WorldWideScience

Sample records for risk index exceeds

  1. How to evaluate the risks of exceeding limits: geostatistical models and their application to air pollution

    International Nuclear Information System (INIS)

    Fouquet, Ch. de; Deraisme, J.; Bobbia, M.

    2007-01-01

    Geo-statistics is increasingly applied to the study of environmental risks in a variety of sectors, especially in the fields of soil decontamination and the evaluation of the risks due to air pollution. Geo-statistics offers a rigorous stochastic modeling approach that makes it possible to answer questions expressed in terms of uncertainty and risk. This article focusses on nonlinear geo-statistical methods, based on the Gaussian random function model, whose essential properties are summarised. We use two examples to characterize situations where direct and thus rapid methods provide appropriate solutions and cases that inevitably require more laborious simulation techniques. Exposure of the population of the Rouen metropolitan area to the risk of NO 2 pollution is assessed by simulations, but the surface area where the pollution exceeds the threshold limit can be easily estimated with nonlinear conditional expectation techniques. A second example is used to discuss the bias introduced by direct simulation, here of a percentile of daily SO 2 concentration for one year in the city of Le Havre; an operational solution is proposed. (authors)

  2. Climate risk index for Italy

    Science.gov (United States)

    Mysiak, Jaroslav; Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-06-01

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  3. Using Probability of Exceedance to Compare the Resource Risk of Renewable and Gas-Fired Generation

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-01

    Of the myriad risks surrounding long-term investments in power plants, resource risk is one of the most difficult to mitigate, and is also perhaps the risk that most-clearly distinguishes renewable generation from natural gas-fired generation. For renewable generators like wind and solar projects, resource risk manifests as a quantity risk—i.e., the risk that the quantity of wind and insolation will be less than expected.i For gas-fired generators (i.e., a combined-cycle gas turbine or “CCGT”), resource risk manifests primarily as a price risk—i.e., the risk that natural gas will cost more than expected. Most often, resource risk—and natural gas price risk in particular—falls disproportionately on utility ratepayers, who are typically not well-equipped to manage this risk. As such, it is incumbent upon utilities, regulators, and policymakers to ensure that resource risk is taken into consideration when making or approving resource decisions, or enacting policies that influence the development of the electricity sector more broadly.

  4. Modelling the risk of Pb and PAH intervention value exceedance in allotment soils by robust logistic regression

    International Nuclear Information System (INIS)

    Papritz, A.; Reichard, P.U.

    2009-01-01

    Soils of allotments are often contaminated by heavy metals and persistent organic pollutants. In particular, lead (Pb) and polycyclic aromatic hydrocarbons (PAHs) frequently exceed legal intervention values (IVs). Allotments are popular in European countries; cities may own and let several thousand allotment plots. Assessing soil contamination for all the plots would be very costly. Soil contamination in allotments is often linked to gardening practice and historic land use. Hence, we predict the risk of IV exceedance from attributes that characterize the history and management of allotment areas (age, nearby presence of pollutant sources, prior land use). Robust logistic regression analyses of data of Swiss allotments demonstrate that the risk of IV exceedance can be predicted quite precisely without costly soil analyses. Thus, the new method allows screening many allotments at small costs, and it helps to deploy the resources available for soil contamination surveying more efficiently. - The contamination of allotment soils, expressed as frequency of intervention value exceedance, depends on the age and further attributes of the allotments and can be predicted by logistic regression.

  5. A general index of inherent risk

    OpenAIRE

    Schnytzer, Adi; Westreich, Sara

    2009-01-01

    We extend the pioneering work of Aumann and Serrano by presenting an index of inherent riskiness of a gamble having the desirable properties of their index, while being applicable to gambles with either positive or negative expectations. As such, our index provides a measure of riskiness which is of use for both risk lovers and risk aversive gamblers, and is defined for all discrete and a large class of continuous gambles. We analyze abstract properties of our index, and present in addition t...

  6. Risk management of stock index futures

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Hong Kong Hang Seng index futures is taken as a study object and a method of empirical analysis is adopted in order to verify the validity of the application of the value-at-risk (VaR) method in the risk measurement of the stock index futures market. The results suggest that under normal market conditions it is feasible to apply the VaR method in the measurement of the market risks of stock index futures. The daily VaR value of the stock index futures provides a foreseeable profit and loss of the stock ...

  7. Human Health Risk from Metals in Fish from Saudi Arabia: Consumption Patterns for Some Species Exceed Allowable Limits

    KAUST Repository

    Burger, Joanna

    2014-10-06

    ABSTRACT: Fish are a healthful source of protein, but contaminants in some fish pose a risk. While there are multiple risk assessments from Europe and North America, there are far fewer for other parts of the world. We examined the risks from mercury, arsenic, lead, and other metals in fish consumed by people in Jeddah area, Saudi Arabia, using site-specific data on consumption patterns and metal levels in fish. The U.S. Environmental Protection Agency\\'s Hazard Quotient (HQ) and cumulative Hazard Index (HI) for non-cancer endpoints and Carcinogenic Index for cancer were used to determine the health risk based on fish consumption rates. Of the 13 fish species examined, HQ was greater than 1 (indicating elevated risk) in two species for arsenic, and seven species for methylmercury. The cumulative HI for all metals was above 1 for all but three species of fish at the mean consumption rates. Generally, fish species with HI above 1 for one sampling location, had HI above 1 for all sampling locations. The implications of these findings are discussed in the light of strategies for reducing risk from fish consumption while encouraging dietary intakes of fish with low mercury and arsenic levels.

  8. The Risk Premia Embedded in Index Options

    DEFF Research Database (Denmark)

    Andersen, Torben Gustav; Fusari, Nicola; Todorov, Viktor

    We study the dynamic relation between market risks and risk premia using time series of index option surfaces. We find that priced left tail risk cannot be spanned by market volatility (and its components) and introduce a new tail factor. This tail factor has no incremental predictive power...... for future volatility and jump risks, beyond current and past volatility, but it critical in predicting future market equity and variance risk premia. Our findings suggest a wide wedge between the dynamics of market risks and their compensation, with the latter typically displaying a far more persistent...

  9. The Risk Premia Embedded in Index Options

    DEFF Research Database (Denmark)

    Andersen, Torben Gustav; Fusari, Nicola; Todorov, Viktor

    We study the dynamic relation between market risks and risk premia using time series of index option surfaces. We find that priced left tail risk cannot be spanned by market volatility (and its components) and introduce a new tail factor. This tail factor has no incremental predictive power...... for future volatility and jump risks, beyond current and past volatility, but is critical in predicting future market equity and variance risk premia. Our findings suggest a wide wedge between the dynamics of market risks and their compensation, with the latter typically displaying a far more persistent...

  10. A novel structural risk index for primary spontaneous pneumothorax: Ankara Numune Risk Index.

    Science.gov (United States)

    Akkas, Yucel; Peri, Neslihan Gulay; Kocer, Bulent; Kaplan, Tevfik; Alhan, Aslihan

    2017-07-01

    In this study, we aimed to reveal a novel risk index as a structural risk marker for primary spontanoeus pneumothorax using body mass index and chest height, structural risk factors for pneumothorax development. Records of 86 cases admitted between February 2014 and January 2015 with or without primary spontaneous pneumothorax were analysed retrospectively. The patients were allocated to two groups as Group I and Group II. The patients were evaluated with regard to age, gender, pneumothorax side, duration of hospital stay, treatment type, recurrence, chest height and transverse diameter on posteroanterior chest graphy and body mass index. Body mass index ratio per cm of chest height was calculated by dividing body mass index with chest height. We named this risk index ratio which is defined first as 'Ankara Numune Risk Index'. Diagnostic value of Ankara Numune Risk Index value for prediction of primary spontaneous pneumothorax development was analysed with Receiver Operating Characteristics curver. Of 86 patients, 69 (80.2%) were male and 17 (19.8%) were female. Each group was composed of 43 (50%) patients. When Receiver Operating Characteristics curve analysis was done for optimal limit value 0.74 of Ankara Numune Risk Index determined for prediction of pneumothorax development risk, area under the curve was 0.925 (95% Cl, 0.872-0.977, p pneumothorax development however it is insufficient for determining recurrence. Copyright © 2015. Published by Elsevier Taiwan.

  11. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

  12. Human Health Risk from Metals in Fish from Saudi Arabia: Consumption Patterns for Some Species Exceed Allowable Limits

    KAUST Repository

    Burger, Joanna; Gochfeld, Michael; Mannalamkunnath Alikunhi, Nabeel; Al-Jahdali, Haitham; Al-Jebreen, Dalal Hamad; Al-Suwailem, Abdulaziz M.; Aziz, Mohammed A M; Batang, Zenon B.

    2014-01-01

    ABSTRACT: Fish are a healthful source of protein, but contaminants in some fish pose a risk. While there are multiple risk assessments from Europe and North America, there are far fewer for other parts of the world. We examined the risks from

  13. STORMTOOLS: Coastal Environmental Risk Index (CERI

    Directory of Open Access Journals (Sweden)

    Malcolm L. Spaulding

    2016-08-01

    Full Text Available One of the challenges facing coastal zone managers and municipal planners is the development of an objective, quantitative assessment of the risk to structures, infrastructure, and public safety that coastal communities face from storm surge in the presence of changing climatic conditions, particularly sea level rise and coastal erosion. Here we use state of the art modeling tool (ADCIRC and STWAVE to predict storm surge and wave, combined with shoreline change maps (erosion, and damage functions to construct a Coastal Environmental Risk Index (CERI. Access to the state emergency data base (E-911 provides information on structure characteristics and the ability to perform analyses for individual structures. CERI has been designed as an on line Geographic Information System (GIS based tool, and hence is fully compatible with current flooding maps, including those from FEMA. The basic framework and associated GIS methods can be readily applied to any coastal area. The approach can be used by local and state planners to objectively evaluate different policy options for effectiveness and cost/benefit. In this study, CERI is applied to RI two communities; Charlestown representing a typical coastal barrier system directly exposed to ocean waves and high erosion rates, with predominantly low density single family residences and Warwick located within Narragansett Bay, with more limited wave exposure, lower erosion rates, and higher residential housing density. Results of these applications are highlighted herein.

  14. Comparative Coastal Risk Index (CCRI: A multidisciplinary risk index for Latin America and the Caribbean.

    Directory of Open Access Journals (Sweden)

    Juliano Calil

    Full Text Available As the world's population grows to a projected 11.2 billion by 2100, the number of people living in low-lying areas exposed to coastal hazards is projected to increase. Critical infrastructure and valuable assets continue to be placed in vulnerable areas, and in recent years, millions of people have been displaced by natural hazards. Impacts from coastal hazards depend on the number of people, value of assets, and presence of critical resources in harm's way. Risks related to natural hazards are determined by a complex interaction between physical hazards, the vulnerability of a society or social-ecological system and its exposure to such hazards. Moreover, these risks are amplified by challenging socioeconomic dynamics, including poorly planned urban development, income inequality, and poverty. This study employs a combination of machine learning clustering techniques (Self Organizing Maps and K-Means and a spatial index, to assess coastal risks in Latin America and the Caribbean (LAC on a comparative scale. The proposed method meets multiple objectives, including the identification of hotspots and key drivers of coastal risk, and the ability to process large-volume multidimensional and multivariate datasets, effectively reducing sixteen variables related to coastal hazards, geographic exposure, and socioeconomic vulnerability, into a single index. Our results demonstrate that in LAC, more than 500,000 people live in areas where coastal hazards, exposure (of people, assets and ecosystems and poverty converge, creating the ideal conditions for a perfect storm. Hotspot locations of coastal risk, identified by the proposed Comparative Coastal Risk Index (CCRI, contain more than 300,00 people and include: El Oro, Ecuador; Sinaloa, Mexico; Usulutan, El Salvador; and Chiapas, Mexico. Our results provide important insights into potential adaptation alternatives that could reduce the impacts of future hazards. Effective adaptation options must not only

  15. Development and implementation of a business continuity management risk index.

    Science.gov (United States)

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  16. An Investigation into the Decision Makers's Risk Attitude Index ...

    African Journals Online (AJOL)

    An Investigation into the Decision Makers's Risk Attitude Index Ranking Technique for Fuzzy Critical Path Analysis. ... Nigerian Journal of Technology ... for a benchmark problem, the decision maker's risk attitude index ranking method produces unrealistic results when the decision maker's attitude towards risk was neutral.

  17. Earthquake Disaster Risk Index for Cities: Baku, Yerevan, Tbilisi

    International Nuclear Information System (INIS)

    Varazanashvili, O.; Mammadli, T.; Nazaretyan, S.

    2005-01-01

    For comparative analysis of seismic risk in the capitals of the South Caucasian States - Baku, Yerevan and Tbilisi - the methodology of determination of earthquake disaster risk index (EDRI) has been used. Earthquake disaster risk indexes have been determined for considered cities. EDRI-analysis is performed, some peculiarities of main risk factors are revealed and risk portraits are made in each city of the given sample. (author)

  18. Modelling of snow exceedances

    Science.gov (United States)

    Jordanova, Pavlina K.; Sadovský, Zoltán; Stehlík, Milan

    2017-07-01

    Modelling of snow exceedances is of great importance and interest for ecology, civil engineering and general public. We suggest the favorable fit for exceedances related to the exceptional snow loads from Slovakia, assuming that the data is driven by Generalised Pareto Distribution or Generalized Extreme Value Distribution. Further, the statistical dependence between the maximal snow loads and the corresponding altitudes is studied.

  19. Entomologic index for human risk of Lyme disease.

    Science.gov (United States)

    Mather, T N; Nicholson, M C; Donnelly, E F; Matyas, B T

    1996-12-01

    An entomologic index based on density estimates of Lyme disease spirochete-infected nymphal deer ticks (lxodes scapularis) was developed to assess human risk of Lyme disease. The authors used a standardized protocol to determine tick density and infection in numerous forested sites in six Rhode Island towns. An entomologic risk index calculated for each town was compared with the number of human Lyme disease cases reported to the Rhode Island State Health Department for the same year. A strong positive relation between entomologic risk index and the Lyme disease case rate for each town suggested that the entomologic index was predictive of Lyme disease risk.

  20. Healthy Eating Index-2010 and food groups consumed by US adults who meet or exceed fiber intake recommendations NHANES 2001–2010

    Directory of Open Access Journals (Sweden)

    Carla R. McGill

    2016-04-01

    Full Text Available Background: The proportion of the US adult population who meet fiber intake recommendations is very low. Information about food groups consumed and diet quality for the adults who consume recommended amounts of fiber are scarce. Objective: To examine food groups consumed and Healthy Eating Index (HEI-2010 scores for US adults meeting the fiber adequate intake (AI based on National Health and Nutrition Examination Survey (NHANES data 2001–2010. Design: A secondary analysis of NHANES data from 2001 to 2010. Participants included adults aged 19 and older (n=24,807 with complete day 1 dietary records. Variables measured were food group sources of fiber and HEI-2010 scores. Sample-weighted data were used to calculate least square means (LSM±standard error of the mean (SEM by fiber intake quartile along with HEI-2010 scores. Significance was set at P<0.05. Results: Major fiber food sources for US adults meeting the AI were grain products, vegetables, legumes, and fruits. The top grain products consumed were grain mixtures, ready-to-eat (RTE cereals, and breads/rolls. The mean HEI-2010 score for adults meeting the AI for fiber was significantly (P<0.001 higher compared with all adult participants. The mean HEI-2010 score increased with increasing fiber intake in both groups. Conclusions: Adults who meet the AI for fiber have a higher quality diet. Fiber may be an important dietary component that predicts diet quality.

  1. 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

  2. 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

  3. Childhood body mass index and multiple sclerosis risk

    DEFF Research Database (Denmark)

    Munger, Kassandra L; Bentzen, Joan; Laursen, Bjarne

    2013-01-01

    BACKGROUND: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. METHODS: Using a prospective design we examined whether body mass index (BMI) at ages 7-13 years...

  4. Genetically Predicted Body Mass Index and Breast Cancer Risk

    DEFF Research Database (Denmark)

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou

    2016-01-01

    BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or enviro...

  5. The influence of freezer storage of urine samples on the BONN-Risk-Index for calcium oxalate crystallization.

    Science.gov (United States)

    Laube, Norbert; Zimmermann, Diana J

    2004-01-01

    This study was performed to quantify the effect of a 1-week freezer storage of urine on its calcium oxalate crystallization risk. Calcium oxalate is the most common urinary stone material observed in urolithiasis patients in western and affluent countries. The BONN-Risk-Index of calcium oxalate crystallization risk in human urine is determined from a crystallization experiment performed on untreated native urine samples. We tested the influence of a 1-week freezing on the BONN-Risk-Index value as well as the effect of the sample freezing on the urinary osmolality. In vitro crystallization experiments in 49 native urine samples from stone-forming and non-stone forming individuals were performed in order to determine their calcium oxalate crystallization risk according to the BONN-Risk-Index approach. Comparison of the results derived from original sample investigations with those obtained from the thawed aliquots by statistical evaluation shows that i) no significant deviation from linearity between both results exists and ii) both results are identical by statistical means. This is valid for both, the BONN-Risk-Index and the osmolality data. The differences in the BONN-Risk-Index results of both procedures of BONN-Risk-Index determination, however, exceed the clinically acceptable difference. Thus, determination of the urinary calcium oxalate crystallization risk from thawed urine samples cannot be recommended.

  6. ATLAS: Exceeding all expectations

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    “One year ago it would have been impossible for us to guess that the machine and the experiments could achieve so much so quickly”, says Fabiola Gianotti, ATLAS spokesperson. The whole chain – from collision to data analysis – has worked remarkably well in ATLAS.   The first LHC proton run undoubtedly exceeded expectations for the ATLAS experiment. “ATLAS has worked very well since the beginning. Its overall data-taking efficiency is greater than 90%”, says Fabiola Gianotti. “The quality and maturity of the reconstruction and simulation software turned out to be better than we expected for this initial stage of the experiment. The Grid is a great success, and right from the beginning it has allowed members of the collaboration all over the world to participate in the data analysis in an effective and timely manner, and to deliver physics results very quickly”. In just a few months of data taking, ATLAS has observed t...

  7. Vector-borne disease risk indexes in spatially structured populations.

    Directory of Open Access Journals (Sweden)

    Jorge Velázquez-Castro

    2018-02-01

    Full Text Available There are economic and physical limitations when applying prevention and control strategies for urban vector borne diseases. Consequently, there are increasing concerns and interest in designing efficient strategies and regulations that health agencies can follow in order to reduce the imminent impact of viruses like Dengue, Zika and Chikungunya. That includes fumigation, abatization, reducing the hatcheries, picking up trash, information campaigns. A basic question that arise when designing control strategies is about which and where these ones should focus. In other words, one would like to know whether preventing the contagion or decrease vector population, and in which area of the city, is more efficient. In this work, we propose risk indexes based on the idea of secondary cases from patch to patch. Thus, they take into account human mobility and indicate which patch has more chance to be a corridor for the spread of the disease and which is more vulnerable, i.e. more likely to have cases?. They can also indicate the neighborhood where hatchery control will reduce more the number of potential cases. In order to illustrate the usefulness of these indexes, we run a set of numerical simulations in a mathematical model that takes into account the urban mobility and the differences in population density among the areas of a city. If we label by i a particular neighborhood, the transmission risk index (TRi measures the potential secondary cases caused by a host in that neighborhood. The vector transmission risk index (VTRi measures the potential secondary cases caused by a vector. Finally, the vulnerability risk index (VRi measures the potential secondary cases in the neighborhood. Transmission indexes can be used to give geographical priority to some neighborhoods when applying prevention and control measures. On the other hand, the vulnerability index can be useful to implement monitoring campaigns or public health investment.

  8. An index of harm for comparing occupational risks

    International Nuclear Information System (INIS)

    Schaaf, E.; Hennig, J.; Schnadt, H.; Becker, G.

    1986-03-01

    An index of harm is presented describing the health hazards of persons occupationally exposed to ionizing radiation, for comparison with occupational risks in conventional working areas. The criterion for evaluating injuries is the remaining lifetime affected by chronic damage. The affected years of life themselves are evaluated in a scheme considering the degree of reduced ability to work. The index of harm is based on an evaluation of a data pool collected by all F.R.G. associations for social insurance against occupational accidents, which recorded all data of first compensation for accidents. The index can be taken into consideration for assessment of risks emanating from ionizing radiation, and for evaluating the radiation protection currently provided by maximum permissible limits, etc. (DG) [de

  9. Comparison between frailty index of deficit accumulation and fracture risk assessment tool (FRAX) in prediction of risk of fractures.

    Science.gov (United States)

    Li, Guowei; Thabane, Lehana; Papaioannou, Alexandra; Adachi, Jonathan D

    2015-08-01

    A frailty index (FI) of deficit accumulation could quantify and predict the risk of fractures based on the degree of frailty in the elderly. We aimed to compare the predictive powers between the FI and the fracture risk assessment tool (FRAX) in predicting risk of major osteoporotic fracture (hip, upper arm or shoulder, spine, or wrist) and hip fracture, using the data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) 3-year Hamilton cohort. There were 3985 women included in the study, with the mean age of 69.4 years (standard deviation [SD] = 8.89). During the follow-up, there were 149 (3.98%) incident major osteoporotic fractures and 18 (0.48%) hip fractures reported. The FRAX and FI were significantly related to each other. Both FRAX and FI significantly predicted risk of major osteoporotic fracture, with a hazard ratio (HR) of 1.03 (95% confidence interval [CI]: 1.02-1.05) and 1.02 (95% CI: 1.01-1.04) for per-0.01 increment for the FRAX and FI respectively. The HRs were 1.37 (95% CI: 1.19-1.58) and 1.26 (95% CI: 1.12-1.42) for an increase of per-0.10 (approximately one SD) in the FRAX and FI respectively. Similar discriminative ability of the models was found: c-index = 0.62 for the FRAX and c-index = 0.61 for the FI. When cut-points were chosen to trichotomize participants into low-risk, medium-risk and high-risk groups, a significant increase in fracture risk was found in the high-risk group (HR = 2.04, 95% CI: 1.36-3.07) but not in the medium-risk group (HR = 1.23, 95% CI: 0.82-1.84) compared with the low-risk women for the FI, while for FRAX the medium-risk (HR = 2.00, 95% CI: 1.09-3.68) and high-risk groups (HR = 2.61, 95% CI: 1.48-4.58) predicted risk of major osteoporotic fracture significantly only when survival time exceeded 18months (550 days). Similar findings were observed for hip fracture and in sensitivity analyses. In conclusion, the FI is comparable with FRAX in the prediction of risk of future fractures, indicating that

  10. Increasing Risk Awareness: The Coastal Community Resilience Index

    Science.gov (United States)

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  11. Hedging with stock index futures: downside risk versus the variance

    NARCIS (Netherlands)

    Brouwer, F.; Nat, van der M.

    1995-01-01

    In this paper we investigate hedging a stock portfolio with stock index futures.Instead of defining the hedge ratio as the minimum variance hedge ratio, we considerseveral measures of downside risk: the semivariance according to Markowitz [ 19591 andthe various lower partial moments according to

  12. Flood Risk Index Assessment in Johor River Basin

    International Nuclear Information System (INIS)

    Ahmad Shakir Mohd Saudi; Hafizan Juahir; Azman Azid; Fazureen Azaman; Ahmad Shakir Mohd Saudi

    2015-01-01

    This study is focusing on constructing the flood risk index in the Johor river basin. The application of statistical methods such as factor analysis (FA), statistical process control (SPC) and artificial neural network (ANN) had revealed the most efficient flood risk index. The result in FA was water level has correlation coefficient of 0.738 and the most practicable variable to be used for the warning alert system. The upper control limits (UCL) for the water level in the river basin Johor is 4.423 m and the risk index for the water level has been set by this method consisting of 0-100.The accuracy of prediction has been evaluated by using ANN and the accuracy of the test result was R"2 = 0.96408 with RMSE= 2.5736. The future prediction for UCL in Johor river basin has been predicted and the value was 3.75 m. This model can shows the current and future prediction for flood risk index in the Johor river basin and can help local authorities for flood control and prevention of the state of Johor. (author)

  13. Environmental risk index: A tool to assess the safety of dams for leachate

    International Nuclear Information System (INIS)

    Colomer Mendoza, Francisco J.; Gallardo Izquierdo, Antonio

    2009-01-01

    Dams for leachate store very toxic substances that contain a large amount of organic material and, probably, heavy metals; they therefore constitute an important threat to the environment. Existing models of environmental risk assessment for landfills do not take into consideration the specific risk that leachate dams may represent for the environment. In this paper a methodology to improve the environmental safety is presented according to the parameters used in their construction and management. In order to do that, the following characteristics of the dam must be known: (1) geotechnical stability, (2) erosion of downstream slope, (3) type of sealing of the dam, (4) overtopping probability, (5) volume of leachate stored inside the dam and (6) pollution load of leachate. Once these parameters have been calculated, they are transformed by means of rating curves into homogeneous units, so as to make it possible to operate between them. From the study and analysis of these parameters an environmental risk index for a dam for leachate can be calculated. If the environmental risk index exceeds an established value then it involves a dam for leachate with high environmental risk, therefore preventive measures in its design, construction and management would be necessary

  14. University building safety index measurement using risk and implementation matrix

    Science.gov (United States)

    Rahman, A.; Arumsari, F.; Maryani, A.

    2018-04-01

    Many high rise building constructed in several universities in Indonesia. The high-rise building management must provide the safety planning and proper safety equipment in each part of the building. Unfortunately, most of the university in Indonesia have not been applying safety policy yet and less awareness on treating safety facilities. Several fire accidents in university showed that some significant risk should be managed by the building management. This research developed a framework for measuring the high rise building safety index in university The framework is not only assessed the risk magnitude but also designed modular building safety checklist for measuring the safety implementation level. The safety checklist has been developed for 8 types of the university rooms, i.e.: office, classroom, 4 type of laboratories, canteen, and library. University building safety index determined using risk-implementation matrix by measuring the risk magnitude and assessing the safety implementation level. Building Safety Index measurement has been applied in 4 high rise buildings in ITS Campus. The building assessment showed that the rectorate building in secure condition and chemical department building in beware condition. While the library and administration center building was in less secure condition.

  15. The effect of financial ratios on systematic risk index

    Directory of Open Access Journals (Sweden)

    Ali Faez

    2013-11-01

    Full Text Available This paper investigates the relationship between financial ratios and indicator of systemic risk in the Tehran Stock Exchange. The study selects 73 manufacturing companies of the Tehran Stock Exchange market over the period 2003-2010. The study first calculates the independent variables in the form of financial ratios and then the ratios affecting the systematic risk index are extracted using entropy method. The output of this stage is the introduction of five influential financial indicators as the independent variables of the study. Using t-test and Pearson correlation coefficient the rate of independent variables effect on the systematic risk index is evaluated and finally, using stepwise regression method, the effect of independent variables on the dependent variable is examined. According to results of our survey, the correlation coefficient of such indices as “the ratio of stock price to the profit of each share”, “Current ratio”, “each share profit ratio” and “the stockholders rights return ratio” have respectively the highest correlation with the systematic risk index.

  16. Radiation effects and risks: overview and a new risk perception index

    International Nuclear Information System (INIS)

    Rehani, M.M.

    2015-01-01

    Uncertainty provides opportunities for differences in perception, and radiation risks at low level of exposures involved in few computed tomography scans fall in this category. While there is good agreement among national and international organisations on risk probability of cancer, risk perception has barely been dealt with by these organisations. Risk perception is commonly defined as the subjective judgment that people make about the characteristics and severity of a risk. Severity and latency are important factors in perception. There is a need to connect all these. Leaving risk perception purely as a subjective judgement provides opportunities for people to amplifying risk. The author postulates a risk perception index as severity divided by latency that becomes determining factor for risk perception. It is hoped that this index will bring rationality in risk perception. (authors)

  17. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  18. El Niño-Southern Oscillation-based index insurance for floods: Statistical risk analyses and application to Peru

    Science.gov (United States)

    Khalil, Abedalrazq F.; Kwon, Hyun-Han; Lall, Upmanu; Miranda, Mario J.; Skees, Jerry

    2007-10-01

    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 because of 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 El Niño-Southern Oscillation (ENSO) related climate indices are explored for use as a proxy to extreme rainfall in one of the districts of Peru, Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions 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 microenterprises. The reliability and quality of the local rainfall data are 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 (1) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall, (2) the effect of sampling uncertainties and the strength of the proxy's association to local outcome, (3) the potential for clustering of payoffs, (4) the potential that the index could be predicted with some lead time prior to the flood season, and (5) evidence

  19. Value at Risk on Composite Price Share Index Stock Data

    Science.gov (United States)

    Oktaviarina, A.

    2018-01-01

    The financial servicest authority was declared Let’s Save Campaign on n commemoration of the World Savings Day that falls on this day, October 31, 2016. The activity was greeted enthusiastically by Indonesia Stock Exchange by taking out the slogan Let’s Save The Stocks. Stock is a form of investment that is expected to benefit in the future despite has risks. Value at Risk (VaR) is a method that can measure how much the risk of a financial investment. Composite Stock Price Indeks is the stock price index used by Indonesia Stock Exchange as stock volatility benchmarks in Indonesia. This study aimed to estimate Value at Risk (VaR) on closing price Composite Price Share Index Stock data on the period 20 September 2016 until 20 September 2017. Box-Pierce test results p value=0.9528 which is greater than a, that shows homoskedasticity. Value at Risk (VaR) with Variance Covariance Method is Rp.3.054.916,07 which means with 99% confindence interval someone who invests Rp.100.000.000,00 will get Rp.3.054.916,07 as a maximum loss.

  20. Development of environmental risk assessment framework using index method

    International Nuclear Information System (INIS)

    Ali, M.W.; Wu, Y.

    2000-01-01

    This paper presents a newly developed framework for assessing the risk from events which are considered to be major accidents to the environment according to the classifications by the United Kingdom Department of Environment (DoE). The application of an environmental risk assessment framework using the newly developed index method is demonstrated by means of a case study. The framework makes use of Environmental Hazard Index (EHI) method by the United Kingdom AEA Technology for releases to river, but improves it by taking account to toxic dose rather than concentration; taking account of long-term effects including persistence and bio accumulation, not just short term effects; extending the method to all aspects of environment, not just rivers; and allowing account to be taken of design changes to mitigate the risk. The development of the framework has also led to a revision of the tolerability criteria to be used with the framework proposed earlier by weakness and recommend further work to improve this newly proposed environmental risk assessment framework. From the study, it is recommended that the environmental risk assessment framework be applied to a wide range of other case studies in order to further improve it. The framework should be modified to maintain consistency when the DoE revises its definitions of major accidents to the environment. Ease-of-use of the framework (and any other environmental framework) would be aided by the compilation of databases for environmental toxicity, river data and available consequence models. Further work could also be done to suggest methods of mitigating the risk and including them as numerical factors within method. (author)

  1. Creating a Flood Risk Index to Improve Community Resilience

    Science.gov (United States)

    Klima, K.; El Gammal, L.

    2017-12-01

    While flood risk reduction is an existent discourse and agenda in policy and insurance, vulnerabilities vary between communities; some communities may have aging infrastructure, or an older/poorer population less able to absorb a flood, putting them at increased risk from the hazards. As a result, some are considering environmental justice aspects of flood risk reduction. To date, catastrophe models have focused on creating floodmaps (e.g., NOAA's Sea Level Rise Viewer, Climate Central's Surging Seas), or on linking hydrological models to economic loss models (e.g., HEC-RAS + HAZUS). However, this approach may be highly inequitable between areas of different income (as well as other demographics). Some have begun work on combining hydrology with vulnerability information (e.g., USACE's North Atlantic Comprehensive Coastal Study). To our knowledge, no one has tried to adapt the more advanced known heat risk theory to water risk by combining hydrology information (e.g., HEC-RAS, floodplain maps) with the social vulnerability (e.g., Cutter et al.) of the residents. This project will create a method to combine water hazard data with a derived water vulnerability index to help a community understand their current and future water risk. We will use the case study area of Pittsburgh, PA, which faces severe precipitation and riverine flooding hazards. Building on present literature of factors influencing water vulnerability contextualized to the Pittsburgh region, we will identify, quantify, and map the top factors impacting water vulnerability. We will combine these with flood maps to identify the geospatial distribution of water risk. This work will allow policy makers to identify location-specific aspects of water vulnerability and risk in any community, thus promoting environmental justice. It is possible that this type of original research would create maps of relative water risk that may prove as understandable to the general public as other flood maps, and may also

  2. Development of a preliminary risk index to identify trauma patients at risk for an unplanned intubation.

    Science.gov (United States)

    Kim, Dennis; Kobayashi, Leslie; Chang, David; Fortlage, Dale; Coimbra, Raul

    2014-01-01

    The development of respiratory failure requiring an emergent unplanned intubation (UI) is a potentially preventable complication associated with increased morbidity and mortality. The objective of this study was to develop a clinical risk index for UI based on readily available clinical data to assist in the identification of trauma patients at risk for this complication. We also sought to determine the impact of UI on patient outcomes. This is a 3-year retrospective analysis of our Level 1 trauma center registry to identify all patients requiring a UI. Patients who required a UI were compared with patients who were never intubated. An additive risk index consisting of 10 clinical variables was created using the final significant variables from a stepwise logistic regression model. The sensitivity and specificity of every possible index score were calculated and added together to calculate the "gain in certainty" values. During the 3-year period, 7,552 patients were admitted, of whom 967 (12.8%) required intubation. Of these, 55 (5.7%) underwent a UI. The final risk index consisted of 10 variables as follows: age 55 years to 64 years, age 65 years or older, male sex, Glasgow Coma Scale (GCS) score of 9 to 13, seizures, chronic obstructive pulmonary disease, traumatic brain injury, four or more rib fractures, spine fractures, and long-bone fractures. Gain in certainty was maximized at an index score of 4, with the highest combined sensitivity and specificity of 86.0% and 74.9%, respectively. The probability of UI increased from 0.9% at a score of 1 to 2.9% at 4 and 43% at 9. UI was associated with increased overall complications, length of stay, and mortality (p the development of an additive risk index. Prospective validation of the risk index is potentially warranted. Diagnostic study, level III.

  3. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  4. Body mass index and lung cancer risk in never smokers

    International Nuclear Information System (INIS)

    Kagohashi, K.; Satoh, H.; Kurishima, K.; Ishikawa, H.; Ohtsuka, M.

    2006-01-01

    Background. A relationship between body mass index (BMI) and lung cancer risk in never smokers has not been reported precisely. To evaluate the risk of lung cancer associated with BMI in never smokers, we conducted a case-control study. Methods. The relationship between BMI and the risk of lung cancer in never smokers was investigated in a study of 204 lung cancer cases and 398 controls admitted between 1987 and 2005. Controls were selected from hospitalized age-matched never-smoking patients with non-malignant respiratory disease. Results. When compared with BMI of the leanest group (BMI<20.8) in men, no inverse association between BMI and lung cancer was observed after the adjustment for age (the second BMI group: BMI≥ 20.8 to < 22.9; p=0.683, the third BMI group: BMI≥ 22.9 to < 24.9; p=0.745, and the highest BMI group: BMI≥ 25.0; p=0.327). Similarly, no association in women was found between BMI and lung cancer in these three BMI groups (the second group, p=0.639; the third group, p=0.667; the highest group, p=0.978) when compared with that of the leanest BMI group. Conclusions. Our present study indicated that the association between leanness and the risk of lung cancer might be influenced by other factors such as smoking. (author)

  5. Body mass index and risk of autoimmune diseases

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Basit, Saima; Andersson, Mikael

    2014-01-01

    .57) and type 1 diabetes mellitus (HR 2.67; 95% CI, 1.71 to 4.17). Risk of dermatitis herpetiformis increased by 14% (95% CI, 1% to 30%) per BMI unit. Conversely, risk of celiac disease and Raynaud's phenomenon decreased by 7% (95% CI, 1% to 13%) and 12% (95% CI, 4% to 19%) per BMI unit, respectively. Further......BACKGROUND: A possible aetiological link between obesity and certain autoimmune diseases (ADs) has been suggested. We investigated the associations between body mass index (BMI, kg/m2) and 43 ADs. METHODS: 75,008 women participating in the Danish National Birth Cohort were followed during a median......-up, 2430 women (3.2%) developed a total of 2607 new-onset ADs. Risk of any autoimmune disease was increased in obese women (HR, 1.27; 95% CI, 1.11 to 1.46) compared with normal weight women (18.5-≤25 kg/m2). Obese women (BMI≥30 kg/m2) were at increased risk of sarcoidosis (HR 3.59; 95% CI, 2.31 to 5...

  6. Risk assessment of coumarin using the bench mark dose (BMD) approach: children in Norway which regularly eat oatmeal porridge with cinnamon may exceed the TDI for coumarin with several folds.

    Science.gov (United States)

    Fotland, T Ø; Paulsen, J E; Sanner, T; Alexander, J; Husøy, T

    2012-03-01

    Coumarin is a naturally occurring flavouring substance in cinnamon and many other plants. It is known that coumarin can cause liver toxicity in several species, and it is considered a non-genotoxic carcinogen in rodents. By using the bench mark dose approach we re-assessed coumarin toxicity and established a new TDI for coumarin of 0.07 mg/kg bw/day. Oral intake of coumarin is related to consumption of cinnamon-containing foods and food supplements. Cinnamon is a widely used spice in Norway, and can be used as topping on oatmeal porridge. Based on analyses of coumarin in Norwegian foods, intake calculations for children and adults were conducted, and a risk assessment of coumarin in the Norwegian population was performed. Intake estimates of coumarin show that small children eating oatmeal porridge several times a week sprinkled with cinnamon could have a coumarin intake of 1.63 mg/kg bw/day and may exceeding the TDI with several folds. Adults drinking cinnamon-based tea and consuming cinnamon supplements also can exceed TDI. The coumarin intake could exceed the TDI by 7- to 20-fold in some intake scenarios. Such large daily exceedances of TDI, even for a limited time period of 1-2 weeks, cause concern of adverse health effects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Aumann and Serrano’s economic index of risk for sums of gambles

    Directory of Open Access Journals (Sweden)

    Minqiang Li

    2014-12-01

    Full Text Available We study Aumann and Serrano’s (2008 risk index for sums of gambles that are not dependent. If the dependent parts are similarly ordered, then the risk index of the sum is always larger than the minimum of the risk indices of the two gambles. For negative dependence, the risk index of the sum is always smaller than the maximum. The above results agree with our intuitions of risk diversification well. These result points out another attractive property of Aumann and Serrano’s risk index. These properties are potentially useful for risk assessment purposes of financial securities.

  8. Body mass index and the risk of Parkinson disease.

    Science.gov (United States)

    Hu, G; Jousilahti, P; Nissinen, A; Antikainen, R; Kivipelto, M; Tuomilehto, J

    2006-12-12

    To examine the association between body mass index (BMI) and the risk of Parkinson disease (PD). Study cohorts included 22,367 Finnish men and 23,439 women 25 to 59 years of age without a history of PD at baseline. Hazards ratios (HRs) of incident PD were estimated for different levels of BMI. During a mean follow-up period of 18.8 years, 272 men and 254 women developed incident PD. After adjustment for confounding factors (age, study years, systolic blood pressure, total cholesterol, education, leisure-time physical activity, smoking, and alcohol, coffee, and tea consumption), the HRs of PD at different levels of BMI ( or =30 kg/m(2)) were 1.00, 1.97 (95% CI: 1.21 to 3.22), 1.83 (95% CI: 1.12 to 2.99), 2.34 (95% CI: 1.45 to 3.78), and 2.44 (95% CI: 1.44 to 4.15) in men, and 1.00, 1.50 (95% CI: 0.95 to 2.37), 1.65 (95% CI: 1.05 to 2.59), 1.79 (95% CI: 1.15 to 2.80), and 1.77 (95% CI: 1.12 to 2.78) in women, and 1.00, 1.70 (95% CI: 1.23 to 2.37), 1.70 (95% CI: 1.23 to 2.37), 2.02 (95% CI: 1.46 to 2.79), and 2.03 (95% CI: 1.44 to 2.85) in men and women combined (adjusted also for sex). In both sexes combined, the multivariate-adjusted direct association between BMI and the risk of PD was present both in subjects aged 25 to 49 years and 50 to 59 years, in never smokers and smokers and in participants diagnosed PD before and after 65 years of age. Body mass index is associated with a risk of Parkinson disease. The effect is graded and independent of other risk factors.

  9. Estimating risks for water-quality exceedances of total-copper from highway and urban runoff under predevelopment and current conditions with the Stochastic Empirical Loading and Dilution Model (SELDM)

    Science.gov (United States)

    Granato, Gregory E.; Jones, Susan C.; Dunn, Christopher N.; Van Weele, Brian

    2017-01-01

    The stochastic empirical loading and dilution model (SELDM) was used to demonstrate methods for estimating risks for water-quality exceedances of event-mean concentrations (EMCs) of total-copper. Monte Carlo methods were used to simulate stormflow, total-hardness, suspended-sediment, and total-copper EMCs as stochastic variables. These simulations were done for the Charles River Basin upstream of Interstate 495 in Bellingham, Massachusetts. The hydrology and water quality of this site were simulated with SELDM by using data from nearby, hydrologically similar sites. Three simulations were done to assess the potential effects of the highway on receiving-water quality with and without highway-runoff treatment by a structural best-management practice (BMP). In the low-development scenario, total copper in the receiving stream was simulated by using a sediment transport curve, sediment chemistry, and sediment-water partition coefficients. In this scenario, neither the highway runoff nor the BMP effluent caused concentration exceedances in the receiving stream that exceed the once in three-year threshold (about 0.54 percent). In the second scenario, without the highway, runoff from the large urban areas in the basin caused exceedances in the receiving stream in 2.24 percent of runoff events. In the third scenario, which included the effects of the urban runoff, neither the highway runoff nor the BMP effluent increased the percentage of exceedances in the receiving stream. Comparison of the simulated geometric mean EMCs with data collected at a downstream monitoring site indicates that these simulated values are within the 95-percent confidence interval of the geometric mean of the measured EMCs.

  10. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  11. An Integrated Risk Index Model Based on Hierarchical Fuzzy Logic for Underground Risk Assessment

    Directory of Open Access Journals (Sweden)

    Muhammad Fayaz

    2017-10-01

    Full Text Available Available space in congested cities is getting scarce due to growing urbanization in the recent past. The utilization of underground space is considered as a solution to the limited space in smart cities. The numbers of underground facilities are growing day by day in the developing world. Typical underground facilities include the transit subway, parking lots, electric lines, water supply and sewer lines. The likelihood of the occurrence of accidents due to underground facilities is a random phenomenon. To avoid any accidental loss, a risk assessment method is required to conduct the continuous risk assessment and report any abnormality before it happens. In this paper, we have proposed a hierarchical fuzzy inference based model for under-ground risk assessment. The proposed hierarchical fuzzy inference architecture reduces the total number of rules from the rule base. Rule reduction is important because the curse of dimensionality damages the transparency and interpretation as it is very tough to understand and justify hundreds or thousands of fuzzy rules. The computation time also increases as rules increase. The proposed model takes 175 rules having eight input parameters to compute the risk index, and the conventional fuzzy logic requires 390,625 rules, having the same number of input parameters to compute risk index. Hence, the proposed model significantly reduces the curse of dimensionality. Rule design for fuzzy logic is also a tedious task. In this paper, we have also introduced new rule schemes, namely maximum rule-based and average rule-based; both schemes can be used interchangeably according to the logic needed for rule design. The experimental results show that the proposed method is a virtuous choice for risk index calculation where the numbers of variables are greater.

  12. A multi-attribute Systemic Risk Index for comparing and prioritizing chemical industrial areas

    International Nuclear Information System (INIS)

    Reniers, G.L.L.; Sörensen, K.; Dullaert, W.

    2012-01-01

    Measures taken to decrease interdependent risks within chemical industrial areas should be based on quantitative data from a holistic (cluster-based) point of view. Therefore, this paper examines the typology of networks representing industrial areas to formulate recommendations to more effectively protect a chemical cluster against existing systemic risks. Chemical industrial areas are modeled as two distinct complex networks and are prioritized by computing two sub-indices with respect to existing systemic safety and security risks (using Domino Danger Units) and supply chain risks (using units from an ordinal expert scale). Subsequently, a Systemic Risk Index for the industrial area is determined employing the Borda algorithm, whereby the systemic risk index considers both a safety and security network risk index and a supply chain network risk index. The developed method allows decreasing systemic risks within chemical industrial areas from a holistic (inter-organizational and/or inter-cluster) perspective. An illustrative example is given.

  13. Risk Profile Analysis on BIST30 Exchange Index

    OpenAIRE

    Ural, Mert; Demireli, Erhan

    2018-01-01

    Inthis study, a portfolio was created by using the stocks listed in BIST30 indexand the portfolio risk was measured by using Capital Asset Pricing Model. Afterthat risk decomposition was made by purifying the risk of the stocks from totalmarket risk and by this way the systematic and non-systematic risk amounts havebeen determined for both the portfolio and each stock.

  14. [Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents].

    Science.gov (United States)

    de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Souza Oliveira, Renata Maria; Mendes, Larissa Loures; Netto, Michele Pereira; Cândido, Ana Paula Carlos

    2016-01-01

    To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Cross-sectional study with 403 adolescents aged 10-14 years, from public and private schools. Anthropometric, clinical, biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Regarding the nutritional status; 66.5% of the adolescents had normal weight; 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents that had high serum triglycerides, body mass index and waist circumference. Adolescents that had anthropometric, clinical and biochemical characteristics considered to be of risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. The Skew Risk Premium in the Equity Index Market

    OpenAIRE

    Roman Kozhan; Anthony Neuberger; Paul Schneider

    2013-01-01

    We develop a new method for measuring moment risk premiums. We find that the skew premium accounts for over 40% of the slope in the implied volatility curve in the S&P 500 market. Skew risk is tightly related to variance risk, in the sense that strategies designed to capture the one and hedge out exposure to the other earn an insignificant risk premium. This provides a new testable restriction for asset pricing models trying to capture, in particular, disaster risk premiums. We base our resul...

  16. Modeling of Ship Collision Risk Index Based on Complex Plane and Its Realization

    OpenAIRE

    Xiaoqin Xu; Xiaoqiao Geng; Yuanqiao Wen

    2016-01-01

    Ship collision risk index is the basic and important concept in the domain of ship collision avoidance. In this paper, the advantages and deficiencies of the various calculation methods of ship collision risk index are pointed out. Then the ship collision risk model based on complex plane, which can well make up for the deficiencies of the widely-used evaluation model proposed by Kearon.J and Liu ruru is proposed. On this basis, the calculation method of collision risk index under the encount...

  17. Evaluation of a risk index for advanced proximal neoplasia of the colon.

    Science.gov (United States)

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-01-01

    A clinical risk index that uses distal colorectal findings at flexible sigmoidoscopy (FS) in conjunction with easily determined risk factors for advanced proximal neoplasia (APN) may be useful for tailoring or prioritizing screening with colonoscopy. To conduct an external evaluation of a previously published risk index in a large, well-characterized cohort. Cross-sectional. Teaching hospital and colorectal cancer screening center. A total of 5139 asymptomatic persons aged 50 to 74 (54.9% women) with a mean age (±SD) of 58.3 (±6.2) years. Between 2003 and 2011, all participants underwent a complete screening colonoscopy and removal of all polyps. Participants were classified as low, intermediate, or high risk for APN, based on their composite risk index scores. The concordance or c-statistic was used to measure discriminating ability of the risk index. A total of 167 persons (3.2%) had APN. The prevalence of those with APN among low-, intermediate-, and high-risk categories was 2.1%, 2.9%, and 6.5%, respectively. High-risk individuals were 3.2 times more likely to have APN compared with those in the low-risk category. The index did not discriminate well between those in the low- and intermediate-risk categories. The c-statistic for the overall index was 0.62 (95% confidence interval, 0.58-0.66). Distal colorectal findings were derived from colonoscopies and not FS itself. The risk index discriminated between those at low risk and those at high risk, but it had limited ability to discriminate between low- and intermediate-risk categories for prevalent APN. Information on other risk factors may be needed to tailor, or prioritize, access to screening colonoscopy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  18. Performance of a risk index for advanced proximal colorectal neoplasia among a racially/ethnically diverse patient population (risk index for advanced proximal neoplasia).

    Science.gov (United States)

    Levitzky, Benjamin E; Brown, Colin C; Heeren, Timothy C; Schroy, Paul C

    2011-06-01

    Tailoring the use of screening colonoscopy based on the risk of advanced proximal neoplasia (APN) has been advocated as a strategy for reducing demand and optimizing effectiveness. A 7-point index based on age, sex, and distal findings at sigmoidoscopy has been proposed that stratifies individuals into low, intermediate, and high-risk categories. The aim of this cross-sectional analysis was to determine the validity of this index, which was originally derived and validated among mostly whites, for black and Hispanic patients. Data, including age, sex, colonoscopic findings, and pathology, were collected retrospectively from 1,481 white, 1,329 black, and 689 Hispanic asymptomatic, average-risk patients undergoing screening colonoscopy between 2000 and 2005. Cumulative scores ranging from 0 to 7 were derived for each subject and categorized as low, intermediate, or high risk. Rates of APN were assessed for each risk category after stratification by race/ethnicity. Index performance was assessed using the C-statistic and compared across the three racial groups. Rates of APN among patients categorized as low, intermediate, or high risk increased from 1.0 to 2.8 to 3.7% for whites, 1.0 to 2.2 to 4.2% for blacks, and 0.6 to 1.9 to 3.7% for Hispanics. The index performed similarly for all three groups, but showed limited ability to discriminate low from intermediate-risk patients, with C-statistic values of 0.62 for whites, 0.63 for blacks, and 0.68 for Hispanics. A risk index based on age, sex, and distal endoscopic findings has limited ability to discriminate low from intermediate-risk white, black, and Hispanic patients for APN.

  19. Development of a brief parent-report risk index for children following parental divorce.

    Science.gov (United States)

    Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

    2013-12-01

    This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

  20. Sensitivity analysis of the Ohio phosphorus risk index

    Science.gov (United States)

    The Phosphorus (P) Index is a widely used tool for assessing the vulnerability of agricultural fields to P loss; yet, few of the P Indices developed in the U.S. have been evaluated for their accuracy. Sensitivity analysis is one approach that can be used prior to calibration and field-scale testing ...

  1. Applying weather index insurance to agricultural pest and disease risks

    NARCIS (Netherlands)

    Norton, Michael; Sprundel, van Gert Jan; Turvey, Calum G.; Meuwissen, Miranda P.M.

    2016-01-01

    In this paper, we explore the application of weather index insurance to plant pest and disease management strategies using two distinct models: (1) insuring crop loss due to disease incidence (“Crop Insurance”) and (2) insuring the use of pesticides (“Pesticide Insurance”). We find that despite

  2. Building a Natural Disaster Risk Index for Supply Chain Operations

    OpenAIRE

    Kun Liao; Ozden Bayazit; Fang Wang

    2014-01-01

    Risk for an organization is associated with uncertainties in all areas of its operations. As firms move toward global sourcing, supply chain risk increases dramatically, which is linked to lower financial performance and market value. One major type of supply chain risk is disruptions caused by natural or man-made disasters. In this paper, major factors causing supply chain disruptions are identified based on resource dependency theory and contingency theory. As a result of the study, a compr...

  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. Idiosyncratic risk in the Dow Jones Eurostoxx50 Index

    Science.gov (United States)

    Daly, Kevin; Vo, Vinh

    2008-07-01

    Recent evidence by Campbell et al. [J.Y. Campbell, M. Lettau B.G. Malkiel, Y. Xu, Have individual stocks become more volatile? An empirical exploration of idiosyncratic risk, The Journal of Finance (February) (2001)] shows an increase in firm-level volatility and a decline of the correlation among stock returns in the US. In relation to the Euro-Area stock markets, we find that both aggregate firm-level volatility and average stock market correlation have trended upwards. We estimate a linear model of the market risk-return relationship nested in an EGARCH(1, 1)-M model for conditional second moments. We then show that traditional estimates of the conditional risk-return relationship, that use ex-post excess-returns as the conditioning information set, lead to joint tests of the theoretical model (usually the ICAPM) and of the Efficient Market Hypothesis in its strong form. To overcome this problem we propose alternative measures of expected market risk based on implied volatility extracted from traded option prices and we discuss the conditions under which implied volatility depends solely on expected risk. We then regress market excess-returns on lagged market implied variance computed from implied market volatility to estimate the relationship between expected market excess-returns and expected market risk.We investigate whether, as predicted by the ICAPM, the expected market risk is the main factor in explaining the market risk premium and the latter is independent of aggregate idiosyncratic risk.

  5. A Land-Use Perspective for Birdstrike Risk Assessment: The Attraction Risk Index.

    Directory of Open Access Journals (Sweden)

    Francesca Coccon

    Full Text Available Collisions between aircraft and birds, birdstrikes, pose a serious threat to aviation safety. The occurrence of these events is influenced by land-uses in the surroundings of airports. Airports located in the same region might have different trends for birdstrike risk, due to differences in the surrounding habitats. Here we developed a quantitative tool that assesses the risk of birdstrike based on the habitats within a 13-km buffer from the airport. For this purpose, we developed Generalized Linear Models (GLMs with binomial distribution to estimate the contribution of habitats to wildlife use of the study area, depending on season. These GLMs predictions were combined to the flight altitude of birds within the 13-km buffer, the airport traffic pattern and the severity indices associated with impacts. Our approach was developed at Venice Marco Polo International airport (VCE, located in northeast Italy and then tested at Treviso Antonio Canova International airport (TSF, which is 20 km inland. Results from the two airports revealed that both the surrounding habitats and the season had a significant influence to the pattern of risk. With regard to VCE, agricultural fields, wetlands and urban areas contributed most to the presence of birds in the study area. Furthermore, the key role of distance of land-uses from the airport on the probability of presence of birds was highlighted. The reliability of developed risk index was demonstrated since at VCE it was significantly correlated with bird strike rate. This study emphasizes the importance of the territory near airports and the wildlife use of its habitats, as factors in need of consideration for birdstrike risk assessment procedures. Information on the contribution of habitats in attracting birds, depending on season, can be used by airport managers and local authorities to plan specific interventions in the study area in order to lower the risk.

  6. Risk management in crop production based on the regional index

    Directory of Open Access Journals (Sweden)

    Kokot Željko

    2017-01-01

    Full Text Available Regional index insurance is one of the newer instruments for reducing losses in crop production. The regional index indicates the average yield or average production value in a region, representing the basis for the premium calculation and insurance benefits. The main advantage of this insurance model is that it does not require the damage assessment, which is one of major problems in the relationship between the insured and insurer. In the case of corn, wheat and sunflower production as the most important crops in the region of Ada municipality, the authors describe the methodology of application of the analysed insurance system. Implementation of this contemporary form of insurance in Serbia would reduce the negative financial consequences in agricultural production. The abovementioned model of insurance can be seen as a significant alternative to conventional insurance, which can increase insured area and number of insured, and trust and confidence in insurance companies would also be restored.

  7. Modeling of Ship Collision Risk Index Based on Complex Plane and Its Realization

    Directory of Open Access Journals (Sweden)

    Xiaoqin Xu

    2016-07-01

    Full Text Available Ship collision risk index is the basic and important concept in the domain of ship collision avoidance. In this paper, the advantages and deficiencies of the various calculation methods of ship collision risk index are pointed out. Then the ship collision risk model based on complex plane, which can well make up for the deficiencies of the widely-used evaluation model proposed by Kearon.J and Liu ruru is proposed. On this basis, the calculation method of collision risk index under the encountering situation of multi-ships is constructed, then the three-dimensional image and spatial curve of the risk index are figured out. Finally, single chip microcomputer is used to realize the model. And attaching this single chip microcomputer to ARPA is helpful to the decision-making of the marine navigators.

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

    Science.gov (United States)

    Bonnafous, Luc; Lall, Upmanu; Siegel, Jason

    2017-04-01

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

  9. Improving index mutual fund risk perception : Increase financial literacy or communicate better?

    NARCIS (Netherlands)

    de Goeij, Peter; Van Campenhout, Geert; Subotic, Marjana

    2017-01-01

    We investigate the effect of financial literacy and index mutual fund risk disclosure format on investors’ risk perception by examining the risk disclosure part in the Key Investor Information Document (KIID) for UCITS funds in Europe. Using an experimental survey administered to 244 university

  10. Visceral adiposity index as an indicator of cardiometabolic risk in patients treated for craniopharyngioma.

    Science.gov (United States)

    Ferraù, Francesco; Spagnolo, Federica; Cotta, Oana Ruxandra; Cannavò, Laura; Alibrandi, Angela; Russo, Giuseppina Tiziana; Aversa, Tommaso; Trimarchi, Francesco; Cannavò, Salvatore

    2017-11-01

    Craniopharyngioma is associated with metabolic alterations leading to increased cardiovascular mortality. Recently, the visceral adiposity index has been proposed as a marker of visceral adipose tissue dysfunction and of the related cardiometabolic risk. The role of the visceral adiposity index has never been explored in craniopharyngioma patients. We assessed the cardiometabolic risk on the basis of the visceral adiposity index in craniopharyngioma patients. We evaluated data of 24 patients treated for craniopharyngioma in a single-centre. We investigated the relationship among patients' clinical and biochemical features, cardiovascular risk -assessed by the Framingham and the atherosclerotic cardiovascular disease risk scores-, visceral adiposity index and adipose tissue dysfunction severity. Increased visceral adiposity index was found in 8 patients (33%). Adipose tissue dysfunction resulted to be severe, moderate or mild in 5, 2 and 1 cases. Increased visceral adiposity index significantly correlated with the occurrence of metabolic syndrome (p 0.027), IRI (p 0.001), triglycerides (p < 0.001), HOMA-IR (p < 0.001) and with lower ISI-Matsuda (p 0.005) and HDL-cholesterol (p < 0.001). Higher degree of adipose tissue dysfunction associated with increased insulin resistance. No gender difference was found for visceral adiposity index, adipose tissue dysfunction severity, and cardiovascular risk scores. Patients with adulthood onset craniopharyngioma showed higher Framingham risk score (p 0.004), atherosclerotic cardiovascular disease 10-year (p < 0.001) and lifetime (p 0.018) risk scores than those with childhood onset disease. Visceral adiposity index is increased in one third of our patients with craniopharyngioma, even if metabolic syndrome does not occur. Increased visceral adiposity index and adipose tissue dysfunction severity correlate with insulin sensitivity parameters, do not correlate with Framingham or atherosclerotic cardiovascular

  11. Body mass index influences prostate cancer risk at biopsy in Japanese men.

    Science.gov (United States)

    Masuda, Hitoshi; Kagawa, Makoto; Kawakami, Satoru; Numao, Noboru; Matsuoka, Yoh; Yokoyama, Minato; Yamamoto, Shinya; Yonese, Junji; Fukui, Iwao; Kihara, Kazunori

    2013-07-01

    To determine the relationship between body mass index and prostate cancer risk at biopsy in Japanese men, and to compared the risk with that of Caucasian men. We retrospectively evaluated 3966 men with prostate-specific antigen levels from 2.5 to 19.9 ng/mL who underwent an initial extended prostate biopsy. Using logistic regression, odds ratios of each body mass index category for risk of prostate cancer and high-grade disease (Gleason score ≥4 + 3) were estimated after controlling for age, prostate-specific antigen, %free prostate-specific antigen, prostate volume, digital rectal examination findings, family history of prostate cancer and the number of biopsy cores. Patients were divided into six categories according to their body mass index (kg/m(2) ) as follows: body mass index and prostate cancer risk at biopsy, with an increased risk observed in men whose body mass index was ≥27.0 compared with the reference group. A significantly increased risk starting at body mass index ≥25.0 was found in high-grade disease. In contrast to our results, there has been no reported increase in the risk of prostate cancer at biopsy in Caucasians within the overweight range (body mass index of 25.0-29.9 based on World Health Organization classification). Japanese men within the overweight body mass index range who have an elevated prostate-specific antigen level also have a significant risk of harboring prostate cancer, especially high-grade disease. Overweight Japanese might be at greater prostate cancer risk at biopsy than overweight Caucasians. © 2012 The Japanese Urological Association.

  12. Draught risk index tool for building energy simulations

    DEFF Research Database (Denmark)

    Vorre, Mette Havgaard; Jensen, Rasmus Lund; Nielsen, Peter V.

    2014-01-01

    Flow elements combined with a building energy simulation tool can be used to indicate areas and periods when there is a risk of draught in a room. The study tests this concept by making a tool for post-processing of data from building energy simulations. The objective is to show indications...... of draught risk during a whole year, giving building designers a tool for the design stage of a building. The tool uses simple one-at-a-time calculations of flow elements and assesses the uncertainty of the result by counting the number of overlapping flow elements. The calculation time is low, making...... it usable in the early design stage to optimise the building layout. The tool provides an overview of the general draught pattern over a period, e.g. a whole year, and of how often there is a draught risk....

  13. Identification of cardiometabolic risk: visceral adiposity index versus triglyceride/HDL cholesterol ratio.

    Science.gov (United States)

    Salazar, Martin R; Carbajal, Horacio A; Espeche, Walter G; Aizpurúa, Marcelo; Maciel, Pablo M; Reaven, Gerald M

    2014-02-01

    The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. The current analysis was initiated to see if the visceral adiposity index would improve the ability of the TG/HDL-C to identify increased cardiometabolic risk and outcome. Cardiometabolic data were obtained in 2003 from 926 apparently healthy individuals, 796 of whom were evaluated in 2012 for evidence of incident cardiovascular disease. The relationship between TG/HDL-C and values for visceral adiposity index was evaluated by Pearson's correlation coefficient. The relative risks for first cardiovascular event between individuals above and below the TG/HDL-C sex-specific cut points, and in the top quartile of visceral adiposity index versus the remaining 3 quartiles, were estimated using Cox proportional hazard models. TG/HDL-C concentration and visceral adiposity index were highly correlated (r = 0.99) in both men and women. Although more men (133 vs121) and women (73 vs 59) were identified as being at "high risk" by an elevated TG/HDL-C ratio, the individual cardiometabolic risk factors were essentially identical with either index used. However, the hazard ratio of developing cardiovascular disease was significantly increased in individuals with an elevated TG/HDL-C, whereas it was not the case when the visceral adiposity index was used to define "high risk." The visceral adiposity index does not identify individuals with an adverse cardiometabolic profile any better than the TG/HDL-C. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Waist-to-height ratio as index of cardiometabolic risk among the doctors

    Directory of Open Access Journals (Sweden)

    Miliva Mozaffor

    2017-12-01

    Full Text Available The aim of this study was to see the cardiometabolic risk among doctors using waist-to-height ratio index as tool. Cardiometabolic risk is an umbrella term that includes all the risk factors of diabetes and cardiovascular disease. The study was conducted among 195 doctors. According to waist-to-height ratio index 167 (85.6% doctors had cardiometabolic risk. Waist-to-height ratio index was found good (area under the curve >0.5, sensitivity 88.1%, specificity 23.2%, positive predictive value 53.9%, and negative predictive value 66.7% for their predictive value of cardiometabolic risk. Age grouping was done and found that no age group was free from cardiometabolic risk.

  15. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh.

    Science.gov (United States)

    Borse, N N; Hyder, A A; Bishai, D; Baker, T; Arifeen, S E

    2011-11-01

    Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Using the Steel Vessel Material-Cost Index to Mitigate Shipbuilder Risk

    National Research Council Canada - National Science Library

    Keating, Edward G; Murphy, Robert; Schank, John F; Birkler, John

    2008-01-01

    This paper describes how the US Navy structures fixed-price and fixed-price, incentive-fee shipbuilding contracts and how labor- and material-cost indexes can mitigate shipbuilder risk in either type of contract...

  17. Body adiposity index versus body mass index and other anthropometric traits as correlates of cardiometabolic risk factors.

    Directory of Open Access Journals (Sweden)

    Charlene T Lichtash

    Full Text Available The worldwide prevalence of obesity mandates a widely accessible tool to categorize adiposity that can best predict associated health risks. The body adiposity index (BAI was designed as a single equation to predict body adiposity in pooled analysis of both genders. We compared body adiposity index (BAI, body mass index (BMI, and other anthropometric measures, including percent body fat (PBF, in their correlations with cardiometabolic risk factors. We also compared BAI with BMI to determine which index is a better predictor of PBF.The cohort consisted of 698 Mexican Americans. We calculated correlations of BAI, BMI, and other anthropometric measurements (PBF measured by dual energy X-ray absorptiometry, waist and hip circumference, height, weight with glucose homeostasis indices (including insulin sensitivity and insulin clearance from euglycemic clamp, lipid parameters, cardiovascular traits (including carotid intima-media thickness, and biomarkers (C-reactive protein, plasminogen activator inhibitor-1 and adiponectin. Correlations between each anthropometric measure and cardiometabolic trait were compared in both sex-pooled and sex-stratified groups.BMI was associated with all but two measured traits (carotid intima-media thickness and fasting glucose in men, while BAI lacked association with several variables. BAI did not outperform BMI in its associations with any cardiometabolic trait. BAI was correlated more strongly than BMI with PBF in sex-pooled analyses (r = 0.78 versus r = 0.51, but not in sex-stratified analyses (men, r = 0.63 versus r = 0.79; women, r = 0.69 versus r = 0.77. Additionally, PBF showed fewer correlations with cardiometabolic risk factors than BMI. Weight was more strongly correlated than hip with many of the cardiometabolic risk factors examined.BAI is inferior to the widely used BMI as a correlate of the cardiometabolic risk factors studied. Additionally, BMI's relationship with total adiposity

  18. The effect of elevated body mass index on ischemic heart disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Palmer, Tom M; Benn, Marianne

    2012-01-01

    Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal.......Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal....

  19. Body mass index and risk of Alzheimer's disease

    DEFF Research Database (Denmark)

    Nordestgaard, Liv Tybjærg; Tybjærg-Hansen, Anne; Nordestgaard, Børge G.

    2017-01-01

    between low BMI and high risk of Alzheimer's disease. Design, Setting, and Participants: Using a Mendelian randomization approach, we studied 95,578 individuals from the Copenhagen General Population Study (CGPS) with up to 36 years of follow-up and consortia data on 303,958 individuals from the Genetic...... Investigation of Anthropometric Traits (GIANT) and the International Genomics of Alzheimer's Project (IGAP). Main Outcome Measure: Risk of Alzheimer's disease. Results: The causal odds ratio for a 1-kg/m2 genetically determined lower BMI was 0.98 [95% confidence interval (CI), 0.77 to 1.23] for a weighted...... allele score in the CGPS. Using 32 BMIdecreasing variants from GIANT and IGAP the causal odds ratio for Alzheimer's disease for a 1-standard deviation (SD) lower genetically determined BMI was 1.02 (95% CI, 0.86 to 1.22). Corresponding observational hazard ratios from the CGPS were 1.07 (95% CI, 1...

  20. Childhood body mass index and risk of adult pancreatic cancer

    DEFF Research Database (Denmark)

    Nogueira, Leticia; Stolzenberg-Solomon, Rachael; Gamborg, Michael

    2017-01-01

    incident pancreatic cancer cases from 1968-2012. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazard regressions. Results: During 8,207,015 person-years of follow-up, 1,268 pancreatic cancer cases were diagnosed. Childhood BMI z-scores at ages 7-13 years were......Background: Excess weight in adulthood is one of the few modifiable risk factors for pancreatic cancer, and height has associations as well. This leads to question whether body weight and height in childhood are associated with adult pancreatic cancer. Objective: To examine if childhood body mass...... from 7-13 years is positively and linearly associated with adult pancreatic cancer; the higher the BMI, the higher the risk. Excess childhood BMI may be indicative of processes initiated early in life that lead to this cancer. Prevention of childhood adiposity may decrease the burden of pancreatic...

  1. Enviromentally sensitive patch index of desertification risk applied to the main habitats of Sicily

    Science.gov (United States)

    Duro, A.; Piccione, V.; Ragusa, M. A.; Rapicavoli, V.; Veneziano, V.

    2017-07-01

    The authors applied the MEDALUS - Mediterranean Desertification and Land Use - procedure to the most representative sicilian habitat by extension, socio-economic and environmental importance, in order to assess the risk of desertification. Thanks to the ESPI, Environmentally Sensitive Patch Index, in this paper the authors estimate the current and future regional levels of desertification risk.

  2. Spatial modelling of population at risk and PM 2.5 exposure index: A ...

    African Journals Online (AJOL)

    However, monitoring, spatial representation and development of associated risk indicators have been major problems undermining formulation of relevant policy on air quality. This study used ... to environmental health. Key Words: Population at risk, PM2.5; Spatial modeling, GIS, Exposure index, environmental health ...

  3. Risk preference or financial literacy? Behavioural experiment on index insurance demand

    NARCIS (Netherlands)

    Awel, Y.; Azomahou, T.T.

    2015-01-01

    We use unique cross-sectional household data from Ethiopia to investigate the effect of risk preference, financial literacy and other socio-economic characteristics on demand for index insurance. We measure risk preference based on survey experiments using lottery choice game with real monetary

  4. An internationally generalizable risk index for mortality after one year of antiretroviral therapy

    NARCIS (Netherlands)

    Tate, Janet P.; Justice, Amy C.; Hughes, Michael D.; Bonnet, Fabrice; Reiss, Peter; Mocroft, Amanda; Nattermann, Jacob; Lampe, Fiona C.; Bucher, Heiner C.; Sterling, Timothy R.; Crane, Heidi M.; Kitahata, Mari M.; May, Margaret; Sterne, Jonathan A. C.

    2013-01-01

    Despite the success of antiretroviral therapy (ART), excess mortality continues for those with HIV infection. A comprehensive approach to risk assessment, addressing multiorgan system injury on ART, is needed. We sought to develop and validate a practical and generalizable mortality risk index for

  5. Body mass index predicts risk for complications from transtemporal cerebellopontine angle surgery.

    Science.gov (United States)

    Mantravadi, Avinash V; Leonetti, John P; Burgette, Ryan; Pontikis, George; Marzo, Sam J; Anderson, Douglas

    2013-03-01

    To determine the relationship between body mass index (BMI) and risk for specific complications from transtemporal cerebellopontine angle (CPA) surgery for nonmalignant disease. Case series with chart review. Tertiary-care academic hospital. Retrospective review of 134 consecutive patients undergoing transtemporal cerebellopontine angle surgery for nonmalignant disease from 2009 to 2011. Data were collected regarding demographics, body mass index, intraoperative details, hospital stay, and complications including cerebrospinal fluid leak, wound complications, and brachial plexopathy. One hundred thirty-four patients were analyzed with a mean preoperative body mass index of 28.58. Statistical analysis demonstrated a significant difference in body mass index between patients with a postoperative cerebrospinal fluid leak and those without (P = .04), as well as a similar significant difference between those experiencing postoperative brachial plexopathy and those with no such complication (P = .03). Logistical regression analysis confirmed that body mass index is significant in predicting both postoperative cerebrospinal fluid leak (P = .004; odds ratio, 1.10) and brachial plexopathy (P = .04; odds ratio, 1.07). Elevated body mass index was not significant in predicting wound complications or increased hospital stay beyond postoperative day 3. Risk of cerebrospinal fluid leak and brachial plexopathy is increased in patients with elevated body mass index undergoing surgery of the cerebellopontine angle. Consideration should be given to preoperative optimization via dietary and lifestyle modifications as well as intraoperative somatosensory evoked potential monitoring of the brachial plexus to decrease these risks.

  6. [Application of occupational hazard risk index model in occupational health risk assessment in a decorative coating manufacturing enterprises].

    Science.gov (United States)

    He, P L; Zhao, C X; Dong, Q Y; Hao, S B; Xu, P; Zhang, J; Li, J G

    2018-01-20

    Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion: The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.

  7. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study.

    Science.gov (United States)

    Buckland, G; Travier, N; Huerta, J M; Bueno-de-Mesquita, H B As; Siersema, P D; Skeie, G; Weiderpass, E; Engeset, D; Ericson, U; Ohlsson, B; Agudo, A; Romieu, I; Ferrari, P; Freisling, H; Colorado-Yohar, S; Li, K; Kaaks, R; Pala, V; Cross, A J; Riboli, E; Trichopoulou, A; Lagiou, P; Bamia, C; Boutron-Ruault, M C; Fagherazzi, G; Dartois, L; May, A M; Peeters, P H; Panico, S; Johansson, M; Wallner, B; Palli, D; Key, T J; Khaw, K T; Ardanaz, E; Overvad, K; Tjønneland, A; Dorronsoro, M; Sánchez, M J; Quirós, J R; Naccarati, A; Tumino, R; Boeing, H; Gonzalez, C A

    2015-08-01

    Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trendshealthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC. © 2014 UICC.

  8. [Development of a portable fall risk index for elderly people living in the community].

    Science.gov (United States)

    Toba, Kenji; Okochi, Jiro; Takahashi, Tai; Matsubayashi, Kozo; Nishinaga, Masanori; Yamada, Shizuru; Takahashi, Ryutaro; Nishijima, Reiko; Kobayashi, Yoshio; Machida, Ayako; Akishita, Masahiro; Sasaki, Hidetada

    2005-05-01

    To develop a portable risk index for falls. Risk factors were chosen from previously established factors then we added several environmental factors to the risk index; previous falls in the last 12 month, trippig or stumbling, inability to ascend or descend stairs without help, decreased walking speed, inability to cross a road within the green signal interval, inability to walk 1km without a break, inability to stand on one leg for 5 seconds (eyes open), using a cane, inability to wring out a towel, dizziness or faintness, stooped or rounded back, knee joint pain, visual disturbance, hearing disturbance, cognitive decline, fear of falling, receiving 5 or more prescribed drugs, sensation of darkness at home, obstacles inside, barrier on the carpet or floor, using steps daily at home, steep slopes around home. The questionnaire sheet was completed by 2,439 community-dwelling elderly subjects (76.3 +/- 7.4 years old). The frequency of each items of fall risk index was compared between fallers (history of fall within one year) and non-fallers. Multiple regression analysis was performed to identify independent risk factors for previous falls. Except barrier, step use and steep slope around home, all items in the fall risk index were more frequent in fallers. Multivariate analysis revealed that tripping or stumbling, inability to cross a road within the green signal interval, dizziness or faintness, obstacles inside, inability to wring out a towel, cane use and knee joint pain were independent risk factors for previous falls. These 7 selected items were further analyzed as predictors. The maximum sum of sensitivity and specificity was reached at the cut-off point of 2/3 (sensitivity 0.65, specificity 0.72) by receiver operating curve. Portable fall risk index is useful for clinical settings to identify high-risk subjects.

  9. Association of waist circumference, body mass index and conicity index with cardiovascular risk factors in postmenopausal women.

    Science.gov (United States)

    Shidfar, Farzad; Alborzi, Fatemeh; Salehi, Maryam; Nojomi, Marzieh

    2012-09-01

    In menopause, changes in body fat distribution lead to increasing risk of cardiovascular disease and metabolic disorders. The aim of this study was to assess the association of adiposity using the conicity index (CI), body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors (hypertension, diabetes and dyslipidaemia). The sample of this cross-sectional study was collected from June to October 2010 and 165 consecutive menopausal women who had attended the Health and Treatment Centre and Endocrine Research Centre of Firoozgar Hospital in Tehran, Iran were assessed. Age, weight, height, WC, waist-hip ratio (WHR), CI and fat mass were measured. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose, insulin, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels were also determined. All statistical analyses were performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA). Results showed that BMI was positively and significantly associated with SBP (r = 0.21; p = 0.009). WC was positively and significantly correlated with SBP (r = 0.26; p = 0.02) and DBP (r = 0.16; p = 0.05). WHR was also significantly and positively associated with SBP (r = 0.29; p = 0.001). Age and WC were associated with CI quartiles at the 0.05 significance level. The correlation of CI quartiles with SBP and weight were at the 0.01 significance level. We showed a significant association of WC with SBP and DBP, and that BMI could be an important determining factor of SBP. For assessing the association between CI and cardiovascular risk factors, future studies with larger sample sizes are recommended.

  10. Predictive value of body mass index to metabolic syndrome risk factors in Syrian adolescents.

    Science.gov (United States)

    Al-Bachir, Mahfouz; Bakir, Mohamad Adel

    2017-06-25

    Obesity has become a serious epidemic health problem in both developing and developed countries. There is much evidence that obesity among adolescents contributed significantly to the development of type 2 diabetes and coronary heart disease in adulthood. Very limited information exists on the prevalence of overweight, obesity, and associated metabolic risk factors among Syrian adolescents. Therefore, the purpose of this study was to determine the relationship between obesity determined by body mass index and the major metabolic risk factors among Syrian adolescents. A cross-sectional study of a randomly selected sample of 2064 apparently healthy Syrian adolescents aged 18 to 19 years from Damascus city, in Syria, was performed. Body mass index and blood pressure were measured. Serum concentrations of glucose, triglycerides, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol were determined. Metabolic syndrome was defined using the national criteria for each determined metabolic risk factor. Individuals with a body mass index 25 to 29.9 were classified as overweight, whereas individuals with a body mass index ≥30 were classified as obese. A receiver operating characteristics curve was drawn to determine appropriate cut-off points of the body mass index for defining overweight and obesity, and to indicate the performance of body mass index as a predictor of risk factors. The obtained data showed that blood pressure and the overall mean concentrations of fasting blood sugar, triglycerides, cholesterol, low-density lipoprotein-cholesterol, and triglycerides/high-density lipoprotein-cholesterol were significantly higher in overweight and obese adolescent groups (p index and some metabolic risks, the data suggest the best body mass index cut-offs ranged between 23.25 and 24.35 kg/m 2 . A strong association between overweight and obesity as determined by body mass index and high concentrations of metabolic syndrome

  11. Rainfall Intensity and Frequency Explain Production Basis Risk in Cumulative Rain Index Insurance

    Science.gov (United States)

    Muneepeerakul, Chitsomanus P.; Muneepeerakul, Rachata; Huffaker, Ray G.

    2017-12-01

    With minimal moral hazard and adverse selection, weather index insurance promises financial resilience to farmers struck by harsh weather conditions through swift compensation at affordable premium. Despite these advantages, the very nature of indexing gives rise to production basis risk as the selected weather indexes do not sufficiently correspond to actual damages. To address this problem, we develop a stochastic yield model, built upon a stochastic soil moisture model driven by marked Poisson rainfall. Our analysis shows that even under similar temperature and rainfall amount yields can differ significantly; this was empirically supported by a 2-year field experiment in which rain-fed maize was grown under very similar total rainfall. Here, the year with more intense, less-frequent rainfall produces a better yield—a rare counter evidence to most climate change projections. Through a stochastic yield model, we demonstrate the crucial roles of rainfall intensity and frequency in determining the yield. Importantly, the model allows us to compute rainfall pattern-related basis risk inherent in cumulative rain index insurance. The model results and a case study herein clearly show that total rainfall is a poor indicator of yield, imposing unnecessary production basis risk on farmers and false-positive payouts on insurers. Incorporating rainfall intensity and frequency in the design of rain index insurance can offer farmers better protection, while maintaining the attractive features of the weather index insurance and thus fulfilling its promise of financial resilience.

  12. Business risk assessment of the companies on the Mexican Stock Exchange’s sustainable index

    Directory of Open Access Journals (Sweden)

    José Antonio Morales Castro

    2014-12-01

    Full Text Available (Received: 2014/10/27 - Accepted: 2014/12/15This work evaluated the business risk change of 20 companies included on the sustainable index of the Mexican Stock Exchange (BMV. The unlevered beta coefficient was used for this analysis. Two periods were compared: the one before, and the one after including the companies on the index. For each of the 20 companies it was used financial information, stocks closing prices and the stock market index value, over a period of 234 weeks. Then, considering the two periods, the statistical difference between the unlevered beta coefficient averages was calculated. Finally, a hypothesis proof was made to evaluate the business risk change. It was found that for 12 out of the 20 companies, the unlevered beta coefficient suffered a reduction. The findings suggest that it is not enough for the companies to certify as sustainable in order to reduce its business risk.

  13. The c-index is not proper for the evaluation of $t$-year predicted risks.

    Science.gov (United States)

    Blanche, Paul; Kattan, Michael W; Gerds, Thomas A

    2018-02-16

    We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.

  14. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  15. Body mass index, waist circumference, body adiposity index, and risk for type 2 diabetes in two populations in Brazil: general and Amerindian.

    Directory of Open Access Journals (Sweden)

    Rafael de Oliveira Alvim

    Full Text Available The use of the anthropometric indices of adiposity, especially body mass index and waist circumference in the prediction of diabetes mellitus has been widely explored. Recently, a new body composition index, the body adiposity index was proposed. The aim of this study was to compare the effectiveness of body mass index, waist circumference, and body adiposity index in the risk assessment for type 2 diabetes mellitus.A total of 1,572 individuals from the general population of Vitoria City, Brazil and 620 Amerindians from the Aracruz Indian Reserve, Brazil were randomly selected. BMI, waist circumference, and BAI were determined according to a standard protocol. Type 2 diabetes mellitus was diagnosed by the presence of fasting glucose ≥126 mg/dL or by the use of antidiabetic drugs.The area under the curve was similar for all anthropometric indices tested in the Amerindian population, but with very different sensitivities or specificities. In women from the general population, the area under the curve of waist circumference was significantly higher than that of the body adiposity index. Regarding risk assessment for type 2 diabetes mellitus, the body adiposity index was a better risk predictor than body mass index and waist circumference in the Amerindian population and was the index with highest odds ratio for type 2 diabetes mellitus in men from the general population, while in women from the general population waist circumference was the best risk predictor.Body adiposity index was the best risk predictor for type 2 diabetes mellitus in the Amerindian population and men from the general population. Our data suggest that the body adiposity index is a useful tool for the risk assessment of type 2 diabetes mellitus in admixture populations.

  16. Development of a risk index for the prediction of chronic post-surgical pain.

    Science.gov (United States)

    Althaus, A; Hinrichs-Rocker, A; Chapman, R; Arránz Becker, O; Lefering, R; Simanski, C; Weber, F; Moser, K-H; Joppich, R; Trojan, S; Gutzeit, N; Neugebauer, E

    2012-07-01

    The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping. © 2011 European Federation of International Association for the Study of Pain Chapters.

  17. Currency risk management of non-financial public limited companies listed on WIG30 index

    Directory of Open Access Journals (Sweden)

    Alicja Mikołajewicz-Woźniak

    2013-12-01

    Full Text Available The objects of the study are selected aspects of currency risk management of nonfinancial public limited companies listed on WIG30 index. The estimation of net profit sensitivity to currencies exchange rates was used to determine importance of currency risk management for functioning of analyzed entities. The indication of the methods and tools used in currency risk management process became the basis for evaluation of taken actions. The determination of the relationship between hedging accounting and risk management results enabled the verification to what extent Polish companies exploit existing opportunities.

  18. A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections.

    Science.gov (United States)

    Crosby, Richard; Shrier, Lydia A

    2013-04-01

    The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.

  19. A novel index for quantifying the risk of early complications for patients undergoing cervical spine surgeries.

    Science.gov (United States)

    Passias, Peter G; Diebo, Bassel G; Marascalchi, Bryan J; Jalai, Cyrus M; Horn, Samantha R; Zhou, Peter L; Paltoo, Karen; Bono, Olivia J; Worley, Nancy; Poorman, Gregory W; Challier, Vincent; Dixit, Anant; Paulino, Carl; Lafage, Virginie

    2017-11-01

    OBJECTIVE It is becoming increasingly necessary for surgeons to provide evidence supporting cost-effectiveness of surgical treatment for cervical spine pathology. Anticipating surgical risk is critical in accurately evaluating the risk/benefit balance of such treatment. Determining the risk and cost-effectiveness of surgery, complications, revision procedures, and mortality rates are the most significant limitations. The purpose of this study was to determine independent risk factors for medical complications (MCs), surgical complications (SCs), revisions, and mortality rates following surgery for patients with cervical spine pathology. The most relevant risk factors were used to structure an index that will help quantify risk and anticipate failure for such procedures. METHODS The authors of this study performed a retrospective review of the National Inpatient Sample (NIS) database for patients treated surgically for cervical spine pathology between 2001 and 2010. Multivariate models were performed to calculate the odds ratio (OR) of the independent risk factors that led to MCs and repeated for SCs, revisions, and mortality. The models controlled for age ( 65 years old), sex, race, revision status (except for revision analysis), surgical approach, number of levels fused/re-fused (2-3, 4-8, ≥ 9), and osteotomy utilization. ORs were weighted based on their predictive category: 2 times for revision surgery predictors and 4 times for mortality predictors. Fifty points were distributed among the predictors based on their cumulative OR to establish a risk index. RESULTS Discharges for 362,989 patients with cervical spine pathology were identified. The mean age was 52.65 years, and 49.47% of patients were women. Independent risk factors included medical comorbidities, surgical parameters, and demographic factors. Medical comorbidities included the following: pulmonary circulation disorder, coagulopathy, metastatic cancer, renal failure, congestive heart failure

  20. THE ASSESSMENT OF LIFE STYLE AND THE VISCERAL ADIPOSITY INDEX AS CARDIOMETABOLIC RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Sigina R. GÂRGAVU

    2018-06-01

    Full Text Available Introduction. The patients with cardiometabolic/ cardiovascular risk are commonly found in clinics and ambulatory clinics. The cardiovascular (CV or cardiometabolic (CM risk factors and biomarkers are certain characteristics of the person without CV disease, which are independently correlated with the subsequent occurrence of CV disease, without necessarily having a causal relationship between factor and disease. The visceral adiposity index (VAI indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The objective of the study was to evaluate the lifestyle and visceral adiposity index as possible cardiometabolic risk factors in patients with diabetes, prediabetes, and in the general population. Methods. The study was epidemiological, transversal, noninterventional, and was performed by analyzing 300 subjects, divided into three groups: group 1 (100 patients with type 2 diabetes, group 2 (100 pre-diabetic patients, and group 3 (control consisting of 100 individuals randomly recruited without diabetes. Results. The accumulation of cardiovascular risk factors results is an increased risk of cardiovascular disease. We found statistically significant differences between the three groups in terms of BMI, CT, VAI, CT, HDL-c and LDL-c values, which were higher in patients with diabetes mellitus (DM than in prediabetics or in the general population, which also coincided with higher cardiovascular risk in these patients. Conclusions. We emphasize the importance of both early cardiovascular risk assessment and the importance of controlling cardiovascular risk factors, both by non-pharmacological methods, and by associating early drug therapy when necessary.

  1. A new index of risks for lethal diseases by ionizing radiation

    International Nuclear Information System (INIS)

    Sato, Fumiaki; Higuti, Isao.

    1979-01-01

    Estimates of the somatic risk of radiation exposure have mainly been based on the incidence of fatal cancers. An improvement on the estimates of the risk will be made by taking mean ages at deaths into consideration in addition to the incidence of cancer. The authors report on an index of contribution of each cause of death to life shortening. The index is the sum of three terms. The first term indicates a contribution of change in incidence and the second term indicates that of changes in mean age at death from the cause of death in question. The last term is an interaction term of the two factors mentioned above. If a radiation exposure increases incidence of a cause of death and shortens the mean age at death from the cause of death, the index gives a large positive value. On the other hand, an increase in incidence of a late occurring cause of death will bring about a small positive or sometimes negative value for the index. The index proposed here will be promising in estimating risks by ionizing radiation. (author)

  2. Italian Mediterranean Index and risk of colorectal cancer in the Italian section of the EPIC cohort.

    Science.gov (United States)

    Agnoli, Claudia; Grioni, Sara; Sieri, Sabina; Palli, Domenico; Masala, Giovanna; Sacerdote, Carlotta; Vineis, Paolo; Tumino, Rosario; Giurdanella, Maria Concetta; Pala, Valeria; Berrino, Franco; Mattiello, Amalia; Panico, Salvatore; Krogh, Vittorio

    2013-03-15

    Colorectal cancer is among the commonest cancers worldwide. Dietary factors have been linked to colorectal cancer risk, however, few studies have evaluated the relationship between a priori dietary patterns and colorectal cancer risk. We evaluated the effect of adherence to a Mediterranean dietary pattern, as measured by the Italian Mediterranean Index, on the risk of colorectal cancer in the 45,275 participants of the Italian section of the EPIC study who completed a dietary questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) for colorectal cancer in relation to categories of Italian Mediterranean Index score were estimated by multivariate Cox models adjusted for known risk factors, on the whole cohort, on men and women and according to cancer subsite. During a mean follow-up of 11.28 years, 435 colorectal cancer cases were identified. The Italian Mediterranean Index was inversely associated with colorectal cancer risk (HR: 0.50; 95% CI: 0.35-0.71 for the highest category compared to the lowest, P-trend: 0.043). Results did not differ by sex. Highest Italian Mediterranean Index score was also significantly associated with reduced risks of any colon cancer (HR: 0.54, 95% CI: 0.36-0.81), distal colon cancer (HR: 0.44, 95% CI: 0.26-0.75) and rectal cancer (HR: 0.41, 95% CI: 0.20-0.81), but not of proximal colon cancer. These findings suggest that adherence to a Mediterranean diet (as measured by the Italian Mediterranean Index) protects against colorectal cancer in general but not against cancer developing in the proximal colon. Copyright © 2012 UICC.

  3. [Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours].

    Science.gov (United States)

    Treviño-Báez, Joaquín Darío; Cantú-Cruz, Javier Alejandro; Medina-Mercado, Javier; Abundis, Alberto

    2016-01-01

    The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  4. Innovation in drought risk management: exploring the potential of weather index insurance

    Science.gov (United States)

    Iglesias, E.; Baez, K.

    2012-04-01

    Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

  5. GLOBALISATION AND THE UNPREDICTABILITY OF CRISIS EPISODES: AN EMPIRICAL ANALYSIS OF COUNTRY RISK INDEXES

    Directory of Open Access Journals (Sweden)

    San-Martín-Albizuri, Nerea

    2012-05-01

    Full Text Available The ongoing globalisation process has not put an end to international financial crises. On the contrary, it seems to have contributed to their appearance and to accentuating their degrees of unpredictability. In this context, the main objective of the present study is to establish whether the values of the best-known and most widely used country risk indexes, namely, the Euromoney index and the International Country Risk Group (ICRG, and the values of their representative variables could have forecasted well in advance the crises that took place between 1994 and 2002, a period which is herein termed the ‘globalisation era’. The results show that, although the selected indexes and their representative variables were able to identify certain vulnerabilities, they could not accurately identify the political, economic, and/or financial factors that developed prior to these crisis episodes.

  6. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer

    DEFF Research Database (Denmark)

    Aarestrup, J.; Gamborg, M.; Ulrich, L. G.

    2016-01-01

    BACKGROUND: Endometrial cancer risk factors include adult obesity and taller stature, but the influence of size earlier in life is incompletely understood. We examined whether childhood body mass index (BMI; kg m(-2)) and height were associated with histologic subtypes of endometrial cancer...

  7. Work Ability Index as Tool to Identify Workers at Risk of Premature Work Exit

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Heymans, Martijn W.; Twisk, Jos W. R.; van der Klink, Jac J. L.; Groothoff, Johan W.; van Rhenen, Willem

    2014-01-01

    Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

  8. Flood risk index pattern assessment: case study in Langat River Basin

    African Journals Online (AJOL)

    This study focus on the creation of flood risk index in the study area based on secondary data derived from the Department of Drainage and Irrigation (DID) since 1982-2012. Based on the result, it shows that the water level is the best variable to be taken for the purposed of flood warning alert system as the result for ...

  9. Parent/Student Risk and Protective Factors in Understanding Early Adolescent's Body Mass Index

    Science.gov (United States)

    Fitzpatrick, Kevin M.; Willis, Don

    2016-01-01

    This article's aim is to examine correlates of middle school students' body mass index (BMI). Little research simultaneously has considered both child and parent correlates in predicting child's BMI; we examine the interrelationships between middle school students and their parent's risks and protective factors and their impact on the child's BMI.…

  10. Overall glycaemic index and glycaemic load of habitual diet and risk of heart disease

    DEFF Research Database (Denmark)

    Grau, Katrine; Tetens, Inge; Bjørnsbo, Kirsten S

    2011-01-01

    Objective To test the hypothesis that diets with high glycaemic index (GI) and glycaemic load (GL) increase the risk of heart disease. Design Overall GI and GL were assessed from 7 d diet records or diet history interviews. Setting Information on hospitalization and death due to CVD and CHD was o...

  11. Predicting nosocomial lower respiratory tract infections by a risk index based system

    NARCIS (Netherlands)

    Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

    2017-01-01

    Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

  12. Work ability index as tool to identify workers at risk of premature work exit

    NARCIS (Netherlands)

    Roelen, C.A.M.; Heymans, M.W.; Twisk, J.W.R.; van der Klink, J.J.L.; Groothoff, J.W.; van Rhenen, W.

    2014-01-01

    Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

  13. Generation of a landslide risk index map for Cuba using spatial multi-criteria evaluation

    NARCIS (Netherlands)

    Castellanos Abella, E.A.

    2007-01-01

    his paper explains the procedure for the generation of a landslide risk index map at national level in Cuba, using a semiquantitative model with ten indicator maps and a cell size of 90× 90 m. The model was designed and implemented using spatial multi-criteria evaluation techniques in a GIS system.

  14. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    Science.gov (United States)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  15. A Risk Prediction Index for Advanced Colorectal Neoplasia at Screening Colonoscopy.

    Science.gov (United States)

    Schroy, Paul C; Wong, John B; O'Brien, Michael J; Chen, Clara A; Griffith, John L

    2015-07-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer screening. Risk stratification for advanced colorectal neoplasia (ACN) might facilitate more effective shared decision making when selecting an appropriate screening option. Our objective was to develop and validate a clinical index for estimating the probability of ACN at screening colonoscopy. We conducted a cross-sectional analysis of 3,543 asymptomatic, mostly average-risk patients 50-79 years of age undergoing screening colonoscopy at two urban safety net hospitals. Predictors of ACN were identified using multiple logistic regression. Model performance was internally validated using bootstrapping methods. The final index consisted of five independent predictors of risk (age, smoking, alcohol intake, height, and a combined sex/race/ethnicity variable). Smoking was the strongest predictor (net reclassification improvement (NRI), 8.4%) and height the weakest (NRI, 1.5%). Using a simplified weighted scoring system based on 0.5 increments of the adjusted odds ratio, the risk of ACN ranged from 3.2% (95% confidence interval (CI), 2.6-3.9) for the low-risk group (score ≤2) to 8.6% (95% CI, 7.4-9.7) for the intermediate/high-risk group (score 3-11). The model had moderate to good overall discrimination (C-statistic, 0.69; 95% CI, 0.66-0.72) and good calibration (P=0.73-0.93). A simple 5-item risk index based on readily available clinical data accurately stratifies average-risk patients into low- and intermediate/high-risk categories for ACN at screening colonoscopy. Uptake into clinical practice could facilitate more effective shared decision-making for CRC screening, particularly in situations where patient and provider test preferences differ.

  16. The construction of power grid operation index system considering the risk of maintenance

    Science.gov (United States)

    Tang, Jihong; Wang, Canlin; Jiang, Xinfan; Ye, Jianhui; Pan, Feilai

    2018-02-01

    In recent years, large-scale blackout occurred at home and abroad caused widespread concern about the operation of the grid in the world, and the maintenance risk is an important indicator of grid safety. The barrier operation of the circuit breaker exists in the process of overhaul of the power grid. The operation of the different barrier is of great significance to the change of the power flow, thus affecting the safe operation of the system. Most of the grid operating status evaluation index system did not consider the risk of maintenance, to this end, this paper from the security, economy, quality and cleanliness of the four angles, build the power grid operation index system considering the risk of maintenance.

  17. Comparison of China's oil import risk. Results based on portfolio theory and a diversification index approach

    International Nuclear Information System (INIS)

    Wu, Gang; Liu, Lan-Cui; Wei, Yi-Ming

    2009-01-01

    In recent years, the international oil price has fluctuated violently, bringing about huge risk for the international oil trade. In fact, the risk of crude oil and petroleum product imports is different because of the different import origins and prices. Which import risk is lower for China? From the perspective of oil supply security, how should China portfolio crude oil and petroleum product imports to minimize its oil import risk? Using portfolio theory and a diversification index approach, this paper compares and analyzes the supply, price and transport risks of crude oil and petroleum product imports. Our results show that the following: (1) Specific risk (diversification risk) and marine transport risk of China's petroleum product imports are lower than that of crude oil imports. (2) The average rate of return of China's petroleum product imports is higher than that of crude oil imports. Moreover, the average import price variance of petroleum product imports is lower than that of crude oil imports. Thus, the systematic risk (price risk) of petroleum products is lower too. Therefore, from the perspective of oil supply security, China should increase petroleum product imports to decrease its oil import risk. (author)

  18. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

    Science.gov (United States)

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S; Massey, Suena H; Mayes, Linda C; Ganiban, Jody M; Reiss, David; Shaw, Daniel S; Leve, Leslie D; Neiderhiser, Jenae M

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development.

  19. Radiation risk index for pediatric CT. A patient-derived metric

    International Nuclear Information System (INIS)

    Samei, Ehsan; Tian, Xiaoyu; Paul Segars, W.; Frush, Donald P.

    2017-01-01

    There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

  20. Radiation risk index for pediatric CT. A patient-derived metric

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Department of Biomedical Engineering, Electrical and Computer Engineering, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Tian, Xiaoyu [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Paul Segars, W. [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Frush, Donald P. [Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Duke University Medical Center, Division of Pediatric Radiology, Department of Radiology, Durham, NC (United States)

    2017-12-15

    There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

  1. A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

    Science.gov (United States)

    Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

    2013-01-01

    The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

  2. The EVIDENT diet quality index is associated with cardiovascular risk and arterial stiffness in adults

    Directory of Open Access Journals (Sweden)

    Carmela Rodríguez-Martin

    2017-04-01

    Full Text Available Abstract Background We aimed to simplify information from food frequency questionnaires (FFQs in a single parameter that allows for rapid identification of quality of patient diet and its relationship to cardiovascular risk and pulse wave velocity (PWV. Methods The sample from the EVIDENT study, consisting of 1553 subjects (aged 20–80 years with no cardiovascular disease selected by random sampling among those attending primary care clinics, was used. The EVIDENT diet index (range 0–100 was calculated based on the results of a FFQ. Evaluation of dietary habits also included adherence to the Mediterranean diet (MD. Cardiovascular risk was estimated, and carotid-femoral pulse wave velocity was measured. Results Mean subject age was 54.9 ± 13.8 years, and 60.3% of subjects were female. The mean value of the EVIDENT diet index was 52.1 ± 3.2 points. Subjects in the third tertile (the highest score had the greatest adherence to MD and the highest energy intake, with greater amounts of carbohydrates, protein, and fiber. The best cut-off point of the EVIDENT diet index for predicting good adherence to the MD is 52.3 (0.71 sensitivity, 0.61 specificity. In a multiple regression analysis, after a complete adjustment, it was estimated that for each one-point increase in the EVIDENT diet index, cardiovascular risk (CVR, blood-pressure, waist circumference, and PWV decreased by 0.14, 0.43, 0.24, and 0.09 respectively (p < 0.05, all. Conclusions The diet quality index developed is associated to CVR and its components, and also with arterial stiffness, as measured with PWV. This index is also a good predictor of adherence to MD.

  3. An index for drought induced financial risk in the mining industry

    Science.gov (United States)

    Bonnafous, L.; Lall, U.; Siegel, J.

    2017-02-01

    Water scarcity has emerged as a potential risk for mining operations. High capital spending for desalination and water conflicts leading to asset stranding have recently occurred. Investors in mining companies are interested in the exposure to such risks across portfolios of mining assets (whether the practical at-site consequences are foregone production, higher OPEX and CAPEX and ensuing lost revenues, or asset-stranding). In this paper, an index of the potential financial exposure of a portfolio is developed and its application is illustrated. Since the likely loss at each mine is hard to estimate a priori, one needs a proxy for potential loss. The index considers drought duration, severity and frequency (defined by a return-level in years) at each mining asset, and provides a measure of financial exposure through weighing of production or Net Asset Value. Changes in human needs are not considered, but are relevant, and could be incorporated if global data on mine and other water use were available at the appropriate resolution. Potential for contemporaneous drought incidence across sites in a portfolio is considered specifically. Through an appropriate choice of drought thresholds, an analyst can customize a scenario to assess potential losses in production value or profits, or whether conflicts could emerge that would lead to stranded assets or capital expenditure to secure alternate water supplies. Global climate data sets that allow a customized development of such an index are identified, and selected mining company portfolios are scored as to the risk associated with one publicly available drought index.

  4. Mendelian Randomization Study of Body Mass Index and Colorectal Cancer Risk

    DEFF Research Database (Denmark)

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike

    2015-01-01

    Background: High body mass index (BMI) is consistently linked to increased risk of colorectal cancer for men, whereas the association is less clear for women. As risk estimates from observational studies may be biased and/or confounded, we conducted a Mendelian randomization study to estimate...... the causal association between BMI and colorectal cancer. Methods: We used data from 10,226 colorectal cancer cases and 10,286 controls of European ancestry. The Mendelian randomization analysis used a weighted genetic risk score, derived from 77 genome-wide association study–identified variants associated......, rather than overall obesity, is a more important risk factor for men requires further investigation. Impact: Overall, conventional epidemiologic and Mendelian randomization studies suggest a strong association between obesity and the risk of colorectal cancer....

  5. Familial psychosocial risk classes and preschooler body mass index: The moderating effect of caregiver feeding style.

    Science.gov (United States)

    Horodynski, Mildred A; Brophy-Herb, Holly E; Martoccio, Tiffany L; Contreras, Dawn; Peterson, Karen; Shattuck, Mackenzie; Senehi, Neda; Favreau, Zachary; Miller, Alison L; Sturza, Julie; Kaciroti, Niko; Lumeng, Julie C

    2018-04-01

    Early child weight gain predicts adolescent and adult obesity, underscoring the need to determine early risk factors affecting weight status and how risk factors might be mitigated. Socioeconomic status, food insecurity, caregiver depressive symptomology, single parenthood, and dysfunctional parenting each have been linked to early childhood weight status. However, the associations between these risk factors and children's weight status may be moderated by caregiver feeding styles (CFS). Examining modifiable factors buffering risk could provide key information to guide early obesity intervention efforts. This analysis used baseline data from the Growing Healthy project that recruited caregivers/child dyads (N = 626) from Michigan Head Start programs. Caregivers were primarily non-Hispanic white (62%) and African American (30%). After using latent class analysis to identify classes of familial psychosocial risk, CFS was tested as a moderator of the association between familial psychosocial risk class and child body mass index (BMI) z-score. Latent class analysis identified three familial psychosocial risk classes: (1) poor, food insecure and depressed families; (2) poor, single parent families; and (3) low risk families. Interactive effects for uninvolved feeding styles and risk group indicated that children in poor, food insecure, and depressed families had higher BMI z-scores compared to children in the low risk group. Authoritative feeding styles in low risk and poor, food insecure, and depressed families showed lower child BMI z-scores relative to poor, single parent families with authoritative feeding styles. Uninvolved feeding styles intensified the risk and an authoritative feeding style muted the risk conferred by living in a poor, food-insecure, and depressed family. Interventions that promote responsive feeding practices could help decrease the associations of familial psychosocial risks with early child weight outcomes. Copyright © 2017 Elsevier Ltd

  6. Index-Based Dietary Patterns and Colorectal Cancer Risk: A Systematic Review123

    Science.gov (United States)

    Steck, Susan E; Guinter, Mark; Zheng, Jiali; Thomson, Cynthia A

    2015-01-01

    Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8–54% lower CRC risk, and higher HEI scores were associated with a 20–56% lower CRC risk. More proinflammatory diet scores were associated with a 12–65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended. PMID:26567200

  7. Geriatric nutritional risk index as a prognostic factor in patients with diffuse large B cell lymphoma.

    Science.gov (United States)

    Kanemasa, Yusuke; Shimoyama, Tatsu; Sasaki, Yuki; Hishima, Tsunekazu; Omuro, Yasushi

    2018-06-01

    The geriatric nutritional risk index (GNRI) is a simple and well-established nutritional assessment tool that is a significant prognostic factor for various cancers. However, the role of the GNRI in predicting clinical outcomes of diffuse large B cell lymphoma (DLBCL) patients has not been investigated. To address this issue, we retrospectively analyzed a total of 476 patients with newly diagnosed de novo DLBCL. We defined the best cutoff value of the GNRI as 96.8 using a receiver operating characteristic curve. Patients with a GNRI risk by National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI), the 5-year OS was significantly lower in patients with a GNRI risk, 59.5 vs. 75.2%, P = 0.006; high risk, 37.4 vs. 64.9%, P = 0.033). In the present study, we demonstrated that the GNRI was an independent prognostic factor in DLBCL patients. The GNRI could identify a population of poor-risk patients among those with high-intermediate and high-risk by NCCN-IPI.

  8. Hazard Assessment on Chlorine Distribution Use of Chemical Transportation Risk Index

    International Nuclear Information System (INIS)

    Kim, Jeong Gon; Byun, Hun Soo

    2014-01-01

    Chlorine is one of the most produced and most used non-flammable chemical substances in the world even though its toxicity and high reactivity cause the ozone layer depletion. However, in modern life, it is impossible to live a good life without using Chlorine and its derivatives since they are being used as an typical ingredient in more than 40 percent of the manufactured goods including medicines, detergents, deodorant, fungicides, herbicides, insecticides, and plastic, etc. Even if Chlorine has been handled and distributed in various business (small and medium-sized businesses, water purification plants, distribution company, etc.), there have been few researches about its possible health hazard and transportation risks. Accordingly, the purpose of this paper is to make a detailed assessment of Chlorinerelated risks and to model an index of chemicals transportation risks that is adequate for domestic circumstances. The assessment of possible health hazard and transportation risks was made on 13 kinds of hazardous chemicals, including liquid chlorine. This research may be contributed to standardizing the risk assessment of Chlorine and other hazardous chemicals by using an index of transportation risks

  9. Hazard Assessment on Chlorine Distribution Use of Chemical Transportation Risk Index

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Gon [Hanwha Chemical Ulsan Site, Ulsan (Korea, Republic of); Byun, Hun Soo [Chonnam National University, Yeosu (Korea, Republic of)

    2014-12-15

    Chlorine is one of the most produced and most used non-flammable chemical substances in the world even though its toxicity and high reactivity cause the ozone layer depletion. However, in modern life, it is impossible to live a good life without using Chlorine and its derivatives since they are being used as an typical ingredient in more than 40 percent of the manufactured goods including medicines, detergents, deodorant, fungicides, herbicides, insecticides, and plastic, etc. Even if Chlorine has been handled and distributed in various business (small and medium-sized businesses, water purification plants, distribution company, etc.), there have been few researches about its possible health hazard and transportation risks. Accordingly, the purpose of this paper is to make a detailed assessment of Chlorinerelated risks and to model an index of chemicals transportation risks that is adequate for domestic circumstances. The assessment of possible health hazard and transportation risks was made on 13 kinds of hazardous chemicals, including liquid chlorine. This research may be contributed to standardizing the risk assessment of Chlorine and other hazardous chemicals by using an index of transportation risks.

  10. Relation of body mass index to risk of stent thrombosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schmiegelow, Michelle; Torp-Pedersen, Christian; Gislason, Gunnar H

    2012-01-01

    Stent thrombosis is a devastating complication after percutaneous coronary intervention (PCI), but the influence of obesity on risk of stent thrombosis is unclear, and it is unknown if this relation is dependent on stent type. The objective of this study was to examine the relation between body...... mass index (BMI) and stent thrombosis after PCI with bare-metal stent (BMS) or drug-eluting stent (DES). We followed 5,515 patients who underwent PCI with implantation of ≥1 BMS or DES at a high-volume tertiary invasive cardiology center from 2000 through 2006. Only patients with a single type of stent...... (BMS or DES) implanted at the index PCI were included. Median follow-up period was 26 months (interquartile range 12 to 44) and definite stent thrombosis occurred in 78 patients. Hazard ratio of definite stent thrombosis adjusted for number of stents at the index PCI was 0.92 (95% confidence interval...

  11. A simplified donor risk index for predicting outcome after deceased donor kidney transplantation.

    Science.gov (United States)

    Watson, Christopher J E; Johnson, Rachel J; Birch, Rhiannon; Collett, Dave; Bradley, J Andrew

    2012-02-15

    We sought to determine the deceased donor factors associated with outcome after kidney transplantation and to develop a clinically applicable Kidney Donor Risk Index. Data from the UK Transplant Registry on 7620 adult recipients of adult deceased donor kidney transplants between 2000 and 2007 inclusive were analyzed. Donor factors potentially influencing transplant outcome were investigated using Cox regression, adjusting for significant recipient and transplant factors. A United Kingdom Kidney Donor Risk Index was derived from the model and validated. Donor age was the most significant factor predicting poor transplant outcome (hazard ratio for 18-39 and 60+ years relative to 40-59 years was 0.78 and 1.49, respectively, Pinformed consent.

  12. The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

    DEFF Research Database (Denmark)

    Janner, Julie Hjortsø; Godtfredsen, N S; Ladelund, S

    2011-01-01

    The augmentation index (AIx) is a measure of systemic arterial stiffness, and previous studies have demonstrated an association between AIx and risk factors of cardiovascular disease (CVD). However, there is limited knowledge about the age and gender differences of the observed associations...... is primarily a marker of CVD in younger subjects.Journal of Human Hypertension advance online publication, 9 June 2011; doi:10.1038/jhh.2011.59....

  13. Poverty Risk Index as A New Methodology for Social Inequality Distribution Assessment

    Science.gov (United States)

    Swiader, Małgorzata; Szewrański, Szymon; Kazak, Jan

    2017-10-01

    The paper presents new concept of poverty risk index measurement due to dynamics of urban development among years. The rapid urbanization could seriously surpass the capacity of the most cities, which may lead to insufficient services of their inhabitants. Consequence of this situation could be polarized, social differentiated cities with high rates of urban poverty. The measurement and analysis of urban poverty phenomenon requires the dedicated tools and techniques. The data based assessment could allow planners and public policy makers to develop more socially integrated cities. This paper presents analysis of urban poverty phenomenon in Wrocław city (Poland) during period 2010-2012. This analysis was conducted for ten Social Assistance Terrain Units (SATU) delineated at the city area. Our primary study objective concerns the proposal and calculation of poverty risk index based on diagnostic features, which represent the most common causes of social benefits granting, as: number of single households granted permanent benefits, number of people in families granted permanent benefits, number of people in families granted temporary benefits due to unemployment, number of people in families granted temporary benefits due to disability, number of people in families granted meals for children. The calculation was conducted by using the theory of development pattern - Hellwig’s economic development measure. The analysis of poverty risk index showed that commonly the central and south-eastern part of the city is characterized by the highest poverty risk index. The obtained results of the inequalities spatial distribution relate to European and American patterns of poverty concentration in urban structures.

  14. 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

  15. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects

    OpenAIRE

    Camargo-Ramos, Claudia Marcela; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

    2017-01-01

    Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and...

  16. Food consumption, body mass index and risk for oral health in adolescents.

    Science.gov (United States)

    Bica, Isabel; Cunha, Madalena; Reis, Margarida; Costa, José; Costa, Patricia; Bica, Alexandra

    2014-11-01

    The food intake has great influence on the oral health of adolescents, being relevant to analyze the type of food consumed by adolescents and their relationship with the DMFT index (decayed, missing and filled), the plaque index (PI) and the body mass index (BMI). Epidemiological study conducted in public schools of the 3rd cycle of basic education, central Portugal. The sociodemographic and dietary habits and frequency characterization was obtained through a self-administered questionnaire completed by adolescents and validated for the population under study. The DMFT index was evaluated according to WHO criteria, oral hygiene was evaluated based on the plaque index and BMI through weight and height in adolescents. Random sample by clusters (schools) with 661 adolescents, 84.1% female and 15.9% male. Adolescents with mean age 13.22 years (± 1.139). The mean DMFT was 2.23 (± 2.484), the prevalence of PI was 96.4%, and ≥ 5 BMI cariogenic foods (r=0.160; P=.000). Adolescents with a higher BMI consume less cariogenic foods (r=-0.1343; P=.001). The value of t reveals that the consumption of cariogenic foods explains 1.8% of the variance of the BMI and 2.6% DMFT. The cariogenic foods are presented as a risk factor for dental caries. The results suggest that it is important to develop up actions for health education. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Gingival immunologic defense index: a new indicator for evaluating dental plaque infection risk in allergic children

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-03-01

    Full Text Available There is a possible relationship between dental plaque and children allergic diseases. According to literatures, gingivitis suffered mostly by allergic children than control. Case reports also revealed that dental plaque control therapy was able to reduce, even eliminate rhinosinusitis and asthmatic symptoms without additional medications. However, the exact method for confirming the gingivitis-related allergy is still uncertain. Allergic diseases have multifactorial etiologies and dental plaque had been proposed as a new trigger of allergic symptoms. Nevertheless, since not every child with gingivitis suffered from allergy or vice versa, this uncertain phenomenon may lead to patients or other clinician disbelief. The objective of the present study was to propose a new method, which involving the Gingival immunologic defense index (GIDI to evaluate the susceptibility to allergic diseases. GIDI is an index that had been developed earlier for evaluating gingival immunologic defense with respect to immunoglobulin A (IgA levels. This index based on the simple count of the inflamed gingival surfaces of a child plus the measurement of salivary IgA content. It provides clinicians with important information about the immunologic defense potential of each subject. Interestingly, most allergic children also had inherited IgA deficiency, thus this concept is likely. Based on literatures, GIDI could be a potential index for evaluating the risk of allergic diseases through gingival health assessment. However, prior investigation to the value of Indonesian GIDI index which related to allergy should be conducted.

  18. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

  19. Ponderal index at birth associates with later risk of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Crusell, Mie; Damm, Peter; Hansen, Torben

    2017-01-01

    PURPOSE: Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose...... metabolism and BW in women with previous GDM. METHODS: GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from...

  20. 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.

  1. Multivariate market risk evaluation between Malaysian Islamic stock index and sectoral indices

    Directory of Open Access Journals (Sweden)

    Sew Lai Ng

    2017-03-01

    Full Text Available Without an efficient financial risk management, it may cause massive consequences to a financial institution as well as individual. Therefore, developing a methodology which gives precise estimates to reduce the exposure of risk to a minimum is of great importance. This paper uses an asymmetric BEKK-GARCH model to examine the return and volatility linkages between the FTSE Bursa Malaysia Emas Shariah (FBMS index and the sectoral indices under a normal market. The findings suggest that the FBMS plays a leading role in the mean return spillover effect. There is a strong evidence of significant transmission of past shocks, volatilities and leverage effects are observed on the current conditional variance-covariance in all the pair-wise models. These empirical results are helpful in quantifying the cross-market risk evaluation, risk minimizing weight and cross-market hedge ratio for strategizing appropriate portfolio selection.

  2. Adult body mass index and risk of ovarian cancer by subtype

    DEFF Research Database (Denmark)

    Dixon, Suzanne C; Nagle, Christina M; Thrift, Aaron P

    2016-01-01

    BACKGROUND: Observational studies have reported a positive association between body mass index (BMI) and ovarian cancer risk. However, questions remain as to whether this represents a causal effect, or holds for all histological subtypes. The lack of association observed for serous cancers may......, for instance, be due to disease-associated weight loss. Mendelian randomization (MR) uses genetic markers as proxies for risk factors to overcome limitations of observational studies. We used MR to elucidate the relationship between BMI and ovarian cancer, hypothesizing that genetically predicted BMI would...... be associated with increased risk of non-high grade serous ovarian cancers (non-HGSC) but not HGSC. METHODS: We pooled data from 39 studies (14 047 cases, 23 003 controls) in the Ovarian Cancer Association Consortium. We constructed a weighted genetic risk score (GRS, partial F-statistic = 172), summing alleles...

  3. Development of prolonged standing strain index to quantify risk levels of standing jobs.

    Science.gov (United States)

    Halim, Isa; Omar, Abdul Rahman

    2012-01-01

    Many occupations in industry such as metal stamping workers, electronics parts assembly operators, automotive industry welders, and lathe operators require working in a standing posture for a long time. Prolonged standing can contribute to discomfort and muscle fatigue particularly in the back and legs. This study developed the prolonged standing strain index (PSSI) to quantify the risk levels caused by standing jobs, and proposed recommendations to minimize the risk levels. Risk factors associated with standing jobs, such as working posture, muscles activity, standing duration, holding time, whole-body vibration, and indoor air quality, were the basis for developing the PSSI. All risk factors were assigned multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness.

  4. Atherogenic index and coronarian risk – comparative assessment regarding the particularities of chronic autoimmune thyroiditis presence

    Directory of Open Access Journals (Sweden)

    Seceleanu Mihaela

    2015-08-01

    Full Text Available Objectives: Assessment of autoimmune cause hypothyroidism and dyslipidemia involvement in the apparition of major vascular complications. Methods: A total of 152 patients were investigated appreciating in comparison to a healthy control lot the hormone serum level, the presence of antimicrosomal thyroid antibodies and the serum levels of lipids. Atherogenic index and coronarian risk were calculated and correlated with the incidence of coronarian and cerebral vascular accidents. Results: Among the patients with goiter it was noted a high incidence of a subclinical hypothyroidism (31,58%. Thyroid autoimmunity was involved in 94,4% of the patients with clinical hypothyroidism, in 93,7 % with subclinical hypothyroidism and 100% in the patients with thyrotoxicosis. Low serum level of HDL-cholesterol was identified in 66,6% of patients with clinical hypothyroidism and 64,5% patients with subclinical hypothyroidism. The assessment of atherogenic index and coronarian risk was significantly higher (p<0,01 in patients with hypothyroidism in comparison to healthy control subjects. The incidence of vascular accidents was significantly higher (p<0,01 among the hypothyroid patients ( 19,7%/ 10,8%, of masculine gender (12,7% where the main cause of hypothyroidism was autoimmunity. Conclusions: The atherogenic index and coronarian risk were higher in patients with hypothyroidism associated to thyroid autoimmunity resulting in an increased probability in producing vascular accidents

  5. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Development of Thresholds and Exceedance Probabilities for Influent Water Quality to Meet Drinking Water Regulations

    Science.gov (United States)

    Reeves, K. L.; Samson, C.; Summers, R. S.; Balaji, R.

    2017-12-01

    Drinking water treatment utilities (DWTU) are tasked with the challenge of meeting disinfection and disinfection byproduct (DBP) regulations to provide safe, reliable drinking water under changing climate and land surface characteristics. DBPs form in drinking water when disinfectants, commonly chlorine, react with organic matter as measured by total organic carbon (TOC), and physical removal of pathogen microorganisms are achieved by filtration and monitored by turbidity removal. Turbidity and TOC in influent waters to DWTUs are expected to increase due to variable climate and more frequent fires and droughts. Traditional methods for forecasting turbidity and TOC require catchment specific data (i.e. streamflow) and have difficulties predicting them under non-stationary climate. A modelling framework was developed to assist DWTUs with assessing their risk for future compliance with disinfection and DBP regulations under changing climate. A local polynomial method was developed to predict surface water TOC using climate data collected from NOAA, Normalized Difference Vegetation Index (NDVI) data from the IRI Data Library, and historical TOC data from three DWTUs in diverse geographic locations. Characteristics from the DWTUs were used in the EPA Water Treatment Plant model to determine thresholds for influent TOC that resulted in DBP concentrations within compliance. Lastly, extreme value theory was used to predict probabilities of threshold exceedances under the current climate. Results from the utilities were used to produce a generalized TOC threshold approach that only requires water temperature and bromide concentration. The threshold exceedance model will be used to estimate probabilities of exceedances under projected climate scenarios. Initial results show that TOC can be forecasted using widely available data via statistical methods, where temperature, precipitation, Palmer Drought Severity Index, and NDVI with various lags were shown to be important

  7. Pre-prepregnancy body mass index and the risk of gestational diabetes mellitus

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    Rudić-Grujić Vesna

    2017-01-01

    Full Text Available Introduction/Objective. Not only do pre-pregnancy overweight or obesity increase the risk of adverse maternal and perinatal outcomes but they also lead to the development of gestational diabetes mellitus. The objective of this study was to estimate the prevalence of pre-pregnancy overweight and obesity in the Republic of Srpska and to investigate its association with hyperglycemia and risk of gestational diabetes mellitus. Methods. A cross-sectional study was carried out during the period from February to October 2012 among 555 pregnant women in gestational period from 24 to 28 weeks. The criterion for exclusion from the sample was previously diagnosed type 1 or type 2 diabetes. Results. Before pregnancy, 20.39% of participants had increased body mass index, while 4.04 % [95% confidence interval (CI; 2.62–6.13] were obese. Gestational diabetes mellitus was diagnosed in 10.91% (95% CI, 8.44–13.98 of them. The increase in body mass index by 1 increased the risk of gestational diabetes mellitus by 1.09 times [odds ratio (OR = 1.09; 95% CI; 1.02–1.16]. Pregnant women who were overweight had a 4.88 times greater risk (OR = 4.88; 95% CI, 1.23–29.41 of developing gestational diabetes. Conclusion. Every fifth pregnant woman in this study was overweight or obese before pregnancy. The increase in body mass index by 1 increased the risk of gestational diabetes by 1.09 times (OR = 1.09; 95% CI; 1.02–1.16. Counselling is necessary for overweight and obese women planning pregnancy.

  8. SUITABILITY OF VISCERAL ADIPOSITY INDEX AS A MARKER FOR CARDIOMETABOLIC RISKS IN JORDANIAN ADULTS.

    Science.gov (United States)

    Numan Ahmad, Mousa; Halim Haddad, Fares

    2015-12-01

    visceral adiposity index (VAI) has recently been proposed as a predictor of cardiometabolic risk, but its usefulness has not been confirmed. to evaluate the association between VAI and conventional adiposity and cardiometabolic risk indices and examine VAI risk predictive ability and compare it with other adiposity indices. a total of 1 622 Jordanian adults, 686 men and 936 women, aged 20-80 years were included this study. VAI, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR) were examined and high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting serum glucose (FSG), systolic (SBP), and diastolic (DBP) blood pressure were determined. Associations and age-and gender specific distribution and differences were evaluated. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used for risk predictive ability comparison. VAI of women (6.82±6.43) was higher than of men (4.15±4.62). VAI severity increased with age in a dose-response trend (padiposity and cardiometabolic indices. VAI markedly associated with TG, HDL-C, FSG, SBP and DBP or WHR, WC, WHtR and BMI in respective order of correlation potency for cardiometabolic or adiposity risk indices. In men and women respectively, the largest AUC was for VAI (0.79 vs. 0.77), followed by WHR (0.73 vs. 0.75), WC (0.69 vs. 0.74), WHtR (0.65 vs. 0.71) and BMI (0.53 vs. 0.51). the findings suggest that VAI potentially associates with cardiometabolic risks and proves to be superior to other adiposity indices in predicting such risk. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Body mass index, exercise capacity, and mortality risk in male veterans with hypertension.

    Science.gov (United States)

    Faselis, Charles; Doumas, Michael; Panagiotakos, Demosthenes; Kheirbek, Raya; Korshak, Lauren; Manolis, Athanasios; Pittaras, Andreas; Tsioufis, Costas; Papademetriou, Vasilios; Fletcher, Ross; Kokkinos, Peter

    2012-04-01

    Overweight and obesity are associated with increased risk of chronic diseases and mortality. Exercise capacity is inversely associated with mortality risk. However, little is known on the interaction between fitness, fatness, and mortality risk in hypertensive individuals. Thus, we assessed the interaction between exercise capacity, fatness, and all-cause mortality in hypertensive males. A graded exercise test was performed in 4,183 hypertensive veterans (mean age ± s.d.; 63.3 ± 10.5 years) at the Veterans Affairs Medical Center, Washington, DC. We defined three body weight categories based on body mass index (BMI): normal weight (BMI 7.5 METs). During a median follow-up period of 7.2 years, there were 1,000 deaths. The association between exercise capacity and mortality risk was strong, inverse, and graded. For each 1-MET increase in exercise capacity the adjusted risk was 20% for normal weight, 12% for overweight, and 25% for obese (P exercise capacity is associated with lower mortality risk in hypertensive males regardless of BMI. The risk for overweight and obese but fit individuals was significantly lower when compared to normal weight but unfit. These findings suggest that in older hypertensive men, it may be healthier to be fit regardless of standard BMI category than unfit and normal weight.

  10. Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

    Science.gov (United States)

    Barge-Caballero, Eduardo; García-López, Fernando; Marzoa-Rivas, Raquel; Barge-Caballero, Gonzalo; Couto-Mallón, David; Paniagua-Martín, María J; Solla-Buceta, Miguel; Velasco-Sierra, Carlos; Pita-Gutiérrez, Francisco; Herrera-Noreña, José M; Cuenca-Castillo, José J; Vázquez-Rodríguez, José Manuel; Crespo-Leiro, María G

    2017-08-01

    To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI risk (83.5 ≤ NRI risk (97.5 ≤ NRI risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  11. The strain index and TLV for HAL: risk of lateral epicondylitis in a prospective cohort.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M; Hegmann, Kurt T; Thiese, Matthew S; Merryweather, Andrew S; Wang, Ying-Chih; Malloy, Elizabeth J

    2014-03-01

    This study's objective was to quantify exposure-response relationships between job physical exposure (JPE) and incidence of lateral epicondylitis (LE). A cohort of 536 workers was enrolled from 10 manufacturing facilities and followed monthly for 6 years to ascertain changes in JPE and health status. JPE was individually measured and quantified using the Strain Index (SI) and TLV for HAL. Worker demographics, medical history, psychosocial factors, and current musculoskeletal disorders were obtained. Fifty-six workers developed LE. In multivariate models JPE, age, family problems, and swimming were associated with increased risk of LE. SI showed an exposure-response relationship with maximum hazard ratio (HR) of 4.5(P = 0.04). TLV for HAL showed a non-statistically significant trend for increased risk of LE (P = 0.19). JPE is associated with increased risk of LE. The SI and TLV for HAL are useful metrics for estimating JPE. © 2013 Wiley Periodicals, Inc.

  12. The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents.

    Science.gov (United States)

    Jackson, C; Henriksen, L; Foshee, V A

    1998-06-01

    Public health research demonstrates increasing interest in mobilizing parental influence to prevent health risk behaviors among children and adolescents. This research focuses on authoritative parenting, which previous studies suggest can prevent health risk behaviors among youth. To evaluate the reliability and validity of a new survey measure of authoritative parenting, data from studies of (1) substance use in a sample of 1,236 fourth- and sixth-grade students; (2) weapon carrying and interpersonal violence in a sample of 1,490 ninth- and tenth-grade students, and (3) anger, alienation, and conflict resolution in a sample of 224 seventh- and eighth-grade students were analyzed. The Authoritative Parenting Index had a factor structure consistent with a theoretical model of the construct; had acceptable reliability; showed grade, sex, and ethnic differences consistent with other studies; and identified parenting types that varied as hypothesized with multiple indicators of social competence and health risk behaviors among children and adolescents.

  13. Air quality trends and potential health effects - Development of an aggregate risk index

    Science.gov (United States)

    Sicard, Pierre; Lesne, Olivia; Alexandre, Nicolas; Mangin, Antoine; Collomp, Rémy

    2011-02-01

    The "Provence Alpes Côte d'Azur" (PACA) region, in the South East of France, is one of Europe's regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990-2005 period, we obtained, using the non-parametric Mann-Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (-5.00% year -1), Cardiovascular (-0.73% year -1), Ischemic (-0.69% year -1) and cerebrovascular diseases (-3.10% year -1). However, for "Other heart diseases" (+0.10% year -1) and "Respiratory" (+0.10% year -1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross's concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM 2.5, PM 10, SO 2, O 3 and NO 2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology

  14. Hazard Quotients, Hazard Indexes, and Cancer Risks of Toxic Metals in PM10 during Firework Displays

    Directory of Open Access Journals (Sweden)

    Siwatt Pongpiachan

    2018-04-01

    Full Text Available Bonfire night is a worldwide phenomenon given to numerous annual celebrations characterised by bonfires and fireworks. Since Thailand has no national ambient air quality standards for metal particulates, it is important to investigate the impacts of particulate injections on elevations of air pollutants and the ecological health impacts resulting from firework displays. In this investigation, Pb and Ba were considered potential firework tracers because their concentrations were significantly higher during the episode, and lower than/comparable with minimum detection limits during other periods, indicating that their elevated concentrations were principally due to pyrotechnic displays. Pb/Ca, Pb/Al, Pb/Mg, and Pb/Cu can be used to pin-point emissions from firework displays. Air mass backward trajectories (72 h from the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT model indicated that areas east and north-east of the study site were the main sources of the airborne particles. Although the combined risk associated with levels of Pb, Cr, Co., Ni, Zn, As, Cd, V, and Mn was far below the standards mentioned in international guidelines, the lifetime cancer risks associated with As and Cr levels exceeded US-EPA guidelines, and may expose inhabitants of surrounding areas of Bangkok to an elevated cancer risk.

  15. Allogeneic Hematopoietic Cell Transplantation for Older Patients: Prognosis Determined by Disease Risk Index.

    Science.gov (United States)

    He, Fiona; Cao, Qing; Lazaryan, Aleksandr; Brunstein, Claudio; Holtan, Shernan; Warlick, Erica; Ustun, Celalettin; McClune, Brian; Arora, Mukta; Rashidi, Armin; Eckfeldt, Craig; Weisdorf, Daniel J; Bejanyan, Nelli

    2017-09-01

    The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced-intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (alloHCT) as a potentially curative option. We studied the association between Disease Risk Index (DRI) and clinical outcomes of 196 elderly patients (median age, 64.8; range, 60 to 75 years) with hematological malignancies receiving RIC alloHCT (2000 to 2014). Donors were related and unrelated adults (n = 100, 51.1%) or umbilical cord blood (n = 96, 48.9%). DRI classified 12 patients (6.1%) as low risk (LR), 146 patients (74.5%) as intermediate risk (IR), and 38 patients (19.4%) as high risk (HR). Two-year overall survival (OS) was 47% (52% for LR/IR versus 29% for HR, P risk of relapse (hazard ratio, 2.07; 95% confidence interval [CI], 1.34 to 3.33; P = .02) and treatment failure (hazard ratio, 2.07; 95% CI, 1.35 to 3.18; P risk of relapse leading to poor survival in HR DRI, participation in clinical trials offering relapse prevention strategies after RIC alloHCT should be encouraged when available. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  16. Body mass index cut-points to identify cardiometabolic risk in black South Africans.

    Science.gov (United States)

    Kruger, H Salome; Schutte, Aletta E; Walsh, Corinna M; Kruger, Annamarie; Rennie, Kirsten L

    2017-02-01

    To determine optimal body mass index (BMI) cut-points for the identification of cardiometabolic risk in black South African adults. We performed a cross-sectional study of a weighted sample of healthy black South Africans aged 25-65 years (721 men, 1386 women) from the North West and Free State Provinces. Demographic, lifestyle and anthropometric measures were taken, and blood pressure, fasting serum triglycerides, high-density lipoprotein (HDL) cholesterol and blood glucose were measured. We defined elevated cardiometabolic risk as having three or more risk factors according to international metabolic syndrome criteria. Receiver operating characteristic curves were applied to identify an optimal BMI cut-point for men and women. BMI had good diagnostic performance to identify clustering of three or more risk factors, as well as individual risk factors: low HDL-cholesterol, elevated fasting glucose and triglycerides, with areas under the curve >.6, but not for high blood pressure. Optimal BMI cut-points averaged 22 kg/m 2 for men and 28 kg/m 2 for women, respectively, with better sensitivity in men (44.0-71.9 %), and in women (60.6-69.8 %), compared to a BMI of 30 kg/m 2 (17-19.1, 53-61.4 %, respectively). Men and women with a BMI >22 and >28 kg/m 2 , respectively, had significantly increased probability of elevated cardiometabolic risk after adjustment for age, alcohol use and smoking. In black South African men, a BMI cut-point of 22 kg/m 2 identifies those at cardiometabolic risk, whereas a BMI of 30 kg/m 2 underestimates risk. In women, a cut-point of 28 kg/m 2 , approaching the WHO obesity cut-point, identifies those at risk.

  17. Managing hydroclimatological risk to water supply with option contracts and reservoir index insurance

    Science.gov (United States)

    Brown, Casey; Carriquiry, Miguel

    2007-11-01

    This paper explores the performance of a system of economic instruments designed to facilitate the reduction of hydroclimatologic variability-induced impacts on stakeholders of shared water supply. The system is composed of bulk water option contracts between urban water suppliers and agricultural users and insurance indexed on reservoir inflows. The insurance is designed to cover the financial needs of the water supplier in situations where the option is likely to be exercised. Insurance provides the irregularly needed funds for exercising the water options. The combined option contract - reservoir index insurance system creates risk sharing between sectors that is currently lacking in many shared water situations. Contracts are designed for a shared agriculture - urban water system in Metro Manila, Philippines, using optimization and Monte Carlo analysis. Observed reservoir inflows are used to simulate contract performance. Results indicate the option - insurance design effectively smooths water supply costs of hydrologic variability for both agriculture and urban water.

  18. A Risk-Free Protection Index Model for Portfolio Selection with Entropy Constraint under an Uncertainty Framework

    Directory of Open Access Journals (Sweden)

    Jianwei Gao

    2017-02-01

    Full Text Available This paper aims to develop a risk-free protection index model for portfolio selection based on the uncertain theory. First, the returns of risk assets are assumed as uncertain variables and subject to reputable experts’ evaluations. Second, under this assumption, combining with the risk-free interest rate we define a risk-free protection index (RFPI, which can measure the protection degree when the loss of risk assets happens. Third, note that the proportion entropy serves as a complementary means to reduce the risk by the preset diversification requirement. We put forward a risk-free protection index model with an entropy constraint under an uncertainty framework by applying the RFPI, Huang’s risk index model (RIM, and mean-variance-entropy model (MVEM. Furthermore, to solve our portfolio model, an algorithm is given to estimate the uncertain expected return and standard deviation of different risk assets by applying the Delphi method. Finally, an example is provided to show that the risk-free protection index model performs better than the traditional MVEM and RIM.

  19. Insulin Secretion and Risk for Future Diabetes in Subjects with a Nonpositive Insulinogenic Index

    Directory of Open Access Journals (Sweden)

    Daisuke Aono

    2018-01-01

    Full Text Available Aim. To characterize subjects with a nonpositive insulinogenic index and longitudinally observe changes in their glucose tolerance. Subjects and Methods. A historical cohort study was conducted using data from the medical checkups of public school workers. Indices of insulin secretion and insulin sensitivity derived from oral glucose tolerance test (OGTT and the incidences of diabetes and impaired glucose tolerance (IGT were compared among subgroups of subjects with different insulinogenic index (change in insulin/change in glucose over the first 30 min on the OGTT. Results. Of the 1464 nondiabetic subjects at baseline, 72 (4.9% subjects had a nonpositive insulinogenic index: 42 of those subjects had a nonpositive glucose response (ΔGlu0–30 ≤ 0 and 30 had a nonpositive insulin response (ΔIns0–30 ≤ 0. Compared with subjects who had normal glucose tolerance (NGT with insulinogenic index ≥ 0.4, subjects with a nonpositive glucose response had a higher first-phase Stumvoll and lower incidences of diabetes and IGT based on a log-rank test (p<0.05, whereas subjects with a nonpositive insulin response had lower indices of insulin secretion and a higher incidence of diabetes (p<0.05. Conclusions. These results demonstrate that in the first 30 min on the OGTT, subjects with a nonpositive insulinogenic index due to a nonpositive glucose response (ΔGlu0–30 ≤ 0 had a lower risk for future diabetes and that subjects with nonpositive insulin response (ΔIns0–30 ≤ 0 had a higher risk for future one.

  20. Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

    Science.gov (United States)

    Wasson, John H; Ho, Lynn; Soloway, Laura; Moore, L Gordon

    2018-01-01

    Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Five measures with well-documented impacts on the use of health services are summed to create a "What Matters Index." These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. The patient-reported "What Matters Index" and the conventional risk models are found to exhibit similar sensitivities and predictive values for subsequent hospital or emergency room use. The "What Matters Index" is also reliable: akin to its performance during development, for patients with index scores of 1, 2, and ≥3, the odds ratios (with 95% confidence intervals) for subsequent hospitalization within 1 year, relative to patients with a score of 0, are 1.3 (1.1-1.6), 2.0 (1.6-2.4), and 3.4 (2.9-4.0), respectively; for emergency room use, the corresponding odds ratios are 1.3 (1.1-1.4), 1.9 (1.6-2.1), and 2.9 (2.6-3.3). Similar findings were replicated among smaller populations of 1061 mostly older patients from nine private practices and 4428 Medicaid patients without chronic conditions. In contrast to complex computer-generated risk models, the brief patient-reported "What Matters Index" immediately and unambiguously identifies fundamental, remediable needs for each patient and more sensibly directs the delivery of services to patient categories based on

  1. Body mass index and risk for mental stress induced ischemia in coronary artery disease.

    Science.gov (United States)

    Soufer, Robert; Fernandez, Antonio B; Meadows, Judith; Collins, Dorothea; Burg, Matthew M

    2016-05-19

    Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4±4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger

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

    OpenAIRE

    Mainik, Georg; Mitov, Georgi; Rüschendorf, Ludger

    2015-01-01

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

  3. Body mass index and risk of BPH: a meta-analysis.

    Science.gov (United States)

    Wang, S; Mao, Q; Lin, Y; Wu, J; Wang, X; Zheng, X; Xie, L

    2012-09-01

    Epidemiological studies have reported conflicting results relating obesity to BPH. A meta-analysis of cohort and case-control studies was conducted to pool the risk estimates of the association between obesity and BPH. Eligible studies were retrieved by both computer searches and review of references. We analyzed abstracted data with random effects models to obtain the summary risk estimates. Dose-response meta-analysis was performed for studies reporting categorical risk estimates for a series of exposure levels. A total of 19 studies met the inclusion criteria of the meta-analysis. Positive association with body mass index (BMI) was observed in BPH and lower urinary tract symptoms (LUTS) combined group (odds ratio=1.27, 95% confidence intervals 1.05-1.53). In subgroup analysis, BMI exhibited a positive dose-response relationship with BPH/LUTS in population-based case-control studies and a marginal positive association was observed between risk of BPH and increased BMI. However, no association between BPH/LUTS and BMI was observed in other subgroups stratified by study design, geographical region or primary outcome. The overall current literatures suggested that BMI was associated with increased risk of BPH. Further efforts should be made to confirm these findings and clarify the underlying biological mechanisms.

  4. Predicting dyslexia at age 11 from a risk index questionnaire at age 5.

    Science.gov (United States)

    Helland, Turid; Plante, Elena; Hugdahl, Kenneth

    2011-08-01

    This study focused on predicting dyslexia in children ahead of formal literacy training. Because dyslexia is a constitutional impairment, risk factors should be seen in preschool. It was hypothesized that data gathered at age 5 using questions targeting the dyslexia endophenotype should be reliable and valid predictors of dyslexia at age 11. A questionnaire was given to caretakers of 120 5-year-old children, and a risk index score was calculated based on questions regarding health, laterality, motor skills, language, special needs education and heredity. An at-risk group (n = 25) and matched controls (n = 24) were followed until age 11, when a similar questionnaire and literacy tests were administered to the children who participated in the follow-up study (22 at risk and 20 control). Half of the at-risk children and two of the control children at age 5 were identified as having dyslexia at age 11 (8 girls and 5 boys). It is concluded that it is possible to identify children at the age of 5 who will have dyslexia at the age of 11 through a questionnaire approach. Copyright © 2011 John Wiley & Sons, Ltd.

  5. A risk index for multicriterial selection of a logging system with low environmental impact

    Energy Technology Data Exchange (ETDEWEB)

    Horodnic, Sergiu Andrei, E-mail: horodnic@usv.ro

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  6. A risk index for multicriterial selection of a logging system with low environmental impact

    International Nuclear Information System (INIS)

    Horodnic, Sergiu Andrei

    2015-01-01

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up

  7. Is risk of degenerative musculoskeletal conditions associated with pre-pregnancy body mass index and parity?

    DEFF Research Database (Denmark)

    Bliddal, Mette; Pottegård, Anton; Kirkegaard, Helene

    Background Obesity among women may influence the risk of degenerative musculoskeletal conditions (MSCs) and contribute to poor quality of life. Parity, which constitutes a sudden natural increase in weight as well it affects long-term body mass index (BMI), may put strain on the musculoskeletal....... Information on height and weight prior to pregnancy was obtained from telephone interviews and parity from the Danish Medical Birth Registry. Diagnoses on degenerative MSC including osteoarthritis, disc disorders, low back pain, and soft tissue disorders were obtained from the National Patient Registry......% confidence interval 1.41-1.83]). Conclusions High pre-pregnancy BMI increased the occurrence of degenerative MSC in the years following pregnancy and childbirth. In combination with increasing pre-pregnancy BMI, higher parity added to an already elevated risk. Prevention of maternal overweight may reduce...

  8. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Directory of Open Access Journals (Sweden)

    Tatiana Uchôa Passos

    2015-03-01

    Full Text Available The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”, guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple.

  9. Evaluation of a temporal fire risk index in Mediterranean forests from NOAA thermal IR

    International Nuclear Information System (INIS)

    Vidal, A.; Pinglo, F.; Durand, H.; Devaux-Ros, C.; Maillet, A.

    1994-01-01

    Mediterranean forests are regularly subjected to a large number of fires; 537,000 ha were burned during the severe European drought of 1990. The French Ministries of Environment, Interior, and Agriculture are trying to implement efficient methods to prevent forest fires and to reduce their incidence. Fire risk is composed of human, ecological, and climatic factors that are already accounted for in prevention methods. However, the importance of biophysical factors, especially the water status of forest trees, bushes, grasses, and litter should also be considered. In a first step, thermal infrared data from NOAA-AVHRR daily images covering an 18-month period were used to estimate temporal variations of forest evapotranspiration through an energy budget-based relationship. Results were related to statistics on fire starts, in order to derive a fire risk index that can be used for a real-time regional alarm. (author)

  10. Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer.

    Science.gov (United States)

    Loeb, Stacy; Shin, Sanghyuk S; Broyles, Dennis L; Wei, John T; Sanda, Martin; Klee, George; Partin, Alan W; Sokoll, Lori; Chan, Daniel W; Bangma, Chris H; van Schaik, Ron H N; Slawin, Kevin M; Marks, Leonard S; Catalona, William J

    2017-07-01

    To examine the use of the Prostate Health Index (PHI) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre US study. The study population included 728 men, with prostate-specific antigen (PSA) levels of 2-10 ng/mL and a negative digital rectal examination, enrolled in a prospective, multi-site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7. First, we evaluated whether the addition of PHI improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [PCPT] and European Randomised Study of Screening for Prostate Cancer [ERSPC] risk calculators). We also designed and internally validated a new PHI-based multivariable predictive model, and created a nomogram. Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The PHI predicted the risk of aggressive prostate cancer across the spectrum of values. Adding PHI significantly improved the predictive accuracy of the PCPT and ERSPC risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume, PSA and PHI, with an area under the curve of 0.746. The bootstrap-corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision-curve analysis. Using PHI as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  11. Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children.

    Science.gov (United States)

    Jang, Myoungock; Grey, Margaret; Sadler, Lois; Jeon, Sangchoon; Nam, Soohyun; Song, Hee-Jung; Whittemore, Robin

    2017-08-03

    To describe obesity-risk behaviours (diet, physical activity and sedentary behaviour) and examine the relationships of the obesity-risk behaviours with body mass index (BMI) in school-aged Korean American children. Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviours in Korean American children. A cross-sectional study. Obesity-risk behaviours of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analysed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. A total of 170 Korean American children (mean age 10.9 [2.0] years; 52.4% girls; mean BMI 19.3 [3.2]; 28.7% ≥85 percentiles) participated in the study. Only 38.3% of Korean American children met established recommendations of five fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity; and 40.8% met recommendations for obesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviours, especially sedentary behaviour, in Korean American children. Clinical assessment and management of the risk of developing overweight and obesity as well as obesity-related behaviours are important to improve obesity-related complications in overall Korean Americans. © 2017 John Wiley & Sons Ltd.

  12. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis.

    Science.gov (United States)

    Niedermaier, Tobias; Behrens, Gundula; Schmid, Daniela; Schlecht, Inga; Fischer, Beate; Leitzmann, Michael F

    2015-10-13

    Whether adiposity and lack of physical activity affect the risk for developing meningioma and glioma is poorly understood. Our objective was to characterize these associations in detail. We conducted a systematic review and meta-analysis of adiposity and physical activity in relation to meningioma and glioma using cohort and case-control studies published through February 2015. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified 12 eligible studies of body mass index (BMI) and 6 studies of physical activity, comprising up to 2,982 meningioma cases and 3,057 glioma cases. Using normal weight as the reference group, overweight (summary relative risk [RR] = 1.21, 95% confidence interval [CI] = 1.01-1.43) and obesity (RR = 1.54, 95% CI = 1.32-1.79) were associated with increased risk of meningioma. In contrast, overweight (RR = 1.06, 95% CI = 0.94-1.20) and obesity (RR = 1.11, 95% CI = 0.98-1.27) were unrelated to glioma. Similarly, dose-response meta-analyses revealed a statistically significant positive association of BMI with meningioma, but not glioma. High vs low physical activity levels showed a modest inverse relation to meningioma (RR = 0.73, 95% CI = 0.61-0.88) and a weak inverse association with glioma (RR = 0.86, 95% CI = 0.76-0.97). Relations persisted when the data were restricted to prospective studies, except for the association between physical activity and glioma, which was rendered statistically nonsignificant (RR = 0.91, 95% CI = 0.77-1.07). Adiposity is related to enhanced risk for meningioma but is unassociated with risk for glioma. Based on a limited body of evidence, physical activity is related to decreased risk of meningioma but shows little association with risk of glioma. © 2015 American Academy of Neurology.

  13. Spontaneous baroreflex sensitivity: toward an ideal index of cardiovascular risk in hypertension?

    Science.gov (United States)

    Lantelme, Pierre; Khettab, Fouad; Custaud, Marc-Antoine; Rial, Marie-Odile; Joanny, Christiane; Gharib, Claude; Milon, Hugues

    2002-05-01

    Estimating the risk entailed by classical risk factors like blood pressure (BP) or serum cholesterol may be difficult because of their variability and the often unknown duration of exposure. Having variables integrating the impact of those classical risk factors on the cardiovascular system would probably aid the prediction of cardiovascular events. The present study aimed at determining whether cardiac baroreflex sensitivity (BRS), correlates with several risk factors and thus is a good candidate for being such an integrative variable. As a comparison, left ventricular mass (LVM), pulse wave velocity (PWV), and creatinine were also tested for association with risk factors. A total of 302 subjects referred for hypertension, were considered. They had a 24-h BP recording and a determination of BRS by two different methods (sequence and alpha coefficient), in two different positions (lying and standing). They were also tested for the presence of left ventricular hypertrophy (LVH) (by echocardiography and electrocardiogram) and had a PWV measurement. Biological testing included serum lipids, blood glucose, creatinine, proteinuria and urinary excretion of microalbumin. There was a strong correlation between the two methods of BRS measurement in each position (P < 0.001). BRS determined by the sequence method in the lying position was correlated significantly and independently with age, 24-h systolic BP, heart rate, and serum cholesterol with P values < 0.001, < 0.001, < 0.01, and < 0.05, respectively. In an univariate analysis, BRS was also correlated with echocardiographic LVM index (r = -0.21, P < 0.05) and PWV (r = -0.27, P < 0.001), which possibly reflects its dependence on both vascular and cardiac damages. The present study supports the hypothesis that BRS could encompass the impact over time of several risk factors on the cardiovascular system. Thus, it may constitute a valuable parameter in assessing more precisely the risk of cardiovascular events.

  14. Assessing heat-related health risk in Europe via the Universal Thermal Climate Index (UTCI)

    Science.gov (United States)

    Di Napoli, Claudia; Pappenberger, Florian; Cloke, Hannah L.

    2018-03-01

    In this work, the potential of the Universal Thermal Climate Index (UTCI) as a heat-related health risk indicator in Europe is demonstrated. The UTCI is a bioclimate index that uses a multi-node human heat balance model to represent the heat stress induced by meteorological conditions to the human body. Using 38 years of meteorological reanalysis data, UTCI maps were computed to assess the thermal bioclimate of Europe for the summer season. Patterns of heat stress conditions and non-thermal stress regions are identified across Europe. An increase in heat stress up to 1 °C is observed during recent decades. Correlation with mortality data from 17 European countries revealed that the relationship between the UTCI and death counts depends on the bioclimate of the country, and death counts increase in conditions of moderate and strong stress, i.e., when UTCI is above 26 and 32 °C. The UTCI's ability to represent mortality patterns is demonstrated for the 2003 European heatwave. These findings confirm the importance of UTCI as a bioclimatic index that is able to both capture the thermal bioclimatic variability of Europe, and relate such variability with the effects it has on human health.

  15. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  16. Determination of the health of Lunyangwa wetland using Wetland Classification and Risk Assessment Index

    Science.gov (United States)

    Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.; Msilimba, Golden

    2016-04-01

    Wetlands are major sources of various ecological goods and services including storage and distribution of water in space and time which help in ensuring the availability of surface and groundwater throughout the year. However, there still remains a poor understanding of the range of values of water quality parameters that occur in wetlands either in its impacted state or under natural conditions. It was thus imperative to determine the health of Lunyangwa wetland in Mzuzu City in Malawi in order to classify and determine its state. This study used the Escom's Wetland Classification and Risk Assessment Index Field Guide to determine the overall characteristics of Lunyangwa wetland and to calculate its combined Wetland Index Score. Data on site information, field measurements (i.e. EC, pH, temperature and DO) and physical characteristics of Lunyangwa wetland were collected from March, 2013 to February, 2014. Results indicate that Lunyangwa wetland is a largely open water zone which is dominated by free-floating plants on the water surface, beneath surface and emergent in substrate. Furthermore, the wetland can be classified as of a C ecological category (score = 60-80%), which has been moderately modified with moderate risks of the losses and changes occurring in the natural habitat and biota in the wetland. It was observed that the moderate modification and risk were largely because of industrial, agricultural, urban/social catchment stressors on the wetland. This study recommends an integrated and sustainable management approach coupled with continuous monitoring and evaluation of the health of the wetland for all stakeholders in Mzuzu City. This would help to maintain the health of Lunyangwa wetland which is currently at risk of being further modified due to the identified catchment stressors.

  17. Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

    Science.gov (United States)

    Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

    2018-02-01

    Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

  18. Can LENR Energy Gains Exceed 1000?

    Science.gov (United States)

    Nagel, David J.

    2011-03-01

    Energy gain is defined as the energy realized from reactions divided by the energy required to produce those reactions. Low Energy Nuclear Reactions (LENR) have already been measured to significantly exceed the energy gain of 10 projected from ITER,possibly 15 years from now. Electrochemical experiments using the Pd-D system have shown energy gains exceeding 10. Gas phase experiments with the Ni-H system were reported to yield energy gains of over 100. Neither of these reports has been adequately verified or reproduced. However, the question in the title still deserves consideration. If, as thought by many, it is possible to trigger nuclear reactions that yield MeV energies with chemical energies of the order of eV, then the most optimistic expectation is that LENR gains could approach one million. Hence, the very tentative answer to the question above is yes. However, if LENR could be initiated with some energy cost, and then continue to ``burn,'' very high energy gains might be realized. Consider a match and a pile of dry logs. The phenomenon termed ``heat after death'' will be examined to see if it might be the initial evidence for nuclear ``burning.''

  19. A new hazard index for the determination of risk potentials of disposed radioactive wastes

    International Nuclear Information System (INIS)

    Kirchner, Gerald

    1990-01-01

    On the basis of a discussion of advantages and limitations of hazard calculations of nuclear waste, a new hazard index is presented. The model deals with environmental processes that determine radiation exposure to man after failure of a geologic repository and release of radionuclides into the biosphere. Included in the model are isotopic composition of the waste, probability for transport of nuclides to man, cycling in the biosphere, radiotoxicity to man and changes of the risk potential which are due to radioactive build-up and decay processes after the waste nuclides enter the biosphere. Nuclide-specific data necessary for the use of the new index are compiled. Calculations for wastes from different nuclear power reactor types and fuel cycle options indicate that 237 Np and 241 Am are the waste constituents with the most demanding requirements in regard to the long-term isolation potential of a repository. Isolation times required for the wastes analyzed are of the order of 10 7 years. Hazard analyses of nuclear wastes with negligible heat generation from various sources show that secondary wastes from nuclear fuel reprocessing and mixed-oxide fuel fabrication have long-term risk potentials which are about two orders of magnitude higher than those from other wastes. They should be disposed of together with high-level wastes. (author)

  20. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Cook, M B; Freedman, N D; Gamborg, M

    2015-01-01

    BACKGROUND: Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life. METHODS: We assessed associations between childhood body mass index (BMI) and height-measured annually between ages 7 and 13-with adult....... RESULTS: During 5.4 million person-years of follow-up, 254 (216 males) incident oesophageal adenocarcinomas occurred. At each examined age, cancer risk increased linearly per unit BMI z-score, although associations were only statistically significant for ages 9-13. The HR for the age of 13 years was 1.......31 (95% CI: 1.13, 1.51) per unit BMI z-score. Associations were similar in men and women and across birth cohorts. Childhood height was not related to cancer risk in men but was in women, although these analyses included just 38 female cases. HRs per unit height z-score at the age of 13 years were 1...

  1. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi [International Medical Center, Chinese PLA General Hospital, Beijing (China)

    2012-04-20

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.

  2. Ponderal index at birth associates with later risk of gestational diabetes mellitus.

    Science.gov (United States)

    Crusell, Mie; Damm, Peter; Hansen, Torben; Pedersen, Oluf; Glümer, Charlotte; Vaag, Allan; Lauenborg, Jeannet

    2017-08-01

    Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose metabolism and BW in women with previous GDM. GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from the original midwifery records. BW and PI were stratified into tertiles for analysis. PI in the lower tertiles was associated with an increased risk of GDM [odds ratio 1.59 (95% confidence interval 1.07-2.36, p = 0.021)]. Among women with previous GDM, the area under the curve (AUC) for plasma levels of glucose and insulin during an OGTT was highest for the lower tertiles of BW (for AUCglucose p = 0.048, for AUCinsulin p = 0.047 adjusted for age and BMI). Lower PI is associated with increased risk of GDM. In women with previous GDM, lower BW is associated with a more severe impairment of glucose metabolism one to two decades after the pregnancy complicated by GDM.

  3. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    International Nuclear Information System (INIS)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi

    2012-01-01

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor

  4. Individual and shared effects of social environment and polygenic risk scores on adolescent body mass index.

    Science.gov (United States)

    Coleman, Jonathan R I; Krapohl, Eva; Eley, Thalia C; Breen, Gerome

    2018-04-20

    Juvenile obesity is associated with adverse health outcomes. Understanding genetic and environmental influences on body mass index (BMI) during adolescence could inform interventions. We investigated independent and interactive effects of parenting, socioeconomic status (SES) and polygenic risk on BMI pre-adolescence, and on the rate of change in BMI across adolescence. Genome-wide genotype data, BMI and child perceptions of parental warmth and punitive discipline were available at 11 years old, and parental SES was available from birth on 3,414 unrelated participants. Linear models were used to test the effects of social environment and polygenic risk on pre-adolescent BMI. Change in BMI across adolescence was assessed in a subset (N = 1943). Sex-specific effects were assessed. Higher genetic risk was associated with increased BMI pre-adolescence and across adolescence (p parenting was not significantly associated with either phenotype, but lower SES was associated with increased BMI pre-adolescence. No interactions passed correction for multiple testing. Polygenic risk scores from adult GWAS meta-analyses are associated with BMI in juveniles, suggesting a stable genetic component. Pre-adolescent BMI was associated with social environment, but parental style has, at most, a small effect.

  5. Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Mi Jung Lee

    2017-12-01

    Full Text Available Background: Geriatric nutritional risk index (GNRI is a validated nutritional assessment method, and lower GNRI values are closely associated with adverse clinical outcomes in dialysis patients. This study investigated the impact of changes in GNRI during the first year of dialysis on cardiovascular outcomes in incident peritoneal dialysis (PD patients. Methods: We reviewed medical records in 133 incident PD patients to determine GNRI at the start of PD and after 12 months. Patients were categorized into improved (delta GNRI > 0 and worsening/stationary (delta GNRI ≤ 0 groups. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs. Results: During a mean follow-up of 51.1 months, the primary outcome was observed in 42 patients (31.6%. The baseline GNRI at PD initiation was not significantly associated with MACCEs (log-rank test, P = 0.40. However, the cumulative event-free rate was significantly lower in the worsening or stationary GNRI group than in the improved group (log-rank test, P = 0.004. Multivariate Cox analysis revealed that a worsening or stationary GNRI was independently associated with higher risk for MACCEs (hazard ratio, 2.47; 95% confidence interval, 1.15–5.29; P = 0.02. In subgroup analysis, patients with worsening or stationary GNRI were at significantly greater risk for MACCEs in both the lower (P = 0.04 and higher (P = 0.01 baseline GNRI groups. Conclusion: Baseline GNRI was not associated with MACCEs, but patients with deteriorating or stationary nutritional status were at significantly greater risk for MACCEs, suggesting that serial monitoring of nutritional status is important to stratify cardiovascular risk in incident PD patients.

  6. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans.

    Science.gov (United States)

    Hu, Hao; Huff, Chad D; Yamamura, Yuko; Wu, Xifeng; Strom, Sara S

    2015-01-01

    Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans. Mexican-Americans are genetically diverse, with a highly variable distribution of Native American, European, and African ancestries. Here, we evaluate the role of Native American ancestry on BMI and diabetes risk in a well-defined Mexican-American population. Participants were randomly selected among individuals residing in the Houston area who are enrolled in the Mexican-American Cohort study. Using a custom Illumina GoldenGate Panel, we genotyped DNA from 4,662 cohort participants for 87 Ancestry-Informative Markers. On average, the participants were of 50.2% Native American ancestry, 42.7% European ancestry and 7.1% African ancestry. Using multivariate linear regression, we found BMI and Native American ancestry were inversely correlated; individuals with ancestry were 2.5 times more likely to be severely obese compared to those with >80% Native American ancestry. Furthermore, we demonstrated an interaction between BMI and Native American ancestry in diabetes risk among women; Native American ancestry was a strong risk factor for diabetes only among overweight and obese women (OR = 1.190 for each 10% increase in Native American ancestry). This study offers new insight into the complex relationship between obesity, genetic ancestry, and their respective effects on diabetes risk. Findings from this study may improve the diabetes risk prediction among Mexican-American individuals thereby facilitating targeted prevention strategies.

  7. Work Ability Index as tool to identify workers at risk of premature work exit.

    Science.gov (United States)

    Roelen, Corné A M; Heymans, Martijn W; Twisk, Jos W R; van der Klink, Jac J L; Groothoff, Johan W; van Rhenen, Willem

    2014-12-01

    To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at baseline and reported their work status (employed, unemployed, disability pension, or retired) after mean 2.3 years of follow-up. Associations between WAI scores and work status were investigated by multinomial logistic regression analysis. The ability of the WAI to discriminate between workers at high and low risk of premature work exit was analyzed by the area (AUC) under the receiver operating characteristic curve. 9,530 (83 %) construction workers had complete data for analysis. At follow-up, 336 (4 %) workers reported disability pension, 125 (1 %) unemployment, and 255 (3 %) retirement. WAI scores were prospectively associated with the risk of disability pension at follow-up, but not with the risk of unemployment and early retirement. The WAI showed fair discrimination to identify workers at risk of disability pension [AUC = 0.74; 95 % confidence interval (CI) 0.70-0.77]. The discriminative ability decreased with age from AUC = 0.78 in workers aged 30-39 years to AUC = 0.69 in workers ≥50 years of age. Discrimination failed for unemployment (AUC = 0.51; 95 % CI 0.47-0.55) and early retirement (AUC = 0.58; 95 % CI 0.53-0.61). The WAI can be used to identify construction workers <50 years of age at increased risk of disability pension and invite them for preventive interventions.

  8. Sleep duration and cancer risk: time to use a "sleep-years" index?

    Science.gov (United States)

    Erren, Thomas C

    2012-09-01

    With a focus on melatonin, a recent paper in the Journal investigated the hypothesis that endometrial cancer might be associated with the duration, and ultimately, amount of sleep. The authors found that "[s]elf-reported sleep duration may not adequately represent melatonin levels." The authors also concluded that there was "weak evidence of an association between sleep duration and endometrial cancer risk." Overall, these are interesting observations because primarily experimental and mechanistic research from many angles supports the study's notion that inappropriate sleep may be a determinant of cancer risk. To find out whether this is so in man, rather than assigning study individuals to fixed or average "baseline sleep categories" i.e., ≤5, 6, 7, 8, ≥9 h of habitual sleep in the present study, the accumulated amount of sleep over decades should be reconstructed in retrospective or constructed in prospective studies. To achieve this end, future epidemiological studies may want to use a sleep-years index [SYI]. This simple exposure parameter promises to be a sensible, feasible, and affordable way to approximate cumulative time spent at sleep in critical time windows over many years which we should expect to be relevant for the development of cancer. The SYI could be tested and used in observational studies which promise to be comparable and can be merged. This commentary provides roots of the index and explains why and how it should be used and how it could be interpreted in rigorous studies of biologically plausible links between sleep, on the one hand, and the development of internal cancers, on the other. This commentary also points out limitations of interpreting the SYI. It is emphasized that, where possible, the SYI should be assessed independently of (a) other sleep facets--such as quality--and of (b) known or suspected cancer risk factors. The respective contribution of (a) and (b) to risk must then be assessed during the analyses. Overall, the

  9. Protective containment behaviour under exceeded design loads

    International Nuclear Information System (INIS)

    Holub, I.; Stepan, J.; Maly, J.; Schererova, K.

    2003-01-01

    The contribution describes the calculation results of the behaviour of containment structure if loaded in excess of its design load. The Temelin NPP comprises two WWER 1000 blocks and containment consists of a pre-stressed reinforced concrete structure with a system of unbonded cables. The objective of the calculations was to determine the level of load caused by the internal pressure and temperature at which the containment protective function would fail. In the first step, the maximum overpressure was determined, which may be transferred by the containment structure. In further steps analyses were made of various combinations of simultaneous pressure and temperature loads. The contribution presents relevant calculation results, including the evaluation of containment structure behaviour including liner under loads that exceed its design parameters. (author)

  10. Human Exposure Risk Assessment Due to Heavy Metals in Groundwater by Pollution Index and Multivariate Statistical Methods: A Case Study from South Africa

    Directory of Open Access Journals (Sweden)

    Vetrimurugan Elumalai

    2017-04-01

    Full Text Available Heavy metals in surface and groundwater were analysed and their sources were identified using multivariate statistical tools for two towns in South Africa. Human exposure risk through the drinking water pathway was also assessed. Electrical conductivity values showed that groundwater is desirable to permissible for drinking except for six locations. Concentration of aluminium, lead and nickel were above the permissible limit for drinking at all locations. Boron, cadmium, iron and manganese exceeded the limit at few locations. Heavy metal pollution index based on ten heavy metals indicated that 85% of the area had good quality water, but 15% was unsuitable. Human exposure dose through the drinking water pathway indicated no risk due to boron, nickel and zinc, moderate risk due to cadmium and lithium and high risk due to silver, copper, manganese and lead. Hazard quotients were high in all sampling locations for humans of all age groups, indicating that groundwater is unsuitable for drinking purposes. Highly polluted areas were located near the coast, close to industrial operations and at a landfill site representing human-induced pollution. Factor analysis identified the four major pollution sources as: (1 industries; (2 mining and related activities; (3 mixed sources- geogenic and anthropogenic and (4 fertilizer application.

  11. Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

    Science.gov (United States)

    McCarney, G. R.; Osgood, D. E.

    2011-12-01

    Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

  12. Diet index-based and empirically derived dietary patterns are associated with colorectal cancer risk.

    Science.gov (United States)

    Miller, Paige E; Lazarus, Philip; Lesko, Samuel M; Muscat, Joshua E; Harper, Gregory; Cross, Amanda J; Sinha, Rashmi; Ryczak, Karen; Escobar, Gladys; Mauger, David T; Hartman, Terryl J

    2010-07-01

    Previous studies have derived patterns by measuring compliance with preestablished dietary guidance or empirical methods, such as principal components analysis (PCA). Our objective was to examine colorectal cancer risk associated with patterns identified by both methods. The study included 431 incident colorectal cancer cases (225 men, 206 women) and 726 healthy controls (330 men, 396 women) participating in a population-based, case-control study. PCA identified sex-specific dietary patterns and the Healthy Eating Index-2005 (HEI-05) assessed adherence to the 2005 Dietary Guidelines for Americans. A fruits and vegetables pattern and a meat, potatoes, and refined grains pattern were identified among men and women; a third pattern (alcohol and sweetened beverages) was identified in men. The fruits and vegetables pattern was inversely associated with risk among men [odds ratio (OR) = 0.38, 95% CI = 0.21-0.69 for the highest compared with the lowest quartile] and women (OR = 0.35, 95% CI = 0.19-0.65). The meat, potatoes, and refined grains pattern was positively associated with risk in women (OR = 2.20, 95% CI = 1.08-4.50) and there was a suggestion of a positive association among men (OR = 1.56, 95% CI = 0.84-2.90; P-trend = 0.070). Men and women with greater HEI-05 scores had a significantly reduced risk of colorectal cancer (OR = 0.56, 95% CI = 0.31-0.99; OR = 0.44, 95% CI = 0.24-0.77, respectively). Following the Dietary Guidelines or a dietary pattern lower in meat, potatoes, high fat, and refined foods and higher in fruits and vegetables may reduce colorectal cancer risk.

  13. Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes.

    Science.gov (United States)

    Du, T; Zhang, J; Yuan, G; Zhang, M; Zhou, X; Liu, Z; Sun, X; Yu, X

    2015-01-01

    Increased cardiovascular disease and mortality risk in metabolically healthy obese (MHO) individuals remain highly controversial. Several studies suggested risk while others do not. The traditional cardiovascular risk factors may be insufficient to demonstrate the complete range of metabolic abnormalities in MHO individuals. Hence, we aimed to compare the prevalence of elevated lipoprotein (a), apolipoprotein B, and uric acid (UA) levels, apolipoprotein B/apolipoprotein A1 ratio, and visceral adiposity index (VAI) scores, and low apolipoprotein A1 levels among 6 body size phenotypes (normal weight with and without metabolic abnormalities, overweight with and without metabolic abnormalities, and obese with or without metabolic abnormalities). We conducted a cross-sectional analysis of 7765 Chinese adults using data from the nationwide China Health and Nutrition Survey 2009. MHO persons had intermediate prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low apolipoprotein A1 levels between metabolically healthy normal-weight (MHNW) and metabolically abnormal obese individuals (P < 0.001 for all comparisons). Elevated apolipoprotein B and UA concentrations, apolipoprotein B/apolipoprotein A1 ratio, and VAI scores were all strongly associated with the MHO phenotype (all P < 0.01). Prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low levels of apolipoprotein A1 was higher among MHO persons than among MHNW individuals. The elevated levels of the nontraditional risk factors and VAI scores in MHO persons could contribute to the increased cardiovascular disease risk observed in long-term studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Towards a Comparative Index of Seaport Climate-Risk: Development of Indicators from Open Data

    Science.gov (United States)

    McIntosh, R. D.; Becker, A.

    2016-02-01

    Seaports represent an example of coastal infrastructure that is at once critical to global trade, constrained to the land-sea interface, and exposed to weather and climate hazards. Seaports face impacts associated with projected changes in sea level, sedimentation, ocean chemistry, wave dynamics, temperature, precipitation, and storm frequency and intensity. Port decision-makers have the responsibility to enhance resilience against these impacts. At the multi-port (regional or national) scale, policy-makers must prioritize adaptation efforts to maximize the efficiency of limited physical and financial resources. Prioritization requires comparing across seaports, and comparison requires a standardized assessment method, but efforts to date have either been limited in scope to exposure-only assessments or limited in scale to evaluate one port in isolation from a system of ports. In order to better understand the distribution of risk across ports and to inform transportation resilience policy, we are developing a comparative assessment method to measure the relative climate-risk faced by a sample of ports. Our mixed-methods approach combines a quantitative, data-driven, indicator-based assessment with qualitative data collected via expert-elicitation. In this presentation, we identify and synthesize over 120 potential risk indicators from open data sources. Indicators represent exposure, sensitivity, and adaptive capacity for a pilot sample of 20 ports. Our exploratory data analysis, including Principal Component Analysis, uncovered sources of variance between individual ports and between indicators. Next steps include convening an expert panel representing the perspectives of multiple transportation system agencies to find consensus on a suite of robust indicators and metrics for maritime freight node climate risk assessment. The index will be refined based on expert feedback, the sample size expanded, and additional indicators sought from closed data sources

  15. Body mass index in relation to serum prostate-specific antigen levels and prostate cancer risk.

    Science.gov (United States)

    Bonn, Stephanie E; Sjölander, Arvid; Tillander, Annika; Wiklund, Fredrik; Grönberg, Henrik; Bälter, Katarina

    2016-07-01

    High Body mass index (BMI) has been directly associated with risk of aggressive or fatal prostate cancer. One possible explanation may be an effect of BMI on serum levels of prostate-specific antigen (PSA). To study the association between BMI and serum PSA as well as prostate cancer risk, a large cohort of men without prostate cancer at baseline was followed prospectively for prostate cancer diagnoses until 2015. Serum PSA and BMI were assessed among 15,827 men at baseline in 2010-2012. During follow-up, 735 men were diagnosed with prostate cancer with 282 (38.4%) classified as high-grade cancers. Multivariable linear regression models and natural cubic linear regression splines were fitted for analyses of BMI and log-PSA. For risk analysis, Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) and natural cubic Cox regression splines producing standardized cancer-free probabilities were fitted. Results showed that baseline Serum PSA decreased by 1.6% (95% CI: -2.1 to -1.1) with every one unit increase in BMI. Statistically significant decreases of 3.7, 11.7 and 32.3% were seen for increasing BMI-categories of 25 prostate cancer risk although results were indicative of a positive association to incidence rates of high-grade disease and an inverse association to incidence of low-grade disease. However, findings regarding risk are limited by the short follow-up time. In conclusion, BMI was inversely associated to PSA-levels. BMI should be taken into consideration when referring men to a prostate biopsy based on serum PSA-levels. © 2016 UICC.

  16. Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

    Science.gov (United States)

    Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

    2012-10-01

    The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

  17. Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status.

    Science.gov (United States)

    Hanyuda, Akiko; Cao, Yin; Hamada, Tsuyoshi; Nowak, Jonathan A; Qian, Zhi Rong; Masugi, Yohei; da Silva, Annacarolina; Liu, Li; Kosumi, Keisuke; Soong, Thing Rinda; Jhun, Iny; Wu, Kana; Zhang, Xuehong; Song, Mingyang; Meyerhardt, Jeffrey A; Chan, Andrew T; Fuchs, Charles S; Giovannucci, Edward L; Ogino, Shuji; Nishihara, Reiko

    2017-05-01

    Previous studies suggest that abnormal energy balance status may dysregulate intestinal epithelial homeostasis and promote colorectal carcinogenesis, yet little is known about how host energy balance and obesity influence enterocyte differentiation during carcinogenesis. We hypothesized that the association between high body mass index (BMI) and colorectal carcinoma incidence might differ according to tumor histopathologic differentiation status. Using databases of the Nurses' Health Study and Health Professionals Follow-up Study, and duplication-method Cox proportional hazards models, we prospectively examined an association between BMI and the incidence of colorectal carcinoma subtypes classified by differentiation features. 120,813 participants were followed for 26 or 32 years and 1528 rectal and colon cancer cases with available tumor pathological data were documented. The association between BMI and colorectal cancer risk significantly differed depending on the presence or absence of poorly-differentiated foci (P heterogeneity  = 0.006). Higher BMI was associated with a higher risk of colorectal carcinoma without poorly-differentiated foci (≥30.0 vs. 18.5-22.4 kg/m 2 : multivariable-adjusted hazard ratio, 1.87; 95% confidence interval, 1.49-2.34; P trend   0.03, with the adjusted α of 0.01). High BMI was associated with risk of colorectal cancer subtype containing no poorly-differentiated focus. Our findings suggest that carcinogenic influence of excess energy balance might be stronger for tumors that retain better intestinal differentiation throughout the tumor areas.

  18. Low amniotic fluid index in high risk pregnancy and poor apgar score at birth

    International Nuclear Information System (INIS)

    Sultana, S.; Akhtar, K.A.K.

    2008-01-01

    To determine the accuracy of antepartum Amniotic Fluid Index (AFI) of 5 cm was labeled as predictor of good outcome at birth. The subjects in both the groups were demographically matched and fulfilled the inclusion and exclusion criteria. The Apgar score was calculated at 5 minutes of birth. The newborns, with Apgar score 6 were labeled as healthy. AFI was compared with Apgar score, using Chi-square and a p-value was calculated to determine the statistical significance. Sensitivity, specificity, efficiency and the predictive values of AFI at a cut off point of < 5 cm as a predictor of adverse outcome at birth (Apgar score of < 6 at 5 minutes of birth) in high-risk pregnancy were calculated. Only 8 neonates of 50 women with low AFI had low Apgar score. Similarly, 6 neonates of 50 women with normal AFI had poor Apgar score. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of AFI as test were 57.1%, 51.3%, 16%, 88% and 52% respectively. Low AFI is a poor predictor of adverse outcome for high-risk term patients. AFI is not a good screening test for high-risk pregnant women at term for birth of an infant with low Apgar score. (author)

  19. Vibrotactile tilt feedback improves dynamic gait index: a fall risk indicator in older adults.

    Science.gov (United States)

    Wall, Conrad; Wrisley, Diane M; Statler, Kennyn D

    2009-07-01

    The purpose of this study was to determine the effectiveness of vibrotactile feedback of body tilt in improving dynamic gait index (DGI) a fall risk indicator in community dwelling older adults. Twelve healthy elderly subjects (three males and nine females, age 79.7+/-5.4 yrs) were tested in an institutional balance rehabilitation laboratory to investigate changes between the feedback off and on conditions. Subjects were acutely exposed to a vibrotactile display that indicated the magnitude and direction of their body tilt from the vertical. DGI and mediolateral (ML) sway were determined during locomotion with, and without, vibrotactile tilt feedback (VTTF). All subjects were at risk for falls based on their initial DGI Score (range: 15-19, mean 17.4+/-1.56), which was taken with the vibratory stimulus turned off. Subjects learned to use the trunk tilt information from the vibrotactile feedback vest through 20-30 min of gait and balance training consisting of activities that challenged their balance. Subjects were then retested on the DGI. Statistically significant changes were demonstrated for the DGI total score while using the vibrotactile tilt feedback. DGI total scores improved from 17.1+/-0.4 to 20.8+/-0.3 (pfall risk indicators for this population.

  20. Arsenic and other elements in drinking water and dietary components from the middle Gangetic plain of Bihar, India: Health risk index.

    Science.gov (United States)

    Kumar, Manoj; Rahman, Mohammad Mahmudur; Ramanathan, A L; Naidu, Ravi

    2016-01-01

    This study investigates the level of contamination and health risk assessment for arsenic (As) and other elements in drinking water, vegetables and other food components in two blocks (Mohiuddinagar and Mohanpur) from the Samastipur district, Bihar, India. Groundwater (80%) samples exceeded the World Health Organization (WHO) guideline value (10μg/L) of As while Mn exceeded the previous WHO limit of 400μg/L in 28% samples. The estimated daily intake of As, Cd, Co, Cr, Cu, Mn, Ni, Pb and Zn from drinking water and food components were 169, 19, 26, 882, 4645, 14582, 474, 1449 and 12,955μg, respectively (estimated exposure 3.70, 0.41, 0.57, 19.61, 103.22, 324.05, 10.53, 32.21 and 287.90μg per kg bw, respectively). Twelve of 15 cooked rice contained high As concentration compared to uncooked rice. Water contributes (67%) considerable As to daily exposure followed by rice and vegetables. Whereas food is the major contributor of other elements to the dietary exposure. Correlation and principal component analysis (PCA) indicated natural source for As but for other elements, presence of diffused anthropogenic activities were responsible. The chronic daily intake (CDI) and health risk index (HRI) were also estimated from the generated data. The HRI were >1 for As in drinking water, vegetables and rice, for Mn in drinking water, vegetables, rice and wheat, for Pb in rice and wheat indicated the potential health risk to the local population. An assessment of As and other elements of other food components should be conducted to understand the actual health hazards caused by ingestion of food in people residing in the middle Gangetic plain. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Assessing systematic risk in the S&P500 index between 2000 and 2011: A Bayesian nonparametric approach

    OpenAIRE

    Rodríguez, Abel; Wang, Ziwei; Kottas, Athanasios

    2017-01-01

    We develop a Bayesian nonparametric model to assess the effect of systematic risks on multiple financial markets, and apply it to understand the behavior of the S&P500 sector indexes between January 1, 2000 and December 31, 2011. More than prediction, our main goal is to understand the evolution of systematic and idiosyncratic risks in the U.S. economy over this particular time period, leading to novel sector-specific risk indexes. To accomplish this goal, we model the appearance of extreme l...

  2. The portfolio risk management and diversification benefits from the South African rand currency index (rain

    Directory of Open Access Journals (Sweden)

    F.Y. Jordaan

    2012-12-01

    Full Text Available This study attempts to explain the source of risk management and diversification benefits that investors may gain from the South African Rand Currency Index (RAIN as it relates to an equity portfolio with stock market exposure (locally or international. These diversification benefits may result from the negative correlation between RAIN and the South African All Share Index (ALSI. To explain and fully exploit the benefits of RAIN, the main variables that represent South Africa’s trading partner equity and bond markets movements, were identified. To account for the interaction of RAIN with the ALSI, the latter was firstly decomposed into its economic groups and secondly into its various sub-sectors. Various analyses were carried out to determine which variables describe the relationship between the ALSI and RAIN. The variables that describe the relationship with a high adjusted R2, were identified. The findings suggest that when the ALSI is decomposed into its ten economic groups and thirty-seven sub-groups, the quadratic as opposed to linear models using response surface regressions, explained the majority of the variation in RAIN over the entire period. The linear models, however, explained more of the variation in RAIN during the recent 2008/2009 financial crisis

  3. Accounting for the risks of phosphorus losses through tile drains in a phosphorus index.

    Science.gov (United States)

    Reid, D Keith; Ball, Bonnie; Zhang, T Q

    2012-01-01

    Tile drainage systems have been identified as a significant conduit for phosphorus (P) losses to surface water, but P indices do not currently account for this transport pathway in a meaningful way. Several P indices mention tile drains, but most account for either the reduction in surface runoff or the enhanced transport through tiles rather than both simultaneously. A summary of the current state of how tile drains are accounted for within P indices is provided, and the challenges in predicting the risk of P losses through tile drains that are relative to actual losses are discussed. A framework for a component P Index is described, along with a proposal to incorporate predictions of losses through tile drains as a component within this framework. Options for calibrating and testing this component are discussed. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  4. Prognostic value of exercise echocardiography: validation of a new risk index combining echocardiographic, treadmill, and exercise electrocardiographic parameters.

    Science.gov (United States)

    Mazur, Wojciech; Rivera, Jose M; Khoury, Alexander F; Basu, Abhijeet G; Perez-Verdia, Alejandro; Marks, Gary F; Chang, Su Min; Olmos, Leopoldo; Quiñones, Miguel A; Zoghbi, William A

    2003-04-01

    Exercise (Ex) echocardiography has been shown to have significant prognostic power, independent of other known predictors of risk from an Ex stress test. The purpose of this study was to evaluate a risk index, incorporating echocardiographic and conventional Ex variables, for a more comprehensive risk stratification and identification of a very low-risk group. Two consecutive, mutually exclusive populations referred for treadmill Ex echocardiography with the Bruce protocol were investigated: hypothesis-generating (388 patients; 268 males; age 55 +/- 13 years) and hypothesis-testing (105 patients; 61 males age: 54 +/- 14 years).Cardiac events included cardiac death, myocardial infarction, late revascularization (>90 days), hospital admission for unstable angina, and admission for heart failure. Mean follow-up in the hypothesis-generating population was 3.1 years. There were 38 cardiac events. Independent predictors of events by multivariate analysis were: Ex wall motion score index (odds ratio [OR] = 2.77/Unit; P or = 1 mm (OR = 2.84; P =.002); and treadmill time (OR = 0.87/min; P =.037). A risk index was generated on the basis of the multivariate Cox regression model as: risk index = 1.02 (Ex wall motion score index) + 1.04 (S-T change) - 0.14 (treadmill time). The validity of this index was tested in the hypothesis-testing population. Event rates at 3 years were lowest (0%) in the lower quartile of risk index (-1.22 to -0.47), highest (29.6%) in the upper quartile (+0.66 to +2.02), and intermediate (19.2% to 15.3%) in the intermediate quartiles. The OR of the risk index for predicting cardiac events was 2.94/Unit ([95% confidence interval: 1.4 to 6.2]; P =.0043). Echocardiographic and Ex parameters are independent powerful predictors of cardiac events after treadmill stress testing. A risk index can be derived with these parameters for a more comprehensive risk stratification with Ex echocardiography.

  5. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study.

    Science.gov (United States)

    Lee, Da Young; Lee, Eun Seo; Kim, Ji Hyun; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung; Lee, Won-Young

    The Triglyceride Glucose Index (TyG index) is considered a surrogate marker of insulin resistance. The aim of this study is to investigate whether the TyG index has a predictive role in identifying individuals with a high risk of incident diabetes and to compare it with other indicators of metabolic health. A total 2900 non-diabetic adults who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital was divided into four subgroups using three methods: (1) baseline TyG index; (2) obesity status (body mass index ≥25 kg/m2) and cutoff value of TyG index; (3) obesity status and metabolic health, defined as having fewer than two of the five components of high blood pressure, fasting blood glucose, triglyceride, low high-density lipoprotein cholesterol, and highest decile of homeostasis model assessment-insulin resistance. The development of diabetes was assessed annually using self-questionnaire, fasting glucose, and glycated hemoglobin. We compared the risk of incident diabetes using multivariate Cox analysis. During 11623 person-years there were 101 case of incident diabetes. Subjects with high TyG index had a high risk of diabetes. For TyG index quartiles, hazard ratios (HRs) of quartiles 3 and 4 were 4.06 (p = 0.033) and 5.65 (p = 0.006) respectively. When the subjects were divided by obesity status and cutoff value of TyG index of 8.8, the subgroups with TyG index ≥ 8.8 regardless of obesity had a significantly high risk for diabetes (HR 2.40 [p = 0.024] and 2.25 [p = 0.048]). For obesity status and metabolic health, the two metabolically unhealthy subgroups regardless of obesity had a significantly high risk for diabetes (HRs 2.54 [p = 0.024] and 2.73 [p = 0.021]). In conclusion, the TyG index measured at a single time point may be an indicator of the risk for incident diabetes. The predictive value of the TyG index was comparable to that of metabolic health.

  6. MAXIMIZING PROFIT - OPTICAL TRADITIONAL TRAVEL AGENCIES EXCEEDED

    Directory of Open Access Journals (Sweden)

    ENEA CONSTANŢA

    2013-12-01

    Full Text Available Recently concepts of globalized the services the advertising only that and substantial modifications, but that just radicals, in the structure net of touristic states. Is directed to of a new conceive the organic fashions of structures ale net of realized and of casting of guy colaborative, baze on interconexion, the interface and flexible interactions, from which his. I result the competitive advantages popularly the partners of business. The optics traditional agencies of tourings considered the production and the delivery touristic services except through the of a alone objective major prism scilicet maximizarea of the profits, falls to is exceeded. For the past decades ale the century XX, the impact technological changes in the industry services becomes all determine maul influenced the „traditional sectors” in charge, as for example the education, the trade, the touring, the informatics. Certainly, globalized can be interpretation in different senses. Referenced to the touristic services, the globalized is define as be a form an advanced still more complex maul of which nationalization involves a degrees of functional integration between the touristic activities disperse on plans transfrontalier.

  7. Evaluation of a clinical risk index for advanced colorectal neoplasia among a North American population of screening age.

    Science.gov (United States)

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-11-19

    A clinical risk index employing age, sex, family history of colorectal cancer (CRC), smoking history and body mass index (BMI) may be useful for prioritizing screening with colonoscopy. The aim of this study was to conduct an external evaluation of a previously published risk index for advanced neoplasia (AN) in a large, well-characterized cohort. Five thousand one hundred thirty-seven asymptomatic persons aged 50 to 74 (54.9 % women) with a mean age (SD) of 58.3 (6.2) years were recruited for the study from a teaching hospital and colorectal cancer screening centre between 2003 and 2011. All participants underwent a complete screening colonoscopy and removal of all polyps. AN was defined as cancer or a tubular adenoma, traditional serrated adenoma (TSA), or sessile serrated adenoma (SSA) with villous characteristics (≥25% villous component), and/or high-grade dysplasia and/or diameter ≥10 mm. Risk scores for each participant were summed to derive an overall score (0-8). The c-statistic was used to measure discriminating ability of the risk index. The prevalence of AN in the study cohort was 6.8 %. The likelihood of detecting AN increased from 3.6 to 13.1 % for those with a risk score of 1 to 6 respectively. The c-statistic for the multivariable logistic model in our cohort was 0.64 (95 % CI = 0.61-067) indicating modest overlap between risk scores. The risk index for AN using age, sex, family history, smoking history and BMI was found to be of limited discriminating ability upon external validation. The index requires further refinement to better predict AN in average risk persons of screening age.

  8. 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.

  9. Modified Creatinine Index and the Risk of Bone Fracture in Patients Undergoing Hemodialysis: The Q-Cohort Study.

    Science.gov (United States)

    Yamada, Shunsuke; Taniguchi, Masatomo; Tokumoto, Masanori; Yoshitomi, Ryota; Yoshida, Hisako; Tatsumoto, Narihito; Hirakata, Hideki; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

    2017-08-01

    Hemodialysis patients are at increased risk for bone fracture and sarcopenia. There is close interplay between skeletal muscle and bone. However, it is still unclear whether lower skeletal muscle mass increases the risk for bone fracture. Cross-sectional study and prospective longitudinal cohort study. An independent cohort of 78 hemodialysis patients in the cross-sectional study and 3,030 prevalent patients undergoing maintenance hemodialysis prospectively followed up for 4 years. Skeletal muscle mass measured by bioelectrical impedance analysis (BIA) and modified creatinine index, an estimate of skeletal muscle mass based on age, sex, Kt/V for urea, and serum creatinine level. Bone fracture at any site. In the cross-sectional study, modified creatinine index was significantly correlated with skeletal muscle mass measured by BIA. During a median follow-up of 3.9 years, 140 patients had bone fracture. When patients were divided into sex-specific quartiles based on modified creatinine index, risk for bone fracture estimated by a Fine-Gray proportional subdistribution hazards model with all-cause death as a competing risk was significantly higher in the lower modified creatinine index quartiles (Q1 and Q2) compared to the highest modified creatinine index quartile (Q4) as the reference value in both sexes (multivariable-adjusted HRs for men were 7.81 [95% CI, 2.63-23.26], 5.48 [95% CI, 2.08-14.40], 2.24 [95% CI, 0.72-7.00], and 1.00 [P for trend creatinine index; no data for residual kidney function and fracture sites and causes. Modified creatinine index was correlated with skeletal muscle mass measured by BIA. Lower modified creatinine index was associated with increased risk for bone fracture in male and female hemodialysis patients. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. The Little Schmidy Pediatric Hospital Fall Risk Assessment Index: A diagnostic accuracy study.

    Science.gov (United States)

    Franck, Linda S; Gay, Caryl L; Cooper, Bruce; Ezrre, Suzanne; Murphy, Barbette; Chan, June Shu-Ling; Buick, Maureen; Meer, Carrie R

    2017-03-01

    Falls are among the most common potentially preventable adverse events. Current pediatric falls risk assessment methods have poor precision and accuracy. To evaluate an inpatient pediatric fall risk assessment index, known as the Little Schmidy, and describe characteristics of pediatric falls. Retrospective case control and descriptive study. The dataset included 114 reported falls and 151,678 Little Schmidy scores documented in medical records during the 5-year study period (2007-2011). Pediatric medical and surgical inpatient units of an academic medical center in the western United States. Pediatric hospital inpatients fall risk each day and night shift throughout the patient's hospitalization. Conditional fixed-effects logistic regressions were used to examine predictive relationships between Little Schmidy scores (at admission, highest prior to fall, and just prior to fall) and the patient's fall status (fell or not). The sensitivity and specificity of different cut-off scores were explored. Associations between Little Schmidy scores and patient and hospitalization factors were examined using multilevel mixed-effects logistic regression and multilevel mixed-effects ordinal logistic regression. Little Schmidy scores were significantly associated with pediatric falls (pfall risk with sensitivity of 79% and specificity of 49%. Patients with an LS4 score ≥1 were 4 times more likely to fall before the next assessment than patients with a score of 0. LS4 scores indicative of fall risk were associated with age ≥5 years, neurological diagnosis, multiple hospitalizations, and night shift, but not with sex, length of hospital stay, or hospital unit. Of the 114 reported falls, 64% involved a male patient, nearly one third (32%) involved adolescents (13-17 years), most resulted in no (59%) or mild (36%) injury, and most (54%) were related to diagnosis or clinical characteristics. For 60% of the falls, fall precautions had been implemented prior to the fall. The

  11. African genetic ancestry interacts with body mass index to modify risk for uterine fibroids.

    Science.gov (United States)

    Giri, Ayush; Edwards, Todd L; Hartmann, Katherine E; Torstenson, Eric S; Wellons, Melissa; Schreiner, Pamela J; Velez Edwards, Digna R

    2017-07-01

    Race, specifically African ancestry, and obesity are important risk factors for uterine fibroids, and likely interact to provide the right conditions for fibroid growth. However, existing studies largely focus on the main-effects rather than their interaction. Here, we firstly provide evidence for interaction between categories of body mass index (BMI) and reported-race in relation to uterine fibroids. We then investigate whether the association between inferred local European ancestry and fibroid risk is modified by BMI in African American (AA) women in the Vanderbilt University Medical Center bio-repository (BioVU) (539 cases and 794 controls) and the Coronary Artery Risk Development in Young Adults study (CARDIA, 264 cases and 173 controls). We used multiple logistic regression to evaluate interactions between local European ancestry and BMI in relation to fibroid risk, then performed fixed effects meta-analysis. Statistical significance threshold for local-ancestry and BMI interactions was empirically estimated with 10,000 permutations (p-value = 1.18x10-4). Admixture mapping detected an association between European ancestry and fibroid risk which was modified by BMI (continuous-interaction p-value = 3.75x10-5) around ADTRP (chromosome 6p24); the strongest association was found in the obese category (ancestry odds ratio (AOR) = 0.51, p-value = 2.23x10-5). Evaluation of interaction between genotyped/imputed variants and BMI in this targeted region suggested race-specific interaction, present in AAs only; strongest evidence was found for insertion/deletion variant (6:11946435), again in the obese category (OR = 1.66, p-value = 1.72x10-6). We found nominal evidence for interaction between local ancestry and BMI at a previously reported region in chromosome 2q31-32, which includes COL5A2, and TFPI, an immediate downstream target of ADTRP. Interactions between BMI and SNPs (single nucleotide polymorphisms) found in this region in AA women were also detected in an

  12. The index of harm: a useful measure for comparing occupational risk across industries

    International Nuclear Information System (INIS)

    Solomon, K.A.; Abraham, S.C.

    1980-01-01

    This paper presents an index of harm methodology which compares occupational risk among workers exposed to radiological and nonradiological harms. It extends the work of the International Commission on Radiological Protection by considering American rather than European and Japanese industry groups, by treating the relative importance of various occupational harms as a parameter rather than an arbitrary constant, and by identifying several ways in which both the methodology and the data base could be improved. In the analysis, the risk affects are examined of six occupational harms-three nonradiological (death, accidental injury and disease or illness) and three radiological (somatic effects, genetic effects, and somatic effects to the fetus or embryo of pregnant women). The analysis was performed under five different assumptions about the relative importance of degree of aversion of the six harms in question. The results of this analysis show that radiological workers exposed to the current industry average of 0.35 rem/yr are among the safest of all industry groupings, and the riskiest industries appear to be mining; agriculture, fishing and farming; construction; transportation; and manufacturing, roughly in that order. (author)

  13. Development of a lane change risk index using vehicle trajectory data.

    Science.gov (United States)

    Park, Hyunjin; Oh, Cheol; Moon, Jaepil; Kim, Seongho

    2018-01-01

    Surrogate safety measures (SSMs) have been widely used to evaluate crash potential, which is fundamental for the development of effective safety countermeasures. Unlike existing SSMs, which are mainly focused on the evaluation of longitudinal vehicle maneuvering leading to rear-end crashes, this study proposes a new method for estimating crash risk while a subject vehicle changes lanes, referred to as the lane change risk index (LCRI). A novel feature of the proposed methodology is its incorporation of the amount of exposure time to potential crash and the expected crash severity level by applying a fault tree analysis (FTA) to the evaluation framework. Vehicle interactions between a subject vehicle and adjacent vehicles in the starting lane and the target lane are evaluated in terms of crash potential during lane change. Vehicle trajectory data obtained from a traffic stream, photographed using a drone flown over a freeway segment, is used to investigate the applicability of the proposed methodology. This study compares the characteristics of compulsory and discretionary lane changes observed in a work zone section and a general section of a freeway using the LCRI. It is expected that the outcome of this study will be valuable in evaluating the effectiveness of various traffic operations and control strategies in terms of lane change safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects.

    Science.gov (United States)

    Camargo-Ramos, Claudia Marcela; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

    2017-10-06

    Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore ( p diet) showed a positive relationship with MetScore ( r = 0.410, p diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD.

  15. Feasibility Study of Land Cover Classification Based on Normalized Difference Vegetation Index for Landslide Risk Assessment

    Directory of Open Access Journals (Sweden)

    Thilanki Dahigamuwa

    2016-10-01

    Full Text Available Unfavorable land cover leads to excessive damage from landslides and other natural hazards, whereas the presence of vegetation is expected to mitigate rainfall-induced landslide potential. Hence, unexpected and rapid changes in land cover due to deforestation would be detrimental in landslide-prone areas. Also, vegetation cover is subject to phenological variations and therefore, timely classification of land cover is an essential step in effective evaluation of landslide hazard potential. The work presented here investigates methods that can be used for land cover classification based on the Normalized Difference Vegetation Index (NDVI, derived from up-to-date satellite images, and the feasibility of application in landslide risk prediction. A major benefit of this method would be the eventual ability to employ NDVI as a stand-alone parameter for accurate assessment of the impact of land cover in landslide hazard evaluation. An added benefit would be the timely detection of undesirable practices such as deforestation using satellite imagery. A landslide-prone region in Oregon, USA is used as a model for the application of the classification method. Five selected classification techniques—k-nearest neighbor, Gaussian support vector machine (GSVM, artificial neural network, decision tree and quadratic discriminant analysis support the viability of the NDVI-based land cover classification. Finally, its application in landslide risk evaluation is demonstrated.

  16. A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

    Science.gov (United States)

    Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

    2006-01-01

    The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

  17. Acceptable-doses exceeding in radionuclides transport

    International Nuclear Information System (INIS)

    Delabarre, P.

    2006-01-01

    Without any foregoing signal, the 12-gliding month dose in an employee of a radionuclides transporting firm raised to 44,30 mSv (over the double of the ICRP recommended yearly maximum of 20 mSv). Apart from immediate prohibition of any further professional exposure to ionising radiation for the employee concerned, and an inquiry for possible explanations concerning as well the employer as the employee, an in-depth investigation of the employees previous records took place. Except from the sudden rise, the investigation showed that the personal dosimeter was mostly presented for analysis weeks, even months, too late, what made any immediate action from occupational health and radioprotection side difficult and anyhow far too late. Investigation of the records of the other 30 employees showed that 1) mostly the dosimeters were not presented on the assumed date for analysis, but months to (sometimes) nearly one year late behind schedule 2) for the same job in the same period, registered doses varied from naught to over 8,00 mSv, depending on the employee 3) several employees had a 12-gliding months dose of over 10,00 mSv, even over 15,00 mSv During discussion with employee, employer, occupational physician and an agent of the qualified organisation for dosimeter analysis, the employer was anything but cooperative; the employee also was rather reluctant to answer questions, and given possible causes could not be corroborated. In an attempt to clarify the multiple problems, the Governmental Agency for Nuclear Control was involved, which imposed in a first time a( not very stringent, rather indulgent) action plan. Meanwhile, a written comment on the monthly dosimeter analyses was sent from as well the occupational physician as the analytical firm to the employer and to the concerned employees if a 12-gliding months dose exceeding 10 mSv was determined, without any reaction neither from the employer nor the employees. At the moment of the abstract submission (sept 05

  18. Body mass index and the risk of dementia among Louisiana low income diabetic patients.

    Directory of Open Access Journals (Sweden)

    Gang Hu

    Full Text Available The association between obesity and dementia risk remains debatable and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between body mass index (BMI and dementia risk among middle and low income diabetic patients.The sample included 44,660 diabetic patients (19,618 white and 25,042 African American 30 to 96 years of age without a history of dementia in the Louisiana State University Hospital-Based Longitudinal Study. During a mean follow-up period of 3.9 years, 388 subjects developed incident dementia. The age- and sex-adjusted hazards ratios (HRs for incident dementia at different levels of BMI (≤ 25, 25-26.9, 27-29.9, 30-34.9, and ≥ 35 kg/m(2 were 1.00, 0.53 (95% CI 0.34-0.83, 0.29 (0.18-0.45, 0.37 (0.25-0.56, and 0.31 (0.21-0.48 (P(trend<0.001 in white diabetic patients, and 1.00, 1.00 (95% CI 0.62-1.63, 0.62 (0.39-0.98, 0.56 (0.36-0.86, and 0.65 (0.43-1.01 (P(trend = 0.029 in African American diabetic patients. Further adjustment for other confounding factors affected the results only slightly. There was a significant interaction between race and BMI on dementia risk (χ(2 = 5.52, 1df, p<0.025, such that the association was stronger in white patients. In stratified analyses, the multivariate-adjusted inverse association between BMI and risk of dementia was present in subjects aged 55-64 years, 65-74 years, and ≥ 75 years, in men and women, in non-smokers and smokers, and in subjects with different types of health insurance.Higher baseline BMI was associated with a lower risk of dementia among diabetic patients, and this association was stronger among white than among African American diabetic patients.

  19. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach

    International Nuclear Information System (INIS)

    Chang, J.W.; Yan, B.R.; Chang, M.H.; Tseng, S.H.; Kao, Y.M.; Chen, J.C.; Lee, C.C.

    2014-01-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP (i + n) in 0–6-yr-old children accounted for 91% (79–107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0–3-yr-old children and 4–6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods. - Graphical abstract: In seven phthalates, the 95th percentile of the average daily dose (ADD) for ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) in 0–3-yr-old male (0–3 M) and female (0–3 F) children accounted for 97% and 84% of TDIs, respectively. For 4–6-yr-old and 7–12-yr-old males and 7–12-yr-old females, ADDs for ΣDBP (i + n) accounted for 79%, 72%, and 65% of TDIs, respectively. - Highlights: • A cumulative risk assessment of PAEs was used in a severe plasticizer-contaminated food episode. • ΣDBP (i + n) posed the highest risk potential of all the dietary phthalates. • Females 4–6 yr old had the highest risk for anti-androgenic effects. • Beverages, milk and dairy products were the major contributors to average daily dose of phthalate esters. - The health of young Taiwanese may be adversely affected by overexposure of plasticizer-contaminated food

  20. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study

    OpenAIRE

    Lee, Da Young; Lee, Eun Seo; Kim, Ji Hyun; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung; Lee, Won-Young

    2016-01-01

    The Triglyceride Glucose Index (TyG index) is considered a surrogate marker of insulin resistance. The aim of this study is to investigate whether the TyG index has a predictive role in identifying individuals with a high risk of incident diabetes and to compare it with other indicators of metabolic health. A total 2900 non-diabetic adults who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital was divided into four subgroups using three methods: (1) baseline TyG ind...

  1. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty.

    Science.gov (United States)

    Inami, Takumi; Kataoka, Masaharu; Shimura, Nobuhiko; Ishiguro, Haruhisa; Yanagisawa, Ryoji; Taguchi, Hiroki; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2013-07-01

    This study sought to identify useful predictors for hemodynamic improvement and risk of reperfusion pulmonary edema (RPE), a major complication of this procedure. Percutaneous transluminal pulmonary angioplasty (PTPA) has been reported to be effective for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). PTPA has not been widespread because RPE has not been well predicted. We included 140 consecutive procedures in 54 patients with CTEPH. The flow appearance of the target vessels was graded into 4 groups (Pulmonary Flow Grade), and we proposed PEPSI (Pulmonary Edema Predictive Scoring Index) = (sum total change of Pulmonary Flow Grade scores) × (baseline pulmonary vascular resistance). Correlations between occurrence of RPE and 11 variables, including hemodynamic parameters, number of target vessels, and PEPSI, were analyzed. Hemodynamic parameters significantly improved after median observation period of 6.4 months, and the sum total changes in Pulmonary Flow Grade scores were significantly correlated with the improvement in hemodynamics. Multivariate analysis revealed that PEPSI was the strongest factor correlated with the occurrence of RPE (p PEPSI to be a useful marker of the risk of RPE (cutoff value 35.4, negative predictive value 92.3%). Pulmonary Flow Grade score is useful in determining therapeutic efficacy, and PEPSI is highly supportive to reduce the risk of RPE after PTPA. Using these 2 indexes, PTPA could become a safe and common therapeutic strategy for CTEPH. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

    OpenAIRE

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

    2005-01-01

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

  3. Definition and GIS-based characterization of an integral risk index applied to a chemical/petrochemical area.

    Science.gov (United States)

    Nadal, Martí; Kumar, Vikas; Schuhmacher, Marta; Domingo, José L

    2006-08-01

    A risk map of the chemical/petrochemical industrial area of Tarragona (Catalonia, Spain) was designed following a two-stage procedure. The first step was the creation of a ranking system (Hazard Index) for a number of different inorganic and organic pollutants: heavy metals, polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polychlorinated aromatic hydrocarbons (PAHs) by applying self-organizing maps (SOM) to persistence, bioaccumulation and toxicity properties of the chemicals. PCBs seemed to be the most hazardous compounds, while the light PAHs showed the minimum values. Subsequently, an Integral Risk Index was developed taking into account the Hazard Index and the concentrations of all pollutants in soil samples collected in the assessed area of Tarragona. Finally, a risk map was elaborated by representing the spatial distribution of the Integral Risk Index with a geographic information system (GIS). The results of the present study seem to indicate that the development of an integral risk map might be useful to help in making-decision processes concerning environmental pollutants.

  4. Elevated body mass index and risk of postoperative CSF leak following transsphenoidal surgery

    Science.gov (United States)

    Dlouhy, Brian J.; Madhavan, Karthik; Clinger, John D.; Reddy, Ambur; Dawson, Jeffrey D.; O’Brien, Erin K.; Chang, Eugene; Graham, Scott M.; Greenlee, Jeremy D. W.

    2012-01-01

    Object Postoperative CSF leakage can be a serious complication after a transsphenoidal surgical approach. An elevated body mass index (BMI) is a significant risk factor for spontaneous CSF leaks. However, there is no evidence correlating BMI with postoperative CSF leak after transsphenoidal surgery. The authors hypothesized that patients with elevated BMI would have a higher incidence of CSF leakage complications following transsphenoidal surgery. Methods The authors conducted a retrospective review of 121 patients who, between August 2005 and March 2010, underwent endoscopic endonasal transsphenoidal surgeries for resection of primarily sellar masses. Patients requiring extended transsphenoidal approaches were excluded. A multivariate statistical analysis was performed to investigate the association of BMI and other risk factors with postoperative CSF leakage. Results In 92 patients, 96 endonasal endoscopic transsphenoidal surgeries were performed that met inclusion criteria. Thirteen postoperative leaks occurred and required subsequent treatment, including lumbar drainage and/or reoperation. The average BMI of patients with a postoperative CSF leak was significantly greater than that in patients with no postoperative CSF leak (39.2 vs 32.9 kg/m2, p = 0.006). Multivariate analyses indicate that for every 5-kg/m2 increase in BMI, patients undergoing a transsphenoidal approach for a primarily sellar mass have 1.61 times the odds (95% CI 1.10–2.29, p = 0.016, by multivariate logistic regression) of having a postoperative CSF leak. Conclusions Elevated BMI is an independent predictor of postoperative CSF leak after an endonasal endoscopic transsphenoidal approach. The authors recommend that patients with BMI greater than 30 kg/m2 have meticulous sellar reconstruction at surgery and close monitoring postoperatively. PMID:22443502

  5. Prepregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups.

    Science.gov (United States)

    Parker, Margaret G; Ouyang, Fengxiu; Pearson, Colleen; Gillman, Matthew W; Belfort, Mandy B; Hong, Xiumei; Wang, Guoying; Heffner, Linda; Zuckerman, Barry; Wang, Xiaobin

    2014-04-30

    To evaluate the association between prepregnancy body mass index (BMI) is associated with early vs. late and medically-induced vs. spontaneous preterm birth (PTB) subtypes. Using data from the Boston Birth Cohort, we examined associations of prepregnancy BMI with 189 early (PTBs and 320 early and 610 late spontaneous PTBs vs. 3281 term births (37-44 weeks) in multinomial regression. To assess for mediation by important pregnancy complications, we performed sequential models with and without hypertensive disorders of pregnancy, chorioamnionitis, and gestational diabetes. Prevalence of prepregnancy obesity (BMI ≥ 30.0 kg/m2) was 28% among mothers with medically-induced PTBs, 18% among mothers with spontaneous PTBs, and 18% among mothers with term births (p = <0.001). After adjustment for demographic and known risk factors for PTB, prepregnancy obesity was associated with higher odds of both early [OR 1.78 (1.19, 2.66)] and late [OR 1.49 (1.09, 2.04)] medically-induced PTB. These effect estimates were attenuated with inclusion of hypertensive disorders of pregnancy and gestational diabetes. For spontaneous deliveries, prepregnancy obesity was associated with decreased odds of PTB (0.76 [0.58, 0.98]) and underweight was nearly associated with increased odds of PTB (1.46 [0.99, 2.16]). Prepregnancy obesity is associated with higher risk of medically-induced, but not spontaneous PTB. Hypertensive disorders of pregnancy and gestational diabetes appear to partially explain the association between prepregnancy obesity and early and late medically-induced PTB.

  6. Cardiometabolic risks and omega-3 index in recent-onset bipolar I disorder.

    Science.gov (United States)

    Wulsin, Lawson R; Blom, Thomas J; Durling, Michelle; Welge, Jeffrey A; DelBello, Melissa P; Adler, Caleb M; McNamara, Robert K; Strakowski, Stephen M

    2018-02-26

    The aims of the present study were to characterize cardiometabolic risk factors in a cohort of bipolar disorder patients with limited exposure to psychotropic medications, and to evaluate their associations with mood symptoms and omega-3 polyunsaturated fatty acid (PUFA) blood levels. Cardiometabolic risk assessments were compared in individuals with bipolar I disorder experiencing a first manic or mixed episode or an early depressive episode (n=117) and healthy subjects (n=56). Patients were medication free at assessment and had no or limited exposure to mood-stabilizer or antipsychotic medications prior to the current admission. Associations among cardiometabolic parameters and Clinical Global Impression-Severity scale (CGI-S), manic (Young Mania Rating Scale [YMRS]), and depressive (Hamilton Depression Rating Scale [HDRS]) symptom ratings were evaluated within the bipolar group. Following adjustment for demographic variables (i.e., age, gender, and parental education), significantly higher fasting triglyceride levels were observed in the bipolar group compared to the healthy group (121.7 mg/dL vs 87.0 mg/dL; Pbipolar group and 6% of the healthy group met the criteria for metabolic syndrome (P=.23). The omega-3 index was lower in the bipolar group (3.4% vs 3.9%; Pbipolar group, no associations were found between the cardiometabolic parameters and CGI-S, YMRS, and HDRS symptom ratings. Recent-onset medication-free bipolar disorder is associated with higher triglyceride levels. These findings are suggestive of early metabolic dysregulation prior to long-term psychotropic medication exposure. Lower omega-3 PUFA levels in individuals with bipolar I disorder represent a potential therapeutic target for additional investigation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Quantitative autistic trait measurements index background genetic risk for ASD in Hispanic families.

    Science.gov (United States)

    Page, Joshua; Constantino, John Nicholas; Zambrana, Katherine; Martin, Eden; Tunc, Ilker; Zhang, Yi; Abbacchi, Anna; Messinger, Daniel

    2016-01-01

    Recent studies have indicated that quantitative autistic traits (QATs) of parents reflect inherited liabilities that may index background genetic risk for clinical autism spectrum disorder (ASD) in their offspring. Moreover, preferential mating for QATs has been observed as a potential factor in concentrating autistic liabilities in some families across generations. Heretofore, intergenerational studies of QATs have focused almost exclusively on Caucasian populations-the present study explored these phenomena in a well-characterized Hispanic population. The present study examined QAT scores in siblings and parents of 83 Hispanic probands meeting research diagnostic criteria for ASD, and 64 non-ASD controls, using the Social Responsiveness Scale-2 (SRS-2). Ancestry of the probands was characterized by genotype, using information from 541,929 single nucleotide polymorphic markers. In families of Hispanic children with an ASD diagnosis, the pattern of quantitative trait correlations observed between ASD-affected children and their first-degree relatives (ICCs on the order of 0.20), between unaffected first-degree relatives in ASD-affected families (sibling/mother ICC = 0.36; sibling/father ICC = 0.53), and between spouses (mother/father ICC = 0.48) were in keeping with the influence of transmitted background genetic risk and strong preferential mating for variation in quantitative autistic trait burden. Results from analysis of ancestry-informative genetic markers among probands in this sample were consistent with that from other Hispanic populations. Quantitative autistic traits represent measurable indices of inherited liability to ASD in Hispanic families. The accumulation of autistic traits occurs within generations, between spouses, and across generations, among Hispanic families affected by ASD. The occurrence of preferential mating for QATs-the magnitude of which may vary across cultures-constitutes a mechanism by which background genetic liability

  8. Risk of malignancy index in the preoperative evaluation of patients with ovarian masses

    International Nuclear Information System (INIS)

    Jabeen, R.; Khan, S.A.; Naveed, S.

    2015-01-01

    Objective: To evaluate the ability of RMI in preoperative discrimination of benign from malignant ovarian mass among women presenting at Nishtar Hospital Multan Pakistan. Methodology: It was a prospective study conducted at department of obstetrics/gynae Nishtar Hospital Multan between September 2008 to August 2009. 60 patients of more than 30 years of age admitted in gynaecology department for surgical exploration of ovarian mass were included. All the women in whom ovarian malignancy had already been diagnosed and admitted for second laparotomy were excluded. Results: The median age at presentation of ovarian malignancy is 56 years. The sensitivity of RMI in our group was 82.3%,the specificity was 88.3%, positive predictive value was 73.7% and the negative predictive value was 92.6%. Receiver operating curves reveal that RMI was a better diagnostic marker than CA-125 or ultrasound score alone for the prediction of malignancy in ovarian masses. Conclusion: The risk of malignancy index has high specificity and sensitivity. It yielded a better diagnostic performance as compared to CA-125 or ultrasound score alone in differentiating benign from malignant ovarian lesions. (author)

  9. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    Science.gov (United States)

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-10-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2013-01-01

    Full Text Available The aim of the study was to investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n=296, group 2 (mild/moderate nonproliferative DR; n=118, and group 3 (severe/very severe NPDR or proliferative DR; n=131. Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P<0.01. We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

  11. Environmental risk assessment of registered insecticides in Iran using Environmental Impact Quotient (EIQ index

    Directory of Open Access Journals (Sweden)

    S. Moinoddini

    2016-05-01

    Full Text Available In the last decades, pesticides have been used extensively, in order to control pests and plant diseases, but negative impacts of pesticides caused several environmental problems and put human health in danger. In order to decrease environmental hazards of pesticide, risk of pesticide application should be measured briefly and precisely. In this study environmental impacts of registered insecticides in Iran which applied in 2001-2002, 2003-2004, 2004-2005, are considered using environmental impact quotient (EIQ index. Results showed that among considered insecticides, Imidacloprid, Fipronil and Tiodicarb, potentially (EIQ were the most hazardous insecticides, respectively. Taking rate of application and active ingredient of insecticide in to account, environmental impact (practical toxicity per cultivated hectare (EIQ Field of each provinces were investigated. In this regard, among different province of Iran, Kerman, Mazandaran and Golestan were in danger more than the others, respectively. Besides, considering the amount of agricultural production in provinces, environmental impact per ton of production were calculated for each provinces which three northern provinces of Mazandaran, Golestan and Guilan, respectively endure the most environmental impact per ton of production. Eventually based on environmental impact quotient, results demonstrated that majority of environmental impacts of insecticide in Iran were due to inadequate knowledge and also overuse of a few number of insecticides. Therefore, by improving knowledge about environmental impact of pesticides and also developing environmental friendly and ecological based methods, negative environmental impacts of insecticides will be reduced significantly.

  12. Body Mass Index and Subjective Social Status: The Coronary Artery Risk Development in Young Adults Study.

    Science.gov (United States)

    Dhurandhar, Emily J; Pavela, Gregory; Kaiser, Kathryn A; Dutton, Gareth R; Fontaine, Kevin R; Kim, Daniel; Shikany, James M; Allison, David B; Lewis, Cora E

    2018-02-01

    Subjective social status (SSS), or perceived social status, may explain, in part, the relationship between socioeconomic status (SES) and obesity. The objective of this study was to test whether SSS mediates the relationship between two indicators of SES (income and education) and body mass index (BMI). A cross-sectional, structural equation path analysis was applied to the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 2,624). The analysis tested whether SSS (MacArthur scale), education, and income were associated with BMI at the year 20 examination (adjusting for sex, age, and race), and it was hypothesized that the associations of education and income with BMI would be at least partly mediated by SSS. SSS had a significant direct effect on BMI (-0.21, P = 0.018). Education had a significant direct relationship with SSS (0.11, P SSS (-0.02, P = 0.022). Although income did not have a significant direct relationship with BMI, it did have a significant indirect relationship through SSS (b = -0.05, P = 0.019). Results are consistent with the hypothesized model in which SSS partially mediates the relationship between SES indicators and BMI. © 2017 The Obesity Society.

  13. Risk of asthma in adult twins with type 2 diabetes and increased body mass index

    DEFF Research Database (Denmark)

    Thomsen, S F; Duffy, D L; Kyvik, K O

    2011-01-01

    . RESULTS: The risk of asthma was increased in subjects with type 2 diabetes relative to nondiabetic subjects both in men (13.5%vs 7.5%), P = 0.001 and in women (16.6%vs 9.6%), P = 0.001. The result remained significant after adjustment for age, BMI, smoking, symptoms of chronic bronchitis, marital status...... asthma and type 2 diabetes, 0.20 (0.01-0.40), P = 0.047; between asthma and BMI in women, 0.15 (0.07-0.22), P type 2 diabetes, 0.40 (0.29-0.43), P type 2 diabetes and increased BMI are strongly associated in adults, particularly in women......AIM: To examine the relationship between asthma, type 2 diabetes and increased body mass index (BMI) in adult twins. METHODS: We performed record linkage between questionnaire-defined asthma and BMI, and hospital discharge diagnoses of type 2 diabetes in 34,782 Danish twins, 20-71 years of age...

  14. The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies.

    Science.gov (United States)

    Harris, William S; Del Gobbo, Liana; Tintle, Nathan L

    2017-07-01

    A recent 19-cohort meta-analysis examined the relationships between biomarkers of omega-3 fatty acids and risk for coronary heart disease (CHD). That study did not, however, report hazard ratios (HRs) specifically as a function of erythrocyte eicosapentaenoic (EPA) plus docosahexaenoic (DHA) levels, a metric called the Omega-3 Index in which EPA + DHA content is expressed as a percent of total fatty acids. The Omega-3 Index has been used in several recent studies and is a validated biomarker of omega-3 fatty acid tissue levels, but additional data are needed to confirm (or refute) the originally-proposed clinical cut-points of Omega-3 Index and median quintile values for this metric across 10 of the cohorts for which the needed data were available. The overall mean (SD) for the Omega-3 Index in these 10 cohort studies was 6.1% (2.1%), and the HR for a 1-SD increase was 0.85 (95% confidence interval, 0.80-0.91). Median quintile 1 and 5 levels were 4.2% vs. 8.3%, respectively. Based on these values, we estimate that risk for fatal CHD would have been reduced by about 30% moving from an Omega-3 Index of 4%-8%. These findings support the use of 8% as reasonable therapeutic targets for the Omega-3 Index. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Risk Quantitative Determination of Fire and Explosion in a Process Unit By Dow’s Fire and Explosion Index

    Directory of Open Access Journals (Sweden)

    S. Varmazyar

    2008-04-01

    Full Text Available Background and aims   Fire and explosion hazards are the first and second of major hazards in process industries, respectively. This study has been done to determine fire and explosion risk severity,radius of exposure and estimating of most probable loss.   Methods   In this quantitative study process unit has been selected with affecting parameters on  fire and explosion risk. Then, it was analyzed by DOW's fire and explosion index (F&EI. Technical data were obtained from process documents and reports, fire and explosion guideline.After calculating of DOW's index, radius of exposure determined and finally most  probable loss was estimated.   Results   The results showed an F&EI value of 226 for this process unit.The F&EI was extremely  high and unacceptable.Risk severity was categorized in sever class.Radius of exposure and damage factor were calculated 57 meters and 83%,respectively. As well as most probable loss was  estimated about 6.7 million dollars.   Conclusion   F&EI is a proper technique for risk assessment and loss estimation of fire and  explosion in process industries.Also,It is an important index for detecting high risk and low risk   areas in an industry. At this technique, all of factors affecting on fire and explosion risk was  showed as index that is a base for judgement risk class. Finally, estimated losses could be used as  a base of fire and explosion insurance.

  16. Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study.

    Science.gov (United States)

    Vahid, Farhad; Shivappa, Nitin; Karamati, Mohsen; Naeini, Alireza Jafari; Hebert, James R; Davoodi, Sayed Hossein

    2017-04-01

    The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DII T3VS1 : b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DII T3VS1 : b = 8.76; 95% CI 1.78, 15.73), HbA1c (DII T3VS1 : b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DII T3VS1 : b = 16.37; 95% CI 11.04, 21.69), triglyceride (DII T3VS1 : b = 21.01; 95% CI 8.61, 33.42) and body fat (DII T3VS1 : b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DII T3VS1 : b = -3.39; 95% CI -5.94, -0.84) and lean body mass (DII T3VS1 : b = -3.11; 95% CI -4.83, -1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DII T3VS1 : OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DII continuous : OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.

  17. Change of flood risk under climate change based on Discharge Probability Index in Japan

    Science.gov (United States)

    Nitta, T.; Yoshimura, K.; Kanae, S.; Oki, T.

    2010-12-01

    Water-related disasters under the climate change have recently gained considerable interest, and there have been many studies referring to flood risk at the global scale (e.g. Milly et al., 2002; Hirabayashi et al., 2008). In order to build adaptive capacity, however, regional impact evaluation is needed. We thus focus on the flood risk over Japan in the present study. The output from the Regional Climate Model 20 (RCM20), which was developed by the Meteorological Research Institute, was used. The data was first compared with observed data based on Automated Meteorological Data Acquisition System and ground weather observations, and the model biases were corrected using the ratio and difference of the 20-year mean values. The bias-corrected RCM20 atmospheric data were then forced to run a land surface model and a river routing model (Yoshimura et al., 2007; Ngo-Duc, T. et al. 2007) to simulate river discharge during 1981-2000, 2031-2050, and 2081-2100. Simulated river discharge was converted to Discharge Probability Index (DPI), which was proposed by Yoshimura et al based on a statistical approach. The bias and uncertainty of the models are already taken into account in the concept of DPI, so that DPI serves as a good indicator of flood risk. We estimated the statistical parameters for DPI using the river discharge for 1981-2000 with an assumption that the parameters stay the same in the different climate periods. We then evaluated the occurrence of flood events corresponding to DPI categories in each 20 years and averaged them in 9 regions. The results indicate that low DPI flood events (return period of 2 years) will become more frequent in 2031-2050 and high DPI flood events (return period of 200 years) will become more frequent in 2081-2100 compared with the period of 1981-2000, though average precipitation will become larger during 2031-2050 than during 2081-2100 in most regions. It reflects the increased extreme precipitation during 2081-2100.

  18. The association between a body shape index and cardiovascular risk in overweight and obese children and adolescents.

    Science.gov (United States)

    Mameli, Chiara; Krakauer, Nir Y; Krakauer, Jesse C; Bosetti, Alessandra; Ferrari, Chiara Matilde; Moiana, Norma; Schneider, Laura; Borsani, Barbara; Genoni, Teresa; Zuccotti, Gianvincenzo

    2018-01-01

    A Body Shape Index (ABSI) and normalized hip circumference (Hip Index, HI) have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2-18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and its components, transaminases, fat mass % detected by bioelectrical impedance analysis) and obesity-related conditions (including hepatic steatosis and metabolic syndrome). We recruited 217 patients (114 males), mean age 11.3 years. Multivariate linear regression showed a significant association of ABSI z score with 10 out of 15 risk markers expressed as continuous variables, while BMI z score showed a significant correlation with 9 and HI only with 1. In multivariate logistic regression to predict occurrence of obesity-related conditions and above-threshold values of risk factors, BMI z score was significantly correlated to 7 out of 12, ABSI to 5, and HI to 1. Overall, ABSI is an independent anthropometric index that was significantly associated with cardiometabolic risk markers in a pediatric population affected by overweight and obesity.

  19. The association between a body shape index and cardiovascular risk in overweight and obese children and adolescents.

    Directory of Open Access Journals (Sweden)

    Chiara Mameli

    Full Text Available A Body Shape Index (ABSI and normalized hip circumference (Hip Index, HI have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2-18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and its components, transaminases, fat mass % detected by bioelectrical impedance analysis and obesity-related conditions (including hepatic steatosis and metabolic syndrome. We recruited 217 patients (114 males, mean age 11.3 years. Multivariate linear regression showed a significant association of ABSI z score with 10 out of 15 risk markers expressed as continuous variables, while BMI z score showed a significant correlation with 9 and HI only with 1. In multivariate logistic regression to predict occurrence of obesity-related conditions and above-threshold values of risk factors, BMI z score was significantly correlated to 7 out of 12, ABSI to 5, and HI to 1. Overall, ABSI is an independent anthropometric index that was significantly associated with cardiometabolic risk markers in a pediatric population affected by overweight and obesity.

  20. The triglycerides and glucose index is associated with cardiovascular risk factors in normal-weight children and adolescents.

    Science.gov (United States)

    Simental-Mendía, Luis E; Hernández-Ronquillo, Gabriela; Gómez-Díaz, Rita; Rodríguez-Morán, Martha; Guerrero-Romero, Fernando

    2017-12-01

    BackgroundGiven the usefulness of the product of triglycerides and glucose (TyG) to recognize individuals at high risk for developing cardiovascular events, the aim of this study was to determine whether the TyG index is associated with the presence of cardiovascular risk factors in apparently healthy normal-weight children and adolescents.MethodsApparently healthy children and adolescents with normal weight, aged 6-15 years, were enrolled in a population-based cross-sectional study. The children were allocated into groups with and without cardiovascular risk factors. Cardiovascular risk factors were considered as the occurrence of at least one of the following: elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), or hyperglycemia.ResultsA total of 2,117 children and adolescents were enrolled in the study; of them, 1,078 (50.9%) participants exhibited cardiovascular risk. The adjusted logistic regression analysis showed that elevated TyG index was significantly associated with hypertriglyceridemia (odds ratio (OR)=96.45, 95% confidence interval (CI): 48.44-192.04), low HDL-C (OR=2.07, 95% CI: 1.46-2.92), and hyperglycemia (OR=3.11, 95% CI: 2.05-4.72), but not with elevated blood pressure (OR=1.39, 95% CI: 0.89-2.16).ConclusionThe elevated TyG index is associated with the presence of cardiovascular risk factors in healthy normal-weight children and adolescents.

  1. Childhood Height and Body Mass Index Were Associated with Risk of Adult Thyroid Cancer in a Large Cohort Study

    DEFF Research Database (Denmark)

    Kitahara, Cari M; Gamborg, Michael; Berrington de González, Amy

    2014-01-01

    Taller stature and obesity in adulthood have been consistently associated with an increased risk of thyroid cancer, but few studies have investigated the role of childhood body size. Using data from a large prospective cohort, we examined associations for height and body mass index (BMI) at ages 7...

  2. Shortened version of the work ability index to identify workers at risk of long-term sickness absence

    NARCIS (Netherlands)

    Schouten, Lianne S.; Bultmann, Ute; Heymans, Martijn W.; Joling, Catelijne I.; Twisk, Jos W. R.; Roelen, Corne A. M.

    2016-01-01

    Background: The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers

  3. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  4. Maternal Body Mass Index in Early Pregnancy and Risk of Epilepsy in Offspring.

    Science.gov (United States)

    Razaz, Neda; Tedroff, Kristina; Villamor, Eduardo; Cnattingius, Sven

    2017-06-01

    There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy. A population-based cohort study of 1 441 623 live single births at 22 or more completed gestational weeks in Sweden from January 1, 1997, to December 31, 2011, was conducted. The diagnosis of epilepsy as well as obesity-related pregnancy and neonatal complications were based on information from the Sweden Medical Birth Register and National Patient Register. Multivariate Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% CIs after adjusting for maternal age, country of origin, educational level, cohabitation with partner, height, smoking, maternal epilepsy, and year of delivery. Data analysis was conducted from June 1 to December 15, 2016. Risk of childhood epilepsy. Of the 1 421 551 children born between January 1, 1997, and December 31, 2011, with covariate information available, 7592 (0.5%) were diagnosed with epilepsy through December 31, 2012. Of these 3530 (46.5%) were female. The overall incidence of epilepsy in children aged 28 days to 16 years was 6.79 per 10 000 child-years. Compared with offspring of normal-weight mothers (BMI 18.5 to epilepsy by maternal BMI categories were as follows: overweight (BMI 25.0 to epilepsy were considerably increased for children with malformations of the nervous system (adjusted HR, 46.4; 95% CI, 42.2-51.0), hypoxic ischemic encephalopathy (adjusted HR, 23.6; 95% CI, 20.6-27.1), and neonatal convulsions (adjusted HR, 33.5; 95% CI, 30.1-37.4). The rates of epilepsy were doubled among children with

  5. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-01-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  6. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-08-21

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  7. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Directory of Open Access Journals (Sweden)

    Hong Yao

    2015-08-01

    Full Text Available Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  8. The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China.

    Science.gov (United States)

    Chen, Chen; Xu, Yan; Guo, Zhi-rong; Yang, Jie; Wu, Ming; Hu, Xiao-shu

    2014-07-08

    Visceral adiposity index (VAI), a novel sex-specific index for visceral fat measurement, has been proposed recently. We evaluate the efficacy of VAI in identifying diabetes risk in Chinese people, and compare the predictive ability between VAI and other body fatness indices, i.e., waist circumference (WC), body mass index (BMI) and waist- to- height ratio (WHtR). Participants (n=3,461) were recruited from an ongoing cohort study in Jiangsu Province, China. Hazard ratio (HR) and corresponding 95% confidence interval (CI) between diabetes risk and different body fatness indices were evaluated by Cox proportional hazard regression model. Receiver operating characteristic (ROC) curve and area under curve (AUC) were applied to compare the ability of identifying diabetes risk between VAI, WC, WHtR and BMI. A total number of 160 new diabetic cases occurred during the follow-up, with an incidence of 4.6%. Significant positive associations were observed for VAI with blood pressure, fasting plasma glucose, triglyceride, WC, BMI and WHtR. Moreover, increased VAI was observed to be associated with higher diabetes risk with a positive dose-response trend (p for trendconvenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of diabetes in large-scale epidemiologic studies.

  9. Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

    DEFF Research Database (Denmark)

    Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

    2014-01-01

    Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based.......001). The overall survival (OS) index identified three different subgroups (Pcolon cancer. Furthermore...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...

  10. Hypoglycaemic and coronary risk index lowering effects of Bauhinia thoningii in alloxan induced diabetic rats.

    Science.gov (United States)

    Ojezele, M O; Abatan, O M

    2011-03-01

    Disease, one of humanity's greatest adversaries, has in recent times showed an intimidating increase in numerical and pathological strength. This stretched the available medications to the limit thereby necessitating the need for the discovery of new and alternative medications to combat the menace of disease. Diabetic mellitus is one disease condition for which ideal synthetic drugs are yet to be discovered. To this end, pharmaceuticals are looking in the direction of medicinal plants. This work aimed at screening Bauhinia thoningii (leaves) for its hypoglycaemic effect. The effect of the extract on lipid profile as a Coronary Risk Index (CRI) was also evaluated. Aqueous crude extract of the plant was administered orally to alloxan induced diabetic rats and fasting blood glucose monitored over a period of 7 days. Blood samples collected from the rats were assayed for full lipid profile and the CRI calculated. Bauhinia thoningii caused 81.37% reduction in blood glucose of the experimental animals over a period of 7 days from an initial 365 mg/dl to 68 mg/dl. The plant extract was also observed to have the capacity to ameliorate diabetic complications like cardiovascular disorders. The extract reduced the Low Density lipoprotein (LDL) and reduced the CRI. Results from this study confirmed the hypoglycaemic efficacy of the extract and ability to ameliorate coronary diabetic complications. Further study is required to purify the plant extract to identify the fraction(s) that are responsible for the hypoglycaemic effects observed. This will also help to isolate the active components and elucidate the likely mechanism of action of the plant extract.

  11. Healthy Food Intake Index (HFII – Validity and reproducibility in a gestational-diabetes-risk population

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2016-07-01

    Full Text Available Abstract Background The aim was to develop and validate a food-based diet quality index for measuring adherence to the Nordic Nutrition Recommendations (NNR in a pregnant population with high risk of gestational diabetes (GDM. Methods This study is a part of the Finnish Gestational Diabetes Prevention Study (RADIEL, a lifestyle intervention conducted between 2008 and 2014. The 443 pregnant participants (61 % of those invited, were either obese or had a history of GDM. Food frequency questionnaires collected at 1st trimester served for composing the HFII; a sum of 11 food groups (available score range 0–17 with higher scores reflecting higher adherence to the NNR. Results The average HFII of the participants was 10.2 (SD 2.8, range 2–17. Factor analysis for the HFII component matrix revealed three factors that explained most of the distribution (59 % of the HFII. As an evidence of the component relevance 9 out of 11 of the HFII components independently contributed to the total score (item-rest correlation coefficients <0.31. Saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, sucrose, and fiber intakes (among other nutrients showed linearity across the HFII categories (P ≤ 0.030 for all nutrients tested; the higher the HFII, the closer the nutrient intake to the recommended intake level. Educational attainment (P = 0.0045, BMI (P = 0.0098, smoking (P = 0.007, and leisure time physical exercise (P = 0.038 showed linearity across the HFII categories. Intra-class correlation coefficient for the HFII was 0.85 (CI 0.79, 0.90. Conclusions The HFII components reflect the food guidelines of the NNR, intakes of relevant nutrients, and characteristics known to vary with diet quality. It largely ignores energy intake, its components have independent contribution to the HFII, and it exhibits reproducibility. The main shortcomings are absence of red and processed meat component, and the validation in a

  12. Assessing a new hip index as a risk predictor for diabetes mellitus.

    Science.gov (United States)

    He, Sen; Zheng, Yi; Chen, Xiaoping

    2017-09-30

    Recently, a new anthropometric parameter (a new hip index [HI]) was developed, and the HI shows a U-shaped relationship to mortality in the USA population. It is well known that there is an inverse relationship between hip circumference (HC) and the risk of diabetes mellitus. Accordingly, the study sought to investigate whether HI could predict future diabetes mellitus, as compared with HC and the waist-to-hip ratio (WHR), in a general Chinese population. In 2007, we carried out a health examination of 687 participants (mean age 48.1 ± 6.2 years, male 58.1%). Development of diabetes mellitus by the 2007 examination was studied in relation to data from a baseline health examination carried out in 1992. During the follow up, 74 participants were diagnosed with diabetes mellitus. Across the quintiles of baseline HI, the incidence rates of diabetes mellitus were 12.4, 12.4, 9.9, 7.8 and 11.3% in quintile (Q)1, Q2, Q3, Q4 and Q5, respectively (P = 0.698). With the lowest quintile (Q1) as reference, univariate and multivariate Cox regression analyses showed that HI was not associated with diabetes mellitus. In contrast, HC and WHR could predict future diabetes mellitus. Furthermore, WHR had the best discriminatory power for diabetes mellitus (area under the receiver operating characteristic curve 0.691, 95% confidence interval 0.621-0.761), followed by HC (area under the receiver operating characteristic curve 0.623, 95% confidence interval 0.558-0.689) and HI (area under the receiver operating characteristic curve 0.464, 95% confidence interval 0.396-0.531). Compared with HC and WHR, HI was not an independent risk factor for diabetes mellitus in the Chinese population. More studies are required to delineate the limits of the utility of HI. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  13. Development of a New Fall Risk Assessment Index for Older Adults

    Directory of Open Access Journals (Sweden)

    Minoru Yamada, RPT, PhD

    2012-09-01

    Conclusion: We have demonstrated that the new index is a reliable indicator for falls in elderly people who have higher levels of functional capacity. Our data suggest that a score of more than 1 point by the new index can predict falls in robust elderly people.

  14. Development of new index for forest fire risk using satellite images in Indonesia through the direct spectral measurements of soil

    Science.gov (United States)

    Hashimoto, A.; Akita, M.; Takahashi, Y.; Suzuki, H.; Hasegawa, Y.; Ogino, Y.; Naruse, N.; Takahashi, Y.

    2016-12-01

    In recent years, the smoke caused by the forest fires in Indonesia has become a serious problem. Most of the land in Indonesia is covered with peat moss, which occurs the expanding of fires due to the burning itself. Thus, the surface soil water, reflecting the amount of precipitation in the area, can become the indication of the risk of fires. This study aims to develop a new index reflecting the risk of forest fires in Indonesia using satellite remote sensing through the direct spectral measurements of peat moss soil.We have prepared the peat moss in 7 steps of soil water content measured at an accuracy of ±15 percent (Field pro, WD-3). We obtained spectra between 400nm and 1050nm (Source: halogen lamp, spectroscope: self-made space time, spectral analysis kit) from the peat moss.The obtained spectra show the difference from the previous spectral measurement for the soil in various water content. There are the features, especially, in the wavelength range of ultraviolet (400-450nm) and infrared (530-800nm) as shown in the figure; the more the soil water increases, the lower the reflectance becomes. We have developed a new index using the New deep blue band (433 453nm and NIR band 845 885nm of Landsat 8. The resulting satellite images calculated by our original index appears to reflect the risk of forest fires rather than well-known indices such as Normalized Difference Water Index and Normalized difference Soil Index.In conclusion, we have created a new index that highly reflects to the degree of soil water of a peat soil in Indonesia.

  15. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes

    DEFF Research Database (Denmark)

    Lacoppidan, Sandra Amalie; Kyrø, Cecilie; Loft, Steffen

    2015-01-01

    BACKGROUND: Type-2 diabetes (T2D) prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally......, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D....... a protective association has been identified. However, other regional diets are less explored. OBJECTIVE: The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal...

  16. Index-Based Insurance Contracts to FOSTER Cooperation Between Agents Exposed to Uncorrelated Drought and Flooding Risks

    Science.gov (United States)

    Denaro, S.; Giuliani, M.; Castelletti, A.; Characklis, G. W.

    2017-12-01

    Worldwide, conflict over shared water resources is exacerbated by population growth, economic development and climate change. In multi-purpose water systems, stakeholders can face higher financial risks as a consequence of increased hydrological uncertainty and recurrent extreme events. In this context, a financial hedging tool able to bundle together the uncorrelated risks faced by different stakeholders may be an efficient solution to both foster cooperation and manage the financial losses associated with extreme events. In this work we explore the potential of risk diversification strategies involving index-based insurance joint contract solutions, to manage financial risk in a multi-purpose water system prone to both drought and flood risk. Risk diversification can allow for reduced insurance premiums in situations in which the bundled risks are entirely, or mostly, uncorrelated. Jointly covering flood and drought related risks from competing users in the same geographic area represents a novel application. The approach is demonstrated using a case study on Lake Maggiore, a regulated lake whose management is highly controversial due to numerous and competing human activities. In particular we focus on the ongoing conflict among the lakeshore population, affected by flood risk, and the downstream farmers' districts, facing drought related losses. Results are promising and indicate that bundling uncorrelated risks from competing users is beneficial to both promoting insurance premium affordability and facilitating collaboration schemes at the catchment scale.

  17. A Comparison of Microplastic Ecological Risk in Sediments of Shanghai and Hong Kong Based on the Ecological Risk Index and Plastic Hazard Classes

    Science.gov (United States)

    Xu, P.; Li, D.

    2017-12-01

    Microplastic which refers to the plastic fragments and particles with diameters less than 5 mm has potential threatening impacts on various ambient medium. The shortage of knowledge of ecological risks from microplastics inhibits the scientific research process. Based on the research of the literature widely, this paper analyzed potential ecological risk of microplastic in sediment of Shanghai and Hong Kong by means of ecological risk index and hazard classes developed by UN Globally Harmonized System. Combining of the two assessment method, results showed that the order of microplastic pollution extents in sediments was Changjiang Estuary

  18. Systemic Immune-Inflammation Index and Circulating T-Cell Immune Index Predict Outcomes in High-Risk Acral Melanoma Patients Treated with High-Dose Interferon

    Directory of Open Access Journals (Sweden)

    Jiayi Yu

    2017-10-01

    Full Text Available High-dose interferon alfa-2b (IFN-α-2b improves the survival of patients with high-risk melanoma. We aimed to identify baseline peripheral blood biomarkers to predict the outcome of acral melanoma patients treated with IFN-α-2b. Pretreatment baseline parameters and clinical data were assessed in 226 patients with acral melanoma. Relapse-free survival (RFS and overall survival (OS were assessed using the Kaplan-Meier method, and multivariate Cox regression analyses were applied after adjusting for stage, lactate dehydrogenase (LDH, and ulceration. Univariate analysis showed that neutrophil-to-lymphocyte ratio ≥2.35, platelet-to-lymphocyte ratio ≥129, systemic immune-inflammation index (SII ≥615 × 109/l, and elevated LDH were significantly associated with poor RFS and OS. The SII is calculated as follows: platelet count × neutrophil count/lymphocyte count. On multivariate analysis, the SII was associated with RFS [hazard ratio (HR=1.661, 95% confidence interval (CI: 1.066-2.586, P=.025] and OS (HR=2.071, 95% CI: 1.204-3.564, P=.009. Additionally, we developed a novel circulating T-cell immune index (CTII calculated as follows: cytotoxic T lymphocytes/(CD4+ regulatory T cells × CD8+ regulatory T cells. On univariate analysis, the CTII was associated with OS (HR=1.73, 95% CI: 1.01-2.94, P=.044. The SII and CTII might serve as prognostic indicators in acral melanoma patients treated with IFN-α-2b. The indexes are easily obtainable via routine tests in clinical practice.

  19. Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study.

    Science.gov (United States)

    Anic, G M; Park, Y; Subar, A F; Schap, T E; Reedy, J

    2016-01-01

    Dietary pattern analysis considers combinations of food intake and may offer a better measure to assess diet-cancer associations than examining individual foods or nutrients. Although tobacco exposure is the major risk factor for lung cancer, few studies have examined whether dietary patterns, based on preexisting dietary guidelines, influence lung cancer risk. After controlling for smoking, we examined associations between four diet quality indices-Healthy Eating Index-2010 (HEI-2010), Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension (DASH)-and lung cancer risk in the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health study. Baseline dietary intake was assessed in 460 770 participants. Over a median of 10.5 years of follow-up, 9272 incident lung cancer cases occurred. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and confidence intervals (CIs). Comparing highest to lowest quintiles, HRs (95% CIs) for lung cancer were as follows: HEI-2010=0.83 (0.77-0.89), AHEI-2010=0.86 (0.80-0.92), aMED=0.85 (0.79-0.91) and DASH=0.84 (0.78-0.90). Among the individual components of the dietary indices, higher consumption of whole grains and fruits was significantly inversely associated with lung cancer risk for several of the diet indices. Total index score analyses stratified by smoking status showed inverse associations with lung cancer for former smokers; however, only HEI-2010 was inversely associated in current smokers and no index score was inversely associated among never smokers. Although smoking is the factor most strongly associated with lung cancer, this study adds to a growing body of evidence that diet may have a modest role in reducing lung cancer risk, especially among former smokers.

  20. Evaluation of dyslipidemia, lipid ratios, and atherogenic index as cardiovascular risk factors among semi-urban dwellers in Nigeria

    Science.gov (United States)

    Olamoyegun, Michael Adeyemi; Oluyombo, Rotimi; Asaolu, Stephen Olabode

    2016-01-01

    Background and Objectives: The increasing frequency of cardiovascular disease (CVD) rests on the presence of major cardiovascular risk factors including dyslipidemia. This dyslipidemia is also a target for the prevention and treatment of many cardiovascular diseases. Hence, identification of individuals at risk of CVD is needed for early identification and prevention. The study was carried out to evaluate dyslipidemia using the lipid ratios and indices instead of just the conventional lipid profile. Methodology: It was a cross-sectional study with 699 participants recruited from semi-urban communities in Nigeria. Anthropometric indices, blood pressure, and fasting lipid profiles were determined. Abnormalities in lipid indices and lipid ratios with atherogenic index were also determined. SPSS software version 17.0 were used for analysis, P < 0.05 was considered statistically significant. Results: There were 699 participants with a mean age of 64.45 ± 15.53 years. Elevated total cholesterol, high low-density lipoprotein-cholesterol, elevated triglyceride, and low high-density lipoprotein were seen in 5.3%, 19.3%, 4.4%, and 76.3% of the participants, respectively. The Castelli's risk index-I (CRI-I) predicted the highest prevalence of predisposition to cardiovascular risk (47.8%) with females being at significantly higher risk (55.2% vs. 29.3%, P < 0.001). Atherogenic coefficient, CRI-II, CHOLIndex, atherogenic index of plasma (AIP) predicted a cardiovascular risk prevalence of 22.5%, 15.9%, 11.2%, and 11.0%, respectively, with no significant difference in between the sexes. Conclusions: Serum lipid ratios and AIP may be used in addition to lipid parameters in clinical practice to assess cardiovascular risks even when lipid profiles are apparently normal. AIP was more gender specific amidst the lipid ratios. PMID:27853034

  1. Automated Assessment of Existing Patient's Revised Cardiac Risk Index Using Algorithmic Software.

    Science.gov (United States)

    Hofer, Ira S; Cheng, Drew; Grogan, Tristan; Fujimoto, Yohei; Yamada, Takashige; Beck, Lauren; Cannesson, Maxime; Mahajan, Aman

    2018-05-25

    Previous work in the field of medical informatics has shown that rules-based algorithms can be created to identify patients with various medical conditions; however, these techniques have not been compared to actual clinician notes nor has the ability to predict complications been tested. We hypothesize that a rules-based algorithm can successfully identify patients with the diseases in the Revised Cardiac Risk Index (RCRI). Patients undergoing surgery at the University of California, Los Angeles Health System between April 1, 2013 and July 1, 2016 and who had at least 2 previous office visits were included. For each disease in the RCRI except renal failure-congestive heart failure, ischemic heart disease, cerebrovascular disease, and diabetes mellitus-diagnosis algorithms were created based on diagnostic and standard clinical treatment criteria. For each disease state, the prevalence of the disease as determined by the algorithm, International Classification of Disease (ICD) code, and anesthesiologist's preoperative note were determined. Additionally, 400 American Society of Anesthesiologists classes III and IV cases were randomly chosen for manual review by an anesthesiologist. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve were determined using the manual review as a gold standard. Last, the ability of the RCRI as calculated by each of the methods to predict in-hospital mortality was determined, and the time necessary to run the algorithms was calculated. A total of 64,151 patients met inclusion criteria for the study. In general, the incidence of definite or likely disease determined by the algorithms was higher than that detected by the anesthesiologist. Additionally, in all disease states, the prevalence of disease was always lowest for the ICD codes, followed by the preoperative note, followed by the algorithms. In the subset of patients for whom the

  2. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome.......To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

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

    Science.gov (United States)

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

    2015-10-01

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

  4. Association of body mass index with amnestic and non-amnestic mild cognitive impairment risk in elderly.

    Science.gov (United States)

    Wang, Feng; Zhao, Minghui; Han, Zhaoli; Li, Dai; Zhang, Shishuang; Zhang, Yongqiang; Kong, Xiaodong; Sun, Ning; Zhang, Qiang; Lei, Ping

    2017-09-15

    Previous studies focused on the relationship between body mass index and cognitive disorder and obtained many conflicting results. This study explored the potential effects of body mass index on the risk of mild cognitive impairment (amnestic and non-amnestic) in the elderly. The study enrolled 240 amnestic mild cognitive impairment patients, 240 non-amnestic mild cognitive impairment patients and 480 normal cognitive function controls. Data on admission and retrospective data at baseline (6 years ago) were collected from their medical records. Cognitive function was evaluated using Mini-Mental State Examination and Montreal Cognitive Assessment. Being underweight, overweight or obese at baseline was associated with an increased risk of amnestic mild cognitive impairment (OR: 2.30, 95%CI: 1.50 ~ 3.52; OR: 1.74, 95%CI: 1.36 ~ 2.20; OR: 1.71, 95%CI: 1.32 ~ 2.22, respectively). Being overweight or obese at baseline was also associated with an increased risk of non-amnestic mild cognitive impairment (OR: 1.51, 95%CI: 1.20 ~ 1.92; OR: 1.52, 95%CI: 1.21 ~ 1.97, respectively). In subjects with normal weights at baseline, an increased or decreased body mass index at follow-up was associated with an elevated risk of amnestic mild cognitive impairment (OR: 1.80, 95%CI: 1.10 ~ 3.05; OR: 3.96, 95%CI: 2.88 ~ 5.49, respectively), but only an increased body mass index was associated with an elevated risk of non-amnestic mild cognitive impairment (OR: 1.71, 95%CI: 1.16 ~ 2.59). Unhealthy body mass index levels at baseline and follow-up might impact the risk of both types of mild cognitive impairment (amnestic and non-amnestic).

  5. A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index.

    Science.gov (United States)

    Keskin, Muhammed; Güvenç, Tolga Sinan; Hayıroğlu, Mert İlker; Kaya, Adnan; Tatlısu, Mustafa Adem; Avşar, Şahin; Öz, Ahmet; Keskin, Taha; Uzun, Ahmet Okan; Kozan, Ömer

    2017-10-01

    Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. We retrospectively evaluated the in-hospital and long-term (4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost-effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Aksglaede, Lise; Munch-Andersen, Thor

    2009-01-01

    Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor...... of glucose metabolism and metabolic risk during puberty....

  7. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes

    DEFF Research Database (Denmark)

    Gunge, V B; Andersen, I; Kyrø, C

    2017-01-01

    BACKGROUND/OBJECTIVES: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether...... adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. SUBJECTS/METHODS: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50 − 64 years recruited between 1993 and 1997. The healthy.......55, 95% CI = 0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR = 0.95, 95% CI = 0.92, 0.99) and women (HR = 0.93, 95% CI = 0.88, 0.98). CONCLUSIONS: A healthy Nordic diet is associated...

  8. Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index.

    Science.gov (United States)

    Reiter, Paul L; Katz, Mira L; Ferketich, Amy K; Ruffin, Mack T; Paskett, Electra D

    2009-12-01

    To develop and validate a risky sexual behavior index specific to cervical cancer research. Sexual behavior data on 428 women from the Community Awareness Resources and Education (CARE) study were utilized. A weighting scheme for eight risky sexual behaviors was generated and validated in creating the CARE Risky Sexual Behavior Index. Cutpoints were then identified to classify women as having a low, medium, or high level of risky sexual behavior. Index scores ranged from 0 to 35, with women considered to have a low level of risky sexual behavior if their score was less than six (31.3% of sample), a medium level if their score was 6–10 (30.6%), or a high level if their score was 11 or greater (38.1%). A strong association was observed between the created categories and having a previous abnormal Pap smear test (p Sexual Behavior Index provides a tool for measuring risky sexual behavior level for cervical cancer research. Future studies are needed to validate this index in varied populations and test its use in the clinical setting.

  9. Childhood body mass index and the risk of prostate cancer in adult men

    DEFF Research Database (Denmark)

    Aarestrup, J; Gamborg, M; Cook, M B

    2014-01-01

    BACKGROUND: Prostate cancer aetiology is poorly understood. It may have origins early in life; previously we found a positive association with childhood height. The effects of early life body mass index (BMI; kg m(-2)) on prostate cancer remain equivocal. We investigated if childhood BMI...... to the Danish Cancer Registry. Cox proportional hazards regressions were performed. RESULTS: Overall, 3355 men were diagnosed with prostate cancer. Body mass index during childhood was positively associated with adult prostate cancer. The hazard ratio of prostate cancer was 1.06 (95% confidence interval (CI): 1...

  10. Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

    DEFF Research Database (Denmark)

    Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

    2014-01-01

    Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...... was associated with an unfavourable recurrence-free cancer-specific survival (RF-CSS), hazard ratio 1.35 (95% confidence interval, 1.03-1.76) (P=0.028). The generated RF-CSS index divided the traditional high-risk patients into subgroups with 5-year RF-CSS rates of 87% and 73%, respectively (P...

  11. The Risk Return Relationship: Evidence from Index Return and Realised Variance Series

    OpenAIRE

    Minxian Yang

    2014-01-01

    The risk return relationship is analysed in bivariate models for return and realised variance(RV) series. Based on daily time series from 21 international market indices for more than 13 years (January 2000 to February 2013), the empirical findings support the arguments of risk return tradeoff, volatility feedback and statistical balance. It is reasoned that the empirical risk return relationship is primarily shaped by two important data features: the negative contemporaneous correlation betw...

  12. Interaction of a genetic risk score with physical activity, physical inactivity, and body mass index in relation to venous thromboembolism risk.

    Science.gov (United States)

    Kim, Jihye; Kraft, Peter; Hagan, Kaitlin A; Harrington, Laura B; Lindstroem, Sara; Kabrhel, Christopher

    2018-06-01

    Venous thromboembolism (VTE) is highly heritable. Physical activity, physical inactivity and body mass index (BMI) are also risk factors, but evidence of interaction between genetic and environmental risk factors is limited. Data on 2,134 VTE cases and 3,890 matched controls were obtained from the Nurses' Health Study (NHS), Nurses' Health Study II (NHS II), and Health Professionals Follow-up Study (HPFS). We calculated a weighted genetic risk score (wGRS) using 16 single nucleotide polymorphisms associated with VTE risk in published genome-wide association studies (GWAS). Data on three risk factors, physical activity (metabolic equivalent [MET] hours per week), physical inactivity (sitting hours per week) and BMI, were obtained from biennial questionnaires. VTE cases were incident since cohort inception; controls were matched to cases on age, cohort, and genotype array. Using conditional logistic regression, we assessed joint effects and interaction effects on both additive and multiplicative scales. We also ran models using continuous wGRS stratified by risk-factor categories. We observed a supra-additive interaction between wGRS and BMI. Having both high wGRS and high BMI was associated with a 3.4-fold greater risk of VTE (relative excess risk due to interaction = 0.69, p = 0.046). However, we did not find evidence for a multiplicative interaction with BMI. No interactions were observed for physical activity or inactivity. We found a synergetic effect between a genetic risk score and high BMI on the risk of VTE. Intervention efforts lowering BMI to decrease VTE risk may have particularly large beneficial effects among individuals with high genetic risk. © 2018 WILEY PERIODICALS, INC.

  13. [Systemic candidiasis in medical intensive care unit: analysis of risk factors and the contribution of colonization index].

    Science.gov (United States)

    Massou, S; Ahid, S; Azendour, H; Bensghir, M; Mounir, K; Iken, M; Lmimouni, B E; Balkhi, H; Drissi Kamili, N; Haimeur, C

    2013-06-01

    Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care. Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CIcandidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively. CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. The Compression Intensity Index: a practical anatomical estimate of the biomechanical risk for a deep tissue injury.

    Science.gov (United States)

    Gefen, Amit

    2008-01-01

    Pressure-related deep tissue injury (DTI) is a severe form of pressure ulcer that initiates in compressed muscle tissues under bony prominences, and progresses superficially towards the skin. Patients with impaired motosensory capacities are at high risk of developing DTI. There is a critical medical need for developing risk assessment tools for DTI. A new anatomical index, the Compression Intensity Index: CII=(BW/Rt);[1/2], which depends on the body weight (BW), radius of curvature of the ischial tuberosities (R) and thickness of the underlying gluteus muscles (t), is suggested for approximating the loading intensity in muscle tissue during sitting in permanent wheelchair users, as part of a clinically-oriented risk assessment for DTI. Preliminary CII data were calculated for 6 healthy and 4 paraplegic subjects following MRI scans, and data were compared between the groups and with respect to a gold standard, being a previously developed subject-specific MRI-finite-element (MRI-FE) method of calculating muscle tissue stresses (Linder-Ganz et al., J. Biomech. 2007). Marked differences between the R and t parameters of the two groups caused the CII values of the paraplegics to be approximately 1.6-fold higher than for the healthy (pbedridden patients. Hence, CII measurements can be integrated into DTI-risk-assessment tools, the need of which is now being discussed intensively in the American and European Pressure Ulcer Advisory Panel meetings.

  15. Association of Classic Cardiovascular Risk Factors and Lifestyles With the Cardio-ankle Vascular Index in a General Mediterranean Population.

    Science.gov (United States)

    Elosua-Bayés, Marc; Martí-Lluch, Ruth; García-Gil, María Del Mar; Camós, Lourdes; Comas-Cufí, Marc; Blanch, Jordi; Ponjoan, Anna; Alves-Cabratosa, Lia; Elosua, Roberto; Grau, María; Marrugat, Jaume; Ramos, Rafel

    2018-06-01

    The cardio-ankle vascular index (CAVI) assesses arterial stiffness. We aimed to describe the distribution of CAVI in a Mediterranean population, to determine the proportion of CAVI ≥ 9 by sex and coronary risk level, and to assess the association of CAVI with classic cardiovascular risk factors and lifestyle patterns. This cross-sectional study was based on the population of Girona province. The CAVI was measured using the VaSera VS-1500. Of 2613 individuals included in this study, the prevalence of CAVI ≥ 9 was 46.8% in men and 36.0% in women and significantly increased with coronary risk: from 21.1% and 24.8%, respectively to 76.7%, in the low-risk group, and 61.9% in the high-risk group. The CAVI increased with age in both sexes, being higher in men across all age groups. In men, CAVI ≥ 9 was associated with hypertension (OR, 2.70; 95%CI, 1.90-3.87) and diabetes (OR, 2.38; 95%CI, 1.52-3.78), body mass index (BMI) ≤ 25 to < 30 (OR, 0.44; 95%CI, 0.27-0.72) and BMI ≥ 30 (OR, 0.28; 95%CI, 0.14-0.58), and physical activity (OR, 0.66; 95%CI, 0.47-0.92). In women, CAVI ≥ 9 was associated with hypertension (OR, 2.22; 95%CI, 1.59-3.09), hypercholesterolemia (OR, 1.40; 95%CI, 1.01-1.94), and BMI ≥ 30 (OR, 0.38; 95%CI, 0.20-0.71). The CAVI increases with age and is higher in men than in women. This index is associated with classic risk factors and coronary risk. It could be a good predictive biomarker, but further follow-up studies are required to assess its added value to cardiovascular risk stratification. Copyright © 2017. Published by Elsevier España, S.L.U.

  16. The reliability of echocardiographic left ventricular wall motion index to identify high-risk patients for multicenter studies

    DEFF Research Database (Denmark)

    Gislason, Gunnar H; Gadsbøll, Niels; Quinones, Miguel A

    2006-01-01

    that were screened for inclusion into the DIAMOND-CHF and DIAMOND-MI trials were reevaluated by an external expert echocardiographer. WMI was calculated using the 16-segment LV model. RESULTS: The external echocardiographer systematically found lower values of WMI than the core laboratory. The average...... difference in WMI was 0.18 (SD: 0.33) in the DIAMOND-CHF trial and 0.09 (SD: 0.33) in the DIAMOND-MI trial. The difference in WMI exceeded 0.33 in 34% of the patients in both trials. The cutoff value for inclusion into the DIAMOND trials was WMI ... overall agreement for identifying patients with severe impairment of LV function. This not only underscores the value of LV-WMI as a useful tool for selecting high-risk patients to be included in multicenter studies but also serves to warn against the use of rigid cutoff values for WMI in the treatment...

  17. Applying the Flood Vulnerability Index as a Knowledge base for flood risk assessment

    NARCIS (Netherlands)

    Balica, S-F.

    2012-01-01

    Floods are one of the most common and widely distributed natural risks to life and property worldwide. An important part of modern flood risk management is to evaluate vulnerability to floods. This evaluation can be done only by using a parametric approach. Worldwide there is a need to enhance our

  18. Weight, height, body mass index and risk of breast cancer in postmenopausal women: a case-control study

    Directory of Open Access Journals (Sweden)

    Vahdaninia Mariam

    2008-09-01

    Full Text Available Abstract Background Many women in Iran have a relatively high body mass index. To investigate whether the condition contributes to excess breast cancer cases, a case-control study was conducted to assess the relationships between anthropometric variables and breast cancer risk in Tehran, Iran. Methods All incident cases of breast cancer in the Iranian Centre for Breast Cancer (ICBC were identified through the case records. Eligible cases were all postmenopausal women with histological confirmed diagnosis of breast cancer during 1996 to year 2000. Controls were randomly selected postmenopausal women attending the ICBC for clinical breast examination during the same period. The body mass index (BMI was calculated based on weights and heights as measured by the ICBC nursing staff. Both tests for trend and logistic regression analysis were performed to calculate odds ratios and 95% confidence intervals as measures of relative risk. Results In all, 116 breast cancer cases and 116 controls were studied. There were no significant differences between cases and control with regard to most independent variables studied. However, a significant difference was observed between cases and controls indicating that the mean BMI was higher in cases as compared to controls (P = 0.004. Performing logistic regression analysis while controlling for age, age at menopause, family history of breast cancer and parity, the results showed that women with a BMI in the obese range had a three fold increased risk of breast cancer [odds ratio (OR = 3.21, 95% confidence interval (CI: 1.15–8.47]. Conclusion The results suggest that obesity in postmenopausal women could increase risk of breast cancer and it merits further investigation in populations such as Iran where it seems that many women are short in height, and have a relatively high body mass index.

  19. Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index.

    Science.gov (United States)

    Fahrion, A S; Beilage, E grosse; Nathues, H; Dürr, S; Doherr, M G

    2014-06-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the

  20. Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam.

    Science.gov (United States)

    Carrillo-Larco, Rodrigo M; Miranda, J Jaime; Bernabé-Ortiz, Antonio

    2016-05-01

    To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models. The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1-5.5) and 1.7 (95 % CI 1.3-2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2-1.8) and 0.3 (95 % CI 0.2-0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In the older cohorts, comparing highest versus bottom wealth index tertile, RR of overweight and obesity was four to nine times higher: 4.25 in Peru (95 % CI 2.21-8.18) and 9.11 in Vietnam (95 % CI 1.07-77.42). The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.

  1. Cardiovascular Risk Factors and Distributions of the Ankle-Brachial Index among Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Badaruddoza Doza

    2012-01-01

    Full Text Available Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (<0.001. Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9 was 4.47% in men and 4.67% in women and high ABI (≥1.30 was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.

  2. Education and inequalities in risk scores for coronary heart disease and body mass index: evidence for a population strategy.

    Science.gov (United States)

    Liu, Sze Yan; Kawachi, Ichiro; Glymour, M Maria

    2012-09-01

    Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in the following two nationally representative datasets: the 2006 wave of the Health and Retirement Survey and the 2003-2008 National Health and Nutrition Examination Survey (NHANES). Higher educational attainment was associated with lower 10-year CHD risk for all groups. However, the magnitude of this association varied considerably across quantiles for some subgroups. For example, among women in NHANES, a high school degree was associated with 4% (95% confidence interval = -9% to 1%) and 17% (-24% to -8%) lower CHD risk in the 10th and 90th percentiles, respectively. For BMI, a college degree was associated with uniform decreases across the distribution for women, but with varying increases for men. Compared with those who had not completed high school, male college graduates in the NHANES sample had a BMI that was 6% greater (2% to 11%) at the 10th percentile of the BMI distribution and 7% lower (-10% to -3%) at the 90th percentile (ie, overweight/obese). Estimates from the Health and Retirement Survey sample and the marginal quantile regression models showed similar patterns. Conventional regression methods may mask important variations in the associations between education and CHD risk.

  3. The influence of body mass index, age and sex on inflammatory disease risk in semi-captive Chimpanzees.

    Directory of Open Access Journals (Sweden)

    Vincent Obanda

    Full Text Available Obesity and ageing are emerging issues in the management of captive primates, including Chimpanzees, Pan troglodytes. Studies on humans show that obesity and old age can independently increase the risk of inflammatory-associated diseases indicated by elevated levels of pro-inflammatory cells and proteins in the blood of older or obese compared to levels in younger or non-obese individuals. In humans, sex can influence the outcomes of these risks. Health management of these problems in chimpanzee populations requires an understanding of similarities and differences of factors influencing inflammatory disease risks in humans and in chimpanzees. We examined the relationship between age, sex and Body Mass Index (BMI with hematological biomarkers of inflammatory disease risk established for humans which include the neutrophil to lymphocyte ratio (NLR, and neutrophil, white blood cell (WBC, platelet microparticle and platelet counts. We found that higher values of NLR, neutrophil count and platelet microparticle count were associated with higher BMI values and older age indicating increased inflammation risk in these groups; a similar pattern to humans. There was a strong sex by age interaction on inflammation risk, with older males more at risk than older females. In contrast to human studies, total WBC count was not influenced by BMI, but like humans, WBC and platelet counts were lower in older individuals compared to younger individuals. Our findings are similar to those of humans and suggest that further insight on managing chimpanzees can be gained from extensive studies of ageing and obesity in humans. We suggest that managing BMI should be an integral part of health management in captive chimpanzee populations in order to partially reduce the risk of diseases associated with inflammation. These results also highlight parallels in inflammation risk between humans and chimpanzees and have implications for understanding the evolution of

  4. Use of Segregation Indices, Townsend Index, and Air Toxics Data to Assess Lifetime Cancer Risk Disparities in Metropolitan Charleston, South Carolina, USA

    Directory of Open Access Journals (Sweden)

    LaShanta J. Rice

    2014-05-01

    Full Text Available Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime cancer risk from air toxics by racial composition, segregation, and deprivation in census tracts in Metropolitan Charleston. Methods: Segregation indices were used to measure the distribution of groups of people from different races within neighborhoods. The Townsend Index was used to measure economic deprivation in the study area. Poisson multivariate regressions were applied to assess the association of lifetime cancer risk with segregation indices and Townsend Index along with several sociodemographic measures. Results: Lifetime cancer risk from all pollution sources was 28 persons/million for half of the census tracts in Metropolitan Charleston. Isolation Index and Townsend Index both showed significant correlation with lifetime cancer risk from different sources. This significance still holds after adjusting for other sociodemographic measures in a Poisson regression, and these two indices have stronger effect on lifetime cancer risk compared to the effects of sociodemographic measures. Conclusions: We found that material deprivation, measured by the Townsend Index and segregation measured by the Isolation index, introduced high impact on lifetime cancer risk by air toxics at the census tract level.

  5. Predictive performance of the visceral adiposity index for a visceral adiposity-related risk: Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Azizi Fereidoun

    2011-05-01

    Full Text Available Abstract Background Visceral adiposity index (VAI has recently been developed based on waist circumference, body mass index (BMI, triglycerides (TGs, and high-density lipoprotein cholesterol (HDL-C. We examined predictive performances for incident diabetes of the VAI per se and as compared to the metabolic syndrome (MetS and waist-to-height-ratio (WHtR. Methods Participants free of diabetes at baseline with at least one follow-up examination (5,964 were included for the current study. Weibull regression models were developed for interval-censored survival data. Absolute and relative integrated discriminatory improvement index (IDI and cut-point-based and cut-point-free net reclassification improvement index (NRI were used as measures of predictive ability for incident diabetes added by VAI, as compared to the MetS and WHtR. Results The annual incidence rate of diabetes was 0.85 per 1000 person. Mean VAI was 3.06 (95%CIs 2.99-3.13. Diabetes risk factors levels increased in stepwise fashion across VAI quintiles. Risk gradient between the highest and lowest quintile of VAI was 4.5 (95%CIs 3.0-6.9. VAI significantly improved predictive ability of the MetS. The relative IDI and cut-point free NRI for predictive ability added to MetS by VAI were 30.3% (95%CIs 18.8-41.8% and 30.7% (95%CIs 20.8-40.7%, respectively. WHtR, outperformed VAI with cut-point-free NRI of 24.6% (95%CIs 14.1-35.2%. Conclusions In conclusion, although VAI could be a prognostic tool for incident diabetes events, gathering information on its components (WC, BMI, TGs, and HDL-C is unlikely to improve the prediction ability beyond what could be achieved by the simply assessable and commonly available information on WHtR.

  6. a case s ation of heavy metals' health risk index in vegetable unflower

    African Journals Online (AJOL)

    userpc

    ntrol of pollution produce from industries affects both air and soil table Amaranth and Sunflower ... ls, Health risk, Sunflower, and Vegetable Amaranth. ign material into a .... were homogenized by grinding using ceramic coated grinder. All the ...

  7. Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach

    DEFF Research Database (Denmark)

    Søeborg, T; Frederiksen, H; Andersson, Anna-Maria

    2012-01-01

    Human risk assessment of chemicals is traditionally presented as the ratio between the actual level of exposure and an acceptable level of exposure, with the acceptable level of exposure most often being estimated by appropriate authorities. This approach is generally sound when assessing the risk...... of individual chemicals. However, several chemicals may concurrently target the same receptor, work through the same mechanism or in other ways induce the same effect(s) in the body. In these cases, cumulative risk assessment should be applied. The present study uses biomonitoring data from 129 Danish children...... and adolescents and resulting estimated daily intakes of four different phthalates. These daily intake estimates are used for a cumulative risk assessment with anti-androgenic effects as the endpoint using Tolerable Daily Intake (TDI) values determined by the European Food Safety Authorities (EFSA) or Reference...

  8. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    International Nuclear Information System (INIS)

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-01-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM 10 , SO 2 , NO 2 and the weighted combined API (APIw) with mortality during 2003–2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0–2 days. Harvesting effects appeared after 2 days’ exposure. The effect estimate of API over lag 0–15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. - Highlights: • The cumulative effects of API on mortality over lag 0–15 days remained significant. • The indices for three specific pollutants had similar associations with mortality. • The effects of API were modified by age, gender and educational attainment. • Our findings can help to communicate health risks of air pollution to the public. - The Air Pollution Index communicates health risks of air pollution

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

    Directory of Open Access Journals (Sweden)

    M. Pourmahabadian

    2005-08-01

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

  10. Body mass index during adolescence, rather than childhood, is critical in determining MS risk.

    Science.gov (United States)

    Hedström, A K; Olsson, T; Alfredsson, L

    2016-06-01

    Obesity in childhood and during adolescence has repeatedly been associated with increased risk of developing multiple sclerosis (MS). We aimed to investigate whether the most critical period occurs during childhood or later, during adolescence. Using a population-based case-control study (1586 cases and 2800 controls), individuals with different body sizes at age 10 and different body mass indices at age 20 were compared regarding MS risk, by calculating odds ratios with 95% confidence intervals. Potential interactions between HLA-DRB1*15 and absence of HLA-A*02, respectively, and both childhood and adolescent obesity were evaluated by calculating the attributable proportion due to interaction. Regardless of body size at age 10, individuals with adolescent obesity had a 90% increased risk of MS. Among participants who were not obese at age 20, no association was observed between body size at age 10 and subsequent MS risk. An interaction was observed between the HLA MS risk genes and adolescent, but not childhood, obesity. Our results suggest that BMI during adolescence, rather than childhood, is critical in determining MS risk. © The Author(s), 2015.

  11. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison

    Directory of Open Access Journals (Sweden)

    Kahn Henry S

    2005-09-01

    Full Text Available Abstract Background Body mass index (BMI, kg/m2 may not be the best marker for estimating the risk of obesity-related disease. Consistent with physiologic observations, an alternative index uses waist circumference (WC and fasting triglycerides (TG concentration to describe lipid overaccumulation. Methods The WC (estimated population minimum 65 cm for men and 58 cm for women and TG concentration from the third National Health and Nutrition Examination Survey (N = 9,180, statistically weighted to represent 100.05 million US adults were used to compute a "lipid accumulation product" [LAP = (WC-65 × TG for men and (WC-58 × TG for women] and to describe the population distribution of LAP. LAP and BMI were compared as categorical variables and as log-transformed continuous variables for their ability to identify adverse levels of 11 cardiovascular risk factors. Results Nearly half of the represented population was discordant for their quartile assignments to LAP and BMI. When 23.54 million with ordinal LAP quartile > BMI quartile were compared with 25.36 million with ordinal BMI quartile > LAP quartile (regression models adjusted for race-ethnicity and sex the former had more adverse risk levels than the latter (p 0.1. As continuous variables, LAP provided a consistently more adverse beta coefficient (slope than BMI for nine cardiovascular risk variables (p 0.2. Conclusion LAP (describing lipid overaccumulation performed better than BMI (describing weight overaccumulation for identifying US adults at cardiovascular risk. Compared to BMI, LAP might better predict the incidence of cardiovascular disease, but this hypothesis needs prospective testing.

  12. Carbohydrate, dietary glycaemic index and glycaemic load, and colorectal cancer risk: a case-control study in China.

    Science.gov (United States)

    Huang, Jing; Fang, Yu-Jing; Xu, Ming; Luo, Hong; Zhang, Nai-Qi; Huang, Wu-Qing; Pan, Zhi-Zhong; Chen, Yu-Ming; Zhang, Cai-Xia

    2018-04-01

    A carbohydrate-rich diet results in hyperglycaemia and hyperinsulinaemia; it may further induce the carcinogenesis of colorectal cancer. However, epidemiological evidence among Chinese population is quite limited. The aim of this study was to investigate total carbohydrate, non-fibre carbohydrate, total fibre, starch, dietary glycaemic index (GI) and glycaemic load (GL) in relation to colorectal cancer risk in Chinese population. A case-control study was conducted from July 2010 to April 2017, recruiting 1944 eligible colorectal cancer cases and 2027 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. There was no clear association between total carbohydrate intake and colorectal cancer risk. The adjusted OR was 0·85 (95 % CI 0·70, 1·03, P trend=0·08) comparing the highest with the lowest quartile. Total fibre was related to a 53 % reduction in colorectal cancer risk (adjusted ORquartile 4 v. 1 0·47; 95 % CI 0·39, 0·58). However, dietary GI was positively associated with colorectal cancer risk, with an adjusted ORquartile 4 v. 1 of 3·10 (95 % CI 2·51, 3·85). No significant association was found between the intakes of non-fibre carbohydrate, starch and dietary GL and colorectal cancer risk. This study indicated that dietary GI was positively associated with colorectal cancer risk, but no evidence supported that total carbohydrate, non-fibre carbohydrate, starch or high dietary GL intake were related to an increased risk of colorectal cancer in a Chinese population.

  13. Body Mass Index and Risk of Infections Among Women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Nielsen, Nete M; Friis-Møller, Nina

    2016-01-01

    baseline BMI and later hospitalization for 1) any infectious disease and 2) infections of the respiratory tract, whereas a dose-response relationship was seen for skin infections. The most pronounced associations were seen for acute upper respiratory infections at multiple and unspecified sites...... was observed among overweight (BMI 25-infections of the upper respiratory tract and skin.......We investigated the possible association between body mass index (BMI; weight (kg)/height (m)(2)) and hospitalization or treatment for acute infection in a prospective cohort study. We linked 75,001 women enrolled in the Danish National Birth Cohort from 1996 to 2002, who had information on BMI...

  14. Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Wissenberg, Mads; Jørgensen, Mads Emil

    2015-01-01

    , II, III, and IV. Multivariable odds ratio estimates were as follows: ischemic heart disease 3.30 (95% confidence interval, 2.96-3.69), high-risk surgery 2.70 (2.46-2.96), congestive heart failure 2.65 (2.29-3.06), cerebrovascular disease 10.02 (9.08-11.05), insulin therapy 1.62 (1.......37-1.93), and kidney disease 1.45 (1.33-1.59). Modeling RCRI classes as a continuous variable, C statistic was highest among age group 56 to 65 years (0.772) and lowest for those aged >85 years (0.683). Sensitivity of RCRI class >I (ie, having ≥ 1 risk factor) for capturing major adverse cardiovascular events was 59...

  15. Body mass index in childhood and adult risk of primary liver cancer

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus

    2014-01-01

    BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort......-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS: During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio...... hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS: Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight...

  16. [Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

    Science.gov (United States)

    Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

    2011-10-01

    Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration.

  17. Trajectories of body mass index among Canadian seniors and associated mortality risk.

    Science.gov (United States)

    Wang, Meng; Yi, Yanqing; Roebothan, Barbara; Colbourne, Jennifer; Maddalena, Victor; Sun, Guang; Wang, Peizhong Peter

    2017-12-04

    This study aims to characterize the heterogeneity in BMI trajectories and evaluate how different BMI trajectories predict mortality risk in Canadian seniors. Data came from the Canadian National Population Health Survey (NPHS, 1994-2011) and 1480 individuals aged 65-79 years with at least four BMI records were included in this study. Group-based trajectory model was used to identify distinct subgroups of longitudinal trajectories of BMI measured over 19 years for men and women. Cox proportional hazards models were used to examine the association between BMI trajectories and mortality risks. Distinct trajectory patterns were found for men and women: 'Normal Weight-Down'(N-D), 'Overweight-Normal weight' (OV-N), 'Obese I-Down' (OB I-D), and 'Obese II- Down' (OB II-D) for women; and 'Normal Weight-Down' (N-D), 'Overweight-Normal weight' (OV-N), 'Overweight-Stable' (OV-S), and 'Obese-Stable' (OB-S) for men. Comparing with OV-N, men in the OV-S group had the lowest mortality risk followed by the N-D (HR = 1.66) and OB-S (HR = 1.98) groups, after adjusting for covariates. Compared with OV-N, women in the OB II-D group with three or more chronic health conditions had higher mortality risk (HR = 1.61); however, women in OB II-D had lower risk (HR = 0.56) if they had less than three conditions. The course of BMI over time in Canadian seniors appears to follow one of four different patterns depending on gender. The findings suggest that men who were overweight at age 65 and lost weight over time had the lowest mortality risk. Interestingly, obese women with decreasing BMI have different mortality risks, depending on their chronic health conditions. The findings provide new insights concerning the associations between BMI and mortality risk.

  18. The prediction of the incidence rate of upper limb musculoskeletal disorders, with CTD risk index method on potters of Meybod city

    Directory of Open Access Journals (Sweden)

    Reza Khani Jazani

    2012-02-01

    Full Text Available Background: The objective of this study was to predict the incidence of musculoskeletal disorders in potters of Meybod city by performing CTD risk index method.Materials and Method: This is a descriptive cross-sectional study. Target society was all workers in pottery workshops which were located in the Meybod. Information related to musculoskeletal disorders was obtained by the Nordic questionnaire and we used CTD risk index method to predict the incidence of musculoskeletal disorders.Results: We observed in this study that 59.3% of the potters had symptoms of musculoskeletal disorders in at least in one of their upper extremities. Also significant differences between mean CTD risk index on potters with and without symptoms of the upper limb musculoskeletal disorders, respectively (p=0.038.Conclusion: CTD risk index method can be as a suitable method for predicting the incidence of musculoskeletal disorders used in the potters

  19. Screening manual and office workers for risk of long-term sickness absence: cut-off points for the Work Ability Index

    NARCIS (Netherlands)

    Schouten, L.S.; Joling, C.I.; van der Gulden, J.W.J.; Heymans, M.W.; Bultmann, U.; Roelen, C.A.M.

    2015-01-01

    OBJECTIVES: The aim of this study was to investigate the Work Ability Index (WAI) as a tool to screen for risk of different durations of long-term sickness absence (LTSA) among manual and office workers.

  20. Pathway index models for construction of patient-specific risk profiles.

    Science.gov (United States)

    Eng, Kevin H; Wang, Sijian; Bradley, William H; Rader, Janet S; Kendziorski, Christina

    2013-04-30

    Statistical methods for variable selection, prediction, and classification have proven extremely useful in moving personalized genomics medicine forward, in particular, leading to a number of genomic-based assays now in clinical use for predicting cancer recurrence. Although invaluable in individual cases, the information provided by these assays is limited. Most often, a patient is classified into one of very few groups (e.g., recur or not), limiting the potential for truly personalized treatment. Furthermore, although these assays provide information on which individuals are at most risk (e.g., those for which recurrence is predicted), they provide no information on the aberrant biological pathways that give rise to the increased risk. We have developed an approach to address these limitations. The approach models a time-to-event outcome as a function of known biological pathways, identifies important genomic aberrations, and provides pathway-based patient-specific assessments of risk. As we demonstrate in a study of ovarian cancer from The Cancer Genome Atlas project, the patient-specific risk profiles are powerful and efficient characterizations useful in addressing a number of questions related to identifying informative patient subtypes and predicting survival. Copyright © 2012 John Wiley & Sons, Ltd.

  1. The impact of house price index specification levels on the risk profile of housing corporations

    NARCIS (Netherlands)

    Kramer, B.; Kuijl, T.; Francke, M.

    2009-01-01

    Asset Liability Management (ALM) for housing corporations is based on stochastic scenario models for important risk and return drivers such as interest and inflation rates, construction costs and sales prices of houses. Given the situation of the housing corporation (current real estate portfolio,

  2. Tail risk analysis of the S&P/OIC COMCEC 50 index

    Directory of Open Access Journals (Sweden)

    Mahmoud Bekri

    2015-03-01

    We show how the use of the stable distributions achieves a great amelioration of the modelling of the S&P/OIC COMCEC 50, considering the different statistical tests and in terms of the assessment of the value of tail risk.

  3. Body Mass Index and Risk of Gallbladder Cancer: Systematic Review and Meta-Analysis of Observational Studies

    Directory of Open Access Journals (Sweden)

    Wenbin Tan

    2015-09-01

    Full Text Available OBJECTIVES: To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI, and the risk of gallbladder cancer (GBC. METHODS: We identified eligible studies in Medline and EMBASE up to 1 February 2015, and reference lists of retrieved articles. Summary relative risks with their 95% confidence intervals were calculated in a random-effects model. Subgroup analyses were performed according to study design, gender, geographic location, ascertainment of exposure and adjustment for confounders. RESUITS: A total of 12 cohort studies and 8 case-control studies were included in the meta-analysis. Overall, compared with “normal” weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04–1.25 for overweight individuals (BMI 25–30 kg/m2 and 1.56 (95% CI, 1.41–1.73 for obese individuals (BMI > 30 kg/m2. Obese women had a higher risk of GBC than men did (women: SRRs 1.67, 95% CI 1.38–2.02; men: SRRs 1.42, 95% CI 1.21–1.66, and there was significant association between overweight and GBC risk in women (SRRs 1.26, 95% CI 1.13–1.40, but not in men (SRRs 1.06, 95% CI 0.94–1.20. CONCLUSIONS: Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC, especially in women. Overweight is associated with GBC risk only in women.

  4. Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

    Science.gov (United States)

    Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

    2015-04-01

    Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, plevels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India.

    Science.gov (United States)

    Bansal, Sanjiv Kumar; Agarwal, Sarita; Daga, Mridul Kumar

    2016-01-01

    The high prevalence, severity, and prematurity of coronary artery disease (CAD) in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. To calculate newly defined advanced atherogenic index (AAI) in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL), small dense LDL (SD LDL), lipoprotein (a) apolipoprotein B (Apo B), and apolipoprotein A1 (Apo A1) were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI) and lipid pentad index (LPI). The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20) as compared to controls (305.84 ± 21.80). AAI has shown better statistical significance and correlation (P statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

  6. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children.

    Science.gov (United States)

    Andersen, Christina Hebsgaard; Thomsen, Per Hove; Nohr, Ellen Aagaard; Lemcke, Sanne

    2018-02-01

    The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother-child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having a child with ADHD was significantly increased if the mother was overweight (HR = 1.28 [95% CI 1.15;1.48]), obese (HR = 1.47 [95% CI 1.26;1.71]) or severely obese (HR = 1.95 [95% CI 1.58;2.40]). The same pattern was seen for the combined ADHD and ASD group. Regarding ASD, an increased risk was observed in underweight (HR = 1.30 [95% CI 1.01;1.69]) and obese (HR = 1.39 [95% CI 1.11;1.75]) mothers. Subgroup analysis revealed that the association in the ADHD group could mostly be attributable to the hyperactive group. Maternal obesity before pregnancy is a risk factor for ADHD in children. Maternal obesity as well as underweight may also be associated with an increased risk for ASD.

  7. Low skeletal muscle mass outperforms the Charlson Comorbidity Index in risk prediction in patients undergoing pancreatic resections.

    Science.gov (United States)

    Wagner, D; Marsoner, K; Tomberger, A; Haybaeck, J; Haas, J; Werkgartner, G; Cerwenka, H; Bacher, H; Mischinger, H J; Kornprat, P

    2018-05-01

    Low skeletal muscle mass is a known predictor of morbidity and mortality in patients undergoing major pancreatic surgeries. We sought to combine low skeletal muscle mass with established risk predictors to improve their prognostic capacity for postoperative outcome and morbidity. As established parameters to predict preoperative mortality risk for patients, the ASA classification and the Charlson Comorbidity Index (CCI) were used. The Hounsfield Units Average Calculation (HUAC) was measured to define low skeletal muscle mass in 424 patients undergoing pancreatic resections for malignancies. Patients in the lowest sex-adjusted quartile for HUAC were defined as having low skeletal muscle mass (muscle wasting). Multivariable Cox regression analysis was utilized to identify preoperative risk factors associated with postoperative morbidity. Median patient age was 63 years (19-87), 47.9% patients were male, and half the cohort had multiple comorbidities (Charlson Comorbidity Index [CCI]>6, 63.2%), 30-day mortality was 5.8% (n = 25). Median HUAC was 19.78 HU (IQR: 15.94-23.54) with 145 patients (34.2%) having low skeletal muscle mass. Preoperative frailty defined by low skeletal muscle mass was associated with an increased risk for postoperative complications (OR 1.55, CI 95% 0.98-2.45, p = 0.014), and a higher 30-day mortality (HR 5.17, CI 95% 1.57-16.69, p = 0.004). With an AUC of 0.85 HUAC showed the highest predictability for 30-day mortality (CI 95% 0.78-0.91, p = 0.0001). Patients with CCI ≥6 and low skeletal muscle mass defined by the HUAC had a 9.78 higher risk of dying in the immediate postoperative phase (HR 9.78, CI 95% 2.98-12.2, p = 0.0001). Low skeletal muscle mass predicts postoperative mortality and complications best and it should be incorporated to conventional risk scores to identify high risk patients. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights

  8. Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors

    DEFF Research Database (Denmark)

    Gögebakan, Özlem; Kohl, Angela; Osterhoff, Martin A.

    2011-01-01

    We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes).......We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes)....

  9. Exceedance probability of the standardized precipitation-evapotranspiration index in the Texas High Plains

    Science.gov (United States)

    Drought is a common occurrence in many arid and semi-arid regions that can have large negative impacts on water resources and agricultural production. Since agricultural drought is affected by both water supply and demand (precipitation and evapotranspiration), it is beneficial to include both in a...

  10. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults.

    Science.gov (United States)

    Knowles, K M; Paiva, L L; Sanchez, S E; Revilla, L; Lopez, T; Yasuda, M B; Yanez, N D; Gelaye, B; Williams, M A

    2011-01-24

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG). For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  11. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    Directory of Open Access Journals (Sweden)

    K. M. Knowles

    2011-01-01

    Full Text Available Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS and elevated C-reactive protein (CRP. Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC, body mass index (BMI, waist-hip ratio (WHR, waist-height ratio (WHtR, and visceral adiposity index (VAI were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG. For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  12. U.S. Civil Air Show Crashes, 1993 to 2013: Burden, Fatal Risk Factors, and Evaluation of a Risk Index for Aviation Crashes.

    Science.gov (United States)

    Ballard, Sarah-Blythe; Osorio, Victor B

    2015-01-01

    This study provides new public health data about U.S. civil air shows. Risk factors for fatalities in civil air show crashes were analyzed. The value of the FIA score in predicting fatal outcomes was evaluated. With the use of the FAA's General Aviation and Air Taxi Survey and the National Transportation Safety Board's data, the incidence of civil air show crashes from 1993 to 2013 was calculated. Fatality risk factors for crashes were analyzed by means of regression methods. The FIA index was validated to predict fatal outcomes by using the factors of fire, instrument conditions, and away-from-airport location, and was evaluated through receiver operating characteristic (ROC) curves. The civil air show crash rate was 31 crashes per 1,000 civil air events. Of the 174 civil air show crashes that occurred during the study period, 91 (52%) involved at least one fatality; on average, 1.1 people died per fatal crash. Fatalities were associated with four major risk factors: fire [adjusted odds ratio (AOR) = 7.1, 95% confidence interval (CI) = 2.4 to 20.6, P Civil air show crashes were marked by a high risk of fatal outcomes to pilots in aerobatic performances but rare mass casualties. The FIA score was not a valid measurement of fatal risk in civil air show crashes.

  13. Comparing 3 dietary pattern methods--cluster analysis, factor analysis, and index analysis--With colorectal cancer risk: The NIH-AARP Diet and Health Study.

    Science.gov (United States)

    Reedy, Jill; Wirfält, Elisabet; Flood, Andrew; Mitrou, Panagiota N; Krebs-Smith, Susan M; Kipnis, Victor; Midthune, Douglas; Leitzmann, Michael; Hollenbeck, Albert; Schatzkin, Arthur; Subar, Amy F

    2010-02-15

    The authors compared dietary pattern methods-cluster analysis, factor analysis, and index analysis-with colorectal cancer risk in the National Institutes of Health (NIH)-AARP Diet and Health Study (n = 492,306). Data from a 124-item food frequency questionnaire (1995-1996) were used to identify 4 clusters for men (3 clusters for women), 3 factors, and 4 indexes. Comparisons were made with adjusted relative risks and 95% confidence intervals, distributions of individuals in clusters by quintile of factor and index scores, and health behavior characteristics. During 5 years of follow-up through 2000, 3,110 colorectal cancer cases were ascertained. In men, the vegetables and fruits cluster, the fruits and vegetables factor, the fat-reduced/diet foods factor, and all indexes were associated with reduced risk; the meat and potatoes factor was associated with increased risk. In women, reduced risk was found with the Healthy Eating Index-2005 and increased risk with the meat and potatoes factor. For men, beneficial health characteristics were seen with all fruit/vegetable patterns, diet foods patterns, and indexes, while poorer health characteristics were found with meat patterns. For women, findings were similar except that poorer health characteristics were seen with diet foods patterns. Similarities were found across methods, suggesting basic qualities of healthy diets. Nonetheless, findings vary because each method answers a different question.

  14. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children

    DEFF Research Database (Denmark)

    Andersen, Christina Hebsgaard; Thomsen, Per Hove; Nohr, Ellen Aagaard

    2018-01-01

    The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large...... birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother-child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy......; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having...

  15. Height, weight and body mass index in early adulthood and risk of schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Mortensen, E L; Reinisch, J M

    2006-01-01

    individuals born between 1959 and 1961. In 1999, cases of schizophrenia were identified in the Danish Psychiatric Central Register, and the cases were compared with the cohort pool of controls with respect to height, weight, and BMI from draft records. The effect of low BMI was adjusted for parental social...... status when the cohort members were 1 year old, birth weight, birth length, and maternal pre-pregnancy BMI. RESULTS: Forty-five cases of schizophrenia had a lower young adult mean body weight and BMI than controls. A significant inverse relationship between BMI and risk of later schizophrenia was found....... No significant differences between cases and controls were observed with respect to adult height. CONCLUSION: Independent of several possible confounders, an inverse relationship between young adult BMI and risk of later development of schizophrenia was demonstrated in this all-male sample....

  16. Occupational coke oven emissions exposure and risk of abnormal liver function: modifications of body mass index and hepatitis virus infection

    Energy Technology Data Exchange (ETDEWEB)

    Y. Hu; B. Chen; J. Qian; L. Jin; T. Jin; D. Lu [Fudan University, Shanghai (China). Department of Occupational and Environmental Health

    2010-03-15

    Occupational coke oven emissions (COEs) have been considered an important health issue. However, there are no conclusive data on human hepatic injury due to COE exposure. The association of COE exposure with liver function was explored and the effects of modification of potential non-occupational factors were assessed. 705 coke oven workers and 247 referents were investigated. Individual cumulative COE exposure was quantitatively estimated. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), {gamma}-glutamyl transferase, alkaline phosphatase, hepatitis B surface antigen and anti-hepatitis C antibody were measured. Among those with high COE exposure, the adjusted ORs of abnormal ALT and AST were 5.23 (95% CI 2.66 to 10.27) and 1.95 (95% CI 1.18 to 3.52), respectively. Overweight individuals (body mass index (BMI) {>=}25 kg/m{sup 2}) with high COE exposure had elevated risks of abnormal ALT (adjusted OR 23.93, 95% CI 8.73 to 65.62) and AST (adjusted OR 5.18, 95% CI 2.32 to 11.58). Risk of liver damage in hepatitis B virus- or hepatitis C virus-positive individuals with COE exposure was also elevated. Long-term exposure to COE increases the risk of liver dysfunction, which is more prominent among those with higher BMI and hepatitis virus infection. The risk assessment of liver damage associated with COE exposure should take BMI and hepatitis virus infection into consideration.

  17. Histological evaluation of patients with gastritis at high risk of developing gastric cancer using a conventional index.

    Science.gov (United States)

    Tanaka, Aki; Kamada, Tomoari; Inoue, Kazuhiko; Shiotani, Akiko; Kusunoki, Hiroaki; Manabe, Noriaki; Ito, Masanori; Hata, Jiro; Haruma, Ken

    2011-06-15

    Although gastric cancer (GCa) is strongly associated with Helicobacter pylori infection, only some H. pylori-positive subjects develop gastric cancer. The aim of this study is to identify H. pylori-positive subjects at high risk of developing GCa by assessment of the histopathological findings in the non-cancer-containing mucosa of patients with and without GCa. The subjects were 35 patients with diffuse-type gastric cancer (D-GCa), 55 with intestinal-type gastric cancer (I-GCa), and 99 H. pylori-positive controls without GCa. Two specimens were taken from the greater curvature of the antrum and the middle body. Histopathological gradings were evaluated using the updated Sydney System, and the risk of GCa was evaluated using a modified Meining's gastric cancer risk index (GCRI). Among the H. pylori-positive controls, corpus gastritis was seen in 98.0% (97/99) and corpus atrophic gastritis in 78.8% (78/99). The mean GCRI for the D-GCa (5.514±2.03) and I-GCa (6.836±2.08) groups was significantly greater than that for the H. pylori-positive controls (4.071±2.07; p=0.0005, pcancer. However, H. pylori-positive patients at high risk of developing GCa (not only intestinal-type but also diffuse-type) may be detected using a simple GCRI. Copyright © 2011 Elsevier GmbH. All rights reserved.

  18. Associations of Body Mass Index with Sexual Risk-Taking and Injection Drug Use among US High School Students

    Directory of Open Access Journals (Sweden)

    Richard Lowry

    2014-01-01

    Full Text Available The purpose of this study was to determine if body mass index (BMI is associated with behaviors that may increase risk for HIV and other sexually transmitted diseases (STDs among US high school students. We analyzed nationally representative data from the 2005–2011 national Youth Risk Behavior Surveys (YRBS to examine associations of BMI categories with sexual risk behaviors and injection drug use among sexually active high school students, using sex-stratified logistic regression models. Controlling for race/ethnicity and grade, among female and male students, both underweight (BMI < 5th percentile and obesity (BMI ≥ 95th percentile were associated with decreased odds of being currently sexually active (i.e., having had sexual intercourse during the past 3 months. However, among sexually active female students, obese females were more likely than normal weight females to have had 4 or more sex partners (odds ratio, OR = 1.59, not used a condom at last sexual intercourse (OR = 1.30, and injected illegal drugs (OR = 1.98. Among sexually active male students, overweight (85th percentile ≤ BMI < 95th percentile was associated with not using a condom at last sexual intercourse (OR = 1.19 and obesity was associated with injection drug use (OR = 1.42. Among sexually active students, overweight and obesity may be indicators of increased risk for HIV and other STDs.

  19. Body Mass Index below Obesity Threshold Implies Similar Cardiovascular Risk among Various Polycystic Ovary Syndrome Phenotypes.

    Science.gov (United States)

    Bagir, Gulay Simsek; Bakiner, Okan S; Bozkirli, Emre; Cavlak, Gulhan; Serinsoz, Hulya; Ertorer, M Eda

    2016-01-01

    The aim of this study was to determine the cardiometabolic risk factors in different polycystic ovary syndrome (PCOS) phenotypes. This cross-sectional study was performed between 2010 and 2011. Eighty-nine patients with PCOS and 25 age- and weight-matched healthy controls were included in the study. Patients were grouped using the Rotterdam 2003 criteria as: group 1, oligomenorrhea and/or anovulation (ANOV) and hyperandrogenemia (HA) and/or hyperandrogenism (n = 23); group 2, ANOV and polycystic ovaries (PCO; n = 22); group 3, HA and PCO (n = 22); group 4, ANOV, HA and PCO (n = 22); group 5, controls (n = 25). Laboratory blood tests for diagnosis and cardiometabolic risk assessments were performed. Insulin resistance (IR) was calculated in all patients with the homeostasis model assessment of IR (HOMA-IR) formula. An euglycemic hyperinsulinemic clamp test was performed on 5 randomly selected cases in each subgroup, making 25 cases in total, and indicated as the 'M' value (mg/kg/min), which is the total body glucose disposal rate. The mean BMl values of the groups were: group 1, 26.1 ± 5.3; group 2, 27.9 ± 5.2; group 3, 24.3 ± 4.2; group 4, 27.9 ± 7.5; group 5, 24.7 ± 5.2 (p > 0.05). There were no differences in the lipid profile, plasma glucose, HOMA-IR, insulin and M values between the groups (p > 0.05). Phenotypes with oligomenorrhea/anovulation (groups 1, 2 and 4) were more obese than group 3 (p = 0.039). The cardiometabolic risk profile was similar among the PCOS subgroups. This finding could be attributed to the mean BMl values, which, being below 30, were not within the obesity range. Obesity appeared to be an important determinant of high cardiovascular risk in PCOS. © 2015 S. Karger AG, Basel.

  20. Body mass index, cognitive deficit and depressive symptoms in high cardiovascular risk patients

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    Amanda Lucas da Costa

    Full Text Available Abstract To evaluate the relationship of obesity, cognitive impairment and depressive symptoms in patients with high cardiovascular risk. Methods: A sample of 93 patients aged 50 years or older was selected from the Center of Dyslipidemia and High Cardiovascular Risk from Hospital de Clínicas de Porto Alegre (HCPA. Patients with stroke were excluded. For cognitive evaluation, the MMSE (Mini Mental State Examination was used. A score of 24 or less was considered as cognitive impairment, and for those who had 4 years or less of education, the cutoff point was 17. The GDS-15 (Geriatric Depression Scale was also used, with the cutoff of 6 for presence of depressive symptoms. Results: Obese patients showed lower mean MMSE scores compared to non-obese patients (p=0.0012. Additionally, for every one point increase in BMI above 30 there was a 27% increase in the chances of the patient having cognitive impairment. The obese patients presented 31% chance of having cognitive impairment compared with overweight subjects. Conclusions: Our findings corroborated the association between obesity and cognitive impairment in high cardiovascular risk patients. This association however, was not observed for depressive symptoms.

  1. Height, waist circumference, body mass index, and body somatotype across the life course and risk of glioma.

    Science.gov (United States)

    Cote, David J; Downer, Mary K; Smith, Timothy R; Smith-Warner, Stephanie A; Egan, Kathleen M; Stampfer, Meir J

    2018-06-26

    Recent studies have suggested height as a risk factor for glioma, but less is known regarding body mass index (BMI) or other anthropomorphic measures. We evaluated the association between body habitus and risk of glioma. We evaluated the association of measures of height, BMI, waist circumference, and somatotypes with risk of glioma in two prospective cohorts, the Nurses' Health Study and the Health Professionals Follow-Up Study. We documented 508 incident cases of glioma (321 glioblastoma [GBM]). In both cohorts, we found no significant association between adult BMI or waist circumference and risk of glioma, with pooled HR for BMI of 1.08 (95% CI 0.85-1.38 comparing ≥ 30 to < 25 kg/m 2 ) and for waist circumference of 1.05 (95% CI 0.80-1.37 highest vs. lowest quintile). Higher young adult BMI (at age 18 in NHS and 21 in HPFS) was associated with modestly increased risk of glioma in the pooled cohorts (pooled HR 1.35, 95% CI 1.06-1.72 comparing ≥ 25 kg/m 2 vs. less; HR 1.34 for women and 1.37 for men). Analysis of body somatotypes suggested reduced risk of glioma among women with heavier body types at all ages this measure was assessed (HRs ranging from 0.52 to 0.65 comparing highest tertile to lowest tertile), but no significant association among men. Height was associated with increased risk of glioma among women (HR 1.09, 95% CI 1.04-1.14 per inch), but not significantly among men. Within the 8 years prior to diagnosis, cases had no material weight loss compared to non-cases. All results were similar when limited to GBM. Adult BMI and waist circumference were not associated with glioma. Higher BMI at age 21 for men and at age 18 for women was modestly associated with risk in the pooled cohort. Based on body somatotypes, however, women with heavier body types during childhood and young adulthood may be at lower risk of glioma, although this association was not observed later in life with measurements of BMI. Greater height was associated with

  2. Índice de riesgo para el intento suicida en México Risk index for attempted suicide in Mexico

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    Guilherme Borges

    2012-12-01

    Full Text Available OBJETIVO: Desarrollar un índice de riesgo de los intentos de suicidio en los últimos 12 meses dentro de un grupo de personas con ideación suicida. MATERIAL Y MÉTODOS: Estudio de prevalencia. Se analizaron los datos de la Encuesta Nacional de Adicciones de 2008. El índice de riesgo estuvo conformado por la edad, estado civil, religión, ocupación, tipo de población, migración a Estados Unidos, consumo de alcohol y drogas, síntomas de depresión, conducta problemática y abuso sexual. RESULTADOS: Se observó un incremento monotónico con el aumento de los factores de riesgo y la ausencia o presencia de un plan y el riesgo, con razones de momios desde 2.07 hasta 152.19. El área bajo la curva fue elevada, con un valor de 0.844, cercano a 1. CONCLUSIÓN: El uso de este índice puede ayudar a prevenir que los pacientes sigan desarrollando ideación suicida e intento suicida de consecuencias inciertas, incluyendo la muerte.OBJECTIVE: To develop a risk index of suicide attempts in the last 12 months among people with suicide ideation. MATERIALS AND METHODS: Cross-sectional study. Data came from the National Addictions Survey 2008. The risk index was made up by age, marital status, religion, occupation, area of the country in which they live, immigrant to the United States, alcohol and drug consumption, depression symptoms, behavioral problems and a history of sexual abuse. RESULTS: We found a monotonic relationship between the increase in risk factors and the existence of a plan and the risk, with an odds ratio over 2.07 up to 152.19. The area under the curve is quite high, with a value of 0.844, very close to 1. CONCLUSION: The use of this index may help prevent patients from further developing their suicide ideation process and may prevent a suicide attempt of uncertain consequences, including death.

  3. Interactive effect of genetic susceptibility with height, body mass index, and hormone replacement therapy on the risk of breast cancer

    Directory of Open Access Journals (Sweden)

    Harlid Sophia

    2012-06-01

    Full Text Available Abstract Background Breast cancer today has many established risk factors, both genetic and environmental, but these risk factors by themselves explain only part of the total cancer incidence. We have investigated potential interactions between certain known genetic and phenotypic risk factors, specifically nine single nucleotide polymorphisms (SNPs and height, body mass index (BMI and hormone replacement therapy (HRT. Methods We analyzed samples from three different study populations: two prospectively followed Swedish cohorts and one Icelandic case–control study. Totally 2884 invasive breast cancer cases and 4508 controls were analysed in the study. Genotypes were determined using Mass spectrometry-Maldi-TOF and phenotypic variables were derived from measurements and/or questionnaires. Odds Ratios and 95% confidence intervals were calculated using unconditional logistic regression with the inclusion of an interaction term in the logistic regression model. Results One SNP (rs851987 in ESR1 tended to interact with height, with an increasingly protective effect of the major allele in taller women (p = 0.007 and rs13281615 (on 8q24 tended to confer risk only in non users of HRT (p-for interaction = 0.03. There were no significant interactions after correction for multiple testing. Conclusions We conclude that much larger sample sets would be necessary to demonstrate interactions between low-risk genetic polymorphisms and the phenotypic variables height, BMI and HRT on the risk for breast cancer. However the present hypothesis-generating study has identified tendencies that would be of interest to evaluate for gene-environment interactions in independent materials.

  4. Shortened version of the work ability index to identify workers at risk of long-term sickness absence.

    Science.gov (United States)

    Schouten, Lianne S; Bültmann, Ute; Heymans, Martijn W; Joling, Catelijne I; Twisk, Jos W R; Roelen, Corné A M

    2016-04-01

    The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers at risk of LTSA. Prospective study including two samples of non-sicklisted workers participating in occupational health checks between 2010 and 2012. A heterogeneous development sample (N= 2899) was used to estimate logistic regression coefficients for the complete WAI, a shortened WAI version without the list of diseases, and single-item Work Ability Score (WAS). These three instruments were calibrated for predictions of different (≥2, ≥4 and ≥6 weeks) LTSA durations in a validation sample of non-sicklisted workers (N= 3049) employed at a steel mill, differentiating between manual (N= 1710) and non-manual (N= 1339) workers. The discriminative ability was investigated by receiver operating characteristic analysis. All three instruments under-predicted the LTSA risks in both manual and non-manual workers. The complete WAI discriminated between individuals at high and low risk of LTSA ≥2, ≥4 and ≥6 weeks in manual and non-manual workers. Risk predictions and discrimination by the shortened WAI without the list of diseases were as good as the complete WAI. The WAS showed poorer discrimination in manual and non-manual workers. The WAI without the list of diseases is a good alternative to the complete WAI to identify non-sicklisted workers at risk of future LTSA durations ≥2, ≥4 and ≥6 weeks. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  5. Body mass index, waist circumference, type 2 diabetes mellitus and risk of liver cancer for U.S. adults

    Science.gov (United States)

    Campbell, Peter T.; Newton, Christina C.; Freedman, Neal D.; Koshiol, Jill; Alavanja, Michael C.; Beane Freeman, Laura E.; Buring, Julie E.; Chan, Andrew T.; Chong, Dawn Q.; Datta, Mridul; Gaudet, Mia M.; Gaziano, J. Michael; Giovannucci, Edward; Graubard, Barry; Hollenbeck, Albert R.; King, Lindsey; Lee, I-Min; Linet, Martha; Palmer, Julie; Petrick, Jessica L.; Poynter, Jenny N.; Purdue, Mark; Robien, Kim; Rosenberg, Lynn; Sahasrabuddhe, Vikrant; Schairer, Catherine; Sesso, Howard D.; Sigurdson, Alice; Stevens, Victoria L.; Wactowski-Wende, Jean; Zeleniuch-Jacquotte, Anne; Renehan, Andrew G.; McGlynn, Katherine A.

    2016-01-01

    Incidence rates for liver cancer have increased threefold since the mid-1970s in the United States in parallel with increasing trends for obesity and type 2 diabetes mellitus (T2DM). We conducted an analysis of baseline body mass index (BMI), waist circumference (WC), and T2DM with risk of liver cancer. The Liver Cancer Pooling Project maintains harmonized data from 1.57 million adults enrolled in 14 U.S.-based prospective studies. Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, study center, alcohol, smoking, race, and BMI (for WC and T2DM). Stratified analyses assessed whether the BMI-liver cancer associations differed by hepatitis sera-positivity in nested analyses for a subset of cases (n=220) and controls (n=547). After enrollment, 2,162 incident liver cancer diagnoses were identified. BMI, per 5 kg/m2, was associated with higher risks of liver cancer, more so for men (HR: 1.38; 95% CI: 1.30 to 1.46) than women (HR: 1.25; 95% CI: 1.17 to 1.35; p-interaction: 0.02). WC, per 5 cm, was associated with higher risks of liver cancer, approximately equally by sex (overall, HR: 1.08; 95% CI: 1.04 to 1.13). T2DM was associated with higher risk of liver cancer (HR: 2.61; 95% CI: 2.34 to 2.91). In stratified analyses, there was a null association between BMI and liver cancer risk for participants who were sera-positive for hepatitis. This study suggests that high BMI, high WC, and T2DM are associated with higher risks of liver cancer and that the association may differ by status of viral hepatitis infection. PMID:27742674

  6. Reduced risk of Parkinson's disease associated with lower body mass index and heavy leisure-time physical activity.

    Science.gov (United States)

    Sääksjärvi, Katri; Knekt, Paul; Männistö, Satu; Lyytinen, Jukka; Jääskeläinen, Tuija; Kanerva, Noora; Heliövaara, Markku

    2014-04-01

    The risk factors for Parkinson's disease (PD) are not well established. We therefore examined the prediction of various lifestyle factors on the incidence of PD in a cohort drawn from the Finnish Mobile Clinic Health Examination Survey, conducted in 1973-1976. The study population comprised 6,715 men and women aged 50-79 years and free of PD at the baseline. All of the subjects completed a baseline health examination (including height and weight measurements) and a questionnaire providing information on leisure-time physical activity, smoking, and alcohol consumption. During a 22-year follow-up, 101 incident cases of PD occurred. The statistical analyses were based on Cox's model including age, sex, education, community density, occupation, coffee consumption, body mass index (BMI), leisure-time physical activity, smoking and alcohol consumption as independent variables. At first, BMI was not associated with PD risk, but after exclusion of the first 15 years of follow-up, an elevated risk appeared at higher BMI levels (P for trend 0.02). Furthermore, subjects with heavy leisure-time physical activity had a lower PD risk than those with no activity [relative risk (RR) 0.27, 95 % confidence interval (CI) 0.08-0.90]. In variance with findings for other chronic diseases, current smokers had a lower PD risk than those who had never smoked (RR 0.23, 95 % CI 0.08-0.67), and individuals with moderate alcohol intake (at the level of Parkinson's disease, but more research is needed.

  7. [Relationship between the risk of emergency cesarean section for nullipara with the prepregnancy body mass index or gestational weight gain].

    Science.gov (United States)

    Zhao, R F; Zhang, W Y; Zhou, L

    2017-11-25

    Objective: To investigate the risk of emergency cesarean section during labor with the pre-pregnancy body mass index or gestational weight gain. Methods: A total of 6 908 healthy nullipara with singleton pregnancy and cephalic presentation who was in term labor in Beijing Obstetrics and Gynecology Hospital from August 1(st), 2014 to September 30(th), 2015 were recruited. They were divided into two groups, the vaginal delivery group (92.88%, 6 416/6 908) and the emergency cesarean section group (7.12%, 492/6 908). According to WHO body mass index (BMI) classification criteria and the pre-pregnancy BMI, the 6 908 women were divided into three groups, the underweight group(BMIgain (GWG) group (16.72%, 1 155/6 908), the appropriate GWG group (43.11%, 2 978/6 908), the excessive GWG group (40.17%, 2 775/6 908). Unadjusted and adjusted odds ratio ( OR ) and confidence interval ( CI ) of the risk of emergency cesarean section were calculated by bivariate logistic regression. Results: (1) Comparing to the vaginal delivery group, women in the emergency cesarean section group were older, with a lower education level. Their prepregnancy BMI was higer and had more gestational weight gain. They had higher morbidity of pregnancy induced hypertension and gestational diabetes mellitus. Comparing to the vaginal delivery group, the neonates in the emergency cesarean section group were elder in gestational week, with higher birth weight. More male infants and large for gestation age infants were seen in the emergency cesarean section group (all P gain was associated with the increased risk of emergency cesarean section, (a OR= 1.03, 95% CI : 1.01-1.05). GWG above IOM giudelines did not independently affect the risk of emergency cesarean section ( OR= 1.30, 95% CI : 1.07-1.58; a OR= 1.01, 95% CI : 0.82-1.24). In the underweight group, the normal weight group and the overweight or obese group, the excessive GWG women and the appropriate GWG women had no significant difference in the

  8. Managing water utility financial risks through third-party index insurance contracts

    Science.gov (United States)

    Zeff, Harrison B.; Characklis, Gregory W.

    2013-08-01

    As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

  9. The Cumulative Lifting Index (CULI) for the Revised NIOSH Lifting Equation: Quantifying Risk for Workers With Job Rotation.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M

    2016-08-01

    The objectives were to: (a) develop a continuous frequency multiplier (FM) for the Revised NIOSH Lifting Equation (RNLE) as a function of lifting frequency and duration of a lifting task, and (b) describe the Cumulative Lifting Index (CULI), a methodology for estimating physical exposure to workers with job rotation. The existing FM for the RNLE (FME) does not differentiate between task duration >2 hr and <8 hr, which makes quantifying physical exposure to workers with job rotation difficult and presents challenges to job designers. Using the existing FMs for 1, 2, and 8 hr of task durations, we developed a continuous FM (FMP) that extends to 12 hr per day. We simulated 157,500 jobs consisting of two tasks each and, using different combinations of Frequency Independent Lifting Index, lifting frequency and duration of lifting. Biomechanical stresses were estimated using the CULI, time-weighted average (TWA), and peak exposure. The median difference between FME and FMP was ±1% (range: 0%-15%). Compared to CULI, TWA underestimated risk of low-back pain (LBP) for 18% to 30% of jobs, and peak exposure for an assumed 8-hr work shift overestimated risk of LBP for 20% to 25% of jobs. Peak task exposure showed 90% agreement with CULI but ignored one of two tasks. The CULI partially addressed the underestimation of physical exposure using the TWA approach and overestimation of exposure using the peak-exposure approach. The proposed FM and CULI may provide more accurate physical exposure estimates, and therefore estimated risk of LBP, for workers with job rotation. © 2016, Human Factors and Ergonomics Society.

  10. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Science.gov (United States)

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  11. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Directory of Open Access Journals (Sweden)

    Davina Fevery

    Full Text Available Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq is used in environmental policy in Flanders (Belgium. The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN. The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  12. Association of a body mass index genetic risk score with growth throughout childhood and adolescence.

    Directory of Open Access Journals (Sweden)

    Nicole M Warrington

    Full Text Available While the number of established genetic variants associated with adult body mass index (BMI is growing, the relationships between these variants and growth during childhood are yet to be fully characterised. We examined the association between validated adult BMI associated single nucleotide polymorphisms (SNPs and growth trajectories across childhood. We investigated the timing of onset of the genetic effect and whether it was sex specific.Children from the ALSPAC and Raine birth cohorts were used for analysis (n = 9,328. Genotype data from 32 adult BMI associated SNPs were investigated individually and as an allelic score. Linear mixed effects models with smoothing splines were used for longitudinal modelling of the growth parameters and measures of adiposity peak and rebound were derived.The allelic score was associated with BMI growth throughout childhood, explaining 0.58% of the total variance in BMI in females and 0.44% in males. The allelic score was associated with higher BMI at the adiposity peak (females  =  0.0163 kg/m(2 per allele, males  =  0.0123 kg/m(2 per allele and earlier age (-0.0362 years per allele in males and females and higher BMI (0.0332 kg/m(2 per allele in females and 0.0364 kg/m(2 per allele in males at the adiposity rebound. No gene:sex interactions were detected for BMI growth.This study suggests that known adult genetic determinants of BMI have observable effects on growth from early childhood, and is consistent with the hypothesis that genetic determinants of adult susceptibility to obesity act from early childhood and develop over the life course.

  13. Piloting a 'spatial isolation' index: the built environment and sexual and drug use risks to sex workers.

    Science.gov (United States)

    Deering, Kathleen N; Rusch, Melanie; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Feng, Cindy X; Shannon, Kate

    2014-05-01

    Employing innovative mapping and spatial analyses of individual and neighbourhood environment data, we examined the social, physical and structural features of overlapping street-based sex work and drug scenes and explored the utility of a 'spatial isolation index' in explaining exchanging sex for drugs and exchanging sex while high. Analyses drew on baseline interview and geographic data (January 2010-October 2011) from a large prospective cohort of street and off-street sex workers (SWs) in Metropolitan Vancouver and external publically-available, neighbourhood environment data. An index measuring 'spatial isolation' was developed from seven indicators measuring features of the built environment within 50m buffers (e.g., industrial or commercial zoning, lighting) surrounding sex work environments. Bivariate and multivariable logistic regression was used to examine associations between the two outcomes (exchanged sex for drugs; exchanged sex while high) and the index, as well as each individual indicator. Of 510 SWs, 328 worked in street-based/outdoor environments (e.g., streets, parks, alleys) and were included in the analyses. In multivariable analysis, increased spatial isolation surrounding street-based/outdoor SWs' main places of servicing clients as measured with the index was significantly associated with exchanging sex for drugs. Exchanging sex for drugs was also significantly positively associated with an indicator of the built environment suggesting greater spatial isolation (increased percent of parks) and negatively associated with those suggesting decreased spatial isolation (increased percent commercial areas, increased count of lighting, increased building footprint). Exchanging sex while high was negatively associated with increased percent of commercial zones but this association was removed when adjusting for police harassment. The results from our exploratory study highlight how built environment shapes risks within overlapping street-based sex

  14. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    Energy Technology Data Exchange (ETDEWEB)

    Cho, W; Wu, H [Seoul National University Hospital, Seoul (Korea, Republic of); Xing, L [Stanford University, Stanford, CA (United States); Suh, T [Catholic UniversityMedical College, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses.

  15. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    International Nuclear Information System (INIS)

    Cho, W; Wu, H; Xing, L; Suh, T

    2014-01-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses

  16. The Role of Age and Excess Body Mass Index in Progression to Type 1 Diabetes in At-Risk Adults.

    Science.gov (United States)

    Ferrara, Christine T; Geyer, Susan M; Evans-Molina, Carmella; Libman, Ingrid M; Becker, Dorothy J; Wentworth, John M; Moran, Antoinette; Gitelman, Stephen E; Redondo, Maria J

    2017-12-01

    Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI >25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values ≥0 kg/m2 and ≥5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of >35 years that reduced risk for type 1 diabetes. In men age >35 years and women age <35 years, sustained obesity (ceBMI ≥5 kg/m2) increased the risk for type 1 diabetes. Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology. Copyright © 2017 Endocrine Society

  17. The Strain Index and ACGIH TLV for HAL: risk of trigger digit in the WISTAH prospective cohort.

    Science.gov (United States)

    Kapellusch, Jay M; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Malloy, Elizabeth J

    2014-02-01

    The objective of this study was to investigate the association between job physical exposure (JPE) and incidence of flexor tendon entrapment of the digits (FTED). FTED, commonly known as trigger digit, is associated with age, gender, and certain health disorders. Although JPE has been suggested as a risk factor for FTED, there are no prospective cohort studies. A cohort of 516 workers was enrolled from 10 diverse manufacturing facilities and followed monthly for 6 years. Worker demographics, medical history, and symptoms of FTED were assessed. JPE was individually measured using the Strain Index (SI) and American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL). Changes in JPE (assessed quarterly) and symptoms (assessed monthly) were recorded during follow-up. FTED was defined as demonstrated triggering on examination. Point prevalence of FTED at baseline was 3.6%. During follow-up there were 23 incident FTED cases (left and/or right hands). The incident rate for first occurrence of FTED from enrollment was 1.38 per 100 person-years. Risk factors were JPE, age, gender, diabetes mellitus, carpometacarpal osteoarthrosis, and rheumatoid arthritis. In multivariate models, the SI showed strong association with risk of FTED when treated as a continuous variable and marginal association when dichotomized (SI > 6.1). TLV for HAL showed a statistical trend of increasing risk of FTED using the ACGIH limits, but no association as a continuous variable. Both JPE and personal risk factors are associated with FTED development. The SI and TLV for HAL are useful tools for estimating JPE.

  18. 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.

  19. Risk estimates of stochastic effects due to exposure to radiation - a stochastic harm index

    International Nuclear Information System (INIS)

    Gonen, Y.G.

    1980-01-01

    The effects of exposure to low level radiation on the survival probability and life expectancy were investigated. The 1977 vital statistics of Jewish males in Israel were used as a baseline, mainly the data on normalized survival probability and life expectation as functions of age. Assumed effects of exposure were superposed on these data and the net differences calculated. It was found that the realistic rate effects of exposure to radiation are generally less than calculated by multiplying the collective dose by the risk factor. The effects are strongly age-dependent, decreasing sharply with age at exposure. The assumed harm due to exposure can be more than offset by improvements in medical care and safety. (H.K.)

  20. An index-based method to assess risks of climate-related hazards in coastal zones: The case of Tetouan

    Science.gov (United States)

    Satta, Alessio; Snoussi, Maria; Puddu, Manuela; Flayou, Latifa; Hout, Radouane

    2016-06-01

    The regional risk assessment carried out within the ClimVar & ICZM Project identified the coastal zone of Tetouan as a hotspot of the Mediterranean Moroccan coast and so it was chosen for the application of the Multi-Scale Coastal Risk Index for Local Scale (CRI-LS). The local scale approach provides a useful tool for local coastal planning and management by exploring the effects and the extensions of the hazards and combining hazard, vulnerability and exposure variables in order to identify areas where the risk is relatively high. The coast of Tetouan is one of the coastal areas that have been most rapidly and densely urbanized in Morocco and it is characterized by an erosive shoreline. Local authorities are facing the complex task of balancing development and managing coastal risks, especially coastal erosion and flooding, and then be prepared to the unavoidable impacts of climate change. The first phase of the application of the CRI-LS methodology to Tetouan consisted of defining the coastal hazard zone, which results from the overlaying of the erosion hazard zone and the flooding hazard zone. Nineteen variables were chosen to describe the Hazards, Vulnerability and Exposure factors. The scores corresponding to each variable were calculated and the weights assigned through an expert judgement elicitation. The resulting values are hosted in a geographic information system (GIS) platform that enables the individual variables and aggregated risk scores to be color-coded and mapped across the coastal hazard zone. The results indicated that 10% and 27% of investigated littoral fall under respectively very high and high vulnerability because of combination of high erosion rates with high capital land use. The risk map showed that some areas, especially the flood plains of Restinga, Smir and Martil-Alila, with distances over 5 km from the coast, are characterized by high levels of risk due to the low topography of the flood plains and to the high values of exposure

  1. Childhood body mass index in relation to subsequent risk of type 1 diabetes-A Danish cohort study

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Aunsholt, Lise; Buschard, Karsten

    2018-01-01

    . The study included 238 cases and 10 147 controls selected from the Copenhagen School Health Record Register (CSHRR). Cases of T1D were identified in the Danish Registry of Childhood and Adolescent Diabetes and 2 regional studies and linked to CSHRR. Using conditional logistic regression models......The incidence of type 1 diabetes (T1D) is increasing, and obesity may be a contributing factor by increasing the risk and accelerating the onset. We investigated the relation between childhood body mass index z-scores (BMIz) and the later risk of T1D, including association with age at onset of T1D...... BMIz at 7 and 13 years of age and the age of onset (P = .34 and P = .42, respectively). Increased BMIz is associated with a moderate increase in risk of T1D, but with no relation to age at onset within the analyzed age range. Increased BMIz over time is unlikely to explain the rising incidence of T1D....

  2. An empirical evaluation of Value-at-Risk: The case of the Belgrade Stock Exchange index - BELEX15

    Directory of Open Access Journals (Sweden)

    Đaković Vladimir

    2012-03-01

    Full Text Available The subject of the research is to test and analyze VaR (Value-at-Risk methods of market risk management on the financial market of the Republic of Serbia. Thus, concrete research is conducted in the period 2005 - 2011, with the goal of VaR methods performance assessment on the Serbian financial market. The tested VaR methods are Historical simulation (HS and Delta normal VaR with 95% and 99% confidence level for 50, 100, 200 and 250 days. BELEX15 stock index of the Belgrade Stock Exchange, which comprises of 15 most liquid securities of the Serbian financial market, is used as a benchmark indicator of the conditions on the Serbian financial market. The goals which are intended for achieving in the research are focused to Historical simulation (HS and Delta normal VaR performance assessment on, according to many criteria, 'specific'-transitory financial market of the Republic of Serbia. The basic goal of the research is to come to concrete, practically tested, knowledge about the possibility and performance of VaR methods application on the financial market of the Republic of Serbia in function of investment decisions optimizing. Research results point to the necessity of VaR methods application in market risk management on the financial market of the Republic of Serbia.

  3. Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia.

    Science.gov (United States)

    Tolppanen, Anna-Maija; Solomon, Alina; Kulmala, Jenni; Kåreholt, Ingemar; Ngandu, Tiia; Rusanen, Minna; Laatikainen, Tiina; Soininen, Hilkka; Kivipelto, Miia

    2015-04-01

    Physical activity may be beneficial for cognition, but the effect may vary depending on personal characteristics. We investigated the associations between leisure-time physical activity (LTPA) from mid- to late life, the risk of dementia, and the role of body mass index, sex, and APOE in the CAIDE study during 28-year follow-up. Cognitive function of a random subsample was assessed at a mean age of 78.8 years (n = 1511), and dementia/Alzheimer's disease (AD) diagnoses were identified from national registers for the entire target population (n = 3559). Moderate (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.08-1.99) and low levels of midlife LTPA (HR, 1.39; 95% CI, 0.99-1.95) were associated with higher risk of dementia in comparison with the most active category. The benefits were more pronounced among men, overweight individuals, and APOE ε4 noncarriers. Maintaining high LTPA (HR, 0.16; 95% CI, 0.06-0.41) or increasing LTPA (HR, 0.19; 95% CI, 0.09-0.40) after midlife was associated with lower dementia risk. Similar results were observed for AD. The window of opportunity for preventive physical activity interventions may extend from midlife to older ages. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  4. Genetically Predicted Body Mass Index and Breast Cancer Risk : Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

    NARCIS (Netherlands)

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou; Michailidou, Kyriaki; Bolla, Manjeet K; Wang, Qin; Garcia-Closas, Montserrat; Milne, Roger L; Schmidt, Marjanka K; Chang-Claude, Jenny; Dunning, Allison; Bojesen, Stig E; Ahsan, Habibul; Aittomäki, Kristiina; Andrulis, Irene L; Anton-Culver, Hoda; Arndt, Volker; Beckmann, Matthias W; Beeghly-Fadiel, Alicia; Benitez, Javier; Bogdanova, Natalia V; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Brand, Judith; Brauch, Hiltrud; Brenner, Hermann; Brüning, Thomas; Burwinkel, Barbara; Casey, Graham; Chenevix-Trench, Georgia; Couch, Fergus J; Cox, Angela; Cross, Simon S; Czene, Kamila; Devilee, Peter; Dörk, Thilo; Dumont, Martine; Fasching, Peter A; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Fostira, Florentia; Gammon, Marilie; Giles, Graham G; Guénel, Pascal; Haiman, Christopher A; Hamann, Ute; Hooning, Maartje J; Hopper, John L; Jakubowska, Anna; Jasmine, Farzana; Jenkins, Mark; John, Esther M; Johnson, Nichola; Jones, Michael E; Kabisch, Maria; Kibriya, Muhammad; Knight, Julia A; Koppert, Linetta B; Kosma, Veli-Matti; Kristensen, Vessela; Le Marchand, Loic; Lee, Eunjung; Li, Jingmei; Lindblom, Annika; Luben, Robert; Lubinski, Jan; Malone, Kathi E; Mannermaa, Arto; Margolin, Sara; Marme, Frederik; McLean, Catriona; Meijers-Heijboer, Hanne; Meindl, Alfons; Neuhausen, Susan L; Nevanlinna, Heli; Neven, Patrick; Olson, Janet E; Perez, Jose I A; Perkins, Barbara; Peterlongo, Paolo; Phillips, Kelly-Anne; Pylkäs, Katri; Rudolph, Anja; Santella, Regina; Sawyer, Elinor J; Schmutzler, Rita K; Seynaeve, Caroline; Shah, Mitul; Shrubsole, Martha J; Southey, Melissa C; Swerdlow, Anthony J; Toland, Amanda E; Tomlinson, Ian; Torres, Diana; Truong, Thérèse; Ursin, Giske; Van Der Luijt, Rob B; Verhoef, Senno; Whittemore, Alice S; Winqvist, Robert; Zhao, Hui; Zhao, Shilin; Hall, Per; Simard, Jacques; Kraft, Peter; Pharoah, Paul; Hunter, David; Easton, Douglas F; Zheng, Wei

    BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or

  5. Effects of a general practice-based intervention on diet, body mass index and blood lipids in patients at cardiovascular risk

    NARCIS (Netherlands)

    Woollard, J.; Burke, V.; Beilin, L.J.; Verheijden, M.W.; Bulsara, M.K.

    2003-01-01

    Background General practice-based health-promotion programmes implemented by nurse-counsellors may reduce cardiovascular risk factors, particularly in patients at increased risk. Neither change in fat intake nor serum cholesterol differed significantly between groups. Body mass index increased in

  6. Advanced atherogenic index for the assessment of consolidated lipid risk in premature coronary artery disease patients in India

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar Bansal

    2016-01-01

    Full Text Available Introduction: The high prevalence, severity, and prematurity of coronary artery disease (CAD in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. Aims and Objectives: To calculate newly defined advanced atherogenic index (AAI in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. Material and Methods: One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL, small dense LDL (SD LDL, lipoprotein (a apolipoprotein B (Apo B, and apolipoprotein A1 (Apo A1 were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI and lipid pentad index (LPI. Results: The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20 as compared to controls (305.84 ± 21.80. AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737 as compared to the earlier indices such as AI (P < 0.01, r = 0.52, LTI (P < 0.001, r = 0.677 and LPI (P < 0.001, r = 0.622 in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Conclusion: Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

  7. The Use of Remotely Sensed Rainfall for Managing Drought Risk: A Case Study of Weather Index Insurance in Zambia

    Directory of Open Access Journals (Sweden)

    Emily Black

    2016-04-01

    Full Text Available Remotely sensed rainfall is increasingly being used to manage climate-related risk in gauge sparse regions. Applications based on such data must make maximal use of the skill of the methodology in order to avoid doing harm by providing misleading information. This is especially challenging in regions, such as Africa, which lack gauge data for validation. In this study, we show how calibrated ensembles of equally likely rainfall can be used to infer uncertainty in remotely sensed rainfall estimates, and subsequently in assessment of drought. We illustrate the methodology through a case study of weather index insurance (WII in Zambia. Unlike traditional insurance, which compensates proven agricultural losses, WII pays out in the event that a weather index is breached. As remotely sensed rainfall is used to extend WII schemes to large numbers of farmers, it is crucial to ensure that the indices being insured are skillful representations of local environmental conditions. In our study we drive a land surface model with rainfall ensembles, in order to demonstrate how aggregation of rainfall estimates in space and time results in a clearer link with soil moisture, and hence a truer representation of agricultural drought. Although our study focuses on agricultural insurance, the methodological principles for application design are widely applicable in Africa and elsewhere.

  8. Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass

    DEFF Research Database (Denmark)

    Håkansson, Fanny; Høgdall, Estrid V S; Nedergaard, Lotte

    2012-01-01

    Abstract Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI =200 are referred to tertiary gynecologic oncology...... the use of RMI =200 as a tool for preoperative identification of ovarian cancer at a tertiary center. Design. Prospective observational study. Setting. A tertiary center in Copenhagen, Denmark. Population. One thousand one hundred and fifty-nine women with pelvic mass. Methods. The RMI was calculated...... pelvic mass. Results. There were 778 women diagnosed with benign pelvic mass, while 251 had ovarian cancer and 74 had borderline ovarian tumor. Fifty-six women were diagnosed with other forms of cancer. Sensitivity and specificity for ovarian cancer vs. benign pelvic mass for RMI =200 were 92 and 82...

  9. Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors?

    Science.gov (United States)

    O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda

    2015-01-01

    Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people.

  10. [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

  11. Prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks and assessment of entomological risk index at localities in Belgrade

    Directory of Open Access Journals (Sweden)

    Krstić Milena

    2016-01-01

    Full Text Available Background/Aim. The first case of human Lyme borreliosis (LB in Serbia was recorded in 1987. The number of reported LB cases has increased in the past decade. The aim of this study was to estimate the density of Ixodes ricinus (I. ricinus ticks, the prevalence of Borrelia burgdorferi sensu lato (B. burgdorferi in them, and entomological risk index (ERI at 19 Belgrade localities which were grouped into three categories (forests, parkforests, parks. The values of ERI were compared with the number of tick bites in humans. Methods. Ticks were collected monthly by using the flag hours method and the infection rate was determined by using dark field microscopy. The ERI value was calculated for each locality where the ticks were collected. The related data about tick bites was obtained from the patient protocol of the Institute of Epidemiology, Military Medical Academy, Belgrade. Results. The total number of collected ticks, the number of nymphs and the infection rates of the nymphs were significantly higher in forests (p < 0.05 than park-forests and parks. Statistically, the ERI value was significantly higher in forests than parks of Belgrade (χ2 = 7.78, p < 0.01. In March and July, the ERI value was also significantly higher in forests, than park-forests (p < 0.01 and parks (p < 0.01. May was the month with the highest ERI value in each ecological category (forests p < 0.05; park-forests p < 0.01; parks p < 0.001. However, the number of tick bites in humans did not correlate with ERI values. Conclusion. The obtained results indicate that the risk of tick bite and human exposure to B. burgdorferi sensu lato is present at all selected localities in Belgrade. For a more comprehensive Lyme disease risk assessment the method of entomological risk index assessment should be combined with other methods, taking into consideration all tick stages and the behaviour and habits of people who may get infected B. burgdorferi sensu lato.

  12. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  13. Prevalence of cardiovascular risk factors in youth with type 1 diabetes and elevated body mass index.

    Science.gov (United States)

    Redondo, Maria J; Foster, Nicole C; Libman, Ingrid M; Mehta, Sanjeev N; Hathway, Joanne M; Bethin, Kathleen E; Nathan, Brandon M; Ecker, Michelle A; Shah, Avni C; DuBose, Stephanie N; Tamborlane, William V; Hoffman, Robert P; Wong, Jenise C; Maahs, David M; Beck, Roy W; DiMeglio, Linda A

    2016-04-01

    The prevalence of cardiovascular risk factors in children with type 1 diabetes and elevated BMI in the USA is poorly defined. We aimed to test the hypothesis that children with type 1 diabetes who are overweight or obese have increased frequencies of hypertension, dyslipidemia, and micro-/macroalbuminuria compared to their healthy weight peers. We studied 11,348 children 2 to 18 years of age enrolled in T1D Exchange between September 2010 and August 2012 with type 1 diabetes for ≥1 year and BMI ≥ 5th age-/sex-adjusted percentile (mean age 12 years, 49 % female, 78 % non-Hispanic White). Overweight and obesity were defined based on Centers for Disease Control and Prevention criteria. Diagnoses of hypertension, dyslipidemia, and micro-/macroalbuminuria were obtained from medical records. Logistic and linear regression models were used to assess factors associated with weight status. Of the 11,348 participants, 22 % were overweight and 14 % obese. Hypertension and dyslipidemia were diagnosed in 1.0 % and 3.8 % of participants, respectively; micro-/macroalbuminuria was diagnosed in 3.8 % of participants with available data (n = 7,401). The odds of either hypertension or dyslipidemia were higher in obese than healthy weight participants [OR 3.5, 99 % confidence interval (CI) 2.0-6.1 and 2.2, 99 % CI 1.6-3.1, respectively]. Obese participants tended to be diagnosed with micro-/macroalbuminuria less often than healthy weight participants (OR 0.6, 99 % CI 0.4-1.0). Obese children with type 1 diabetes have a higher prevalence of hypertension and dyslipidemia than healthy weight children with type 1 diabetes. The possible association of obesity with lower micro-/macroalbuminuria rates warrants further investigation.

  14. Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

    Science.gov (United States)

    Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

    2016-01-01

    Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

  15. Documentation of body mass index and control of associated risk factors in a large primary care network

    Directory of Open Access Journals (Sweden)

    Grant Richard W

    2009-12-01

    Full Text Available Abstract Background Body mass index (BMI will be a reportable health measure in the United States (US through implementation of Healthcare Effectiveness Data and Information Set (HEDIS guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m2, overweight (OW, 25-29.9, and obese (OB, ≥ 30. We measured documentation (yes/no and control (above/below of the following three risk factors: blood pressure (BP ≤130/≤85 mmHg, low-density lipoprotein (LDL ≤130 mg/dL (3.367 mmol/L, and fasting glucose Results BMI was documented in 48,376 patients (61%, range 34-94%, distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend Conclusions In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.

  16. ATRF Earns Three Green Globes, Exceeds NIH Building Standards | Poster

    Science.gov (United States)

    By Ashley DeVine, Staff Writer From project management and energy and water efficiency to emissions and the indoor environment, the Advanced Technology Research Facility (ATRF) was built with sustainability in mind, exceeding the National Institutes of Health’s (NIH’s) building standards and earning three Green Globes from the Green Building Initiative (GBI).

  17. Piloting a ‘Spatial Isolation’ Index: The Built Environment and Sexual and Drug Use Risks to Sex Workers

    Science.gov (United States)

    Deering, Kathleen N; Rusch, Melanie; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Feng, Cindy X; Shannon, Kate

    2014-01-01

    Background Employing innovative mapping and spatial analyses of individual and neighborhood environment data, we examined the social, physical and structural features of overlapping street-based sex work and drug scenes and explored the utility of a ‘spatial isolation index’ in explaining exchanging sex for drugs and exchanging sex while high. Methods Analyses drew on baseline interview and geographic data (Jan/10-Oct/11) from a large prospective cohort of street and off-street sex workers (SWs) in Metropolitan Vancouver and external publically-available, neighborhood environment data. An index measuring ‘spatial isolation’ was developed from seven indicators measuring features of the built environment within 50m buffers (e.g. industrial or commercial zoning, lighting) surrounding sex work environments. Bivariate and multivariable logistic regression was used to examine associations between the two outcomes (exchanged sex for drugs; exchanged sex while high) and the index, as well as each individual indicator. Results Of 510 SWs, 328 worked in street-based/outdoor environments (e.g. streets, parks, alleys) and were included in the analyses. In multivariable analysis, increased spatial isolation surrounding street-based/outdoor SWs’ main places of servicing clients as measured with the index was significantly associated with exchanging sex for drugs. Exchanging sex for drugs was also significantly positively associated with an indicator of the built environment suggesting greater spatial isolation (increased percent of parks) and negatively associated with those suggesting decreased spatial isolation (increased percent commercial areas, increased count of lighting, increased building footprint). Exchanging sex while high was negatively associated with increased percent of commercial zones but this association was removed when adjusting for police harassment. Conclusions The results from our exploratory study highlight how built environment shapes risks

  18. Birth weight, childhood body mass index and risk of coronary heart disease in adults: combined historical cohort studies.

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    Lise Geisler Andersen

    Full Text Available BACKGROUND: Low birth weight and high childhood body mass index (BMI is each associated with an increased risk of coronary heart disease (CHD in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood. METHODS/PRINCIPAL FINDINGS: Birth weight and BMI at age seven years were available in 216,771 Danish and Finnish individuals born 1924-1976. Linkage to national registers for hospitalization and causes of death identified 8,805 CHD events during up to 33 years of follow-up (median = 24 years after age 25 years. Analyses were conducted with Cox regression based on restricted cubic splines. Using median birth weight of 3.4 kg as reference, a non-linear relation between birth weight and CHD was found. It was not significantly different between cohorts, or between men and women, nor was the association altered by childhood BMI. For birth weights below 3.4 kg, the risk of CHD increased linearly and reached 1.28 (95% confidence limits: 1.13 to 1.44 at 2 kg. Above 3.4 kg the association weakened, and from about 4 kg there was virtually no association. BMI at age seven years was strongly positively associated with the risk of CHD and the relation was not altered by birth weight. The excess risk in individuals with a birth weight of 2.5 kg and a BMI of 17.7 kg/m(2 at age seven years was 44% (95% CI: 30% to 59% compared with individuals with median values of birth weight (3.4 kg and BMI (15.3 kg/m(2. CONCLUSIONS/SIGNIFICANCE: Birth weight and BMI at age seven years appeared independently associated with the risk of CHD in adulthood. From a public health perspective we suggest that particular attention should be paid to children with a birth weight below the average in combination with excess relative weight in childhood.

  19. Association and interaction between triglyceride-glucose index and obesity on risk of hypertension in middle-aged and elderly adults.

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    Jian, Song; Su-Mei, Nie; Xue, Chen; Jie, Zhang; Xue-Sen, Wu

    2017-01-01

    To investigate the association between triglyceride-glucose(TyG) index and the risk of hypertension. A cross-sectional study was conducted in Bengbu, China. The participants received relevant questionnaire survey, anthropometric tests, and laboratory examination. Multivariate logistic regression analysis was performed to estimate the possible association between TyG index and hypertension risk. The additive interaction evaluated by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index(SI) was calculated. A total of 1777 participants (748 men and 1029 women) were investigated. There was a significant increase in the risk of hypertension and isolated systolic hypertension (ISH) when comparing the highest TyG index (the fourth quartile) to the lowest TyG index (the first quartile) and corresponding ORs were 2.446 (95% CI: 1.746-3.426) and 2.621(95%CI: 1.627-4.224), respectively. However, no significant relationship was observed between TyG index and isolated diastolic hypertension (IDH). In males, significant interactions between TyG index and WHtR (RERI:1.978, 95%CI: 0.162-3.792; AP: 0.359, 0.113-0.605; SI:1.782, 1.017-3.122), smoking (AP: 0.437, 95%CI: 0.048-0.825), family history of hypertension (AP:0.433, 95%CI: 0.203-0.662; SI:2.248, 95%CI: 1.333-3.791) were observed. As for females, there were also significant interactions between TyG index and WHtR (RERI:1.415, 95%CI: 0.693-2.136; AP: 0.198, 95%CI: 0.104-0.291; SI:1.298, 95%CI:1.101-1.530), family history of hypertension (RERI:1.744, 95%CI: 0.221-3.267; AP:0.405, 95%CI: 0.113-0.697) on risk of hypertension. Increased TyG index was significantly associated with higher risk of hypertension and ISH, but not for IDH in middle-aged and elderly adults. Our results also demonstrated interactions of TyG index and abdominal obesity and family history of hypertension on hypertension risk.

  20. Cross-cultural adaptation of the "Australian National University Alzheimer's Disease Risk Index" for the Brazilian population.

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    Borges, Marcus Kiiti; Jacinto, Alessandro Ferrari; Citero, Vanessa de Albuquerque

    2017-01-01

    Alzheimer's disease (AD) represents a major public health problem and it is therefore crucial that modifiable risk factors be known prior to onset of dementia in late-life. The "Australian National University - Alzheimer's Disease Risk Index" (ANU-ADRI) is one of the potential tools for primary prevention of the disease. The aim of this study was to devise an adapted version of the ANU-ADRI for use in Brazil. The instrument was translated from its original language of English into Portuguese and then back-translated into English by bilingual translators. It was subsequently reviewed and evaluated as to the degree of translation issues and equivalence. In this study, the ANU-ADRI was applied using individual (face-to-face) interviews in a public hospital, unlike the original version which is applied online by self-report. The final version (pretest) was evaluated in a sample of 10 participants with a mean age of 60 years (±11.46) and mean education of 11 years (±6.32). The intraclass correlation coefficient (ICC) (inter-rater) was 0.954 (P<0.001 for a confidence interval (CI) of 95%=[0.932; 0.969]). Cultural equivalence was performed without the need for a second instrument application step. After cross-cultural adaptation, the language of the resultant questionnaire was deemed easily understandable by the Brazilian population.

  1. Cross-cultural adaptation of the "Australian National University Alzheimer's Disease Risk Index" for the Brazilian population

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    Marcus Kiiti Borges

    Full Text Available ABSTRACT Alzheimer's disease (AD represents a major public health problem and it is therefore crucial that modifiable risk factors be known prior to onset of dementia in late-life. The "Australian National University - Alzheimer's Disease Risk Index" (ANU-ADRI is one of the potential tools for primary prevention of the disease. Objective: The aim of this study was to devise an adapted version of the ANU-ADRI for use in Brazil. Methods: The instrument was translated from its original language of English into Portuguese and then back-translated into English by bilingual translators. It was subsequently reviewed and evaluated as to the degree of translation issues and equivalence. In this study, the ANU-ADRI was applied using individual (face-to-face interviews in a public hospital, unlike the original version which is applied online by self-report. The final version (pretest was evaluated in a sample of 10 participants with a mean age of 60 years (±11.46 and mean education of 11 years (±6.32. Results: The intraclass correlation coefficient (ICC (inter-rater was 0.954 (P<0.001 for a confidence interval (CI of 95%=[0.932; 0.969]. Cultural equivalence was performed without the need for a second instrument application step. Conclusion: After cross-cultural adaptation, the language of the resultant questionnaire was deemed easily understandable by the Brazilian population.

  2. 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.

  3. Usefulness of cardiometabolic index for the estimation of ischemic stroke risk among general population in rural China.

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    Wang, Haoyu; Chen, Yintao; Guo, Xiaofan; Chang, Ye; Sun, Yingxian

    2017-11-01

    Cardiometabolic index (CMI) has been recognized as a novel and practical marker for the assessment of cardiometabolic risk as it is independently related to diabetes and atherosclerotic progression. This study tested the hypothesis that CMI represents a risk of ischemic stroke in a general population of rural China. From July 2012 to August 2013, we examined data from a large cross-sectional study of 11,345 participants (mean age 53.8 years; 60.8% females) who underwent biochemical determinations and anthropometric measurements in rural areas of northeast China. Ischemic stroke was documented as a history of cerebrovascular events and verified by medical record review. The prevalence of ischemic stroke was given to 3.1% of females and 3.2% of males. The cardio-metabolic profile was notably more adverse in ischemic stroke groups, irrespective of gender. A dose-response manner was detected for the prevalence of ischemic stroke, exhibiting a significant increase from the lowest to the highest quartiles of CMI (1.2% to 6.4% in females, P for trenddiscrimination power of CMI in predicting ischemic stroke was relatively higher for females (AUC: 0.685) than males (AUC: 0.573). The strong and independent association of CMI with ischemic stroke in females, in comparison with the much lesser degree in males, provides further insight to better stratify by sex in investigations of ischemic stroke and solidly corroborates the potential role of ischemic stroke prevention targeted at CMI.

  4. Derivation and validation of REASON: a risk score identifying candidates to screen for peripheral arterial disease using ankle brachial index.

    Science.gov (United States)

    Ramos, Rafel; Baena-Díez, Jose Miguel; Quesada, Miquel; Solanas, Pascual; Subirana, Isaac; Sala, Joan; Alzamora, Maite; Forès, Rosa; Masiá, Rafel; Elosua, Roberto; Grau, María; Cordón, Ferran; Pera, Guillem; Rigo, Fernando; Martí, Ruth; Ponjoan, Anna; Cerezo, Carlos; Brugada, Ramon; Marrugat, Jaume

    2011-02-01

    The recommendation of screening with ankle brachial index (ABI) in asymptomatic individuals is controversial. The aims of the present study were to develop and validate a pre-screening test to select candidates for ABI measurement in the Spanish population 50-79 years old, and to compare its predictive capacity to current Inter-Society Consensus (ISC) screening criteria. Two population-based cross-sectional studies were used to develop (n = 4046) and validate (n = 3285) a regression model to predict ABI guidelines, and similar sensitivity. This resulted in fewer patients screened per diagnosis of ABI < 0.9 (10.6 vs. 8.75) and a lower proportion of the population aged 50-79 years candidate to ABI screening (63.3% vs. 55.0%). This model provides accurate ABI < 0.9 risk estimates for ages 50-79, with a better predictive capacity than that of ISC criteria. Its use could reduce possible harms and unnecessary work-ups of ABI screening as a risk stratification strategy in primary prevention of peripheral vascular disease. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women's Health Initiative.

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    Tabung, Fred K; Steck, Susan E; Ma, Yunsheng; Liese, Angela D; Zhang, Jiajia; Caan, Bette; Hou, Lifang; Johnson, Karen C; Mossavar-Rahmani, Yasmin; Shivappa, Nitin; Wactawski-Wende, Jean; Ockene, Judith K; Hebert, James R

    2015-03-01

    Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women's Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50-79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5-Q1 1.22; 95 % CI 1.05, 1.43; p trend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5-Q1 1.35; 95 % CI 1.05, 1.67; p trend = 0.01) but not distal colon cancer (HRQ5-Q1 0.84; 95 % CI 0.61, 1.18; p trend = 0.63) or rectal cancer (HRQ5-Q1 1.20; 95 % CI 0.84, 1.72; p trend = 0.65). Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.

  6. INDEXING AND INDEX FUNDS

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    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.

  7. Cumulative trauma disorders in the upper extremities: reliability of the postural and repetitive risk-factors index.

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    James, C P; Harburn, K L; Kramer, J F

    1997-08-01

    This study addresses test-retest reliability of the Postural and Repetitive Risk-Factors Index (PRRI) for work-related upper body injuries. This assessment was developed by the present authors. A repeated measures design was used to assess the test-retest reliability of a videotaped work-site assessment of subjects' movements. Ten heavy users of video display terminals (VDTs) from a local banking industry participated in the study. The 10 subjects' movements were videotaped for 2 hours on each of 2 separate days, while working on-site at their VDTs. The videotaped assessment, which utilized known postural risk factors for developing musculoskeletal disorder, pain, and discomfort in heavy VDT users (ie, repetitiveness, awkward and static postures, and contraction time), was called the PRRI. The videotaped movement assessments were subsequently analyzed in 15-minute sessions (five sessions per 2-hour videotape, which produced a total of 10 sessions over the 2 testing days), and each session was chosen randomly from the videotape. The subjects' movements were given a postural risk score according to the criteria in the PRRI. Each subject was therefore tested a total of 10 times (ie, 10 sessions), over two days. The maximum PRRI score for both sides of the body was 216 points. Reliability coefficients (RCs) for the PRRI scores were calculated, and the reliability of any one session met the minimum criterion for excellent reliability, which was .75. A two-way analysis of variance (ANOVA) confirmed that there was no statistically significant difference between sessions (p < .05). Calculations using the standard error of measurement (SEM) indicated that an individual tested once, on one day and with a PRRI score of 25, required a change of at least 8 points in order to be confident that a true change in score had occurred. The significant results from the reliability tests indicated that the PRRI was a reliable measurement tool that could be used by occupational health

  8. Incongruence in body image and body mass index: A surrogate risk marker in Black women for type 2 diabetes mellitus

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    Rynal Devanathan

    2013-07-01

    Full Text Available Background: Excess weight contributes to the development and progression of Type 2 diabetes mellitus (T2DM. Distorted body image amongst urban Black women and the perception that thinness is linked with HIV, may however be compounding the problem, particularly in areas with a high HIV burden. Objectives: This study aimed to compare the perception of body image in urban Black women with and without T2DM. Methods: A cross-sectional comparative study was conducted on 328 Black women systematically sampled into two groups (with and without T2DM. Body mass index (BMI (weight [kg]/height[m2] was determined and the adapted Stunkard Body Image Silhouettes for Black women was used to determine perceived body image (PBI. Results: Seventy-two per cent had T2DM and in this group 89% were obese, with a mean BMI of 39.5 kg/m2 (s.d. ± 8.5. In the non-diabetes group (NDG 44% were obese, with a mean BMIof 31.3 kg/m2 (s.d. ± 9.0 Black women underestimated their body image across all weight categories (p < 0.05. Both groups (99% of the study group also perceived thinness as being associated with HIV. Conclusions: This study identified an incongruence between PBI and actual BMI amongst urban Black women. This, combined with their belief that thinness is associated with HIV, places those with T2DM at risk of secondary complications arising from diabetes mellitus, and those without diabetes mellitus at a higher risk of developing T2DM. A discrepancy between PBI and BMI may therefore serve as a risk marker to alert clinicians to use a more ethno-cultural specific approach in engaging with urban Black women regarding weight loss strategies in the future.

  9. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes—The Danish Diet, Cancer and Health Cohort Study

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    Sandra Amalie Lacoppidan

    2015-10-01

    Full Text Available Background: Type-2 diabetes (T2D prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally a protective association has been identified. However, other regional diets are less explored. Objective: The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal, apples and pears, and root vegetables. Methods: Data was obtained from a prospective cohort study of 57,053 Danish men and women aged 50–64 years, at baseline, of whom 7366 developed T2D (median follow-up: 15.3 years. The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D, adjusted for potential confounders. Results: Greater adherence to the healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders. An index score of 5−6 points (high adherence was associated with a statistically significantly 25% lower T2D risk in women (HR: 0.75, 95%CI: 0.61–0.92 and 38% in men (HR: 0.62; 95%CI: 0.53–0.71 compared to those with an index score of 0 points (poor adherence. Conclusion: Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D.

  10. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes--The Danish Diet, Cancer and Health Cohort Study.

    Science.gov (United States)

    Lacoppidan, Sandra Amalie; Kyrø, Cecilie; Loft, Steffen; Helnæs, Anne; Christensen, Jane; Hansen, Camilla Plambeck; Dahm, Christina Catherine; Overvad, Kim; Tjønneland, Anne; Olsen, Anja

    2015-10-21

    Type-2 diabetes (T2D) prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally a protective association has been identified. However, other regional diets are less explored. The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal, apples and pears, and root vegetables. Data was obtained from a prospective cohort study of 57,053 Danish men and women aged 50-64 years, at baseline, of whom 7366 developed T2D (median follow-up: 15.3 years). The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D, adjusted for potential confounders. Greater adherence to the healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders. An index score of 5-6 points (high adherence) was associated with a statistically significantly 25% lower T2D risk in women (HR: 0.75, 95%CI: 0.61-0.92) and 38% in men (HR: 0.62; 95%CI: 0.53-0.71) compared to those with an index score of 0 points (poor adherence). Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D.

  11. Prospective association between a dietary quality index based on a nutrient profiling system and cardiovascular disease risk.

    Science.gov (United States)

    Adriouch, Solia; Julia, Chantal; Kesse-Guyot, Emmanuelle; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Donnenfeld, Mathilde; Deschasaux, Mélanie; Menai, Mehdi; Hercberg, Serge; Touvier, Mathilde; Fezeu, Léopold K

    2016-10-01

    Public health strategies are essential to guide consumers' choices and produce a substantial population impact on cardiovascular disease risk prevention through nutrition. Our aim was to investigate the prospective association between the Food Standards Agency nutrient profiling system dietary index (FSA-NPS DI) and cardiovascular disease risk. The FSA-NPS has been proposed to serve as a basis for a five-colour nutrition label suggested in France to be put on the front of pack of food products. A total of 6515 participants to the SU.VI.MAX cohort (1994-2007), who completed at least six 24-hour dietary records during the first two years of the study, were followed for a median of 12.4 years (25th-75th percentiles: 11.0-12.6). Multivariable Cox proportional hazards models were used to characterise the associations between FSA-NPS DI (continuous and sex-specific quartiles) and the incidence of cardiovascular diseases. Interactions with individual characteristics were tested; 181 major cardiovascular events were reported (59 myocardial infarctions, 43 strokes, 79 anginas). A higher FSA-NPS DI, characterising poorer food choices, was associated with an overall increase in cardiovascular disease risk (HRfor a 1-point increment = 1.14 (1.03-1.27); HRQ4vs.Q1 = 1.61 (1.05-2.47), Ptrend Q4-Q1 = 0.03). This association tended to be stronger in smokers (HRfor a 1-point increment = 1.39 (1.11-1.73); Pinteraction = 0.01) and those less physically active (HRfor a 1-point increment = 1.26 (1.08-1.46); Pinteraction = 0.04). Our results suggest that poorer food choices, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (smokers and physically inactive persons). This score could be a useful tool for public health prevention strategies. ClinicalTrials.gov identifier: NCT00272428. © The European Society of Cardiology 2016.

  12. Index analysis and human health risk model application for evaluating ambient air-heavy metal contamination in Chemical Valley Sarnia.

    Science.gov (United States)

    Olawoyin, Richard; Schweitzer, Linda; Zhang, Kuangyuan; Okareh, Oladapo; Slates, Kevin

    2018-02-01

    The impacts of air emissions as a consequence of industrial activities around communities of human habitation have been extensively reported. This study is the first to assess potential adverse human health effects in the Chemical Valley Sarnia (CVS) area, around the St. Clair River, using health risk models, ecological and pollution indices. Large quantities of particulate matters (PM) are generated from anthropogenic activities, which contain several heavy metals in trace quantities with potentially adverse effects to humans and environmental health. The distribution, and human health impact assessment of trace element concentrations in PM fractions were examined. Elemental concentrations of As, Cd, Cr (VI), Cu, Fe, Mn, Pb, Ni, Zn were determined in the PM size-segregated samples collected from the CVS area between 2014 and 2017. The results showed relatively high concentration of PM air quality guidelines. Pb concentration (143.03 ± 46.87ηg/m 3 ) was 3.6 times higher than the air quality standards of NAAQS. Cr (VI) showed moderate to considerable contamination ( C f =4) in the CVS while Cr (VI), Pb, and Ni had enrichment factor E f < 3 (minimal), signifying contributions from anthropogenic activities. Pollution load index (P Li ) value observed was 1.4 indicating human health risk from the PM, especially for the children in the area. The deposition fluxes (DΦ) showed that PM-bound metals could potentially bypass the head airways and cause damages to the tracheobronchial tree, increasing the human health risks of nephroblastomasis development. The main route of entry for the heavy metal bound PM in humans were observed as through ingestion and inhalation. The highest total excess cancer risks observed for children (6.7×10 -4 ) and adult (1.0×10 -4 ) indicating potential cancer effects. The Incremental Lifetime Cancer Risk (ILCR) increased from Pb < Ni < Cd < Cr (VI) < As. Overall, children are more likely to develop carcinogenic and non-carcinogenic health

  13. Adiposity Indexes as Phenotype-Specific Markers of Preclinical Metabolic Alterations and Cardiovascular Risk in Polycystic Ovary Syndrome: A Cross-Sectional Study.

    Science.gov (United States)

    Mario, Fernanda Missio; Graff, Scheila Karen; Spritzer, Poli Mara

    2017-05-01

    Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age. 2 PCOS phenotypes (classic and ovulatory) are currently recognized as the most prevalent, with important differences in terms of cardiometabolic features. We studied the performance of different adiposity indexes to predict preclinical metabolic alterations and cardiovascular risk in 234 women with PCOS (173 with classic and 61 with ovulatory PCOS) and 129 controls. Performance of waist circumference, waist-to-height ratio, conicity index, lipid accumulation product, and visceral adiposity index was assessed based on HOMA-IR ≥ 3.8 as reference standard for screening preclinical metabolic alterations and cardiovascular risk factors in each group. Lipid accumulation product had the best accuracy for classic PCOS, and visceral adiposity index had the best accuracy for ovulatory PCOS. By applying the cutoff point of lipid accumulation productcardiometabolic alterations (Prisk for hypertension, dyslipidemia, and impaired glucose tolerance. In ovulatory PCOS, visceral adiposity index ≥ 1.32 was capable of detecting women with significantly higher blood pressure and less favorable glycemic and lipid variables as compared to ovulatory PCOS with lower visceral adiposity index (Pcardiometabolic risk and secure early interventions. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia.

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    Soleto, Lorena; Pirard, Marianne; Boelaert, Marleen; Peredo, Remberto; Vargas, Reinerio; Gianella, Alberto; Van der Stuyft, Patrick

    2003-01-01

    To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country. A prospective study with patient follow-up until the 30th postoperative day. A general surgical ward of a public hospital in Santa Cruz, Bolivia. Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed. Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a "local" risk index constructed with the above cutoff points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3. SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

  15. Estimating the exceedance probability of rain rate by logistic regression

    Science.gov (United States)

    Chiu, Long S.; Kedem, Benjamin

    1990-01-01

    Recent studies have shown that the fraction of an area with rain intensity above a fixed threshold is highly correlated with the area-averaged rain rate. To estimate the fractional rainy area, a logistic regression model, which estimates the conditional probability that rain rate over an area exceeds a fixed threshold given the values of related covariates, is developed. The problem of dependency in the data in the estimation procedure is bypassed by the method of partial likelihood. Analyses of simulated scanning multichannel microwave radiometer and observed electrically scanning microwave radiometer data during the Global Atlantic Tropical Experiment period show that the use of logistic regression in pixel classification is superior to multiple regression in predicting whether rain rate at each pixel exceeds a given threshold, even in the presence of noisy data. The potential of the logistic regression technique in satellite rain rate estimation is discussed.

  16. Atherogenic index of plasma and 10-year risk of cardiovascular disease in adult Africans living with HIV infection: A cross-sectional study from Yaoundé, Cameroon

    Directory of Open Access Journals (Sweden)

    Steve Raoul Noumegni

    2017-11-01

    Full Text Available Background The paucity of data regarding the association between atherogenic index of plasma and risk of cardiovascular disease in HIV-infected populations living in sub-Saharan Africa prompted us to conduct this study which aimed to assess the relationship between atherogenic index of plasma and risk of cardiovascular disease among a Cameroonian HIV-infected population. Methods This was a cross-sectional study conducted among 452 HIV-infected adults in Yaoundé, Cameroon. Risk of cardiovascular disease was calculated using the Framingham risk score; atherogenic index of plasma was derived as log (triglycerides/high-density lipoproteins cholesterol. Results Participants’ mean age (80% females was 44.4 ± 9.8 years. Atherogenic index of plasma values ranged from –0.63 to 1.36 with a median of 0.11 (25th–75th percentiles: –0.08-0.31. Most participants (88.5% were on antiretroviral treatment. There was a significant correlation between atherogenic index of plasma and fasting plasma glucose (r = 0.116; p  = 0.014, atherogenic index of plasma and total cholesterol (r = –0.164; p  < 0.001. Atherogenic index of plasma was significantly associated with the risk of cardiovascular disease either in univariable (β = 5.05, 95% CI: 3.31–6.79; p  < 0.001, R 2  = 0.067 or in multivariable linear regression model after adjusting for socio-demographic, clinical and biological confounders (adjusted β = 3.79, 95% CI: 1.65 – 4.88; p  < 0.001, R 2  = 0.187. Conclusion Atherogenic index of plasma may be an independent factor impacting the risk of cardiovascular disease among Cameroonian HIV-infected people. More studies are needed to better elucidate the association between atherogenic index of plasma and risk of cardiovascular disease in our setting.

  17. Wind erosion risk in the southwest of Buenos Aires Province, Argentina, and its relationship to the productivity index

    Science.gov (United States)

    Silenzi, Juan C.; Echeverría, Nora E.; Vallejos, Adrián G.; Bouza, Mariana E.; De Lucia, Martín P.

    2012-01-01

    Wind erosion risk (WER) for soils of each municipality in the southwest (SW) of Buenos Aires Province (10,491,172 ha) was determined using the wind erosion equation (WEQ) model. WER results from multiplying the soil erodibility index (" I") of the soil by the climatic factor ( C). WER (Mg ha -1 year -1) of each municipality was: Bahía Blanca: 22.4, Coronel Dorrego: 18.6, Coronel Pringles: 4.5, Coronel Rosales: 48.2, Coronel Suárez: 4.5, Guaminí: 3.0, Patagones: 104.6, Puan: 12.2, Saavedra: 3.0, Tornquist: 6.8, and Villarino: 31.7. The maximum weighted average of " I" (Mg ha -1 year -1) corresponded to Coronel Rosales (87.6), Patagones (87.2), Villarino (85.7), Puan (67.9); Guaminí (59.6), Coronel Dorrego (53.1), and Bahía Blanca (39.3); the remaining municipalities ranged between 34.9 and 32.1 Mg ha -1 year -1. The highest C (%) corresponded to Patagones (120), Bahía Blanca (57), Coronel Rosales (55), Villarino (37), Coronel Dorrego (35), Tornquist (21), and Puan (18); for the remaining municipalities it was 14%. The productivity index (PI) is known to establish a numerical value of the productive capacity of lands. The relationship between WER and PI, weighted averages, in all the studied municipalities was fitted by means of a linear model, WER (Mg ha -1 year -1) = 95.23 - 2.09 * PI (%) ( R2 = 66%), and a second-order polynomial model, WER (Mg ha -1 year -1) = 139.41 - 5.86 * PI (%) + 0.07 * PI 2 (%) ( R2 = 74%). No statistically significant relationship was found between WER and PI for each municipality.

  18. Cardiometabolic risk in young adults from northern Mexico: Revisiting body mass index and waist-circumference as predictors

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    Abraham Wall-Medrano

    2016-03-01

    Full Text Available Abstract Background A body mass index (BMI ≥30 kg/m2 and a waist circumference (WC ≥80 cm in women (WCF or ≥90 cm in men (WCM are reference cardiometabolic risk markers (CMM for Mexicans adults. However, their reliability to predict other CMM (index tests in young Mexicans has not been studied in depth. Methods A cross-sectional descriptive study evaluating several anthropometric, physiological and biochemical CMM from 295 young Mexicans was performed. Sensitivity (Se, specificity (Sp and Youden’s index (J of reference BMI/WC cutoffs toward other CMM (n = 14 were obtained and their most reliable cutoffs were further calculated at Jmax. Results Prevalence, incidence and magnitude of most CMM increased along the BMI range (p < 0.01. BMI explained 81 % of WC’s variance [Se (97 %, Sp (71 %, J (68 %, Jmax (86 %, BMI = 30 kg/m2] and 4–50 % of other CMM. The five most prevalent (≥71 % CMM in obese subjects were high WC, low HDL-C, and three insulin-related CMM [Fasting insulin, HOMA-IR, and QUICKI]. For a BMI = 30 kg/m2, J ranged from 16 % (HDL-C/LDL-C to 68 % (WC, being moderately reliable (Jmax = 61–67 to predict high uric acid (UA, metabolic syndrome (MetS and the hypertriglyceridemic-waist phenotype (HTGW. Corrected WCM/WCF were moderate-highly reliable (Jmax = 66–90 to predict HTGW, MetS, fasting glucose and UA. Most CMM were moderate-highly predicted at 27 ± 3 kg/m2 (CI 95 %, 25–28, 85 ± 5 cm (CI 95 %, 82–88 and 81 ± 6cm (CI 95 %, 75–87, for BMI, WCM and WCF, respectively. Conclusion BMI and WC are good predictors of several CMM in the studied population, although at different cutoffs than current reference values.

  19. Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn.

    Science.gov (United States)

    Pazhohan, Azar; Rezaee Moradali, Monireh; Pazhohan, Nahideh

    2017-11-20

    To evaluate the association of maternal first-trimester plasma lipid profiles, fasting plasma glucose (FPG), and triglyceride (TyG) index with the risk of gestational diabetes mellitus (GDM) and large for gestational age (LGA) infant in Iranian mothers. Nine hundred and fifty-four healthy pregnant women were prospectively followed till after delivery. Maternal fasting lipids and glucose concentration were measured at nine-week gestation on average. We used generalized linear models to calculate the relative risks and 95% confidence intervals. The incidence of GDM and LGA infants among our participants was 18.4% and 26.1%, respectively. There was a significant correlation between the increase in FPG, triglyceride, TG/HDL-C ratio, as well as TyG index with the risk of GDM and LGA infant. After adjusting for potential confounders, the relative risk of GDM in women in the top tertile of FPG, triglyceride (TG), triglyceride/high-density lipoprotein-cholesterol (TG/HDL-C) and TyG index was 4.2-, 4.2-, 3.9-, and 4.9-folds of its risk in women in the bottom tertile, respectively. Also after adjusting for GDM, the relative risk of LGA infants in women in the top tertile of FPG, TG, TG/HDL-C ratio and TyG index was 3.9-, 4.3-, 4.8-, and 5.3-folds of its risk in women in the bottom tertile, respectively. Based on our findings, TyG index is more robust early predictors of GDM and LGA in Iranian women.

  20. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA, and risk malignancy index (RMI for the classification of ovarian masses

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    Cristina Anton

    2012-01-01

    Full Text Available OBJECTIVE: Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4 as well as the risk ovarian malignancy algorithm (ROMA and risk malignancy index (RMI values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system. METHODS: Patients who had been diagnosed with ovarian masses through imaging analyses (n = 128 were assessed for their expression of the tumor markers CA125 and HE4. The ROMA and RMI values were also determined. The sensitivity and specificity of each parameter were calculated using receiver operating characteristic curves according to the area under the curve (AUC for each method. RESULTS: The sensitivities associated with the ability of CA125, HE4, ROMA, or RMI to distinguish between malignant versus benign ovarian masses were 70.4%, 79.6%, 74.1%, and 63%, respectively. Among carcinomas, the sensitivities of CA125, HE4, ROMA (pre-and post-menopausal, and RMI were 93.5%, 87.1%, 80%, 95.2%, and 87.1%, respectively. The most accurate numerical values were obtained with RMI, although the four parameters were shown to be statistically equivalent. CONCLUSION: There were no differences in accuracy between CA125, HE4, ROMA, and RMI for differentiating between types of ovarian masses. RMI had the lowest sensitivity but was the most numerically accurate method. HE4 demonstrated the best overall sensitivity for the evaluation of malignant ovarian tumors and the differential diagnosis of endometriosis. All of the parameters demonstrated increased sensitivity when tumors with low malignancy potential were considered low-risk, which may be used as an acceptable assessment method for referring patients to reference centers.

  1. Development of the Informing Relatives Inventory (IRI): Assessing Index Patients' Knowledge, Motivation and Self-Efficacy Regarding the Disclosure of Hereditary Cancer Risk Information to Relatives.

    Science.gov (United States)

    de Geus, Eveline; Aalfs, Cora M; Menko, Fred H; Sijmons, Rolf H; Verdam, Mathilde G E; de Haes, Hanneke C J M; Smets, Ellen M A

    2015-08-01

    Despite the use of genetic services, counselees do not always share hereditary cancer information with at-risk relatives. Reasons for not informing relatives may be categorized as a lack of: knowledge, motivation, and/or self-efficacy. This study aims to develop and test the psychometric properties of the Informing Relatives Inventory, a battery of instruments that intend to measure counselees' knowledge, motivation, and self-efficacy regarding the disclosure of hereditary cancer risk information to at-risk relatives. Guided by the proposed conceptual framework, existing instruments were selected and new instruments were developed. We tested the instruments' acceptability, dimensionality, reliability, and criterion-related validity in consecutive index patients visiting the Clinical Genetics department with questions regarding hereditary breast and/or ovarian cancer or colon cancer. Data of 211 index patients were included (response rate = 62%). The Informing Relatives Inventory (IRI) assesses three barriers in disclosure representing seven domains. Instruments assessing index patients' (positive) motivation and self-efficacy were acceptable and reliable and suggested good criterion-related validity. Psychometric properties of instruments assessing index patients knowledge were disputable. These items were moderately accepted by index patients and the criterion-related validity was weaker. This study presents a first conceptual framework and associated inventory (IRI) that improves insight into index patients' barriers regarding the disclosure of genetic cancer information to at-risk relatives. Instruments assessing (positive) motivation and self-efficacy proved to be reliable measurements. Measuring index patients knowledge appeared to be more challenging. Further research is necessary to ensure IRI's dimensionality and sensitivity to change.

  2. Saturated fat intake modulates the association between an obesity genetic risk score and body mass index in two US populations.

    Science.gov (United States)

    Casas-Agustench, Patricia; Arnett, Donna K; Smith, Caren E; Lai, Chao-Qiang; Parnell, Laurence D; Borecki, Ingrid B; Frazier-Wood, Alexis C; Allison, Matthew; Chen, Yii-Der Ida; Taylor, Kent D; Rich, Stephen S; Rotter, Jerome I; Lee, Yu-Chi; Ordovás, José M

    2014-12-01

    Combining multiple genetic variants related to obesity into a genetic risk score (GRS) might improve identification of individuals at risk of developing obesity. Moreover, characterizing gene-diet interactions is a research challenge to establish dietary recommendations to individuals with higher predisposition to obesity. Our objective was to analyze the association between an obesity GRS and body mass index (BMI) in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) population, focusing on gene-diet interactions with total fat and saturated fatty acid (SFA) intake, and to replicate findings in the Multi-Ethnic Study of Atherosclerosis (MESA) population. Cross-sectional analyses included 783 white US participants from GOLDN and 2,035 from MESA. Dietary intakes were estimated with validated food frequency questionnaires. Height and weight were measured. A weighted GRS was calculated on the basis of 63 obesity-associated variants. Multiple linear regression models adjusted by potential confounders were used to examine gene-diet interactions between dietary intake (total fat and SFA) and the obesity GRS in determining BMI. Significant interactions were found between total fat intake and the obesity GRS using these variables as continuous for BMI (P for interaction=0.010, 0.046, and 0.002 in GOLDN, MESA, and meta-analysis, respectively). These association terms were stronger when assessing interactions between SFA intake and GRS for BMI (P for interaction=0.005, 0.018, and obesity GRS in modulating BMI in two US populations. Although determining the causal direction requires further investigation, these findings suggest that potential dietary recommendations to reduce BMI effectively in populations with high obesity GRS would be to reduce total fat intake mainly by limiting SFAs. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. How wildfire risk is related to urban planning and Fire Weather Index in SE France (1990-2013).

    Science.gov (United States)

    Fox, D M; Carrega, P; Ren, Y; Caillouet, P; Bouillon, C; Robert, S

    2018-04-15

    Wildfires burn >450,000ha of forest every year in Euro-Mediterranean countries. Many fires originate in the Wildland Urban Interface (WUI) where housing density and weather conditions affect fire occurrence. Housing density is determined by long term land use policies while weather conditions evolve quickly. The first objective was to quantify the impacts of land use policy on WUI characteristics and fire risk in SE France during 1990-2012. The second objective was to quantify how Fire Weather Index (FWI) is related to fire occurrence. WUI was mapped from 1990, 1999, and 2012 building layers and crossed with a NDVI derived vegetation layer. In all, 12 WUI categories were derived: 4 building density classes and 3 vegetation layers. The I87 FWI was based on daily temperature, wind speed, relative humidity and soil water content. Despite a 30% increase in the number of new buildings, WUI area increased by only 5% as new housing filled in open space in existing WUI area. This trend can be linked to national level urban planning legislation and forest fire protection laws. Major driver variables determining housing location were aspect, slope, and distance to city centers. Fire frequency and burned area were nonlinearly related to FWI: 73% of the 99 fires occurred during weeks with FWI values ≥90 even though these accounted for only 44% of all weeks. Burned area was even more sensitive to FWI since 97% of total burned area occurred during weeks with mean FWI values ≥90. All days with burned areas >100ha had FWI values >150. The study demonstrated that WUI legislation can be an efficient tool to limit WUI fire risk. FWI results suggest the predicted increase in extreme summer heat events with global warming could increase burned area as firefighting resources are stretched beyond capacity. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Volatility forecasting and value-at-risk estimation in emerging markets: the case of the stock market index portfolio in South Africa

    Directory of Open Access Journals (Sweden)

    Lumengo Bonga-Bonga

    2011-04-01

    Full Text Available Accurate modelling of volatility is important as it relates to the forecasting of Value-at-Risk (VaR. The RiskMetrics model to forecast volatility is the benchmark in the financial sector. In an important regulatory innovation, the Basel Committee has proposed the use of an internal method for modelling VaR instead of the strict use of the benchmark model. The aim of this paper is to evaluate the performance of RiskMetrics in comparison to other models of volatility forecasting, such as some family classes of the Generalised Auto Regressive Conditional Heteroscedasticity models, in forecasting the VaR in emerging markets. This paper makes use of the stock market index portfolio, the All-Share Index, as a case study to evaluate the market risk in emerging markets. The paper underlines the importance of asymmetric behaviour for VaR forecasting in emerging markets’ economies.

  5. A Modified Soil Quality Index to Assess the Influence of Soil Degradation Processes on Desertification Risk: The Apulia Case

    Directory of Open Access Journals (Sweden)

    Valeria Ancona

    2010-10-01

    Full Text Available Apulia is one of the most prone Italian regions to soil alteration phenomena, due to geographical and climatic conditions and also to human activities’ impact. In this study, in order to investigate regional soil degradation processes, following the “European Directive for Soil Protection”, the ESA’s method has been adopted. It is based on the use of an indicator’s set to assess the desertification risk. This approach simplifies the diagnosis and monitoring of soil degradation processes, defining their status and trend. Special attention has been given to Soil Quality Index (SQI determined by six predisposing indicators (parent material, soil texture, rock fragment, soil depth, drainage and slope grade. The integration in the SQI calculation of two additional soil parameters (organic matter content and soil salinity has been considered particularly significant. In fact, through the evaluation of a so “modified SQI” and the Apulia land use too, it could be possible to assess the role of agriculture management on soil degradation processes, which predisposing regional area to desertification threat. Moreover this approach provides short, but accurate, information thanks to GIS integration, which defines phenomena in detail, offering helpful planning tools.

  6. 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.

  7. PERFORMANCE OF QUANTITATIVE ULTRASOUND AND SIX OSTEOPOROSIS RISK INDEXES IN MENOPAUSAL WOMEN: VALIDATION AND COMPARATIVE EVALUATION STUDY.

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    Imad GHOZLANI

    2016-12-01

    Full Text Available Background: A number of questionnaire-based systems and the use of portable quantitative ultrasound scanners (QUS have been devised in an attempt to produce a cost-effective method of screening for osteoporosis.Objective: to assess the sensitivity and specificity of different techniques and their ability to act as screening tools in relation to dual energy X-ray absorptiometry (DXA.Methods: 295 white postmenopausal women aged over 60 were enrolled. Each subject completed a standardized questionnaire which permits the measure of six osteoporosis indexes and had bone mineral density (BMD measured using QUS and DXA. Sensitivity and specificity of the different techniques in relation to DXA were plotted as receiver-operating characteristic (ROC curves at DXA T-score total hip ≤ -2.5 (osteoporosis.Results: BUA sensitivity and specificity values were respectively 76.8% and 51.2% at the total hip. The optimal cut-off T-score for QUS was -2 at the total hip. The osteoporosis self-assessment tool (OST provided consistently the highest AUC (0.80 among the clinical tools and had the best sensitivity and specificity balance (90.2%-44.5%. OST negative likelihood ratio was 0.22.Conclusion: OST (based only on the weight and the age performed slightly better than QUS and other risk questionnaires in predicting low BMD at the total hip

  8. 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.

  9. 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.

  10. Cross-sectional study of the ankle-brachial index and cardiovascular risk factors in postmenopausal women.

    Science.gov (United States)

    Wierzchowski, Paweł; Dereziński, Tadeusz; Migdalski, Arkadiusz; Woda, Łukasz; Wąsikowska, Beata; Jakubowski, Grzegorz; Jawień, Arkadiusz

    2017-01-01

    The incidence of peripheral artery disease (PAD) and cardiovascular (CV) events in the female population has been on the increase. To analyse the risk factors of a CV event and PAD in women and to assess the usefulness of the ankle-brachial index (ABI). Evaluation of selected parameters in a cohort of 365 women living in the same district. The following data were prospectively recorded: weight, height, waist size, hip circumference, smoking, the intima-media complex, ABI value, and laboratory results. PAD symptoms, CV events and neurological events were noted. ABI was analysed assuming pathology for values: ≤ 0.9 or ≤ 1.0. Age, plasma glucose level, atrial fibrillation, and nicotine addiction were correlated independently with CV disease and stroke (p < 0.001). The high-density lipoprotein cholesterol level, height, and systolic blood pressure were correlated independently with ABI values (p < 0.05). There was no correlation between the occurrence of a CV event in the past and the ABI, irrespective of the cut-off point for the reference value (p = NS). There is no evidence that stricter criteria for the assessment of ABI better represent the vascular status in the female population.

  11. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    OpenAIRE

    Aki Kiuchi; Yasushi Ohashi; Reibin Tai; Toshiyuki Aoki; Sonoo Mizuiri; Toyoko Ogura; Atsushi Aikawa; Ken Sakai

    2016-01-01

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were ...

  12. Do body mass index trajectories affect the risk of type 2 diabetes? A case-control study.

    Science.gov (United States)

    Mano, Yoshihiko; Yokomichi, Hiroshi; Suzuki, Kohta; Takahashi, Atsunori; Yoda, Yoshioki; Tsuji, Masahiro; Sato, Miri; Shinohara, Ryoji; Mizorogi, Sonoko; Mochizuki, Mie; Yamagata, Zentaro

    2015-07-28

    Although obesity is a well-studied risk factor for diabetes, there remains an interest in whether "increasing body mass index (BMI)," "high BMI per se," or both are the actual risk factors for diabetes. The present study aimed to retrospectively compare BMI trajectories of individuals with and without diabetes in a case-control design and to assess whether increasing BMI alone would be a risk factor. Using comprehensive health check-up data measured over ten years, we conducted a case-control study and graphically drew the trajectories of BMIs among diabetic patients and healthy subjects, based on coefficients in fitted linear mixed-effects models. Patient group was matched with healthy control group at the onset of diabetes with an optimal matching method in a 1:10 ratio. Simple fixed-effects models assessed the differences in increasing BMIs over 10 years between patient and control groups. At the time of matching, the mean ages in male patients and controls were 59.3 years [standard deviation (SD) = 9.2] and 57.7 years (SD = 11.2), whereas the mean BMIs were 25.0 kg/m(2) (SD = 3.1) and 25.2 kg/m(2) (SD = 2.9), respectively. In female patients and controls, the mean ages were 61.4 years (SD = 7.9) and 60.1 years (SD = 9.6), whereas the mean BMIs were 24.8 kg/m(2) (SD = 3.5) and 24.9 kg/m(2) (SD = 3.4), respectively. The simple fixed-effects models detected no statistical significance for the differences of increasing BMIs between patient and control groups in males (P = 0.19) and females (P = 0.67). Sudden increases in BMI were observed in both male and female patients when compared with BMIs 1 year prior to diabetes onset. The present study suggested that the pace of increasing BMIs is similar between Japanese diabetic patients and healthy individuals. The increasing BMI was not detected to independently affect the onset of type 2 diabetes.

  13. Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants

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    Pao-Hwa Lin

    2012-06-01

    Full Text Available Background: The clinical significance of glycemic index (GI and glycemic load (GL is inconclusive. Objective : This study was conducted to examine the association of GI and GL with clinical cardiovascular disease (CVD risk factors including body weight, blood pressure (BP, serum lipids, fasting glucose, insulin and homocysteine over time among the PREMIER participants. Design: PREMIER was an 18-month randomized lifestyle intervention trial, conducted from 2000 to 2002, designed to help participants reduce BP by following the Dietary Approaches to Stop Hypertension (DASH dietary pattern, losing weight, reducing sodium and increasing physical activity. GI and GL were estimated from 24 h diet recall data at baseline, 6 and 18 months after intervention. PROC MIXED model was used to examine the association of changes in GI or GL with changes in CVD risk factors. Results: A total of 756 randomized participants, 62% females and 34% African Americans and who averaged 50.0±0.3 years old and 95.3±0.7 kg, were included in this report. Neither GI nor GL changes was associated with changes in any risk factors at 6 months. At 18 months, however, the GI change was significantly and positively associated with total cholesterol (TC change only (p<0.05, β = 23.80±12.11 mg/dL or 0.62±0.31 mmol/L with a significant age interaction. The GL change was significantly associated with TC (p=0.02, β = 0.28±0.15 mg/dL or 0.01±0.00 mmol/L positively and with low density lipoprotein cholesterol (LDL-C changes negatively (p=0.03, β = − 0.01±0.00 mg/dL or −0.00±0.00 mmol/L, and significant age interactions were observed for both. Conclusion: GI and GL was associated with TC and LDL-C after controlling for energy, fat and fiber intake and other potential confounders and the associations were modified by age. Further investigation into this relationship is important because of its potential clinical impact.

  14. The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale.

    Science.gov (United States)

    Knobe, M; Giesen, M; Plate, S; Gradl-Dietsch, G; Buecking, B; Eschbach, D; van Laack, W; Pape, H-C

    2016-10-01

    The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale. For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland-Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated. The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = -0.78, p control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off 5 points). The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA

  15. Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

    2014-01-01

    Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

  16. Work ability as prognostic risk marker of disability pension: single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; van Rhenen, W.; Groothoff, J.W.; van der Klink, J.J.L.; Twisk, J.W.R.; Heymans, M.W.

    2014-01-01

    Objectives Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP. Methods This

  17. Work ability as prognostic risk marker of disability pension : single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, Corne A. M.; van Rhenen, Willem; Groothoff, Johan W.; van der Klink, Jac J. L.; Twisk, Jos W. R.; Heymans, Martijn W.

    Objectives Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP. Methods This

  18. Screening manual and office workers for risk of long-term sickness absence : cut-off points for the Work Ability Index

    NARCIS (Netherlands)

    Schouten, Lianne S.; Joling, Catelijne I.; van der Gulden, Joost W. J.; Heymans, Martijn W.; Bultmann, Ute; Roelen, Corne A. M.

    Objectives The aim of this study was to investigate the Work Ability Index (WAI) as a tool to screen for risk of different durations of long-term sickness absence (LTSA) among manual and office workers. Methods The prospective study comprised a cohort of 3049 (1710 manual and 1339 office) workers

  19. A Prospective Study of Height and Body Mass Index in Childhood, Birth Weight, and Risk of Adult Glioma Over 40 Years of Follow-up

    DEFF Research Database (Denmark)

    Kitahara, Cari M; Gamborg, Michael; Rajaraman, Preetha

    2014-01-01

    Greater attained height and greater body mass index (BMI; weight (kg)/height (m)(2)) in young adulthood have been associated with glioma risk, but few studies have investigated the association with body size at birth or during childhood, when the brain undergoes rapid cell growth...

  20. Integrated Monitoring and Modeling of Carbon Dioxide Leakage Risk Using Remote Sensing, Ground-Based Monitoring, Atmospheric Models and Risk-Indexing Tools

    Science.gov (United States)

    Burton, E. A.; Pickles, W. L.; Gouveia, F. J.; Bogen, K. T.; Rau, G. H.; Friedmann, J.

    2006-12-01

    estimating its associated risk, spatially and temporally. This requires integration of subsurface, surface and atmospheric data and models. To date, we have developed techniques to map risk based on predicted atmospheric plumes and GIS/MT (meteorologic- topographic) risk-indexing tools. This methodology was derived from study of large CO2 releases from an abandoned well penetrating a natural CO2 reservoir at Crystal Geyser, Utah. This integrated approach will provide a powerful tool to screen for high-risk zones at proposed sequestration sites, to design and optimize surface networks for site monitoring and/or to guide setting science-based regulatory compliance requirements for monitoring sequestration sites, as well as to target critical areas for first responders should a catastrophic-release event occur. This work was performed under the auspices of the U.S. Dept. of Energy by University of California, Lawrence Livermore National Laboratory under Contract W-7405-Eng-48.

  1. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study.

    Science.gov (United States)

    Gunge, V B; Andersen, I; Kyrø, C; Hansen, C P; Dahm, C C; Christensen, J; Tjønneland, A; Olsen, A

    2017-05-01

    For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.

  2. Effects of using the simplified airway risk index vs usual airway assessment on unanticipated difficult tracheal intubation - a cluster randomized trial with 64,273 participants

    DEFF Research Database (Denmark)

    Nørskov, A K; Wetterslev, J; Rosenstock, C V

    2016-01-01

    departments vs 1.00% (302) in Non-SARI departments. Adjusted OR was 1.26 (0.68-2.34). CONCLUSIONS: Using the SARI compared with usual airway assessment we detected no statistical significant changes in unanticipated difficult- or easy intubations. CLINICAL TRIAL REGISTRATION: NCT01718561.......BACKGROUND: Unanticipated difficult intubation remains a challenge in anaesthesia. The Simplified Airway Risk Index (SARI) is a multivariable risk model consisting of seven independent risk factors for difficult intubation. Our aim was to compare preoperative airway assessment based on the SARI...

  3. Analyzing the risk of recurrence after mastectomy for DCIS: a new use for the USC/Van Nuys Prognostic Index.

    Science.gov (United States)

    Kelley, Leah; Silverstein, Melvin; Guerra, Lisa

    2011-02-01

    Patients with ductal carcinoma in situ (DCIS) who are treated with mastectomy seldom recur locally or with metastatic disease. When patients with DCIS recur with invasive cancer, they are upstaged and their lives are threatened. We questioned whether histopathologic data could be used to predict these infrequent events. We reviewed a prospective database of 1,472 patients with pure DCIS. All patients were scored from 4 to 12 using the USC Van Nuys Prognostic Index, an algorithm based on DCIS size, nuclear grade, necrosis, margin width, and patient age. Probabilities of recurrence and death were calculated using the Kaplan-Meier method. A total of 496 patients with pure DCIS were treated with mastectomy. None received any form of postmastectomy adjuvant treatment. Average follow-up was 83 months. Eleven patients developed recurrences, all of whom scored 10-12 using the USC/VNPI. No patient who scored 4-9 recurred. All 11 patients who recurred had multifocal disease and comedo-type necrosis. The probability of disease recurrence after mastectomy for patients scoring 10-12 was 9.6% at 12 years, compared with 0% for those scoring 4-9. There was no difference in overall survival. There were no recurrences among mastectomy patients who scored 4-9 using the USC/VNPI. Patients scoring 10-12 were significantly more likely to develop recurrence after mastectomy. At risk were young patients with large, high-grade, and multifocal or multicentric tumors. For every 100 patients with USC/VNPI scores of 10-12, 10 patients will recur by 12 years and 2-3 will develop metastatic disease.

  4. Pollution potential leaching index as a tool to assess water leaching risk of arsenic in excavated urban soils.

    Science.gov (United States)

    Li, Jining; Kosugi, Tomoya; Riya, Shohei; Hashimoto, Yohey; Hou, Hong; Terada, Akihiko; Hosomi, Masaaki

    2018-01-01

    Leaching of hazardous trace elements from excavated urban soils during construction of cities has received considerable attention in recent years in Japan. A new concept, the pollution potential leaching index (PPLI), was applied to assess the risk of arsenic (As) leaching from excavated soils. Sequential leaching tests (SLT) with two liquid-to-solid (L/S) ratios (10 and 20Lkg -1 ) were conducted to determine the PPLI values, which represent the critical cumulative L/S ratios at which the average As concentrations in the cumulative leachates are reduced to critical values (10 or 5µgL -1 ). Two models (a logarithmic function model and an empirical two-site first-order leaching model) were compared to estimate the PPLI values. The fractionations of As before and after SLT were extracted according to a five-step sequential extraction procedure. Ten alkaline excavated soils were obtained from different construction projects in Japan. Although their total As contents were low (from 6.75 to 79.4mgkg -1 ), the As leaching was not negligible. Different L/S ratios at each step of the SLT had little influence on the cumulative As release or PPLI values. Experimentally determined PPLI values were in agreement with those from model estimations. A five-step SLT with an L/S of 10Lkg -1 at each step, combined with a logarithmic function fitting was suggested for the easy estimation of PPLI. Results of the sequential extraction procedure showed that large portions of more labile As fractions (non-specifically and specifically sorbed fractions) were removed during long-term leaching and so were small, but non-negligible, portions of strongly bound As fractions. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Why Different Drought Indexes Show Distinct Future Drought Risk Outcomes in the U.S. Great Plains?

    Science.gov (United States)

    Feng, S.; Hayes, M. J.; Trnka, M.

    2015-12-01

    Vigorous discussions and disagreements about the future changes in drought intensity in the US Great Plains have been taking place recently within the literature. These discussions have involved widely varying estimates based on drought indices and model-based projections of the future. To investigate and understand the causes for such a disparity between these previous estimates, we analyzed 10 commonly-used drought indexes using the output from 26 state-of-the-art climate models. These drought indices were computed using potential evapotranspiration estimated by the physically-based Penman-Monteith method (PE_pm) and the empirically-based Thornthwaite method (PE_th). The results showed that the short-term drought indicators are similar to modeled surface soil moisture and show a small but consistent drying trend in the future. The long-term drought indicators and the total column soil moisture, however, are consistent in projecting more intense future drought. When normalized, the drought indices with PE_th all show unprecedented and possibly unrealistic future drying, while the drought indices with PE_pm show comparable dryness with the modeled soil moisture. Additionally, the drought indices with PE_pm are closely related to soil moisture during both the 20th and 21st Centuries. Overall, the drought indices with PE_pm, as well as the modeled total column soil moisture, suggest a widespread and very significant drying of the Great Plains region toward the end of the Century. Our results suggested that the sharp contracts about future drought risk in the Great Plains discussed in previous studies are caused by 1) comparing the projected changes in short-term droughts with that of the long-term droughts, and/or 2) computing the atmospheric evaporative demand using the empirically-based method (e.g., PE_th). Our analysis may be applied for drought projections in other regions across the globe.

  6. Validation of a second-generation multivariate index assay for malignancy risk of adnexal masses.

    Science.gov (United States)

    Coleman, Robert L; Herzog, Thomas J; Chan, Daniel W; Munroe, Donald G; Pappas, Todd C; Smith, Alan; Zhang, Zhen; Wolf, Judith

    2016-07-01

    Women with adnexal mass suspected of ovarian malignancy are likely to benefit from consultation with a gynecologic oncologist, but imaging and biomarker tools to ensure this referral show low sensitivity and may miss cancer at critical stages. The multivariate index assay (MIA) was designed to improve the detection of ovarian cancer among women undergoing surgery for a pelvic mass. To improve the prediction of benign masses, we undertook the redesign and validation of a second-generation MIA (MIA2G). MIA2G was developed using banked serum samples from a previously published prospective, multisite registry of patients who underwent surgery to remove an adnexal mass. Clinical validity was then established using banked serum samples from the OVA500 trial, a second prospective cohort of adnexal surgery patients. Based on the final pathology results of the OVA500 trial, this intended-use population for MIA2G testing was high risk, with an observed cancer prevalence of 18.7% (92/493). Coded samples were assayed for MIA2G biomarkers by an external clinical laboratory. Then MIA2G results were calculated and submitted to a clinical statistics contract organization for decoding and comparison to MIA results for each subject. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, among other measures, and stratified by menopausal status, stage, and histologic subtype. Three MIA markers (cancer antigen 125, transferrin, and apolipoprotein A-1) and 2 new biomarkers (follicle-stimulating hormone and human epididymis protein 4) were included in MIA2G. A single cut-off separated high and low risk of malignancy regardless of patient menopausal status, eliminating potential for confusion or error. MIA2G specificity (69%, 277/401 [n/N]; 95% confidence interval [CI], 64.4-73.4%) and PPV (40%, 84/208; 95% CI, 33.9-47.2%) were significantly improved over MIA (specificity, 54%, 215/401; 95% CI, 48.7-58.4%, and PPV, 31%, 85/271; 95

  7. Estimating the causal influence of body mass index on risk of Parkinson disease: A Mendelian randomisation study.

    Directory of Open Access Journals (Sweden)

    Alastair J Noyce

    2017-06-01

    Full Text Available Both positive and negative associations between higher body mass index (BMI and Parkinson disease (PD have been reported in observational studies, but it has been difficult to establish causality because of the possibility of residual confounding or reverse causation. To our knowledge, Mendelian randomisation (MR-the use of genetic instrumental variables (IVs to explore causal effects-has not previously been used to test the effect of BMI on PD.Two-sample MR was undertaken using genome-wide association (GWA study data. The associations between the genetic instruments and BMI were obtained from the GIANT consortium and consisted of the per-allele difference in mean BMI for 77 independent variants that reached genome-wide significance. The per-allele difference in log-odds of PD for each of these variants was estimated from a recent meta-analysis, which included 13,708 cases of PD and 95,282 controls. The inverse-variance weighted method was used to estimate a pooled odds ratio (OR for the effect of a 5-kg/m2 higher BMI on PD. Evidence of directional pleiotropy averaged across all variants was sought using MR-Egger regression. Frailty simulations were used to assess whether causal associations were affected by mortality selection. A combined genetic IV expected to confer a lifetime exposure of 5-kg/m2 higher BMI was associated with a lower risk of PD (OR 0.82, 95% CI 0.69-0.98. MR-Egger regression gave similar results, suggesting that directional pleiotropy was unlikely to be biasing the result (intercept 0.002; p = 0.654. However, the apparent protective influence of higher BMI could be at least partially induced by survival bias in the PD GWA study, as demonstrated by frailty simulations. Other important limitations of this application of MR include the inability to analyse non-linear associations, to undertake subgroup analyses, and to gain mechanistic insights.In this large study using two-sample MR, we found that variants known to influence

  8. The association of inflammatory markers and periodontal indexes with the risk of coronary heart disease in Chinese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Chen, Ling; Wei, Bin; Xu, Liang; Wu, Yun

    2018-01-01

    The present study was designed to investigate the association of four inflammatory markers and five periodontal indexes with the risk of coronary heart disease (CHD) in 131 patients with type 2 diabetes mellitus (T2DM). All subjects were inpatients, including 63 T2DM patients with comorbid CHD ("cases") and 68 T2DM patients without CHD ("controls"). The diagnosis of CHD is based on coronary angiography. Peripheral blood concentrations of high sensitivity C-reactive protein (hs-CRP) (11.51 vs. 10.39 mg/L), leptin (24.60 vs. 21.22 ng/L) and visfatin (65.92 vs. 57.62 ng/L) were significantly higher in cases than in controls (P = .033, 0.041 and 0.041, respectively). The levels of three periodontal indexes - probing pocket depth, attachment loss (AL) and sulcus bleeding index, were significantly higher in cases than in controls, especially for periodontal AL (3.60 mm vs. 3.29 mm, P = .002). A Forward logistic regression was performed for selection, and specifically hs-CRP, leptin, visfatin and periodontal AL were found to be associated with the significant risk of CHD (odds ratio: 1.16, 1.07, 1.03 and 2.04; P = .025, .022, .022 and .010, respectively). Importantly, the benefits of inflammatory markers and periodontal indexes over basic risk factors were significant (likelihood ratio test) and obvious (decision curve analysis). A nomogram was delineated based on significant variables, and it had good accuracy (C-index: 0.801, P periodontal indexes to the pathogenesis of CHD in T2DM. Specifically, hs-CRP, leptin, visfatin and periodontal AL were identified as significant contributors. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Transmission risk of Trypanosoma cruzi in Metztitlán municipality from Hidalgo state, México, by characterization of domiciliary units and their entomologic indexes].

    Science.gov (United States)

    Becerril, Marco A; Angeles-Pérez, Vidal; Noguez-García, Julio Cr; Imbert-Palafox, José L

    2010-01-01

    In order to determine the risk of transmission of Trypanosoma cruzi by triatomines in Metztitlan municipality, Hidalgo State, Mexico, entomological indexes were calculated and the characteristics of dwellings were described. A transversal, retrospective, descriptive, and observational study was performed by means of an intentional not probabilistic and expertise sampling from January to December of 2005 in 10 localities in which presence of triatomines were investigated either intra or peridomestic environmental in 699 houses. Building material and presence of infected triatomines with T. cruzi were registered to determine entomologic indexes. The triatomine species collected were: Triatoma barberi (Usinger) and T. mexicana (Herrich-Schaeffer) (Hemiptera: Reduviidae). The results indicated that natural infection index varied from 7.7% to 50%; colonization index reached 80%; infestation index varied from 7.7% to 25%; dispersion index was 70%. Stone-walled houses were more infested. We can conclude that it is necessary to establish T. cruzi transmission control measures against triatomines in localities from Metztitlan, primarily in stone-walled houses where T. barberi occurs, as it was the most important vector species in the transmission of T. cruzi in this municipality.

  10. Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk.

    Science.gov (United States)

    Buscemi, Silvio; Cosentino, Loretta; Rosafio, Giuseppe; Morgana, Manuela; Mattina, Alessandro; Sprini, Delia; Verga, Salvatore; Rini, Giovam Battista

    2013-06-01

    The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk. Forty nondiabetic obese participants were randomly assigned to a three-month treatment with either a low glycemic index (LGI; n=19) or high glycemic index (HGI; n=21) hypocaloric diet with similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation (FMD) of the brachial artery before and after dieting. In addition, 48-h continuous subcutaneous glucose monitoring was done before and after dieting in a subgroup of 24 participants. The amount of weight loss after dieting was similar in both groups. The glycemic index of the diet significantly influenced the FMD (Pdiet, and -0.9±3.6% after the HGI diet (Pdiet on results was observed. The glycemic index of the diet significantly influenced the 48-h glycemic variability measured as coefficient of variability (CV%; Pdiet (from 23.5 to 20.0%) and increased after the HGI diet (from 23.6 to 26.6%). The change in percentage of FMD was inversely correlated with the change in the 48-h glycemic CV% (r=-0.45; Phypocaloric diet in nondiabetic obese persons. ISRCTN56834511. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  11. Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement

    DEFF Research Database (Denmark)

    Thornqvist, Catharina; Gislason, Gunnar H; Køber, Lars

    2014-01-01

    underwent elective primary hip or knee replacement surgery between 2005 and 2011. We used multivariable Cox regression models to calculate the 30-day risks of MACE and mortality associated with 5 BMI groups (underweight (BMI ...BACKGROUND AND PURPOSE: Obesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event...... (MACE: ischemic stroke, acute myocardial infarction, or cardiovascular death) or the risk of all-cause mortality in a nationwide Danish cohort of patients who underwent primary hip or knee replacement surgery. METHODS: Using Danish nationwide registries, we identified 34,744 patients aged ≥ 20 years who...

  12. White dwarf stars exceeding the Chandrasekhar mass limit

    Science.gov (United States)

    Tomaschitz, Roman

    2018-01-01

    The effect of nonlinear ultra-relativistic electron dispersion on the mass-radius relation of high-mass white dwarfs is studied. The dispersion is described by a permeability tensor in the Dirac equation, generated by the ionized high-density stellar matter, which constitutes the neutralizing background of the nearly degenerate electron plasma. The electron dispersion results in a stable mass-radius relation for high-mass white dwarfs, in contrast to a mass limit in the case of vacuum permeabilities. In the ultra-relativistic regime, the dispersion relation is a power law whose amplitude and scaling exponent is inferred from mass and radius estimates of two high-mass white dwarfs, Sirius B and LHS 4033. Evidence for the existence of super-Chandrasekhar mass white dwarfs is provided by several Type Ia supernovae (e.g., SN 2013cv, SN 2003fg, SN 2007if and SN 2009dc), whose mass ejecta exceed the Chandrasekhar limit by up to a factor of two. The dispersive mass-radius relation is used to estimate the radii, central densities, Fermi temperatures, bulk and compression moduli and sound velocities of their white dwarf progenitors.

  13. Modeling environmental noise exceedances using non-homogeneous Poisson processes.

    Science.gov (United States)

    Guarnaccia, Claudio; Quartieri, Joseph; Barrios, Juan M; Rodrigues, Eliane R

    2014-10-01

    In this work a non-homogeneous Poisson model is considered to study noise exposure. The Poisson process, counting the number of times that a sound level surpasses a threshold, is used to estimate the probability that a population is exposed to high levels of noise a certain number of times in a given time interval. The rate function of the Poisson process is assumed to be of a Weibull type. The presented model is applied to community noise data from Messina, Sicily (Italy). Four sets of data are used to estimate the parameters involved in the model. After the estimation and tuning are made, a way of estimating the probability that an environmental noise threshold is exceeded a certain number of times in a given time interval is presented. This estimation can be very useful in the study of noise exposure of a population and also to predict, given the current behavior of the data, the probability of occurrence of high levels of noise in the near future. One of the most important features of the model is that it implicitly takes into account different noise sources, which need to be treated separately when using usual models.

  14. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  15. Amino acid production exceeds plant nitrogen demand in Siberian tundra

    Science.gov (United States)

    Wild, Birgit; Eloy Alves, Ricardo J.; Bárta, Jiři; Čapek, Petr; Gentsch, Norman; Guggenberger, Georg; Hugelius, Gustaf; Knoltsch, Anna; Kuhry, Peter; Lashchinskiy, Nikolay; Mikutta, Robert; Palmtag, Juri; Prommer, Judith; Schnecker, Jörg; Shibistova, Olga; Takriti, Mounir; Urich, Tim; Richter, Andreas

    2018-03-01

    Arctic plant productivity is often limited by low soil N availability. This has been attributed to slow breakdown of N-containing polymers in litter and soil organic matter (SOM) into smaller, available units, and to shallow plant rooting constrained by permafrost and high soil moisture. Using 15N pool dilution assays, we here quantified gross amino acid and ammonium production rates in 97 active layer samples from four sites across the Siberian Arctic. We found that amino acid production in organic layers alone exceeded literature-based estimates of maximum plant N uptake 17-fold and therefore reject the hypothesis that arctic plant N limitation results from slow SOM breakdown. High microbial N use efficiency in organic layers rather suggests strong competition of microorganisms and plants in the dominant rooting zone. Deeper horizons showed lower amino acid production rates per volume, but also lower microbial N use efficiency. Permafrost thaw together with soil drainage might facilitate deeper plant rooting and uptake of previously inaccessible subsoil N, and thereby promote plant productivity in arctic ecosystems. We conclude that changes in microbial decomposer activity, microbial N utilization and plant root density with soil depth interactively control N availability for plants in the Arctic.

  16. Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance.

    Science.gov (United States)

    Du, Tingting; Yuan, Gang; Zhang, Muxun; Zhou, Xinrong; Sun, Xingxing; Yu, Xuefeng

    2014-10-20

    To directly compare traditional lipid ratios (total cholesterol [TC]/high density lipoprotein cholesterol [HDL-C], non-HDL-C/HDL-C, low density lipoprotein cholesterol [LDL-C]/HDL-C, and triglycerides [TG]/HDL-C), apolipoprotein B (apoB)/apolipoprotein A-I (apoA-I) ratio, visceral adiposity index (VAI), lipid accumulation product (LAP), and the product of TG and fasting glucose (TyG) for strength and independence as risk factors for insulin resistance (IR). We conducted a cross-sectional analysis of 7629 Chinese adults using data from the China Health and Nutrition Survey 2009. For all lipid ratios (traditional lipid ratios and apoB/apoA-I), among both sexes, TG/HDL-C explained the most additional percentage of variation in HOMA-IR (2.9% in men, and 2.3% in women); for all variables of interest, the variability in HOMA-IR explained by VAI and TG/HDL-C were comparable; TyG had the most significant association with HOMA-IR, which explained 9.1% for men and 7.8% for women of the variability in HOMA-IR. Logistic regression analysis showed the similar patterns. Receiver operating characteristic (ROC) curve analysis showed that, among both sexes, TG/HDL-C was a better discriminator of IR than apoB/apoA-I; the area under the ROC curve (AUC) for VAI (0.695 in men and 0.682 in women) was greater than that for TG/HDL-C (AUC 0.665 in men and 0.664 in women); TyG presented the greatest value of AUC (0.709 in men and 0.711 in women). The apoB/apoA-I performs no better than any of the traditional lipid ratios in correlating with IR. The TG/HDL-C, VAI and TyG are better markers for early identification of IR individuals.

  17. Evaluation of the clinical risk index in very low birth weight newborns at a public tertiary maternity in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Pedro Alexandre Breuel

    2007-12-01

    Full Text Available Objective: To evaluate the clinical risk index in very low birthweight newborns at a public maternity hospital, its associationwith mortality, some selected neonatal respiratory diseases andsurfactant therapy. Methods: A cohort prospective study carriedout at the Hospital Municipal Vila Nova Cachoeirinha e MaternidadeEscola, in São Paulo, Brazil. All newborns with gestational age< 31 weeks and birth weight < 1500 g were evaluated for theapplication of the clinical risk index for babies (CRIB. Newbornswho died in the first 12 hours of life or were referred from othermaternities were excluded from this study. Statistical analysesused logistic regression, Spearman correlation test and Student’st test. Results: Seventy-one cases were studied. The meangestational age was 27.30 ± 2.61 weeks; the mean weight was1032.61 ± 280.62 g. Birth weight and gestational age showedbetter predictive values for neonatal mortality than the clinicalrisk index for babies (80.30%, 76.10%, 73.20%. Twins showed nosignificant index differences (t = 0.601; p = 0.748. The scorewas inversely related to Apgar scores at 1 and 5 minutes and wasassociated with the respiratory distress syndrome, pneumothoraxand the use of surfactants. There was no significant correlation withchronic lung disease. Conclusion: The clinical risk index for babieswas not the best predictor for neonatal mortality as compared toweight and gestational age, but showed a significant associationwith 1 and 5-minute Apgar scores, respiratory distress syndrome,extrapulmonary air and the use of surfactants. It was not predictivefor chronic lung disease. Twins were not associated with CRIB.

  18. Derivation and Mapping of Critical Loads for Nitrogen and Trends in Their Exceedance in Germany

    Directory of Open Access Journals (Sweden)

    Hans-Dieter Nagel

    2001-01-01

    Full Text Available The term “critical load” means a quantitative estimate of an exposure to one or more pollutants below which significant harmful effects on specified sensitive elements of the environment do not occur, according to present knowledge. In the case of nitrogen, both oxidised and reduced compounds contribute to the total deposition of acidity, which exceeds critical loads in many forest ecosystems. These also cause negative effects through eutrophication. Critical loads of nitrogen were derived for forest soils (deciduous and coniferous forest, natural grassland, acid fens, heathland, and mesotrophic peat bogs. In Germany, a decrease in sulphur emissions over the past 15 years resulted in a reduced exceedance of critical loads for acid deposition. In the same period it was noted that reduction in the emissions of nitrogen oxides and ammonia remained insignificant. Therefore, emissions of nitrogen compounds have become relatively more important and will continue to threaten ecosystem function and stability. The risk of environmental damage remains at an unacceptable level. The German maps show the degree to which the critical loads are exceeded, and they present current developments and an expected future trend. Results indicate that recovery from pollutant stress occurs only gradually.

  19. Lifestyle index and work ability.

    Science.gov (United States)

    Kaleta, Dorota; Makowiec-Dabrowska, Teresa; Jegier, Anna

    2006-01-01

    In many countries around the world, negative changes in lifestyles are observed. The aim of this study was to analyze the influence of selected lifestyle indicators on work ability among professionally active individuals. The study was performed in the randomly selected group of full-time employees (94 men and 93 women) living in the city of Lódź. Work ability was measured with the work ability index and lifestyle characteristic was assessed with the healthy lifestyle index. We analyzed four lifestyle indicators: non-smoking, healthy weight, fiber intake per day, and regular physical activity. Logistic regression was used to estimate odds ratios and 95% confidence intervals to control the effects of lifestyle and work ability. The analysis of lifestyle index indicated that 27.7, 30.9, 27.7 and 11.7% of men and 15.1, 21.5, 35.5 and 26.9% of women scored 0, 1, 2, 3 points, respectively. Only 2.1% of men and 1.1% of women met the criteria for the healthy lifestyle (score 4). Work ability was excellent, good and moderate in 38.3, 46.8 and 14.9% of men, and in 39.8, 14.9 and 19.3% of women, respectively. Poor work ability was found in 9.7% women. Work ability was strongly associated with lifestyle in both men and women. Among men with index score = 0, the risk of moderate work ability was nearly seven times higher than in men whose lifestyle index score exceeded 1 or more points (OR = 6.67; 95% CI: 1.94-22.90). Among women with lifestyle index score = 0, the risk of moderate or lower work ability was also highly elevated as compared to those with lifestyle index = 1 or higher (OR = 14.44; 95% CI: 3.53-59.04). Prophylactic schedules associated with the improvement of lifestyles should be addressed to all adults. Future programs aimed at increasing work ability should consider work- and lifestyle-related factors.

  20. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study

    OpenAIRE

    Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

    2014-01-01

    Background It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. Methods A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample inclu...

  1. Did European temperatures in 1540 exceed present-day records?

    Science.gov (United States)

    Orth, Rene; Vogel, Martha M.; Luterbacher, Jürg; Pfister, Christian; Seneviratne, Sonia I.

    2017-04-01

    There is strong evidence that the year 1540 was exceptionally dry and warm in Central Europe. Here we infer 1540 summer temperatures from the number of dry days (NDDs) in spring (March-May) and summer (June-August) in 1540 derived from historical documentary evidence published elsewhere, and compare our estimates with present-day temperatures. We translate the NDD values into temperature distributions using a linear relationship between modeled temperature and NDD from a 3000 year pre-industrial control simulation with the Community Earth System Model (CESM). Our results show medium confidence that summer mean temperatures (T JJA) and maximum temperatures (TXx) in Central Europe in 1540 were warmer than the respective present-day mean summer temperatures (assessed between 1966-2015). The model-based reconstruction suggests further that with a probability of 40%-70%, the highest daily temperatures in 1540 were even warmer than in 2003, while there is at most a 20% probability that the 1540 mean summer temperature was warmer than that of 2003 in Central Europe. As with other state-of-the-art analyses, the uncertainty of the reconstructed 1540 summer weather in this study is considerable, for instance as extrapolation is required because 1540-like events are not captured by the employed Earth system model (ESM), and neither by other ESMs. However, in addition to paleoclimatological approaches we introduce here an independent methodology to estimate 1540 temperatures, and contribute consequently to a reduced overall uncertainty in the analysis of this event. The characterization of such events and the related climate system functioning is particularly relevant in the context of global warming and the corresponding increase of extreme heat wave magnitude and occurrence frequency. Orth, R., M.M. Vogel, J. Luterbacher, C. Pfister, and S.I. Seneviratne, (2016): Did European temperatures in 1540 exceed present-day records? Env. Res. Lett., 11, 114021, doi: 10.1088/1748-9326/11/11/114021

  2. Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.

    Science.gov (United States)

    Suria, Stéphanie; Wyniecki, Anne; Eghiaian, Alexandre; Monnet, Xavier; Weil, Grégoire

    2014-01-01

    Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown. We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded. 23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (-0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period. The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge. clinicaltrials.gov NCT02063009.

  3. Risk of Breast Cancer in Relation to Combined Effects of Hormone Therapy, Body Mass Index, and Alcohol Use, by Hormone-receptor Status

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Tjonneland, Anne; Keiding, Niels

    2015-01-01

    BACKGROUND: Alcohol consumption, increased body mass index (BMI), and hormone therapy are risk factors for postmenopausal breast cancer, but their combined effects are not well understood. Because hormone therapy is effective for the relief of menopausal symptoms, the identification of "high......,789 women ages 50+ years (study period 1981 to 2009). Information on risk factors was obtained in baseline questionnaires. We performed analyses using the Aalen additive hazards model. Serum estradiol and testosterone measurements were obtained in a subsample of approximately 1000 women. RESULTS: During 392...

  4. Health, safety and environment risk assessment in gas pipelines by indexing method:case of Kermanshah Sanandaj oil pipeline

    OpenAIRE

    Y. Hamidi; I. Mohamadfam; M. Motamedzadeh

    2009-01-01

    Background and AimsUsing pipelines for oil products transportation involves ranges of safety, health and environmental risks, this option however, is dominant with numerous  advantages. The purpose of this study was; relative risk assessment of abovementioned risk in Kermanshah-Sanandaj Oil Pipeline.MethodsThe method used in this study was Kent Muhlbauer method in which relative risk was assessed using third-party damage, corrosion, design, incorrect operations and leak impact  factor.Results...

  5. Intrinsic clotting factors in dependency of age, sex, body mass index, and oral contraceptives: definition and risk of elevated clotting factor levels.

    Science.gov (United States)

    Luxembourg, Beate; Schmitt, Joern; Humpich, Marek; Glowatzki, Matthias; Seifried, Erhard; Lindhoff-Last, Edelgard

    2009-10-01

    Elevated clotting factors have been demonstrated to be a risk factor for venous thromboembolism (VTE). The aim of our study was to investigate the impact of age, sex, body mass index, and oral contraceptives on the clotting factor activities of factors VIII, IX, XI, and XII and their impact on the cutoff definition and risk of VTE associated with elevated clotting factors. Factor VIII, IX, XI, and XII activities were measured in 499 blood donors and 286 patients with VTE. Age and body mass index predicted significantly and independently the clotting factor activities of factors VIII, IX, and XI, whereas use of oral contraceptives predicted factor IX, XI, and XII levels. Percentiles of clotting factor activities, which are often used for the cutoff definition of elevated clotting factors, varied due to the effect of age, body mass index, and oral contraceptives. The adjusted odds ratios for VTE were 10.3 [95% confidence interval (CI) 5.1-20.7], 6.1 (95% CI 3.1-12.0), and 3.3 (95% CI 1.9-5.8) for elevated factors VIII, IX, and XI, respectively. Furthermore, our study demonstrates for the first time that elevated factor XII is associated with an increased risk of VTE (adjusted odds ratio 2.9, 95% CI 1.6-5.3).

  6. Family history and body mass index predict perceived risks of diabetes and heart attack among community-dwelling Caucasian, Filipino, Korean, and Latino Americans--DiLH Survey.

    Science.gov (United States)

    Fukuoka, Yoshimi; Choi, JiWon; S Bender, Melinda; Gonzalez, Prisila; Arai, Shoshana

    2015-07-01

    The purpose of the study was to explore the perceived risk for diabetes and heart attack and associated health status of Caucasian, Filipino, Korean, and Latino Americans without diabetes. A cross-sectional survey was conducted with 904 urban adults (mean age 44.3±16.1 years; 64.3% female) in English, Spanish or Korean between August and December 2013. Perceived risk for developing diabetes was indicated by 46.5% (n=421), and 14.3% (n=129) perceived themselves to be at risk for having a heart attack in their lifetime. Significant predictors of pessimistic diabetes risk perceptions: Filipino (adjusted odds ratio [AOR]=1.7; 95% CI: 1.04-2.86) and Korean (AOR=2.4; 1.33-4.48) ethnicity, family history of diabetes (AOR=1.4; 1.00-1.84), female gender (AOR=1.4; 1.04-1.96), high cholesterol (AOR= 1.6; 1.09-2.37) and higher body mass index (BMI) (AOR=1.1; 1.08-1.15). Predictors of pessimistic heart attack risk perceptions were family history of an early heart attack (AOR=2.9; 1.69-5.02), high blood pressure (AOR=2.4; 1.45-3.84), and higher BMI (AOR=1.1; 1.04-1.12) after controlling for socio-demographic factors. Older age, physical inactivity, smoking, and low HDL levels were not associated with risk perceptions. Multiple risk factors were predictive of greater perceived diabetes risk, whereas, only family history of heart attack, high blood pressure and increases in BMI significantly contributed to perceived risk of heart attack among ethnically diverse at risk middle-aged adults. It is important that healthcare providers address the discordance between an individual's risk perceptions and the presence of actual risk factors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Cardiac risk index as a simple geometric indicator to select patients for the heart-sparing radiotherapy of left-sided breast cancer

    International Nuclear Information System (INIS)

    Sung, KiHoon; Choi, Young Eun; Lee, Kyu Chan

    2017-01-01

    This is a dosimetric study to identify a simple geometric indicator to discriminate patients who meet the selection criterion for heart-sparing radiotherapy (RT). The authors proposed a cardiac risk index (CRI), directly measurable from the CT images at the time of scanning. Treatment plans were regenerated using the CT data of 312 consecutive patients with left-sided breast cancer. Dosimetric analysis was performed to estimate the risk of cardiac mortality using cardiac dosimetric parameters, such as the relative heart volumes receiving ≥25 Gy (heart V 25 ). For each CT data set, in-field heart depth (HD) and in-field heart width (HW) were measured to generate the geometric parameters, including maximum HW (HW max ) and maximum HD (HD max ). Seven geometric parameters were evaluated as candidates for CRI. Receiver operating characteristic (ROC) curve analyses were used to examine the overall discriminatory power of the geometric parameters to select high-risk patients (heart V 25 ≥ 10%). Seventy-one high-risk (22.8%) and 241 low-risk patients (77.2%) were identified by dosimetric analysis. The geometric and dosimetric parameters were significantly higher in the high-risk group. Heart V 25 showed the strong positive correlations with all geometric parameters examined (r > 0.8, p < 0.001). The product of HD max and HW max (CRI) revealed the largest area under the curve (AUC) value (0.969) and maintained 100% sensitivity and 88% specificity at the optimal cut-off value of 14.58 cm 2 . Cardiac risk index proposed as a simple geometric indicator to select high-risk patients provides useful guidance for clinicians considering optimal implementation of heart-sparing RT.

  8. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    OpenAIRE

    Knowles, K. M.; Paiva, L. L.; Sanchez, S. E.; Revilla, L.; Lopez, T.; Yasuda, M. B.; Yanez, N. D.; Gelaye, B.; Williams, M. A.

    2011-01-01

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric mea...

  9. Comparison of Oncotype DX® Recurrence Score® with other risk assessment tools including the Nottingham Prognostic Index in the identification of patients with low-risk invasive breast cancer.

    Science.gov (United States)

    Cotter, Maura Bríd; Dakin, Alex; Maguire, Aoife; Walshe, Janice M; Kennedy, M John; Dunne, Barbara; Riain, Ciarán Ó; Quinn, Cecily M

    2017-09-01

    Oncotype DX® is a gene expression assay that quantifies the risk of distant recurrence in patients with hormone receptor positive early breast cancer, publicly funded in Ireland since 2011. The aim of this study was to correlate Oncotype DX® risk groupings with traditional histopathological parameters and the results of other risk assessment tools including Recurrence Score-Pathology-Clinical (RSPC), Adjuvant Risk Index (Adj RI), Nottingham Prognostic Index (NPI) and the Adjuvant! Online 10-year score (AO). Patients were retrospectively identified from the histopathology databases of two Irish hospitals and patient and tumour characteristics collated. Associations between categorical variables were evaluated with Pearson's chi-square test. Correlations were calculated using Spearman's correlation coefficient and concordance using Lin's concordance correlation coefficient. Statistical analysis was performed using SPSS software, version 22.0.In our 300 patient cohort, Oncotype DX® classified 59.7% (n = 179) as low, 30% (n = 90) as intermediate, and 10.3% (n = 31) as high risk. Overall concordance between the RS and RSPC, Adj RI, NPI, and AO was 67.3% (n = 202), 56.3% (n = 169), 59% (n = 177), and 36.3% (n = 109), respectively. All risk assessment tools classified the majority of patients as low risk apart from the AO 10-year score, with RSPC classifying the highest number of patients as low risk. This study demonstrates that there is good correlation between the RS and scores obtained using alternative risk tools. Concordance with NPI is strong, particularly in the low-risk group. NPI, calculated from traditional clinicopathological characteristics, is a reliable alternative to Oncotype DX® in the identification of low-risk patients who may avoid adjuvant chemotherapy.

  10. Susceptibility of forests in the northeastern USA to nitrogen and sulfur deposition: critical load exceedance and forest health

    Science.gov (United States)

    N. Duarte; L.H. Pardo; M.J. Robin-Abbott

    2013-01-01

    The objectives of this study were to assess susceptibility to acidification and nitrogen (N) saturation caused by atmospheric deposition to northeastern US forests, evaluate the benefits and shortcomings of making critical load assessments using regional data, and assess the relationship between expected risk (exceedance) and forest health. We calculated the critical...

  11. A retrospective cohort study on the influence of UV index and race/ethnicity on risk of stress and lower limb fractures.

    Science.gov (United States)

    Montain, Scott J; McGraw, Susan M; Ely, Matthew R; Grier, Tyson L; Knapik, Joseph J

    2013-04-12

    Low vitamin D status increases the risk of stress fractures. As ultraviolet (UV) light is required for vitamin D synthesis, low UV light availability is thought to increase the risk of vitamin D insufficiency and poor bone health. The purpose of this investigation was to determine if individuals with low UV intensity at their home of record (HOR) or those with darker complexions are at increased risk of developing stress fractures and lower limb fractures during U.S. Army Basic Combat Training (BCT). This was a retrospective cohort study using the Armed Forces Health Surveillance Center data repository. All Basic trainees were identified from January 1997 to January 2007. Cases were recruits diagnosed with stress fractures and lower limb fractures during BCT. The recruit's home of record (HOR) was identified from the Defense Manpower Data Center database. The average annual UV intensity at the recruits' HOR was determined using a U.S National Weather Service database and recruits were stratified into low (≤3.9); moderate (4.0-5.4), and high (≥5.5) UV index regions. Race was determined from self-reports. The dataset had 421,461 men and 90,141 women. Compared to men, women had greater risk of developing stress fractures (odds ratio (OR) = 4.5, 95% confidence interval (95%CI) = 4.4-4.7, p lower risk of stress fractures (male OR (low UV/high UV) = 0.92, 95%CI = 0.87-0.97; females OR = 0.89, 95%CI = 0.84-0.95, p lower limb fractures (male OR = 0.98, 95%CI = 0.89-1.07; female OR = 0.93, 95%CI = 0.80-1.09) than recruits from high UV index areas. Blacks had lower risk of stress and lower limb fractures than non-blacks, and there was no indication that Blacks from low UV areas were at increased risk for bone injuries. The UV index at home of record is not associated with stress or lower limb fractures in BCT. These data suggest that UV intensity is not a risk factor for poor bone health in younger American adults.

  12. A continuation of the Asia-Pacific Risk Index for natural disasters: extending the record for an updated analysis from 1900-2015

    Science.gov (United States)

    Daniell, James; Daniell, Trevor; Daniell, Katherine; Khazai, Bijan; Schaefer, Andreas; Wenzel, Friedemann

    2016-04-01

    In 2010, an Asia-Pacific risk index was created for the CECAR5 (Civil Engineering Conference for the Asia-Pacific Region) by Daniell et al. (2010a) for floods and earthquakes, using empirical and analytical risk data for direct as well as socio-economic community vulnerability. The socio-economic situation of countries can aggravate the physical risk of natural disaster impacts, as demonstrated by the impacts of earthquakes in Christchurch and Tohoku 2011; add to this a number of deadly typhoon (Haiyan 2013), cyclone (Yasi 2011), flood (Thailand 2011), bushfire and weather effects, and significant changes to the index in 2010 have been seen. At least 10,000 historical events have been recorded since 1900 across the Asia-Pacific region (western Pacific). The database for global socio-economic indicators was produced to allow comparison of countries in terms of their socio-economic situation for use in risk studies. In addition, a global damaging natural disasters database (CATDAT) has been created over the last 14 years to better understand the historical impact of natural disasters on the Asia-Pacific region as well as globally. Simplified hazard models have been used in conjunction with historical damage data added to human exposure. Post-flood and post-typhoon loss models have been produced this methodology. The relative country level rural and urban building inventories and historical building trends are used to define levels of vulnerability, exposure and hazard. From this, physical and community risk indices are derived for the countries of the Asia-Pacific region. It was found that the vulnerabilities in communities of developing countries such as Indonesia and the Philippines can further intensify the impact from direct damages by many times, showing the increased need for earthquake and flood risk reduction policy. Trends based on HDI and other indicators within the fields of economy, poverty, demographics, governance and environment are also presented

  13. Validated Alzheimer's Disease Risk Index (ANU-ADRI) is associated with smaller volumes in the default mode network in the early 60s.

    Science.gov (United States)

    Cherbuin, Nicolas; Shaw, Marnie E; Walsh, Erin; Sachdev, Perminder; Anstey, Kaarin J

    2017-12-14

    Strong evidence is available suggesting that effective reduction of exposure to demonstrated modifiable risk factors in mid-life or before could significantly decrease the incidence of Alzheimer's disease (AD) and delay its onset. A key ingredient to achieving this goal is the reliable identification of individuals at risk well before they develop clinical symptoms. The aim of this study was to provide further neuroimaging evidence of the effectiveness of a validated tool, the ANU Alzheimer's Disease Risk Index, for the assessment of future risk of cognitive decline. Participants were 461 (60-64 years, 48% female) community-living individuals free of dementia at baseline. Associations between risk estimates obtained with the ANU-ADRI, total and regional brain volumes including in the default mode network (DMN) measured at the same assessment and diagnosis of MCI/dementia over a 12-year follow-up were tested in a large sample of community-living individuals free of dementia at baseline. Higher risk estimates on the ANU-ADRI were associated with lower cortical gray matter and particularly in the DMN. Importantly, difference in participants with high and low risk scores explained 7-9% of the observed difference in gray matter volume. In this sample, every one additional risk point on the ANU-ADRI was associated with an 8% increased risk of developing MCI/dementia over a 12-year follow-up and this association was partly mediated by a sub-region of the DMN. Risk of cognitive decline assessed with a validated instrument is associated with gray matter volume, particularly in the DMN, a region known to be implicated in the pathological process of the disease.

  14. Body Mass Index, Self-Esteem, and Suicide Risk in Clinically Depressed African American and White American Females.

    Science.gov (United States)

    Palmer, Charles James, Jr.

    2003-01-01

    Assessed whether clinically depressed healthy-weight, overweight, and obese females would differ on self-esteem and suicide risk measures. Data on clinically depressed females from an inpatient psychiatric unit indicated that the three groups did not differ significantly on measures of self-esteem and suicide risk, but depressed, obese, white…

  15. [Relationship between the triglyceride/high-density lipoprotein-cholesterol ratio, insulin resistance index and cardiometabolic risk factors in women with polycystic ovary syndrome].

    Science.gov (United States)

    Roa Barrios, Marlene; Arata-Bellabarba, Gabriela; Valeri, Lenin; Velázquez-Maldonado, Elsy

    2009-02-01

    To evaluate the relationship between the triglyceride/high density lipoprotein cholesterol (TG/HDL-c) ratio, insulin resistance index and cardiometabolic risk factors in women with polycystic ovary syndrome (PCOS). The present crosssectional study analyzed 62 women with PCOS and 48 healthy women (control group) aged 17- 35 years old. Body mass index (BMI), waist circumference (WC) and blood pressure were registered. Plasma concentrations of glucose, insulin, triglycerides, total cholesterol and HDL-c were measured. TheTG/HDL-c ratio, homeostasis model assessment for insulin resistance (HOMA(IR)) and quantitative insulin sensitivity check index (QUICKI) were calculated. Women with PCOS showed significantly higher values of the TG/HDL-c ratio and HOMA(IR), and a significantly lower QUICKI value. These differences were related to BMI and WC, with the highest values being observed in obese patients. The 50th percentile for the TG/HDL-c ratio was 3.64; the TG/cHDL ratio was positively correlated with BMI, WC and HOMA(IR) (r=0.48, pglucose > 100 mg/dl (10% vs 3%; ptriglycerides>150 mg/dl (55% vs 20%; p80 cm (82.3% vs 43.8%; pindexes (HOMA(IR), QUICKI). The TG/HDL-c ratio could be considered as a useful and practical method to identify an increased risk of cardiovascular disease in patients with PCOS.

  16. Added sugars and sugar-sweetened beverage consumption, dietary carbohydrate index and depression risk in the Seguimiento Universidad de Navarra (SUN) Project.

    Science.gov (United States)

    Sanchez-Villegas, Almudena; Zazpe, Itziar; Santiago, Susana; Perez-Cornago, Aurora; Martinez-Gonzalez, Miguel A; Lahortiga-Ramos, Francisca

    2018-01-01

    The association between added sugars or sugar-sweetened beverage consumption and the risk of depression, as well as the role of carbohydrate quality in depression risk, remains unclear. Among 15 546 Spanish university graduates from the Seguimiento Universidad de Navarra (SUN) prospective cohort study, diet was assessed with a validated 136-item semi-quantitative FFQ at baseline and at 10-year follow-up. Cumulative average consumption of added sugars, sweetened drinks and an overall carbohydrate quality index (CQI) were calculated. A better CQI was associated with higher whole-grain consumption and fibre intake and lower glycaemic index and consumption of solid (instead of liquid) carbohydrates. Clinical diagnoses of depression during follow-up were classified as incident cases. Multivariable time-dependent Cox regression models were used to estimate hazard ratios (HR) of depression according to consumption of added sugars, sweetened drinks and CQI. We observed 769 incident cases of depression. Participants in the highest quartile of added sugars consumption showed a significant increment in the risk of depression (HR=1·35; 95 % CI 1·09, 1·67, P=0·034), whereas those in the highest quartile of CQI (upper quartile of the CQI) showed a relative risk reduction of 30 % compared with those in the lowest quartile of the CQI (HR=0·70; 95 % CI 0·56, 0·88). No significant association between sugar-sweetened beverage consumption and depression risk was found. Higher added sugars and lower quality of carbohydrate consumption were associated with depression risk in the SUN Cohort. Further studies are necessary to confirm the reported results.

  17. Diet and endometrial cancer: a focus on the role of fruit and vegetable intake, Mediterranean diet and dietary inflammatory index in the endometrial cancer risk.

    Science.gov (United States)

    Ricceri, Fulvio; Giraudo, Maria Teresa; Fasanelli, Francesca; Milanese, Dario; Sciannameo, Veronica; Fiorini, Laura; Sacerdote, Carlotta

    2017-11-13

    Endometrial cancer is the fourth most common cancer in European women. The major risk factors for endometrial cancer are related to the exposure of endometrium to estrogens not opposed to progestogens, that can lead to a chronic endometrial inflammation. Diet may play a role in cancer risk by modulating chronic inflammation. In the framework of a case-control study, we recruited 297 women with newly diagnosed endometrial cancer and 307 controls from Northern Italy. Using logistic regression, we investigated the role of fruit and vegetable intake, adherence to the Mediterranean diet (MD), and the dietary inflammatory index (DII) in endometrial cancer risk. Women in the highest quintile of vegetable intake had a statistically significantly lower endometrial cancer risk (adjusted OR 5th quintile vs 1st quintile: 0.34, 95% CI 0.17-0.68). Women with high adherence to the MD had a risk of endometrial cancer that was about half that of women with low adherence to the MD (adjusted OR: 0.51, 95% CI 0.39-0.86). A protective effect was detected for all the lower quintiles of DII, with the highest protective effect seen for the lowest quintile (adjusted OR 5th quintile vs 1st quintile: 3.28, 95% CI 1.30-8.26). These results suggest that high vegetable intake, adherence to the MD, and a low DII are related to a lower endometrial cancer risk, with several putative connected biological mechanisms that strengthen the biological plausibility of this association.

  18. Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects?

    Directory of Open Access Journals (Sweden)

    Lu Liping

    2011-01-01

    Full Text Available Abstract Background Obesity is associated with metabolic risk factors. Body mass index (BMI, waist circumference, waist-hip ratio (WHR and waist-height ratio (WHtR are used to predict the risk of obesity related diseases. However, it has not been examined whether these four indicators can detect the clustering of metabolic risk factors in Chinese subjects. Methods There are 772 Chinese subjects in the present study. Metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were identified according to the criteria from WHO. All statistical analyses were performed separately according to sex by using the SPSS 12.0. Results BMI, waist circumference and WHtR values were all significantly associated with blood pressure, glucose, triglyceride and also with the number of metabolic risk factors in both male and female subjects (all of P Conclusion The BMI, waist circumference and WHtR values can similarly predict the presence of multiple metabolic risk factors in Chinese subjects.

  19. Sublethal effects of catch-and-release fishing: measuring capture stress, fish impairment, and predation risk using a condition index

    Science.gov (United States)

    Campbell, Matthew D.; Patino, Reynaldo; Tolan, J.M.; Strauss, R.E.; Diamond, S.

    2009-01-01

    The sublethal effects of simulated capture of red snapper (Lutjanus campechanus) were analysed using physiological responses, condition indexing, and performance variables. Simulated catch-and-release fishing included combinations of depth of capture and thermocline exposure reflective of environmental conditions experienced in the Gulf of Mexico. Frequency of occurrence of barotrauma and lack of reflex response exhibited considerable individual variation. When combined into a single condition or impairment index, individual variation was reduced, and impairment showed significant increases as depth increased and with the addition of thermocline exposure. Performance variables, such as burst swimming speed (BSS) and simulated predator approach distance (AD), were also significantly different by depth. BSSs and predator ADs decreased with increasing depth, were lowest immediately after release, and were affected for up to 15 min, with longer recovery times required as depth increased. The impairment score developed was positively correlated with cortisol concentration and negatively correlated with both BSS and simulated predator AD. The impairment index proved to be an efficient method to estimate the overall impairment of red snapper in the laboratory simulations of capture and shows promise for use in field conditions, to estimate release mortality and vulnerability to predation.

  20. Health, safety and environment risk assessment in gas pipelines by indexing method:case of Kermanshah Sanandaj oil pipeline

    Directory of Open Access Journals (Sweden)

    Y. Hamidi

    2009-10-01

    Full Text Available Background and AimsUsing pipelines for oil products transportation involves ranges of safety, health and environmental risks, this option however, is dominant with numerous  advantages. The purpose of this study was; relative risk assessment of abovementioned risk in Kermanshah-Sanandaj Oil Pipeline.MethodsThe method used in this study was Kent Muhlbauer method in which relative risk was assessed using third-party damage, corrosion, design, incorrect operations and leak impact  factor.ResultsOnce applying this method, collection of required data and performing needed experiments, scoring results showed 96 risk segments along the pipeline length in which lengths 100+860, 101+384 and 103+670 had relative risk scores 9.74, 9.82 and 9.91 respectively and therefore these segments were identified as focal risk points and priority for improvement actions.ConclusionRegarding importance of pipeline failure, inspection and regular patrol along the pipeline route, precise control of cathodic protection of pipeline and using communication technologies such as SCADA or optical fibers along the pipeline route were amongst the mostimportant control action suggested by the study.

  1. Statistical modeling of complex health outcomes and air pollution data: Application of air quality health indexing for asthma risk assessment

    Directory of Open Access Journals (Sweden)

    Swarna Weerasinghe

    2017-03-01

    Conclusion:  This study demonstrated the importance of complex statistical model use and the consequences of lack of such modelling that accounted for data structures in public health risk assessments.

  2. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Rahman, M M; Abe, S K; Kanda, M; Narita, S; Rahman, M S; Bilano, V; Ota, E; Gilmour, S; Shibuya, K

    2015-09-01

    We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index (BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. PubMed, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27), low birthweight (OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age (OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk (PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries. © 2015 World Obesity.

  3. Serum Alanine Aminotransferase Levels within Normal Range Have Different Associations with Augmentation Index and Other Cardiometabolic Risk Factors in Nondrinkers and Drinkers: A Chinese Community-Based Analysis

    Directory of Open Access Journals (Sweden)

    Shihui Fu

    2017-01-01

    Full Text Available Background. To investigate whether serum alanine aminotransferase (ALT levels within normal range were associated with augmentation index (AIx and cardiometabolic risk factors in nondrinkers and drinkers in Chinese community-dwelling population. Methods. There were 4165 participants with serum ALT levels within normal range. Results. Alcohol drinking was observed in 1173 participants (28.2%. In multivariate analysis, serum ALT levels of nondrinkers were independently associated with age, sex, body mass index (BMI, hypertension, diabetes mellitus, diastolic blood pressure, triglyceride, low-density lipoprotein-cholesterol (LDL-c, and AIx, while serum ALT levels of drinkers were independently associated with age, sex, BMI, triglyceride, and LDL-c (p<0.05 for all. Conclusions. Associations of serum ALT levels within normal range with age, sex, body height and weight, and blood lipid were simultaneously present in participants with and without alcohol drinking, while associations of serum ALT levels within normal range with AIx, blood pressure, and glucose were seen in nondrinkers rather than in drinkers. These findings not only provide the evidence that serum ALT levels, even within the normal range, have different associations with arteriosclerosis and cardiometabolic risk factors in nondrinkers and drinkers but also are helpful in understanding the underlying pathophysiologic mechanisms linking the hepatic function to arteriosclerosis and cardiometabolic risk factors.

  4. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study.

    Science.gov (United States)

    Kiuchi, Aki; Ohashi, Yasushi; Tai, Reibin; Aoki, Toshiyuki; Mizuiri, Sonoo; Ogura, Toyoko; Aikawa, Atsushi; Sakai, Ken

    2016-10-23

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients ( r = -0.33, p protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61-15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  5. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    Directory of Open Access Journals (Sweden)

    Aki Kiuchi

    2016-10-01

    Full Text Available Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9% had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = −0.33, p < 0.001 and those with lower glomerular filtration rate (r = 0.47, p < 0.001. The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR = 4.94; 95% confidence interval (CI = 1.61–15.42, p = 0.012 and cardiovascular events (HR = 9.37; 95% CI = 2.49–37.34, p = 0.006, but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  6. Relation of body mass index to risk of developing inflammatory bowel disease amongst women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Mendall, Michael; Harpsøe, Maria Christina; Kumar, Devinder

    2018-01-01

    BACKGROUND: Crohn's disease (CD) has traditionally been associated with weight loss and low BMI, yet paradoxically obesity has recently been suggested as a risk factor for CD, but not for ulcerative colitis (UC). We therefore hypothesized that the relation between BMI and CD is U shaped. AIM...... diagnosed at age 18-weight subjects as the reference, adjusted HRs for risk of developing CD (at age 18-

  7. How to Manage the Mortgage Credit Risk in Turkey? Can Dual-indexed Mortgages be a Remedy?

    OpenAIRE

    Ali Alp; M. Mete Doganay

    2009-01-01

    A market-oriented housing finance system has been under discussion in Turkey recently. In this article we analyze different types of mortgages that have been used in developed and developing countries to select the one that is most appropriate for Turkey-one which minimizes risks for both lenders and borrowers. Each type of mortgage presents different risks to borrowers and lenders. After taking into consideration the economic history of Turkey, we conclude that the most appropriate mortgage ...

  8. Effect of the Apulia air quality plan on PM10 and benzo(apyrene exceedances

    Directory of Open Access Journals (Sweden)

    L. Trizio

    2016-03-01

    Full Text Available During the last years, several exceedances of PM10 and benzo(apyrene limit values exceedances were recorded in Taranto, a city in southern Italy included in so-called areas at high risk of environmental crisis because of the presence of a heavy industrial district including the largest steel factory in Europe. A study of these critical pollution events showed a close correlation with the wind coming from the industrial site to the adjacent urban area. During 2011, at monitoring sites closes to the industrial area, at least the 65% of PM10 exceedances were related to wind day conditions (characterized by at least 3 consecutive hours of wind coming from 270-360±2deg with an associated speed higher than 7 m/s. For this reason, in 2012 an integrated environmental permit and a regional air quality plan were enacted to reduce pollutant emissions from industrial plants. A study of PM10 levels registered during windy days was performed during critical episodes of pollution highlighting that the difference between windy days and no windy days’ concentrations reduces from 2012 to 2014 in industrial site. False negative events (verified ex-post by observed meteorological data not identified by the forecast model - did not show a significant influence on PM concentration: PM10 values were comparable and sometimes lower than windy days levels. It is reasonable that the new scenario with a relevant reduction emissions form Ilva plant reduced the pollutants contribution from industrial area, contributing to PM10 levels decrease, also in false negative events.

  9. Biodex Fall Risk Assessment in the Elderly With Ataxia: A New Age-Dependent Derived Index in Rehabilitation: An Observational Study.

    Science.gov (United States)

    Prometti, Paola; Olivares, Adriana; Gaia, Giuseppina; Bonometti, Giampietro; Comini, Laura; Scalvini, Simonetta

    2016-03-01

    The aim of this study was to evaluate if the Biodex Fall Risk Assessment could provide an age-adjusted index useful for classifying patients at "risk of fall."This was a cohort study conducted on 61 chronic patients, in stable conditions, having a history of ataxia, difficulty in walking or loss of balance, and aged >64 years. These patients were coming from home to our Institute undergoing a period of in-hospital standard rehabilitation. Assessment of clinical parameters was performed at entry. Functional scales (Functional Independence Measure [FIM] for motor and cognitive function, Barthel G, Tinetti POMA), and the Biodex Fall Risk Index (FRI) were performed at entry and discharge. The Normalized FRI, obtained adjusting FRI to the reported maximum predictive FRI for the relevant age, identified 2 types of patients: those with a greater risk of fall than expected for that age, labeled Case 1 (Normalized FRI>1); and those with an equal or even lesser risk of fall than expected for that age, labeled Case 0 (Normalized FRI≤1).FRI, Normalized FRI as well as independent variables as age, sex, pathology group, FIM, BarthelG, were considered in a multiple regression analysis to predict the functional improvement (i.e., delta Tinetti Total score) after rehabilitation.Normalized FRI is useful in assessing patients at risk of falls both before and after rehabilitation. At admission, the Normalized FRI evidenced high fall risk in 46% of patients (Case 1) which decreased to 12% after rehabilitation, being greater than age-predicted in 7 patients (Case 1-1) despite the functional improvement observed after the rehabilitation treatment. Normalized FRI evidenced Case 1-1 patients as neurological, "very old" (86% in age-group 75-84 years), and with serious events at 18 to 24 months' follow-up. Normalized FRI, but not FRI, at admission was a predictor of improvement in Tinetti Total scores.The normalized FRI effectively indicated patients at higher risk of fall, in whom health

  10. ABSI (A Body Shape Index) and ARI (Anthropometric Risk Indicator) in Bariatric Surgery. First Application on a Bariatric Cohort and Possible Clinical Use.

    Science.gov (United States)

    Consalvo, Vincenzo; Krakauer, Jesse C; Krakauer, Nir Y; Canero, Antonio; Romano, Mafalda; Salsano, Vincenzo

    2018-01-29

    BMI (body mass index) is used to identify candidates for bariatric surgery, with a criterion of BMI ≥ 40. For lesser degrees of obesity, BMI 35-39.9, comorbidities are also considered. A Body Shape Index (ABSI) was derived to correct WC (waist circumference) for BMI and height. ABSI has been shown to be a linear predictor of long-term mortality across the range of BMI. Anthropometric risk indicator (ARI) combines the complementary contributions of BMI and ABSI and further improves mortality hazard prediction. We report for the first time ABSI and ARI for a bariatric surgical cohort at baseline and with 3-year follow-up. ABSI and BMI were calculated for 101 subjects from our bariatric surgery center database at baseline and after 3 years of follow-up. Raw values for BMI and ABSI were converted to Z scores and ARI values based on sex- and age-specific normals and risk associations from the National Health and Nutrition Examination Survey (NHANES) III sample of the US general population. Baseline scores for the anthropometric variables BMI and ABSI and the corresponding ARI were all higher than for the NHANES population sample. At 3-year post surgery, all three measures decreased significantly. While baseline BMI did not predict the change in mortality risk by ARI, baseline ABSI did (r = - 0.73), as did baseline ARI (r = - 0.94). Sleeve gastrectomy lowers ABSI and the associated mortality risk estimated from population studies after 3 years of follow-up. Considering our results, bariatric surgical candidates with BMI in the range of 35 to 39.9 with an increased ABSI-related mortality risk may have considerable survival benefit from bariatric surgery, even in the absence of qualifying comorbidities. 2814.

  11. Carbohydrates from Sources with a Higher Glycemic Index during Adolescence: Is Evening Rather than Morning Intake Relevant for Risk Markers of Type 2 Diabetes in Young Adulthood?

    Directory of Open Access Journals (Sweden)

    Tanja Diederichs

    2017-06-01

    Full Text Available Background: This study investigated whether glycemic index (GI or glycemic load (GL of morning or evening intake and morning or evening carbohydrate intake from low- or higher-GI food sources (low-GI-CHO, higher-GI-CHO during adolescence are relevant for risk markers of type 2 diabetes in young adulthood. Methods: Analyses included DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD study participants who had provided at least two 3-day weighed dietary records (median: 7 records during adolescence and one blood sample in young adulthood. Using multivariable linear regression analyses, estimated morning and evening GI, GL, low-GI-CHO (GI < 55 and higher-GI-CHO (GI ≥ 55 were related to insulin sensitivity (N = 252, hepatic steatosis index (HSI, fatty liver index (FLI (both N = 253, and a pro-inflammatory-score (N = 249. Results: Morning intakes during adolescence were not associated with any of the adult risk markers. A higher evening GI during adolescence was related to an increased HSI in young adulthood (p = 0.003. A higher consumption of higher-GI-CHO in the evening was associated with lower insulin sensitivity (p = 0.046 and an increased HSI (p = 0.006, while a higher evening intake of low-GI-CHO was related to a lower HSI (p = 0.009. Evening intakes were not related to FLI or the pro-inflammatory-score (all p > 0.1. Conclusion: Avoidance of large amounts of carbohydrates from higher-GI sources in the evening should be considered in preventive strategies to reduce the risk of type 2 diabetes in adulthood.

  12. Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study.

    Directory of Open Access Journals (Sweden)

    Koert N J Burger

    Full Text Available BACKGROUND: The associations of glycemic load (GL and glycemic index (GI with the risk of cardiovascular diseases (CVD are not well-established, particularly in men, and may be modified by gender. OBJECTIVE: To assess whether high dietary GL and GI increase the risk of CVD in men and women. METHODS: A large prospective cohort study (EPIC-MORGEN was conducted within the general Dutch population among 8,855 men and 10,753 women, aged 21-64 years at baseline (1993-1997 and free of diabetes and CVD. Dietary intake was assessed with a validated food-frequency questionnaire and GI and GL were calculated using Foster-Powell's international table of GI. Information on morbidity and mortality was obtained through linkage with national registries. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs for incident coronary heart disease (CHD and stroke, while adjusting for age, CVD risk factors, and dietary factors. RESULTS: During a mean follow-up of 11.9 years, 581 CHD cases and 120 stroke cases occurred among men, and 300 CHD cases and 109 stroke cases occurred among women. In men, GL was associated with an increased CHD risk (adjusted HR per SD increase, 1.17 [95% CI, 1.02-1.35], while no significant association was found in women (1.09 [0.89-1.33]. GI was not associated with CHD risk in both genders, while it was associated with increased stroke risk in men (1.27 [1.02-1.58] but not in women (0.96 [0.75-1.22]. Similarly, total carbohydrate intake and starch intake were associated with a higher CHD risk in men (1.23 [1.04-1.46]; and 1.24 [1.07-1.45], but not in women. CONCLUSION: Among men, high GL and GI, and high carbohydrate and starch intake, were associated with increased risk of CVD.

  13. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag Health Study.

    Science.gov (United States)

    Mork, Paul J; Vasseljen, Ottar; Nilsen, Tom I L

    2010-05-01

    To examine the association between leisure time physical exercise, body mass index (BMI), and risk of fibromyalgia (FM). A longitudinal study with baseline assessment of physical exercise (frequency, duration, and intensity) and BMI was used to explore the risk of having FM at 11-year followup in a large, unselected female population (n = 15,990) without FM or physical impairments at baseline. At followup, 380 cases of incident FM were reported. A weak dose-response association was found between level of physical exercise and risk of FM (for trend, P = 0.13) where women who reported the highest exercise level had a relative risk (RR) of 0.77 (95% confidence interval [95% CI] 0.55-1.07). BMI was an independent risk factor for FM (for trend, P BMI > or =25.0 kg/m(2)) had a 60-70% higher risk compared with women with normal weight (BMI 18.5-24.9 kg/m(2)). Overweight or obese women who exercised > or =1 hour per week had an RR of 1.72 (95% CI 1.07-2.76) compared with normal-weight women with a similar activity level, whereas the risk was >2-fold higher for overweight or obese women who were either inactive (RR 2.09, 95% CI 1.36-3.21) or exercised <1 hour per week (RR 2.19, 95% CI 1.39-3.46). Being overweight or obese was associated with an increased risk of FM, especially among women who also reported low levels of physical exercise. Community-based measures aimed at reducing the incidence of FM should emphasize the importance of regular exercise and the maintenance of normal body weight.

  14. Estimating the risk of cyanobacterial occurrence using an index integrating meteorological factors: application to drinking water production.

    Science.gov (United States)

    Ndong, Mouhamed; Bird, David; Nguyen-Quang, Tri; de Boutray, Marie-Laure; Zamyadi, Arash; Vinçon-Leite, Brigitte; Lemaire, Bruno J; Prévost, Michèle; Dorner, Sarah

    2014-06-01

    The sudden appearance of toxic cyanobacteria (CB) blooms is still largely unpredictable in waters worldwide. Many post-hoc explanations for CB bloom occurrence relating to physical and biochemical conditions in lakes have been developed. As potentially toxic CB can accumulate in drinking water treatment plants and disrupt water treatment, there is a need for water treatment operators to determine whether conditions are favourable for the proliferation and accumulation of CB in source waters in order to adjust drinking water treatment accordingly. Thus, a new methodology with locally adaptable variables is proposed in order to have a single index, f(p), related to various environmental factors such as temperature, wind speed and direction. The index is used in conjunction with real time monitoring data to determine the probability of CB occurrence in relation to meteorological factors, and was tested at a drinking water intake in Missisquoi Bay, a shallow transboundary bay in Lake Champlain, Québec, Canada. These environmental factors alone were able to explain a maximum probability of 68% that a CB bloom would occur at the drinking water treatment plant. Nutrient limitation also influences CB blooms and intense blooms only occurred when the dissolved inorganic nitrogen (DIN) to total phosphorus (TP) mass ratio was below 3. Additional monitoring of DIN and TP could be considered for these source waters prone to cyanobacterial blooms to determine periods of favourable growth. Real time monitoring and the use of the index could permit an adequate and timely response to CB blooms in drinking water sources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. A new clinically applicable age-specific comorbidity index for preoperative risk assessment of ovarian cancer patients

    DEFF Research Database (Denmark)

    Noer, Mette Calundann; Sperling, Cecilie Dyg; Antonsen, Sofie Leisby

    2016-01-01

    Cancer Database between January 1, 2005 and December 31, 2012. The study population was divided into a development cohort (n=2020) and a validation cohort (n=1975). Age-stratified multivariate Cox regression analyses were conducted to identify comorbidities significantly impacting five-year overall....... CONCLUSION: This new age-specific comorbidity index based on self-reported information is a significant predictor of overall and cancer-specific survival in ovarian cancer. It can be used to quickly identify those ovarian cancer patients requiring special attention in terms of preoperative optimization...

  16. Influence of body mass index on short-term subjective improvement and risk of reoperation after mid-urethral sling surgery

    DEFF Research Database (Denmark)

    Weltz, Vibeke; Guldberg, Rikke; Larsen, Michael D.

    2018-01-01

    Introduction and hypothesis: The objective was to evaluate the impact of body mass index (BMI) on the subjective improvement and risk of reoperation after first-time mid-urethral sling surgery. Methods: Data were retrieved from the national Danish Urogynaecological Database, including women...... was defined as any new surgical procedure for stress urinary incontinence performed within the study period. Results: During the study period, 6,414 mid-urethral sling procedures were performed; 80.0% of these women filled out both pre- and post-surgical International Consultation on Incontinence...

  17. A healthy lifestyle index is associated with reduced risk of colorectal adenomatous polyps among non-users of non-steroidal anti-inflammatory drugs.

    Science.gov (United States)

    Tabung, Fred K; Steck, Susan E; Burch, James B; Chen, Chin-Fu; Zhang, Hongmei; Hurley, Thomas G; Cavicchia, Philip; Alexander, Melannie; Shivappa, Nitin; Creek, Kim E; Lloyd, Stephen C; Hebert, James R

    2015-02-01

    In a Columbia, South Carolina-based case-control study, we developed a healthy lifestyle index from five modifiable lifestyle factors (smoking, alcohol intake, physical activity, diet, and body mass index), and examined the association between this lifestyle index and the risk of colorectal adenomatous polyps (adenoma). Participants were recruited from a local endoscopy center and completed questionnaires related to lifestyle behaviors prior to colonoscopy. We scored responses on each of five lifestyle factors as unhealthy (0 point) or healthy (1 point) based on current evidence and recommendations. We added the five scores to produce a combined lifestyle index for each participant ranging from 0 (least healthy) to 5 (healthiest), which was dichotomized into unhealthy (0-2) and healthy (3-5) lifestyle scores. We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) for adenoma with adjustment for multiple covariates. We identified 47 adenoma cases and 91 controls. In the main analyses, there was a statistically nonsignificant inverse association between the dichotomous (OR 0.54; 95% CI 0.22, 1.29) and continuous (OR 0.75; 95% CI 0.51, 1.10) lifestyle index and adenoma. Odds of adenoma were significantly modified by the use of non-steroidal anti-inflammatory drugs (NSAIDs) (p(interaction) = 0.04). For participants who reported no use of NSAIDs, those in the healthy lifestyle category had a 72% lower odds of adenoma as compared to those in the unhealthy category (OR 0.28; 95% CI 0.08, 0.98), whereas a one-unit increase in the index significantly reduced odds of adenoma by 53% (OR 0.47; 95% CI 0.26, 0.88). Although these findings should be interpreted cautiously given our small sample size, our results suggest that higher scores from this index are associated with reduced odds of adenomas, especially in non-users of NSAIDs. Lifestyle interventions are required to test this approach as a strategy to prevent colorectal adenomatous

  18. Alcohol consumption, body mass index and breast cancer risk by hormone receptor status: Women’ Lifestyle and Health Study

    International Nuclear Information System (INIS)

    Shin, Aesun; Sandin, Sven; Lof, Marie; Margolis, Karen L.; Kim, Kyeezu; Couto, Elisabeth; Adami, Hans Olov; Weiderpass, Elisabete

    2015-01-01

    We aimed to estimate the effect of alcohol consumption on breast cancer risk and to test whether overweight and obesity modifies this association. We included in the analysis 45,233 women enrolled in the Swedish Women’s Lifestyle and Health study between 1991 and 1992. Participants were followed for occurrence of breast cancer and death until December 2009. Poisson regression models were used, and analyses were done for overall breast cancer and for estrogen receptor positive or negative (ER+, ER-) and progesterone receptor positive and negative (PR+, PR-) tumors separately. A total of 1,385 breast cancer cases were ascertained during the follow-up period. Overall, we found no statistically significant association between alcohol intake and breast cancer risk after adjustment for confounding, with an estimated relative risk (RR) of 1.01 (95 % CI: 0.98–1.04) for an increment in alcohol consumption of 5 g/day. A statistically significant elevated breast cancer risk associated with higher alcohol consumption was found only among women with BMI ≤25 (RR 1.03, 95 % CI 1.0–1.05 per 5 g/day increase). An increase in breast cancer risk with higher alcohol consumption was found for breast cancers in women with a BMI ≤25 kg/m 2

  19. Risk forewarning of regional development sustainability based on a natural resources and environmental carrying index in China

    Science.gov (United States)

    Fan, Jie; Wang, Yafei; Ouyang, Zhiyun; Li, Lijuan; Xu, Yong; Zhang, Wenzhong; Wang, Chuansheng; Xu, Weihua; Li, Jiuyi; Yu, Jianhui; Zhou, Kan

    2017-02-01

    It is a matter of public consensus that China's high growth rate has been achieved at the expense of natural resources and the environment, leading to serious risks to sustainability. This research, which proposes a theoretical model to forewarn of risks to regional developmental sustainability in China, constitutes the first empirical evaluation of this to be undertaken there. The results show that: (a) the areas at risk cover almost 43% of the land and 44% of the population of mainland China. In those areas, 83.56% of people at risk are threatened by the low carrying capacity of the environment and limited water resources. (b) With 70% of the total population living in "at risk" areas, urbanization zones remain as the primary category suffering from overload across China. Extensive industrialization has resulted in environmental pollution, which contributes the most to the forewarning status, while the secondary cause is found to be the special coupling of the scarcity of natural water resources and their inefficient use. In addition, most urban conglomerations suffer from pollution by industrial production and household consumption, which tends to extend to their surrounding agricultural areas. Extensive mineral exploitation in ecologically fragile areas has made them increasingly more vulnerable to disturbances from their neighboring resource-driven urban areas. The paper uses these findings to suggest how to intensify the special regulatory administration of resources and the environment, and to transform approaches to industrialization, in order to address sustainable development issues in developing countries.

  20. The effect of leisure-time physical activity on the risk of acute myocardial infarction depending on Body Mass Index: a population-based case-control study

    Directory of Open Access Journals (Sweden)

    Reuterwall Christina

    2006-12-01

    Full Text Available Abstract Background High body mass index (BMI and lack of physical activity have been recognized as important risk factors for coronary heart disease. The aim of the present study was to evaluate whether leisure-time physical activity compensates for the increased risk of acute myocardial infarction associated with overweight and obesity. Methods Data from the SHEEP (Stockholm Heart Epidemiology Program study were used. The SHEEP study is a large Swedish population-based case-control study, comprising 1204 male and 550 female cases, and 1538 male and 777 female controls, conducted in Stockholm County, Sweden, during the period 1992–1994. Odds ratios (OR, together with 95 % confidence intervals (95% CI, were calculated using unconditional logistic regression, as estimates of the relative risks. Results Regular leisure-time physical activity was associated with a decreased risk of myocardial infarction among lean, normal-weight and overweight subjects, but not among obese subjects. Obese (BMI ≥ 30 and physically active persons had an almost twofold risk of myocardial infarction, compared with normal-weight and sedentary persons (OR 1.85, 95% CI 1.07–3.18. The results were similar for men and women. Conclusion While regular leisure-time physical activity seems to provide protection against myocardial infarction among lean, normal-weight and overweight subjects, this does not appear to be the case in obese subjects.