: 1) the atmospheric correction procedures to estimate surface reflectances; 2) the proximity of Landsatobserved surface reflectance and corresponding reflectances as characterized by the model simulation; and 3) the quality of the input land cover type in accurately delineating pure vegetated components as opposed to mixed pixels. Accounting for these factors, a pilot implementation of the LAI retrieval algorithm was demonstrated for the state of California utilizing the Global Land Survey (GLS) 2005 Landsat data archive. In a separate exercise, the performance of the LAI algorithm over California was evaluated by using the short-wave infrared band in addition to the red and near-infrared bands. Results show that the algorithm, while ingesting the short-wave infrared band, has the ability to delineate open canopies with understory effects and may provide useful information compared to a more traditional two-band retrieval. Future research will involve implementation of this algorithm at continental scales and a validation exercise will be performed in evaluating the accuracy of the 30-m LAI products at several field sites. ©

  6. Investigation on the Patterns of Global Vegetation Change Using a Satellite-Sensed Vegetation Index

    Directory of Open Access Journals (Sweden)

    Ainong Li

    2010-06-01

    Full Text Available The pattern of vegetation change in response to global change still remains a controversial issue. A Normalized Difference Vegetation Index (NDVI dataset compiled by the Global Inventory Modeling and Mapping Studies (GIMMS was used for analysis. For the period 1982–2006, GIMMS-NDVI analysis indicated that monthly NDVI changes show homogenous trends in middle and high latitude areas in the northern hemisphere and within, or near, the Tropic of Cancer and Capricorn; with obvious spatio-temporal heterogeneity on a global scale over the past two decades. The former areas featured increasing vegetation activity during growth seasons, and the latter areas experienced an even greater amplitude in places where precipitation is adequate. The discussion suggests that one should be cautious of using the NDVI time-series to analyze local vegetation dynamics because of its coarse resolution and uncertainties.

  7. Influence of hypothermia combined with erythropoietin on serum neurological function indexes in newborns with severe hypoxic ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Hua Tian

    2017-05-01

    Full Text Available Objective: To study the influence of hypothermia combined with erythropoietin (EPO on serum neurological function indexes in newborns with severe hypoxic ischemic encephalopathy (HIE. Methods: A total of 48 cases of newborns with severe hypoxic ischemic encephalopathy in our hospital were enrolled and divided into control group and observation group according to random number table, 24 cases in each group. On the basis of conventional treatment, patients in control group were treated with mild hypothermia, and those in observation group were treated with mild hypothermia combined with EPO. Serum nerve injury indexes, neurological function indexes and nerve apoptosis indexes were compared between two groups before and after treatment. Results: Before treatment, differences in the levels of nerve injury indexes, neurological function indexes and nerve apoptosis indexes were not statistically significant between two groups. After treatment, serum nerve injury indexes NSE and S-100B levels of observation group were lower than those of control group, neurolocial function indexes BDNF, NGF, IGF-1 and GH levels of observation group were higher than those of control group, and nerve apoptosis indexes sFas and sFasL levels of observation group were lower than those of control group. Conclusion: Mild hypothermia combined with EPO can reduce the neurological damage and inhibit neuronal apoptosis in children with severe HIE.

  8. Application of global rainbow technique in sprays with a dependence of the refractive index on droplet size

    Science.gov (United States)

    Saengkaew, S.; Bodoc, V.; Lavergne, G.; Grehan, G.

    2013-01-01

    In liquid combustion, the evaporation process is one of the key parameters which controls combustion efficiency. To understand the combustion process, and to be able to develop an efficient combustor which produces less pollutant, it is necessary to be able to measure evaporation properties. Several techniques exist to measure the physical properties of fuel droplets, but very few exist to measure the thermo-chemical properties. The global rainbow technique (GRT) has been proposed and successfully used to measure the average temperature and the size distribution of sprays under the assumption that all the droplets are at the same temperature. This paper explores the applicability of GRT to sprays where the refractive index is a function of the particle size. A first result proves that the refractive index measured by GRT is weighted by the droplet diameter to the power of 7/3. This result permits accurate and fast comparisons between the numerical simulations and the experiments. A second result is the measurement of the refractive index by the size class by coupling GRT and Phase Doppler Anemometry (PDA) measurements (or another measurement technique with a low sensitivity to the refractive index such as holography, diffractometry, etc).

  9. The relationship between the Nasality Severity Index 2.0 and perceptual judgments of hypernasality.

    Science.gov (United States)

    Bettens, Kim; De Bodt, Marc; Maryn, Youri; Luyten, Anke; Wuyts, Floris L; Van Lierde, Kristiane M

    2016-01-01

    The Nasality Severity Index 2.0 (NSI 2.0) forms a new, multiparametric approach in the identification of hypernasality. The present study aimed to investigate the correlation between the NSI 2.0 scores and the perceptual assessment of hypernasality. Speech samples of 35 patients, representing a range of nasality from normal to severely hypernasal, were rated by four expert speech-language pathologists using visual analogue scaling (VAS) judging the degree of hypernasality, audible nasal airflow (ANA) and speech intelligibility. Inter- and intra-listener reliability was verified using intraclass correlation coefficients. Correlations between NSI 2.0 scores and its parameters (i.e. nasalance score of an oral text and vowel /u/, voice low tone to high tone ratio of the vowel /i/) and the degree of hypernasality were determined using Pearson correlation coefficients. Multiple linear regression analysis was used to investigate the possible influence of ANA and speech intelligibility on the NSI 2.0 scores. Overall good to excellent inter- and intra-listener reliability was found for the perceptual ratings. A moderate, but significant negative correlation between NSI 2.0 scores and perceived hypernasality (r=-0.64) was found, in which a more negative NSI 2.0 score indicates the presence of more severe hypernasality. No significant influence of ANA or intelligibility on the NSI 2.0 was observed based on the regression analysis. Because the NSI 2.0 correlates significantly with perceived hypernasality, it provides an easy-to-interpret severity score of hypernasality which will facilitate the evaluation of therapy outcomes, communication to the patient and other clinicians, and decisions for treatment planning, based on a multiparametric approach. However, research is still necessary to further explore the instrumental correlates of perceived hypernasality. The reader will be able to (1) describe and discuss current issues and influencing variables regarding perceptual

  10. [Validation of the Pneumonia Severity Index for hospitalizing patients with community-acquired pneumonia].

    Science.gov (United States)

    Querol-Ribelles, José M; Tenías, José M; Querol-Borrás, José M; González-Granda, Damiana; Hernández, Manuel; Ferreruela, Rosa; Martínez, Isidoro

    2004-04-10

    Our main objective was to assess the utility of the Pneumonia Severity Index (PSI) to decide the site of care home or hospital of patients with community-acquired pneumonia (CAP). All CAP patients who came to the emergency department from 1 January to 31 December, 2000, were prospectively assessed with a protocol based on the PSI and additional admission criteria applied to classes I, II and III. Mortality within 30 days and poor outcome were used as endpoints. We tested the diagnostic efficacy of the PSI scale in predicting mortality or unfavourable events by calculating the area below the ROC curve. Of the 243 CAP patients included, 124 (51%) belonged to classes I, II and III, and 119 (49%) belonged to classes IV and V. One hundred and fifty six (64%) patients were admitted. Fifteen (6.2%) patients died, all of them belonging to classes IV and V. Forty four (18%) patients showed a poor outcome. Only one patient who was initially sent home had a poor outcome. The prognostic value of the PSI scale to predict mortality (ROC = 0.92; CI 95%, 0.88-0.95) was high. Our results confirm that the PSI scale is a good prognostic index in clinical practice for predicting mortality due to CAP. In order to use the PSI to decide the site of care of patients with CAP, not only the score obtained but also additional factors should be taken into account.

  11. Factor structure of the autonomy preference index in people with severe mental illness.

    Science.gov (United States)

    Bonfils, Kelsey A; Adams, Erin L; Mueser, Kim T; Wright-Berryman, Jennifer L; Salyers, Michelle P

    2015-08-30

    People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Visceral adiposity index as a predictor of clinical severity and therapeutic outcome of PCOS.

    Science.gov (United States)

    Zheng, Sai-Hua; Li, Xue-Lian

    2016-01-01

    Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disease which often accompany with abnormal fat distribution. Visceral adiposity has association with abnormal lipid metabolic, pro-inflammatory activity, insulin resistance (IR) and hyperandrogenism. Increased visceral adiposity raises the risk of metabolic syndrome, type 2 diabetes and cardiovascular (CV) events, and aggravates ovulatory dysfunction and hyperandrogenism in PCOS women. Visceral adiposity index (VAI), a simple surrogate maker of visceral adipose dysfunction and visceral adiposity, is a predictor of IR, and link hyperinsulinemia, hyperandrogenism and anovulation. This review aims to discuss the visceral adiposity situation in PCOS women, and suggests that VAI may be a useful predictor of clinical severity and therapeutic outcome of PCOS.

  13. Validation of the insomnia severity index as a web-based measure.

    Science.gov (United States)

    Thorndike, Frances P; Ritterband, Lee M; Saylor, Drew K; Magee, Joshua C; Gonder-Frederick, Linda A; Morin, Charles M

    2011-01-01

    Although the Insomnia Severity Index (ISI) is already administered online, this frequently used instrument has not been validated for Web delivery. This study compares online and paper-and-pencil ISI versions completed by participants in a randomized controlled trial testing an Internet-delivered intervention for insomnia. Forty-three adults with insomnia completed both ISI versions during pre- (Assessment 1) and post-intervention (Assessment 2). Correlations between total scores of both versions were significant (rs ≥ .98, ps < .001). For both ISI versions, internal consistency was acceptable (Assessment 1, α = .61; Assessment 2, α ≥ .88). Among participants not receiving the parent study intervention, correlations between 1 format at Assessment 1 and the alternative format at Assessment 2 were generally significant (rs = .26-.82). Together, findings suggest the ISI can be delivered online.

  14. Global variability in angina pectoris and its association with body mass index and poverty.

    Science.gov (United States)

    Liu, Longjian; Ma, Jixiang; Yin, Xiaoyan; Kelepouris, Ellie; Eisen, Howard J

    2011-03-01

    In the absence of a previous global comparison, we examined the variability in the prevalence of angina across 52 countries and its association with body weight and the poverty index using data from the World Health Organization-World Health Survey. The participants with angina were defined as those who had positive results using a Rose angina questionnaire and/or self-report of a physician diagnosis of angina. The body mass index (BMI) was determined as the weight in kilograms divided by the square of the height in meters. The poverty index (a standard score of socioeconomic status for a given country) was extracted from the United Nations' statistics. The associations of angina with the BMI and poverty index were analyzed cross-sectionally using univariate and multivariate analyses. The results showed that the total participants (n = 210,787) had an average age of 40.64 years. The prevalence of angina ranged from 2.44% in Tunisia to 23.89% in Chad. Those participants with a BMI of poverty status was considered. A tendency was seen for underweight status and a poverty index >14.65% to be associated with the risk of having angina, although these associations were not statistically significant in the multilevel models. In conclusion, significant variations were found in the anginal rates across 52 countries worldwide. An increased BMI was significantly associated with the odds of having angina. Published by Elsevier Inc.

  15. Improve Gear Fault Diagnosis and Severity Indexes Determinations via Time Synchronous Average

    Directory of Open Access Journals (Sweden)

    Mohamed El Morsy

    2016-11-01

    Full Text Available In order to reduce operation and maintenance costs, prognostics and health management (PHM of the geared system is needed to improve effective gearbox fault detection tools.  PHM system allows less costly maintenance because it can inform operators of needed repairs before a fault causes collateral damage happens to the gearbox. In this article, time synchronous average (TSA technique and complex continuous wavelet analysis enhancement are used as gear fault detection approach. In the first step, extract the periodic waveform from the noisy measured signal is considered as The main value of Time synchronous averaging (TSA for gearbox signals analyses, where it allows the vibration signature of the gear under analysis to be separated from other gears and noise sources in the gearbox that are not synchronous with faulty gear. In the second step, the complex wavelet analysis is used in case of multi-faults in same gear. The signal phased-locked with the angular position of a shaft within the system is done. The main aims for this research is to improve the gear fault diagnosis and severity index determinations based on TSA  of measured signal for investigated passenger vehicle gearbox under different operation conditions. In addition to, correct the variations in shaft speed such that the spreading of spectral energy into an adjacent gear mesh bin helps in detecting the gear fault position (faulted tooth or teeth and improve the Root Mean Square (RMS, Kurtosis, and Peak Pulse as the sensitivity of severity indexes for maintenance, prognostics and health management (PHM purposes. The open loop test stand is equipped with two dynamometers and investigated vehicle gearbox of mid-size passenger car; the total power is taken-off from one side only. Reference Number: www.asrongo.org/doi:4.2016.1.1.6

  16. Creating a spatially-explicit index: a method for assessing the global wildfire-water risk

    Science.gov (United States)

    Robinne, François-Nicolas; Parisien, Marc-André; Flannigan, Mike; Miller, Carol; Bladon, Kevin D.

    2017-04-01

    The wildfire-water risk (WWR) has been defined as the potential for wildfires to adversely affect water resources that are important for downstream ecosystems and human water needs for adequate water quantity and quality, therefore compromising the security of their water supply. While tools and methods are numerous for watershed-scale risk analysis, the development of a toolbox for the large-scale evaluation of the wildfire risk to water security has only started recently. In order to provide managers and policy-makers with an adequate tool, we implemented a method for the spatial analysis of the global WWR based on the Driving forces-Pressures-States-Impacts-Responses (DPSIR) framework. This framework relies on the cause-and-effect relationships existing between the five categories of the DPSIR chain. As this approach heavily relies on data, we gathered an extensive set of spatial indicators relevant to fire-induced hydrological hazards and water consumption patterns by human and natural communities. When appropriate, we applied a hydrological routing function to our indicators in order to simulate downstream accumulation of potentially harmful material. Each indicator was then assigned a DPSIR category. We collapsed the information in each category using a principal component analysis in order to extract the most relevant pixel-based information provided by each spatial indicator. Finally, we compiled our five categories using an additive indexation process to produce a spatially-explicit index of the WWR. A thorough sensitivity analysis has been performed in order to understand the relationship between the final risk values and the spatial pattern of each category used during the indexation. For comparison purposes, we aggregated index scores by global hydrological regions, or hydrobelts, to get a sense of regional DPSIR specificities. This rather simple method does not necessitate the use of complex physical models and provides a scalable and efficient tool

  17. Body mass index, initial neurological severity and long-term mortality in ischemic stroke.

    Science.gov (United States)

    Ryu, Wi-Sun; Lee, Seung-Hoon; Kim, Chi Kyung; Kim, Beom Joon; Yoon, Byung-Woo

    2011-01-01

    Obesity is believed to increase the risks of ischemic stroke or coronary heart disease; however, regarding outcome after established vascular diseases, recent unexpected evidence has suggested that an increased body mass index (BMI) might have beneficial effects (obesity paradox). The aim of this study was to evaluate the independent association between BMI and long-term mortality after ischemic stroke. A total of 1,592 consecutive patients with ischemic stroke were prospectively included through our stroke cohort. In this study, the levels of BMI were classified based on guidelines for the Asian-Pacific population. Initial neurological severity was estimated by the National Institutes of Health Stroke Scale (NIHSS) score. Information on mortality was collected until the end of 2009, and the median follow-up period was 4 years. To examine the association between BMI and long-term mortality, we used Cox's proportional regression analysis. During follow-up, 23% of patients died. Linear regression analysis showed that the level of BMI was inversely related to initial neurological severity (p = 0.002). In the model of adjustment of age and gender using Cox's proportional regression analysis, this inverse trend was also significant (reference, normal weight; hazard ratio of underweight, 2.45; overweight, 0.77; obesity, 0.60). However, after adjustment of all covariates, including initial neurological severity, only the harmful effect of underweight remained significant (2.79; 95% CI, 1.92-4.05); however, beneficial effects of overweight and obesity did not. Our study showed that an independent association between BMI and long-term mortality after ischemic stroke was found only in underweight patients. The obesity paradox phenomenon seems to be limited, and might not be interpreted as a direct causal relationship due to a strong association with initial neurological severity. Copyright © 2011 S. Karger AG, Basel.

  18. Assessing and mapping drought hazard in Africa and South-Central America with a Meteorological Drought Severity Index

    Science.gov (United States)

    Carrao, Hugo; Barbosa, Paulo; Vogt, Jürgen

    2015-04-01

    Drought is a recurring extreme climate event characterized by a temporary deficit of precipitation, soil moisture, streamflow, or any combination of the three taking place at the same time. The immediate consequences of short-term (i.e. a few weeks duration) droughts are, for example, a fall in crop production, poor pasture growth and a decline in fodder supplies from crop residues, whereas prolonged water shortages (e.g. of several months or years duration) may, amongst others, lead to a reduction in hydro-electrical power production and an increase of forest fires. As a result, comprehensive drought risk management is nowadays critical for many regions in the world. Examples are many African and South-and Central American countries that strongly depend on rain-fed agriculture for economic development with hydroelectricity and biomass as main sources of energy. Drought risk is the probability of harmful consequences, or expected losses resulting from interactions between drought hazard, i.e. the physical nature of droughts, and the degree to which a population or activity is vulnerable to its effects. As vulnerability to drought is increasing globally and certain tasks, such as distributive policies (e.g. relief aid, regulatory exemptions, or preparedness investments), require information on drought severity that is comparable across different climatic regions, greater attention has recently been directed to the development of methods for a standardized quantification of drought hazard. In this study we, therefore, concentrate on a methodology for assessing the severity of historical droughts and on mapping the frequency of their occurrence. To achieve these goals, we use a new Meteorological Drought Severity Index (MDSI). The motivation is twofold: 1) the observation that primitive indices of drought severity directly measure local precipitation shortages and cannot be compared geographically; and that 2) standardized indices of drought do not take into account

  19. The Clinical Impression of Severity Index for Parkinson's Disease: international validation study.

    Science.gov (United States)

    Martínez-Martín, Pablo; Rodríguez-Blázquez, Carmen; Forjaz, Maria João; de Pedro, Jesús

    2009-01-30

    This study sought to provide further information about the psychometric properties of the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), in a large, international, cross-culturally diverse sample. Six hundred and fourteen patients with PD participated in the study. Apart from the CISI-PD, assessments were based on Hoehn & Yahr (HY) staging, the Scales for Outcomes in PD-Motor (SCOPA-M), -Cognition (SCOPA-COG) and -Psychosocial (SCOPA-PS), the Cumulative Illness Rating Scale-Geriatrics, and the Hospital Anxiety and Depression Scale. The total CISI-PD score displayed no floor or ceiling effects. Internal consistency was 0.81, the test-retest intraclass correlation coefficient was 0.84, and item homogeneity was 0.52. Exploratory and confirmatory factor analysis (CFI = 0.99, RMSEA = 0.07) confirmed CISI-PD's unifactorial structure. The CISI-PD showed adequate convergent validity with SCOPA-COG and SCOPA-M (r(S) = 0.46-0.85, respectively) and discriminative validity for HY stages and disease duration (P validation study, thus showing that the CISI-PD is a valid instrument to measure clinical impression of severity in PD. Its simplicity and easy application make it an attractive and useful tool for clinical practice and research.

  20. Evaluation of environmental impact produced by different economic activities with the global pollution index.

    Science.gov (United States)

    Zaharia, Carmen

    2012-07-01

    The paper analyses the environment pollution state in different case studies of economic activities (i.e. co-generation electric and thermal power production, iron profile manufacturing, cement processing, waste landfilling, and wood furniture manufacturing), evaluating mainly the environmental cumulative impacts (e.g. cumulative impact against the health of the environment and different life forms). The status of the environment (air, water resources, soil, and noise) is analysed with respect to discharges such as gaseous discharges in the air, final effluents discharged in natural receiving basins or sewerage system, and discharges onto the soil together with the principal pollutants expressed by different environmental indicators corresponding to each specific productive activity. The alternative methodology of global pollution index (I (GP)*) for quantification of environmental impacts is applied. Environmental data analysis permits the identification of potential impact, prediction of significant impact, and evaluation of cumulative impact on a commensurate scale by evaluation scores (ES(i)) for discharge quality, and global effect to the environment pollution state by calculation of the global pollution index (I (GP)*). The I (GP)* values for each productive unit (i.e. 1.664-2.414) correspond to an 'environment modified by industrial/economic activity within admissible limits, having potential of generating discomfort effects'. The evaluation results are significant in view of future development of each productive unit and sustain the economic production in terms of environment protection with respect to a preventive environment protection scheme and continuous measures of pollution control.

  1. [Experience, prevalence, severity, treatment needs for dental caries and care index in Mexican adolescents and young adults].

    Science.gov (United States)

    García-Cortés, José Obed; Mejia-Cruz, Jorge Adrián; Medina-Cerda, Eduardo; Orozco-De la Torre, Guillermo; Medina-Solís, Carlo Carlo; Márquez-Rodríguez, Sonia; Navarrete-Hernández, José de Jesús; Islas-Granillo, Horacio

    2014-01-01

    To determine the experience, prevalence and severity of dental caries as well as to establish the treatment needs and restorative care in adolescents and young adults. This cross-sectional study included 638 subjects 16-25 years old candidates to enter to state public university of San Luis Potosí, México. For caries detection was used the DMFT index (sum of decayed teeth + missing teeth + filled teeth in the permanent dentition). With DMFT index data were calculated the experience, the prevalence and the severity of caries. Also are reported the significant caries index (SiC), the treatment needs index (TNI) and the care index (CI). Statistical analysis was performed using nonparametric tests. The mean DMFT index was 4.24 ± 3.85, prevalence 76.5% and severity of 52.3% for DMFT > 3 and 26.2% for DMFT > 6. The SiC index was 8.7. The TNI was 43.0% and 52.8% CI. No variation was observed (p > 0.05) on the experience, prevalence and severity of caries by age. The component "filled teeth" showed differences by age (p caries experience and severity than men (p dental caries in this sample of adolescents and young adults. We found almost 40% of untreated caries lesions. We found some differences by sex.

  2. Validity of the American Board of Orthodontics Discrepancy Index and the Peer Assessment Rating Index for comprehensive evaluation of malocclusion severity.

    Science.gov (United States)

    Liu, S; Oh, H; Chambers, D W; Baumrind, S; Xu, T

    2017-08-01

    To assess the validity of the American Board of Orthodontics Discrepancy Index (ABO-DI) and Peer Assessment Rating (PAR) Index in evaluating malocclusion severity in Chinese orthodontic patients. A stratified random sample of 120 orthodontic patients based on Angle classification was collected from six university orthodontic centres. Sixty-nine orthodontists rated malocclusion severity on a five-point scale by assessing a full set of pre-treatment records for each case and listed reasons for their decision. Their judgement was then compared with ABO-DI and PAR scores determined by three calibrated examiners. Excellent interexaminer reliability of clinician judgement, ABO-DI and PAR index was demonstrated by the Intraclass Correlation Coefficient (rho= 0.995, 0.990 and 0.964, respectively). Both the ABO-DI and US-PAR index showed good correlation with clinician judgement (r=.700 and r=.707, respectively). There was variability among the different Angle classifications: the ABO-DI showed the highest correlation with clinician judgement in Class II patients (r=.780), whereas the US-PAR index showed the highest correlation with clinician judgement in Class III patients (r=.710). Both indices demonstrated the lowest correlations with clinician judgement in Class I patients. With strong interexaminer agreement, the panel consensus was used for validating the ABO-DI and US-PAR index for malocclusion severity. Overall, the ABO-DI and US-PAR index were reliable for measuring malocclusion severity with significantly variable weightings for different Angle classifications. Further modification of the indices for different Angle classification may be indicated. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Global Ecosystem Response Types Derived from the Standardized Precipitation Evapotranspiration Index and FPAR3g Series

    DEFF Research Database (Denmark)

    Ivits, Eva; Horion, Stéphanie Marie Anne F; Fensholt, Rasmus

    2014-01-01

    Observing trends in global ecosystem dynamics is an important first step, but attributing these trends to climate variability represents a further step in understanding Earth system changes. In the present study, we classified global Ecosystem Response Types (ERTs) based on common spatio-temporal......Observing trends in global ecosystem dynamics is an important first step, but attributing these trends to climate variability represents a further step in understanding Earth system changes. In the present study, we classified global Ecosystem Response Types (ERTs) based on common spatio...... were observed in Asia and North America. These ERTs complement traditional pixel based methods by enabling the combined assessment of the location, timing, duration, frequency and severity of climatic and vegetation anomalies with the joint assessment of wetting and drying climatic conditions. The ERTs...

  4. Climate change and marine fisheries: Least developed countries top global index of vulnerability.

    Science.gov (United States)

    Blasiak, Robert; Spijkers, Jessica; Tokunaga, Kanae; Pittman, Jeremy; Yagi, Nobuyuki; Österblom, Henrik

    2017-01-01

    Future impacts of climate change on marine fisheries have the potential to negatively influence a wide range of socio-economic factors, including food security, livelihoods and public health, and even to reshape development trajectories and spark transboundary conflict. Yet there is considerable variability in the vulnerability of countries around the world to these effects. We calculate a vulnerability index of 147 countries by drawing on the most recent data related to the impacts of climate change on marine fisheries. Building on the Intergovernmental Panel on Climate Change framework for vulnerability, we first construct aggregate indices for exposure, sensitivity and adaptive capacity using 12 primary variables. Seven out of the ten most vulnerable countries on the resulting index are Small Island Developing States, and the top quartile of the index includes countries located in Africa (17), Asia (7), North America and the Caribbean (4) and Oceania (8). More than 87% of least developed countries are found within the top half of the vulnerability index, while the bottom half includes all but one of the Organization for Economic Co-operation and Development member states. This is primarily due to the tremendous variation in countries' adaptive capacity, as no such trends are evident from the exposure or sensitivity indices. A negative correlation exists between vulnerability and per capita carbon emissions, and the clustering of states at different levels of development across the vulnerability index suggests growing barriers to meeting global commitments to reducing inequality, promoting human well-being and ensuring sustainable cities and communities. The index provides a useful tool for prioritizing the allocation of climate finance, as well as activities aimed at capacity building and the transfer of marine technology.

  5. Global Incidence and Mortality Rates of Stomach Cancer and the Human Development Index: an Ecological Study.

    Science.gov (United States)

    Khazaei, Salman; Rezaeian, Shahab; Soheylizad, Mokhtar; Khazaei, Somayeh; Biderafsh, Azam

    2016-01-01

    Stomach cancer (SC) is the second leading cause of cancer death with the rate of 10.4% in the world. The correlation between the incidence and mortality rates of SC and human development index (HDI) has not been globally determined. Therefore, this study aimed to determine the association between the incidence and mortality rates of SC and HDI in various regions. In this global ecological study, we used the data about the incidence and mortality rate of SC and HDI from the global cancer project and the United Nations Development Programme database, respectively. In 2012, SCs were estimated to have affected a total of 951,594 individuals (crude rate: 13.5 per 100,000 individuals) with a male/female ratio of 1.97, and caused 723,073 deaths worldwide (crude rate: 10.2 per 100,000 individuals). There was a positive correlation between the HDI and both incidence (r=0.28, countries with high and very high HDI is remarkable which should be the top priority of interventions for global health policymakers. In addition, health programs should be provided to reduce the burden of this disease in the regions with high incidence and mortality rates of SC.

  6. Vegetation Index and Phenology (VIP) Vegetation Indices 7Days Global 0.05Deg CMG V004

    Data.gov (United States)

    National Aeronautics and Space Administration — The NASA Making Earth System Data Records for Use in Research Environments (MEaSUREs) Vegetation Index and Phenology (VIP) global datasets were created using...

  7. MODIS/Aqua Clear Radiance Statistics Indexed to Global Grid 5-Min L2 Swath 10km V006

    Data.gov (United States)

    National Aeronautics and Space Administration — The MODIS/Aqua Clear Radiance Statistics Indexed to Global Grid 5-Min L2 Swath 10km (MYDCSR_G) provides a variety of statistical measures that characterize observed...

  8. A Global Database of Field-observed Leaf Area Index in Woody Plant Species, 1932-2011

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set provides global leaf area index (LAI) values for woody species. The data are a compilation of field-observed data from 1,216 locations obtained from...

  9. A Global Database of Field-observed Leaf Area Index in Woody Plant Species, 1932-2011

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: This data set provides global leaf area index (LAI) values for woody species. The data are a compilation of field-observed data from 1,216 locations...

  10. Auroral Electrojet Index Designed to Provide a Global Measure, l-minute Intervals, of Auroral Zone Magnetic Activity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Auroral Electrojet index (AE) is designed to provide a global quantitative measure of auroral zone magnetic activity produced by enhanced ionospheric currents...

  11. Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis.

    Science.gov (United States)

    Lech, Agnieszka K; Dobrowolski, Piotr P; Klisiewicz, Anna; Hoffman, Piotr

    2017-01-01

    The management of patients with asymptomatic severe aortic stenosis (ASAS) is still under discussion. Therefore, it is advisable to search for the parameters of early damage to left ventricular (LV) function. The aim of the study was to assess exercise-induced changes in LV global longitudinal strain (GLS) in ASAS. The ASAS group consisted of 50 patients (26 women and 24 men, aged 38.4 ± 18.1 years) meeting the echocardiographic criteria of severe aortic stenosis (AVA 4 m/s, mean aortic gradient > 40 mm Hg), with normal LV ejection fraction (LVEF ≥ 55%) and sinus rhythm on electrocardiogram, and without significant concomitant valvular heart diseases. The control group consisted of 21 people matched for age and sex. Echocardiographic examinations and echocardiographic stress tests with the assessment of GLS using the speckle tracking imaging were performed. The ASAS group was characterised by statistically significantly higher LV mass index (LVMI) and higher LVEF. GLS values at rest in both groups were within normal limits but were significantly higher in the control group (-18.9 ± 2.4% vs. -20.7 ± 1.7%, p = 0.006). An increase in GLS at peak exercise in both groups was observed, lower in the ASAS group (the difference was not statistically significant: -0.8 ± 3.0% vs. -2.2 ± 3.1%, p = 0.086). Changes in GLS during exercise (ΔGLS) did not correlate with the parameters of the severity of aortic stenosis. In the multivariate model, LVMI proved to be a factor associated with GLS at rest and during exercise. In patients with ASAS, GLS is a non-invasive marker of an early stage of LV myocardial damage associated with myocardial hypertrophy. An increase in GLS during exercise in the ASAS group, smaller than in the control group, indicates a preserved functional reserve of the LV myocardium but smaller than in healthy individuals. The assessment of the clinical usefulness of exercise-induced changes in GLS requires further research.

  12. Is a mobile emergency severity index (ESI) triage better than the paper ESI?

    Science.gov (United States)

    Savatmongkorngul, Sorravit; Yuksen, Chaiyaporn; Suwattanasilp, Chanakarn; Sawanyawisuth, Kittisak; Sittichanbuncha, Yuwares

    2017-12-01

    This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators. There were 486 patients enrolled in the study; 235 patients (48.4%) were assessed using the mobile ESI, and 251 patients (51.6%) were in the original ESI group. The baseline characteristics of patients in both groups were mostly comparable except for the ED visit time. The percentages of concordance and kappa statistics in the original ESI group were lower than in the mobile group in all three comparisons (medical students vs gold standard, emergency physicians vs gold standard, and medical students vs emergency physicians). The highest kappa in the original ESI group is 0.69, comparing emergency physicians vs gold standard, while the lowest kappa in the application group is 0.84 comparing the medical students vs gold standard. Both medical students and emergency physicians are more confident with the mobile ESI application triage. In conclusion, the mobile ESI has better inter-rater reliability, and is more user-friendly than the original paper form.

  13. Effect of geographical and ethnic variation on Dysphonia Severity Index: a study of Indian population.

    Science.gov (United States)

    Jayakumar, T; Savithri, S R

    2012-01-01

    Dysphonia Severity Index (DSI) is a widely used multiparametric approach to objectively quantify the voice quality. Few research groups have investigated the test-retest, interobserver variability, and influence of age and gender. They have also verified the application of DSI in various voice rehabilitation conditions. However, all these studies have been conducted on European population. There is a possibility of variation in the basic parameters of DSI across geographical and ethnic groups. Hence, the present study evaluated DSI in Indian population. One hundred twenty voluntary participants (60 males, 60 females) who had G(0) on the Grade, Roughness, Breathiness, Aesthenia, Strain (GRBAS) scale participated in the study (age range of 18-25 years, M=21.8, standard deviation=2.7). Maximum phonation time (MPT), frequency intensity, and jitter measurements were made using CSL 4500 (Kay Elemetrics, Pine Brook, NJ). Results showed noticeable difference between Indian and European population on MPT, Highest frequency (F(0)-High), and DSI values. Significant gender difference was also observed on MPT and F(0)-High. Test-retest reliability showed >95% for all the parameters. The MPT decrement lead to a reduction in the overall DSI value in both the genders. These results of the study caution voice professionals to reinvestigate and establish their own norms for their geographical and ethnic groups. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  14. Validation of the Spanish Addiction Severity Index Multimedia Version (S-ASI-MV).

    Science.gov (United States)

    Butler, Stephen F; Redondo, José Pedro; Fernandez, Kathrine C; Villapiano, Albert

    2009-01-01

    This study aimed to develop and test the reliability and validity of a Spanish adaptation of the ASI-MV, a computer administered version of the Addiction Severity Index, called the S-ASI-MV. Participants were 185 native Spanish-speaking adult clients from substance abuse treatment facilities serving Spanish-speaking clients in Florida, New Mexico, California, and Puerto Rico. Participants were administered the S-ASI-MV as well as Spanish versions of the general health subscale of the SF-36, the work and family unit subscales of the Social Adjustment Scale Self-Report, the Michigan Alcohol Screening Test, the alcohol and drug subscales of the Personality Assessment Inventory, and the Hopkins Symptom Checklist-90. Three-to-five-day test-retest reliability was examined along with criterion validity, convergent/discriminant validity, and factorial validity. Measurement invariance between the English and Spanish versions of the ASI-MV was also examined. The S-ASI-MV demonstrated good test-retest reliability (ICCs for composite scores between .59 and .93), criterion validity (rs for composite scores between .66 and .87), and convergent/discriminant validity. Factorial validity and measurement invariance were demonstrated. These results compared favorably with those reported for the original interviewer version of the ASI and the English version of the ASI-MV.

  15. Consciousness Indexing and Outcome Prediction with Resting-State EEG in Severe Disorders of Consciousness.

    Science.gov (United States)

    Stefan, Sabina; Schorr, Barbara; Lopez-Rolon, Alex; Kolassa, Iris-Tatjana; Shock, Jonathan P; Rosenfelder, Martin; Heck, Suzette; Bender, Andreas

    2018-04-17

    We applied the following methods to resting-state EEG data from patients with disorders of consciousness (DOC) for consciousness indexing and outcome prediction: microstates, entropy (i.e. approximate, permutation), power in alpha and delta frequency bands, and connectivity (i.e. weighted symbolic mutual information, symbolic transfer entropy, complex network analysis). Patients with unresponsive wakefulness syndrome (UWS) and patients in a minimally conscious state (MCS) were classified into these two categories by fitting and testing a generalised linear model. We aimed subsequently to develop an automated system for outcome prediction in severe DOC by selecting an optimal subset of features using sequential floating forward selection (SFFS). The two outcome categories were defined as UWS or dead, and MCS or emerged from MCS. Percentage of time spent in microstate D in the alpha frequency band performed best at distinguishing MCS from UWS patients. The average clustering coefficient obtained from thresholding beta coherence performed best at predicting outcome. The optimal subset of features selected with SFFS consisted of the frequency of microstate A in the 2-20 Hz frequency band, path length obtained from thresholding alpha coherence, and average path length obtained from thresholding alpha coherence. Combining these features seemed to afford high prediction power. Python and MATLAB toolboxes for the above calculations are freely available under the GNU public license for non-commercial use ( https://qeeg.wordpress.com ).

  16. Psychosocial characteristics of drunk drivers assessed by the Addiction Severity Index, prediction of relapse.

    Science.gov (United States)

    Hubicka, Beata; Laurell, Hans; Bergman, Hans

    2010-02-01

    To investigate psychosocial characteristics and problems of a representative sample of Swedish drunk drivers with special consideration of the gender of the driver; analyze criminal records of the drivers before and after enrollment in the study; identify psychosocial predictors of relapse to drunk driving. Psychosocial characteristics were assessed by the Addiction Severity Index (ASI). Alcohol problems were additionally assessed by the Alcohol Use Disorders Identification Test (AUDIT). Criminal records were collected for the five year period before the enrollment, and for the subsequent two years, from Sweden's official crime statistics. About half of the investigated drivers had other psychosocial problems besides the drink driving offence. Female drivers had more alcohol, drug, psychiatric and relational problems, including with parents when growing up, than male drivers, but less previous and subsequent criminality. Heavily drunk drivers (blood alcohol concentration > or = 0.1%) had more problems with alcohol, legal status and employment and support than the other drunk drivers. Problems with legal status, family and social relations and alcohol use increased the risk of relapse in drunk driving, while medical problems seemed to be a protective factor. Different ASI risk factors were identified for relapse in either traffic offences or other crimes. As well as the drunk driving offence, drunk drivers often have other psychosocial problems, female drivers in particular. Already the blood alcohol concentration per se gives some indication of the psychosocial problem profile of a drunk driver and the ASI profile has some prognostic value for relapse in drunk driving.

  17. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis.

    Science.gov (United States)

    Maheux-Lacroix, S; Nesbitt-Hawes, E; Deans, R; Won, H; Budden, A; Adamson, D; Abbott, J A

    2017-11-01

    Can live birth be accurately predicted following surgical resection of moderate-severe (Stage III-IV) endometriosis? Live births can accurately be predicted with the endometriosis fertility index (EFI), with adnexal function being the most important factor to predict non-assisted reproductive technology (non-ART) fertility or the requirement for ART (www.endometriosisefi.com). Fertility prognosis is important to many women with severe endometriosis. Controversy persists regarding optimal post-operative management to achieve pregnancy and the counselling of patients regarding duration of conventional treatments before undergoing ART. The EFI is reported to correlate with expectant management pregnancy rate, although external validation has been performed without specifically addressing fertility in women with moderate and severe endometriosis. Retrospective cohort study of 279 women from September 2001 to June 2016. We included women undergoing laparoscopic resection of Stage III-IV endometriosis who attempted pregnancy post-operatively. The EFI was calculated based on detailed operative reports and surgical images. Fertility outcomes were obtained by direct patient contact. Kaplan-Meier model, log rank test and Cox regression were used for analyses. The follow-up rate was 84% with a mean duration of 4.1 years. A total of 147 women (63%) had a live birth following surgery, 94 of them (64%) without ART. The EFI was highly associated with live births (P years was 0% and steadily increased up to 91% with an EFI of 9-10, while the proportion of women who attempted ART and had a live birth, steadily increased from 38 to 71% among the same EFI strata (P = 0.1). A low least function score was the most significant predictor of failure (P = 0.003), followed by having had a previous resection (P = 0.019) or incomplete resection (P = 0.028), being older than 40 compared to years of age (P = 0.027), and having leiomyomas (P = 0.037). The main limitation of this study is its

  18. [Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

    Science.gov (United States)

    Machado, Flávia Mori Sarti; Simões, Arlete Naresse

    2008-02-01

    To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

  19. Emergency Severity Index version 4: a valid and reliable tool in pediatric emergency department triage.

    Science.gov (United States)

    Green, Nicole A; Durani, Yamini; Brecher, Deena; DePiero, Andrew; Loiselle, John; Attia, Magdy

    2012-08-01

    The Emergency Severity Index version 4 (ESI v.4) is the most recently implemented 5-level triage system. The validity and reliability of this triage tool in the pediatric population have not been extensively established. The goals of this study were to assess the validity of ESI v.4 in predicting hospital admission, emergency department (ED) length of stay (LOS), and number of resources utilized, as well as its reliability in a prospective cohort of pediatric patients. The first arm of the study was a retrospective chart review of 780 pediatric patients presenting to a pediatric ED to determine the validity of ESI v.4. Abstracted data included acuity level assigned by the triage nurse using ESI v.4 algorithm, disposition (admission vs discharge), LOS, and number of resources utilized in the ED. To analyze the validity of ESI v.4, patients were divided into 2 groups for comparison: higher-acuity patients (ESI levels 1, 2, and 3) and lower-acuity patients (ESI levels 4 and 5). Pearson χ analysis was performed for categorical variables. For continuous variables, we conducted a comparison of means based on parametric distribution of variables. The second arm was a prospective cohort study to determine the interrater reliability of ESI v.4 among and between pediatric triage (PT) nurses and pediatric emergency medicine (PEM) physicians. Three raters (2 PT nurses and 1 PEM physician) independently assigned triage scores to 100 patients; k and interclass correlation coefficient were calculated among PT nurses and between the primary PT nurses and physicians. In the validity arm, the distribution of ESI score levels among the 780 cases are as follows: ESI 1: 2 (0.25%); ESI 2: 73 (9.4%); ESI 3: 289 (37%); ESI 4: 251 (32%); and ESI 5: 165 (21%). Hospital admission rates by ESI level were 1: 100%, 2: 42%, 3: 14.9%, 4: 1.2%, and 5: 0.6%. The admission rate of the higher-acuity group (76/364, 21%) was significantly greater than the lower-acuity group (4/415, 0.96%), P group was

  20. The oxygen reactivity index and its relation to sensor technology in patients with severe brain lesions.

    Science.gov (United States)

    Dengler, Julius; Frenzel, Christin; Vajkoczy, Peter; Horn, Peter; Wolf, Stefan

    2013-08-01

    The oxygen reactivity index (ORx) has been introduced to assess the status of cerebral autoregulation after traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Currently, there is some controversy about whether the ORx depends on the type of PbrO2-sensor technology used for its calculation. To examine if the probe technology does matter, we compared the ORx and the resulting optimal cerebral perfusion pressures (CPPopt) of simultaneously implanted Licox (CC1.SB, Integra Neuroscience, France) and Neurovent-PTO (Raumedic, Germany) probes in patients after aneurysmal SAH or severe TBI. Licox and Raumedic probes were implanted side by side in 11 patients after TBI or SAH. ORx and CPPopt were recorded continuously. The equivalence of both probes was examined using Bland-Altman analyses. The mean difference in ORx was 0.1, with Licox producing higher values. The limits of agreement regarding ORx ranged from -0.6 to +0.7. When both probes' ORx values were compared in each patient, no specific pattern in their relationship was seen. The mean difference in CPPopt was 0 mmHg with limits of agreement between -16.5 and +16.4 mmHg. Owing to the rather limited number of patients, we view the results of this study as preliminary. The main result is that Licox and Raumedic showed consistent differences in ORx and CPPopt. Therefore, ORx values of both probes cannot be interchanged and should not be viewed as equivalent. This should be taken into consideration when discussing ORx data generated by different PbrO2 probe types.

  1. Global longitudinal strain and its dynamics after replacement of aortal valve in patients with severe aortic stenosis

    Directory of Open Access Journals (Sweden)

    N.V. Ponych

    2017-09-01

    Full Text Available The aim – to determine factors that may influence the global longitudinal strain (GLS and its dynamics after replacement aortic valve (RAV in patients with severe aortic stenosis (AS. Materials and methods. In a one-center prospective study, 30 patients with severe AS were sequentially screened for RAV surgery. Among them there were 16 (53,3 % men and 14 (46,7 % women. The median age was 63 (range from 46 to 77, quartiles 57–69 years. All patients underwent clinical and instrumental study, including transthoracic echocardiography (TTE and coronary angiography. In the early postoperative period and 6–12 months after surgery, all patients performed a repeat TTE according to a standard protocol that included an assessment of the GLS. GLS data and their dynamics was performed in the groups of patients with preserved (n = 18 and low (n = 12 left ventricular ejection fraction (LV EF. Results. In patients with preserved LV EF, the median of the preoperative GLS was –12 % (in the quartiles from –15 to –11 %, postoperative GLS –11 % (quartiles from –11 to –9 %. In patients with reduced LV EF, the median of the preoperative GLS was –6 % (from –8.5 to –4 % for quartiles, –8.5 % for postoperative GLS (from –10 to –6 % for quartiles (p < 0.001 for comparison of baseline and p < 0.05 relative to differences in dynamics of GLS in comparable groups. In the examined patients, significant correlations were found between baseline GLS with functional class of heart failure, concomitant tricuspid insufficiency, atrial fibrillation, duration of QRS complex, LV EF, end-diastolic, endsystolic volume index (EDV, ESV and volume left atrium (LA, left ventricular myocardial mass index, aortic valve orifice area index, E/A ratio, and Thei index. In turn, the positive dynamics of GLS significantly depended on the initial functional class of heart failure, the stage of arterial hypertension, the degree of tricuspid insufficiency, LV EF, the index

  2. Hemolysis is associated with low reticulocyte production index and predicts blood transfusion in severe malarial anemia.

    Directory of Open Access Journals (Sweden)

    Rolf Fendel

    Full Text Available BACKGROUND: Falciparum Malaria, an infectious disease caused by the apicomplexan parasite Plasmodium falciparum, is among the leading causes of death and morbidity attributable to infectious diseases worldwide. In Gabon, Central Africa, one out of four inpatients have severe malarial anemia (SMA, a life-threatening complication if left untreated. Emerging drug resistant parasites might aggravate the situation. This case control study investigates biomarkers of enhanced hemolysis in hospitalized children with either SMA or mild malaria (MM. METHODS AND FINDINGS: Ninety-one children were included, thereof 39 SMA patients. Strict inclusion criteria were chosen to exclude other causes of anemia. At diagnosis, erythrophagocytosis (a direct marker for extravascular hemolysis, EVH was enhanced in SMA compared to MM patients (5.0 arbitrary units (AU (interquartile range (IR: 2.2-9.6 vs. 2.1 AU (IR: 1.3-3.9, p<0.01. Furthermore, indirect markers for EVH, (i.e. serum neopterin levels, spleen size enlargement and monocyte pigment were significantly increased in SMA patients. Markers for erythrocyte ageing, such as CD35 (complement receptor 1, CD55 (decay acceleration factor and phosphatidylserine exposure (annexin-V-binding were investigated by flow cytometry. In SMA patients, levels of CD35 and CD55 on the red blood cell surface were decreased and erythrocyte removal markers were increased when compared to MM or reconvalescent patients. Additionally, intravascular hemolysis (IVH was quantified using several indirect markers (LDH, alpha-HBDH, haptoglobin and hemopexin, which all showed elevated IVH in SMA. The presence of both IVH and EVH predicted the need for blood transfusion during antimalarial treatment (odds ratio 61.5, 95% confidence interval (CI: 8.9-427. Interestingly, this subpopulation is characterized by a significantly lowered reticulocyte production index (RPI, p<0.05. CONCLUSIONS: Our results show the multifactorial pathophysiology of SMA

  3. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  4. Global warming influence on climatic variables and thermal comfort index in Paraíba state, Brazil

    OpenAIRE

    Silva, Gustavo de Assis; Instituto Agronômico de Pernambuco; Souza, Bonifácio Benicio de; Universidade Federal Campina Grande; Silva, Elisângela Maria Nunes da; UFCG

    2015-01-01

    The increase in the concentration of greenhouse gases originated from burning fossil fuels, along with breeding, been appointed as the main causes of global climate change resulting from global warming in earth's atmosphere. These changes can cause serious impacts on the lives and livestock production mainly in tropical regions. Therefore, the aim with this work was to evaluate the effect of global warming on the climatological variables, thermal comfort index and animal production in the sta...

  5. Estimates of global HIV/AIDS mortality, prevalence and incidence rates, and their association with the Human Development Index

    OpenAIRE

    Kamyar Mansori; Erfan Ayubi; Fatemeh Khosravi Shadmani; Shiva Mansouri Hanis; Somayeh Khazaei; Mohadeseh Sani; Yousef Moradi; Salman Khazaei; Abolfazl Mohammadbeigi

    2017-01-01

    Background: HIV/AIDS is one of greatest global public health concerns today due to the high incidence, prevalence and mortality rates. The aim of this research was investigate and estimate the global HIV/AIDS mortality, prevalence and incidence rates, and explore their associations with the Human Development Index. Methods: The global age-standardized rates of mortality, prevalence and incidence of HIV/AIDS were obtained from the UNAIDS for different countries in 2015. The human developm...

  6. Progress in Global Surveillance and Response Capacity 10 Years After Severe Acute Respiratory Syndrome

    Centers for Disease Control (CDC) Podcasts

    2013-04-10

    Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseases' synopsis, Progress in Global Surveillance and Response Capacity 10 Years after Severe Acute Respiratory Syndrome.  Created: 4/10/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/11/2013.

  7. Assessing global exposure and vulnerability towards natural hazards: the Disaster Risk Index

    Directory of Open Access Journals (Sweden)

    P. Peduzzi

    2009-07-01

    Full Text Available This paper presents a model of factors influencing levels of human losses from natural hazards at the global scale, for the period 1980–2000. This model was designed for the United Nations Development Programme as a building stone of the Disaster Risk Index (DRI, which aims at monitoring the evolution of risk. Assessing what countries are most at risk requires considering various types of hazards, such as droughts, floods, cyclones and earthquakes. Before assessing risk, these four hazards were modelled using GIS and overlaid with a model of population distribution in order to extract human exposure. Human vulnerability was measured by crossing exposure with selected socio-economic parameters. The model evaluates to what extent observed past losses are related to population exposure and vulnerability. Results reveal that human vulnerability is mostly linked with country development level and environmental quality. A classification of countries is provided, as well as recommendations on data improvement for future use of the model.

  8. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhou Xiao-Yu

    2012-12-01

    Full Text Available Abstract Background Prognostic assessment is important for the management of patients with acute pulmonary embolism (APE. Pulmonary Embolism Severity Index (PESI and simple PESI (sPESI are new emerged prognostic assessment tools for APE. The aim of this meta-analysis is to assess the accuracy of the PESI and the sPESI to predict prognostic outcomes (all-cause and PE-related mortality, serious adverse events in APE patients, and compare between these two PESIs. Methods MEDLINE and EMBASE database were searched up to June 2012 using the terms “Pulmonary Embolism Severity Index” and “pulmonary embolism”. Summary odds ratio (OR with 95% confidence intervals (CIs for prognostic outcomes in low risk PESI versus high risk PESI were calculated. Summary receiver operating characteristic curve (SROC used to estimate overall predicting accuracies of prognostic outcomes. Results Twenty-one studies were included in this meta-analysis. The results showed low-risk PESI was significantly associated with lower all-cause mortality (OR 0.13; 95% CI 0.12 to 0.15, PE-related mortality (OR 0.09; 95% CI 0.05 to 0.17 and serious adverse events (OR 0.34; 95% CI 0.29 to 0.41, with no homogeneity across studies. In sPESI subgroup, the OR of all-cause mortality, PE-related mortality, and serious adverse events was 0.10 (95% CI 0.08 to 0.14, 0.09 (95% CI 0.03 to 0.26 and 0.40 (95% CI 0.31 to 0.51, respectively; while in PESI subgroup, the OR was 0.14 (95% CI 0.13 to 0.16, 0.09 (95% CI 0.04 to 0.21, and 0.30 (95% CI 0.23 to 0.38, respectively. For accuracy analysis, the pooled sensitivity, the pooled specificity, and the overall weighted AUC for PESI predicting all-cause mortality was 0.909 (95% CI: 0.900 to 0.916, 0.411 (95% CI: 0.407 to 0.415, and 0.7853±0.0058, respectively; for PE-related mortality, it was 0.953 (95% CI: 0.913 to 0.978, 0.374 (95% CI: 0.360 to 0.388, and 0.8218±0.0349, respectively; for serious adverse events, it was 0.821 (95% CI: 0.795 to 0

  9. A Comparison of Global Indexing Schemes to Facilitate Earth Science Data Management

    Science.gov (United States)

    Griessbaum, N.; Frew, J.; Rilee, M. L.; Kuo, K. S.

    2017-12-01

    Recent advances in database technology have led to systems optimized for managing petabyte-scale multidimensional arrays. These array databases are a good fit for subsets of the Earth's surface that can be projected into a rectangular coordinate system with acceptable geometric fidelity. However, for global analyses, array databases must address the same distortions and discontinuities that apply to map projections in general. The array database SciDB supports enormous databases spread across thousands of computing nodes. Additionally, the following SciDB characteristics are particularly germane to the coordinate system problem: SciDB efficiently stores and manipulates sparse (i.e. mostly empty) arrays. SciDB arrays have 64-bit indexes. SciDB supports user-defined data types, functions, and operators. We have implemented two geospatial indexing schemes in SciDB. The simplest uses two array dimensions to represent longitude and latitude. For representation as 64-bit integers, the coordinates are multiplied by a scale factor large enough to yield an appropriate Earth surface resolution (e.g., a scale factor of 100,000 yields a resolution of approximately 1m at the equator). Aside from the longitudinal discontinuity, the principal disadvantage of this scheme is its fixed scale factor. The second scheme uses a single array dimension to represent the bit-codes for locations in a hierarchical triangular mesh (HTM) coordinate system. A HTM maps the Earth's surface onto an octahedron, and then recursively subdivides each triangular face to the desired resolution. Earth surface locations are represented as the concatenation of an octahedron face code and a quadtree code within the face. Unlike our integerized lat-lon scheme, the HTM allow for objects of different size (e.g., pixels with differing resolutions) to be represented in the same indexing scheme. We present an evaluation of the relative utility of these two schemes for managing and analyzing MODIS swath data.

  10. Climatology of UVA and ozone variations and the global solar UV-index

    International Nuclear Information System (INIS)

    Roy, C.R.; Gies, H.P.; Toomey, S.J.

    1996-01-01

    Human overexposure to solar ultraviolet radiation (UVR) can result in acute and chronic adverse health effects on both the skin and the eye. Skin cancer (both non-melanoma and malignant melanoma) and cataract impose a huge social and cost burden on many societies throughout the world. Such human health problems can be avoided if the individual reduces their UVR exposure. Unfortunately enlightenment may not help persons who have experienced high episodic exposures during childhood as this appears to be an important causal factor in melanoma. In some countries public educational campaigns have been underway for decades in other countries they are just beginning; the global solar uv-index provides a globally consistent means of reporting or predicting UVR as part of public education on UVR exposure. There are now indications that some of these programs have been effective in halting the climb in melanoma incidence. The UVR, and in particular UVB, reaching the earth's surface varies with both latitude and time (both of the day and year). The transmission of the extraterrestrial radiation through the atmosphere is determined by ozone clouds, aerosols and to a lesser extent, trace gases. In recent decades there has been considerable concern that long-term changes in ozone and perhaps clouds and aerosols may result in changes in the UVB at the earth's surface. (author)

  11. Global Trends in Seasonality of Normalized Difference Vegetation Index (NDVI, 1982–2011

    Directory of Open Access Journals (Sweden)

    Assaf Anyamba

    2013-09-01

    Full Text Available A 30-year series of global monthly Normalized Difference Vegetation Index (NDVI imagery derived from the Global Inventory Modeling and Mapping Studies (GIMMS NDVI3g archive was analyzed for the presence of trends in changing seasonality. Using the Seasonal Trend Analysis (STA procedure, over half (56.30% of land surfaces were found to exhibit significant trends. Almost half (46.10% of the significant trends belonged to three classes of seasonal trends (or changes. Class 1 consisted of areas that experienced a uniform increase in NDVI throughout the year, and was primarily associated with forested areas, particularly broadleaf forests. Class 2 consisted of areas experiencing an increase in the amplitude of the annual seasonal signal whereby increases in NDVI in the green season were balanced by decreases in the brown season. These areas were found primarily in grassland and shrubland regions. Class 3 was found primarily in the Taiga and Tundra biomes and exhibited increases in the annual summer peak in NDVI. While no single attribution of cause could be determined for each of these classes, it was evident that they are primarily found in natural areas (as opposed to anthropogenic land cover conversions and that they are consistent with climate-related ameliorations of growing conditions during the study period.

  12. Seasonal variation of photosynthetic model parameters and leaf area index from global Fluxnet eddy covariance data

    Science.gov (United States)

    Groenendijk, M.; Dolman, A. J.; Ammann, C.; Arneth, A.; Cescatti, A.; Dragoni, D.; Gash, J. H. C.; Gianelle, D.; Gioli, B.; Kiely, G.; Knohl, A.; Law, B. E.; Lund, M.; Marcolla, B.; van der Molen, M. K.; Montagnani, L.; Moors, E.; Richardson, A. D.; Roupsard, O.; Verbeeck, H.; Wohlfahrt, G.

    2011-12-01

    Global vegetation models require the photosynthetic parameters, maximum carboxylation capacity (Vcm), and quantum yield (α) to parameterize their plant functional types (PFTs). The purpose of this work is to determine how much the scaling of the parameters from leaf to ecosystem level through a seasonally varying leaf area index (LAI) explains the parameter variation within and between PFTs. Using Fluxnet data, we simulate a seasonally variable LAIF for a large range of sites, comparable to the LAIM derived from MODIS. There are discrepancies when LAIF reach zero levels and LAIM still provides a small positive value. We find that temperature is the most common constraint for LAIF in 55% of the simulations, while global radiation and vapor pressure deficit are the key constraints for 18% and 27% of the simulations, respectively, while large differences in this forcing still exist when looking at specific PFTs. Despite these differences, the annual photosynthesis simulations are comparable when using LAIF or LAIM (r2 = 0.89). We investigated further the seasonal variation of ecosystem-scale parameters derived with LAIF. Vcm has the largest seasonal variation. This holds for all vegetation types and climates. The parameter α is less variable. By including ecosystem-scale parameter seasonality we can explain a considerable part of the ecosystem-scale parameter variation between PFTs. The remaining unexplained leaf-scale PFT variation still needs further work, including elucidating the precise role of leaf and soil level nitrogen.

  13. Exploring energy efficiency in several European countries. An attribution analysis of the Divisia structural change index

    International Nuclear Information System (INIS)

    Fernández González, P.

    2015-01-01

    Highlights: • We present a new attribution analysis approach to study structural change index. • Based on LMDI method, we decompose changes in AEI in the EU in 1995–2010. • Mild AEI drop as a result of structural change, particularly in Eastern economies. • Transport, hotels and restaurants: positive contributors, specifically in Western EU. • Strategies should be focused on Industry: the most influential sector in reducing AEI. - Abstract: This paper aims at exploring the influence that the changes in sectoral composition in most EU economies have had on aggregate energy intensity. We rely on the so-called Logarithmic Mean Divisia Index (LMDI) method, implemented within a multiplicative energy intensity approach. Then, based on the Index Decomposition Analysis (IDA), we present, develop and apply a new methodology that enables the exploration of the contribution of each sector to the percent change in the structural factors index. Our findings show: (a) a greater importance of the intensity factor over the structural one, (b) a positive influence of structural change in some ex-communist countries, and (c) a strong, negative contribution of the industrial sector (including construction) to changes in aggregate energy intensity in most European economies, particularly in the Western ones. In short, adaptation to more efficient techniques, innovation, R and D, and substitution for higher quality energies, seem to be the action lines to follow, although in former communist countries these strategies should be accompanied by other policies aiming at accelerating the transition processes

  14. Development of a Global Evaporative Stress Index Based on Thermal and Microwave LST towards Improved Monitoring of Agricultural Drought

    Science.gov (United States)

    Hain, C.; Anderson, M. C.; Otkin, J.; Holmes, T. R.; Gao, F.

    2017-12-01

    This presentation will describe the development of a global agricultural monitoring tool, with a focus on providing early warning of developing vegetation stress for agricultural decision-makers and stakeholders at relatively high spatial resolution (5-km). The tool is based on remotely sensed estimates of evapotranspiration, retrieved via energy balance principals using observations of land surface temperature. The Evaporative Stress Index (ESI) represents anomalies in the ratio of actual-to-potential ET generated with the ALEXI surface energy balance model. The LST inputs to ESI have been shown to provide early warning information about the development of vegetation stress with stress-elevated canopy temperatures observed well before a decrease in greenness is detected in remotely sensed vegetation indices. As a diagnostic indicator of actual ET, the ESI requires no information regarding antecedent precipitation or soil moisture storage capacity - the current available moisture to vegetation is deduced directly from the remotely sensed LST signal. This signal also inherently accounts for both precipitation and non-precipitation related inputs/sinks to the plant-available soil moisture pool (e.g., irrigation) which can modify crop response to rainfall anomalies. Independence from precipitation data is a benefit for global agricultural monitoring applications due to sparseness in existing ground-based precipitation networks, and time delays in public reporting. Several enhancements to the current ESI framework will be addressed as requested from project stakeholders: (a) integration of "all-sky" MW Ka-band LST retrievals to augment "clear-sky" thermal-only ESI in persistently cloudy regions; (b) operational production of ESI Rapid Change Indices which provide important early warning information related to onset of actual vegetation stress; and (c) assessment of ESI as a predictor of global yield anomalies; initial studies have shown the ability of intra

  15. Pengaruh Corporate Governance Perception Index Terhadap Kinerja perusahaan dalam Masa Krisis Ekonomi Global

    Directory of Open Access Journals (Sweden)

    Adi Suharna

    2016-04-01

    Full Text Available This research examines the infl uence of corporate governance toward corporate performance, in this case market performance and fi nancial performance. The rating of corporate governance perception index (CGPI for 2008 until 2010 by The Indonesian Institute for Corporate Governance is used to measure the corporate governance implementation and Tobin’s Q as a market performance measurement  with  Return  on  Equity  (ROE  and  Return  on  Assets  (ROA  as fi nancial performance measurement. The control variables used are leverage, age,  type  of  industry  and  size  of  fi rm.  This  study  is  causal  research  which companies that scored CGPI and fi nancial statement during 2008-2010 were drawn using purposive sampling method. Research data are pooling data which combines time series and cross sectional data during the observation period 2008-2010. This research employs a multiple regression to test hypothesis that corporate governance and corporate performance are positively related.  From  the  fi rst  regression  equation,  the  result  of  this  study  shows  that  there is  influence  between  corporate  governance  perception  index  and  market performance  (Tobin’s  Q  during  crisis  while  the  control  variables  have  no effect  on  market  performance  unless  leverage  levels  negatively  affect  the market  performance  of  the  company  during  the  global  economic  crisis.  The second  regression  equation  shows  that  there  is  infl uence  between  corporate governance  perception  index  and  fi nancial  performance  (ROE  during  crisis while the control variables have no effect on fi nancial performance (ROE. The third regression equation shows that there has no infl uence between corporate governance  perception  index  (CGPI  and  the  control  variables  to  fi nancial performance (ROA during the

  16. Pengaruh Corporate Governance Perception Index Terhadap Kinerja perusahaan dalam Masa Krisis Ekonomi Global

    Directory of Open Access Journals (Sweden)

    Adi Suharna

    2017-05-01

    Full Text Available This research examines the infl uence of corporate governance toward corporate performance, in this case market performance and fi nancial performance. The rating of corporate governance perception index (CGPI for 2008 until 2010 by The Indonesian Institute for Corporate Governance is used to measure the corporate governance implementation and Tobin’s Q as a market performance measurement  with  Return  on  Equity  (ROE  and  Return  on  Assets  (ROA  as fi nancial performance measurement. The control variables used are leverage, age,  type  of  industry  and  size  of  fi rm.  This  study  is  causal  research  which companies that scored CGPI and fi nancial statement during 2008-2010 were drawn using purposive sampling method. Research data are pooling data which combines time series and cross sectional data during the observation period 2008-2010. This research employs a multiple regression to test hypothesis that corporate governance and corporate performance are positively related.  From  the  fi rst  regression  equation,  the  result  of  this  study  shows  that  there is  influence  between  corporate  governance  perception  index  and  market performance  (Tobin’s  Q  during  crisis  while  the  control  variables  have  no effect  on  market  performance  unless  leverage  levels  negatively  affect  the market  performance  of  the  company  during  the  global  economic  crisis.  The second  regression  equation  shows  that  there  is  infl uence  between  corporate governance  perception  index  and  fi nancial  performance  (ROE  during  crisis while the control variables have no effect on fi nancial performance (ROE. The third regression equation shows that there has no infl uence between corporate governance  perception  index  (CGPI  and  the  control  variables  to  fi nancial performance (ROA during the

  17. Towards a Global Names Architecture: The future of indexing scientific names.

    Science.gov (United States)

    Pyle, Richard L

    2016-01-01

    For more than 250 years, the taxonomic enterprise has remained almost unchanged. Certainly, the tools of the trade have improved: months-long journeys aboard sailing ships have been reduced to hours aboard jet airplanes; advanced technology allows humans to access environments that were once utterly inaccessible; GPS has replaced crude maps; digital hi-resolution imagery provides far more accurate renderings of organisms that even the best commissioned artists of a century ago; and primitive candle-lit microscopes have been replaced by an array of technologies ranging from scanning electron microscopy to DNA sequencing. But the basic paradigm remains the same. Perhaps the most revolutionary change of all - which we are still in the midst of, and which has not yet been fully realized - is the means by which taxonomists manage and communicate the information of their trade. The rapid evolution in recent decades of computer database management software, and of information dissemination via the Internet, have both dramatically improved the potential for streamlining the entire taxonomic process. Unfortunately, the potential still largely exceeds the reality. The vast majority of taxonomic information is either not yet digitized, or digitized in a form that does not allow direct and easy access. Moreover, the information that is easily accessed in digital form is not yet seamlessly interconnected. In an effort to bring reality closer to potential, a loose affiliation of major taxonomic resources, including GBIF, the Encyclopedia of Life, NBII, Catalog of Life, ITIS, IPNI, ICZN, Index Fungorum, and many others have been crafting a "Global Names Architecture" (GNA). The intention of the GNA is not to replace any of the existing taxonomic data initiatives, but rather to serve as a dynamic index to interconnect them in a way that streamlines the entire taxonomic enterprise: from gathering specimens in the field, to publication of new taxa and related data.

  18. Toward the Development of an Objective Index of Dysphonia Severity: A Four-Factor Acoustic Model

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson

    2006-01-01

    During assessment and management of individuals with voice disorders, clinicians routinely attempt to describe or quantify the severity of a patient's dysphonia. This investigation used acoustic measures derived from sustained vowel samples to predict dysphonia severity (as determined by auditory-perceptual ratings), for a diverse set of voice…

  19. Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index

    Science.gov (United States)

    Stevens, Gretchen A.; Ezzati, Majid; Black, Robert E.; Kraemer, Klaus

    2015-01-01

    Background Deficiencies in essential vitamins and minerals–also termed hidden hunger–are pervasive and hold negative consequences for the cognitive and physical development of children. Methods This analysis evaluates the change in hidden hunger over time in the form of one composite indicator–the Hidden Hunger Index (HHI)–using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency). Net changes from 1995–2011 and population weighted regional means for various time periods are measured. Findings Globally, hidden hunger improved (-6.7 net change in HHI) from 1995–2011. Africa was the only region to see a deterioration in hidden hunger (+1.9) over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0), while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased. Interpretation This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs). However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda. Funding Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish. PMID:26673631

  20. Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index.

    Directory of Open Access Journals (Sweden)

    Julie C Ruel-Bergeron

    Full Text Available Deficiencies in essential vitamins and minerals-also termed hidden hunger-are pervasive and hold negative consequences for the cognitive and physical development of children.This analysis evaluates the change in hidden hunger over time in the form of one composite indicator-the Hidden Hunger Index (HHI-using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency. Net changes from 1995-2011 and population weighted regional means for various time periods are measured.Globally, hidden hunger improved (-6.7 net change in HHI from 1995-2011. Africa was the only region to see a deterioration in hidden hunger (+1.9 over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0, while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased.This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs. However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda.Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish.

  1. A comparison principle for an American option on several assets: Index and spread options

    Directory of Open Access Journals (Sweden)

    Peter Laurence

    2003-07-01

    Full Text Available Using the method of symmetrization, we compare the price of the American option on an index or spread to that of the solution of a parabolic variational inequality in one spatial variable. This comparison principle is established for a broad class of diffusion operators with time and state dependent coefficients. The purpose is to take a first step towards deriving symmmetrized problems whose solutions bound solutions of multidimensional American option problems with variable coefficients when the computation of the latter lies beyond the scope of the most powerful numerical methods.

  2. Management model of productive capacity: integrating theory of constraints and the global operational efficiency index (IROG

    Directory of Open Access Journals (Sweden)

    Diego Augusto Pacheco

    2012-08-01

    Full Text Available This paper presents a model of management capacity in productive systems integrating the concepts of the Theory of Constraints and Total Productive Maintenance (TPM. The main objective of this study is to discuss and propose a model of management capacity, able to answer the following key questions: i capacity indicators which should be considered and how to measure them to measure the productive capacity of manufacturing systems? ii what is the real productive capacity of the system analyzed under a determined relationship between capacity and demand? The discussion of the proposed model is relevant because the definition of productive capacity system enables better management of resources and capabilities, improve production scheduling on the factory floor and meeting the demands imposed by the market. This paper presents the proposition of using the Operating Income Index Global (IROG with a different approach from traditional literature dealing with the theme, presented by Nakajima (1988. The results of this paper enable to develop a model to determine the capacity of the production system and the impact on the productive capacity of the entire system, not to consider the quality conformances that occur after the bottleneck resource of the production flow.

  3. An Index of Trauma Severity Based on Multiattribute Utility: An Illustration of Complex Utility Modeling.

    Science.gov (United States)

    1981-10-01

    measure for Central Nervus System is the Glasgow Cons Score (GCS), a scale of brain and spinal cord injury (Langfitt [1978]), and is itself an additive...concerns directly relating to the injury itself were identified. These were: 1. Ventilation Severity 2 Circulation Severity 3. Central Nervous System ...interacting system within which these concerns represent interacting parts. Most trauma involves only one of these systems , but more than one may be

  4. The WHO maternal near-miss approach and the maternal severity index model (MSI: tools for assessing the management of severe maternal morbidity.

    Directory of Open Access Journals (Sweden)

    Joao Paulo Souza

    Full Text Available OBJECTIVES: To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments. METHODS: In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity. RESULTS: Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6. The maternal severity index (MSI model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993. CONCLUSION: The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.

  5. Proposal of a service delivery integration index of home care for older persons: application in several European cities

    Directory of Open Access Journals (Sweden)

    Jean-Claude Henrard

    2006-07-01

    Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

  6. Discussion on calculation of disease severity index values from scales with unequal intervals

    Science.gov (United States)

    When estimating severity of disease, a disease interval (or category) scale comprises a number of categories of known numeric values – with plant disease this is generally the percent area with symptoms (e.g., the Horsfall-Barratt (H-B) scale). Studies in plant pathology and plant breeding often use...

  7. Association between Experience of Child Abuse and Severity of Drug Addiction Measured by the Addiction Severity Index among Japanese Drug-Dependent Patients

    Science.gov (United States)

    Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka

    2015-01-01

    The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence. PMID:25741639

  8. Association between Experience of Child Abuse and Severity of Drug Addiction Measured by the Addiction Severity Index among Japanese Drug-Dependent Patients

    Directory of Open Access Journals (Sweden)

    Yasukazu Ogai

    2015-03-01

    Full Text Available The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J. One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA had a significantly higher severity of drug use than men who did not experience it (MNEA. Female participants who experienced child abuse (FEA had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA. Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence.

  9. Association between experience of child abuse and severity of drug addiction measured by the Addiction Severity Index among Japanese drug-dependent patients.

    Science.gov (United States)

    Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka

    2015-03-03

    The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence.

  10. TOMS/Earth-Probe Total Ozone Aerosol Index UV-Reflectivity UV-B Erythemal Irradiance Daily L3 Global 1x1.25 deg V008

    Data.gov (United States)

    National Aeronautics and Space Administration — The Total Ozone Mapping Spectrometer (TOMS) version 8 daily global gridded data consist of total column ozone, aerosol index, Lambertian effective surface...

  11. Time-frequency wavelet analysis of the interrelationship between the global macro assets and the fear indexes

    Science.gov (United States)

    Abid, Fathi; Kaffel, Bilel

    2018-01-01

    Understanding the interrelationships of the global macro assets is crucial for global macro investing. This paper investigates the local variance and the interconnection between the stock, gold, oil, Forex and the implied volatility markets in the time/frequency domains using the wavelet methodology, including the wavelet power spectrum, the wavelet squared coherence and phase difference, the wavelet multiple correlation and cross-correlation. The univariate analysis reveals that, in some crisis periods, underlying asset markets present the same pattern in terms of the wavelet power spectrum indicating high volatility for the medium scale, and that for the other market stress periods, volatility behaves differently. Moreover, unlike the underlying asset markets, the implied volatility markets are characterized by high power regions across the entire period, even in the absence of economic events. Bivariate results show a bidirectional relationship between the underlying assets and their corresponding implied volatility indexes, and a steady co-movement between the stock index and its corresponding fear index. Multiple correlation analysis indicates a strong correlation between markets at high scales with evidence of a nearly perfect integration for a period longer than a year. In addition, the hedging strategies based on the volatility index lead to an increase in portfolio correlation. On the other hand, the results from multiple cross-correlations reveal that the lead-lag effect starts from the medium scale and that the VIX (stock market volatility index) index is the potential leader or follower of the other markets.

  12. Breath Alkane as an index of severity for oral submucous fibrosis: A new perspective?

    Science.gov (United States)

    Arakeri, Gururaj; Boraks, George; Aljabab, Abdulsalam S; Patil, Shekar Gowda; Merkx, M A W; Brennan, Peter A

    2017-01-01

    Oral submucous fibrosis (OSMF) is a devastating disease commonly seen in the Asian subcontinent that results in significant functional morbidity for patients and has a high potential for malignant transformation. Over the last three decades, different diagnostic methods have been described to quantify and grade OSMF severity. Some methods have been used with perceived favorable outcomes although recurrence and malignant transformation remains a problem in many cases, and OSMF presents a major therapeutic challenge. We present a simple, noninvasive and less time-consuming diagnostic method which measures the severity of OSMF, helping to predict its malignant transformation and monitoring the effect of medical therapy on this disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Spatio-Temporal Characteristics in the Clearness Index Derived from Global Solar Radiation Observations in Korea

    Directory of Open Access Journals (Sweden)

    Yeonjin Jung

    2016-04-01

    Full Text Available The spatio-temporal characteristics of the clearness index (KT were investigated using daily global solar irradiance measurements (290–2800 nm for the period of 2000–2014 at 21 sites in Korea, a complex region in East Asia with a distinct monsoon season and heavy aerosol loading year-round. The annual mean KT value for all sites is 0.46, with values of 0.63 and 0.25 for clear and overcast skies, respectively. The seasonal variations in monthly average KT show a minimum of 0.37 in July at all sites except for Jeju, where the value was 0.29 in January. The maximum value (KT = 0.51 is observed in October, followed by a secondary peak (KT = 0.49 during February–April. The lowest KT value (KT = 0.42 was observed at both the Seoul and Jeju sites, and the highest (KT = 0.48 in the southeastern regions. Increases in average KT exceeding 4% per decade were observed in the middle and southeastern regions, with the maximum (+8% per decade at the Daegu site. Decreasing trends (<−4% per decade were observed in the southwestern regions, with the maximum (−7% per decade at the Mokpo site. Cloud amount, relative humidity, and aerosol optical depth together explained 57% of the variance in daily mean KT values. The contributions of these three variables to variations in KT are 42%, 9% and 6%, respectively. Thus, the variations in KT in Korea can be primarily attributed to the presence of clouds and water vapor, with relatively weak aerosol effects.

  14. Application of New MODIS-Based Aerosol Index for Air Pollution Severity Assessment and Mapping in Upper Northern Thailand

    Directory of Open Access Journals (Sweden)

    Chat Phayungwiwatthanakoon

    2014-06-01

    Full Text Available This paper reports capability of a newly-proposed index called the aerosol prediction index (API in the determination and mapping of near-ground PM10 concentrations (at spatial resolution of 500 x 500 m during the 2009 and 2010 burning seasons in upper northern Thailand. API is a normalized index defined based on the difference in the observed reflectance data at two spectral bands of the MODIS instrument aboard NASA�s Terra satellite; Band 3 (blue and Band 7 (mid-infrared. Initial analysis suggested that API had strong correlation with the corresponding MODIS-AOD and AERONET-AOD with coefficient of determination (R2 about 0.62 in both cases, and also with the reference PM10 data with R2 of 0.66. In terms of predictive performance, it exhibited low bias at low PM10 condition and achieved impressive prediction accuracy with relative error of 10.78 %. The near-ground PM10 concentration map yielded from the proposed index was proved very useful in the comprehensive assessment of aerosol pollution situation over entire area at fine spatial detail. This task could not be fulfilled from sole use of the ground-based measured data or standard MODIS-AOD product. These findings indicate that API should be a promising tool for the regular monitoring of air pollution severity over the concerned area.

  15. Building and verifying a severity prediction model of acute pancreatitis (AP) based on BISAP, MEWS and routine test indexes.

    Science.gov (United States)

    Ye, Jiang-Feng; Zhao, Yu-Xin; Ju, Jian; Wang, Wei

    2017-10-01

    To discuss the value of the Bedside Index for Severity in Acute Pancreatitis (BISAP), Modified Early Warning Score (MEWS), serum Ca2+, similarly hereinafter, and red cell distribution width (RDW) for predicting the severity grade of acute pancreatitis and to develop and verify a more accurate scoring system to predict the severity of AP. In 302 patients with AP, we calculated BISAP and MEWS scores and conducted regression analyses on the relationships of BISAP scoring, RDW, MEWS, and serum Ca2+ with the severity of AP using single-factor logistics. The variables with statistical significance in the single-factor logistic regression were used in a multi-factor logistic regression model; forward stepwise regression was used to screen variables and build a multi-factor prediction model. A receiver operating characteristic curve (ROC curve) was constructed, and the significance of multi- and single-factor prediction models in predicting the severity of AP using the area under the ROC curve (AUC) was evaluated. The internal validity of the model was verified through bootstrapping. Among 302 patients with AP, 209 had mild acute pancreatitis (MAP) and 93 had severe acute pancreatitis (SAP). According to single-factor logistic regression analysis, we found that BISAP, MEWS and serum Ca2+ are prediction indexes of the severity of AP (P-value0.05). The multi-factor logistic regression analysis showed that BISAP and serum Ca2+ are independent prediction indexes of AP severity (P-value0.05); BISAP is negatively related to serum Ca2+ (r=-0.330, P-valuemodel is as follows: ln()=7.306+1.151*BISAP-4.516*serum Ca2+. The predictive ability of each model for SAP follows the order of the combined BISAP and serum Ca2+ prediction model>Ca2+>BISAP. There is no statistical significance for the predictive ability of BISAP and serum Ca2+ (P-value>0.05); however, there is remarkable statistical significance for the predictive ability using the newly built prediction model as well as BISAP

  16. Nest building is a novel method for indexing severity of alcohol withdrawal in mice.

    Science.gov (United States)

    Greenberg, G D; Huang, L C; Spence, S E; Schlumbohm, J P; Metten, P; Ozburn, A R; Crabbe, J C

    2016-04-01

    Withdrawal after chronic ethanol (EtOH) affects body temperature, goal-directed behavior and motor function in mice and increases general central nervous system excitability. Nest-building tests have been used to assay these states but to this point have not been employed as measures of EtOH withdrawal severity. We first refined nest-scoring methods using a genetically heterogeneous stock of mice (HS/Npt). Mice were then made physically dependent following three days of chronic EtOH vapor inhalation to produce average blood EtOH concentrations (BECs) of 1.89 mg/mL. EtOH withdrawal affected the progression of nest building over time when mice were tested 2-4 days after removal from three days of chronic exposure to EtOH. In a separate group of mice, chronic EtOH vapor inhalation (BECs 1.84 mg/mL) suppressed nest building over days 1-2 but not days 2-3 of withdrawal. In a following experiment, EtOH withdrawal dose-dependently slowed recovery of nest building for up to 32 h. Finally, we determined that long-lasting nest-building deficits extend to mice undergoing withdrawal from a high dose (4 g/kg) of acute EtOH. Sex differences for nest building were absent following EtOH exposure. In mice naïve to EtOH treatments, male mice had lower pre-test body temperatures and increased nest scores across a two-day testing period compared to females. These results suggest that nest building can be used to assess chronic and acute EtOH withdrawal severity in mice. Published by Elsevier B.V.

  17. The Correlation of Human Development Index on Fertility and Mortality Rate: a Global Ecological Study

    Directory of Open Access Journals (Sweden)

    Amir Almasi-Hashiani

    2016-12-01

    Full Text Available BackgroundSeveral studies have examined the relationship between Human Development Index (HDI and various health outcomes. The aim of this study was to investigate the relationship between HDI, and infant mortality rate, mortality rate of children under one year and under 5 years, maternal mortality rate, and total fertility rate.Materials and MethodsIn this ecologic study, data on HDI, total fertility rate (TFR, maternal mortality rate (MMR, neonatal mortality rate (NMR, infant mortality rate (IMR and mortality rate in children under 5 years of age (< 5MR, were extracted from 188 countries in 2014 in the world. The data required in this study was obtained from the World Bank. Data analysis was performed using Pearson correlation in Stata version 12.0 software. ResultsIn this study, a negative significant correlation was observed between HDI and IMR (r = -0.878, P = 0.001, NMR (r = -0.870, 95% CI: -0.902, -0.828, P = 0.001, ConclusionIMR, children under one year old and under 5 years, and MMR mostly occur in developing countries. There was a correlation between HDI and its components, and the neonatal, infants, children under 5 years, maternal mortality rate and total fertility. The average annual percentage change of HDI also had a correlation with neonatal, infants, children under 5- year mortality rate, total fertility and maternal deaths.

  18. Entrepreneurship in the World: The Analysis of the Global Entrepreneurship Index in the Period 2015-2017

    Directory of Open Access Journals (Sweden)

    Grădinaru Cătălin

    2017-01-01

    Full Text Available The last decades have witnessed the rapid spread of entrepreneurship all over the world. Consequently, the state of entrepreneurship has significantly improved. The aim of the paper is to present the evolution of the top ten countries in the world according to the Global Entrepreneurship Index in the period 2015-2017. The research methodology is based on a quantitative method. The paper shows that the top ten countries in the world according to this index in the last three years were the same in a high proportion and demonstrates the absolute domination of the United States of America and the growing presence of the European countries.

  19. Development of a Chinese medicine pattern severity index for understanding eating disorders.

    Science.gov (United States)

    Fogarty, Sarah; Harris, David; Zaslawski, Chris; McAinch, Andrew J; Stojanovska, Lily

    2012-06-01

    Eating disorders commonly affect young girls and women. Four eating disorders are analyzed in this study: anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and binge eating disorder (BED). Eating disorders are a modern concept and as such there is no critically appraised research on how Traditional Chinese Medicine (TCM) conceptualizes of or treats eating disorders. The purpose of this study is to identify and quantify the TCM patterns relevant to eating disorders based on a systematic evaluation of the results of a self-reported questionnaire. One hundred and ninety-six (196) female participants (142 with a self-reported eating disorder and 54 with no eating disorder) completed an online survey, designed to collect data on their current general health and, where relevant, their eating disorder. The Berle methodology was used to identify TCM patterns involved in eating disorders to tabulate and score the number of signs and symptoms experienced by the participants. For many of the TCM patterns, statistically significant differences were found between presentation severity across the four eating disorders. For the first time, there is evidence-based research to classify the TCM patterns involved in AN, BN, EDNOS, and BED. Evidence is given to support the anecdotal theories of TCM patterns involved in eating disorder presentation. These results have relevance on how eating disorders are treated and viewed by TCM practitioners.

  20. Role of bedside index for severity of acute pancreatitis (bisap score in predicting outcome in acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Shahnawaz Bashir Bhat

    2015-12-01

    Full Text Available Objective: To investigate the role of Bedside index for severity of acute pancreatitis (BISAP score in predicting the outcome of acute pancreatitis. Methods: This single hospital based prospective study included fifty patients of acute pancreatitis admitted within 48 hours of onset of symptoms, who were divided into two groups according to admission BISAP score. BISAP score 3 (severe acute pancreatitis. The ability of BISAP score to predict mortality, morbidity and hospital stay in acute pancreatitis patients was analyzed. Results: A BISAP score of >3 was associated with increased risk of development of transient organ failure, persistent organ failure and pancreatic necrosis (Statistically significant. Mortality in group with BISAP and #8805;3 was 23.5% (4 patients which was statistically higher than group with BISAP score and #706;3 (0 patients (p=0.019.The mean duration of hospital stay of patients in group with BISAP score < 3 was 7.58 +/- 4.04 days and in group with BISAP score and #8805;3 was 15.35 +/- 1.66.(p=0.02. Conclusion: Bedside index for severity in acute pancreatitis (BISAP score, at admission is an excellent score in predicting the mortality, morbidity and hospital stay and hence management protocol in patients admitted with acute pancreatitis. [J Contemp Med 2015; 5(4.000: 215-220

  1. Development of resilience evaluation method for nuclear power plant. Part 1. Proposal of resilience index for assessment of safety of nuclear power plant under severe accident

    International Nuclear Information System (INIS)

    Demachi, Kazuyuki; Suzuki, Masaaki; Itoi, Tatsuya

    2016-01-01

    In this research, a new index 'The Resilience Index' was proposed to evaluate the capability of nuclear power plant to recover from the situation of safety function lost. Three elements assumed to evaluate the resilience index are the achievement rate, necessary time, and probability of success of each accident management activity. The resilience index is expected to visualize the improvement of safety of each nuclear power plant against severe accidents. (author)

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

    Science.gov (United States)

    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

  3. Increased body mass index predicts severity of asthma symptoms but not objective asthma traits in a large sample of asthmatics

    DEFF Research Database (Denmark)

    Bildstrup, Line; Backer, Vibeke; Thomsen, Simon Francis

    2015-01-01

    AIM: To examine the relationship between body mass index (BMI) and different indicators of asthma severity in a large community-based sample of Danish adolescents and adults. METHODS: A total of 1186 subjects, 14-44 years of age, who in a screening questionnaire had reported a history of airway...... symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms and furthermore height and weight, skin test reactivity, lung function, and airway responsiveness were measured...

  4. Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

    Science.gov (United States)

    Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

    2016-04-01

    The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

  5. Blood global DNA methylation is decreased in non-severe chronic obstructive pulmonary disease (COPD) patients.

    Science.gov (United States)

    Zinellu, Angelo; Sotgiu, Elisabetta; Fois, Alessandro G; Zinellu, Elisabetta; Sotgia, Salvatore; Ena, Sara; Mangoni, Arduino A; Carru, Ciriaco; Pirina, Pietro

    2017-10-01

    Alterations in global DNA methylation have been associated with oxidative stress (OS). Since chronic obstructive pulmonary disease (COPD) is characterized by increased oxidative stress we aimed to evaluate the levels of global DNA methylation in this patient group. We assessed methylcytosine (mCyt) levels in DNA from blood collected in 43 COPD patients (29 with mild and 14 with moderate disease) and 43 age- and sex-matched healthy controls. DNA methylation was significantly lower in COPD patients vs. controls (4.20 ± 0.18% mCyt vs. 4.29 ± 0.18% mCyt, p = 0.02). Furthermore, DNA methylation in COPD patients with moderate disease was significantly lower than that in patients with mild disease (4.14 ± 0.15% mCyt vs. 4.23 ± 0.19% mCyt, p COPD (crude OR = 0.06, 95% CI 0.00 to 0.67, p = 0.023). This relationship remained significant after adjusting for several confounders (OR 0.03, 95% CI 0.00 to 0.67; p = 0.028). Receiver operating characteristics (ROC) curve analysis demonstrated the area under the curve of mCyt was 0.646, with 46.6% sensitivity and 79.1% specificity for presence of COPD. There were no significant correlations between methylation and OS indices. The presence and severity of COPD is associated with progressively lower DNA methylation in blood. However, this epigenetic alteration seems independent of oxidative stress. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale.

    Science.gov (United States)

    McGuire, Joseph F; Piacentini, John; Storch, Eric A; Murphy, Tanya K; Ricketts, Emily J; Woods, Douglas W; Walkup, John W; Peterson, Alan L; Wilhelm, Sabine; Lewin, Adam B; McCracken, James T; Leckman, James F; Scahill, Lawrence

    2018-05-08

    To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed. © 2018 American Academy of Neurology.

  7. The effect of computer-mediated administration on self-disclosure of problems on the addiction severity index.

    Science.gov (United States)

    Butler, Stephen F; Villapiano, Albert; Malinow, Andrew

    2009-12-01

    People tend to disclose more personal information when communication is mediated through the use of a computer. This study was conducted to examine the impact of this phenomenon on the way respondents answer questions during computer-mediated, self-administration of the Addiction Severity Index (ASI) called the Addiction Severity Index-Multimedia Version((R)) (ASI-MV((R))). A sample of 142 clients in substance abuse treatment was administered the ASI via an interviewer and the computerized ASI-MV((R)), three to five days apart in a counterbalanced order. Seven composite scores were compared between the two test administrations using paired t-tests. Post hoc analyses examined interviewer effects. Comparisons of composite scores for each of the domains between the face-to-face administered and computer-mediated, self-administered ASI revealed that significantly greater problem severity was reported by clients in five of the seven domains during administration of the computer-mediated, self-administered version compared to the trained interviewer version. Item analyses identified certain items as responsible for significant differences, especially those asking clients to rate need for treatment. All items that were significantly different between the two modes of administration revealed greater problem severity reported on the ASI-MV((R)) as compared to the interview administered assessment. Post hoc analyses yielded significant interviewer effects on four of the five domains where differences were observed. These data support a growing literature documenting a tendency for respondents to be more self-disclosing in a computer-mediated format over a face-to-face interview. Differences in interviewer skill in establishing rapport may account for these observations.

  8. Modeling variation in global consumer’ participation behaviour intentions using an institutional market index

    NARCIS (Netherlands)

    Schumann, J.H.; Nijssen, E.J.; Lentz, P.

    2014-01-01

    Purpose Enhancing customer participation behaviour (CPB) is critical for service firms. However, in a global context, cultural and local market factors are relevant. This study details how and why global service firms can and should account for such factors. Prior research relied on cultural value

  9. HURRICANE AND SEVERE STORM SENTINEL (HS3) GLOBAL HAWK HIGH ALTITUDE MMIC SOUNDING RADIOMETER (HAMSR) V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hurricane and Severe Storm Sentinel (HS3) Global Hawk High Altitude MMIC Sounding Radiometer (HAMSR) datasets include measurements gathered by the HAMSR...

  10. HURRICANE AND SEVERE STORM SENTINEL (HS3) GLOBAL HAWK ADVANCED VERTICAL ATMOSPHERIC PROFILING SYSTEM (AVAPS) DROPSONDE SYSTEM V2

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hurricane and Severe Storm Sentinel (HS3) Global Hawk Advanced Vertical Atmospheric Profiling System (AVAPS) Dropsonde System dataset was collected by the...

  11. Profit Malmquist Index and Its Global Form in the Presence of the Negative Data in DEA

    Directory of Open Access Journals (Sweden)

    Ghasem Tohidi

    2014-01-01

    Full Text Available This paper first introduces the allocative and profit efficiency in the presence of the negative data and then presents a new circular index to measure the productivity change of decision making units (DMUs for the case that the dataset contains the inputs and/or outputs with the negative values in data envelopment analysis (DEA. The proposed index is decomposed into four components in the two stages. The range directional model (RDM and the proposed efficiencies are used to compute the proposed index and its components. The interpretations of the components are presented. Finally, a numerical example is organized to illustrate the proposed index and its components at three successive periods of time.

  12. The CROES percutaneous nephrolithotomy global study: the influence of body mass index on outcome

    DEFF Research Database (Denmark)

    Fuller, Andrew; Razvi, Hassan; Denstedt, John D

    2012-01-01

    In addition to more commonly forming stones, obese patients present a number of challenges when undergoing percutaneous nephrolithotomy. We evaluated percutaneous nephrolithotomy outcomes in 3,709 patients stratified by body mass index.......In addition to more commonly forming stones, obese patients present a number of challenges when undergoing percutaneous nephrolithotomy. We evaluated percutaneous nephrolithotomy outcomes in 3,709 patients stratified by body mass index....

  13. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole.

    Science.gov (United States)

    Peura, D A; Pilmer, B; Hunt, B; Mody, R; Perez, M C

    2013-04-01

    Higher body mass index (BMI) is a recognised risk factor for gastro-oesophageal reflux disease (GERD). Data regarding the impact of BMI on proton pump inhibitor (PPI) therapy are conflicting. To assess the impact of BMI on baseline heartburn symptom severity and frequency and response to PPI therapy in patients with non-erosive GERD (NERD) or erosive oesophagitis (EO). In post hoc analyses of phase 3 trial data, 621 NERD and 2692 EO patients were stratified by BMI (heartburn severity increased with increasing BMI. The impact of PPI therapy on the reduction in heartburn symptom frequency and severity in both NERD and EO patients was similar across BMI categories. EO healing rates in patients treated with dexlansoprazole but not lansoprazole were higher in obese patients compared with those with a BMI heartburn regardless of baseline BMI. In addition, because patients with higher BMI have more severe symptoms at baseline, they may experience greater therapeutic gain with dexlansoprazole (NERD and erosive oesophagitis) and possibly lansoprazole (erosive oesophagitis) treatment. © 2013 Blackwell Publishing Ltd.

  14. Quantitative analysis of Miller mobility index for the diagnosis of moderate to severe periodontitis - A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Chung-Ping Wu

    2018-03-01

    Full Text Available Background/purpose: We assessed the mobility of single-root teeth by using Miller's mobility index (MMI and to analyze the validity of MMI for the diagnosis of periodontitis. Materials and methods: A total of 30 patients were included and the Spearman correlation coefficient was used to assess the correlation between MMI, clinical attachment level (CAL, and probing depth (PD. The validity of MMI for the diagnosis of the severity of periodontitis was evaluated using the receiver operating characteristic (ROC curve, area under curve (AUC value, positive predictive value (PPV. Results: Strong correlations were observed between MMI and CAL (r = 0.92 and between MMI and PD (r = 0.76. When the CAL = 3–4 mm and CAL ≥5 mm groups were pooled together, the AUC value was 0.81. The AUC was 0.86 for diagnosis with MMI in the CAL ≥5 mm group. A PPV of 100% was achieved for all grades when MMI >1. When the teeth with PD ≥ 5 to <7 mm and PD ≥ 7 mm groups were pooled together, the AUC value for MMI was 0.80. The PPV was 98.8%, 99%, and 100% for MMI Grade 1, Grade 2, and Grade 3, respectively. When PD ≥ 7 mm was defined as severe periodontitis, the AUC value for MMI was 0.72. Conclusion: MMI may provide valuable information for the diagnosis of moderate and severe periodontitis when CAL is not obtainable during routine practice. Keywords: Miller's mobility index, Negative predictive value, Nonsurgical periodontal therapy, Positive predictive value, Receiver operating characteristic curve, Tooth mobility

  15. Usefulness of CURB-65 and pneumonia severity index for influenza A H1N1v pneumonia.

    Science.gov (United States)

    Estella, A

    2012-01-01

    Usefulness of CURB-65 and pneumonia severity index for influenza A H1N1v pneumonia. A. Estella. Different prognostic scales have been documented to assess the severity and indications for hospitalization and ICU admissions of community acquired pneumonia. During the past two years Influenza A H1N1v infections have been commonly attended to in emergency departments. The aim of the study was to analyse the usefulness of the application of the Pneumonia Severity Index (PSI) and CURB-65 prognostic scales in patients with primary viral pneumonia caused by influenza A H1N1v. A retrospective study was performed at a community hospital with a 17 bed-intensive care unit. Patients admitted in hospital with influenza A H1N1v pneumonia over a two year period were analysed. CURB 65 and PSI scales were applied in the emergency department and outcome and destination of admission were analysed. 24 patients were registered, 19 required ICU admission and 5 patients were admitted in medical wards. Most of the patients admitted to the intensive care unit (78.9%) required mechanical ventilation. Mortality was 21.1%. Most patients admitted to the ICU had CURB 65 scale of 1 (60%), 13.3% obtained 0 and 26.7% 2. PSI scale resulted class I in a 20%, class II 40%, 26.7% class IV and 13.3% class V. The scales CURB 65 and PSI showed no differences in scores according to the destination of admission and mortality. Use of CURB-65 and PSI in the emergency department may underestimate the risk of patients with Influenza A H1N1v pneumonia. Based in our results, the ability of these scales to predict ICU admissions for Influenza A H1N1v pneumonia is questioned.

  16. Global monthly water stress: II. Water demand and severity of water

    NARCIS (Netherlands)

    Wada, Y.; Beek, L.P.H. van; Viviroli, D.; Dürr, H.H.; Weingartner, R.; Bierkens, M.F.P.

    2011-01-01

    This paper assesses global water stress at a finer temporal scale compared to conventional assessments. To calculate time series of global water stress at a monthly time scale, global water availability, as obtained from simulations of monthly river discharge from the companion paper, is confronted

  17. Artificial intelligence techniques applied to hourly global irradiance estimation from satellite-derived cloud index

    Energy Technology Data Exchange (ETDEWEB)

    Zarzalejo, L.F.; Ramirez, L.; Polo, J. [DER-CIEMAT, Madrid (Spain). Renewable Energy Dept.

    2005-07-01

    Artificial intelligence techniques, such as fuzzy logic and neural networks, have been used for estimating hourly global radiation from satellite images. The models have been fitted to measured global irradiance data from 15 Spanish terrestrial stations. Both satellite imaging data and terrestrial information from the years 1994, 1995 and 1996 were used. The results of these artificial intelligence models were compared to a multivariate regression based upon Heliosat I model. A general better behaviour was observed for the artificial intelligence models. (author)

  18. Artificial intelligence techniques applied to hourly global irradiance estimation from satellite-derived cloud index

    International Nuclear Information System (INIS)

    Zarzalejo, Luis F.; Ramirez, Lourdes; Polo, Jesus

    2005-01-01

    Artificial intelligence techniques, such as fuzzy logic and neural networks, have been used for estimating hourly global radiation from satellite images. The models have been fitted to measured global irradiance data from 15 Spanish terrestrial stations. Both satellite imaging data and terrestrial information from the years 1994, 1995 and 1996 were used. The results of these artificial intelligence models were compared to a multivariate regression based upon Heliosat I model. A general better behaviour was observed for the artificial intelligence models

  19. Global meta-analysis of leaf area index in wetlands indicates uncertainties in understanding of their ecosystem function

    Science.gov (United States)

    Dronova, I.; Taddeo, S.; Foster, K.

    2017-12-01

    Projecting ecosystem responses to global change relies on the accurate understanding of properties governing their functions in different environments. An important variable in models of ecosystem function is canopy leaf area index (LAI; leaf area per unit ground area) declared as one of the Essential Climate Variables in the Global Climate Observing System and extensively measured in terrestrial landscapes. However, wetlands have been largely under-represented in these efforts, which globally limits understanding of their contribution to carbon sequestration, climate regulation and resilience to natural and anthropogenic disturbances. This study provides a global synthesis of >350 wetland-specific LAI observations from 182 studies and compares LAI among wetland ecosystem and vegetation types, biomes and measurement approaches. Results indicate that most wetland types and even individual locations show a substantial local dispersion of LAI values (average coefficient of variation 65%) due to heterogeneity of environmental properties and vegetation composition. Such variation indicates that mean LAI values may not sufficiently represent complex wetland environments, and the use of this index in ecosystem function models needs to incorporate within-site variation in canopy properties. Mean LAI did not significantly differ between direct and indirect measurement methods on a pooled global sample; however, within some of the specific biomes and wetland types significant contrasts between these approaches were detected. These contrasts highlight unique aspects of wetland vegetation physiology and canopy structure affecting measurement principles that need to be considered in generalizing canopy properties in ecosystem models. Finally, efforts to assess wetland LAI using remote sensing strongly indicate the promise of this technology for cost-effective regional-scale modeling of canopy properties similar to terrestrial systems. However, such efforts urgently require more

  20. Women who abuse prescription opioids: findings from the Addiction Severity Index-Multimedia Version Connect prescription opioid database.

    Science.gov (United States)

    Green, Traci C; Grimes Serrano, Jill M; Licari, Andrea; Budman, Simon H; Butler, Stephen F

    2009-07-01

    Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. Data collected November 2005 to April 2008 derived from the Addiction Severity Index Multimedia Version Connect (ASI-MV Connect) database. Bivariate and multivariable logistic regression examined correlates of prescription opioid abuse stratified by gender. 29,906 assessments from 220 treatment centers were included, of which 12.8% (N=3821) reported past month prescription opioid abuse. Women were more likely than men to report use of any prescription opioid (29.8% females vs. 21.1% males, phistory of drug overdose. Men-specific correlates were age screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted.

  1. A global coupling index of multivariate neural series with application to the evaluation of mild cognitive impairment.

    Science.gov (United States)

    Wen, Dong; Xue, Qing; Lu, Chengbiao; Guan, Xinyong; Wang, Yuping; Li, Xiaoli

    2014-08-01

    Recently, the synchronization between neural signals has been widely used as a key indicator of brain function. To understand comprehensively the effect of synchronization on the brain function, accurate computation of the synchronization strength among multivariate neural series from the whole brain is necessary. In this study, we proposed a method named global coupling index (GCI) to estimate the synchronization strength of multiple neural signals. First of all, performance of the GCI method was evaluated by analyzing simulated EEG signals from a multi-channel neural mass model, including the effects of the frequency band, the coupling coefficient, and the signal noise ratio. Then, the GCI method was applied to analyze the EEG signals from 12 mild cognitive impairment (MCI) subjects and 12 normal controls (NC). The results showed that GCI method had two major advantages over the global synchronization index (GSI) or S-estimator. Firstly, simulation data showed that the GCI method provided both a more robust result on the frequency band and a better performance on the coupling coefficients. Secondly, the actual EEG data demonstrated that GCI method was more sensitive in differentiating the MCI from control subjects, in terms of the global synchronization strength of neural series of specific alpha, beta1 and beta2 frequency bands. Hence, it is suggested that GCI is a better method over GSI and S-estimator to estimate the synchronization strength of multivariate neural series for predicting the MCI from the whole brain EEG recordings. Copyright © 2014. Published by Elsevier Ltd.

  2. Predictors of severity and outcome of global developmental delay without definitive etiologic yield: a prospective observational study

    OpenAIRE

    Thomaidis, Loretta; Zantopoulos, Georgios Zacharias; Fouzas, Sotirios; Mantagou, Lito; Bakoula, Chryssa; Konstantopoulos, Andreas

    2014-01-01

    Background Although several determinants of global developmental delay (GDD) have been recognized, a significant number of children remain without definitive etiologic diagnosis. The objective of this study was to assess the effect of various prenatal and perinatal factors on the severity and outcome of developmental delay without definitive etiologic yield. Methods From March 2008 to February 2010, 142 children with developmental quotient (DQ)

  3. CO_2 emissions reduction of Chinese light manufacturing industries: A novel RAM-based global Malmquist–Luenberger productivity index

    International Nuclear Information System (INIS)

    Emrouznejad, Ali; Yang, Guo-liang

    2016-01-01

    Climate change has become one of the most challenging issues facing the world. Chinese government has realized the importance of energy conservation and prevention of the climate changes for sustainable development of China's economy and set targets for CO_2 emissions reduction in China. In China industry contributes 84.2% of the total CO_2 emissions, especially manufacturing industries. Data envelopment analysis (DEA) and Malmquist productivity (MP) index are the widely used mathematical techniques to address the relative efficiency and productivity of a group of homogenous decision making units, e.g. industries or countries. However, in many real applications, especially those related to energy efficiency, there are often undesirable outputs, e.g. the pollutions, waste and CO_2 emissions, which are produced inevitably with desirable outputs in the production. This paper introduces a novel Malmquist–Luenberger productivity (MLP) index based on directional distance function (DDF) to address the issue of productivity evolution of DMUs in the presence of undesirable outputs. The new RAM (Range-adjusted measure)-based global MLP index has been applied to evaluate CO_2 emissions reduction in Chinese light manufacturing industries. Recommendations for policy makers have been discussed. - Highlights: •CO_2 emissions reduction in Chinese light manufacturing industries are measured. •A novel RAM based Malmquist–Luenberger productivity index has been developed. •Recommendation to policy makers for reducing CO_2 reduction in China are given.

  4. Proper Methodology and Methods of Collecting and Analyzing Slavery Data: An Examination of the Global Slavery Index

    Directory of Open Access Journals (Sweden)

    Andrew Guth

    2014-11-01

    Full Text Available The Global Slavery Index aims to, among other objectives, recognize the forms, size, and scope of slavery worldwide as well as the strengths and weaknesses of individual countries. An analysis of the Index’s methods exposes significant and critical weaknesses and raises questions into its replicability and validity. The Index may prove more valuable in the future if proper methods are implemented, but the longer improper methods are used the more damage is done to the public policy debate on slavery by advancing data and policy that is not based on sound methodology. To implement proper methods, a committee of sophisticated methodologists needs to develop measurement tools and constantly analyze and refine these methods over the years as data is collected.

  5. Investigation into the applicability of Bond Work Index (BWI) and Hardgrove Grindability Index (HGI) tests for several biomasses compared to Colombian La Loma coal

    OpenAIRE

    Williams, Orla; Eastwick, Carol; Kingman, Sam; Giddings, Donald; Lormor, Stephen; Lester, Edward

    2015-01-01

    With increasing quantities of biomass being combusted in coal fired power stations, there is an urgent need to be able to predict the grindability of biomass in existing coal mills, but currently no standard biomass grindability test exists. In this study, the applicability of the Hardgrove Grindability Index (HGI) and Bond Work Index (BWI) as standard grindability tests for biomass were investigated for commercially sourced wood pellets, steam exploded pellets, torrefied pellets, sunflower p...

  6. Seasonal variation of photosynthetic model parameters and leaf area index from global Fluxnet eddy covariance data

    NARCIS (Netherlands)

    Groenendijk, M.; Dolman, A.J.; Ammann, C.; Arneth, A.; Cescatti, A.; Molen, van der M.K.; Moors, E.J.

    2011-01-01

    Global vegetation models require the photosynthetic parameters, maximum carboxylation capacity (Vcm), and quantum yield (a) to parameterize their plant functional types (PFTs). The purpose of this work is to determine how much the scaling of the parameters from leaf to ecosystem level through a

  7. Global equity allocation with index of economic freedom—A Black-Litterman equilibrium approach

    OpenAIRE

    Mohanty, Subhransu Sekhar

    2006-01-01

    The purpose of the present study is to examine the impact of Index of Economic Freedom (IEF) in strategic equity allocation process, in ternis of riskreturn efficiency, across 49 countries using the Black-Litterman's Absolute View approach. We have attempted to carry an ex-post comparative risk-return performance analysis of traditional CAPM, the Black-Litterman Equilibrium model and our view based strategy based on Black-Litterman's Absolute View approach to analyse whether our view-based st...

  8. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI

    Directory of Open Access Journals (Sweden)

    Carlos Eugênio Lira Tenório

    Full Text Available ABSTRACT Objective To evaluate risk factors for mortality in patients with Fournier's gangrene (FG, with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI. Materials and Methods This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Results Of the 124 patients, 99 were men (79.8%, the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%. The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03, hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission.

  9. Severe obesity is a limitation for the use of body mass index standard deviation scores in children and adolescents.

    Science.gov (United States)

    Júlíusson, Pétur B; Roelants, Mathieu; Benestad, Beate; Lekhal, Samira; Danielsen, Yngvild; Hjelmesaeth, Jøran; Hertel, Jens K

    2018-02-01

    We analysed the distribution of the body mass index standard deviation scores (BMI-SDS) in children and adolescents seeking treatment for severe obesity, according to the International Obesity Task Force (IOTF), World Health Organization (WHO) and the national Norwegian Bergen Growth Study (BGS) BMI reference charts and the percentage above the International Obesity Task Force 25 cut-off (IOTF-25). This was a cross-sectional study of 396 children aged four to 17 years, who attended a tertiary care obesity centre in Norway from 2009 to 2015. Their BMI was converted to SDS using the three growth references and expressed as the percentage above IOTF-25. The percentage of body fat was assessed by bioelectrical impedance analysis. Regardless of which BMI reference chart was used, the BMI-SDS was significantly different between the age groups, with a wider range of higher values up to 10 years of age and a more narrow range of lower values thereafter. The distributions of the percentage above IOTF-25 and percentage of body fat were more consistent across age groups. Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. Concurrent chart review provides more accurate documentation and increased calculated case mix index, severity of illness, and risk of mortality.

    Science.gov (United States)

    Frazee, Richard C; Matejicka, Anthony V; Abernathy, Stephen W; Davis, Matthew; Isbell, Travis S; Regner, Justin L; Smith, Randall W; Jupiter, Daniel C; Papaconstantinou, Harry T

    2015-04-01

    Case mix index (CMI) is calculated to determine the relative value assigned to a Diagnosis-Related Group. Accurate documentation of patient complications and comorbidities and major complications and comorbidities changes CMI and can affect hospital reimbursement and future pay for performance metrics. Starting in 2010, a physician panel concurrently reviewed the documentation of the trauma/acute care surgeons. Clarifications of the Centers for Medicare and Medicaid Services term-specific documentation were made by the panel, and the surgeon could incorporate or decline the clinical queries. A retrospective review of trauma/acute care inpatients was performed. The mean severity of illness, risk of mortality, and CMI from 2009 were compared with the 3 subsequent years. Mean length of stay and mean Injury Severity Score by year were listed as measures of patient acuity. Statistical analysis was performed using ANOVA and t-test, with p reimbursement and more accurately stratify outcomes measures for care providers. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Transport Risk Index of Physiologic Stability, version II (TRIPS-II): a simple and practical neonatal illness severity score.

    Science.gov (United States)

    Lee, Shoo K; Aziz, Khalid; Dunn, Michael; Clarke, Maxine; Kovacs, Lajos; Ojah, Cecil; Ye, Xiang Y

    2013-05-01

    Derive and validate a practical assessment of infant illness severity at admission to neonatal intensive care units (NICUs). Prospective study involving 17,075 infants admitted to 15 NICUs in 2006 to 2008. Logistic regression was used to derive a prediction model for mortality comprising four empirically weighted items (temperature, blood pressure, respiratory status, response to noxious stimuli). This Transport Risk Index of Physiologic Stability, version II (TRIPS-II) was then validated for prediction of 7-day and total NICU mortality. TRIPS-II discriminated 7-day (receiver operating curve [ROC] area, 0.90) and total NICU mortality (ROC area, 0.87) from survival. Furthermore, there was a direct association between changes in TRIPS-II at 12 and 24 hours and mortality. There was good calibration across the full range of TRIPS-II scores and the gestational age at birth, and addition of TRIPS-II improved performance of prediction models that use gestational age and baseline population risk variables. TRIPS-II is a validated benchmarking tool for assessing infant illness severity at admission and for up to 24 hours after. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI).

    Science.gov (United States)

    Tenório, Carlos Eugênio Lira; Lima, Salvador Vilar Correia; Albuquerque, Amanda Vasconcelos de; Cavalcanti, Mariana Pauferro; Teles, Flávio

    2018-01-01

    To evaluate risk factors for mortality in patients with Fournier's gangrene (FG), with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI). This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Of the 124 patients, 99 were men (79.8%), the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%). The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03), hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission. Copyright® by the International Brazilian Journal of Urology.

  13. Global Prostate Cancer Incidence and Mortality Rates According to the Human Development Index.

    Science.gov (United States)

    Khazaei, Salman; Rezaeian, Shahab; Ayubi, Erfan; Gholamaliee, Behzad; Pishkuhi, Mahin Ahmadi; Khazaei, Somayeh; Mansori, Kamyar; Nematollahi, Shahrzad; Sani, Mohadeseh; Hanis, Shiva Mansouri

    2016-01-01

    Prostate cancer (PC) is one of the leading causes of death, especially in developed countries. The human development index (HDI) and its dimensions seem correlated with incidence and mortality rates of PC. This study aimed to assess the association of the specific components of HDI (life expectancy at birth, education, gross national income per 1000 capita, health, and living standards) with burden indicators of PC worldwide. Information of the incidence and mortality rates of PC was obtained from the GLOBOCAN cancer project in year 2012 and data about the HDI 2013 were obtained from the World Bank database. The correlation between incidence, mortality rates, and the HDI parameters were assessed using STATA software. A significant inequality of PC incidence rates was observed according to concentration indexes=0.25 with 95% CI (0.22, 0.34) and a negative mortality concentration index of -0.04 with 95% CI (-0.09, 0.01) was observed. A positive significant correlation was detected between the incidence rates of PC and the HDI and its dimensions including life expectancy at birth, education, income, urbanization level and obesity. However, there was a negative significant correlation between the standardized mortality rates and the life expectancy, income and HDI.

  14. Evaluating and Quantifying the Climate-Driven Interannual Variability in Global Inventory Modeling and Mapping Studies (GIMMS) Normalized Difference Vegetation Index (NDVI3g) at Global Scales

    Science.gov (United States)

    Zeng, Fanwei; Collatz, George James; Pinzon, Jorge E.; Ivanoff, Alvaro

    2013-01-01

    Satellite observations of surface reflected solar radiation contain informationabout variability in the absorption of solar radiation by vegetation. Understanding thecauses of variability is important for models that use these data to drive land surface fluxesor for benchmarking prognostic vegetation models. Here we evaluated the interannualvariability in the new 30.5-year long global satellite-derived surface reflectance index data,Global Inventory Modeling and Mapping Studies normalized difference vegetation index(GIMMS NDVI3g). Pearsons correlation and multiple linear stepwise regression analyseswere applied to quantify the NDVI interannual variability driven by climate anomalies, andto evaluate the effects of potential interference (snow, aerosols and clouds) on the NDVIsignal. We found ecologically plausible strong controls on NDVI variability by antecedent precipitation and current monthly temperature with distinct spatial patterns. Precipitation correlations were strongest for temperate to tropical water limited herbaceous systemswhere in some regions and seasons 40 of the NDVI variance could be explained byprecipitation anomalies. Temperature correlations were strongest in northern mid- to-high-latitudes in the spring and early summer where up to 70 of the NDVI variance was explained by temperature anomalies. We find that, in western and central North America,winter-spring precipitation determines early summer growth while more recent precipitation controls NDVI variability in late summer. In contrast, current or prior wetseason precipitation anomalies were correlated with all months of NDVI in sub-tropical herbaceous vegetation. Snow, aerosols and clouds as well as unexplained phenomena still account for part of the NDVI variance despite corrections. Nevertheless, this study demonstrates that GIMMS NDVI3g represents real responses of vegetation to climate variability that are useful for global models.

  15. TOMS/Nimbus-7 Total Ozone Aerosol Index UV-Reflectivity UV-B Erythemal Irradiances Daily L3 Global 1x1.25 deg V008

    Data.gov (United States)

    National Aeronautics and Space Administration — The Total Ozone Mapping Spectrometer (TOMS) version 8 Daily Gridded Data consist of daily, global coverage of total column ozone, aerosol index, Lambertian effective...

  16. The Severity of Dysmenorrhea and its Relationship with Body Mass Index among Female Adolescents in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Batool Khodakarami

    2015-09-01

    Full Text Available Background & aim: Primary dysmenorrhea is a common problem among women, resulting in a decline in their performance level and quality of life. Previous studies have not indicated a definite relationship between body mass index (BMI and dysmenorrhea. Therefore, this study aimed to determine the severity of dysmenorrhea and investigate its relationship with BMI among female adolescents in Hamadan, Iran. Methods:This cross-sectional study was conducted on 579 single, female adolescents in schools of Hamadan, Iran in 2011. Students with primary dysmenorrhea (without any other conditions were selected, using random cluster sampling. Demographic characteristics and menstrual cycle information were collected, using two separate questionnaires. BMI was recorded in all participants and visual analogue scale was applied for pain assessment. Chi-square, t-test, Fisher's exact test and logistic regression were used to examine the relationship between variables. Data were analyzed, using SPSS version 16. P-value less than 0.05 was considered statistically significant. Results: The mean age, BMI and age at menarche in participants were 15.94±1.17 years, 21.16±3.36 kg/m2 and 12.92± 1.05 years, respectively. The frequency of dysmenorrhea was estimated to be 85.31%. The frequency and severity of dysmenorrhea was higher in the normal-weight group than other subjects. No relationship was seen between the severity and duration of dysmenorrhea with BMI. But dysmenorrhea had a significant relationship with age at menarche and premenstrual syndrome (P

  17. Development of the Respiratory Index of Severity in Children (RISC score among young children with respiratory infections in South Africa.

    Directory of Open Access Journals (Sweden)

    Carrie Reed

    Full Text Available OBJECTIVE: Pneumonia is a leading cause of death in children worldwide. A simple clinical score predicting the probability of death in a young child with lower respiratory tract infection (LRTI could aid clinicians in case management and provide a standardized severity measure during epidemiologic studies. METHODS: We analyzed 4,148 LRTI hospitalizations in children <24 months enrolled in a pneumococcal conjugate vaccine trial in South Africa from 1998-2001, to develop the Respiratory Index of Severity in Children (RISC. Using clinical data at admission, a multivariable logistic regression model for mortality was developed and statistically evaluated using bootstrap resampling techniques. Points were assigned to risk factors based on their coefficients in the multivariable model. A child's RISC score is the sum of points for each risk factor present. Separate models were developed for HIV-infected and non-infected children. RESULTS: Significant risk factors for HIV-infected and non-infected children included low oxygen saturation, chest indrawing, wheezing, and refusal to feed. The models also included age and HIV clinical classification (for HIV-infected children or weight-for-age (for non-infected children. RISC scores ranged up to 7 points for HIV-infected or 6 points for non-infected children and correlated with probability of death (0-47%, HIV-infected; 0-14%, non-infected. Final models showed good discrimination (area under the ROC curve and calibration (goodness-of-fit. CONCLUSION: The RISC score incorporates a simple set of risk factors that accurately discriminate between young children based on their risk of death from LRTI, and may provide an objective means to quantify severity based on the risk of mortality.

  18. A Satellite-Based Multi-Pollutant Index of Global Air Quality

    Science.gov (United States)

    Cooper, Mathew J.; Martin, Randall V.; vanDonkelaar, Aaron; Lamsal, Lok; Brauer, Michael; Brook, Jeffrey R.

    2012-01-01

    Air pollution is a major health hazard that is responsible formillions of annual excess deaths worldwide. Simpleindicators are useful for comparative studies and to asses strends over time. The development of global indicators hasbeen impeded by the lack of ground-based observations in vast regions of the world. Recognition is growing of the need for amultipollutant approach to air quality to better represent human exposure. Here we introduce the prospect of amultipollutant air quality indicator based on observations from satellite remote sensing.

  19. Global assessment of coastal aquifer state and its vulnerability respect to Sea Water Intrusion. Application to several Mediterranean Coastal Aquifers.

    Science.gov (United States)

    Baena, Leticia; Pulido-Velazquez, David; Renau-Pruñonosa, Arianna; Morell, Ignacio

    2017-04-01

    In this research we propose a method for a global assessment of coastal aquifer state and its vulnerability to Sea Water Intrusion (SWI). It is based on two indices, the MART index, which summarize the global significance of the SWI phenomenon, and the L_GALDIT for a lumped assessment of the vulnerability to SWI. Both of them can be useful as a tool to assess coastal groundwater bodies in risk of not achieving good status in accordance with the Water Framework Directive (WFD, 2000) and to identify possible management alternative to reduce existing impacts. They can be obtained even from a reduced number of data (in the MART case only depend on the geometry and available aquifer state data) with simple calculations, which have been implemented in a general GIS tool that can be easily applied to other case studies. The MART index in an aquifer is related with the total mass of chloride in the aquifer due to sea water intrusion and can be obtained by simple linear operations of volume and concentrations that can be deduced from a schematic conceptual cross-section approach (orthogonal to the shore line) defined to summarize the intrusion volume in the aquifer. At a certain historical time, this representative aquifer cross-section can be defined in a systhematic way from the aquifer geometry, the specific yield, and the hydraulic head and chloride concentration fields that can be deduced from the available information by using appropriate interpolation methods. Following the proposed procedure we will finally obtain a summary of the historical significance of the SWI in an aquifer at different spatial resolution: 3D salinity concentration maps, 2D representative conceptual cross-section of intrusion and the MART lumped significance index. The historical evolution of the MART can be employed to perform a global assessment of the resilience and trends of global significance of the SWI in an aquifer. It can be useful to compare the significance of intrusion problems in

  20. Evaluation of the impact of atmospheric ozone and aerosols on the horizontal global/diffuse UV Index at Livorno (Italy)

    Science.gov (United States)

    Scaglione, Daniele; Giulietti, Danilo; Morelli, Marco

    2016-08-01

    A study was conducted at Livorno (Italy) to evaluate the impact of atmospheric aerosols and ozone on the solar UV radiation and its diffuse component at ground in clear sky conditions. Solar UV radiation has been quantified in terms of UV Index (UVI), following the ISO 17166:1999/CIE S007/E-1998 international standard. UVI has been calculated by exploiting the libRadtran radiative transfer modelling software as a function of both the Aerosols Optical Depth (AOD) and the Total Ozone Column (TOC). In particular AOD and TOC values have been remotely sensed by the Ozone Monitoring Instrument (OMI) on board the NASA's EOS (Earth Observing System) satellites constellation. An experimental confirmation was also obtained by exploiting global UVI ground-based measurements from the 26/9/14 to 12/8/15 and diffuse UVI ground-based measurements from the 17/5/15 to 12/8/15. For every considered value of Solar Zenith Angle (SZA) and atmospheric condition, estimates and measurements confirm that the diffuse component contributes for more than 50% on the global UV radiation. Therefore an exposure of human skin also to diffuse solar UV radiation can be potentially harmful for health and need to be accurately monitored, e.g. by exploiting innovative applications such as a mobile app with a satellite-based UV dosimeter that has been developed. Global and diffuse UVI variations due to the atmosphere are primarily caused by the TOC variations (typically cyclic): the maximum TOC variation detected by OMI in the area under study leads to a corresponding variation in global and diffuse UVI of about 50%. Aerosols in the area concerned, mainly of maritime nature, have instead weaker effects causing a maximum variation of the global and diffuse UVI respectively of 9% and 35% with an SZA of 20° and respectively of 13% and 10% with an SZA of 60°.

  1. [Risk factors of venous thromboembolism recurrence and the predictive value of simplified pulmonary embolism severity index in medical inpatients].

    Science.gov (United States)

    Shi, C L; Zhou, H X; Tang, Y J; Wang, L; Yi, Q; Liang, Z A

    2016-04-12

    To explore the risk factors of venous thromboembolism (VTE) recurrence and the predictive value of simplified pulmonary embolism severity index (sPESI) in medical inpatients. A total of 149 consecutive patients with first diagnosed VTE from the medical departments of West China Hospital of Sichuan University from January 2011 and December 2012 were enrolled and followed-up for 24 months. The VTE recurrence rate was calculated and univariate and multivariate cox proportional hazards regression analysis were performed to identify the risk factors associated with VTE recurrence. All the patients were evaluated by sPESI, and survival analysis was used to explore its value in predicting VTE recurrence in these medical patients. Out of the included 149 patients, 23(15.4%) patients had VTE recurrence during the 2 years' follow-up and median recurrence time was 167 days. The univariate analysis showed bed rest, severe lung disease, nephrotic syndrome, inappropriate anticoagulant therapy, smoking, diabetes, and malignant neoplasm might be associated with VTE recurrence (P=0.043, 0.006, 0.009, 0.032, 0.098, 0.048, 0.021). Among these risk factors, the multivariate analysis revealed severe lung disease, nephrotic syndrome, and malignant neoplasm were the independent risk factors (HR=3.45, 5.67, 3.60; P=0.020, 0.020, 0.047); while for inappropriate anticoagulant therapy, the P value was marginal (HR=3.94, 95% CI: 0.99-15.63, P=0.051). The median sPESI scores of the patients with VTE recurrence was higher than that of the patients without VTE recurrence[1(1, 2) vs 0(0, 1), P=0.001], and patients with sPESI≥1 were associated with 5.57-fold increased risk of VTE recurrence compared with patients with sPESI=0 (95%CI: 1.79-17.30, P=0.001). Survival analysis also showed that the 2-year cumulative VTE recurrence rate of patients with sPESI≥1 was significant higher than that of patients with sPESI=0 (38.4% vs 5.7%, P=0.001). The medical VTE patients have high VTE recurrence risk

  2. Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Q.; Li, T. [Department of Respirology, Qilu Hospital of Shandong University, Jinan, Shandong Province (China); Li, J.C. [Neurosurgical Intensive Care Unit, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province (China); Li, Y. [Department of Respirology, Qilu Hospital of Shandong University, Jinan, Shandong Province (China)

    2015-07-10

    The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m{sup 2}), normal weight (18.5≤BMI<25.0 kg/m{sup 2}), overweight (25.0≤BMI<30.0 kg/m{sup 2}), and obese (BMI≥30.0 kg/m{sup 2}). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m{sup 2}. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ{sup 2}=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.

  3. Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

    International Nuclear Information System (INIS)

    Qi, Q.; Li, T.; Li, J.C.; Li, Y.

    2015-01-01

    The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m 2 ), normal weight (18.5≤BMI<25.0 kg/m 2 ), overweight (25.0≤BMI<30.0 kg/m 2 ), and obese (BMI≥30.0 kg/m 2 ). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m 2 . The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ 2 =35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis

  4. Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

    Science.gov (United States)

    Rizkallah, Jean; Schwartz, Stephane; Rauch, Frank; Glorieux, Francis; Vu, Duy-Dat; Muller, Katia; Retrouvey, Jean-Marc

    2013-03-01

    Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  5. Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

    Directory of Open Access Journals (Sweden)

    Q. Qi

    2015-08-01

    Full Text Available The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m2, normal weight (18.5≤BMI<25.0 kg/m2, overweight (25.0≤BMI<30.0 kg/m2, and obese (BMI≥30.0 kg/m2. Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ2=35.16, P<0.001. The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.

  6. Psychometric properties of the Sleep Condition Indicator and Insomnia Severity Index in the evaluation of insomnia disorder.

    Science.gov (United States)

    Wong, Mark Lawrence; Lau, Kristy Nga Ting; Espie, Colin A; Luik, Annemarie I; Kyle, Simon D; Lau, Esther Yuet Ying

    2017-05-01

    The Sleep Condition Indicator (SCI) and Insomnia Severity Index (ISI) are commonly used instruments to assess insomnia. We evaluated their psychometric properties, particularly their discriminant validity against structured clinical interview (according to DSM-5 and ICSD-3), and their concurrent validity with measures of sleep and daytime functioning. A total of 158 young adults, 16% of whom were diagnosed with DSM-5 insomnia disorder and 13% with ICSD-3 Chronic Insomnia by structured interview, completed the ISI and SCI twice in 7-14 days, in addition to measures of sleep and daytime function. The Chinese version of the SCI was validated with good psychometric properties (ICC = 0.882). A cutoff of ≥8 on the ISI, ≤5 on the SCI short form, and ≤21 on the SCI achieved high discriminant validity (AUC > 0.85) in identifying individuals with insomnia based on both DSM-5 and ICSD-3 criteria. The SCI and ISI had comparable associations with subjective (0.18 sleep (0.31 disorder. Moreover, they showed good concordance with measures of daytime dysfunction, as well as subjective and objective sleep. The SCI and ISI are recommended for use in clinical and research settings. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. The Global Sustainability Index: An Instrument For Assessing The Progress Towards The Sustainable Organization

    Science.gov (United States)

    Grecu, Valentin

    2015-09-01

    There is rarely an optimal solution in sustainable development but most frequently a need to build compromises between conflicting aspects such as economic, social and environmental ones and different expectations of stakeholders. Moreover, information is rarely available and precise. This paper will focus on how to use indicators to monitor sustainable development, integrating the information provided by many of them into a complex general sustainability index. Having this general indicator is essential for decision makers as it is very complicated to evaluate the performance of the organization based on multiple indicators. The objective of this paper is to find mathematical algorithms for simplifying the decision-making process by offering an instrument for the evaluation of the sustainability progress.

  8. Global drought and severe drought-affected populations in 1.5 and 2 °C warmer worlds

    Science.gov (United States)

    Liu, Wenbin; Sun, Fubao; Lim, Wee Ho; Zhang, Jie; Wang, Hong; Shiogama, Hideo; Zhang, Yuqing

    2018-03-01

    The 2015 Paris Agreement proposed a more ambitious climate change mitigation target on limiting global warming to 1.5 °C instead of 2 °C above preindustrial levels. Scientific investigations on environmental risks associated with these warming targets are necessary to inform climate policymaking. Based on the Coupled Model Intercomparison Project phase 5 (CMIP5) climate models, we present the first risk-based assessment of changes in global drought and the impact of severe drought on populations from additional 1.5 and 2 °C warming conditions. Our results highlight the risk of drought on a global scale and in several hotspot regions such as the Amazon, northeastern Brazil, southern Africa and Central Europe at both 1.5 and 2 °C global warming relative to the historical period, showing increases in drought durations from 2.9 to 3.2 months. Correspondingly, more total and urban populations would be exposed to severe droughts globally (+132.5 ± 216.2 million and +194.5 ± 276.5 million total population and +350.2 ± 158.8 million and +410.7 ± 213.5 million urban populations in 1.5 and 2 °C warmer worlds) and regionally (e.g., East Africa, West Africa and South Asia). Less rural populations (-217.7 ± 79.2 million and -216.2 ± 82.4 million rural populations in 1.5 and 2 °C warmer worlds) would be exposed to severe drought globally under climate warming, population growth and especially the urbanization-induced population migration. By keeping global warming at 1.5 °C above the preindustrial levels instead of 2 °C, there is a decrease in drought risks (i.e., less drought duration, less drought intensity and severity but relatively more frequent drought) and the affected total, urban and rural populations would decrease globally and in most regions. While challenging for both East Africa and South Asia, the benefits of limiting warming to below 1.5 °C in terms of global drought risk and impact reduction are significant.

  9. Mass Spectrometry–Based Biomarker Discovery: Toward a Global Proteome Index of Individuality

    Science.gov (United States)

    Hawkridge, Adam M.; Muddiman, David C.

    2011-01-01

    Biomarker discovery and proteomics have become synonymous with mass spectrometry in recent years. Although this conflation is an injustice to the many essential biomolecular techniques widely used in biomarker-discovery platforms, it underscores the power and potential of contemporary mass spectrometry. Numerous novel and powerful technologies have been developed around mass spectrometry, proteomics, and biomarker discovery over the past 20 years to globally study complex proteomes (e.g., plasma). However, very few large-scale longitudinal studies have been carried out using these platforms to establish the analytical variability relative to true biological variability. The purpose of this review is not to cover exhaustively the applications of mass spectrometry to biomarker discovery, but rather to discuss the analytical methods and strategies that have been developed for mass spectrometry–based biomarker-discovery platforms and to place them in the context of the many challenges and opportunities yet to be addressed. PMID:20636062

  10. The association of the human development index with global kidney cancer incidence and mortality.

    Science.gov (United States)

    Patel, Amit R; Prasad, Sandip M; Shih, Ya-Chen Tina; Eggener, Scott E

    2012-06-01

    We describe contemporary worldwide age standardized incidence and mortality rates for kidney cancer, and their association with social and economic development metrics. We obtained gender specific, age standardized incidence and mortality rates for 184 countries and 16 major world regions from the GLOBOCAN 2008 database. We compared the mortality-to-incidence ratio on the national and regional levels in males and females, and assessed the association with the development level of each country using the United Nations Human Development Index. The age standardized incidence rate varied twentyfold worldwide with the highest rate in North America, and the lowest in Africa and South Central Asia (11.8 vs 1.2 and 1.0/100,000 individuals, respectively). The geographic distribution of the age standardized mortality rate was similar to that of the age standardized incidence rate with the highest rates in Europe and North America (3.1 and 2.6/100,000 individuals, respectively) and the lowest rates in Asian and African regions (0.6 to 1.5). Age standardized incidence and mortality rates were 4.5 and 2.8 times higher, respectively, in more developed countries than in developing countries. However, the mortality-to-incidence ratio was highest in Africa and Asia, and lowest in North America (0.6 to 0.8 vs 0.2/100,000 individuals). There was a strong inverse relationship between the Human Development Index and the mortality-to-incidence ratio (regression coefficient -0.79, p<0.0001). Kidney cancer incidence and mortality rates vary widely throughout the world while the mortality-to-incidence ratio is highest in less developed nations. These observations suggest significant health care disparities and may reflect differences in risk factors, health care access, quality of care, diagnostic modalities and treatment options available. Future research should assess whether the mortality-to-incidence ratio decreases with increasing development. Copyright © 2012 American Urological

  11. Development and initial validation of the Localized Scleroderma Skin Damage Index and Physician Global Assessment of disease Damage: a proof-of-concept study

    Science.gov (United States)

    Vilaiyuk, Soamarat; Torok, Kathryn S.; Medsger, Thomas A.

    2010-01-01

    Objective. To develop and assess the psychometric properties of the Localized Scleroderma (LS) Skin Damage Index (LoSDI) and Physician Global Assessment of disease Damage (PGA-D). Methods. Damage was defined as irreversible/persistent changes (>6 months) due to previous active disease/complications of therapy. Eight rheumatologists assessed the importance of 17 variables in formulating the PGA-D/LoSDI. LS patients were evaluated by two rheumatologists using both tools to assess their psychometric properties. LoSDI was calculated by summing three scores for cutaneous features of damage [dermal atrophy (DAT), subcutaneous atrophy (SAT) and dyspigmentation (DP)] measured at 18 anatomic sites. Patient GA of disease severity (PtGA-S), Children's Dermatology Life Quality Index (CDLQI) and PGA-D were recorded at the time of each examination. Results. Thirty LS patients (112 lesions) and nine patient-visit pairs (18 lesions) were included for inter- and intra-rater reliability study. LoSDI and its domains DAT, SAT, DP and PGA-D demonstrated excellent inter- and intra-rater reliability (reliability coefficients 0.86–0.99 and 0.74–0.96, respectively). LoSDI correlated moderately with PGA-D and poorly with PtGA-S and CDLQI. PGA-D correlated moderately with PtGA-S, but poorly with CDLQI. Conclusions. To complete the LS Cutaneous Assessment Tool (LoSCAT), we developed and evaluated the psychometric properties of the LoSDI and PGA-D in addition to the LS Skin Severity Index (LoSSI). These instruments will facilitate evaluation of LS patients for individual patient management and clinical trials. LoSDI and PGA-D demonstrated excellent reliability and high validity. LoSCAT provides an improved understanding of LS natural history. Further study in a larger group of patients is needed to confirm these preliminary findings. PMID:20008472

  12. A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: the Copenhagen Psoriasis Severity Index.

    NARCIS (Netherlands)

    Berth-Jones, J.; Thompson, J.; Papp, K.

    2008-01-01

    BACKGROUND: There is a perceived need for a better method for clinical assessment of the severity of psoriasis vulgaris. The most frequently used system is the Psoriasis Area and Severity Index (PASI), which has significant disadvantages, including the requirement for assessment of the percentage of

  13. Validating the cross-cultural factor structure and invariance property of the Insomnia Severity Index: evidence based on ordinal EFA and CFA.

    Science.gov (United States)

    Chen, Po-Yi; Yang, Chien-Ming; Morin, Charles M

    2015-05-01

    The purpose of this study is to examine the factor structure of the Insomnia Severity Index (ISI) across samples recruited from different countries. We tried to identify the most appropriate factor model for the ISI and further examined the measurement invariance property of the ISI across samples from different countries. Our analyses included one data set collected from a Taiwanese sample and two data sets obtained from samples in Hong Kong and Canada. The data set collected in Taiwan was analyzed with ordinal exploratory factor analysis (EFA) to obtain the appropriate factor model for the ISI. After that, we conducted a series of confirmatory factor analyses (CFAs), which is a special case of the structural equation model (SEM) that concerns the parameters in the measurement model, to the statistics collected in Canada and Hong Kong. The purposes of these CFA were to cross-validate the result obtained from EFA and further examine the cross-cultural measurement invariance of the ISI. The three-factor model outperforms other models in terms of global fit indices in Taiwan's population. Its external validity is also supported by confirmatory factor analyses. Furthermore, the measurement invariance analyses show that the strong invariance property between the samples from different cultures holds, providing evidence that the ISI results obtained in different cultures are comparable. The factorial validity of the ISI is stable in different populations. More importantly, its invariance property across cultures suggests that the ISI is a valid measure of the insomnia severity construct across countries. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Intrathecal IgM index correlates with a severe disease course in multiple sclerosis: Clinical and MRI results.

    Science.gov (United States)

    Ozakbas, Serkan; Cinar, Bilge Piri; Özcelik, Pinar; Baser, Hatice; Kosehasanoğullari, Gorkem

    2017-09-01

    Intrathecally synthesized IgM can be seen not only in the cerebrospinal fluid (CSF) in infectious and inflammatory diseases of the central nervous system, but also in that of patients with multiple sclerosis (MS). Intrathecal IgM synthesis in MS seems to be correlated with an unfavorable disease course. In one cross-sectional study, intrathecal synthesis of IgM (IgM index) was found to be correlated with cranial magnetic resonance imaging (MRI) parameters. The purpose of this study was to determine the possible relationship between the IgM index and MRI and clinical parameters. Eighty-one patients with MS (58 female) undergoing lumbar puncture were included in the study. Fifty-one patients had a relapsing-remitting (RR) disease course, while 30 cases were secondary progressive MS (SPMS). IgM was detected in paired CSF and serum specimens using ELISA. The IgM index was calculated using the formula CSF IgM/serum IgM: CSF albumin/serum albumin. IgM indexes higher than 0.1 were considered "increased". All patients underwent brain and whole spinal cord MRI. The IgM index was normal in 43 of the 81 patients (53.1%) and increased in 38 (46.9%). A significant correlation was determined between the IgM index and Expanded Disability Status Scale (EDSS) (r=0.638, p=0.001). Most of the subjects with increased IgM indexes were SPMS patients, 28 having a SPMS course and 10 a RRMS course. Only two patients with SPMS courses had normal IgM indexes. EDSS scores were significantly higher in patients with increased IgM indexes (EDSS 4.3 vs EDSS 2.8, p=0.000). All patients with EDSS >3 had increased IgM indexes. All patients with IgM index values higher than 0.2 IgM had SPMS courses and EDSS >6. Time to onset of the secondary progressive phase of the disease was correlated with IgM index values (p=0.004). IgM index values were also correlated with T1 hypointense lesions (r=0.0431, p=0.008) and Gd enhancing lesions (r=0.0396, p=0.006). Patients with increased IgM indexes also had more

  15. Utility of the Instability Severity Index Score in Predicting Failure After Arthroscopic Anterior Stabilization of the Shoulder.

    Science.gov (United States)

    Phadnis, Joideep; Arnold, Christine; Elmorsy, Ahmed; Flannery, Mark

    2015-08-01

    The redislocation rate after arthroscopic stabilization for anterior glenohumeral instability is up to 30%. The Instability Severity Index Score (ISIS) was developed to preoperatively rationalize the risk of failure, but it has not yet been validated by an independent group. To assess the utility of the ISIS in predicting failure of arthroscopic anterior shoulder stabilization and to identify other preoperative factors for failure. Case-control study; Level of evidence, 3. A case-control study was performed on 141 consecutive patients, comparing those who suffered failure of arthroscopic stabilization with those who had successful arthroscopic stabilization. The mean follow-up time was 47 months (range, 24-132 months). The ISIS was applied retrospectively, and an analysis was performed to establish independent risk factors for failure. A receiver operator coefficient curve was constructed to set a threshold ISIS for considering alternative surgery. Of 141 patients, 19 (13.5%) suffered recurrent instability. The mean ISIS of the failed stabilization group was higher than that of the successful stabilization group (5.1 vs 1.7; P surgery (P < .001), age at first dislocation (P = .01), competitive-level participation in sports (P < .001), and participation in contact or overhead sports (P = .03). The presence of glenoid bone loss carried the highest risk of failure (70%). There was a 70% risk of failure if the ISIS was ≥4, as opposed to a 4% risk of failure if the ISIS was <4. This is the first completely independent study to confirm that the ISIS is a useful preoperative tool. It is recommended that surgeons consider alternative forms of stabilization if the ISIS is ≥4. © 2015 The Author(s).

  16. Association of Human Development Index with global bladder, kidney, prostate and testis cancer incidence and mortality.

    Science.gov (United States)

    Greiman, Alyssa K; Rosoff, James S; Prasad, Sandip M

    2017-12-01

    To describe contemporary worldwide age-standardized incidence and mortality rates for bladder, kidney, prostate and testis cancer and their association with development. We obtained gender-specific, age-standardized incidence and mortality rates for 184 countries and 16 major world regions from the GLOBOCAN 2012 database. We compared the mortality-to-incidence ratios (MIRs) at national and regional levels in males and females, and assessed the association with socio-economic development using the 2014 United Nations Human Development Index (HDI). Age-standardized incidence rates were 2.9 (bladder) to 7.4 (testis) times higher for genitourinary malignancies in more developed countries compared with less developed countries. Age-standardized mortality rates were 1.5-2.2 times higher in more vs less developed countries for prostate, bladder and kidney cancer, with no variation in mortality rates observed in testis cancer. There was a strong inverse relationship between HDI and MIR in testis (regression coefficient 1.65, R 2 = 0.78), prostate (regression coefficient -1.56, R 2 = 0.85), kidney (regression coefficient -1.34, R 2 = 0.74), and bladder cancer (regression coefficient -1.01, R 2 = 0.80). While incidence and mortality rates for genitourinary cancers vary widely throughout the world, the MIR is highest in less developed countries for all four major genitourinary malignancies. Further research is needed to understand whether differences in comorbidities, exposures, time to diagnosis, access to healthcare, diagnostic techniques or treatment options explain the observed inequalities in genitourinary cancer outcomes. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  17. Measuring Globalization

    OpenAIRE

    Andersen, Torben M.; Herbertsson, Tryggvi Thor

    2003-01-01

    The multivariate technique of factor analysis is used to combine several indicators of economic integration and international transactions into a single measure or index of globalization. The index is an alternative to the simple measure of openness based on trade, and it produces a ranking of countries over time for 23 OECD countries. Ireland is ranked as the most globalized country during the 1990?s, while the UK was at the top during the 1980?s. Some of the most notable changes in the rank...

  18. An index-based framework for assessing patterns and trends in river fragmentation and flow regulation by global dams at multiple scales

    International Nuclear Information System (INIS)

    Grill, Günther; Lehner, Bernhard; Lumsdon, Alexander E; Zarfl, Christiane; MacDonald, Graham K; Reidy Liermann, Catherine

    2015-01-01

    The global number of dam constructions has increased dramatically over the past six decades and is forecast to continue to rise, particularly in less industrialized regions. Identifying development pathways that can deliver the benefits of new infrastructure while also maintaining healthy and productive river systems is a great challenge that requires understanding the multifaceted impacts of dams at a range of scales. New approaches and advanced methodologies are needed to improve predictions of how future dam construction will affect biodiversity, ecosystem functioning, and fluvial geomorphology worldwide, helping to frame a global strategy to achieve sustainable dam development. Here, we respond to this need by applying a graph-based river routing model to simultaneously assess flow regulation and fragmentation by dams at multiple scales using data at high spatial resolution. We calculated the cumulative impact of a set of 6374 large existing dams and 3377 planned or proposed dams on river connectivity and river flow at basin and subbasin scales by fusing two novel indicators to create a holistic dam impact matrix for the period 1930–2030. Static network descriptors such as basin area or channel length are of limited use in hierarchically nested and dynamic river systems, so we developed the river fragmentation index and the river regulation index, which are based on river volume. These indicators are less sensitive to the effects of network configuration, offering increased comparability among studies with disparate hydrographies as well as across scales. Our results indicate that, on a global basis, 48% of river volume is moderately to severely impacted by either flow regulation, fragmentation, or both. Assuming completion of all dams planned and under construction in our future scenario, this number would nearly double to 93%, largely due to major dam construction in the Amazon Basin. We provide evidence for the importance of considering small to medium

  19. A confirmatory study of the Combined Index of Severity of Fibromyalgia (ICAF*: factorial structure, reliability and sensitivity to change

    Directory of Open Access Journals (Sweden)

    Rejas Javier

    2011-06-01

    Full Text Available Abstract Background Fibromyalgia (FM is a complex syndrome that affects many aspects of the patients life and it is very difficult to evaluate in clinical practice. A recent study has developed the Combined Index of Severity of Fibromyalgia (ICAF, an instrument that evaluates diverse aspects of FM and offers five indices: emotional, physical, active coping, passive coping and total. The objective of this study is to confirm the structure of the ICAF, check its test-retest reliability, assess its sensitivity to change, and compare the results obtained in a sample of patients with fibromyalgia with another sample of healthy controls. Methods A total of 232 patients took part in the study, 228 women and 4 men, with a mean age of 47.73 years of age (SD = 8.61 and a time of disease evolution since diagnosis of 4.28 years (SD = 4.03. The patients from the FM group completed the ICAF. Between one and two weeks later, they again attended the clinic and complete the 59 items on the ICAF (retest and immediately afterwards they began treatment (according to daily clinical practice criteria. A sample of healthy subjects was also studied as a control group: 110 people were included (106 women and 4 men with a mean age of 46.01 years of age (SD = 9.35. The study was conducted in Spain. Results The results obtained suggest that the four-factor model obtained in the previous study adequately fits the data obtained in this study. The test-retest reliability and internal consistency were all significant and show a high degree of correlation for all the factors as well as in overall score. With the exception of the passive coping factor, all the other scores, including the overall score, were sensitive to change after the therapeutic intervention. The ICAF scores of the patients with fibromyalgia compared with those of the control group were markedly different. Conclusions The findings suggest that the ICAF is a valid, reliable, sensitive to change instrument with

  20. A confirmatory study of the Combined Index of Severity of Fibromyalgia (ICAF*): factorial structure, reliability and sensitivity to change

    Science.gov (United States)

    2011-01-01

    Background Fibromyalgia (FM) is a complex syndrome that affects many aspects of the patients life and it is very difficult to evaluate in clinical practice. A recent study has developed the Combined Index of Severity of Fibromyalgia (ICAF), an instrument that evaluates diverse aspects of FM and offers five indices: emotional, physical, active coping, passive coping and total. The objective of this study is to confirm the structure of the ICAF, check its test-retest reliability, assess its sensitivity to change, and compare the results obtained in a sample of patients with fibromyalgia with another sample of healthy controls. Methods A total of 232 patients took part in the study, 228 women and 4 men, with a mean age of 47.73 years of age (SD = 8.61) and a time of disease evolution since diagnosis of 4.28 years (SD = 4.03). The patients from the FM group completed the ICAF. Between one and two weeks later, they again attended the clinic and complete the 59 items on the ICAF (retest) and immediately afterwards they began treatment (according to daily clinical practice criteria). A sample of healthy subjects was also studied as a control group: 110 people were included (106 women and 4 men) with a mean age of 46.01 years of age (SD = 9.35). The study was conducted in Spain. Results The results obtained suggest that the four-factor model obtained in the previous study adequately fits the data obtained in this study. The test-retest reliability and internal consistency were all significant and show a high degree of correlation for all the factors as well as in overall score. With the exception of the passive coping factor, all the other scores, including the overall score, were sensitive to change after the therapeutic intervention. The ICAF scores of the patients with fibromyalgia compared with those of the control group were markedly different. Conclusions The findings suggest that the ICAF is a valid, reliable, sensitive to change instrument with the added advantage

  1. Exercise training with weight loss and either a high- or low-glycemic index diet reduces metabolic syndrome severity in older adults

    DEFF Research Database (Denmark)

    Malin, Steven K; Niemi, Nicole; Solomon, Thomas

    2012-01-01

    The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score).......The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score)....

  2. Climate conditions and drought assessment with the Palmer Drought Severity Index in Iran: evaluation of CORDEX South Asia climate projections (2070-2099)

    Science.gov (United States)

    Senatore, Alfonso; Hejabi, Somayeh; Mendicino, Giuseppe; Bazrafshan, Javad; Irannejad, Parviz

    2018-03-01

    Climate change projections were evaluated over both the whole Iran and six zones having different precipitation regimes considering the CORDEX South Asia dataset, for assessing space-time distribution of drought occurrences in the future period 2070-2099 under RCP4.5 scenario. Initially, the performances of eight available CORDEX South Asia Regional Climate Models (RCMs) were assessed for the baseline period 1970-2005 through the GPCC v.7 precipitation dataset and the CFSR temperature dataset, which were previously selected as the most reliable within a set of five global datasets compared to 41 available synoptic stations. Though the CCLM RCM driven by the MPI-ESM-LR General Circulation Model is in general the most suitable for temperature and, together with the REMO 2009 RCM also driven by MPI-ESM-LR, for precipitation, their performances do not overwhelm other models for every season and zone in which Iranian territory was divided according to a principal component analysis approach. Hence, a weighting approach was tested and adopted to take into account useful information from every RCM in each of the six zones. The models resulting more reliable compared to current climate show a strong precipitation decrease. Weighted average predicts an overall yearly precipitation decrease of about 20%. Temperature projections provide a mean annual increase of 2.4 °C. Future drought scenarios were depicted by means of the self-calibrating version of the Palmer drought severity index (SC-PDSI) model. Weighted average predicts a sharp drying that can be configured as a real shift in mean climate conditions, drastically affecting water resources of the country.

  3. Characterizing ecosystem response to water supply changes inferred from GRACE drought severity index and surface soil moisture anomalies from ESA CCI and SMAP

    Science.gov (United States)

    Zhao, M.; Velicogna, I.; Kimball, J. S.

    2017-12-01

    Climate change such as more frequent heatwaves and drought is threatening our food security and ecosystem by reducing water supply to vegetation. Characterizing vegetation response to water supply changes is not only important for evaluating and mitigating climatic change impacts on ecosystem functions and services, but also to determine the feedback mechanisms that ecosystem response may generate on the climate itself. However, such characterization is not well-known at the global scale partly because large scale observations of underground water supply changes are limited. Satellite observations of soil moisture (SM) datasets such as from Soil Moisture Active and Passive (SMAP) and European Space Agency Climate Change Initiative (ESA CCI) do not penetrate more than a few centimeters and do not capture the entire root-zone. Here we employ a newly developed Drought Severity Index from Gravity Recovery and Climate Experiment (GRACE-DSI) to complement SM observations by informing total water supply changes in the entire terrestrial hydrological cycle. We use MODIS vegetation indices as proxies for vegetation growth and investigate their seasonal and interannual variability in relation to GRACE-DSI. We find that total water supply constrains vegetation growth across the entire continental US. Water constraint begins at an earlier date of year and lasts for a longer period in the lower latitude than in the higher latitude. We also find that water constraint occurs at different phenological stages depending on vegetation type. For instance, water constrain forest growth during reproductive period in eastern US but constrain shrub land growth during green-up in Arizona (Fig. 1). In western United States, eastern Australia and the horn of Africa, we find that vegetation growth changes closely follows GRACE-DSI but can have 16-day to one-month delay with respect to SM anomalies from SMAP and ESA CCI. This suggests that in these regions, vegetation is sensitive to water

  4. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren

    2016-01-01

    ) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...... and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL). RESULTS: Mean Gait Deviation Index was positively associated with hip abduction strength (pstrength (p = 0...

  5. Proposal of a service delivery integration index of home care for older persons: application in several European cities.

    NARCIS (Netherlands)

    Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

    2006-01-01

    PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

  6. Evaluation of the patient generated index as a measure of quality-of-life in people with severe traumatic brain injury.

    LENUS (Irish Health Repository)

    Hogan, Mark

    2013-01-01

    Quality-of-life (QoL) measures may be useful in quantifying the personal impact of an acquired brain injury and as an indicator of the effectiveness of service provision. This study investigated the validity of the patient generated index (PGI) as a measure of QoL with a sample of adults who had sustained a severe traumatic brain injury.

  7. Satellite Leaf Area Index: Global Scale Analysis of the Tendencies Per Vegetation Type Over the Last 17 Years

    Directory of Open Access Journals (Sweden)

    Simon Munier

    2018-03-01

    Full Text Available The main objective of this study is to detect and quantify changes in the vegetation dynamics of each vegetation type at the global scale over the last 17 years. With recent advances in remote sensing techniques, it is now possible to study the Leaf Area Index (LAI seasonal and interannual variability at the global scale and in a consistent way over the last decades. However, the coarse spatial resolution of these satellite-derived products does not permit distinguishing vegetation types within mixed pixels. Considering only the dominant type per pixel has two main drawbacks: the LAI of the dominant vegetation type is contaminated by spurious signal from other vegetation types and at the global scale, significant areas of individual vegetation types are neglected. In this study, we first developed a Kalman Filtering (KF approach to disaggregate the satellite-derived LAI from GEOV1 over nine main vegetation types, including grasslands and crops as well as evergreen, broadleaf and coniferous forests. The KF approach permits the separation of distinct LAI values for individual vegetation types that coexist within a pixel. The disaggregated LAI product, called LAI-MC (Multi-Cover, consists of world-wide LAI maps provided every 10 days for each vegetation type over the 1999–2015 period. A trend analysis of the original GEOV1 LAI product and of the disaggregated LAI time series was conducted using the Mann-Kendall test. Resulting trends of the GEOV1 LAI (which accounts for all vegetation types compare well with previous regional or global studies, showing a greening over a large part of the globe. When considering each vegetation type individually, the largest global trend from LAI-MC is found for coniferous forests (0.0419 m 2 m − 2 yr − 1 followed by summer crops (0.0394 m 2 m − 2 yr − 1 , while winter crops and grasslands show the smallest global trends (0.0261 m 2 m − 2 yr − 1 and 0.0279 m 2 m − 2 yr − 1 , respectively. The LAI

  8. Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Are More Effective than the Fournier's Gangrene Severity Index for Predicting Poor Prognosis in Fournier's Gangrene.

    Science.gov (United States)

    Yim, Sang Un; Kim, Sun Woo; Ahn, Ji Hoon; Cho, Yang Hyun; Chung, Hoseok; Hwang, Eu Chang; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

    2016-04-01

    We investigated the value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as markers of mortality in patients with Fournier's gangrene. Records from 62 patients treated for Fournier's gangrene between 2003 and 2014 were reviewed retrospectively. Data were collected regarding medical history, symptoms, physical examination findings, admission laboratory tests, and the extent of body surface area involved (%). Fournier's Gangrene Severity Index score, NLR, and PLR were calculated. The data were assessed separately for surviving and deceased patients. Of the 62 patients, 36 survived (58%, group 1) and 26 died (42%, group 2). Parameters that were statistically different between the two groups (p Fournier's Gangrene Severity Index score, and admission laboratory parameters, including body temperature, heart rate, bicarbonate, albumin, and serum calcium. The average body surface area affected in group 2 was statistically different from that of group 1 (6.0% versus 2.3%, p = 0.001). A high Fournier's Gangrene Severity Index score (>9), high NLR (>8), and high PLR (>140) were associated more frequently with group 2 patients. Multivariable regression analysis showed that high NLR (adjusted odds ratio [OR], 4.66; 95% confidence interval [CI], 1.25-17.3; p = 0.022) and high PLR (adjusted OR, 11.6; 95% CI, 2.7-49.5; p = 0.001) were independent prognostic factors for poor prognosis from Fournier's gangrene. However, the Fournier's Gangrene Severity Index score did not shown any statistically significant effect on mortality (p = 0.086). The Fournier's Gangrene Severity Index scoring system was not associated with determining poor prognosis, however, high NLR and high PLR were associated with predictors of mortality in patients with Fournier's gangrene.

  9. Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

    2017-09-15

    To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

  10. Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

    International Nuclear Information System (INIS)

    Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin

    2017-01-01

    To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

  11. Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification

    Science.gov (United States)

    Yu, Mengmeng; Li, Yuehua; Li, Wenbin; Lu, Zhigang; Wei, Meng

    2017-01-01

    Objective To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Materials and Methods Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. Results A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Conclusion Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation. PMID:28860893

  12. A fuzzy-based model to implement the global safety buildings index assessment for agri-food buildings

    Directory of Open Access Journals (Sweden)

    Francesco Barreca

    2014-06-01

    Full Text Available The latest EU policies focus on the issue of food safety with a view to ensuring adequate and standard quality levels for the food produced and/or consumed within the EC. To that purpose, the environment where agricultural products are manufactured and processed plays a crucial role in achieving food hygiene. As a consequence, it is of the outmost importance to adopt proper building solutions which meet health and hygiene requirements as well as to use suitable tools to measure the levels achieved. Similarly, it is necessary to verify and evaluate the level of workers’ safety and welfare in their working environment. Workers’ safety has not only an ethical and social value but also an economic implication, since possible accidents or environmental stressors are the major causes of the lower efficiency and productivity of workers. Therefore, it is fundamental to design suitable models of analysis that allow assessing buildings as a whole, taking into account both health and hygiene safety as well as workers’ safety and welfare. Hence, this paper proposes an assessment model that, based on an established study protocol and on the application of a fuzzy logic procedure, allows assessing the global safety level of an agri-food building by means of a global safety buildings index. The model here presented is original since it uses fuzzy logic to evaluate the performances of both the technical and environmental systems of an agri-food building in terms of health and hygiene safety of the manufacturing process as well as of workers’ health and safety. The result of the assessment is expressed through a triangular fuzzy membership function which allows carrying out comparative analyses of different buildings. A specific procedure was developed to apply the model to a case study which tested its operational simplicity and the validity of its results. The proposed model allows obtaining a synthetic and global value of the building performance of

  13. Effects of Human Development Index and Its Components on Colorectal Cancer Incidence and Mortality: a Global Ecological Study.

    Science.gov (United States)

    Khazaei, Salman; Rezaeian, Shahab; Khazaei, Somayeh; Mansori, Kamyar; Sanjari Moghaddam, Ali; Ayubi, Erfan

    2016-01-01

    Geographic disparity for colorectal cancer (CRC) incidence and mortality according to the human development index (HDI) might be expected. This study aimed at quantifying the effect measure of association HDI and its components on the CRC incidence and mortality. In this ecological study, CRC incidence and mortality was obtained from GLOBOCAN, the global cancer project for 172 countries. Data were extracted about HDI 2013 for 169 countries from the World Bank report. Linear regression was constructed to measure effects of HDI and its components on CRC incidence and mortality. A positive trend between increasing HDI of countries and age-standardized rates per 100,000 of CRC incidence and mortality was observed. Among HDI components education was the strongest effect measure of association on CRC incidence and mortality, regression coefficients (95% confidence intervals) being 2.8 (2.4, 3.2) and 0.9 (0.8, 1), respectively. HDI and its components were positively related with CRC incidence and mortality and can be considered as targets for prevention and treatment intervention or tracking geographic disparities.

  14. Effects of glucocorticoid combined with antibiotics on serum infection indexes, acute phase proteins and stress hormones in patients with severe pneumonia

    Directory of Open Access Journals (Sweden)

    Yang Yu

    2017-10-01

    Full Text Available Objective: To study the effects of glucocorticoid combined with antibiotics on serum infection indexes, acute phase proteins and stress hormones in patients with severe pneumonia. Methods: a total of 80 patients with severe pneumonia who were hospitalized between August 2014 and January 2017 were retrospectively analyzed and divided into the routine treatment group (n=46 who received conventional antibiotic therapy and the combined treatment group (n=34 who received glucocorticoid combined with antibiotic therapy, and the differences in infection indexes, acute proteins and stress hormones were compared between the two groups of patients before and after treatment. Results: The differences in serum levels of infection indexes, acute phase proteins and stress hormones were not statistically significant between the two groups before treatment. After 1 week of treatment, serum infection indexes CRP and PCT levels of observation group were lower than those of control group; serum acute phase proteins α1-AT, α1-AG and CER levels were lower than those of control group; serum stress hormones Cor, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Glucocorticoid combined with antibiotics can effectively inhibit systemic infection and stress and optimize the illness in patients with severe pneumonia.

  15. Globalization

    Directory of Open Access Journals (Sweden)

    Tulio Rosembuj

    2006-12-01

    Full Text Available There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  16. Globalization

    OpenAIRE

    Tulio Rosembuj

    2006-01-01

    There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  17. [Discordance between mitral valve area (MVA) and pressure gradient in patients with mitral valve stenosis: mean transmitral valve gradient is a severity index or a tolerance index of severity of mitralss valve stenosis?

    Science.gov (United States)

    Najih, Hayat; Arous, Salim; Laarje, Aziza; Baghdadi, Dalila; Benouna, Mohamed Ghali; Azzouzi, Leila; Habbal, Rachida

    2016-01-01

    Rheumatic mitral valve stenosis (MVS) is a frequent valvulopathy in developing countries. However, industrialized countries have seen the emergence of new etiologies of MVS in recent years, in particular drug-induced and/or toxic valvular regurgitation and stenosis. For this reason, the echocardiographic assessment of MVS and especially the definition of objective diagnostic criteria for severe MVS remains relevant. The objectives are: to determine whether there is a direct causal link between mean transmitral gradient (MTG) and severity of MVS in patients with severe MVS or true severe MVS (primary criterion); to analyze different parameters determining mean transmitral gradient (MTG) (secondary criterion). We conducted a single-center cross-sectional study including all patients with severe or true severe MVS admitted to the Department of Cardiology, University Hospital Ibn Rushd, Casablanca over a period of one year (January 2014-December 2014). We analyzed data from two groups of patients separately: those with a mean transmitral gradientgradient>10mmHg (group 2). 50 patients with severe or true severe MVS have been included in the study. The average age of our patients was 41.7 years with a female predominance (sex ratio 0,25). 64% of patients had severe MVS and 36% of patients had true severe MVS. 52% (26 patients) had MTG gradient> 10mmHg, suggesting no direct correlation between the severity of MVS and MTG (Pearson's correlation coefficient R: -0,137). With regards to dyspnea, 80% of patients of group 1 had stage II NYHA dyspnea (classification system) and 70% of patients of group 2 had stage III NYHA dyspnea (41%) or IV NYHA dyspnea (29%), which means that there was a significant correlation between MTG and the severity of dyspnea (R: 0,586 and p: 0,001). The analytical study of heart rate and the presence of cardiac decompensation compared with mean gradient transmitral showed a significant correlation. Indeed, among patients in group 1, 96% had HR

  18. Clinical laboratory markers of inflammation as determinants of chronic graft-versus-host disease activity and NIH global severity.

    Science.gov (United States)

    Grkovic, L; Baird, K; Steinberg, S M; Williams, K M; Pulanic, D; Cowen, E W; Mitchell, S A; Hakim, F T; Martires, K J; Avila, D N; Taylor, T N; Salit, R B; Rowley, S D; Zhang, D; Fowler, D H; Bishop, M R; Gress, R E; Pavletic, S Z

    2012-04-01

    Chronic graft-versus-host disease (cGVHD) remains a major cause of non-relapse morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Currently there are no accepted measures of cGVHD activity to aid in clinical management and disease staging. We analyzed clinical markers of inflammation in the sera of patients with established cGVHD and correlated those with definitions of disease activity. In all, 189 adults with cGVHD (33% moderate and 66% severe according to National Institutes of Health (NIH) global scoring) were consecutively enrolled onto a cross-sectional prospective cGVHD natural history study. At the time of evaluation, 80% were receiving systemic immunosuppression and failed a median of four prior systemic therapies (PST) for their cGVHD. Lower albumin (P<0.0001), higher C-reactive protein (P = 0.043), higher platelets (P = 0.030) and higher number of PST (P<0.0001) were associated with active disease defined as clinician's intention to intensify or alter systemic therapy due to the lack of response. Higher platelet count (P = 0.021) and higher number of PST (P<0.0001) were associated with more severe diseased defined by NIH global score. This study identified common laboratory indicators of inflammation that can serve as markers of cGVHD activity and severity.

  19. AA Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  20. TOMS/Nimbus-7 UV Aerosol Index Daily L3 Global 1x1.25 deg Lat/Lon Grid V008

    Data.gov (United States)

    National Aeronautics and Space Administration — This data product contains TOMS/Nimbus-7 UV Aerosol Index Daily L3 Global 1x1.25 deg Lat/Lon Grid Version 8 data in ASCII format. The Total Ozone Mapping...

  1. TOMS/Earth Probe UV Aerosol Index Monthly L3 Global 1x1.25 deg Lat/Lon Grid V008

    Data.gov (United States)

    National Aeronautics and Space Administration — This data product contains TOMS/Earth Probe UV Aerosol Index Monthly L3 Global 1x1.25 deg Lat/Lon Grid Version 8 data in ASCII format. (The shortname for this...

  2. TOMS/Nimbus-7 UV Aerosol Index Monthly L3 Global 1x1.25 deg Lat/Lon Grid V008

    Data.gov (United States)

    National Aeronautics and Space Administration — This data product contains TOMS/Nimbus-7 UV Aerosol Index Monthly L3 Global 1x1.25 deg Lat/Lon Grid Version 8 data in ASCII format. The Total Ozone Mapping...

  3. Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study.

    Science.gov (United States)

    van Ingen, Jakko; Kohl, Thomas A; Kranzer, Katharina; Hasse, Barbara; Keller, Peter M; Katarzyna Szafrańska, Anna; Hillemann, Doris; Chand, Meera; Schreiber, Peter Werner; Sommerstein, Rami; Berger, Christoph; Genoni, Michele; Rüegg, Christian; Troillet, Nicolas; Widmer, Andreas F; Becker, Sören L; Herrmann, Mathias; Eckmanns, Tim; Haller, Sebastian; Höller, Christiane; Debast, Sylvia B; Wolfhagen, Maurice J; Hopman, Joost; Kluytmans, Jan; Langelaar, Merel; Notermans, Daan W; Ten Oever, Jaap; van den Barselaar, Peter; Vonk, Alexander B A; Vos, Margreet C; Ahmed, Nada; Brown, Timothy; Crook, Derrick; Lamagni, Theresa; Phin, Nick; Smith, E Grace; Zambon, Maria; Serr, Annerose; Götting, Tim; Ebner, Winfried; Thürmer, Alexander; Utpatel, Christian; Spröer, Cathrin; Bunk, Boyke; Nübel, Ulrich; Bloemberg, Guido V; Böttger, Erik C; Niemann, Stefan; Wagner, Dirk; Sax, Hugo

    2017-10-01

    Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates. Isolates were analysed by next-generation whole-genome sequencing using Illumina and Pacific Biosciences technologies, and compared with published M chimaera genomes. Phylogenetic analysis based on whole-genome sequencing of 250 isolates revealed two major M chimaera groups. Cardiac surgery-related patient isolates were all classified into group 1, in which all, except one, formed a distinct subgroup. This subgroup also comprised isolates from 11 cardiac surgery-related patients reported from the USA, most isolates from LivaNova HCUs, and one from their production site. Isolates from other HCUs and unrelated patients were more widely distributed in the phylogenetic tree. HCU contamination with M chimaera at the LivaNova factory seems a likely source for cardiothoracic surgery-related severe M chimaera infections diagnosed in Switzerland, Germany, the Netherlands, the UK, the USA, and Australia. Protective measures and heightened clinician awareness are essential to guarantee patient safety. Partly funded by the EU Horizon 2020 programme, its FP7 programme, the German Center for Infection Research (DZIF), the Swiss National Science Foundation, the Swiss Federal Office of Public Health, and National Institute of Health Research Oxford Health Protection

  4. Detecting post-fire burn severity and vegetation recovery using multitemporal remote sensing spectral indices and field-collected composite burn index data in a ponderosa pine forest

    Science.gov (United States)

    Chen, Xuexia; Vogelmann, James E.; Rollins, Matt; Ohlen, Donald; Key, Carl H.; Yang, Limin; Huang, Chengquan; Shi, Hua

    2011-01-01

    It is challenging to detect burn severity and vegetation recovery because of the relatively long time period required to capture the ecosystem characteristics. Multitemporal remote sensing data can providemultitemporal observations before, during and after a wildfire, and can improve the change detection accuracy. The goal of this study is to examine the correlations between multitemporal spectral indices and field-observed burn severity, and to provide a practical method to estimate burn severity and vegetation recovery. The study site is the Jasper Fire area in the Black Hills National Forest, South Dakota, that burned during August and September 2000. Six multitemporal Landsat images acquired from 2000 (pre-fire), 2001 (post-fire), 2002, 2003, 2005 and 2007 were used to assess burn severity. The normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), normalized burn ratio (NBR), integrated forest index (IFI) and the differences of these indices between the pre-fire and post-fire years were computed and analysed with 66 field-based composite burn index (CBI) plots collected in 2002. Results showed that differences of NDVI and differences of EVI between the pre-fire year and the first two years post-fire were highly correlated with the CBI scores. The correlations were low beyond the second year post-fire. Differences of NBR had good correlation with CBI scores in all study years. Differences of IFI had low correlation with CBI in the first year post-fire and had good correlation in later years. A CBI map of the burnt area was produced using regression tree models and the multitemporal images. The dynamics of four spectral indices from 2000 to 2007 indicated that both NBR and IFI are valuable for monitoring long-term vegetation recovery. The high burn severity areas had a much slower recovery than the moderate and low burn areas.

  5. Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity

    DEFF Research Database (Denmark)

    Bech, Per; Timmerby, N; Martiny, K

    2015-01-01

    BACKGROUND: The Major Depression Inventory (MDI) was developed to cover the universe of depressive symptoms in DSM-IV major depression as well as in ICD-10 mild, moderate, and severe depression. The objective of this study was to evaluate the standardization of the MDI as a depression severity......-IV major depression. The conventional VAS scores for no, mild, moderate, and severe depression were used for the standardization of the MDI. RESULTS: The inter-correlation for the MDI with the clinician ratings (VAS, MES, HAM-D17 and HAM-D6) increased over the rating weeks in terms of Pearson coefficients....... After nine weeks of therapy the coefficient ranged from 0.74 to 0.83. Using the clinician-rated VAS depression severity scale, the conventional MDI cut-off scores for no or doubtful depression, and for mild, moderate and severe depression were confirmed. CONCLUSIONS: Using the VAS as index of external...

  6. Interannual variations and trends in global land surface phenology derived from enhanced vegetation index during 1982-2010

    Science.gov (United States)

    Zhang, Xiaoyang; Tan, Bin; Yu, Yunyue

    2014-05-01

    Land surface phenology is widely retrieved from satellite observations at regional and global scales, and its long-term record has been demonstrated to be a valuable tool for reconstructing past climate variations, monitoring the dynamics of terrestrial ecosystems in response to climate impacts, and predicting biological responses to future climate scenarios. This study detected global land surface phenology from the advanced very high resolution radiometer (AVHRR) and the Moderate Resolution Imaging Spectroradiometer (MODIS) data from 1982 to 2010. Based on daily enhanced vegetation index at a spatial resolution of 0.05 degrees, we simulated the seasonal vegetative trajectory for each individual pixel using piecewise logistic models, which was then used to detect the onset of greenness increase (OGI) and the length of vegetation growing season (GSL). Further, both overall interannual variations and pixel-based trends were examined across Koeppen's climate regions for the periods of 1982-1999 and 2000-2010, respectively. The results show that OGI and GSL varied considerably during 1982-2010 across the globe. Generally, the interannual variation could be more than a month in precipitation-controlled tropical and dry climates while it was mainly less than 15 days in temperature-controlled temperate, cold, and polar climates. OGI, overall, shifted early, and GSL was prolonged from 1982 to 2010 in most climate regions in North America and Asia while the consistently significant trends only occurred in cold climate and polar climate in North America. The overall trends in Europe were generally insignificant. Over South America, late OGI was consistent (particularly from 1982 to 1999) while either positive or negative GSL trends in a climate region were mostly reversed between the periods of 1982-1999 and 2000-2010. In the Northern Hemisphere of Africa, OGI trends were mostly insignificant, but prolonged GSL was evident over individual climate regions during the last 3

  7. Globalization

    OpenAIRE

    Andru?cã Maria Carmen

    2013-01-01

    The field of globalization has highlighted an interdependence implied by a more harmonious understanding determined by the daily interaction between nations through the inducement of peace and the management of streamlining and the effectiveness of the global economy. For the functioning of the globalization, the developing countries that can be helped by the developed ones must be involved. The international community can contribute to the institution of the development environment of the gl...

  8. Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children.

    Science.gov (United States)

    Benzian, Habib; Monse, Bella; Heinrich-Weltzien, Roswitha; Hobdell, Martin; Mulder, Jan; van Palenstein Helderman, Wim

    2011-07-13

    Dental decay is the most common childhood disease worldwide and most of the decay remains untreated. In the Philippines caries levels are among the highest in the South East Asian region. Elementary school children suffer from high prevalence of stunting and underweight.The present study aimed to investigate the association between untreated dental decay and Body Mass Index (BMI) among 12-year-old Filipino children. Data collection was part of the National Oral Health Survey, a representative cross-sectional study of 1951 11-13-year-old school children using a modified, stratified cluster sampling design based on population classifications of the Philippine National Statistics Office. Caries was scored according to WHO criteria (1997) and odontogenic infections using the PUFA index. Anthropometric measures were performed by trained nurses. Some socio-economic determinants were included as potential confounding factors. The overall prevalence of caries (DMFT + dmft > 0) was 82.3% (95%CI; 80.6%-84.0%). The overall prevalence of odontogenic infections due to caries (PUFA + pufa > 0) was 55.7% (95% CI; 53.5%-57.9%) The BMI of 27.1% (95%CI; 25.1%-29.1%) of children was below normal, 1% (95%CI; 0.5%-1.4%) had a BMI above normal. The regression coefficient between BMI and caries was highly significant (p Children with odontogenic infections (PUFA + pufa > 0) as compared to those without odontogenic infections had an increased risk of a below normal BMI (OR: 1.47; 95% CI: 1.19-1.80). This is the first-ever representative survey showing a significant association between caries and BMI and particularly between odontogenic infections and below normal BMI. An expanded model of hypothesised associations is presented that includes progressed forms of dental decay as a significant, yet largely neglected determinant of poor child development.

  9. Development of a self-reporting tool to obtain a Combined Index of Severity of Fibromyalgia (ICAF*

    Directory of Open Access Journals (Sweden)

    Esteve-Vives Joaquim

    2010-01-01

    Full Text Available Abstract Background Fibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome. Methods Application was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28, the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients. Results The ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%, Physical-Activity (15%, Active Coping (9% and Passive Coping (6.3%. A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs. Conclusions This study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a

  10. Cerebral Perfusion Pressure Targets Individualized to Pressure-Reactivity Index in Moderate to Severe Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Needham, Edward; McFadyen, Charles; Newcombe, Virginia; Synnot, Anneliese J; Czosnyka, Marek; Menon, David

    2017-03-01

    Traumatic brain injury (TBI) frequently triggers a disruption of cerebral autoregulation. The cerebral perfusion pressure (CPP) at which autoregulation is optimal ("CPPopt") varies between individuals, and can be calculated based on fluctuations between arterial blood pressure and intracranial pressure. This review assesses the effect of individualizing CPP targets to pressure reactivity index (a measure of autoregulation) in patients with TBI. Cochrane Central Register of Controlled Trials, MEDLINE®, Embase, and Cumulative Index of Nursing and Allied Health Literature were searched in March 2015 for studies assessing the effect of targeting CPPopt in TBI. We included all studies that assessed the impact of targeting CPPopt on outcomes including mortality, neurological outcome, and physiological changes. Risk of bias was assessed using the RTI Item Bank and evidence quality was considered using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Eight cohort studies (based on six distinct data sets) assessing the association between CPPopt and mortality, Glasgow Outcome Scale and physiological measures in TBI were included. The quality of evidence was deemed very low based on the GRADE criteria. Although the data suggest an association between variation from CPPopt and poor clinical outcome at 6 months, the quality of evidence prevents firm conclusions, particularly regarding causality, from being drawn. Available data suggest that targeting CPPopt might represent a technique to improve outcomes following TBI, but currently there is insufficient high-quality data to support a recommendation for use in clinical practice. Further prospective, randomized controlled studies should be undertaken to clarify its role in the acute management of TBI.

  11. Haploinsufficiency of KDM6A is associated with severe psychomotor retardation, global growth restriction, seizures and cleft palate.

    Science.gov (United States)

    Lindgren, Amelia M; Hoyos, Tatiana; Talkowski, Michael E; Hanscom, Carrie; Blumenthal, Ian; Chiang, Colby; Ernst, Carl; Pereira, Shahrin; Ordulu, Zehra; Clericuzio, Carol; Drautz, Joanne M; Rosenfeld, Jill A; Shaffer, Lisa G; Velsher, Lea; Pynn, Tania; Vermeesch, Joris; Harris, David J; Gusella, James F; Liao, Eric C; Morton, Cynthia C

    2013-05-01

    We describe a female subject (DGAP100) with a 46,X,t(X;5)(p11.3;q35.3)inv(5)(q35.3q35.1)dn, severe psychomotor retardation with hypotonia, global postnatal growth restriction, microcephaly, globally reduced cerebral volume, seizures, facial dysmorphia and cleft palate. Fluorescence in situ hybridization and whole-genome sequencing demonstrated that the X chromosome breakpoint disrupts KDM6A in the second intron. No genes were directly disrupted on chromosome 5. KDM6A is a histone 3 lysine 27 demethylase and a histone 3 lysine 4 methyltransferase. Expression of KDM6A is significantly reduced in DGAP100 lymphoblastoid cells compared to control samples. We identified nine additional cases with neurodevelopmental delay and various other features consistent with the DGAP100 phenotype with copy number variation encompassing KDM6A from microarray databases. We evaluated haploinsufficiency of kdm6a in a zebrafish model. kdm6a is expressed in the pharyngeal arches and ethmoid plate of the developing zebrafish, while a kdm6a morpholino knockdown exhibited craniofacial defects. We conclude KDM6A dosage regulation is associated with severe and diverse structural defects and developmental abnormalities.

  12. Glycaemic index of parboiled rice depends on the severity of processing: study in type 2 diabetic subjects

    DEFF Research Database (Denmark)

    Larsen, H. N.; Rasmussen, O. W.; Rasmussen, Peter Have

    2000-01-01

    Objective: To study the influence of parboiling and the severity of the process on glycaemic and insulinaemic responses to rice in type 2 diabetes. Moreover, to examine changes in starch structure related to parboiling, which may affect the metabolic responses and digestibility. Design: Nine type 2...... that to white bread (P type 2 diabetic...... diabetic subjects ingested four test meals: white bread (WB) and three meals of cooked polished rice of the same variety being non-parboiled (NP), mildly traditionally parboiled (TP) and severely pressure parboiled (PP). The participants ingested the test meals (50 g available carbohydrates) on separate...

  13. TST, as a polysomnographic variable, is superior to the apnea hypopnea index for evaluating intermittent hypoxia in severe obstructive sleep apnea.

    Science.gov (United States)

    Zhang, Xiao-Bin; Zen, Hui-Qing; Lin, Qi-Chang; Chen, Gong-Ping; Chen, Li-Da; Chen, Hua

    2014-10-01

    The polysomnography (PSG) index of the apnea hypopnea index (AHI) is considered the 'gold standard' for stratifying the severity of obstructive sleep apnea (OSA). However, AHI cannot reflect the true characteristic of chronic intermittent hypoxia (CIH), which may trigger systemic inflammation in some OSA patients. High-sensitivity C-reactive protein (hsCRP) is considered a biomarker of systemic inflammation in OSA patients. The aim of the present study was to evaluate the relationship between PSG variables and hsCRP in men with severe OSA. Men with severe OSA (AHI ≥ 30 events/h) diagnosed by PSG were enrolled. AHI and body mass index were matched between a high hsCRP group (hsCRP ≥ 3.0 mg/L) and a low hsCRP group. A blood sample was taken for serum hsCRP analysis. Multiple regression analysis was performed to assess independent predictors of high hsCRP. One hundred and fifty-two subjects were enrolled in the study (76 in each group). Mean serum hsCRP was 3.76 ± 2.13 mg/L. The mean percentage of total sleep time spent with SaO2 hypoxia variables.

  14. Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment.

    Science.gov (United States)

    Annesi, James J

    2008-01-01

    It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI > or = 40 kg/m(2)), however. This research tested these relationships in women with severe obesity. 57 women with a mean BMI of 43.8 kg/m(2) were enrolled in a cognitive-behavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Findings suggested significant relations of mood and weight change as well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit. Copyright 2008 S. Karger AG, Basel.

  15. The relation between ankle-brachial index (ABI and coronary artery disease severity and risk factors: an angiographic study

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2011-07-01

    .Keywords: Ankle–Brachial Index, Angiography, Atherosclerotic Risk Factors.

  16. Measurement properties of the ASAS Health Index: results of a global study in patients with axial and peripheral spondyloarthritis.

    Science.gov (United States)

    Kiltz, Uta; van der Heijde, Désirée; Boonen, Annelies; Akkoc, Nurullah; Bautista-Molano, Wilson; Burgos-Vargas, Ruben; Wei, James Cheng-Chung; Chiowchanwisawakit, Praveena; Dougados, Maxime; Duruoz, M Tuncay; Elzorkany, Bassel Kamal; Gaydukova, Inna; Gensler, Lianne S; Gilio, Michele; Grazio, Simeon; Gu, Jieruo; Inman, Robert D; Kim, Tae-Jong; Navarro-Compan, Victoria; Marzo-Ortega, Helena; Ozgocmen, Salih; Pimentel Dos Santos, Fernando; Schirmer, Michael; Stebbings, Simon; Van den Bosch, Filip E; van Tubergen, Astrid; Braun, Juergen

    2018-06-01

    To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Among the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM=-0.44 for non-steroidal anti-inflammatory drugs, -0.69 for conventional synthetic disease-modifying antirheumatic drug and -0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. The ASAS HI proved to be valid, reliable and responsive. It can be used to evaluate the impact of SpA and its treatment on functioning and health. Furthermore, comparison of disease impact between populations is possible. © Article author(s) (or their employer(s) unless otherwise

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

    Science.gov (United States)

    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

  18. Predicting Tropical Cyclogenesis with a Global Mesoscale Model: Preliminary Results with Very Severe Cyclonic Storm Nargis (2008)

    Science.gov (United States)

    Shen, B.; Tao, W.; Atlas, R.

    2008-12-01

    Very Severe Cyclonic Storm Nargis, the deadliest named tropical cyclone (TC) in the North Indian Ocean Basin, devastated Burma (Myanmar) in May 2008, causing tremendous damage and numerous fatalities. An increased lead time in the prediction of TC Nargis would have increased the warning time and may therefore have saved lives and reduced economic damage. Recent advances in high-resolution global models and supercomputers have shown the potential for improving TC track and intensity forecasts, presumably by improving multi-scale simulations. The key but challenging questions to be answered include: (1) if and how realistic, in terms of timing, location and TC general structure, the global mesoscale model (GMM) can simulate TC genesis and (2) under what conditions can the model extend the lead time of TC genesis forecasts. In this study, we focus on genesis prediction for TCs in the Indian Ocean with the GMM. Preliminary real-data simulations show that the initial formation and intensity variations of TC Nargis can be realistically predicted at a lead time of up to 5 days. These simulations also suggest that the accurate representations of a westerly wind burst (WWB) and an equatorial trough, associated with monsoon circulations and/or a Madden-Julian Oscillation (MJO), are important for predicting the formation of this kind of TC. In addition to the WWB and equatorial trough, other favorable environmental conditions will be examined, which include enhanced monsoonal circulation, upper-level outflow, low- and middle-level moistening, and surface fluxes.

  19. Several thoughts for using new satellite remote sensing and global modeling for aerosol and cloud climate studies

    Science.gov (United States)

    Nakajima, Teruyuki; Hashimoto, Makiko; Takenaka, Hideaki; Goto, Daisuke; Oikawa, Eiji; Suzuki, Kentaroh; Uchida, Junya; Dai, Tie; Shi, Chong

    2017-04-01

    The rapid growth of satellite remote sensing technologies in the last two decades widened the utility of satellite data for understanding climate impacts of aerosols and clouds. The climate modeling community also has received the benefit of the earth observation and nowadays closed-collaboration of the two communities make us possible to challenge various applications for societal problems, such as for global warming and global-scale air pollution and others. I like to give several thoughts of new algorithm developments, model use of satellite data for climate impact studies and societal applications related with aerosols and clouds. Important issues are 1) Better aerosol detection and solar energy application using expanded observation ability of the third generation geostationary satellites, i.e. Himawari-8, GOES-R and future MTG, 2) Various observation functions by directional, polarimetric, and high resolution near-UV band by MISR, POLDER&PARASOL, GOSAT/CAI and future GOSAT2/CAI2, 3) Various applications of general purpose-imagers, MODIS, VIIRS and future GCOM-C/SGLI, and 4) Climate studies of aerosol and cloud stratification and convection with active and passive sensors, especially climate impact of BC aerosols using CLOUDSAT&CALIPSO and future Earth Explorer/EarthCARE.

  20. Frailty index of deficit accumulation and falls: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort.

    Science.gov (United States)

    Li, Guowei; Ioannidis, George; Pickard, Laura; Kennedy, Courtney; Papaioannou, Alexandra; Thabane, Lehana; Adachi, Jonathan D

    2014-05-29

    To investigate the association between frailty index (FI) of deficit accumulation and risk of falls, fractures, death and overnight hospitalizations in women aged 55 years and older. The data were from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton Cohort. In this 3-year longitudinal, observational cohort study, women (N=3,985) aged ≥ 55 years were enrolled between May 2008 and March 2009 in Hamilton, Canada. A FI including co-morbidities, activities of daily living, symptoms and signs, and healthcare utilization was constructed using 34 health deficits at baseline. Relationship between the FI and falls, fractures, death and overnight hospitalizations was examined. The FI was significantly associated with age, with a mean rate of deficit accumulation across baseline age of 0.004 or 0.021 (on a log scale) per year. During the third year of follow-up, 1,068 (31.89%) women reported at least one fall. Each increment of 0.01 on the FI was associated with a significantly increased risk of falls during the third year of follow-up (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.02-1.03). The area under the curve (AUC) of the predictive model was 0.69 (95% CI: 0.67-0.71). Results of subgroup and sensitivity analyses indicated the relationship between the FI and risk of falls was robust, while bootstrap analysis judged its internal validation. The FI was significantly related to fractures (hazard ratio [HR]: 1.02, 95% CI: 1.01-1.03), death (OR: 1.05, 95% CI: 1.03-1.06) during the 3-year follow-up period and overnight hospitalizations (incidence rate ratio [IRR]: 1.02, 95% CI: 1.02-1.03) for an increase of 0.01 on the FI during the third year of follow-up. Measured by per standard deviation (SD) increment of the FI, the ORs were 1.21 and 1.40 for falls and death respectively, while the HR was 1.17 for fractures and the IRR was 1.18 for overnight hospitalizations respectively. The FI of deficit accumulation increased with chronological age

  1. Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.

    Science.gov (United States)

    Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

    2015-11-01

    Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. The EIT-based global inhomogeneity index is highly correlated with regional lung opening in patients with acute respiratory distress syndrome.

    Science.gov (United States)

    Zhao, Zhanqi; Pulletz, Sven; Frerichs, Inéz; Müller-Lisse, Ullrich; Möller, Knut

    2014-02-06

    The electrical impedance tomography (EIT)-based global inhomogeneity (GI) index was introduced to quantify tidal volume distribution within the lung. Up to now, the GI index was evaluated for plausibility but the analysis of how it is influenced by various physiological factors is still missing. The aim of our study was to evaluate the influence of proportion of open lung regions measured by EIT on the GI index. A constant low-flow inflation maneuver was performed in 18 acute respiratory distress syndrome (ARDS) patients (58 ± 14 years, mean age ± SD) and 8 lung-healthy patients (41 ± 12 years) under controlled mechanical ventilation. EIT raw data were acquired at 25 scans/s and reconstructed offline. Recruited lung regions were identified as those image pixels of the lung regions within the EIT scans where local impedance amplitudes exceeded 10% of the maximum amplitude during the maneuver. A series of GI indices was calculated during mechanical lung inflation, based on the differential images obtained between different time points. Respiratory system elastance (Ers) values were calculated at 10 lung volume levels during low-flow maneuver. The GI index decreased during low-flow inflation, while the percentage of open lung regions increased. The values correlated highly in both ARDS (r2 = 0.88 ± 0.08, p EIT. The GI index may prove to be a useful EIT-based index to guide ventilation therapy.

  3. Age differences in emotional responses to daily stress: the role of timing, severity, and global perceived stress.

    Science.gov (United States)

    Scott, Stacey B; Sliwinski, Martin J; Blanchard-Fields, Fredda

    2013-12-01

    Research on age differences in emotional responses to daily stress has produced inconsistent findings. Guided by recent theoretical advances in aging theory (S. T. Charles, 2010, Strength and vulnerability integration: A model of emotional well-being across adulthood, Psychological Bulletin, Vol. 136, pp. 1068-1091) that emphasize the importance of context for predicting when and how age is related to affective well-being, the current study examined age differences in emotional responses to everyday stressors. The present study examined how three contextual features (e.g., timing of exposure, stressor severity, global perceived stress [GPS]) moderate age differences in emotional experience in an ecological momentary assessment study of adults (N = 190) aged 18-81 years. Results indicated that older adults' negative affect (NA) was less affected by exposure to recent stressors than younger adults, but that there were no age differences in the effects of stressor exposure 3-6 hr afterward. Higher levels of GPS predicted amplified NA responses to daily stress, and controlling for GPS eliminated age differences in NA responses to stressors. No age differences in NA responses as a function of stressor severity were observed. In contrast, older age was associated with less of a decrease in PA when exposed to recent stressors or with more severe recent stressors. There were no age differences in the effect of previous stressor exposure or severity on PA, or any interactions between momentary or previous stress and GPS on PA. Together, these results support the notion that chronic stress plays a central role in emotional experience in daily life. We discuss the implications of these results for emotion theories of aging. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. Neural correlates of instrumental responding in the context of alcohol-related cues index disorder severity and relapse risk.

    Science.gov (United States)

    Schad, Daniel J; Garbusow, Maria; Friedel, Eva; Sommer, Christian; Sebold, Miriam; Hägele, Claudia; Bernhardt, Nadine; Nebe, Stephan; Kuitunen-Paul, Sören; Liu, Shuyan; Eichmann, Uta; Beck, Anne; Wittchen, Hans-Ulrich; Walter, Henrik; Sterzer, Philipp; Zimmermann, Ulrich S; Smolka, Michael N; Schlagenhauf, Florian; Huys, Quentin J M; Heinz, Andreas; Rapp, Michael A

    2018-01-08

    The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = - 3.86, p < .001), but not in healthy controls (t = - 0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t (30)  = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors. LeAD study, http://www.lead-studie.de , NCT01679145.

  5. Globalization

    DEFF Research Database (Denmark)

    Plum, Maja

    Globalization is often referred to as external to education - a state of affair facing the modern curriculum with numerous challenges. In this paper it is examined as internal to curriculum; analysed as a problematization in a Foucaultian sense. That is, as a complex of attentions, worries, ways...... of reasoning, producing curricular variables. The analysis is made through an example of early childhood curriculum in Danish Pre-school, and the way the curricular variable of the pre-school child comes into being through globalization as a problematization, carried forth by the comparative practices of PISA...

  6. Globalization

    OpenAIRE

    F. Gerard Adams

    2008-01-01

    The rapid globalization of the world economy is causing fundamental changes in patterns of trade and finance. Some economists have argued that globalization has arrived and that the world is “flat†. While the geographic scope of markets has increased, the author argues that new patterns of trade and finance are a result of the discrepancies between “old†countries and “new†. As the differences are gradually wiped out, particularly if knowledge and technology spread worldwide, the t...

  7. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

    Directory of Open Access Journals (Sweden)

    Ciccone Marco M

    2011-11-01

    Full Text Available Abstract Background Intima-media thickness of the common carotid artery (CCA-IMT is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD, left ventricular hypertrophy (LVH and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness. Methods 115 patients (76 men, mean age: 65.1 ± 12 years referred to our department and shown significant (≥ 70% luminal obstruction stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69% had one, 24 patients (21% two, 12 patients (10% three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF. Results Dividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004, LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P 2 = 0.88, RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017, LVMI (regression coefficient ± SE: 0.01 ± 0.001; P Conclusions RFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

  8. The Influence of Body Mass Index on Outcomes in Ureteroscopy: Results from the Clinical Research Office of Endourological Society URS Global Study.

    Science.gov (United States)

    Krambeck, Amy; Wijnstok, Nienke; Olbert, Peter; Mitroi, George; Bariol, Simon; Shah, Hemendra N; El-Abd, Ahmed S; Onal, Bulent; de la Rosette, Jean

    2017-01-01

    Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy. This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between body mass index (BMI), diabetes, and creatinine, with retreatment, stone-free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses. Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% were super obese. Overall, 86.7% patients were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone-free rates, and any deviation from normal weight was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size, the association between BMI and lower stone-free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients, and 343 (3.4%) experienced a postoperative complication. Postoperative complications were more frequent in the underweight and super obese subjects, and there was no relationship between BMI and intraoperative complications. Although URS for stone disease was found to be an overall safe procedure for obese and super obese patients, efficacy of the procedure may be lower compared with normal-weight subjects and higher retreatment rates may be necessary.

  9. Left ventricular global longitudinal strain is predictive of all-cause mortality independent of aortic stenosis severity and ejection fraction.

    Science.gov (United States)

    Ng, Arnold C T; Prihadi, Edgard A; Antoni, M Louisa; Bertini, Matteo; Ewe, See Hooi; Ajmone Marsan, Nina; Leung, Dominic Y; Delgado, Victoria; Bax, Jeroen J

    2017-07-28

    Left ventricular (LV) global longitudinal strain (GLS) may identify subclinical myocardial dysfunction in patients with aortic stenosis (AS). The aims of the present retrospective single centre study were to determine the independent prognostic value of LV GLS over LV ejection fraction (EF) and the role of LV GLS to further risk stratify severe AS patients before aortic valve replacement. A total of 688 patients (median age 72 years, 61.2% men) with mild (n = 130), moderate (n = 264) and severe AS (n = 294) were included. LV GLS was determined by 2D speckle tracking echocardiography. A total of 114 (16.6%) patients died before surgery during the study. When patients with severe AS and normal LVEF were dichotomized based on the median LV GLS value (-14.0%), patients with normal LVEF and 'preserved' LV GLS of ≤ -14% had significantly higher survival than patients with 'impaired' LV GLS of > -14%. There was no difference in survival between patients with normal LVEF but 'impaired' LV GLS ( > -14%) and patients with impaired LVEF (log-rank P = 0.34). LV GLS was independently associated with all-cause mortality on multivariable Cox regression analysis (hazard ratio 1.17, 95% confidence interval 1.09-1.26; P optimal timing of aortic valve replacement. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  10. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    2017-07-15

    National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This

  11. Higher body mass index is associated with greater severity of alopecia in men with male-pattern androgenetic alopecia in Taiwan: a cross-sectional study.

    Science.gov (United States)

    Yang, Chao-Chun; Hsieh, Fu-Nien; Lin, Li-Yu; Hsu, Chao-Kai; Sheu, Hamm-Ming; Chen, WenChieh

    2014-02-01

    Obesity is a risk factor for multiple health problems, but its association with androgenetic alopecia (AGA) remains controversial. We sought to determine the association between body mass index (BMI) and alopecia severity in men with AGA and early-onset AGA. A cross-sectional study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed. In all, 189 men were enrolled with a mean age of 30.8 years. In male-pattern AGA (n = 142), men with severe alopecia (grade V-VII) had higher BMI than those with mild to moderate alopecia (grade I-IV) (25.1 vs 22.8 kg/m(2), P = .01). After multivariate adjustments, the risk for severe alopecia was higher in the overweight or obese (BMI ≥24 kg/m(2)) subjects with male-pattern AGA (odds ratio 3.52, P < .01). In early-onset male-pattern AGA (n = 46), the risk for having severe alopecia was also higher in the overweight or obese subjects (odds ratio 4.97, P = .03). Parameters used to evaluate obesity were limited because of the retrospective nature of the study. Higher BMI was significantly associated with greater severity of hair loss in men with male-pattern AGA, especially in those with early-onset AGA. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study.

    Science.gov (United States)

    Dreber, H; Reynisdottir, S; Angelin, B; Tynelius, P; Rasmussen, F; Hemmingsson, E

    2017-02-01

    Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m -2 ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m -2 ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m -2 ) or severe obesity (n = 41, mean BMI = 39.7 kg m -2 ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P Young adult treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels. © 2017 World Obesity Federation.

  13. Challenges in Evaluating the Severity of Fibropapillomatosis: A Proposal for Objective Index and Score System for Green Sea Turtles (Chelonia mydas) in Brazil.

    Science.gov (United States)

    Rossi, Silmara; Sánchez-Sarmiento, Angélica María; Vanstreels, Ralph Eric Thijl; Dos Santos, Robson Guimarães; Prioste, Fabiola Eloisa Setim; Gattamorta, Marco Aurélio; Grisi-Filho, José Henrique Hildebrand; Matushima, Eliana Reiko

    2016-01-01

    Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution. The patterns in quantity, size and distribution of tumors revealed interesting aspects in the clinical manifestation of FP in specimens studied in Brazil, and that FP scoring systems developed for other areas might not perform adequately when applied to sea turtles on the Southwest Atlantic Ocean. We therefore propose a novel method to evaluate the clinical manifestation of FP: fibropapillomatosis index (FPI) that provides the Southwest Atlantic fibropapillomatosis score (FPSSWA). In combination, these indexing and scoring systems allow for a more objective, rapid and detailed evaluation of the severity of FP in green sea turtles. While primarily designed for the clinical manifestation of FP currently witnessed in our dataset, this index and the score system can be adapted for other areas and compare the characteristics of the disease across regions. In conclusion, scoring systems to classify the severity of FP can assist our understanding on the environmental factors that modulate its development and its impacts on the individual and population health of green sea turtles.

  14. Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies.

    Science.gov (United States)

    Gerber, Markus; Lang, Christin; Lemola, Sakari; Colledge, Flora; Kalak, Nadeem; Holsboer-Trachsler, Edith; Pühse, Uwe; Brand, Serge

    2016-05-31

    A variety of objective and subjective methods exist to assess insomnia. The Insomnia Severity Index (ISI) was developed to provide a brief self-report instrument useful to assess people's perception of sleep complaints. The ISI was developed in English, and has been translated into several languages including German. Surprisingly, the psychometric properties of the German version have not been evaluated, although the ISI is often used with German-speaking populations. The psychometric properties of the ISI are tested in three independent samples: 1475 adolescents, 862 university students, and 533 police and emergency response service officers. In all three studies, participants provide information about insomnia (ISI), sleep quality (Pittsburgh Sleep Quality Index), and psychological functioning (diverse instruments). Descriptive statistics, gender differences, homogeneity and internal consistency, convergent validity, and factorial validity (including measurement invariance across genders) are examined in each sample. The findings show that the German version of the ISI has generally acceptable psychometric properties and sufficient concurrent validity. Confirmatory factor analyses show that a 1-factor solution achieves good model fit. Furthermore, measurement invariance across gender is supported in all three samples. While the ISI has been widely used in German-speaking countries, this study is the first to provide empirical evidence that the German version of this instrument has good psychometric properties and satisfactory convergent and factorial validity across various age groups and both men and women. Thus, the German version of the ISI can be recommended as a brief screening measure in German-speaking populations.

  15. Modeling the Severity of Drinking Consequences in First-Year College Women: An Item Response Theory Analysis of the Rutgers Alcohol Problem Index*

    Science.gov (United States)

    Cohn, Amy M.; Hagman, Brett T.; Graff, Fiona S.; Noel, Nora E.

    2011-01-01

    Objective: The present study examined the latent continuum of alcohol-related negative consequences among first-year college women using methods from item response theory and classical test theory. Method: Participants (N = 315) were college women in their freshman year who reported consuming any alcohol in the past 90 days and who completed assessments of alcohol consumption and alcohol-related negative consequences using the Rutgers Alcohol Problem Index. Results: Item response theory analyses showed poor model fit for five items identified in the Rutgers Alcohol Problem Index. Two-parameter item response theory logistic models were applied to the remaining 18 items to examine estimates of item difficulty (i.e., severity) and discrimination parameters. The item difficulty parameters ranged from 0.591 to 2.031, and the discrimination parameters ranged from 0.321 to 2.371. Classical test theory analyses indicated that the omission of the five misfit items did not significantly alter the psychometric properties of the construct. Conclusions: Findings suggest that those consequences that had greater severity and discrimination parameters may be used as screening items to identify female problem drinkers at risk for an alcohol use disorder. PMID:22051212

  16. Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.

    Science.gov (United States)

    Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C

    2009-11-01

    Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.

  17. Comparative studies of RNFL thickness measured by OCT with global index of visual fields in patients with ocular hypertension and early open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Sergios Taliantzis

    2009-06-01

    Full Text Available Sergios Taliantzis, Dimitris Papaconstantinou, Chrysanthi Koutsandrea, Michalis Moschos, Michalis Apostolopoulos, Gerasimos GeorgopoulosAthens University Medical School, Department of Ophthalmology, Athens, GreecePurpose: To compare the functional changes in visual fields with optical coherence tomography (OCT findings in patients with ocular hypertension, open angle glaucoma, and suspected glaucoma. In addition, our purpose is to evaluate the correlation of global indices with the structural glaucomatous defect, to assess their statistical importance in all the groups of our study, and to estimate their validity to the clinical practice.Methods: One hundred sixty nine eyes (140 patients were enrolled. The patients were classified in three groups. Group 1 consisted of 54 eyes with ocular hypertension, group 2 of 42 eyes with preperimetric glaucoma, and group 3 of 73 eyes with chronic open angle glaucoma. All of them underwent ophthalmic examination according to a prefixed protocol, OCT exam (Stratus 3000 for retinal nerve fiber layer (RNFL thickness measurement with fast RNFL thickness protocol and visual fields (VF examination with Octopus perimeter (G2 program, central 30–2 threshold strategy. Pearson correlation was calculated between RNFL thickness and global index of VF.Results: A moderate correlation between RNFL thickness and indices mean sensitivity (MS, mean defect (MD and loss variance (LV of VF (0.547, -0.582, -0.527, respectively; P < 0.001 was observed for all patients. Correlations of the ocular hypertension and preperimetric groups are weak. Correlation of RNFL thickness with global indices becomes stronger as the structural alterations become deeper in OCT exam. Correlation of RNFL thickness with the global index of VF, in respective segments around optic disk was also calculated and was found significant in the nasal, inferior, superior, and temporal segments.Conclusion: RNFL average thickness is not a reliable index for early

  18. Are the Insomnia Severity Index and Pittsburgh Sleep Quality Index valid outcome measures for Cognitive Behavioral Therapy for Insomnia? Inquiry from the perspective of response shifts and longitudinal measurement invariance in their Chinese versions.

    Science.gov (United States)

    Chen, Po-Yi; Jan, Ya-Wen; Yang, Chien-Ming

    2017-07-01

    The purpose of this study was to examine whether the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) are valid outcome measures for Cognitive Behavioral Therapy for Insomnia (CBT-I). Specifically, we tested whether the factorial parameters of the ISI and the PSQI could remain invariant against CBT-I, which is a prerequisite to using their change scores as an unbiased measure of the treatment outcome of CBT-I. A clinical data set including scores on the Chinese versions of the ISI and the PSQI obtained from 114 insomnia patients prior to and after a 6-week CBT-I program in Taiwan was analyzed. A series of measurement invariance (MI) tests were conducted to compare the factorial parameters of the ISI and the PSQI before and after the CBT-I treatment program. Most factorial parameters of the ISI remained invariant after CBT-I. However, the factorial model of the PSQI changed after CBT-I treatment. An extra loading with three residual correlations was added into the factorial model after treatment. The partial strong invariance of the ISI supports that it is a valid outcome measure for CBT-I. In contrast, various changes in the factor model of the PSQI indicate that it may not be an appropriate outcome measure for CBT-I. Some possible causes for the changes of the constructs of the PSQI following CBT-I are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Role of Global Longitudinal Strain in the Prediction of Outcome in Patients With Severe Aortic Valve Stenosis.

    Science.gov (United States)

    Fries, Bastian; Liu, Dan; Gaudron, Philipp; Hu, Kai; Nordbeck, Peter; Ertl, Georg; Weidemann, Frank; Herrmann, Sebastian

    2017-08-15

    In the present study, we assessed the role of Global Longitudinal Strain (GLS) as a predictor of all-cause mortality in patients with severe aortic valve stenosis (AS), irrespective of their type of treatment. Data of 807 patients with AS receiving complete echocardiographic and clinical examination were retrospectively analyzed. Valve area <1 cm 2 and sufficient image quality were inclusion criteria; patients with severe concomitant valvulopathy were excluded. Patients were grouped into treatment (aortic valve replacement [AVR]) and conservative (non-AVR) groups. Multivariable Cox analysis was used to assess predictors of all-cause mortality. Five hundred fourteen patients were included and 53.3% were of male gender. Mean age at inclusion was 76.4 ± 9.8 years; 326 received AVR. Death from any cause occurred in 72.9% of non-AVR group and 17.8% of AVR group (p <0.001). GLS (expressed as |%|) was found to be an independent predictor of all-cause mortality in non-AVR group (hazard ratio [HR] 0.933, 95% CI 0.854 to 0.987, p = 0.038). In patients receiving AVR, GLS and history of coronary artery bypass graft were found to be independent predictors of all-cause mortality (HR for GLS 0.912, 95% CI 0.730 to 0.999, p = 0.048; HR for coronary artery bypass graft 2.977, 95% CI 1.014 to 6.273, p = 0.013). In non-AVR patients, GLS <9.7% showed a higher 1- and 5-year mortality (log rank p values of 0.002 and 0.010, respectively). In conclusion, GLS is an independent predictor of all-cause mortality in severe AS, irrespective of their type of treatment. GLS <9.7% indicates a significantly higher 1- and 5-year mortality in non-AVR patients. Therefore, GLS should be regularly assessed for enhanced risk stratification and clinical decision-making. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Automatic Assessment of Global Craniofacial Differences between Crouzon mice and Wild-type mice in terms of the Cephalic Index

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Oubel, Estanislao; Frangi, Alejandro F.

    2006-01-01

    of landmark matching is limited using only affine transformations, the errors were considered acceptable. The automatic estimation of the cephalic index was in full agreement with the gold standard measurements. Discriminant analysis of the three scaling parameters resulted in a good classification...

  1. The Association Between Body Mass Index and the Prevalence, Severity, and Frequency of Low Back Pain: Data From the Osteoarthritis Initiative.

    Science.gov (United States)

    Su, Charles A; Kusin, David J; Li, Samuel Q; Ahn, Uri M; Ahn, Nicholas U

    2018-02-16

    Cross-sectional study. To determine whether there is an association between body mass index (BMI) and the prevalence, severity, and frequency of low back pain and identify other potential patient risk factors for the development of low back pain. Many studies have implicated that a high BMI is a risk factor for low back pain. However, few studies have examined the association between increased BMI and the prevalence, severity, and frequency of low back pain. Data from the Osteoarthritis Initiative, a multicenter, prospective study of knee osteoarthritis, were used to conduct this study, which included 4796 patients. BMI was categorized according to the World Health Organization classification and the prevalence, severity, and frequency of low back pain were assessed. Logistic regression was performed to identify additional patient risk factors associated with low back pain. The prevalence of low back pain was found to be significantly higher in patients with an elevated BMI compared to those with normal or underweight BMI and demonstrated a stepwise increase with each BMI category. Approximately 47.4% of patients with normal or underweight BMI complained of low back pain compared with 72.8% of morbidly obese patients (P frequency or severity of low back pain episodes. Osteoarthritis of the back and depression were patient variables found to be associated with all three measures (prevalence, severity, and frequency) of low back pain. Elevated BMI is strongly associated with an increased prevalence of low back pain. Depression and osteoarthritis of the back are associated with the prevalence, severity, and frequency of low back pain. 3.

  2. Assessing the Quality of Life Using the Health Utilities Index Questionnaire in Children With Severe Persistent Asthma During the Treatment With Omalizumab

    Directory of Open Access Journals (Sweden)

    Leyla S. Namazova-Baranova

    2017-01-01

    Full Text Available Background. Quality of life (QoL is an important parameter that provides additional information about changes in health status. Objective. Our aim was to study the change in QoL of patients with severe persistent bronchial asthma (BA during the treatment with genetically engineered biological preparation (GIBP omalizumab in addition to daily background therapy. Methods. The QoL assessment was conducted using the Health Utilities Index Mark 3 and Mark 2 (HUI3, HUI2 questionnaires at two points (1st point and 2nd point — in 6 months in 47 children with severe BA at the age of 13 (7; 17 years, 72% of them are boys. At the same points, QoL was evaluated using the PAQLQ (S specialized pediatric questionnaire (Standardized Pediatric Asthma Quality of Life Questionnaire. Results. Depending on the duration of omalizumab therapy, all children were divided into 5 groups: 1st group — children who did not receive treatment with monoclonal antibodies at the 1st point; in 2, 3, 4, 5-th groups, the QoL assessment was performed on GIBP treatment for different time. In children of the 1st group whose QoL was evaluated before starting GIBP therapy and in 6 months, a statistically significant change in scores on the Health Utilities Index questionnaire was noted: the multi-attribute indices HUI2 and HUI3 improved, respectively, by 21.3 and 10.71% (p = 0.041 and 0.086. According to the HUI2 classification system, a significant improvement in the emotion attribute was revealed, which positively correlated with the overall indicator and the emotion indicator of the PAQLQ (S questionnaire. In the remaining groups, the indicators of the Health Utilities Index questionnaire did not change significantly. Conclusion. The study results showed that the dynamics of the quality of life in children with severe persistent BA is an important additional criterion in a comprehensive assessment of the efficacy of targeted bioengineering therapy. 

  3. Is Clinical Assessment of Addiction Severity of Individuals with Substance Use Disorder, Using the Addiction Severity Index, A Predictor of Future Inpatient Mental Health Hospitalization? A Nine-Year Registry Study.

    Science.gov (United States)

    Padyab, Mojgan; Armelius, Bengt-Åke; Armelius, Kerstin; Nyström, Siv; Blom, Björn; Grönlund, Ann-Sofie; Lundgren, Lena

    2018-04-23

    In Sweden, the Addiction Severity Index (ASI) is the Swedish National Board of Health and Welfare's recommended substance use disorder assessment tool and used routinely for patient intakes. Our study of 213 individuals assessed for substance use disorder with the ASI used nine years of the National Patient Register and examined whether clinical social workers' assessments of addiction severity at baseline were associated with later hospitalizations for mental health disorder (MHD). ASI composite scores and interviewer severity rating were used to measure clients' problems in seven areas (mental health, family and social relationships, employment, alcohol, drug use, health, and legal) at baseline. A stepwise regression method was used to assess the relative importance of ASI composite scores, MHD hospitalization two years prior to baseline, age, and gender for MHD hospitalization seven years post-baseline. Almost two-thirds of the individuals (63%) were hospitalized at least once for MHD in the seven years post-baseline. At the multivariable level, MHD hospitalization prior to baseline was the strongest predictor of future MHD hospitalization, followed by ASI composite scores for drug use, employment, mental health and, last, male gender. A key finding is that higher ASI composite scores for drug use and mental health are predictors of future need for MHD treatment. Future studies will replicate this effort with a national population of individuals with substance use disorder.

  4. Sequential Oxygenation Index and Organ Dysfunction Assessment within the First 3 Days of Mechanical Ventilation Predict the Outcome of Adult Patients with Severe Acute Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Hsu-Ching Kao

    2013-01-01

    Full Text Available Objective. To determine early predictors of outcomes of adult patients with severe acute respiratory failure. Method. 100 consecutive adult patients with severe acute respiratory failure were evaluated in this retrospective study. Data including comorbidities, Sequential Organ Failure Assessment (SOFA score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II score, PaO2, FiO2, PaO2/FiO2, PEEP, mean airway pressure (mPaw, and oxygenation index (OI on the 1st and the 3rd day of mechanical ventilation, and change in OI within 3 days were recorded. Primary outcome was hospital mortality; secondary outcome measure was ventilator weaning failure. Results. 38 out of 100 (38% patients died within the study period. 48 patients (48% failed to wean from ventilator. Multivariate analysis showed day 3 OI ( and SOFA ( score were independent predictors of hospital mortality. Preexisting cerebrovascular accident (CVA ( was the predictor of weaning failure. Results from Kaplan-Meier method demonstrated that higher day 3 OI was associated with shorter survival time (log-Rank test, . Conclusion. Early OI (within 3 days and SOFA score were predictors of mortality in severe acute respiratory failure. In the future, prospective studies measuring serial OIs in a larger scale of study cohort is required to further consolidate our findings.

  5. First direct landscape-scale measurement of tropical rain forest Leaf Area Index, a key driver of global primary productivity

    Science.gov (United States)

    David B. Clark; Paulo C. Olivas; Steven F. Oberbauer; Deborah A. Clark; Michael G. Ryan

    2008-01-01

    Leaf Area Index (leaf area per unit ground area, LAI) is a key driver of forest productivity but has never previously been measured directly at the landscape scale in tropical rain forest (TRF). We used a modular tower and stratified random sampling to harvest all foliage from forest floor to canopy top in 55 vertical transects (4.6 m2) across 500 ha of old growth in...

  6. The Global Land-Ocean Temperature Index in Relation to Sunspot Number, the Atlantic Multidecadal Oscillation Index, the Mauna Loa Atmospheric Concentration of CO2, and Anthropogenic Carbon Emissions

    Science.gov (United States)

    Wilson, Robert M.

    2013-01-01

    Global warming/climate change has been a subject of scientific interest since the early 19th century. In particular, increases in the atmospheric concentration of carbon dioxide (CO2) have long been thought to account for Earth's increased warming, although the lack of a dependable set of observational data was apparent as late as the mid 1950s. However, beginning in the late 1950s, being associated with the International Geophysical Year, the opportunity arose to begin accurate continuous monitoring of the Earth's atmospheric concentration of CO2. Consequently, it is now well established that the atmospheric concentration of CO2, while varying seasonally within any particular year, has steadily increased over time. Associated with this rising trend in the atmospheric concentration of CO2 is a rising trend in the surface-air and sea-surface temperatures (SSTs). This Technical Publication (TP) examines the statistical relationships between 10-year moving averages (10-yma) of the Global Land-Ocean Temperature Index (GLOTI), sunspot number (SSN), the Atlantic Multidecadal Oscillation (AMO) index, and the Mauna Loa CO2 (MLCO2) index for the common interval 1964-2006, where the 10-yma values are used to indicate trends in the data. Scatter plots using the 10-yma values between GLOTI and each of the other parameters are determined, both as single-variate and multivariate fits. Scatter plots are also determined for MLCO2 using single-variate and bivariate (BV) fits, based on the GLOTI alone and the GLOTI in combination with the AMO index. On the basis of the inferred preferential fits for MLCO2, estimates for MLCO2 are determined for the interval 1885-1964, thereby yielding an estimate of the preindustrial level of atmospheric concentration of CO2. Lastly, 10-yma values of MLCO2 are compared against 10-yma estimates of the total carbon emissions (TCE) to determine the likelihood that manmade sources of carbon emissions are indeed responsible for the recent warming now

  7. Gender gap matters in maternal mortality in low and lower-middle-income countries: A study of the global Gender Gap Index.

    Science.gov (United States)

    Choe, Seung-Ah; Cho, Sung-Il; Kim, Hongsoo

    2017-09-01

    Reducing maternal mortality has been a crucial part of the global development agenda. According to modernisation theory, the effect of gender equality on maternal health may differ depending on a country's economic development status. We explored the correlation between the Global Gender Gap Index (GGI) provided by the World Economic Forum and the maternal mortality ratio (MMR) obtained from the World Development Indicators database of the World Bank. The relationships between each score in the GGI, including its four sub-indices (measuring gender gaps in economic participation, educational attainment, health and survival, and political empowerment), and the MMR were analysed. When the countries were stratified by gross national income per capita, the low and lower-middle-income countries had lower scores in the GGI, and lower scores in the economic participation, educational attainment, and political empowerment sub-indices than the high-income group. Among the four sub-indices, the educational attainment sub-index showed a significant inverse correlation with the MMR in low and lower-middle-income countries when controlling for the proportion of skilled birth attendance and public share of health expenditure. This finding suggests that strategic efforts to reduce the gender gap in educational attainment could lead to improvements in maternal health in low and lower-middle-income countries.

  8. Exercise training with weight loss and either a high- or low-glycemic index diet reduces metabolic syndrome severity in older adults.

    Science.gov (United States)

    Malin, Steven K; Niemi, Nicole; Solomon, Thomas P J; Haus, Jacob M; Kelly, Karen R; Filion, Julianne; Rocco, Michael; Kashyap, Sangeeta R; Barkoukis, Hope; Kirwan, John P

    2012-01-01

    The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score). Twenty-one adults (66.2±1.1 years; BMI=35.3±0.9 kg/m2) with the metabolic syndrome were randomized to 12 weeks of exercise (60 min/day for 5 days/week at about 85% HRmax) and provided a LoGIx (n=11) or HiGIx (n=10) diet. Z-scores were determined from: blood pressure, triglycerides (TGs), high-density lipoproteins (HDLs), fasting plasma glucose (FPG), and waist circumference (WC) before and after the intervention. Body composition, aerobic fitness, insulin resistance, and nonesterfied fatty acid (NEFA) suppression were also assessed. LoGIx and HiGIx diets decreased body mass and insulin resistance and increased aerobic fitness comparably (pdiets decreased the Z-score similarly as each intervention decreased blood pressure, TGs, FPG and WC (pdiet tended to suppress NEFA during insulin stimulation compared with the LoGIx diet (p=0.06). Our findings highlight that exercise with weight loss reduces the severity of the metabolic syndrome whether individuals were randomized to a HiGIx or a LoGIx diet.

  9. Usefulness of modified Pulmonary Index Score (mPIS) as a quantitative tool for the evaluation of severe acute exacerbation in asthmatic children.

    Science.gov (United States)

    Koga, Takeshi; Tokuyama, Kenichi; Itano, Atsushi; Morita, Eiji; Ueda, Yutaka; Katsunuma, Toshio

    2015-04-01

    Acute exacerbation of asthma is divided qualitatively into mild, moderate, and severe attacks and respiratory failure. This system is, however, not suitable for estimating small changes in respiratory condition with time and for determining the efficacy of treatments, because it has a qualitative, but not quantitative nature. To evaluate the usefulness of quantitative estimation of asthma exacerbation, modified Pulmonary Index Score (mPIS) values were measured in 87 asthmatic children (mean age, 5.0 ± 0.4 years) during hospitalization. mPIS was calculated by adding the sum of scores for 6 items (scores of 0-3 were given for each item). These consisted of heart rate, respiratory rate, accessory muscle use, inspiratory-to-expiratory flow ratio, degree of wheezing, and oxygen saturation in room air. Measurements were made at visits and at hospitalization and were then made twice a day until discharge. mPIS values were highly correlated among raters. mPIS values at visits were 9.1 ± 0.1 and 12.6 ± 0.4 in subjects with moderate and severe attacks, respectively (p asthma attacks, including the determination of a treatment plan, and prediction of the period of hospitalization in admitted patients, although prospective studies would be required to establish our hypothesis. Copyright © 2014 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  10. Assessment of malocclusion severity and orthodontic treatment needs in 12-15-year-old school children of Namakkal District, Tamil Nadu, using Dental Aesthetic Index.

    Science.gov (United States)

    Nagalakshmi, S; James, S; Rahila, C; Balachandar, K; Satish, R

    2017-01-01

    The present study was aimed to assess the severity of malocclusion and orthodontic treatment needs among 12-15-year-old schoolchildren in rural area of Namakkal district, Tamil Nadu, India, using the Dental Aesthetic Index (DAI). A cross-sectional study was conducted among a sample of 1078 schoolchildren (12-15 years of age) who were selected by two-stage cluster sampling technique. Severity of malocclusion and orthodontic treatment needs were assessed according to the DAI using a specially designed survey pro forma with the aid of the WHO's Oral Health Survey: Basic Methods. Based on the distribution of data, analysis of variance and unpaired student t-test were used. Out of the total of 1078 children examined, 528 (49%) were males and 550 (57%) were females. The results indicate that 82.74% of the schoolchildren were found with little or no malocclusion requiring no orthodontic treatment. The gender-wise distribution of DAI score among children aged 12 years had significant difference between males (20.43 ± 3.67) and females (21.62 ± 4.335) (P = 0.015) and children aged 15 years also showed highly significant difference among gender (P = 0.000). Malocclusion not only impacts the appearance of the person but also affects the self-esteem and psychological well-being. This is the first step in understanding the treatment need so that further steps can be taken in preventive and interceptive care.

  11. Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

    Science.gov (United States)

    Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

    2018-01-01

    The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, psuicide (SHR=11.45, pdrug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Evaluation of the correlation between Scoring Feline Allergic Dermatitis and Feline Extent and Severity Index and skin hydration in atopic cats.

    Science.gov (United States)

    Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Łukasz R; Zając, Marcin; Gołyński, Marcin; Sitkowski, Wiesław; Taszkun, Iwona

    2018-02-01

    Evaluation of the severity of clinical signs of cats with allergic skin diseases has used two scoring systems: Scoring Feline Allergic Dermatitis (SCORFAD) and the Feline Extent and Severity Index (FeDESI). The integrity of the cutaneous barrier can also be evaluated by measuring skin hydration. A correlation between the clinical score and skin hydration has been observed in humans and dogs with atopic dermatitis (AD). To demonstrate a correlation between the clinical score and skin hydration of cats affected with presumed AD. European short hair cats (n = 18): 11 females and seven males with a confirmed diagnosis of AD. SCORFAD and FeDESI scores were calculated and the measurements of skin hydration were assessed from seven body sites using corneometry. The correlation between the SCORFAD and FeDESI systems and skin hydration of each site, and the average skin hydration was calculated. There was a positive correlation between the SCORFAD score and skin hydration for the axilla, thorax and forelimb; for FeDESI and axilla and lumbar sites. There was a negative correlation between the FeDESI and skin hydration for the pinna (r = -0.47). Measurements of skin hydration could be a useful tool for the evaluation of allergic cats. There is limited evidence of any useful correlation between clinical scoring systems and measurements of hydration. The pinna may be a suitable region for the assessment of skin barrier function in normal and allergic cats. © 2017 ESVD and ACVD.

  13. Evaluation of the utility of the Fournier′s gangrene severity index in the management of Fournier′s gangrene in North India: A multicentre retrospective study

    Directory of Open Access Journals (Sweden)

    Satyajeet Verma

    2012-01-01

    Full Text Available Objective: To study the utility of Fournier′s Gangrene Severity Index (FGSI with mortality predictive value in our tertiary institutes in North India. Materials and Methods: A retrospective study of 95 cases of Fournier′s Gangrene (FG, admitted from 2009 to 2011, was carried out. We analysed clinical and laboratory findings, various prognostic factors, surgical treatments and their outcomes in FG patients. FGSI was used as individual variable to estimate the severity of FG; the effects of these factors on mortality were also evaluated. Results: The overall mean age was 46.5 ± 15.6 (range 24-82 years. Anorectal and urological regions were the main sites of the infection. The most common site of infection origin was scrotum in 81.3% in group A and 41.2% in group B. One or more predisposing factors such as diabetes mellitus (DM; 55% malignancies (4.6%, chronic renal failure (4.5% and previous surgery (9.2% were detected. We observed mortality in 26.5% cases (17/65. The FGSI calculated averaged 5.95 ± 365 in group A and 9.44 ± 2.56 in group B, at the time of admission ( P > 0.05. Conclusion: In FG, an early diagnosis and early surgical debridement are essential. The FGSI seems to be an excellent tool for the outcome prediction.

  14. Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index.

    Science.gov (United States)

    García-Solís, Pablo; Solís-S, Juan Carlos; García-Gaytán, Ana Cristina; Reyes-Mendoza, Vanessa A; Robles-Osorio, Ludivina; Villarreal-Ríos, Enrique; Leal-García, Luisa; Hernández-Montiel, Hebert Luis

    2013-08-01

    To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

  15. Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis

    Directory of Open Access Journals (Sweden)

    Jennifer Mancio

    2017-10-01

    Full Text Available Abstract Background Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC and poor outcomes in aortic stenosis (AS. However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. Aims To determine the association of body mass index (BMI and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR. Methods This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Results Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05. At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1–4.9; p = 0.021 and HR with obese/high VAF was 2.5 (95% CI 1.1–5.8; p = 0.031 compared with obese/low VAF patients. Conclusions In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

  16. Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis.

    Science.gov (United States)

    Mancio, Jennifer; Fonseca, Paulo; Figueiredo, Bruno; Ferreira, Wilson; Carvalho, Monica; Ferreira, Nuno; Braga, Pedro; Rodrigues, Alberto; Barros, Antonio; Falcao-Pires, Ines; Leite-Moreira, Adelino; Ribeiro, Vasco Gama; Bettencourt, Nuno

    2017-01-01

    Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1-4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1-5.8; p = 0.031) compared with obese/low VAF patients. In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

  17. Global drought and severe drought-affected populations in 1.5 and 2 °C warmer worlds

    Directory of Open Access Journals (Sweden)

    W. Liu

    2018-03-01

    Full Text Available The 2015 Paris Agreement proposed a more ambitious climate change mitigation target on limiting global warming to 1.5 °C instead of 2 °C above preindustrial levels. Scientific investigations on environmental risks associated with these warming targets are necessary to inform climate policymaking. Based on the Coupled Model Intercomparison Project phase 5 (CMIP5 climate models, we present the first risk-based assessment of changes in global drought and the impact of severe drought on populations from additional 1.5 and 2 °C warming conditions. Our results highlight the risk of drought on a global scale and in several hotspot regions such as the Amazon, northeastern Brazil, southern Africa and Central Europe at both 1.5 and 2 °C global warming relative to the historical period, showing increases in drought durations from 2.9 to 3.2 months. Correspondingly, more total and urban populations would be exposed to severe droughts globally (+132.5 ± 216.2 million and +194.5 ± 276.5 million total population and +350.2 ± 158.8 million and +410.7 ± 213.5 million urban populations in 1.5 and 2 °C warmer worlds and regionally (e.g., East Africa, West Africa and South Asia. Less rural populations (−217.7 ± 79.2 million and −216.2 ± 82.4 million rural populations in 1.5 and 2 °C warmer worlds would be exposed to severe drought globally under climate warming, population growth and especially the urbanization-induced population migration. By keeping global warming at 1.5 °C above the preindustrial levels instead of 2 °C, there is a decrease in drought risks (i.e., less drought duration, less drought intensity and severity but relatively more frequent drought and the affected total, urban and rural populations would decrease globally and in most regions. While challenging for both East Africa and South Asia, the benefits of limiting warming to below 1.5 °C in terms of global drought risk

  18. Indicators for the Data Usage Index (DUI): an incentive for publishing primary biodiversity data through global information infrastructure

    DEFF Research Database (Denmark)

    Ingwersen, Peter; Chavan, Vishwas

    2011-01-01

    download instances. The DUI is proposed to include relative as well as species profile weighted comparative indicators. Conclusions We believe that in addition to the recognition to the data publisher and all players involved in the data life cycle, a DUI will also provide much needed yet novel insight...... into how users use primary biodiversity data. A DUI consisting of a range of usage indicators obtained from the GBIF network and other relevant access points is within reach. The usage of biodiversity datasets leads to the development of a family of indicators in line with well known citation-based......Background A professional recognition mechanism is required to encourage expedited publishing of an adequate volume of 'fit-for-use' biodiversity data. As a component of such a recognition mechanism, we propose the development of the Data Usage Index (DUI) to demonstrate to data publishers...

  19. Validation of the Hong Kong Cantonese Version of World Health Organization Five Well-Being Index for People with Severe Mental Illness.

    Science.gov (United States)

    Kong, C L; Lee, C C; Ip, Y C; Chow, L P; Leung, C H; Lam, Y C

    2016-03-01

    The World Health Organization Five Well-Being Index (WHO-5) has been developed to measure psychological wellbeing. Translation and linguistic validation of the WHO-5 into a Cantonese version has been accomplished for local use but it is not yet validated in people with severe mental illness in Hong Kong. This study aimed to examine the applicability of WHO-5 in measuring the psychological wellbeing dimension of people with severe mental illness. A brief and easily administrated tool to measure psychological wellbeing of people with severe mental illness can be used to provide an outcome measure in research studies and clinical trials. Subjects were randomly recruited from the Extended-Care Patient Intensive Treatment, Early Diversion and Rehabilitation Stepping-Stone Project (EXITERS) and the Rehabilitation Activity Centre (RAC) of Kwai Chung Hospital in Hong Kong. They were invited to complete the abbreviated version of Hong Kong Chinese World Health Organization Quality of Life (WHOQOL-BREF [HK]) and WHO-5 (Cantonese version) separately and concurrent validity was examined. A total of 84 subjects were recruited, 42 each from EXITERS and RAC. In all, 49 (58%) were male and 35 (42%) were female. The mean ± standard deviation age was 43.2 ± 9.7 years. Their mean duration of mental illness was 16.4 ± 10.5 years and the mean years of education was 10.17 ± 2.5 years, i.e. about junior secondary school level in Hong Kong. The internal consistency of the WHO-5 was satisfactory (0.86) and was comparable with previous reports. Regarding validity, 1-factor structure with an eigenvalue of 3.24 explained 64.8% of total variance of WHO-5 for people with severe mental illness. Concurrent validity was established with moderate correlation (0.41-0.51) between WHO-5 and 4 domains of the WHOQOL-BREF (HK). The WHO-5 (Cantonese version) is a reliable and valid tool to assess the psychological wellbeing of people with severe mental illness in Hong Kong. It can be used to monitor

  20. Comparing the Life Cycle Energy Consumption, Global Warming and Eutrophication Potentials of Several Water and Waste Service Options

    Science.gov (United States)

    Managing the water-energy-nutrient nexus for the built environment requires, in part, a full system analysis of energy consumption, global warming and eutrophication potentials of municipal water services. As an example, we evaluated the life cycle energy use, greenhouse gas (GHG...

  1. Characteristics and trends on global environmental monitoring research: a bibliometric analysis based on Science Citation Index Expanded.

    Science.gov (United States)

    Zhang, Di; Fu, Hui-Zhen; Ho, Yuh-Shan

    2017-11-01

    A bibliometric analysis based on the Science Citation Index Expanded from Web of Science was carried out to provide insights into research activities and trends of the environmental monitoring from 1993 to 2012. Study emphases covered publication outputs, language, categories, journals, countries/territories, institutions, words, and hot issues. The results indicated that the annual output of environmental monitoring publications increased steadily. The environmental sciences and analytical chemistry were the two most common categories. Environmental Monitoring and Assessment published the most articles. The USA and the UK ranked in the top two in terms of all five indicators. The U.S. Environmental Protection Agency took the leading position of the institutions in terms of publication output. The synthesized analysis by words in title, author keywords, and KeyWords Plus provided important clues for hot issues. Researchers paid more attention on water environment monitoring than other environmental factors. The contaminants including organic contaminants, heavy metal, and radiation were most common research focuses, and the organic contaminants and heavy metal of the degree of concern were gradually rising. Sensor and biosensor played an important role in the field of environmental monitoring devices. In addition to conventional device detection method, the remote sensing, GIS, and wireless sensor networks were the mainstream environmental monitoring methods. The international organization, social awareness, and the countries' positive and effective political and policies promoted the published articles.

  2. Assessment of malocclusion severity and orthodontic treatment needs in 12–15-year-old school children of Namakkal District, Tamil Nadu, using Dental Aesthetic Index

    Directory of Open Access Journals (Sweden)

    S Nagalakshmi

    2017-01-01

    Full Text Available Objectives: The present study was aimed to assess the severity of malocclusion and orthodontic treatment needs among 12–15-year-old schoolchildren in rural area of Namakkal district, Tamil Nadu, India, using the Dental Aesthetic Index (DAI. Materials and Methods: A cross-sectional study was conducted among a sample of 1078 schoolchildren (12–15 years of age who were selected by two-stage cluster sampling technique. Severity of malocclusion and orthodontic treatment needs were assessed according to the DAI using a specially designed survey pro forma with the aid of the WHO's Oral Health Survey: Basic Methods. Based on the distribution of data, analysis of variance and unpaired student t-test were used. Results: Out of the total of 1078 children examined, 528 (49% were males and 550 (57% were females. The results indicate that 82.74% of the schoolchildren were found with little or no malocclusion requiring no orthodontic treatment. The gender-wise distribution of DAI score among children aged 12 years had significant difference between males (20.43 ± 3.67 and females (21.62 ± 4.335 (P = 0.015 and children aged 15 years also showed highly significant difference among gender (P = 0.000. Conclusion: Malocclusion not only impacts the appearance of the person but also affects the self-esteem and psychological well-being. This is the first step in understanding the treatment need so that further steps can be taken in preventive and interceptive care.

  3. G-231A and G+70C polymorphisms of endothelin receptor type-A gene could affect the psoriasis area and severity index score and endothelin 1 levels

    Directory of Open Access Journals (Sweden)

    Gökhan Okan

    2015-01-01

    Full Text Available Background: The etiopathogenesis of psoriasis has not been clearly elucidated although the role of chronic inflammation, imbalance between pro- and anti-inflammatory cytokines, and many immunological events have been established. Endothelin 1 (EDN1 and endothelin receptor type-A (EDNRA are implicated in the inflammatory process. The relationships between EDN1 and EDNRA polymorphisms with several diseases have been found. Aims and Objectives: This study examined the possible association of EDN1 (G5665T and T-1370G and EDNRA (G-231A and G + 70C single nucleotide polymorphisms (SNPs with the occurence of psoriasis, and evaluated the relationship between genotypes and clinical/laboratory manifestation of psoriasis. Materials and Methods: We analyzed genotype and allele distributions of the above-mentioned polymorphisms in 151 patients with psoriasis and 152 healthy controls by real-time PCR combined with melting curve analysis. Results: We did not find significant differences in the genotype and allele distributions of EDN1 T-1370G, EDNRA G-231A, and EDNRA G+70C polymorphisms between patients with psoriasis and healthy controls. Psoriasis area and severity index (PASI score of EDNRA -231 polymorphic A allele carrying subjects (AA and AA + AG was higher than that of wild homozygotes (P = 0.044 and P = 0.027, respectively. In addition, EDN1 levels in EDNRA+70 polymorphic C allele carriers (CC + CG were elevated when compared with GG genotype; however, the difference was at borderline significance (P = 0.05. Conclusion: Although there were no associations between studied polymorphisms and psoriasis susceptibility, the PASI score and EDN1 levels seem to be affected by EDNRA G-231A and G + 70C polymorphisms.

  4. Correlation of the Dysphonia Severity Index (DSI), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and Gender in Brazilians With and Without Voice Disorders.

    Science.gov (United States)

    Nemr, Katia; Simões-Zenari, Marcia; de Souza, Glaucia S; Hachiya, Adriana; Tsuji, Domingos H

    2016-11-01

    This study aims to analyze the Dysphonia Severity Index (DSI) in Brazilians with or without voice disorders and investigate DSI's correlation with gender and auditory-perceptual evaluation data obtained via the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol. A total of 66 Brazilian adults from both genders participated in the study, including 24 patients with dysphonia confirmed on laryngeal examination (dysphonic group [DG]) and 42 volunteers without voice or hearing complaints and without auditory-perceptual voice disorders (nondysphonic group [NDG]). The vocal tasks included in CAPE-V and DSI were performed and recorded. Data were analyzed by means of the independent t test, the Mann-Whitney U test, and Pearson correlation at the 5% significance level. Differences were found in the mean DSI values between the DG and the NDG. Differences were also found in all DSI items between the groups, except for the highest frequency parameter. In the DG, a moderate negative correlation was detected between overall dysphonia severity (CAPE-V) and DSI value, and between breathiness and DSI value, and a weak negative correlation was detected between DSI value and roughness. In the NDG, the maximum phonation time was higher among males. In both groups, the highest frequency parameter was higher among females. The DSI discriminated among Brazilians with or without voice disorders. A correlation was found between some aspects of the DSI and the CAPE-V but not between DSI and gender. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. The Impact of Clinical Information on the Assessment of Endoscopic Activity: Characteristics of the Ulcerative Colitis Endoscopic Index Of Severity [UCEIS].

    Science.gov (United States)

    Travis, Simon P L; Schnell, Dan; Feagan, Brian G; Abreu, Maria T; Altman, Douglas G; Hanauer, Stephen B; Krzeski, Piotr; Lichtenstein, Gary R; Marteau, Philippe R; Mary, Jean-Yves; Reinisch, Walter; Sands, Bruce E; Schnell, Patrick; Yacyshyn, Bruce R; Colombel, Jean-Frédéric; Bernhardt, Christian A; Sandborn, William J

    2015-08-01

    To determine whether clinical information influences endoscopic scoring by central readers using the Ulcerative Colitis Endoscopic Index of Severity [UCEIS; comprising 'vascular pattern', 'bleeding', 'erosions and ulcers']. Forty central readers performed 28 evaluations, including 2 repeats, from a library of 44 video sigmoidoscopies stratified by Mayo Clinic Score. Following training, readers were randomised to scoring with ['unblinded', n = 20, including 4 control videos with misleading information] or without ['blinded', n 20] clinical information. A total of 21 virtual Central Reader Groups [CRGs], of three blinded readers, were created. Agreement criteria were pre-specified. Kappa [κ] statistics quantified intra- and inter-reader variability. Mean UCEIS scores did not differ between blinded and unblinded readers for any of the 40 main videos. UCEIS standard deviations [SD] were similar [median blinded 0.94, unblinded 0.93; p = 0.97]. Correlation between UCEIS and visual analogue scale [VAS] assessment of overall severity was high [r blinded = 0.90, unblinded = 0.93; p = 0.02]. Scores for control videos were similar [UCEIS: p ≥ 0.55; VAS: p ≥ 0.07]. Intra- [κ 0.47-0.74] and inter-reader [κ 0.40-0.53] variability for items and full UCEIS was 'moderate'-to-'substantial', with no significant differences except for intra-reader variability for erosions and ulcers [κ blinded: 0.47 vs unblinded: 0.74; p 0.047]. The SD of CRGs was lower than for individual central readers [0.54 vs 0.95; p < 0.001]. Correlation between blinded UCEIS and patient-reported symptoms was high [stool frequency: 0.76; rectal bleeding: 0.82; both: 0.81]. The UCEIS is minimally affected by knowledge of clinical details, strongly correlates with patient-reported symptoms, and is a suitable instrument for trials. CRGs performed better than individuals. © European Crohn’s and Colitis Organisation 2015.

  6. Patients with tattoo reactions have reduced quality of life and suffer from itch: Dermatology Life Quality Index and Itch Severity Score measurements.

    Science.gov (United States)

    Hutton Carlsen, K; Serup, J

    2015-02-01

    Tattoos are a trend with increasing side-effects. The burden of local reaction with swelling, itching and discomfort may impel sufferers to consult medical assistance. To assess tattoo reactions and their influence on quality of life and itching by utilizing the Dermatology Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients attending their routine consultations completed the ISS and DLQI questionnaires. Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated with itch. Tattoo reactions warrant diagnosis and treatment with same professional intent shared with other skin diseases. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Correlation among the dysphonia severity index (DSI), the RBH voice perceptual evaluation, and minimum glottal area in female patients with vocal fold nodules.

    Science.gov (United States)

    Hussein Gaber, Ammar Gaber; Liang, Fa-Ya; Yang, Jin-Shan; Wang, Ya-Jing; Zheng, Yi-Qing

    2014-01-01

    To investigate the clinical significance and correlation of the dysphonia severity index (DSI), the RBH (roughness [R]; breathiness [B]; hoarseness [H]) perceptual voice quality evaluation, and minimum glottal area (MGA) in patients with vocal fold nodules and validate the practicality of the DSI further. The DSI evaluation, the voice RBH perceptual evaluation, and the MGA were performed on 30 female patients with vocal fold nodules (the patient group) and 30 female volunteers with normal voices (the control group). The DSI determination was calculated using the following formula: DSI = 0.13 × MPT + 0.0053 × F(0)-High - 0.26 × I-Low - 1.18 × Jitter(%) + 12.4. The RBH evaluation was graded according to four scales. The MGA was measured by KayPENTAX Kips (7105) software. The differences among the DSI, the RBH grade, and MGA of the patients were compared. The median DSI values of the patient group and the control group were -0.81 and 3.79, respectively, and the difference was statistically significant (P dysphonia in female patients with vocal nodules has significant clinical application and good correlation with MGA measurement. Copyright © 2014 The Voice Foundation. All rights reserved.

  8. Whole lesion histogram analysis of meningiomas derived from ADC values. Correlation with several cellularity parameters, proliferation index KI 67, nucleic content, and membrane permeability.

    Science.gov (United States)

    Surov, Alexey; Hamerla, Gordian; Meyer, Hans Jonas; Winter, Karsten; Schob, Stefan; Fiedler, Eckhard

    2018-09-01

    To analyze several histopathological features and their possible correlations with whole lesion histogram analysis derived from ADC maps in meningioma. The retrospective study involved 36 patients with primary meningiomas. For every tumor, the following histogram analysis parameters of apparent diffusion coefficient (ADC) were calculated: ADC mean , ADC max , ADC min , ADC median , ADC mode , ADC percentiles: P10, P25, P75, P90, as well kurtosis, skewness, and entropy. All measures were performed by two radiologists. Proliferation index KI 67, minimal, maximal and mean cell count, total nucleic area, and expression of water channel aquaporin 4 (AQP4) were estimated. Spearman's correlation coefficient was used to analyze associations between investigated parameters. A perfect interobserver agreement for all ADC values (0.84-0.97) was identified. All ADC values correlated inversely with tumor cellularity with the strongest correlation between P10, P25 and mean cell count (-0.558). KI 67 correlated inversely with all ADC values except ADC min . ADC parameters did not correlate with total nucleic area. All ADC values correlated statistically significant with expression of AQP4. ADC histogram analysis is a valid method with an excellent interobserver agreement. Cellularity parameters and proliferation potential are associated with different ADC values. Membrane permeability may play a greater role for water diffusion than cell count and proliferation activity. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Are neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as effective as Fournier's gangrene severity index for predicting the number of debridements in Fourner's gangrene?

    Science.gov (United States)

    Kahramanca, Sahin; Kaya, Oskay; Özgehan, Gülay; Irem, Burak; Dural, Ibrahim; Küçükpınar, Tevfik; Kargıcı, Hülagü

    2014-03-01

    Fournier's gangrene (FG) is a rapidly progressive and necrotizing infection of the subcutaneous and fascial tissues with a high mortality rate. In the present study, we aimed to investigate prognostic factors and analyze the outcomes of 68 patients in a tertiary reference hospital. Patients admitted to the emergency department were investigated retrospectively between January 2006 and January 2013 and divided into two groups. The patients in Group I (G1) required one debridement, and Group II (G2) patients required more than one. Patient demographic and clinical characteristics were encoded. Fournier's Gangrene Severity Index (FGSI) scores, neutrophil-lymphocyte ratios (NLR), and platelet-lymphocyte ratios (PLR) were calculated. Prognostic factors were compared between the groups. There were no statistically significant differences between the groups in terms of mean age, female-male ratio, or duration of symptoms on admission; however, there were more infection sources, predisposal factors, and positive culture results in G2. Additionally, hospital stay, total cost, and mortality rate values were high in G2. We found statistically higher NLR and PLR ratios in G2, but there was no significant difference in FGSI scores between the groups. The FGSI scoring system was not found to be valuable in determining prognosis. However, NLR and PLR were valuable, and previous use of NLR and PLR for determining Fournier's gangrene prognosis could not be found in the English literature.

  10. Global drought and severe drought-affected populations in 1.5 and 2 °C warmer worlds

    OpenAIRE

    W. Liu; F. Sun; F. Sun; F. Sun; F. Sun; W. H. Lim; W. H. Lim; J. Zhang; H. Wang; H. Shiogama; Y. Zhang

    2018-01-01

    The 2015 Paris Agreement proposed a more ambitious climate change mitigation target on limiting global warming to 1.5 °C instead of 2 °C above preindustrial levels. Scientific investigations on environmental risks associated with these warming targets are necessary to inform climate policymaking. Based on the Coupled Model Intercomparison Project phase 5 (CMIP5) climate models, we present the first risk-based assessment of changes in global drought and the impact of severe drou...

  11. Green Plants in the Red: A Baseline Global Assessment for the IUCN Sampled Red List Index for Plants.

    Directory of Open Access Journals (Sweden)

    Neil A Brummitt

    Full Text Available Plants provide fundamental support systems for life on Earth and are the basis for all terrestrial ecosystems; a decline in plant diversity will be detrimental to all other groups of organisms including humans. Decline in plant diversity has been hard to quantify, due to the huge numbers of known and yet to be discovered species and the lack of an adequate baseline assessment of extinction risk against which to track changes. The biodiversity of many remote parts of the world remains poorly known, and the rate of new assessments of extinction risk for individual plant species approximates the rate at which new plant species are described. Thus the question 'How threatened are plants?' is still very difficult to answer accurately. While completing assessments for each species of plant remains a distant prospect, by assessing a randomly selected sample of species the Sampled Red List Index for Plants gives, for the first time, an accurate view of how threatened plants are across the world. It represents the first key phase of ongoing efforts to monitor the status of the world's plants. More than 20% of plant species assessed are threatened with extinction, and the habitat with the most threatened species is overwhelmingly tropical rain forest, where the greatest threat to plants is anthropogenic habitat conversion, for arable and livestock agriculture, and harvesting of natural resources. Gymnosperms (e.g. conifers and cycads are the most threatened group, while a third of plant species included in this study have yet to receive an assessment or are so poorly known that we cannot yet ascertain whether they are threatened or not. This study provides a baseline assessment from which trends in the status of plant biodiversity can be measured and periodically reassessed.

  12. The potential of the Global Person Generated Index for evaluating the perceived impacts of conservation interventions on subjective well-being

    DEFF Research Database (Denmark)

    Rasolofoson, Ranaivo Andriarilala; Nielsen, Martin Reinhardt; Jones, Julia P.G.

    2018-01-01

    a subjective measure), and impacts (requiring a participatory approach), but very few, if any, conservation evaluations live up to these standards. We used a participatory impact evaluation approach with the Global Person Generated Index (GPGI) to investigate the relative impacts of strict protection......There is growing interest in the importance of ensuring that biodiversity conservation is not achieved at the expense of local people’s well-being. It has been suggested that when evaluating the impact of an intervention, the affected population should be allowed to define well-being (requiring......, and the relative importance of the five identified domains. Participatory impact evaluation establishes local perceptions of the cause-effect relationship between an intervention and respondents’ performance in each domain. Over half the respondents perceived no positive or negative impacts from the conservation...

  13. Comparison of several methods to calculate sunshine hours from global radiation; Vergelijking van diverse methodes voor de berekening van zonneschijnduur uit globale straling

    Energy Technology Data Exchange (ETDEWEB)

    Schipper, J.

    2004-07-01

    A formal definition of sunshine duration by the World Meteorological Organisation (WMO) has allowed the development of automatic instruments for measuring sunshine hours. This defines sunshine hours as the sum of the time intervals (in hours) during which the direct (normal) solar irradiance exceeds a threshold of 120W{sup m-2} . The most complex (and most accurate) of these instruments are tracking pyrheliometers, where a collimated sensor automatically moves to track the movement of the sun. This reads the direct beam radiation only. Any reading over 120Wm{sup -2} is defined as being sunshine. However, as this type of sensor does not truly track the sun it requires regular adjustment to take into account the seasonal changes in solar declination. Also, this sensor is relatively expensive and has moving parts requiring extra power. A much simpler approach is to try to estimate sunshine hours from the single pyranometer/solarimeter of the type normally installed on most weather stations. As these sensors measure total global radiation the normal definition of 'sunshine' cannot be used. Simple fixed thresholds, as often used in low grade weather stations, do not give reliable answers either, as diffuse radiation from a completely cloudy sky in the summer will often exceed direct beam radiation in the winter. An alternative algorithm has been suggested by workers at the Royal Dutch Meteorological Institute (KNMI). They have proposed and tested an algorithm (Slob-algorithm) which defines sunshine as being when the measured global radiation (G) is greater than 0.4 times the potential solar radiation outside the earth's atmosphere on a horizontal surface (G{sub 0}). One long term test of this algorithm showed that estimates of sunshine hours were on average within 0.9 hours of the daily total. While this might appear to give rather poor accuracy compared to that one would expect for totalised solar radiation, they consider it accurate enough for normal

  14. Prehospital shock index and pulse pressure/heart rate ratio to predict massive transfusion after severe trauma: Retrospective analysis of a large regional trauma database.

    Science.gov (United States)

    Pottecher, Julien; Ageron, François-Xavier; Fauché, Clémence; Chemla, Denis; Noll, Eric; Duranteau, Jacques; Chapiteau, Laurent; Payen, Jean-François; Bouzat, Pierre

    2016-10-01

    Early and accurate detection of severe hemorrhage is critical for a timely trigger of massive transfusion (MT). Hemodynamic indices combining heart rate (HR) and either systolic (shock index [SI]) or pulse pressure (PP) (PP/HR ratio) have been shown to track blood loss during hemorrhage. The present study assessed the accuracy of prehospital SI and PP/HR ratio to predict subsequent MT, using the gray-zone approach. This was a retrospective analysis (January 1, 2009, to December 31, 2011) of a prospectively developed trauma registry (TRENAU), in which the triage scheme combines patient severity and hospital facilities. Thresholds for MT were defined as either classic (≥10 red blood cell units within the first 24 hours [MT1]) or critical (≥3 red blood cells within the first hour [MT2]). The receiver operating characteristic curves and gray zones were defined for SI and PP/HR ratio to predict MT1 and MT2 and faced with initial triage scheme. The TRENAU registry included 3,689 trauma patients, of which 2,557 had complete chart recovery and 176 (6.9%) required MT. In the whole population, PP/HR ratio and SI moderately and similarly predicted MT1 (area under the receiver operating characteristic curve, 0.77 [95% confidence interval {CI}, 0.70-0.84] and 0.80 [95% CI, 0.74-0.87], respectively, p = 0.064) and MT2 (0.71 [95% CI, 0.67-0.76] and 0.72 [95% CI, 0.68-0.77], respectively, p = 0.48). The proportions of patients in the gray zone for PP/HR ratio and SI were 61% versus 40%, respectively, to predict MT1 (p ratio outperformed SI to predict MT2 (0.72 [95% CI, 0.59-0.84] vs. 0.54 [95% CI, 0.33-0.74]; p ratio were moderately accurate in predicting MT. In the seemingly least severe patients, an improvement of prehospital undertriage for MT may be gained by using the PP/HR ratio. Epidemiolgic study, level III.

  15. A Smart Thermo-hygrometric Global Index for the Evaluation of Particularly Critical Urban Areas Quality: the City of Messina Chosen as a Case Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Cannistraro

    2014-03-01

    Full Text Available The development of the city, as it has grown up to the present day, is no longer sustainable. The design of the city turns toward smart urban development which achieves the theoretical ideal of an environmental sustainability deeply linked to the well-being of the inhabitants. In this perspective, the idea of comfort is related to the achievement of thermohygrometric conditions satisfaction (both indoor and outdoor. The present work proposes an innovative tool evaluating the external environment quality applied to a case study: the Messina’s urban center. The well-being has been investigated from the point of view of temperature and relative humidity, taking not into account other aspects characterizing quality of the urban environment such as traffic, degree of urbanization, air pollution, etc.. For this reason the overall hygrothermal index formulation results of particular interest: this one can be also used to make comparable various results obtained at international level. One of the key properties of the global index is the comparability of the results, when applied to different realities. Such an important property can be exploited to compare the climatic characteristics of different cities and for different areas of the same city. In fact, with the help of multiple monitoring stations within the urban area, you would be able to detect the so-called heat islands. In this way it is possible constructing a map of the hygrometric comfort suitable to achieve better urban planning (for example improving thermal comfort through the construction of green areas.

  16. Suicide rate in relation to the Human Development Index and other health related factors: A global ecological study from 91 countries.

    Science.gov (United States)

    Khazaei, Salman; Armanmehr, Vajihe; Nematollahi, Shahrzad; Rezaeian, Shahab; Khazaei, Somayeh

    2017-06-01

    There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index (HDI) and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 (95% confidence intervals: 8.8, 12.2) per 100,000 individuals, which significantly varied according to gender (16.3 in males vs. 4.6 in females, pgender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  17. Suicide rate in relation to the Human Development Index and other health related factors: A global ecological study from 91 countries

    Directory of Open Access Journals (Sweden)

    Salman Khazaei

    2017-06-01

    Full Text Available There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index (HDI and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 (95% confidence intervals: 8.8, 12.2 per 100,000 individuals, which significantly varied according to gender (16.3 in males vs. 4.6 in females, p < 0.001 and different levels of human development (11.64/100,000 individuals in very high development countries, 7.93/100,000 individuals in medium development countries, and 13.94/100,000 individuals in high development countries, p = 0.004. In conclusion, the suicide rate varies greatly between countries with different development levels. Our findings also suggest that male gender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world.

  18. Machine-Learning-Based Electronic Triage More Accurately Differentiates Patients With Respect to Clinical Outcomes Compared With the Emergency Severity Index.

    Science.gov (United States)

    Levin, Scott; Toerper, Matthew; Hamrock, Eric; Hinson, Jeremiah S; Barnes, Sean; Gardner, Heather; Dugas, Andrea; Linton, Bob; Kirsch, Tom; Kelen, Gabor

    2018-05-01

    Standards for emergency department (ED) triage in the United States rely heavily on subjective assessment and are limited in their ability to risk-stratify patients. This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. A multisite, retrospective, cross-sectional study of 172,726 ED visits from urban and community EDs was conducted. E-triage is composed of a random forest model applied to triage data (vital signs, chief complaint, and active medical history) that predicts the need for critical care, an emergency procedure, and inpatient hospitalization in parallel and translates risk to triage level designations. Predicted outcomes and secondary outcomes of elevated troponin and lactate levels were evaluated and compared with the Emergency Severity Index (ESI). E-triage predictions had an area under the curve ranging from 0.73 to 0.92 and demonstrated equivalent or improved identification of clinical patient outcomes compared with ESI at both EDs. E-triage provided rationale for risk-based differentiation of the more than 65% of ED visits triaged to ESI level 3. Matching the ESI patient distribution for comparisons, e-triage identified more than 10% (14,326 patients) of ESI level 3 patients requiring up triage who had substantially increased risk of critical care or emergency procedure (1.7% ESI level 3 versus 6.2% up triaged) and hospitalization (18.9% versus 45.4%) across EDs. E-triage more accurately classifies ESI level 3 patients and highlights opportunities to use predictive analytics to support triage decisionmaking. Further prospective validation is needed. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  19. The role of severity of obstructive sleep apnea measured by apnea-hypopnea index in predicting compliance with pressure therapy, a meta-analysis.

    Science.gov (United States)

    Madbouly, Essam M; Nadeem, Rashid; Nida, Mahwish; Molnar, Janos; Aggarwal, Saurabh; Loomba, Rohit

    2014-01-01

    Obstructive sleep apnea (OSA) is associated with diabetes, hypertension, stroke, coronary artery disease, and premature death. Positive airway pressure (PAP) is the mainstay of therapy. Despite its effective treatment with PAP therapy, noncompliance remains high. Many factors determine compliance. The role of severity of OSA measured by the apnea-hypopnea index (AHI) remains controversial. Meta-analysis of studies examining this role of AHI was performed. A systematic review of the medical literature was conducted using PubMed and Cochrane library by utilizing different combinations of key words: sleep apnea, AHI, compliance, and nonadherence. Inclusion criteria were English articles; Studies with adult population; with 2 groups of patients (compliant and noncompliant); Studies utilizing objective definition of compliance (PAP usage of >4 hours per night for 70% of days or usage >5 d/wk and for >4 hours per night). Studies were analyzed by standard methods of meta-analysis. The studies were heterogeneous for AHI; therefore, the random effect model was used. Six hundred forty-one manuscripts were found. Of these, 230 were found to be appropriate for full text evaluation. Thirty-one met inclusion criteria. Twelve of these studies used objective criteria for PAP compliance and were hence included in meta-analysis. All the subjects had OSA determined by polysomnography, for whom PAP was employed. Compliance to PAP therapy was evaluated after a period of time ranging from 4 weeks to 8 years. There were 1438 subjects included in the meta-analysis; 886 subjects were PAP compliant, whereas 552 subjects were noncompliant. A greater AHI was found in PAP compliant patients. The mean difference between compliant and noncompliant groups was 5.9 (95% confidence interval: 0.19-11.67, P compliance.

  20. Predicting mortality among older adults hospitalized for community-acquired pneumonia: an enhanced confusion, urea, respiratory rate and blood pressure score compared with pneumonia severity index.

    Science.gov (United States)

    Abisheganaden, John; Ding, Yew Yoong; Chong, Wai-Fung; Heng, Bee-Hoon; Lim, Tow Keang

    2012-08-01

    Pneumonia Severity Index (PSI) predicts mortality better than Confusion, Urea >7 mmol/L, Respiratory rate >30/min, low Blood pressure: diastolic blood pressure blood pressure 65 years (CURB-65) for community-acquired pneumonia (CAP) but is more cumbersome. The objective was to determine whether CURB enhanced with a small number of additional variables can predict mortality with at least the same accuracy as PSI. Retrospective review of medical records and administrative data of adults aged 55 years or older hospitalized for CAP over 1 year from three hospitals. For 1052 hospital admissions of unique patients, 30-day mortality was 17.2%. PSI class and CURB-65 predicted 30-day mortality with area under curve (AUC) of 0.77 (95% confidence interval (CI): 0.73-0.80) and 0.70 (95% CI: 0.66-0.74) respectively. When age and three co-morbid conditions (metastatic cancer, solid tumours without metastases and stroke) were added to CURB, the AUC improved to 0.80 (95% CI: 0.77-0.83). Bootstrap validation obtained an AUC estimate of 0.78, indicating negligible overfitting of the model. Based on this model, a clinical score (enhanced CURB score) was developed that had possible values from 5 to 25. Its AUC was 0.79 (95% CI: 0.76-0.83) and remained similar to that of PSI class. An enhanced CURB score predicted 30-day mortality with at least the same accuracy as PSI class did among older adults hospitalized for CAP. External validation of this score in other populations is the next step to determine whether it can be used more widely. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  1. Reliability, factor analysis and internal consistency calculation of the Insomnia Severity Index (ISI) in French and in English among Lebanese adolescents.

    Science.gov (United States)

    Chahoud, M; Chahine, R; Salameh, P; Sauleau, E A

    2017-06-01

    Our goal is to validate and to verify the reliability of the French and English versions of the Insomnia Severity Index (ISI) in Lebanese adolescents. A cross-sectional study was implemented. 104 Lebanese students aged between 14 and 19 years participated in the study. The English version of the questionnaire was distributed to English-speaking students and the French version was administered to French-speaking students. A scale (1 to 7 with 1 = very well understood and 7 = not at all) was used to identify the level of the students' understanding of each instruction, question and answer of the ISI. The scale's structural validity was assessed. The factor structure of ISI was evaluated by principal component analysis. The internal consistency of this scale was evaluated by Cronbach's alpha. To assess test-retest reliability the intraclass correlation coefficient (ICC) was used. The principal component analysis confirmed the presence of a two-component factor structure in the English version and a three-component factor structure in the French version with eigenvalues > 1. The English version of the ISI had an excellent internal consistency (α = 0.90), while the French version had a good internal consistency (α = 0.70). The ICC presented an excellent agreement in the French version (ICC = 0.914, CI = 0.856-0.949) and a good agreement in the English one (ICC = 0.762, CI = 0.481-890). The Bland-Altman plots of the two versions of the ISI showed that the responses over two weeks' were comparable and very few outliers were detected. The results of our analyses reveal that both English and French versions of the ISI scale have good internal consistency and are reproducible and reliable. Therefore, it can be used to assess the prevalence of insomnia in Lebanese adolescents.

  2. Relationships among participant international prostate symptom score, benign prostatic hyperplasia impact index changes and global ratings of change in a trial of phytotherapy in men with lower urinary tract symptoms.

    Science.gov (United States)

    Barry, Michael J; Cantor, Alan; Roehrborn, Claus G

    2013-03-01

    We related changes in American Urological Association symptom index scores with bother measures and global ratings of change in men with lower urinary tract symptoms who were enrolled in a saw palmetto trial. To be eligible for study men were 45 years old or older, and had a peak uroflow of 4 ml per second or greater and an American Urological Association symptom index score of 8 to 24. Participants self-administered the American Urological Association symptom index, International Prostate Symptom Score quality of life item, Benign Prostatic Hyperplasia Impact Index and 2 global change questions at baseline, and at 24, 48 and 72 weeks. In 357 participants global ratings of a little better were associated with a mean decrease in American Urological Association symptom index scores from 2.8 to 4.1 points across 3 time points. The analogous range for mean decreases in Benign Prostatic Hyperplasia Impact Index scores was 1.0 to 1.7 points and for the International Prostate Symptom Score quality of life item it was 0.5 to 0.8 points. At 72 weeks for the first global change question each change measure discriminated between participants who rated themselves at least a little better vs unchanged or worse 70% to 72% of the time. A multivariate model increased discrimination to 77%. For the second global change question each change measure correctly discriminated ratings of at least a little better vs unchanged or worse 69% to 74% of the time and a multivariate model increased discrimination to 79%. Changes in American Urological Association symptom index scores could discriminate between participants rating themselves at least a little better vs unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in American Urological Association symptom index scores of at least 3 points. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2018-01-01

    used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods...... and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used......·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America...

  4. Existence and global attractivity of positive periodic solutions of periodic n-species Lotka-Volterra competition systems with several deviating arguments.

    Science.gov (United States)

    Fan, M; Wang, K; Jiang, D

    1999-08-01

    In this paper, we study the existence and global attractivity of positive periodic solutions of periodic n-species Lotka-Volterra competition systems. By using the method of coincidence degree and Lyapunov functional, a set of easily verifiable sufficient conditions are derived for the existence of at least one strictly positive (componentwise) periodic solution of periodic n-species Lotka-Volterra competition systems with several deviating arguments and the existence of a unique globally asymptotically stable periodic solution with strictly positive components of periodic n-species Lotka-Volterra competition system with several delays. Some new results are obtained. As an application, we also examine some special cases of the system we considered, which have been studied extensively in the literature. Some known results are improved and generalized.

  5. Relationship between global severity of patients with Alzheimer's disease and costs of care in Spain; results from the co-dependence study in Spain.

    Science.gov (United States)

    Darbà, J; Kaskens, L; Lacey, L

    2015-11-01

    The objectives of this analysis were to examine how patients' global severity with Alzheimer's disease (AD) relates to costs of care and explore the incremental effects of global severity measured by the clinical dementia rating (CDR) scale on these costs for patients in Spain. The Codep-EA study is an 18-multicenter, cross-sectional, observational study among patients (343) with AD according to the CDR score and their caregivers in Spain. The data obtained included (in addition to clinical measures) also socio-demographic data concerning the patient and its caregiver. Cost analyses were based on resource use for medical care, social care, caregiver productivity losses, and informal caregiver time reported in the resource utilization in dementia (RUD). Lite instrument and a complementary questionnaire. Multivariate regression analysis was used to model the effects of global severity and other socio-demographic and clinical variables on cost of care. The mean (standard deviation) costs per patient over 6 months for direct medical, social care, indirect and informal care costs, were estimated at €1,028.1 (1,655.0), €843.8 (2,684.8), €464.2 (1,639.0) and €33,232.2 (30,898.9), respectively. Dementia severity, as having a CDR score 0.5, 2, or 3 with CDR score 1 being the reference group were all independently and significantly associated with informal care costs. Whereas having a CDR score of 2 was also significantly related with social care costs, a CDR score of 3 was associated with most cost components including direct medical, social care, and total costs, all compared to the reference group. The costs of care for patients with AD in Spain are substantial, with informal care accounting for the greatest part. Dementia severity, measured by CDR score, showed that with increasing severity of the disease, direct medical, social care, informal care and total costs augmented.

  6. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1987-01-01

    Best estimates of possible additional health effects were projected for the Northern Hemisphere: (1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths from natural or spontaneous causes; (2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and (3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Due to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs., 4 figs., 6 tabs

  7. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1987-01-01

    Best estimates of possible additional health effects were projected for the Northern Hemisphere: (1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths FR-om natural or spontaneous causes; (2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and (3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Due to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs., 4 figs., 6 tabs

  8. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  9. Comparing the Life Cycle Energy Consumption, Global Warming and Eutrophication Potentials of Several Water and Waste Service Options

    Directory of Open Access Journals (Sweden)

    Xiaobo Xue

    2016-04-01

    Full Text Available Managing the water-energy-nutrient nexus for the built environment requires, in part, a full system analysis of energy consumption, global warming and eutrophication potentials of municipal water services. As an example, we evaluated the life cycle energy use, greenhouse gas (GHG emissions and aqueous nutrient releases of the whole anthropogenic municipal water cycle starting from raw water extraction to wastewater treatment and reuse/discharge for five municipal water and wastewater systems. The assessed options included conventional centralized services and four alternative options following the principles of source-separation and water fit-for-purpose. The comparative life cycle assessment identified that centralized drinking water supply coupled with blackwater energy recovery and on-site greywater treatment and reuse was the most energy- and carbon-efficient water service system evaluated, while the conventional (drinking water and sewerage centralized system ranked as the most energy- and carbon-intensive system. The electricity generated from blackwater and food residuals co-digestion was estimated to offset at least 40% of life cycle energy consumption for water/waste services. The dry composting toilet option demonstrated the lowest life cycle eutrophication potential. The nutrients in wastewater effluent are the dominating contributors for the eutrophication potential for the assessed system configurations. Among the parameters for which variability and sensitivity were evaluated, the carbon intensity of the local electricity grid and the efficiency of electricity production by the co-digestion with the energy recovery process were the most important for determining the relative global warming potential results.

  10. Association between Global Assessment of Functioning scores and indicators of functioning, severity, and prognosis in first-time schizophrenia

    DEFF Research Database (Denmark)

    Köhler-Forsberg, Ole; Horsdal, Henriette Thisted; Baandrup, Lone

    2016-01-01

    are associated with other indicators of functioning, severity, and hospitalization. METHODS: A Danish population-based cohort study of adults (≥18 years) with a recorded GAF-F score at first-time schizophrenia diagnosis during 2004-2011 was performed. The internal validity of GAF-F was evaluated by assessing its...... of schizophrenia with a GAF-F score at first-time diagnosis (73.0% inpatients; 62.6% males). GAF-F was associated with several baseline measures of functioning and illness severity, such as female sex, being in work, and a longer baseline hospitalization. Lower GAF-F scores were associated with higher.......36-3.90), fitting a dose-response relationship (P=0.031). This association was not found in females. CONCLUSION: GAF-F at first-time schizophrenia diagnosis showed good internal validity against other measures of functionality in a Danish hospital setting. Severe impairment (as measured by the GAF-F score) at first...

  11. Global scale variability of the mineral dust long-wave refractive index: a new dataset of in situ measurements for climate modeling and remote sensing

    Science.gov (United States)

    Di Biagio, Claudia; Formenti, Paola; Balkanski, Yves; Caponi, Lorenzo; Cazaunau, Mathieu; Pangui, Edouard; Journet, Emilie; Nowak, Sophie; Caquineau, Sandrine; Andreae, Meinrat O.; Kandler, Konrad; Saeed, Thuraya; Piketh, Stuart; Seibert, David; Williams, Earle; Doussin, Jean-François

    2017-02-01

    Modeling the interaction of dust with long-wave (LW) radiation is still a challenge because of the scarcity of information on the complex refractive index of dust from different source regions. In particular, little is known about the variability of the refractive index as a function of the dust mineralogical composition, which depends on the specific emission source, and its size distribution, which is modified during transport. As a consequence, to date, climate models and remote sensing retrievals generally use a spatially invariant and time-constant value for the dust LW refractive index. In this paper, the variability of the mineral dust LW refractive index as a function of its mineralogical composition and size distribution is explored by in situ measurements in a large smog chamber. Mineral dust aerosols were generated from 19 natural soils from 8 regions: northern Africa, the Sahel, eastern Africa and the Middle East, eastern Asia, North and South America, southern Africa, and Australia. Soil samples were selected from a total of 137 available samples in order to represent the diversity of sources from arid and semi-arid areas worldwide and to account for the heterogeneity of the soil composition at the global scale. Aerosol samples generated from soils were re-suspended in the chamber, where their LW extinction spectra (3-15 µm), size distribution, and mineralogical composition were measured. The generated aerosol exhibits a realistic size distribution and mineralogy, including both the sub- and super-micron fractions, and represents in typical atmospheric proportions the main LW-active minerals, such as clays, quartz, and calcite. The complex refractive index of the aerosol is obtained by an optical inversion based upon the measured extinction spectrum and size distribution. Results from the present study show that the imaginary LW refractive index (k) of dust varies greatly both in magnitude and spectral shape from sample to sample, reflecting the

  12. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1988-01-01

    Estimates of projected collective dose and average individual dose commitments from Chernobyl releases were made for various regions. Consideration was given to the possible effectiveness of protective actions taken by various countries to reduce projected doses to their populations. Although some preliminary data indicate possible mean reductions of about 25% in total collective doses over the first year, and of about 55% in collective dose to the thyroid, no corrections were made to these dose estimates because of the variable nature of the data. A new combined set of dose-effect models recently published by the United States Nuclear Regulatory Commission was then applied to estimate the ranges of possible future additional health effects due to the Chernobyl accident. In this method possible health effects are estimated on an individual site basis and the results are then summed. Both absolute and relative risk projection models are used. By use of these methods, ''best'' estimates of possible additional health effects were projected for the Northern Hemisphere as follows: 1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths from natural or spontaneous causes; 2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and 3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Owing to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs, 4 figs, 6 tabs

  13. Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

    DEFF Research Database (Denmark)

    Sidaros, Annette; Skimminge, Arnold Jesper Møller; Liptrot, Matthew George

    2009-01-01

    with percent brain volume change (%BVC) ranging between − 0.6% and − 9.4% (mean − 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using......Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D...... scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy...

  14. Desenvolvimento e avaliação das propriedades psicométricas da versão brasileira do Addiction Severity Index 6 (ASI-6 Light

    Directory of Open Access Journals (Sweden)

    Lídia Reis Fernandes

    2015-06-01

    Full Text Available Objetivo Desenvolver e avaliar as propriedades psicométricas de uma versão brasileira reduzida do Addiction Severity Index 6 Light (ASI-6 Light previamente proposta com base em um estudo de validação dos construtos do instrumento e desenvolver os novos escores de cada área do instrumento baseados na Teoria de Resposta ao Item (TRI. Métodos Foram entrevistados 200 sujeitos, 100 com uso problemático de álcool e outras drogas e 100 sem uso problemático. Foram calculados os escores dos indivíduos com base na TRI. As propriedades psicométricas foram avaliadas pela correlação entre os escores do ASI-6 Light e do Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, padrão-ouro do estudo. Foram avaliados os índices de sensibilidade e especificidade. Resultados Foi encontrada alta correlação entre os escores da área “álcool” do ASI-6 Light e os escores do ASSIST em relação ao álcool (r = 0,79, correlações moderadas em relação ao tabaco (r = 0,47 e cocaína/crack (r = 0,44 e baixa (r = 0,39 em relação à maconha. Ao correlacionarem-se os escores do ASSIST e os escores da área “drogas” do ASI-6 Light, obteve-se alta correlação em relação à cocaína/crack (r = 0,85, correlações moderadas em relação ao tabaco (r = 0,57 e maconha (r = 0,68 e baixa (r = 0,29 em relação ao álcool. A área sob a curva ROC da área “álcool” foi de 0,93 e a da área “drogas” foi de 0,88. Conclusão Boas evidências de validade das áreas “álcool” e “drogas” foram apresentadas. Essa nova versão tornou-se um instrumento de fácil manejo e de rápida aplicação, contendo os itens que melhor avaliam a gravidade de problemas.

  15. Radiative efficiencies and global warming potentials using theoretically determined absorption cross-sections for several hydrofluoroethers (HFEs) and hydrofluoropolyethers (HFPEs)

    International Nuclear Information System (INIS)

    Bravo, Ivan; Marston, George; Nutt, David R.; Shine, Keith P.

    2011-01-01

    Integrated infrared cross-sections and wavenumber positions for the vibrational modes of a range of hydrofluoroethers (HFEs) and hydrofluoropolyethers (HFPEs) have been calculated. Spectra were determined using a density functional method with an empirically derived correction for the wavenumbers of band positions. Radiative efficiencies (REs) were determined using the Pinnock et al. method and were used with atmospheric lifetimes from the literature to determine global warming potentials (GWPs). For the HFEs and the majority of the molecules in the HG series HFPEs, theoretically determined absorption cross-sections and REs lie within ca. 10% of those determined using measured spectra. For the larger molecules in the HG series and the HG' series of HFPEs, agreement is less good, with theoretical values for the integrated cross-sections being up to 35% higher than the experimental values; REs are up to 45% higher. Our method gives better results than previous theoretical approaches, because of the level of theory chosen and, for REs, because an empirical wavenumber correction derived for perfluorocarbons is effective in predicting the positions of C-F stretching frequencies at around 1250 cm -1 for the molecules considered here.

  16. Regional and global science: Publications from Latin America and the Caribbean in the SciELO Citation Index and the Web of Science

    NARCIS (Netherlands)

    Vélez-Cuartas, G.; Lucio-Arias, D.; Leydesdorff, L.

    2016-01-01

    In this article the authors compare the visibility of Latin American and Caribbean (LAC) publications in the Core Collection indexes of the Web of Science (WoS) inlcuding Science Citation Index Expanded, Social Sciences Citation Index, and Arts & Humanities Citation Index, and the SciELO Citation

  17. A global amnesia associated with the specific variant of posterior reversible encephalopathy syndrome (PRES) that developed due to severe preeclampsia and malignant hypertension.

    Science.gov (United States)

    Borovac, Josip Anđelo; Božić, Joško; Žaja, Nikola; Kolić, Krešimir; Hrboka, Vedran

    2016-04-01

    A case is reported of a 26-year-old primiparous woman in the 32nd week of gestation who presented to the emergency department with the symptoms of a severe headache, nausea and vomiting. The patient was diagnosed with preeclampsia that later progressed to eclampsia. This state was characterized by a sudden onset of a headache and diplopia that advanced to cortical blindness and precipitated significant alterations in mental status, most notable being global amnesia that resolved within 48 h. A post-partum magnetic resonance imaging of the brain in FLAIR mode revealed multiple cortico-subcortical areas of hyperintense signals suggestive of edematous lesions that chiefly involved occipital and parietal lobes with additional atypical manifestations. Such radiologic findings suggested a posterior reversible encephalopathy syndrome variant with the global amnesia as an extraordinary constituent. This unique feature should be acknowledged when treating a preeclamptic or hypertensive patient that exhibits neurological symptomatology and vision disturbances.

  18. Globalization of consumer confidence

    Directory of Open Access Journals (Sweden)

    Çelik Sadullah

    2017-01-01

    Full Text Available The globalization of world economies and the importance of nowcasting analysis have been at the core of the recent literature. Nevertheless, these two strands of research are hardly coupled. This study aims to fill this gap through examining the globalization of the consumer confidence index (CCI by applying conventional and unconventional econometric methods. The US CCI is used as the benchmark in tests of comovement among the CCIs of several developing and developed countries, with the data sets divided into three sub-periods: global liquidity abundance, the Great Recession, and postcrisis. The existence and/or degree of globalization of the CCIs vary according to the period, whereas globalization in the form of coherence and similar paths is observed only during the Great Recession and, surprisingly, stronger in developing/emerging countries.

  19. Measuring the Total-Factor Carbon Emission Performance of Industrial Land Use in China Based on the Global Directional Distance Function and Non-Radial Luenberger Productivity Index

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2016-04-01

    Full Text Available Industry is a major contributor to carbon emissions in China, and industrial land is an important input to industrial production. Therefore, a detailed analysis of the carbon emission performance of industrial land use is necessary for making reasonable carbon reduction policies that promote the sustainable use of industrial land. This paper aims to analyze the dynamic changes in the total-factor carbon emission performance of industrial land use (TCPIL in China by applying a global directional distance function (DDF and non-radial Luenberger productivity index. The empirical results show that the eastern region enjoys better TCPIL than the central and western regions, but the regional gaps in TCPIL are narrowing. The growth in NLCPILs (non-radial Luenberger carbon emission performance of industrial land use in the eastern and central regions is mainly driven by technological progress, whereas efficiency improvements contribute more to the growth of NLCPIL in the western region. The provinces in the eastern region have the most innovative and environmentally-friendly production technologies. The results of the analysis of the influencing factors show implications for improving the NLCPIL, including more investment in industrial research and development (R&D, the implementation of carbon emission reduction policies, reduction in the use of fossil energy, especially coal, in the process of industrial production, actively learning about foreign advanced technology, properly solving the problem of surplus labor in industry and the expansion of industrial development.

  20. A new index for differential diagnosis between mild hepatic lesions associated with chronic alcoholism (steatosis, steatofibrosis) and severe alcoholic liver disease (cirrhosis) by a combination of an aminopyrine breath test and a colloid hepatosplenic scintigraphy

    International Nuclear Information System (INIS)

    Urbain, D.; Jeghers, O.; Lenaers, A.; Wanet, P.; Abramovici, J.; Preux, C.

    1984-01-01

    The severity of liver disease is related not only to the degree of hepatocellular lesions but also to the hemodynamic changes created by extensive fibrosis. Theoretically, the combination of two tests providing information on these two aspects should allow a better identification of patients with severe alcoholic liver disease. In the present work our new functional index clearly improves the ability in differentiating mild alcoholic hepatic lesions from alcoholic cirrhosis. (orig.)

  1. Global tilt and lumbar lordosis index: two parameters correlating with health-related quality of life scores-but how do they truly impact disability?

    Science.gov (United States)

    Boissière, Louis; Takemoto, Mitsuru; Bourghli, Anouar; Vital, Jean-Marc; Pellisé, Ferran; Alanay, Ahmet; Yilgor, Caglar; Acaroglu, Emre; Perez-Grueso, Francisco Javier; Kleinstück, Frank; Obeid, Ibrahim

    2017-04-01

    Many radiological parameters have been reported to correlate with patient's disability including sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL). European literature reports other parameters such as lumbar lordosis index (LLI) and the global tilt (GT). If most parameters correlate with health-related quality of life scores (HRQLs), their impact on disability remains unclear. This study aimed to validate these parameters by investigating their correlation with HRQLs. It also aimed to evaluate the relationship between each of these sagittal parameters and HRQLs to fully understand the impact in adult spinal deformity management. A retrospective review of a multicenter, prospective database was carried out. The database inclusion criteria were adults (>18 years old) presenting any of the following radiographic parameters: scoliosis (Cobb ≥20°), SVA ≥5 cm, thoracic kyphosis ≥60° or PT ≥25°. All patients with complete data at baseline were included. Health-related quality of life scores, demographic variables (DVs), and radiographic parameters were collected at baseline. Differences in HRQLs among groups of each DV were assessed with analyses of variance. Correlations between radiographic variables and HRQLs were assessed using the Spearman rank correlation. Multivariate linear regression models were fitted for each of the HRQLs (Oswestry Disability Index [ODI], Scoliosis Research Society-22 subtotal score, or physical component summaries) with sagittal parameters and covariants as independent variables. A p<.05 value was considered statistically significant. Among a total of 755 included patients (mean age, 52.1 years), 431 were non-surgical candidates and 324 were surgical candidates. Global tilt and LLI significantly correlated with HRQLs (r=0.4 and -0.3, respectively) for univariate analysis. Demographic variables such as age, gender, body mass index, past surgery, and surgical or non-surgical candidate

  2. Assessment of lettuce quality during storage at low relative humidity using Global Stability Index methodology Avaliação da qualidade da alface durante o armazenamento em baixa umidade relativa usando o Índice Global da Estabilidade

    Directory of Open Access Journals (Sweden)

    María Roberta Ansorena

    2012-06-01

    Full Text Available During postharvest, lettuce is usually exposed to adverse conditions (e.g. low relative humidity that reduce the vegetable quality. In order to evaluate its shelf life, a great number of quality attributes must be analyzed, which requires careful experimental design, and it is time consuming. In this study, the modified Global Stability Index method was applied to estimate the quality of butter lettuce at low relative humidity during storage discriminating three lettuce zones (internal, middle, and external. The results indicated that the most relevant attributes were: the external zone - relative water content, water content , ascorbic acid, and total mesophilic counts; middle zone - relative water content, water content, total chlorophyll, and ascorbic acid; internal zone - relative water content, bound water, water content, and total mesophilic counts. A mathematical model that takes into account the Global Stability Index and overall visual quality for each lettuce zone was proposed. Moreover, the Weibull distribution was applied to estimate the maximum vegetable storage time which was 5, 4, and 3 days for the internal, middle, and external zone, respectively. When analyzing the effect of storage time for each lettuce zone, all the indices evaluated in the external zone of lettuce presented significant differences (p Durante a pós-colheita a alface é exposta a condições adversas (baixa umidade relativa que reduzem a qualidade do vegetal. A fim de avaliar sua vida útil, um grande número de índices de qualidade tem que ser analisado, requerendo um cuidadoso delineamento experimental e um longo consumo de tempo. Neste trabalho, o método modificado do Índice Global da Estabilidade foi aplicado para estimar a qualidade da alface manteiga a uma baixa umidade relativa durante o armazenamento diferenciando três zonas (interna, média e externa. Os resultados indicaram que, para a zona externa, os índices mais relevantes foram o conte

  3. 'Translation is not enough': using the Global Person Generated Index (GPGI) to assess individual quality of life in Bangladesh, Thailand, and Ethiopia.

    Science.gov (United States)

    Camfield, Laura; Ruta, Danny

    2007-08-01

    Currently few subjective measures of Quality of Life (QoL) are available for use in developing countries, which limits their theoretical, methodological, and practical contribution (for example, exploring the relationship between economic development and QoL, and ensuring effective and equitable service provision). One reason for this is the difficulty of ensuring that translated measures preserve conceptual, item, semantic, operational, measurement; and functional equivalence (Herdman, M., Fox-Rushby, J., & Badia, X. (1998). Quality of Life Research, 7, 331), which is illustrated by an account of the translation, pre-piloting, and administration of a new individualised QoL measure, the Global Person Generated Index or 'GPGI'. The GPGI is based on the widely used Patient Generated Index (Ruta, Camfield, & Martin, (2004) Quality of Life Research, 13, 1545.) and offers many of the advantages of the participatory approaches commonly used in developing countries, with added methodological rigour, and quantitative outcomes. It was successfully validated in Bangladesh, Thailand, and Ethiopia, using quantitative and qualitative methods--open-ended, semi-structured interviews (SSIs), conducted immediately post-administration. Both the measure and method of 'qualitative validation' described later in the paper offer an exciting alternative for future researchers and practitioners in this field. The quantitative results suggest the GPGI shows cultural sensitivity, and is able to capture both the areas that are important to respondents, and aspects of life one would expect to impact on QoL in developing countries. There were strong correlation between scores from the GPGI and SSIs for the area of health, and moderate correlations for 'material wellbeing' (MWB)('Material wellbeing' refers to respondents' perceptions of their achievement in the areas of farming, debt reduction, assets, crops, livestock, job, land, property, and agriculture) and children. Weak to moderate

  4. Subcortical vascular cognitive impairment, no dementia : EEG global power independently predicts vascular impairment and brain symmetry index reflects severity of cognitive decline

    NARCIS (Netherlands)

    Sheorajpanday, Rishi V.A.; Mariën, Peter; Nagels, Guy; Weeren, Arie J.T.M.; Saerens, Jos; Van Putten, Michel J.A.M.; de Deyn, Peter P.

    2014-01-01

    Background and Purpose: Vascular cognitive impairment, no dementia (vCIND) is a prevalent and potentially preventable disorder. Clinical presentation of the small-vessel subcortical subtype may be insidious, and differential difficulties can arise with mild cognitive impairment. We investigated EEG

  5. Subcortical Vascular Cognitive Impairment, No Dementia : EEG Global Power Independently Predicts Vascular Impairment and Brain Symmetry Index Reflects Severity of Cognitive Decline

    NARCIS (Netherlands)

    Sheorajpanday, Rishi V. A.; Marien, Peter; Nagels, Guy; Weeren, Arie J. T. M.; Saerens, Jos; van Putten, Michel J. A. M.; De Deyn, Peter P.

    2014-01-01

    Background and Purpose:Vascular cognitive impairment, no dementia (vCIND) is a prevalent and potentially preventable disorder. Clinical presentation of the small-vessel subcortical subtype may be insidious, and differential difficulties can arise with mild cognitive impairment. We investigated EEG

  6. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  7. Quantifying Dysphonia Severity Using a Spectralcepstral-Based Acoustic Index: Comparisons with Auditory-Perceptual Judgements from the CAPE-V

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson; JettE, Marie E.; Meltzner, Geoffrey S.; Hillman, Robert E.

    2010-01-01

    This study investigated the relationship between acoustic spectral/cepstral measures and listener severity ratings in normal and disordered voice samples. CAPE-V sentence samples and the vowel /[script]/were elicited from eight normal speakers and 24 patients with varying degrees of dysphonia severity. Samples were analysed for measures of the…

  8. Estimates of phytomass and net primary productivity in terrestrial ecosystems of the former Soviet Union identified by classified Global Vegetation Index

    Energy Technology Data Exchange (ETDEWEB)

    Gaston, G.G.; Kolchugina, T.P. [Oregon State Univ., Corvallis, OR (United States)

    1995-12-01

    Forty-two regions with similar vegetation and landcover were identified in the former Soviet Union (FSU) by classifying Global Vegetation Index (GVI) images. Image classes were described in terms of vegetation and landcover. Image classes appear to provide more accurate and precise descriptions for most ecosystems when compared to general thematic maps. The area of forest lands were estimated at 1,330 Mha and the actual area of forest ecosystems at 875 Mha. Arable lands were estimated to be 211 Mha. The area of the tundra biome was estimated at 261 Mha. The areas of the forest-tundra/dwarf forest, taiga, mixed-deciduous forest and forest-steppe biomes were estimated t 153, 882, 196, and 144 Mha, respectively. The areas of desert-semidesert biome and arable land with irrigated land and meadows, were estimated at 126 and 237 Mha, respectively. Vegetation and landcover types were associated with the Bazilevich database of phytomass and NPP for vegetation in the FSU. The phytomass in the FSU was estimated at 97.1 Gt C, with 86.8 in forest vegetation, 9.7 in natural non-forest and 0.6 Gt C in arable lands. The NPP was estimated at 8.6 Gt C/yr, with 3.2, 4.8, and 0.6 Gt C/yr of forest, natural non-forest, and arable ecosystems, respectively. The phytomass estimates for forests were greater than previous assessments which considered the age-class distribution of forest stands in the FSU. The NPP of natural ecosystems estimated in this study was 23% greater than previous estimates which used thematic maps to identify ecosystems. 47 refs., 4 figs., 2 tabs.

  9. Comparison between frailty index of deficit accumulation and phenotypic model to predict risk of falls: data from the global longitudinal study of osteoporosis in women (GLOW Hamilton cohort.

    Directory of Open Access Journals (Sweden)

    Guowei Li

    Full Text Available To compare the predictive accuracy of the frailty index (FI of deficit accumulation and the phenotypic frailty (PF model in predicting risks of future falls, fractures and death in women aged ≥55 years.Based on the data from the Global Longitudinal Study of Osteoporosis in Women (GLOW 3-year Hamilton cohort (n = 3,985, we compared the predictive accuracy of the FI and PF in risks of falls, fractures and death using three strategies: (1 investigated the relationship with adverse health outcomes by increasing per one-fifth (i.e., 20% of the FI and PF; (2 trichotomized the FI based on the overlap in the density distribution of the FI by the three groups (robust, pre-frail and frail which were defined by the PF; (3 categorized the women according to a predicted probability function of falls during the third year of follow-up predicted by the FI. Logistic regression models were used for falls and death, while survival analyses were conducted for fractures.The FI and PF agreed with each other at a good level of consensus (correlation coefficients ≥ 0.56 in all the three strategies. Both the FI and PF approaches predicted adverse health outcomes significantly. The FI quantified the risks of future falls, fractures and death more precisely than the PF. Both the FI and PF discriminated risks of adverse outcomes in multivariable models with acceptable and comparable area under the curve (AUCs for falls (AUCs ≥ 0.68 and death (AUCs ≥ 0.79, and c-indices for fractures (c-indices ≥ 0.69 respectively.The FI is comparable with the PF in predicting risks of adverse health outcomes. These findings may indicate the flexibility in the choice of frailty model for the elderly in the population-based settings.

  10. Comparison between frailty index of deficit accumulation and phenotypic model to predict risk of falls: data from the global longitudinal study of osteoporosis in women (GLOW) Hamilton cohort.

    Science.gov (United States)

    Li, Guowei; Thabane, Lehana; Ioannidis, George; Kennedy, Courtney; Papaioannou, Alexandra; Adachi, Jonathan D

    2015-01-01

    To compare the predictive accuracy of the frailty index (FI) of deficit accumulation and the phenotypic frailty (PF) model in predicting risks of future falls, fractures and death in women aged ≥55 years. Based on the data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) 3-year Hamilton cohort (n = 3,985), we compared the predictive accuracy of the FI and PF in risks of falls, fractures and death using three strategies: (1) investigated the relationship with adverse health outcomes by increasing per one-fifth (i.e., 20%) of the FI and PF; (2) trichotomized the FI based on the overlap in the density distribution of the FI by the three groups (robust, pre-frail and frail) which were defined by the PF; (3) categorized the women according to a predicted probability function of falls during the third year of follow-up predicted by the FI. Logistic regression models were used for falls and death, while survival analyses were conducted for fractures. The FI and PF agreed with each other at a good level of consensus (correlation coefficients ≥ 0.56) in all the three strategies. Both the FI and PF approaches predicted adverse health outcomes significantly. The FI quantified the risks of future falls, fractures and death more precisely than the PF. Both the FI and PF discriminated risks of adverse outcomes in multivariable models with acceptable and comparable area under the curve (AUCs) for falls (AUCs ≥ 0.68) and death (AUCs ≥ 0.79), and c-indices for fractures (c-indices ≥ 0.69) respectively. The FI is comparable with the PF in predicting risks of adverse health outcomes. These findings may indicate the flexibility in the choice of frailty model for the elderly in the population-based settings.

  11. The total right/left-volume index: a new and simplified cardiac magnetic resonance measure to evaluate the severity of Ebstein anomaly of the tricuspid valve: a comparison with heart failure markers from various modalities.

    Science.gov (United States)

    Hösch, Olga; Sohns, Jan Martin; Nguyen, Thuy-Trang; Lauerer, Peter; Rosenberg, Christina; Kowallick, Johannes Tammo; Kutty, Shelby; Unterberg, Christina; Schuster, Andreas; Faßhauer, Martin; Staab, Wieland; Paul, Thomas; Lotz, Joachim; Steinmetz, Michael

    2014-07-01

    The classification of clinical severity of Ebstein anomaly still remains a challenge. The aim of this study was to focus on the interaction of the pathologically altered right heart with the anatomically-supposedly-normal left heart and to derive from cardiac magnetic resonance (CMR) a simple imaging measure for the clinical severity of Ebstein anomaly. Twenty-five patients at a mean age of 26±14 years with unrepaired Ebstein anomaly were examined in a prospective study. Disease severity was classified using CMR volumes and functional measurements in comparison with heart failure markers from clinical data, ECG, laboratory and cardiopulmonary exercise testing, and echocardiography. All examinations were completed within 24 hours. A total right/left-volume index was defined from end-diastolic volume measurements in CMR: total right/left-volume index=(RA+aRV+fRV)/(LA+LV). Mean total right/left-volume index was 2.6±1.7 (normal values: 1.1±0.1). This new total right/left-volume index correlated with almost all clinically used biomarkers of heart failure: brain natriuretic peptide (r=0.691; P=0.0003), QRS (r=0.432; P=0.039), peak oxygen consumption/kg (r=-0.479; P=0.024), ventilatory response to carbon dioxide production at anaerobic threshold (r=0.426; P=0.048), the severity of tricuspid regurgitation (r=0.692; P=0.009), tricuspid valve offset (r=0.583; P=0.004), and tricuspid annular plane systolic excursion (r=0.554; P=0.006). Previously described severity indices ([RA+aRV]/[fRV+LA+LV]) and fRV/LV end-diastolic volume corresponded only to some parameters. In patients with Ebstein anomaly, the easily acquired index of right-sided to left-sided heart volumes from CMR correlated well with established heart failure markers. Our data suggest that the total right/left-volume index should be used as a new and simplified CMR measure, allowing more accurate assessment of disease severity than previously described scoring systems. © 2014 American Heart Association, Inc.

  12. Effect of a short and severe intermittent drought on transpiration, seed yield components, and harvest index in four landraces of bambara groundnut

    DEFF Research Database (Denmark)

    Jørgensen, Søren Thorndal; Ntundu, W.H.; Ouédraogo, M.

    2011-01-01

    % of pot holding capacity until seed maturity or drought-stressed (DS) in the period from 76 to 85 days after sowing (flowering and early podding stage). During drought, although the total water use differed among the four landraces, transpiration rate and stomatal conductance (gs) responded similarly...... to soil drying. The high soil water thresholds for the reduction of transpiration rate and gs of bambara groundnuts indicate their great sensitivity in the stomatal control over plant water loss during soil drying. Even though the shoot dry weight at maturity was hardly affected by DS, seed yield, seed...... number, and harvest index were all significantly decreased in the DS plants. Among landraces, LunT and Ramayana were more susceptible to DS than S19-3 and Uniswa Red in terms of reduction of seed number and seed yield. The different responses of the landraces to DS may reflect their adaptation...

  13. The effects of cinacalcet treatment on bone mineral metabolism, anemia parameters, left ventricular mass index and parathyroid gland volume in hemodialysis patients with severe secondary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Dilek Torun

    2016-01-01

    Full Text Available The aim of this study was to investigate the effects of cinacalcet therapy on anemia parameters, bone mineral metabolism, left ventricular mass index (LVMI and parathyroid gland volume in hemodialysis (HD patients with secondary hyperparathyroidism. Twenty-five HD patients (M/F: 11/14, mean age: 45.2 ± 17.9 years, mean HD duration: 96.4 ± 32.7 months were included in this prospective pilot study. The indication to start calcimimetic therapy was persistent serum levels of parathyroid hormone (PTH >1000 pg/mL, refractory to intravenous (i.v. vitamin D and phosphate-binding therapy. The initial and one-year results of adjusted serum calcium (Ca +2 , phosphate (P, Ca × P product, PTH, hemoglobin (Hb and ferritin levels, transferrin saturation index (TSAT, median weekly erythropoietin (EPO dose, LVMI, and parathyroid volume by parathyroid ultrasonography were determined. There were no differences between pre- and post-treatment levels of serum Ca +2 (P = 0.853, P (P = 0.447, Ca × P product (P = 0.587, PTH (P = 0.273, ferritin (P = 0.153 and TSAT (P = 0.104. After 1 year of calcimimetic therapy, the Hb levels were significantly higher than the initial levels (P = 0.048. The weekly dose of EPO decreased with no statistical significance. The dose of cinacalcet was increased from 32.4 ± 12.0 to 60.0 ± 24.4 mg/day (P = 0.01. There were no differences between the pre- and post-treatment results regarding weekly vitamin D dose, parenteral iron dose, LVMI and parathyroid volume. The results of our study suggest that cinacalcet therapy might have an additional benefit in the control anemia in HD patients.

  14. 2016 GRI Index

    OpenAIRE

    World Bank

    2016-01-01

    This 2016 World Bank Global Reporting Initiative (GRI) Index provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting GRI guidelines (https://www.globalrepo...

  15. Usefulness of modified Pulmonary Index Score (mPIS as a quantitative tool for the evaluation of severe acute exacerbation in asthmatic children

    Directory of Open Access Journals (Sweden)

    Takeshi Koga

    2015-04-01

    Conclusions: mPIS could be a useful tool for several aspects during acute asthma attacks, including the determination of a treatment plan, and prediction of the period of hospitalization in admitted patients, although prospective studies would be required to establish our hypothesis.

  16. Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW).

    Science.gov (United States)

    Compston, Juliet E; Flahive, Julie; Hosmer, David W; Watts, Nelson B; Siris, Ethel S; Silverman, Stuart; Saag, Kenneth G; Roux, Christian; Rossini, Maurizio; Pfeilschifter, Johannes; Nieves, Jeri W; Netelenbos, J Coen; March, Lyn; LaCroix, Andrea Z; Hooven, Frederick H; Greenspan, Susan L; Gehlbach, Stephen H; Díez-Pérez, Adolfo; Cooper, Cyrus; Chapurlat, Roland D; Boonen, Steven; Anderson, Frederick A; Adami, Silvano; Adachi, Jonathan D

    2014-02-01

    Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and at 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or nonlinear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5 kg/m(2) were 0.80 (0.71-0.90), 0.83 (0.76-0.92), and 0.88 (0.83-0.94), respectively (all p fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02-1.07) (p fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75-0.97) (p = 0.02) and 0.73 (0.57-0.92) (p = 0.009), respectively. For pelvic and rib fractures, the best models were for nonlinear BMI or weight (p = 0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling. © 2014 American Society for Bone and Mineral Research.

  17. Perceived spatial stigma, body mass index and blood pressure: a global positioning system study among low-income housing residents in New York City

    Directory of Open Access Journals (Sweden)

    Dustin T. Duncan

    2016-05-01

    Full Text Available Previous research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI, and blood pressure among a sample of low-income housing residents in New York City (NYC. Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample. Global positioning systems (GPS tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051, as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01 and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004. In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR=1.32, 95%CI: 1.1, 1.4, P=0.02 and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007. However, we found no differences in spatial mobility (based GPS data among participants who reported living in neighborhoods with and without spatial stigma (P>0.05. Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals

  18. Density, refraction index and vapor–liquid equilibria of N-methyl-2-hydroxyethylammonium butyrate plus (methyl acetate or ethyl acetate or propyl acetate) at several temperatures

    International Nuclear Information System (INIS)

    Alvarez, V.H.; Mattedi, S.; Aznar, M.

    2013-01-01

    Highlights: ► Densities, refraction indices and VLE were measured for ester + m-2-HEAB mixtures. ► V E , apparent molar volumes and thermal expansion coefficients were calculated. ► Peng–Robinson EoS + Wong–Sandler mixing rule + COSMO-SAC predicted the data. -- Abstract: This paper reports the densities, refraction indices, and vapor liquid equilibria for binary systems ester + N-methyl-2-hydroxyethylammonium butyrate (m-2-HEAB): methyl acetate (1) + m-2-HEAB (2), ethyl acetate (1) + m-2-HEAB and propyl acetate (1) + m-2-HEAB (2). The excess molar volumes, deviations in the refraction index, apparent molar volumes, and thermal expansion coefficients for the binary systems were fitted to polynomial equations. The Peng–Robinson equation of state, coupled with the Wong–Sandler mixing rule, is used to describe the experimental data. Since the predictive activity coefficient model COSMO-SAC is used in the Wong–Sandler mixing rule, the resulting thermodynamic model is a completely predictive one. The prediction results for the density and for the vapor–liquid equilibria have a deviation lower than 1.0% and 1.1%, respectively

  19. Evaluation of Ra-226, Th-232 and K-40 activities concentrations and radium equivalent index in several Brazilian economic wall paints

    International Nuclear Information System (INIS)

    Fonseca, Leandro M.; Pecequilo, Brigitte R.S.

    2015-01-01

    The titanium dioxide used as the white pigment in paints is produced from the processing of ilmenite minerals. As monazite, the main ilmenite radioactive contaminant, contains 1 to 20% thorium dioxide and also some uranium traces, so, eventually, wall paints can contain radioactivity. Activity concentrations of the naturally occurring radionuclides 226 Ra, 232 Th and 40 K were determined in 15 Brazilian economic wall paints samples, by high resolution gamma-ray spectrometry. The activities concentrations in the studied samples ranged from 1.3 ± 0.2 Bq/kg to 23.4 ± 0.7 Bq/kg for 226 Ra; from 2.5 ± 0.4 Bq/kg to 45.8 ± 1.5 Bq/kg for 232 Th and from 5.8 ± 2.1 Bq/kg to 157 ± 22 Bq/kg for 40 K. The radium equivalent index, calculated from the 226 Ra, 232 Th and 40 K concentrations, varied from 1.30 Bq/kg up to 95.9 Bq/kg, below the value of 370 Bq/kg recommended by OECD for a safety use in residential building applications. (author)

  20. Right ventricular longitudinal strain and right ventricular stroke work index in patients with severe heart failure: left ventricular assist device suitability for transplant candidates.

    Science.gov (United States)

    Cameli, M; Bernazzali, S; Lisi, M; Tsioulpas, C; Croccia, M G; Lisi, G; Maccherini, M; Mondillo, S

    2012-09-01

    Right ventricular (RV) systolic function has a critical role in determining the clinical outcome and the success of using left ventricular assist devices in patients with refractory heart failure. RV deformation analysis by speckle tracking echocardiography (STE) has recently allowed the analysis of RV longitudinal function. Using cardiac catheterization as the reference standard, this study aimed to explore the correlation between RV longitudinal function by STE and RV stroke work index (RVSWI) among patients referred for cardiac transplantation. Right heart catheterization and transthoracic echo-Doppler were simultaneously performed in 47 patients referred for cardiac transplant assessment due to refractory heart failure (ejection fraction 25.1 ± 4.5%). Thermodilution RV stroke volume and invasive pulmonary pressures were used to obtain RVSWI. RV longitudinal strain (RVLS) by STE was assessed averaging RV free-wall segments (free-wall RVLS). We also calculated. Tricuspid S' and tricuspid annular plane systolic excursion (TAPSE). No significant correlation was observed for TAPSE on tricuspid S' with RV stroke volume (r = 0.14 and r = 0.06, respectively). A close negative correlation between free-wall RVLS and RVSWI was found (r = -0.82; P rights reserved.

  1. Original Research. The Evaluation of Caries Severity Index and Dental Hypoplasia in Children with Acute Lymphoblastic Leukemia. Results from a Romanian Medical Center

    Directory of Open Access Journals (Sweden)

    Bica Cristina

    2017-03-01

    Full Text Available Acute lymphoblastic leukemia (ALL is a type of cancer that most frequently affects children, and its treatment involves intensive chemotherapy, which might interfere with the normal development of dental tissues. The aim of our study was to measure the incidence of dental caries and enamel hypoplasia in children diagnosed with ALL treated according to the Berlin-Frankfurt-Munster-95 (ALL-BFM-95 protocol during the complete remission phase. Two groups of children between 8-12 years of age were investigated: Group 1 consisted of 36 children with ALL, and Group 2 of 58 control age-matched children. The decay-missing-filling index for the deciduous teeth (DMFT and the presence of hypoplasia in the first permanent molars (MH or in both incisors and molars (MIH were recorded. The results were statistically analyzed and showed that there were no differences between the groups regarding the DMFT values (p >0.05, but there was a statistically significant difference in the incidence of MH and MIH between groups (p <0.05. According to our results, chemotherapy was not responsible for the decay process, as there were no differences in DMFT indices between the groups, but the high incidence of MH and MIH in the ALL group indicates the need of a good dental care for these children in order to prevent future dental complications.

  2. High-molecular-weight adiponectin is selectively reduced in women with polycystic ovary syndrome independent of body mass index and severity of insulin resistance.

    LENUS (Irish Health Repository)

    O'Connor, A

    2010-03-01

    Context: High-molecular-weight (HMW) adiponectin contributes to insulin resistance (IR), which is closely associated with the pathophysiology of polycystic ovary syndrome (PCOS). Abnormalities in adipocyte function have been identified in PCOS and potentially contribute to lower adiponectin concentrations. Objective: Our objective was to determine which variables in plasma and adipose tissue influence HMW adiponectin in a well characterized cohort of women with PCOS. Design: This was a cross-sectional study. Settings and Participants: A teaching hospital. Women with PCOS (n = 98) and body mass index (BMI)-matched controls (n = 103) (including 68 age-, BMI-, and IR-matched pairs). Interventions: A standard 75-g oral glucose tolerance test was performed for each participant. Subcutaneous adipose tissue samples were taken by needle biopsy for a subset of PCOS women (n = 9) and controls (n = 8). Main Outcome Measures: Serum levels of HMW adiponectin and their relation to indices of insulin sensitivity, body composition, and circulating androgens as well as adipose tissue expression levels of ADIPOQ, TNFalpha, PPARgamma, and AR were assessed. Results: HMW adiponectin was significantly lower in women with PCOS compared with both BMI- and BMI- and IR-matched controls (P = 0.009 and P = 0.027, respectively). Although BMI and IR were the main predictors of HMW adiponectin, an interaction between waist to hip ratio and plasma testosterone contributed to its variance (P = 0.026). Adipose tissue gene expression analysis demonstrated that AR and TNFalpha (P = 0.008 and P = 0.035, respectively) but not ADIPOQ mRNA levels were increased in PCOS compared with controls. Conclusions: HMW adiponectin is selectively reduced in women with PCOS, independent of BMI and IR. Gene expression analysis suggests that posttranscriptional\\/translational modification contributes to reduced HMW adiponectin in PCOS.

  3. Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adults with schizophrenia and bipolar diagnoses.

    Science.gov (United States)

    Aas, Monica; Dieset, Ingrid; Hope, Sigrun; Hoseth, Eva; Mørch, Ragni; Reponen, Elina; Steen, Nils Eiel; Laskemoen, Jannicke Fjæra; Ueland, Thor; Aukrust, Pål; Agartz, Ingrid; Andreassen, Ole A; Melle, Ingrid

    2017-10-01

    Several studies have described an association between childhood maltreatment and inflammatory markers in the psychotic disorders (schizophrenia [SZ] and bipolar disorder [BD]). Previous studies have been relatively small (childhood abuse severity and clinical diagnosis on inflammatory markers were investigated in a large sample (n=483) of patients with a disorder on the psychosis spectrum and in healthy controls (HCs). Plasma levels of inflammatory markers (high-sensitivity C-reactive protein [hs-CRP], soluble tumor necrosis factor receptor type 1 [TNFR-R1], glycoprotein 130 [gp130]) were analyzed, and BMI and data on childhood trauma events, on the basis of the Childhood Trauma Questionnaire (CTQ), were obtained from all participants. Patients had increased levels of hs-CRP (Pchildhood maltreatment experiences (Pchildhood abuse (up to three types of abuse: sexual abuse, physical abuse, and emotional abuse) was associated with elevated BMI (f=8.46, Pchildhood abuse were found for elevated hs-CRP (f=4.76, P<0.001, Cohen's d=0.4). Differences among the groups disappeared when BMI was added to the model. Trauma-altered immune activation via elevated hs-CRP in patients with SZ and BD may be mediated by higher BMI; however, the direction of this association needs further clarification. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Therapeutic whole-body hypothermia reduces mortality in severe traumatic brain injury if the cooling index is sufficiently high: meta-analyses of the effect of single cooling parameters and their integrated measure.

    Science.gov (United States)

    Olah, Emoke; Poto, Laszlo; Hegyi, Peter; Szabo, Imre; Hartmann, Petra; Solymar, Margit; Petervari, Erika; Balasko, Marta; Habon, Tamas; Rumbus, Zoltan; Tenk, Judit; Rostas, Ildiko; Weinberg, Jordan; Romanovsky, Andrej A; Garami, Andras

    2018-04-21

    Therapeutic hypothermia was investigated repeatedly as a tool to improve the outcome of severe traumatic brain injury (TBI), but previous clinical trials and meta-analyses found contradictory results. We aimed to determine the effectiveness of therapeutic whole-body hypothermia on the mortality of adult patients with severe TBI by using a novel approach of meta-analysis. We searched the PubMed, EMBASE, and Cochrane Library databases from inception to February 2017. The identified human studies were evaluated regarding statistical, clinical, and methodological designs to ensure inter-study homogeneity. We extracted data on TBI severity, body temperature, mortality, and cooling parameters; then we calculated the cooling index, an integrated measure of therapeutic hypothermia. Forest plot of all identified studies showed no difference in the outcome of TBI between cooled and not cooled patients, but inter-study heterogeneity was high. On the contrary, by meta-analysis of RCTs which were homogenous with regards to statistical, clinical designs and precisely reported the cooling protocol, we showed decreased odds ratio for mortality in therapeutic hypothermia compared to no cooling. As independent factors, milder and longer cooling, and rewarming at < 0.25°C/h were associated with better outcome. Therapeutic hypothermia was beneficial only if the cooling index (measure of combination of cooling parameters) was sufficiently high. We conclude that high methodological and statistical inter-study heterogeneity could underlie the contradictory results obtained in previous studies. By analyzing methodologically homogenous studies, we show that cooling improves the outcome of severe TBI and this beneficial effect depends on certain cooling parameters and on their integrated measure, the cooling index.

  5. The Role of Low-severity Fire and Thermal Alteration of Soil Organic Matter in Carbon Preservation and GHG Flux From Global Peatlands

    Science.gov (United States)

    Flanagan, N. E.; Wang, H.; Hodgkins, S. B.; Richardson, C. J.

    2017-12-01

    Many global peatlands are dominated by fire-adapted plant communities and are subject to frequent wildfires with return intervals ranging between 3 to 100 years. Wildfires in peatlands are typically low-severity events that occur in winter and spring when vegetation is desiccated and soil moisture content is high. As a result, most wildfires consume aboveground fuels in a matter of minutes without igniting the nearly saturated peat. In such fires, surface soil layers are subjected to flash heating with a rapid loss of soil moisture but little loss of soil organic matter (SOM). Such fires have the potential to alter the chemical structure of SOM, even in the absence of combustion, through Maillard's Reaction and similar chemical processes, and through structural changes that protect SOM from decomposition. This study examines the effects of low-intensity surface fires on the recalcitrance of SOM from fire-adapted communities located in subtropical, temperate and sub-boreal peatlands. In addition, soil from a non-fire-adapted Peruvian palm peatland was examined for response to thermal alteration. The timing and temperatures of low-intensity fires were measured in the field during prescribed burns and replicated in simulated fires. The effects of fire on the chemical structure of SOM were examined with FTIR, SEM and XPS. Burned and unburned peat replicates were incubated at three temperatures (5oC, 15oC, 25oC) in controlled chambers for more than six months. Burned replicates initially showed higher CO2, CH4 and NO2 emissions. Yet, within four weeks emissions from the burned replicates dropped below those of unburned replicates and remained significantly lower (10-50%) for the duration of the experiment. In addition, thermal alteration significantly reduced the temperature sensitivity (Q10) of thermally altered peat. After accounting for small initial losses of organic matter (<10 %) during the fire simulations, thermal alteration of SOM resulted in a net long

  6. Relationships between Participants' International Prostate Symptom Score and BPH Impact Index Changes and Global Ratings of Change in a Trial of Phytotherapy for Men with Lower Urinary Tract Symptoms

    Science.gov (United States)

    Barry, Michael J.; Cantor, Alan; Roehrborn, Claus G.

    2014-01-01

    Purpose To relate changes in AUA Symptom Index (AUASI) scores with bother measures and global ratings of change among men with lower urinary tract symptoms enrolled in a trial of saw palmetto. Materials and Methods To be eligible, men were ≥45 years old, had ajpeak uroflow ≥4 ml/sec, and an AUASI score ≥ 8 and ≤ 24. Participants self-administered the AUASI, IPSS quality of life item (IPSS QoL), BPH Impact Index (BII) and two global change questions at baseline and 24, 48, and 72 weeks. Results Among 357 participants, global ratings of “a little better” were associated with mean decreases in AUASI scores from 2.8 to 4.1 points, across three time points. The analogous range for mean decreases in BII scores was 1.0 to 1.7 points, and for the IPSS QoL item 0.5 to 0.8 points. At 72 weeks, for the first global change question, each change measure could discriminate between participants rating themselves at least a little better versus unchanged or worse 70-72% of the time. A multivariable model increased discrimination to 77%. For the second global change question, each change measure correctly discriminated ratings of at least a little better versus unchanged or worse 69-74% of the time, and a multivariable model increased discrimination to 79%. Conclusions Changes in AUASI scores could discriminate between participants rating themselves at least a little better versus unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in AUASI scores of at least 3 points. PMID:23017510

  7. Pengaruh Beberapa Indeks Saham dan Indikator Ekonomi Global terhadap Kondisi Pasar Modal Indonesia

    OpenAIRE

    Rahyuda, Henny; Purbawangsa, Ida Bagus Anom; Andiyasa, I Gusti Agus

    2014-01-01

    Indonesian capital market is highly developed capital markets in recent years. With the growing world of investment and finance , the events that occurred in other countries, be it stock index or economic indicator will have an impact to the Indonesian state. This study aimed to determine the effect of several stock indices and global economic indicators to the condition of the Indonesian Capital Market. Global stock indices used in this study is the Dow Jones index, Nikkei 225 index, Shangha...

  8. Global educational disparities in the associations between body mass index and diabetes mellitus in 49 low-income and middle-income countries

    NARCIS (Netherlands)

    Wang, Aolin; Stronks, Karien; Arah, Onyebuchi A.

    2014-01-01

    Despite the well-established link between body mass index (BMI) and diabetes mellitus (DM), it remains unclear whether this association is more pronounced at certain levels of education. This study assessed the modifying effect of educational attainment on the associations between BMI and DM-as well

  9. Indexes of leading climate indicators for impact assessment

    International Nuclear Information System (INIS)

    Easterling, W.E.; Kates, R.W.

    1995-01-01

    Could users of climate information for impact assessment be overlooking an important source of information in climate indicators? We argue that indexes of leading climate indicators of impacts may be usable knowledge for consumers and may provide guidance to the global climate observing community concerning the types of data and information that users need. Five classes of indexes are suggested: Climate Extremes Index (CEI) and Greenhouse Climate Response Index (GCRI) - such are already available from scientists at the US National Climatic Data Center - plus proposed indexes of Hazard Warning, Ecosystem Health, and Energy Demand and Renewable Natural Resources. We conclude that the CEI and GCRI posses several necessary attributes to become usable knowledge; the other indexes have the potential to become usable knowledge, but remain to be implemented with climate data and fully evaluated. 34 refs

  10. The mediating effects of perceived parental teasing on relations of body mass index to depression and self-perception of physical appearance and global self-worth in children.

    Science.gov (United States)

    Bang, Kyung-Sook; Chae, Sun-Mi; Hyun, Myung-Sun; Nam, Hye Kyung; Kim, Ji-Soo; Park, Kwang-Hee

    2012-12-01

    To report a correlational study of the relation of body mass index to children's perceptions of physical appearance and global self-worth and depression, as mediated by their perceptions of parental teasing. The relation between depression and self-perception in children with obesity has been reported. Recently, parental factors were found to be related to childhood obesity. Little is known about the effects of perceived parental teasing on depression and self-perception in children. A descriptive correlational research design was used. Data were collected from 455 children in the fifth and sixth grades in four provinces of South Korea using self-report questionnaires for measuring self-perception of physical appearance and global self-worth, depression and perceived parental teasing between October-December in 2009. The children's weight and height information from school health records was used. Multiple regression analysis and the Sobel test were used to identify the mediating effect of perceived parental teasing. Among the children, 20% were overweight or obese. Although children with obesity did not differ in the level of depression from their normal weight counterparts, they demonstrated lower perceived physical appearance and higher perceived parental teasing. The mediating effects of perceived parental teasing were found for the relations between body mass index and self-perception of physical appearance and global self-worth, and body mass index and depression, respectively. Obese children at risk of parental teasing should be identified to prevent their psychological problems. A well-designed intervention study is necessary to examine the effects of psycho-emotional interventions for obese children. © 2012 Blackwell Publishing Ltd.

  11. Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the Individual Burden of Illness Index for Depression (IBI-D).

    Science.gov (United States)

    Ishak, Waguih William; Greenberg, Jared M; Cohen, Robert M

    2013-10-01

    Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse. Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n=956), nine (n=778), and twelve months (n=479) using generalized linear models. Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β=0.921 ± 0.194, z=4.76, pDepressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD. © 2013 Elsevier B.V. All rights reserved.

  12. Digital teaching tools and global learning communities [v2; ref status: indexed, http://f1000r.es/5la

    Directory of Open Access Journals (Sweden)

    Mary Williams

    2015-07-01

    Full Text Available In 2009, we started a project to support the teaching and learning of university-level plant sciences, called Teaching Tools in Plant Biology. Articles in this series are published by the plant science journal, The Plant Cell (published by the American Society of Plant Biologists. Five years on, we investigated how the published materials are being used through an analysis of the Google Analytics pageviews distribution and through a user survey. Our results suggest that this project has had a broad, global impact in supporting higher education, and also that the materials are used differently by individuals in terms of their role (instructor, independent learner, student and geographical location. We also report on our ongoing efforts to develop a global learning community that encourages discussion and resource sharing.

  13. Energy efficiency as a unifying principle for human, environmental, and global health [v1; ref status: indexed, http://f1000r.es/y8

    Directory of Open Access Journals (Sweden)

    Luigi Fontana

    2013-04-01

    Full Text Available A strong analogy exists between over/under consumption of energy at the level of the human body and of the industrial metabolism of humanity. Both forms of energy consumption have profound implications for human, environmental, and global health. Globally, excessive fossil-fuel consumption, and individually, excessive food energy consumption are both responsible for a series of interrelated detrimental effects, including global warming, extreme weather conditions, damage to ecosystems, loss of biodiversity, widespread pollution, obesity, cancer, chronic respiratory disease, and other lethal chronic diseases. In contrast, data show that the efficient use of energy—in the form of food as well as fossil fuels and other resources—is vital for promoting human, environmental, and planetary health and sustainable economic development. While it is not new to highlight how efficient use of energy and food can address some of the key problems our world is facing, little research and no unifying framework exists to harmonize these concepts of sustainable system management across diverse scientific fields into a single theoretical body. Insights beyond reductionist views of efficiency are needed to encourage integrated changes in the use of the world’s natural resources, with the aim of achieving a wiser use of energy, better farming systems, and healthier dietary habits. This perspective highlights a range of scientific-based opportunities for cost-effective pro-growth and pro-health policies while using less energy and natural resources.

  14. Prevalência e gravidade da asma em adolescentes e sua relação com índice de massa corporal Prevalence and severity of asthma among adolescents and their relationship with the body mass index

    Directory of Open Access Journals (Sweden)

    Vitor E. Cassol

    2005-08-01

    Full Text Available OBJETIVO: Investigar a relação entre o aumento do índice de massa corporal e a prevalência e a gravidade da asma em escolares adolescentes residentes em Santa Maria e região (RS. MÉTODO: Estudo transversal de base populacional, do qual participaram 4.010 adolescentes (13 e 14 anos de idade, sem restrições de sexo, tendo preenchido de forma correta o questionário do International Study of Asthma and Allergies fase III (módulo asma. Utilizou-se o índice de massa corporal (kg/m² com os seguintes percentis (Organização Mundial de Saúde para definir o estado nutricional: abaixo do quinto (desnutrição, igual ou superior ao quinto e inferior ao 85° (normal, igual ou superior ao 85° e inferior ao 95° (sobrepeso, igual ou superior ao 95° (obesidade. Para verificar a associação entre índice de massa corporal e a prevalência e gravidade da asma, foi utilizado o teste do qui-quadrado para tendência linear, com nível de significância de 5%. RESULTADOS: O aumento do índice de massa corporal mostrou associação positiva e significante com o da prevalência de "sibilos alguma vez" (p = 0,036 e a de "sibilos após exercício" (p = 0,008, independentemente do sexo. Quando estratificado por gênero, houve associação positiva apenas para "sibilos alguma vez" (p = 0,028 para meninos e "sibilos após exercício" (p = 0,03 para meninas. CONCLUSÃO: O aumento do índice de massa corporal associou-se com o aumento da prevalência de sibilos alguma vez na vida, mas não com o aumento da prevalência e gravidade da asma em adolescentes.OBJECTIVE: To investigate the relationship between the increase of body mass index and the prevalence and severity of asthma in adolescents from Santa Maria, in southern Brazil, and surrounding regions. METHOD: A cross-sectional, observational, population-based study was carried out with 4,010 schoolchildren aged 13 and 14 years, without any gender restrictions, who answered the written questionnaire of the

  15. Psychiatric severity and mortality in substance abusers. A 15 year follow-up

    DEFF Research Database (Denmark)

    Fridell, Mats; Hesse, Morten

    2006-01-01

    on the Symptom Checklist 90 [SCL-90] Global Severity Index, lower meaningfulness on the Sense of Coherence scale, and lower Global Assessment of Functioning [GAF] scores at 5-year follow-up. By contrast, there were no associations between baseline drug use and antisocial personality disorder diagnoses...

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 501 - 550 of 913 ... Vol 10, No 1 (2018), Modeling and comparison of IP and fuzzy-pi ... Modeling the potential impacts of global climate change in Bangladesh: An optimal ... Vol 9, No 4S (2017): Special Issue, New flood risk index in tropical ...

  17. Walkability Index

    Science.gov (United States)

    The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

  18. Síndrome agudo respiratorio severo: un panorama mundial de la epidemia Severe acute respiratory syndrome: a global view of the epidemic

    Directory of Open Access Journals (Sweden)

    Carlos Franco-Paredes

    2003-06-01

    despite extensive diagnostic workups. Most of these reports pointed out that the outbreak started in Southern China, specifically in the Guandong Province. The initial outbreak in South East Asia has already spread to other Regions in Asia, Europe, North and South America, and South Africa. Many of these cases can be linked through chains of transmission to an index case from the Guandong Province who visited Hong Kong. Although the exact mode of transmission has not been clearly established, the etiology of this syndrome has already been identified. A novel Coronavirus has been identified by electron microscopy and molecular assays in multiple laboratories from respiratory specimens throughout the world. The syndrome has been defined as SARS (Severe Acute Respiratory Syndrome by WHO, and is characterized by an incubation period between 1 and 10 days (average 5 days and by a febrile phase that usually lasts approximately 3 days. During the respiratory phase that begins around day 3, patients start developing a dry cough, shortness of breath and hypoxemia. Mechanical ventilatory support is required in about 10 to 40% of cases and the case-fatality rate ranges between 3 and 16%. The laboratory findings in SARS cases include leukopenia, thrombocytopenia, and a rise in transaminases and lactic dehydrogenase levels. Treatment of SARS includes supportive measures and the empiric use of ribavirin. Respiratory isolation, use of respiratory masks, and compulsory hand hygiene constitute the principal preventive measures. The confirmation of a case can be performed at reference laboratories by serologic and molecular assays. From the onset of this epidemic Mexico established a surveillance system as well as clinical guidelines and recommendations for the identification, prevention of secondary spread, and medical management of suspicious and probable cases by health care personnel.

  19. An open ecosystem engagement strategy through the lens of global food safety [v1; ref status: indexed, http://f1000r.es/527

    Directory of Open Access Journals (Sweden)

    Paul Stacey

    2015-05-01

    Full Text Available The Global Food Safety Partnership (GFSP is a public/private partnership established through the World Bank to improve food safety systems through a globally coordinated and locally-driven approach. This concept paper aims to establish a framework to help GFSP fully leverage the potential of open models.   In preparing this paper the authors spoke to many different GFSP stakeholders who asked questions about open models such as: what is it? what’s in it for me? why use an open rather than a proprietary model? how will open models generate equivalent or greater sustainable revenue streams compared to the current “traditional” approaches?  This last question came up many times with assertions that traditional service providers need to see opportunity for equivalent or greater revenue dollars before they will buy-in. This paper identifies open value propositions for GFSP stakeholders and proposes a framework for creating and structuring that value.   Open Educational Resources (OER were the primary open practice GFSP partners spoke to us about, as they provide a logical entry point for collaboration. Going forward, funders should consider requiring that educational resources and concomitant data resulting from their sponsorship should be open, as a public good. There are, however, many other forms of open practice that bring value to the GFSP. Nine different open strategies and tactics (Appendix A are described, including: open content (including OER and open courseware, open data, open access (research, open government, open source software, open standards, open policy, open licensing and open hardware. It is recommended that all stakeholders proactively pursue "openness" as an operating principle.   This paper presents an overall GFSP Open Ecosystem Engagement Strategy within which specific local case examples can be situated. Two different case examples, China and Colombia, are presented to show both project-based and crowd

  20. 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.

  1. 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.

  2. 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.

  3. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  4. Body mass index trajectory classes and incident asthma in childhood: results from 8 European Birth Cohorts--a Global Allergy and Asthma European Network initiative.

    Science.gov (United States)

    Rzehak, Peter; Wijga, Alet H; Keil, Thomas; Eller, Esben; Bindslev-Jensen, Carsten; Smit, Henriette A; Weyler, Joost; Dom, Sandra; Sunyer, Jordi; Mendez, Michelle; Torrent, Maties; Vall, Oriol; Bauer, Carl-Peter; Berdel, Dietrich; Schaaf, Beate; Chen, Chih-Mei; Bergström, Anna; Fantini, Maria P; Mommers, Monique; Wahn, Ulrich; Lau, Susanne; Heinrich, Joachim

    2013-06-01

    The causal link between body mass index (BMI) or obesity and asthma in children is still being debated. Analyses of large longitudinal studies with a sufficient number of incident cases and in which the time-dependent processes of both excess weight and asthma development can be validly analyzed are lacking. We sought to investigate whether the course of BMI predicts incident asthma in childhood. Data from 12,050 subjects of 8 European birth cohorts on asthma and allergies were combined. BMI and doctor-diagnosed asthma were modeled during the first 6 years of life with latent growth mixture modeling and discrete time hazard models. Subpopulations of children were identified with similar standardized BMI trajectories according to age- and sex-specific "World Health Organization (WHO) child growth standards" and "WHO growth standards for school aged children and adolescents" for children up to age 5 years and older than 5 years, respectively (BMI-SDS). These types of growth profiles were analyzed as predictors for incident asthma. Children with a rapid BMI-SDS gain in the first 2 years of life had a higher risk for incident asthma up to age 6 years than children with a less pronounced weight gain slope in early childhood. The hazard ratio was 1.3 (95% CI, 1.1-1.5) after adjustment for birth weight, weight-for-length at birth, gestational age, sex, maternal smoking in pregnancy, breast-feeding, and family history of asthma or allergies. A rapid BMI gain at 2 to 6 years of age in addition to rapid gain in the first 2 years of life did not significantly enhance the risk of asthma. Rapid growth in BMI during the first 2 years of life increases the risk of asthma up to age 6 years. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  5. Measurement of Regional and Global Pulmonary Clearance of 99mTc-DTPA (Demethylamitriptylene-Acetate): An Index of Alveolar Epithelial Permeability

    International Nuclear Information System (INIS)

    Vaskova, Olivija

    1996-01-01

    The main purpose of this study has been introduction of a new method for alveoli-capillary permeability evaluation. Many reports pointed out to the altered transit of soluble particles through this barrier. From pathophysiological aspect the main interest is the elucidation of permeability's alteration in different pulmonary pathology. We decided to use for lung epithelial permeability measurements 99m Tc-DTPA inhaled aerosols and sequential assessment of its lung clearance. The aerosols were obtained using oxygen flow nebulizers with aerosols' generators Ultra Vent (Malinkrodt) and Venticis II (CIS bio international) that enabled as to get submicron particles. Oxygen flow between 9 and 11 liters per minute was used. Optimum images were obtained with 1480 MBq of inhaled aerosols at least 2 to 3 minutes. DTPA that was used for aerosols labeling had been produced in our Department and the results were compared with DTPA provided by CIS bio international. High correlation between both agents was proven. During the whole study ex tamper prepared radiopharmaceuticals were used and quality control was done using paper chromatography method. Acquisition was done in sitting position with gamma camera interfaced to a ADAC and Scintiview. The measurements lasted for 20 minutes. Data were stored on 64x64 matrices. Regions of interest over both lungs were drown and each one was divided in three segments: apical, medial, and basal. Using computer program curves of 99m Tc-DTPA lung clearance were derived. From the obtained time activity curves half-time of the global and the regional lung clearance was assessed. In the control group comprised of 32 healthy volunteers (non-smokers) we had got values, used after works as reference range. Our normal values for global clearance are: 68±5,5 min. for left whole lung, 68,1±6,5 min for right whole lung, and 49±7,7 min for apical, 66,9±8 min for middle, and 75,9±6,4 min basal regional lung clearance, and they are in keeping with the

  6. Body Mass Index at onset of Puberty in Rats Exposed to Aqueous ...

    African Journals Online (AJOL)

    Rev Dr Olaleye

    ... Index Medicus (WHO), CAB Abstracts, Index Copernicus, Global Health Abstracts, Asian Science Index, Index ... has any effect on body weight, body mass index (BMI) and weights of some ... detrimental when nutrition was more abundant in.

  7. Assessment of a correlation between Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and selected biophysical skin measures (skin hydration, pH, and erythema intensity) in dogs with naturally occurring atopic dermatitis.

    Science.gov (United States)

    Zając, Marcin; Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Łukasz R; Pomorski, Zbigniew J H; Sitkowski, Wiesław; Gołyński, Marcin

    2015-04-01

    Atopic dermatitis is a common allergic skin disease in dogs. The aim of this study was to examine the possibility of a correlation between biophysical skin variables: skin hydration (SH), skin pH, and erythema intensity measured in 10 different body regions and both total Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and CADESI measured in a given region (CADESI L). The study was conducted using 33 dogs with atopic dermatitis. The assessment of the biophysical variables was done in 10 body regions: the lumbar region, right axillary fossa, right inguinal region, ventral abdominal region, right lateral thorax region, internal surface of the auricle, interdigital region of right forelimb, cheek, bridge of nose, and lateral site of antebrachum. Positive correlations were found between SH and CADESI L for the following regions: the inguinal region (r = 0.73) and the interdigital region (r = 0.82), as well as between total CADESI and SH on digital region (r = 0.52). Also, positive correlations were reported for skin pH and CADESI L in the lumbar region (r = 0.57), the right lateral thorax region (r = 0.40), and the lateral antebrachum (r = 0.35). Positive correlations were found in the interdigital region between erythema intensity and the total CADESI-03 (r = 0.60) as well as the CADESI L (r = 0.7). The results obtained suggest that it may be possible to use skin hydration, pH, and erythema intensity to assess the severity of skin lesion but positive correlation was only found in < 13.3% of possible correlations and usage of these measures in dogs is limited.

  8. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  9. Diversity Index

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This map service summarizes racial and ethnic diversity in the United States in 2012.The Diversity Index shows the likelihood that two persons chosen at random from...

  10. AUTHOR INDEX

    Indian Academy of Sciences (India)

    a granitic terrain of southern India using factor analysis and GIS. 1059. Radhakrishna M see Dev Sheena V .... Landslide susceptibility analysis using Probabilistic. Certainty Factor ... index via entropy-difference analysis. 687. Yidana Sandow ...

  11. Intelligent indexing

    International Nuclear Information System (INIS)

    Farkas, J.

    1992-01-01

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space ι 2 to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs

  12. Intelligent indexing

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J

    1993-12-31

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space {iota}{sup 2} to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs.

  13. Using Linear Equating to Map PROMIS(®) Global Health Items and the PROMIS-29 V2.0 Profile Measure to the Health Utilities Index Mark 3.

    Science.gov (United States)

    Hays, Ron D; Revicki, Dennis A; Feeny, David; Fayers, Peter; Spritzer, Karen L; Cella, David

    2016-10-01

    Preference-based health-related quality of life (HR-QOL) scores are useful as outcome measures in clinical studies, for monitoring the health of populations, and for estimating quality-adjusted life-years. This was a secondary analysis of data collected in an internet survey as part of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) project. To estimate Health Utilities Index Mark 3 (HUI-3) preference scores, we used the ten PROMIS(®) global health items, the PROMIS-29 V2.0 single pain intensity item and seven multi-item scales (physical functioning, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, sleep disturbance), and the PROMIS-29 V2.0 items. Linear regression analyses were used to identify significant predictors, followed by simple linear equating to avoid regression to the mean. The regression models explained 48 % (global health items), 61 % (PROMIS-29 V2.0 scales), and 64 % (PROMIS-29 V2.0 items) of the variance in the HUI-3 preference score. Linear equated scores were similar to observed scores, although differences tended to be larger for older study participants. HUI-3 preference scores can be estimated from the PROMIS(®) global health items or PROMIS-29 V2.0. The estimated HUI-3 scores from the PROMIS(®) health measures can be used for economic applications and as a measure of overall HR-QOL in research.

  14. Virginia ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  15. SUBJECT INDEX

    Indian Academy of Sciences (India)

    R.Narasimhan(krishtel emaging)1461 1996 Oct 15 13:05:22

    bian Pacific Ocean and its relationship with the wind field using .... Electron spin resonance dating of fault gouge from ... impact. Assimilation of IRS-P4 (MSMR) meteorological data in the NCMRWF global data ... mobile auroral current systems.

  16. Hospital-acquired pneumonia is an independent predictor of poor global outcome in severe traumatic brain injury up to 5 years after discharge.

    Science.gov (United States)

    Kesinger, Matthew Ryan; Kumar, Raj G; Wagner, Amy K; Puyana, Juan Carlos; Peitzman, Andrew P; Billiar, Timothy R; Sperry, Jason L

    2015-02-01

    Long-term outcomes following traumatic brain injury (TBI) correlate with initial head injury severity and other acute factors. Hospital-acquired pneumonia (HAP) is a common complication in TBI. Limited information exists regarding the significance of infectious complications on long-term outcomes after TBI. We sought to characterize risks associated with HAP on outcomes 5 years after TBI. This study involved data from the merger of an institutional trauma registry and the Traumatic Brain Injury Model Systems outcome data. Individuals with severe head injuries (Abbreviated Injury Scale [AIS] score ≥ 4) who survived to rehabilitation were analyzed. Primary outcome was Glasgow Outcome Scale-Extended (GOSE) at 1, 2, and 5 years. GOSE was dichotomized into low (GOSE score GOSE score ≥ 6). Logistic regression was used to determine adjusted odds of low GOSE score associated with HAP after controlling for age, sex, head and overall injury severity, cranial surgery, Glasgow Coma Scale (GCS) score, ventilation days, and other important confounders. A general estimating equation model was used to analyze all outcome observations simultaneously while controlling for within-patient correlation. A total of 141 individuals met inclusion criteria, with a 30% incidence of HAP. Individuals with and without HAP had similar demographic profiles, presenting vitals, head injury severity, and prevalence of cranial surgery. Individuals with HAP had lower presenting GCS score. Logistic regression demonstrated that HAP was independently associated with low GOSE scores at follow-up (1 year: odds ratio [OR], 6.39; 95% confidence interval [CI], 1.76-23.14; p = 0.005) (2 years: OR, 7.30; 95% CI, 1.87-27.89; p = 0.004) (5-years: OR, 6.89; 95% CI, 1.42-33.39; p = 0.017). Stratifying by GCS score of 8 or lower and early intubation, HAP remained a significant independent predictor of low GOSE score in all strata. In the general estimating equation model, HAP continued to be an independent

  17. Hospital Acquired Pneumonia is an Independent Predictor of Poor Global Outcome in Severe Traumatic Brain Injury up to 5 Years after Discharge

    Science.gov (United States)

    Kesinger, Matthew R.; Kumar, Raj G.; Wagner, Amy K.; Puyana, Juan C.; Peitzman, Andrew P.; Billiar, Timothy R.; Sperry, Jason L.

    2016-01-01

    Objectives Long-term outcomes following traumatic brain injury (TBI) correlate with initial head injury severity and other acute factors. Hospital-acquired pneumonia (HAP) is a common complication in TBI. Little information exists regarding the significance of infectious complications on long-term outcomes post-TBI. We sought to characterize risks associated with HAP on outcomes 5 years post-TBI. Methods Ddata from the merger of an institutional trauma registry and the TBI Model Systems outcome data. Individuals with severe head injuries (Abbreviated Injury Scale≥4), who survived to rehabilitation were analyzed. Primary outcome was Glasgow Outcome Scaled-Extended (GOSE) at 1, 2, and 5 years. GOSE was dichotomized into LOW (GOSEGOSE≥6). Logistic regression was utilized to determine adjusted odds of LOW-GOSE associated with HAP after controlling for age, sex, head and overall injury severity, cranial surgery, Glasgow Coma Scale (GCS), ventilation days, and other important confounders. A general estimating equation (GEE) model was used to analyze all outcome observations simultaneously while controlling for within-patient correlation. Results A total of 141 individuals met inclusion criteria, with a 30% incidence of HAP. Individuals with and without HAP had similar demographic profiles, presenting vitals, head injury severity, and prevalence of cranial surgery. Individuals with HAP had lower presenting GCS. Logistic regression demonstrated that HAP was independently associated with LOW-GOSE scores at follow-up (1year: OR=6.39, 95%CI: 1.76-23.14, p=0.005; 2-years: OR=7.30, 95%CI 1.87-27.89, p=0.004; 5-years: OR=6.89, 95%CI: 1.42-33.39, p=0.017). Stratifying by GCS≤8 and early intubation, HAP remained a significant independent predictor of LOW-GOSE in all strata. In the GEE model, HAP continued to be an independent predictor of LOW-GOSE (OR: 4.59; 95%CI: 1.82-11.60′ p=0.001). Conclusion HAP is independently associated with poor outcomes in severe-TBI extending 5

  18. Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Wichmann, Julian L. [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Universitaetsklinikum Frankfurt, Institut fuer Diagnostische und Interventionelle Radiologie, Frankfurt am Main (Germany); Majenka, Pawel; Beeres, Martin; Kromen, Wolfgang; Schulz, Boris; Bauer, Ralf W.; Kerl, J.M.; Gruber-Rouh, Tatjana; Hammerstingl, Renate; Vogl, Thomas J.; Lehnert, Thomas [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Wesarg, Stefan [Fraunhofer IGD, Cognitive Computing and Medical Imaging, Darmstadt (Germany)

    2014-11-15

    To intra-individually compare single-portal-phase low-tube-voltage (100-kVp) computed tomography (CT) with 120-kVp images for short-term follow-up assessment of CT severity index (CTSI) of acute pancreatitis, interobserver agreement and radiation dose. We retrospectively analysed 66 patients with acute pancreatitis who underwent initial dual-contrast-phase CT (unenhanced, arterial, portal phase) at admission and short-term (mean interval 11.4 days) follow-up dual-contrast-phase dual-energy CT. The 100-kVp and linearly blended images representing 120-kVp acquisition follow-up CT images were independently evaluated by three radiologists using a modified CTSI assessing pancreatic inflammation, necrosis and extrapancreatic complications. Scores were compared with paired t test and interobserver agreement was evaluated using intraclass correlation coefficients (ICC). Mean CTSI scores on unenhanced, portal- and dual-contrast-phase images were 4.9, 6.1 and 6.2 (120 kVp) and 5.0, 6.0 and 6.1 (100 kVp), respectively. Contrast-enhanced series showed a higher CTSI compared to unenhanced images (P < 0.05) but no significant differences between single- and dual-contrast-phase series (P > 0.7). CTSI scores were comparable for 100-kVp and 120-kVp images (P > 0.05). Interobserver agreement was substantial for all evaluated series and subcategories (ICC 0.67-0.93). DLP of single-portal-phase 100-kVp images was reduced by 41 % compared to 120-kVp images (363.8 versus 615.9 mGy cm). Low-tube-voltage single-phase 100-kVp CT provides sufficient information for follow-up evaluation of acute pancreatitis and significantly reduces radiation exposure. (orig.)

  19. Changes in quality of life (WHOQOL-BREF) and addiction severity index (ASI) among participants in opioid substitution treatment (OST) in low and middle income countries: an international systematic review.

    Science.gov (United States)

    Feelemyer, Jonathan P; Jarlais, Don C Des; Arasteh, Kamyar; Phillips, Benjamin W; Hagan, Holly

    2014-01-01

    Opioid substitution treatment (OST) can increase quality of life (WHOQOL-BREF) and reduce addiction severity index (ASI) scores among participants over time. OST program participants have noted that improvement in quality of life is one of the most important variables to their reduction in drug use. However, there is little systematic understanding of WHOQOL-BREF and ASI domain changes among OST participants in low and middle-income countries (LMIC). Utilizing PRISMA guidelines we conducted a systematic literature search to identify OST program studies documenting changes in WHOQOL-BREF or ASI domains for participants in buprenorphine or methadone programs in LMIC. Standardized mean differences for baseline and follow-up domain scores were compared along with relationships between domain scores, OST dosage, and length of follow-up. There were 13 OST program studies with 1801 participants from five countries eligible for inclusion in the review. Overall, statistically significant changes were noted in all four WHOQOL-BREF domain and four of the seven ASI domain scores (drug, psychological, legal, and family) documented in studies. Dosage of pharmacologic medication and length of follow-up did not affect changes in domain scores. WHOQOL-BREF and ASI domain scoring is a useful tool in measuring overall quality of life and levels of addiction among OST participants. Coupled with measurements of blood-borne infection, drug use, relapse, and overdose, WHOQOL-BREF and ASI represent equally important tools for evaluating the effects of OST over time and should be further developed as integrated tools in the evaluation of participants in LMIC. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Indexing mechanisms

    International Nuclear Information System (INIS)

    Wood, A.G.; Parker, G.E.; Berry, R.

    1976-01-01

    It is stated that the indexing mechanism described can be used in a nuclear reactor fuel element inspection rig. It comprises a tubular body adapted to house a canister containing a number of fuel elements located longtitudinally, and has two chucks spaced apart for displacing the fuel elements longitudinally in a stepwise manner, together with a plunger mechanism for displacing them successively into the chucks. A measuring unit is located between the chucks for measuring the diameter of the fuel elements at intervals about their circumferences, and a secondary indexing mechanism is provided for rotating the measuring unit in a stepwise manner. (U.K.)

  1. Influence of Quaternary Benzophenantridine and Protopine Alkaloids on Growth Performance, Dietary Energy, Carcass Traits, Visceral Mass, and Rumen Health in Finishing Ewes under Conditions of Severe Temperature-humidity Index

    Directory of Open Access Journals (Sweden)

    A. Estrada-Angulo

    2016-05-01

    Full Text Available Twenty Pelibuey×Katahdin ewes (35±2.3 kg were used to determine the effects of the consumption of standardized plant extract containing a mixture of quaternary benzophenanthridine alkaloids and protopine alkaloids (QBA+PA on growth performance, dietary energetics, visceral mass, and ruminal epithelial health in heat-stressed ewes fed with a high-energy corn-based diet. The basal diet (13.9% crude protein and 2.09 Mcal of net energy [NE] of maintenance/kg of dry matter contained 49.7% starch and 15.3% neutral detergent fiber. Source of QBA+PA was Sangrovit RS (SANG which contains 3 g of quaternary benzophenathridine and protopine alkaloids per kg of product. Treatments consisted of a daily consumption of 0 or 0.5 g SANG/ewe. Ewes were grouped by weight and assigned to 10 pens (5 pens/treatment, with two ewes per pen. The experimental period lasted 70 days. The mean temperature humidity index during the course of this experiment was 81.7±1.0 (severe heat stress. There were no treatment effects on water intake. Dry matter intake was not affected (p = 0.70 by treatments, but the group fed SANG had a numerically (11.2% higher gain in comparison to the control group, SANG improved gain efficiency (8.3%, p = 0.04, dietary NE (5.2%, p<0.01 and the observed-to-expected NE (5.9%, p<0.01. Supplemental SANG did not affect (p≥0.12 carcass characteristics, chemical composition of shoulder, and organ weights (g/kg empty body weight of stomach complex, intestines, and heart/lung. Supplemental SANG decreased liver weight (10.3%, p = 0.02 and increased visceral fat (16.9%, p = 0.02. Rumen epithelium of ewes fed SANG had lower scores for cellular dropsical degeneration (2.08 vs 2.34, p = 0.02, parakeratosis (1.30 vs 1.82, p = 0.03 and neutrophil infiltration (2.08 vs 2.86, p = 0.05 than controls. It is concluded that SANG supplementation helped ameliorate the negative effects of severe heat on growth performance of feedlot ewes fed high-energy corn

  2. Association between moderate-to-severe diarrhea in young children in the global enteric multicenter study (GEMS) and types of handwashing materials used by caretakers in Mirzapur, Bangladesh.

    Science.gov (United States)

    Baker, Kelly K; Dil Farzana, Fahmida; Ferdous, Farzana; Ahmed, Shahnawaz; Kumar Das, Sumon; Faruque, A S G; Nasrin, Dilruba; Kotloff, Karen L; Nataro, James P; Kolappaswamy, Krishnan; Levine, Myron M

    2014-07-01

    Handwashing practices among caretakers of case and control children hygiene purposes and were kept together at handwashing areas. Caretakers preferred soap for handwashing, but frequently relied on ash, or a detergent/ash mixture, as a low-cost alternative. Moderate-to-severe diarrhea was equally likely for children of caretakers who kept soap versus those who kept ash (matched OR = 0.91; 0.62-1.32). Contact with ash and water reduced concentrations of bacterial enteropathogens, without mechanical scrubbing. Thus, washing hands with ash is a prevalent behavior in Mirzapur and may help diminish transmission of diarrheal pathogens to children. © The American Society of Tropical Medicine and Hygiene.

  3. A Rare de novo Interstitial Duplication at 4p15.2 in a Boy with Severe Congenital Heart Defects, Limb Anomalies, Hypogonadism, and Global Developmental Delay.

    Science.gov (United States)

    Liang, Liyang; Xie, Yingjun; Shen, Yiping; Yin, Qibin; Yuan, Haiming

    2016-01-01

    Proximal 4p deletion syndrome is a relatively rare genetic condition characterized by dysmorphic facial features, limb anomalies, minor congenital heart defects, hypogonadism, cafe-au-lait spots, developmental delay, tall and thin habitus, and intellectual disability. At present, over 20 cases of this syndrome have been published. However, duplication of the same region in proximal 4p has never been reported. Here, we describe a 2-year-5-month-old boy with severe congenital heart defects, limb anomalies, hypogonadism, distinctive facial features, pre- and postnatal developmental delay, and mild cognitive impairments. A de novo 4.5-Mb interstitial duplication at 4p15.2p15.1 was detected by chromosomal microarray analysis. Next-generation sequencing was employed and confirmed the duplication, but revealed no additional pathogenic variants. Several candidate genes in this interval responsible for the complex clinical phenotype were identified, such as RBPJ, STIM2, CCKAR, and LGI2. The results suggest a novel contiguous gene duplication syndrome. © 2016 S. Karger AG, Basel.

  4. Author Index

    Indian Academy of Sciences (India)

    user1

    Astr. (2012) 33, 419–420. Author Index. 419. AGGARWAL SUNNY. Photoionization Cross-Section of Chlorine-like Iron, 291. AMBASTHA ASHOK see Das, A. C., 1. ARAKIDA HIDEYOSHI. Effect of Inhomogeneity of the Universe on a Gravitationally. Bound Local System: A No-Go Result for Explaining the Secular Increase in.

  5. AUTHOR INDEX

    Indian Academy of Sciences (India)

    automorphic solutions to fractional order abstract integro-differential equations. 323. Afrouzi G A see Ala Samira ... 521. Agarwal Praveen. Certain fractional integral operators and the generalized multi-index Mittag- ... of positive solutions for sys- tems of second order multi-point bound- ary value problems on time scales 353.

  6. Cardiff acne disability index in Sarawak, Malaysia.

    Science.gov (United States)

    Yap, Felix Boon-Bin

    2012-05-01

    Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown. The aim of this study is to determine the impact of acne on quality of life and its relationship with severity. A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia. The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income 0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; pSarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation.

  7. 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...

  8. 77 FR 49839 - IndexIQ Advisors LLC and IndexIQ Active ETF Trust; Notice of Application

    Science.gov (United States)

    2012-08-17

    ... Advisors LLC and IndexIQ Active ETF Trust; Notice of Application August 13, 2012. AGENCY: Securities and... IndexIQ Active ETF Trust (the ``Trust''). SUMMARY OF APPLICATION: Applicants request an order that... series, IQ Global Equity Active ETF (``Global Equity ETF''), IQ Global Fixed Income Active ETF (``Global...

  9. Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Mendoza Dorinna D

    2010-07-01

    Full Text Available Abstract Objectives To examine relationships between severity of echocardiography (echo -evidenced diastolic dysfunction (DD and volumetric filling by automated processing of routine cine cardiovascular magnetic resonance (CMR. Background Cine-CMR provides high-resolution assessment of left ventricular (LV chamber volumes. Automated segmentation (LV-METRIC yields LV filling curves by segmenting all short-axis images across all temporal phases. This study used cine-CMR to assess filling changes that occur with progressive DD. Methods 115 post-MI patients underwent CMR and echo within 1 day. LV-METRIC yielded multiple diastolic indices - E:A ratio, peak filling rate (PFR, time to peak filling rate (TPFR, and diastolic volume recovery (DVR80 - proportion of diastole required to recover 80% stroke volume. Echo was the reference for DD. Results LV-METRIC successfully generated LV filling curves in all patients. CMR indices were reproducible (≤ 1% inter-reader differences and required minimal processing time (175 ± 34 images/exam, 2:09 ± 0:51 minutes. CMR E:A ratio decreased with grade 1 and increased with grades 2-3 DD. Diastolic filling intervals, measured by DVR80 or TPFR, prolonged with grade 1 and shortened with grade 3 DD, paralleling echo deceleration time (p 80 identified 71% of patients with echo-evidenced grade 1 but no patients with grade 3 DD, and stroke-volume adjusted PFR identified 67% with grade 3 but none with grade 1 DD (matched specificity = 83%. The combination of DVR80 and PFR identified 53% of patients with grade 2 DD. Prolonged DVR80 was associated with grade 1 (OR 2.79, CI 1.65-4.05, p = 0.001 with a similar trend for grade 2 (OR 1.35, CI 0.98-1.74, p = 0.06, whereas high PFR was associated with grade 3 (OR 1.14, CI 1.02-1.25, p = 0.02 DD. Conclusions Automated cine-CMR segmentation can discern LV filling changes that occur with increasing severity of echo-evidenced DD. Impaired relaxation is associated with prolonged

  10. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    basis. The data are divided into different indicators such as security, polls, drug, social, economic, refugees etc. This represents a practical division and does not indicate that a picture as to for instance security can be obtained by solely looking at the data under security. In order to obtain...... a more valid picture on security this must incorporate an integrated look on all data meaning that for instance the economic data provides an element as to the whole picture of security.......The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...

  11. Going global?

    DEFF Research Database (Denmark)

    Fejerskov, Adam Moe; Rasmussen, Christel

    2016-01-01

    occurred at a more micro level. This article explores this issue by studying the international activities of Danish foundations. It finds that grant-making on global issues is increasing, and that several foundations have undergone transformations in their approach to grantmaking, making them surprisingly...

  12. Analysis of changes in tornadogenesis conditions over Northern Eurasia based on a simple index of atmospheric convective instability

    Science.gov (United States)

    Chernokulsky, A. V.; Kurgansky, M. V.; Mokhov, I. I.

    2017-12-01

    A simple index of convective instability (3D-index) is used for analysis of weather and climate processes that favor to the occurrence of severe convective events including tornadoes. The index is based on information on the surface air temperature and humidity. The prognostic ability of the index to reproduce severe convective events (thunderstorms, showers, tornadoes) is analyzed. It is shown that most tornadoes in North Eurasia are characterized by high values of the 3D-index; furthermore, the 3D-index is significantly correlated with the available convective potential energy. Reanalysis data (for recent decades) and global climate model simulations (for the 21st century) show an increase in the frequency of occurrence of favorable for tornado formation meteorological conditions in the regions of Northern Eurasia. The most significant increase is found on the Black Sea coast and in the south of the Far East.

  13. Gender differences in addiction severity.

    Science.gov (United States)

    Díaz-Mesa, Eva M; García-Portilla, Paz; Fernández-Artamendi, Sergio; Sáiz, Pilar A; Bobes Bascarán, Teresa; Casares, María José; Fonseca, Eduardo; Al-Halabí, Susana; Bobes, Julio

    2016-06-14

    Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.

  14. An empirical model of L-band scintillation S4 index constructed by using FORMOSAT-3/COSMIC data

    Science.gov (United States)

    Chen, Shih-Ping; Bilitza, Dieter; Liu, Jann-Yenq; Caton, Ronald; Chang, Loren C.; Yeh, Wen-Hao

    2017-09-01

    Modern society relies heavily on the Global Navigation Satellite System (GNSS) technology for applications such as satellite communication, navigation, and positioning on the ground and/or aviation in the troposphere/stratosphere. However, ionospheric scintillations can severely impact GNSS systems and their related applications. In this study, a global empirical ionospheric scintillation model is constructed with S4-index data obtained by the FORMOSAT-3/COSMIC (F3/C) satellites during 2007-2014 (hereafter referred to as the F3CGS4 model). This model describes the S4-index as a function of local time, day of year, dip-latitude, and solar activity using the index PF10.7. The model reproduces the F3/C S4-index observations well, and yields good agreement with ground-based reception of satellite signals. This confirms that the constructed model can be used to forecast global L-band scintillations on the ground and in the near surface atmosphere.

  15. A generalized cost Malmquist index in DEA for DMUs with negative data

    Directory of Open Access Journals (Sweden)

    Ghasem Tohidi

    2014-10-01

    Full Text Available In some data envelopment analysis (DEA applications, some inputs of DMUs have negative values with positive cost. This paper generalizes the global cost Malmquist productivity index to compare the productivity of different DMUs with negative inputs in any two periods of times under variable returns to scale (VRS technology, and then the generalized index is decomposed to several components. The obtained components are computed using the nonparametric linear programming models, known as DEA. To illustrate the generalized index and its components, a numerical example at three successive periods of time is given.

  16. Epidemiology, Seasonality and Factors Associated with Rotavirus Infection among Children with Moderate-to-Severe Diarrhea in Rural Western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS.

    Directory of Open Access Journals (Sweden)

    Richard Omore

    Full Text Available To evaluate factors associated with rotavirus diarrhea and to describe severity of illness among children <5 years old with non-dysenteric, moderate-to-severe diarrhea (MSD in rural western Kenya.We analyzed data from children <5 years old with non-dysenteric MSD enrolled as cases in the Global Enteric Multicenter Study (GEMS in Kenya. A non-dysenteric MSD case was defined as a child with ≥3 loose stools in 24 hrs. and one or more of the following: sunken eyes, skin tenting, intravenous rehydration, or hospitalization, who sought care at a sentinel health center within 7 days of illness onset. Rotavirus antigens in stool samples were detected by ELISA. Demographic and clinical information was collected at enrollment and during a single follow-up home visit at approximately 60 days. We analyzed diarrhea severity using a GEMS 17 point numerical scoring system adapted from the Vesikari score. We used logistic regression to evaluate factors associated with rotavirus infection.From January 31, 2008 to September 30, 2012, among 1,637 (92% non-dysenteric MSD cases, rotavirus was detected in stools of 245 (15.0%. Rotavirus-positive compared with negative cases were: younger (median age, 8 vs. 13 months; p<0.0001, had more severe illness (median severity score, 9 vs 8; p<0.0001 and had to be hospitalized more frequently (37/245 [15.1%] vs. 134/1,392 [9.6%], p <0.013. Independent factors associated with rotavirus infection included age 0-11 months old (aOR = 5.29, 95% CI 3.14-8.89 and presenting with vomiting ≥3 times/24hrs (aOR = 2.58, 95% CI [1.91-3.48]. Rotavirus was detected more commonly in warm and dry months than in the cool and rainy months (142/691 [20%] vs 70/673 [10%] p<0.0001.Diarrhea caused by rotavirus is associated with severe symptoms leading to hospitalization. Consistent with other settings, infants had the greatest burden of disease.

  17. U.S. Hail Frequency and the Global Wind Oscillation

    Science.gov (United States)

    Gensini, Vittorio A.; Allen, John T.

    2018-02-01

    Changes in Earth relative atmospheric angular momentum can be described by an index known as the Global Wind Oscillation. This global index accounts for changes in Earth's atmospheric budget of relative angular momentum through interactions of tropical convection anomalies, extratropical dynamics, and engagement of surface torques (e.g., friction and mountain). It is shown herein that U.S. hail events are more (less) likely to occur in low (high) atmospheric angular momentum base states when excluding weak Global Wind Oscillation days, with the strongest relationships found in the boreal spring and fall. Severe, significant severe, and giant hail events are more likely to occur during Global Wind Oscillation phases 8, 1, 2, and 3 during the peak of U.S. severe weather season. Lower frequencies of hail events are generally found in Global Wind Oscillation phases 4-7 but vary based on Global Wind Oscillation amplitude and month. In addition, probabilistic anomalies of atmospheric ingredients supportive of hail producing supercell thunderstorms closely mimic locations of reported hail frequency, helping to corroborate report results.

  18. Estimativa da radiação global incidente em superfícies inclinadas por modelos isotrópicos e índice de claridade Estimation of the incident global radiation on tilted surfaces using isotropic models and clearness index

    Directory of Open Access Journals (Sweden)

    Adilson Pacheco de Souza

    2010-04-01

    Full Text Available O objetivo deste trabalho foi avaliar o desempenho de modelos isotrópicos de estimativa do total de radiação incidente em superfícies inclinadas e propor estimativas com base nas correlações entre os índices de claridade horizontais e inclinados, em diferentes condições de cobertura de céu, em Botucatu, SP. Foram avaliadas superfícies com inclinação de 12,85º, 22,85º e 32,85º, pelos modelos isotrópicos propostos por Liu & Jordan, Revfeim, Jimenez & Castro, Koronakis, a teoria Circunsolar, e a correlação entre os índices de claridade horizontais e inclinados, para diferentes condições de cobertura de céu. O banco de dados de radiação global utilizado corresponde ao período de 1998 a 2007, com intervalos de 4/1998 a 8/2001 para a inclinação de 22,85º, de 9/2001 a 2/2003 para 12,85º e de 1/2004 a 12/2007 para 32,85º. O desempenho dos modelos foi avaliado pelos indicadores estatísticos erro absoluto médio, raiz quadrada do quadrado médio do erro e índice "d" de Wilmott. Os modelos de Liu & Jordan, Koronakis e de Revfeim apresentaram os melhores desempenhos em dias nublados, em todas as inclinações. As coberturas de céu parcialmente difuso e parcialmente aberto, nos maiores ângulos de inclinação, apresentaram as maiores dispersões entre valores estimados e medidos, independentemente do modelo. As equações estatísticas apresentaram bons resultados em aplicações com agrupamentos de dados mensais.The objective of this work was to evaluate the performance of isotropic models estimative of the global radiation on tilted surfaces and to propose estimations based on correlation between the clearness index for horizontal and tilted surfaces, for different sky conditions, in Botucatu, SP, Brazil. The isotropic model proposed by Liu & Jordan, Revfeim, Jimenez & Castro, Koronakis, the Circunsolar theory and the correlation between the clearness index for horizontal and tilted surfaces, for different sky conditions

  19. Cognitive impairment, clinical severity and MRI changes in MELAS syndrome.

    Science.gov (United States)

    Kraya, Torsten; Neumann, Lena; Paelecke-Habermann, Yvonne; Deschauer, Marcus; Stoevesandt, Dietrich; Zierz, Stephan; Watzke, Stefan

    2017-12-29

    To examine clinical severity, cognitive impairment, and MRI changes in patients with MELAS syndrome. Cognitive-mnestic functions, brain MRI (lesion load, cella media index) and clinical severity of ten patients with MELAS syndrome were examined. All patients carried the m.3243A>G mutation. The detailed neuropsychological assessment revealed cognitive deficits in attention, executive function, visuoperception, and -construction. There were significant correlations between these cognitive changes, lesion load in MRI, disturbances in everyday life (clinical scale), and high scores in NMDAS. Patients with MELAS syndrome showed no global neuropsychological deficit, but rather distinct cognitive deficits. Copyright © 2018 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  20. GLOBAL OR NATIONAL BRANDS?

    Directory of Open Access Journals (Sweden)

    Sorina GÎRBOVEANU

    2007-01-01

    Full Text Available Today, branding is such a strong force that hardly anything goes unbranded. Branding in global markets poses several challenges to the marketers. A key decision is the choice between global and nationals brands. This article gives the answers to the questions: what is, what is need for, what are the advantages, costs and risks of global and national brands? All go to the following conclusion: use global brands where possible and national brands where necessary.

  1. Conformity index: A review

    International Nuclear Information System (INIS)

    Feuvret, Loic; Noel, Georges; Mazeron, Jean-Jacques; Bey, Pierre

    2006-01-01

    We present a critical analysis of the conformity indices described in the literature and an evaluation of their field of application. Three-dimensional conformal radiotherapy, with or without intensity modulation, is based on medical imaging techniques, three-dimensional dosimetry software, compression accessories, and verification procedures. It consists of delineating target volumes and critical healthy tissues to select the best combination of beams. This approach allows better adaptation of the isodose to the tumor volume, while limiting irradiation of healthy tissues. Tools must be developed to evaluate the quality of proposed treatment plans. Dosimetry software provides the dose distribution in each CT section and dose-volume histograms without really indicating the degree of conformity. The conformity index is a complementary tool that attributes a score to a treatment plan or that can compare several treatment plans for the same patient. The future of conformal index in everyday practice therefore remains unclear

  2. A new relative hazard index

    International Nuclear Information System (INIS)

    Smith, C.F.; Burnett, T.W.T; Kastenberg, W.E.

    1976-01-01

    Several indexes for the evaluation of relative radionuclide hazards have been previously developed. In this paper, a new relative hazard index is derived for use in the assessment of the future burden to mankind from the presence of radionuclides in the environment. Important features of this hazard index are that it takes into account multiple decay schemes, non-equilibrium conditions, and finite time periods. As an application of this hazard index, a comparison is made between thermal reactor radioactive waste and the uranium required as fuel with the following conclusions: (1) For short time intervals (d 234 U breaking the uranium decay chain. (3) For long time intervals of concern (d >= 500 000 years), the reactor waste and consumed uranium indexes are equal after a much shorter decay time (approximately 10 years.) (author)

  3. Relatively lower body mass index is associated with an excess of severe truncal asymmetry in healthy adolescents: Do white adipose tissue, leptin, hypothalamus and sympathetic nervous system influence truncal growth asymmetry?

    Directory of Open Access Journals (Sweden)

    Triantafyllopoulos Georgios

    2009-06-01

    Full Text Available Abstract Background In healthy adolescents normal back shape asymmetry, here termed truncal asymmetry (TA, is evaluated by higher and lower subsets of BMI. The study was initiated after research on girls with adolescent idiopathic scoliosis (AIS showed that higher and lower BMI subsets discriminated patterns of skeletal maturation and asymmetry unexplained by existing theories of pathogenesis leading to a new interpretation which has therapeutic implications (double neuro-osseous theory. Methods 5953 adolescents age 11–17 years (boys 2939, girls 3014 were examined in a school screening program in two standard positions, standing forward bending (FB and sitting FB. The sitting FB position is thought to reveal intrinsic TA free from back humps induced by any leg-length inequality. TA was measured in both positions using a Pruijs scoliometer as angle of trunk inclinations (ATIs across the back at each of three spinal regions, thoracic, thoracolumbar and lumbar. Abnormality of ATIs was defined as being outside 2 standard deviations for each age group, gender, position and spinal region, and termed severe TA. Results In the sitting FB position after correcting for age,relatively lower BMIs are statistically associated with a greater number of severe TAs than with relatively higher BMIs in both girls (thoracolumbar region and boys (thoracolumbar and lumbar regions. The relative frequency of severe TAs is significantly higher in girls than boys for each of the right thoracic (56.76% and thoracolumbar (58.82% regions (p = 0.006, 0.006, respectively. After correcting for age, smaller BMIs are associated with more severe TAs in boys and girls. Discussion BMI is a surrogate measure for body fat and circulating leptin levels. The finding that girls with relatively lower BMI have significantly later menarche, and a significant excess of TAs, suggests a relation to energy homeostasis through the hypothalamus. The hypothesis we suggest for the pathogenesis

  4. Deterministic indexing for packed strings

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye

    2017-01-01

    Given a string S of length n, the classic string indexing problem is to preprocess S into a compact data structure that supports efficient subsequent pattern queries. In the deterministic variant the goal is to solve the string indexing problem without any randomization (at preprocessing time...... or query time). In the packed variant the strings are stored with several character in a single word, giving us the opportunity to read multiple characters simultaneously. Our main result is a new string index in the deterministic and packed setting. Given a packed string S of length n over an alphabet σ...

  5. Severe form of hemolytic-uremic syndrome with multiple organ failure in a child: a case report [v1; ref status: indexed, http://f1000r.es/24q

    Directory of Open Access Journals (Sweden)

    Dino Mijatovic

    2014-03-01

    Full Text Available Introduction: Hemolytic-uremic syndrome (HUS is a leading cause of acute renal failure in infants and young children. It is traditionally defined as a triad of acute renal failure, hemolytic anemia and thrombocytopenia that occur within a week after prodromal hemorrhagic enterocolitis. Severe cases can also be presented by acute respiratory distress syndrome (ARDS, toxic megacolon with ileus, pancreatitis, central nervous system (CNS disorders and multiple organ failure (MOF. Case presentation: A previously healthy 4-year old Caucasian girl developed acute renal failure, thrombocytopenia and hemolytic anemia following a short episode of abdominal pain and bloody diarrhea. In the next week of, what initially appeared as typical HUS, she developed MOF, including ileus, pancreatitis, hepatitis, coma and ARDS, accompanied by hemodynamic instability and extreme leukocytosis. Nonetheless, the girl made a complete recovery after one month of the disease. She was successfully treated in the intensive care unit and significant improvement was noticed after plasmapheresis and continuous veno-venous hemodialysis. Conclusions: Early start of plasmapheresis and meticulous supportive treatment in the intensive care unit, including renal placement therapy, may be the therapy of choice in severe cases of HUS presented by MOF. Monitoring of prognostic factors is important for early performance of appropriate diagnostic and therapeutical interventions.

  6. Corporate Sustainability Indexes: FTSE 4 Good Index Report on Nestle

    Directory of Open Access Journals (Sweden)

    Gülay Keskin

    2018-04-01

    Full Text Available Corporate sustainability and economic business activities are focused on the social and environmental impacts. In this sense, the economic activity created by the businesses is to pursue social and environmental impacts, and producing information related to these effects is essential for the formation of structure for a sustainable business. Sustainability indices are structures edited on first generation sustainability indicators, which are structures constructed in order to share information with consumers and businesses. The most important benefits are improvements in transparency without the need for regulation of the sustainability index, better understanding of the social and environmental impact of companies and the guidance for arrangements to minimize the negative side effects of company activities. FTSE4Good is a responsible investment index designed to help investors identify companies that meet globally recognised corporate responsibility standards. It is the only index of its kind since it includes specific criteria on the responsible marketing of breast milk substitutes.

  7. New approaches for calculating Moran's index of spatial autocorrelation.

    Science.gov (United States)

    Chen, Yanguang

    2013-01-01

    Spatial autocorrelation plays an important role in geographical analysis; however, there is still room for improvement of this method. The formula for Moran's index is complicated, and several basic problems remain to be solved. Therefore, I will reconstruct its mathematical framework using mathematical derivation based on linear algebra and present four simple approaches to calculating Moran's index. Moran's scatterplot will be ameliorated, and new test methods will be proposed. The relationship between the global Moran's index and Geary's coefficient will be discussed from two different vantage points: spatial population and spatial sample. The sphere of applications for both Moran's index and Geary's coefficient will be clarified and defined. One of theoretical findings is that Moran's index is a characteristic parameter of spatial weight matrices, so the selection of weight functions is very significant for autocorrelation analysis of geographical systems. A case study of 29 Chinese cities in 2000 will be employed to validate the innovatory models and methods. This work is a methodological study, which will simplify the process of autocorrelation analysis. The results of this study will lay the foundation for the scaling analysis of spatial autocorrelation.

  8. New approaches for calculating Moran's index of spatial autocorrelation.

    Directory of Open Access Journals (Sweden)

    Yanguang Chen

    Full Text Available Spatial autocorrelation plays an important role in geographical analysis; however, there is still room for improvement of this method. The formula for Moran's index is complicated, and several basic problems remain to be solved. Therefore, I will reconstruct its mathematical framework using mathematical derivation based on linear algebra and present four simple approaches to calculating Moran's index. Moran's scatterplot will be ameliorated, and new test methods will be proposed. The relationship between the global Moran's index and Geary's coefficient will be discussed from two different vantage points: spatial population and spatial sample. The sphere of applications for both Moran's index and Geary's coefficient will be clarified and defined. One of theoretical findings is that Moran's index is a characteristic parameter of spatial weight matrices, so the selection of weight functions is very significant for autocorrelation analysis of geographical systems. A case study of 29 Chinese cities in 2000 will be employed to validate the innovatory models and methods. This work is a methodological study, which will simplify the process of autocorrelation analysis. The results of this study will lay the foundation for the scaling analysis of spatial autocorrelation.

  9. Análise custo-efetividade e índice de qualidade da refeição aplicados à Estratégia Global da OMS Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy

    Directory of Open Access Journals (Sweden)

    Flávia Mori Sarti Machado

    2008-02-01

    menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost. Health benefits were estimated based on adaptation of the Diet Quality Index (DQI. Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. RESULTS: The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58 as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72 compared to the others (DQI2=48 / DQI4=58. CONCLUSIONS: The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

  10. The index of a holomorphic flow with an isolated singularity

    International Nuclear Information System (INIS)

    Verjovsky, A.; Gomez-Mont, X.; Seade, J.

    1987-05-01

    The index of a holomorphic vector field Z defined on a germ of a hypersurface V with an isolated singularity is defined. The index coincides with the Hopf index in the smooth case. Formulae for the index in terms of the ideals defining Z and V are given. Topological invariance of the index and the Chern class as well as formulae relating global invariants of the Poincare-Hopf type are proven. (author). 26 refs

  11. Globalization and Gender Equality in Developing Countries

    OpenAIRE

    Niklas Potrafke; Heinrich Ursprung

    2011-01-01

    This study empirically assesses the influence of globalization on the institutional root causes of gender equality as measured by the new OECD Social Institutions and Gender Index (SIGI). We capture the multifaceted concept of globalization with the KOF index and its three sub-indices which measure the economic, social and political dimensions of globalization. Observing the progress of globalization for a sample of almost one hundred countries at ten year intervals starting in 1970, we find ...

  12. THE NONLINEAR IMPACT OF GLOBALIZATION ON CORRUPTION

    OpenAIRE

    Jayoti Das; Cassandra DiRienzo

    2009-01-01

    Some researchers have argued that globalization has increased the opportunity for corrupt practices, while others state that globalization has lead to a decrease in corruption as countries wishing to join the global economy must comply with international anti-corruption rules and regulations. This study empirically explores this paradox using the Corruption Perceptions Index (CPI) and the Konjunkturforschungsstelle (KOF) globalization Index. The results suggest that a nonlinear relationship e...

  13. Prediction of massive bleeding. Shock index and modified shock index.

    Science.gov (United States)

    Terceros-Almanza, L J; García-Fuentes, C; Bermejo-Aznárez, S; Prieto-Del Portillo, I J; Mudarra-Reche, C; Sáez-de la Fuente, I; Chico-Fernández, M

    2017-12-01

    To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Retrospective cohort. Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. Depth-dependent mortality of reef corals following a severe bleaching event: implications for thermal refuges and population recovery [v3; ref status: indexed, http://f1000r.es/2zg

    Directory of Open Access Journals (Sweden)

    Tom C. L. Bridge

    2014-02-01

    Full Text Available Coral bleaching caused by rising sea temperature is a primary cause of coral reef degradation. However, bleaching patterns often show significant spatial variability, therefore identifying locations where local conditions may provide thermal refuges is a high conservation priority. Coral bleaching mortality often diminishes with increasing depth, but clear depth zonation of coral communities and putative limited overlap in species composition between deep and shallow reef habitats has led to the conclusion that deeper reef habitats will provide limited refuge from bleaching for most species. Here, we show that coral mortality following a severe bleaching event diminished sharply with depth. Bleaching-induced mortality of Acropora was approximately 90% at 0-2m, 60% at 3-4 m, yet at 6-8m there was negligible mortality. Importantly, at least two-thirds of the shallow-water (2-3 m Acropora assemblage had a depth range that straddled the transition from high to low mortality. Cold-water upwelling may have contributed to the lower mortality observed in all but the shallowest depths. Our results demonstrate that, in this instance, depth provided a refuge for individuals from a high proportion of species in this Acropora-dominated assemblage. The persistence of deeper populations may provide a critical source of propagules to assist recovery of adjacent shallow-water reefs.

  15. Depth-dependent mortality of reef corals following a severe bleaching event: implications for thermal refuges and population recovery [v2; ref status: indexed, http://f1000r.es/26m

    Directory of Open Access Journals (Sweden)

    Tom C. L. Bridge

    2013-10-01

    Full Text Available Coral bleaching caused by rising sea temperature is a primary cause of coral reef degradation. However, bleaching patterns often show significant spatial variability, therefore identifying locations where local conditions may provide thermal refuges is a high conservation priority. Coral bleaching mortality often diminishes with increasing depth, but clear depth zonation of coral communities and putative limited overlap in species composition between deep and shallow reef habitats has led to the conclusion that deeper reef habitats will provide limited refuge from bleaching for most species. Here, we show that coral mortality following a severe bleaching event diminished sharply with depth. Bleaching-induced mortality of Acropora was approximately 90% at 0-2m, 60% at 3-4 m, yet at 6-8m there was negligible mortality. Importantly, at least two-thirds of the shallow-water (2-3 m Acropora assemblage had a depth range that straddled the transition from high to low mortality. Cold-water upwelling may have contributed to the lower mortality observed in all but the shallowest depths. Our results demonstrate that, in this instance, depth provided a refuge for individuals from a high proportion of species in this Acropora-dominated assemblage. The persistence of deeper populations may provide a critical source of propagules to assist recovery of adjacent shallow-water reefs.

  16. EJSCREEN Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are:...

  17. EJSCREEN Indexes 2016 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are:...

  18. [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].

    Science.gov (United States)

    Mastro-Martínez, Ignacio; Montes-Arjona, Ana María; Escudero-Lirio, Margarita; Hernández-García, Bárbara; Fernández-Cantalejo Padial, José

    2015-01-01

    Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v2; ref status: indexed, http://f1000r.es/30q

    Directory of Open Access Journals (Sweden)

    Ida E. H. Madsen

    2014-02-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  20. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v1; ref status: indexed, http://f1000r.es/1yz

    Directory of Open Access Journals (Sweden)

    IPD-Work Consortium

    2013-11-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  1. Integration of an Informatics System in a High Throughput Experimentation. Description of a Global Framework Illustrated Through Several Examples Intégration informatique des outils d’expérimentation haut débit. Présentation d’une architecture globale via plusieurs exemples

    Directory of Open Access Journals (Sweden)

    Celse B.

    2013-07-01

    Full Text Available High Throughput Experimentation (HTE is a rapidly expanding field. However, the productivity gains obtained via the synthesis or parallel testing of catalysts may be lost due to poor data management (numerous manual inputs, information difficult to access, etc.. A global framework has then been developed. It includes the HTE pilot plants in the global information system. It produces dedicated computer tools offering spectacular time savings in the operation of HTE units, information storage and rapid extraction of relevant information. To optimize the productivity of engineers, Excel has been included in the system by adding specific features in order to treat it as an industrial tool (development of additional modules, update of modules, etc.. The success obtained by setting up the information system is largely due to the chosen development method. An Agile method (Agile Alliance (2012 http://www.agilealliance.org/the-alliancel[1] was chosen since close collaboration between the computer specialists and the chemist engineers is essential. Rather than a global and precise description of the framework which might be boring and tedious, the global framework is presented through 3 examples: scheduling experiments applied to zeolite synthesis; data management (storage and access; real application to pilot plant: dedicated interfaces to pilot and supervise HTE pilot plants, comparison of tests runs coming from several pilot plants. L’Expérimentation Haut Débit (EHD est un domaine en plein essor. Cependant, les gains de productivité obtenus via la synthèse ou le test parallélisé de catalyseurs peuvent être annihilés par une mauvaise gestion de données (nombreuses saisies manuelles, difficulté d’accès à l’information, etc.. Dans ce document, une nouvelle architecture permettant d’intégrer les unités EHD dans un système d’information global est présentée. Des outils informatiques dédiés ont été développés. Ils permettent

  2. 3D Model Retrieval Based on Vector Quantisation Index Histograms

    International Nuclear Information System (INIS)

    Lu, Z M; Luo, H; Pan, J S

    2006-01-01

    This paper proposes a novel technique to retrieval 3D mesh models using vector quantisation index histograms. Firstly, points are sampled uniformly on mesh surface. Secondly, to a point five features representing global and local properties are extracted. Thus feature vectors of points are obtained. Third, we select several models from each class, and employ their feature vectors as a training set. After training using LBG algorithm, a public codebook is constructed. Next, codeword index histograms of the query model and those in database are computed. The last step is to compute the distance between histograms of the query and those of the models in database. Experimental results show the effectiveness of our method

  3. Turning the Big Mac Index into the Medical MAC Index | Wilson ...

    African Journals Online (AJOL)

    Objective: The purpose of this study was to create a global medical earnings index, called the Medical MAC Index, to enable a comparison of what medical specialists earn in the countries included in the study. Design: The study gathered data on the earnings of specialist anaesthetists employed in state hospitals with five ...

  4. The development of a value based pricing index for new drugs in metastatic colorectal cancer

    OpenAIRE

    Lubbe, Martha Susanna; Dranitsaris, George; Truter, Ilse

    2011-01-01

    Background Worldwide, prices for cancer drugs have been under downward pressure where several governments have mandated price cuts of branded products. A better alternative to government mandated price cuts would be to estimate a final price based on drug performance, cost effectiveness and a country’s ability to pay. We developed a global pricing index for new cancer drugs in patients with metastatic colorectal cancer (mCRC) that encompasses all of these attributes. Methods ...

  5. Application of the Haines Index in the fire warning system

    Science.gov (United States)

    Kalin, Lovro; Marija, Mokoric; Tomislav, Kozaric

    2016-04-01

    Croatia, as all Mediterranean countries, is strongly affected by large wildfires, particularly in the coastal region. In the last two decades the number and intensity of fires has been significantly increased, which is unanimously associated with climate change, e.g. global warming. More extreme fires are observed, and the fire-fighting season has been expanded to June and September. The meteorological support for fire protection and planning is therefore even more important. At the Meteorological and Hydrological Service of Croatia a comprehensive monitoring and warning system has been established. It includes standard components, such as short term forecast of Fire Weather Index (FWI), but long range forecast as well. However, due to more frequent hot and dry seasons, FWI index often does not provide additional information of extremely high fire danger, since it regularly takes the highest values for long periods. Therefore the additional tools have been investigated. One of widely used meteorological products is the Haines index (HI). It provides information of potential fire growth, taking into account only the vertical instability of the atmosphere, and not the state of the fuel. Several analyses and studies carried out at the Service confirmed the correlation of high HI values with large and extreme fires. The Haines index forecast has been used at the Service for several years, employing European Centre for Medium Range Weather Forecast (ECMWF) global prediction model, as well as the limited-area Aladin model. The verification results show that these forecast are reliable, when compared to radiosonde measurements. All these results provided the introduction of the additional fire warnings, that are issued by the Service's Forecast Department.

  6. An Index of Loss Aversion

    NARCIS (Netherlands)

    Köbberling, V.; Wakker, P.P.

    2005-01-01

    To a considerable extent, risk aversion as it is commonly observed is caused by loss aversion. Several indexes of loss aversion have been proposed in the literature. The one proposed in this paper leads to a clear decomposition of risk attitude into three distinct components: basic utility,

  7. An Index of Loss Aversion

    NARCIS (Netherlands)

    V. Köbberling (Veronika); P.P. Wakker (Peter)

    2005-01-01

    textabstractTo a considerable extent, risk aversion as it is commonly observed is caused by loss aversion. Several indexes of loss aversion have been proposed in the literature. The one proposed in this paper leads to a clear decomposition of risk attitude into three distinct components: basic

  8. The Chiral Index of the Fermionic Signature Operator

    OpenAIRE

    Finster, Felix

    2014-01-01

    We define an index of the fermionic signature operator on even-dimensional globally hyperbolic spin manifolds of finite lifetime. The invariance of the index under homotopies is studied. The definition is generalized to causal fermion systems with a chiral grading. We give examples of space-times and Dirac operators thereon for which our index is non-trivial.

  9. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study.

    Science.gov (United States)

    Baker, Kelly K; O'Reilly, Ciara E; Levine, Myron M; Kotloff, Karen L; Nataro, James P; Ayers, Tracy L; Farag, Tamer H; Nasrin, Dilruba; Blackwelder, William C; Wu, Yukun; Alonso, Pedro L; Breiman, Robert F; Omore, Richard; Faruque, Abu S G; Das, Sumon Kumar; Ahmed, Shahnawaz; Saha, Debasish; Sow, Samba O; Sur, Dipika; Zaidi, Anita K M; Quadri, Fahreen; Mintz, Eric D

    2016-05-01

    Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age. The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1-2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India. This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings

  10. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study

    Science.gov (United States)

    O’Reilly, Ciara E.; Levine, Myron M.; Kotloff, Karen L.; Farag, Tamer H.; Nasrin, Dilruba; Alonso, Pedro L.; Breiman, Robert F.; Omore, Richard; Faruque, Abu S. G.; Das, Sumon Kumar; Ahmed, Shahnawaz; Saha, Debasish; Sow, Samba O.; Sur, Dipika; Zaidi, Anita K. M.; Quadri, Fahreen; Mintz, Eric D.

    2016-01-01

    Background Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age. Methods/Findings The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children sanitation facilities with 1–2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India. Conclusions This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of

  11. Global warning, global warming

    International Nuclear Information System (INIS)

    Benarde, M.A.

    1992-01-01

    This book provides insights into the formidable array of issues which, in a warmer world, could impinge upon every facet of readers lives. It examines climatic change and long-term implications of global warming for the ecosystem. Topics include the ozone layer and how it works; the greenhouse effect; the dangers of imbalance and its effects on human and animal life; disruptions to the basic ecology of the planet; and the real scientific evidence for and against aberrant climatic shifts. The author also examines workable social and political programs and changes that must be instituted to avoid ecological disaster

  12. Assessing pediatric ileocolonic Crohn's disease activity based on global MR enterography scores

    Energy Technology Data Exchange (ETDEWEB)

    Pomerri, Fabio; Zuliani, Monica; Giorgi, Benedetta; Muzzio, Pier Carlo [University of Padova, Department of Medicine-DIMED, Padova (Italy); Al Bunni, Faise [Rovigo Hospital, Radiology Unit, S. Maria della Misericordia, Rovigo (Italy); Guariso, Graziella; Gasparetto, Marco; Cananzi, Mara [University of Padova, Department of Women and Child Health, Padova (Italy)

    2017-03-15

    This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD). This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels. Based on PCDAI, comparison of both global MaRIA and MEGS was made between patients with mild and moderate/severe disease activity. Global MaRIA correlated with SES-CD (r = 0.70, p = 0.001) and PCDAI (r = 0.42, p = 0.016). MEGS correlated with PCDAI (r = 0.46, p = 0.007) and CRP levels (r = 0.35, p = 0.046). MEGS differed significantly (p = 0.027) between patients grouped by clinical disease severity. MRE-based global scores correlated with clinical indexes of CD activity. Therefore, they represent a potential useful tool to predict CD activity and severity, as well as a possible promising alternative to endoscopy, to monitor paediatric patients with CD during their follow-up. (orig.)

  13. Automated Water Extraction Index

    DEFF Research Database (Denmark)

    Feyisa, Gudina Legese; Meilby, Henrik; Fensholt, Rasmus

    2014-01-01

    Classifying surface cover types and analyzing changes are among the most common applications of remote sensing. One of the most basic classification tasks is to distinguish water bodies from dry land surfaces. Landsat imagery is among the most widely used sources of data in remote sensing of water...... resources; and although several techniques of surface water extraction using Landsat data are described in the literature, their application is constrained by low accuracy in various situations. Besides, with the use of techniques such as single band thresholding and two-band indices, identifying...... an appropriate threshold yielding the highest possible accuracy is a challenging and time consuming task, as threshold values vary with location and time of image acquisition. The purpose of this study was therefore to devise an index that consistently improves water extraction accuracy in the presence...

  14. Relations among several nuclear and electronic density functional reactivity indexes

    Science.gov (United States)

    Torrent-Sucarrat, Miquel; Luis, Josep M.; Duran, Miquel; Toro-Labbé, Alejandro; Solà, Miquel

    2003-11-01

    An expansion of the energy functional in terms of the total number of electrons and the normal coordinates within the canonical ensemble is presented. A comparison of this expansion with the expansion of the energy in terms of the total number of electrons and the external potential leads to new relations among common density functional reactivity descriptors. The formulas obtained provide explicit links between important quantities related to the chemical reactivity of a system. In particular, the relation between the nuclear and the electronic Fukui functions is recovered. The connection between the derivatives of the electronic energy and the nuclear repulsion energy with respect to the external potential offers a proof for the "Quantum Chemical le Chatelier Principle." Finally, the nuclear linear response function is defined and the relation of this function with the electronic linear response function is given.

  15. Assessment of Severity of Peritonitis Using Mannheim Peritonitis Index

    African Journals Online (AJOL)

    risk factors, by Wacha, 8 of these were of prognostic relevance and was currently ... The study was done in fifty patients with peritonitis who presented at Government ..... [German]. 5. Seiler CA, Brügger L, Forssmann U, Baer HU, Büchler MW.

  16. ENSO-Based Index Insurance: Approach and Peru Flood Risk Management Application

    Science.gov (United States)

    Khalil, A. F.; Kwon, H.; Lall, U.; Miranda, M. J.; Skees, J. R.

    2006-12-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable, and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations data are inadequate to develop an index due to short time-series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here, ENSO related climate indices are explored for use as a proxy to extreme rainfall in one of the departments of Peru -- Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions (MFIs) to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods, but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many micro-enterprises. The reliability and quality of the local rainfall data is variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (a) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall; (b) the potential for clustering of payoffs; (c) the potential that the index could be predicted with some lead time prior to the flood season; and (d) evidence for climate change or non-stationarity in the flood exceedance probability from the long ENSO record. Finally, prospects for

  17. Against Globalization

    DEFF Research Database (Denmark)

    Philipsen, Lotte; Baggesgaard, Mads Anders

    2013-01-01

    In order to understand globalization, we need to consider what globalization is not. That is, in order to understand the mechanisms and elements that work toward globalization, we must, in a sense, read against globalization, highlighting the limitations of the concept and its inherent conflicts....... Only by employing this as a critical practice will we be analytically able to gain a dynamic understanding of the forces of globalization as they unfold today and as they have developed historically....

  18. Hourly distributions of the diffuse fraction of global solar irradiation in Cordoba (Spain)

    Energy Technology Data Exchange (ETDEWEB)

    Posadillo, R.; Lopez Luque, R. [Grupo de Investigacion de Fisica para las Energias y Recursos Renovables, Dpto. de Fisica Aplicada/UCO, Edificio C2 Campus de Rabanales, 14071 Cordoba (Spain)

    2009-02-15

    Hourly global irradiations on tilted planes are required for dimensioning PV systems. However, for most sites, only global irradiations on a horizontal plane are available, and, given that to calculate the global irradiation on inclined planes the first step is to determine the diffuse component and this is not collected, we have studied the behaviour of the diffuse component on an hourly basis. Most parametrization models for the derivation of hourly diffuse irradiance from hourly global irradiance involve the clearness index, a parameter that implicitly includes solar altitude. The present paper has focused on the possibility of also including ''mean solar altitude anti {alpha}'' explicitly as a parameter in addition to the clearness index. Several analytical models are proposed, validated and compared here, using solar data collected on our station located in Cordoba (Spain). (author)

  19. Hourly distributions of the diffuse fraction of global solar irradiation in Cordoba (Spain)

    International Nuclear Information System (INIS)

    Posadillo, R.; Lopez Luque, R.

    2009-01-01

    Hourly global irradiations on tilted planes are required for dimensioning PV systems. However, for most sites, only global irradiations on a horizontal plane are available, and, given that to calculate the global irradiation on inclined planes the first step is to determine the diffuse component and this is not collected, we have studied the behaviour of the diffuse component on an hourly basis. Most parametrization models for the derivation of hourly diffuse irradiance from hourly global irradiance involve the clearness index, a parameter that implicitly includes solar altitude. The present paper has focused on the possibility of also including 'mean solar altitude α-bar' explicitly as a parameter in addition to the clearness index. Several analytical models are proposed, validated and compared here, using solar data collected on our station located in Cordoba (Spain)

  20. Global teaching of global seismology

    Science.gov (United States)

    Stein, S.; Wysession, M.

    2005-12-01

    Our recent textbook, Introduction to Seismology, Earthquakes, & Earth Structure (Blackwell, 2003) is used in many countries. Part of the reason for this may be our deliberate attempt to write the book for an international audience. This effort appears in several ways. We stress seismology's long tradition of global data interchange. Our brief discussions of the science's history illustrate the contributions of scientists around the world. Perhaps most importantly, our discussions of earthquakes, tectonics, and seismic hazards take a global view. Many examples are from North America, whereas others are from other areas. Our view is that non-North American students should be exposed to North American examples that are type examples, and that North American students should be similarly exposed to examples elsewhere. For example, we illustrate how the Euler vector geometry changes a plate boundary from spreading, to strike-slip, to convergence using both the Pacific-North America boundary from the Gulf of California to Alaska and the Eurasia-Africa boundary from the Azores to the Mediterranean. We illustrate diffuse plate boundary zones using western North America, the Andes, the Himalayas, the Mediterranean, and the East Africa Rift. The subduction zone discussions examine Japan, Tonga, and Chile. We discuss significant earthquakes both in the U.S. and elsewhere, and explore hazard mitigation issues in different contexts. Both comments from foreign colleagues and our experience lecturing overseas indicate that this approach works well. Beyond the specifics of our text, we believe that such a global approach is facilitated by the international traditions of the earth sciences and the world youth culture that gives students worldwide common culture. For example, a video of the scene in New Madrid, Missouri that arose from a nonsensical earthquake prediction in 1990 elicits similar responses from American and European students.

  1. How indexes have changed

    International Nuclear Information System (INIS)

    Farrar, G.L.

    1993-01-01

    The accompanying table compares refinery construction and operating wages monthly for the years 1990 and 1991. The Nelson-Farrar refinery construction cost indexes are inflation indexes, while the operating indexes incorporate a productivity which shows improvement with experience and the increasing size of operations. The refinery construction wage indexes in the table show a steady advance over the 2-year period. Common labor indexes moved up faster than skilled indexes. Refinery operating wages showed a steady increase, while productivities averaged higher near the end of the period. Net result is that labor costs remained steady for the period

  2. Some connectivity indices and zagreb index of polyhex nanotubes.

    Science.gov (United States)

    Farahani, Mohammad Reza

    2012-12-01

    Several topological indices are investigated in polyhex nanotubes: Randić connectivity index, sum-connectivity index, atom-bond connectivity index, geometric-arithmetic index, First and Second Zagreb indices and Zagreb polynomials. Formulas for calculating the above topological descriptors in polyhex zigzag TUZC6[m,n] and armchair TUAC6[m,n] nanotube families are given.

  3. How Do We Capture "Global Specialization" When Measuring Firms' Degree of Internationalization?

    DEFF Research Database (Denmark)

    Geisler Asmussen, Christian; Pedersen, Torben; Petersen, Bent

    The IB literature informs us of several ways to measure firms' degree of internationalization. In this paper we make the argument that in fact none of the existing indices really measure firms' degree of "global specialization", that is, to what extent their allocation of resources is multidomestic...... or global. As argued, all the existing measures may gauge a purely multidomestic firm as having a high degree of internationalization, whereas a truly global firm may be ranked low. In order to remedy this we introduce a complementary index measuring how firms are configuring their value chains - whether...

  4. Western Alaska ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  5. Estudo da radiação solar global e do índice de transmissividade (kt, externo e interno, em uma floresta de mangue em Alagoas - Brasil Study of the global solar radiation and the internal and external transmissivity index in a mangrove forest in Alagoas - Brazil

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Santos Querino

    2011-06-01

    Full Text Available As florestas de manguezais são de extrema importância social, econômica e ambiental, pois as mesmas são detentoras de uma rica fauna e flora. O Brasil possui uma das maiores áreas de manguezais do mundo que se estende desde o extremo Norte até o Sul do país, e devido a isso, os efeitos da alteração de manguezal em área degradada influenciam diretamente no microclima da região. No aspecto meteorológico, é necessário que seja limitada a forma de exploração desse ecossistema, pois a conversão de florest