WorldWideScience

Sample records for world risk index

  1. Rationale and Development of a Security Assurance Index with Application toward the Development of a World Risk Index

    Energy Technology Data Exchange (ETDEWEB)

    M. M. Plum; G. A. Beitel, PhD

    2006-06-01

    Assurance categories were previously developed to support the Department of Homeland Security’s efforts in the mitigation of Cyber Control System events. Defined according to the risk of life and economic loss, the minimum range is designated by policy, whereas the maximum limit seems to be constrained only by limits and interdependencies of the event. Use of this life / assets scale has proven to be helpful in managing risk due to the scale's ease of use, communication, and understanding. Suggestions have been made that this scale could be applied to all events of terror, disaster, and calamity of an international scale, with equally good results. This paper presents the history of some existing scales of disaster and assurance, the rationale behind the development of the original Security Assurance Index, and our proposed scale of disaster and calamity as a World Risk Index.

  2. The World Bank's "Employing Workers" index

    DEFF Research Database (Denmark)

    Lee, Sangheon; McCann, Deirdre; Torm, Nina Elisabeth

    2008-01-01

    This note provides an update on the ongoing debate over the World Bank's Doing Business project with a particular focus on its "Employing Workers" index, which is intended to measure difficulty of hiring, rigidity of working hours and difficulty of firing. The authors review the findings of studies...... that have used this index or been influenced by it and of those that inspired its construction. They go on to examine criticisms of this instrument, highlighting both conceptual and empirical problems. Their paper concludes with suggestions for alternative approaches and future research....

  3. Denotational World-indexed Logical Relations and Friends

    DEFF Research Database (Denmark)

    Thamsborg, Jacob Junker

    and solve the fundamental type-worlds circularity by metric-space theory. This approach scales to state-of-theart step-indexed techniques and permits unrestricted relational reasoning by the use of so-called Bohr relations. Along the way, we develop auxiliary theory; most notably a generalized version...

  4. Step-indexed Kripke models over recursive worlds

    DEFF Research Database (Denmark)

    Birkedal, Lars; Reus, Bernhard; Schwinghammer, Jan

    2011-01-01

    worlds that are recursively defined in a category of metric spaces. In this paper, we broaden the scope of this technique from the original domain-theoretic setting to an elementary, operational one based on step indexing. The resulting method is widely applicable and leads to simple, succinct models...

  5. Indexing real-world data using semi-structured documents

    NARCIS (Netherlands)

    A.R. Schmidt; M.A. Windhouwer; M.L. Kersten (Martin)

    1999-01-01

    textabstractWe address the problem of deriving meaningful semantic index information for a multi-media database using a semi-structured docu-ment model. We show how our framework, called {em feature grammars, can be used to (1)~exploit third-party interpretation modules for real-world unstructured

  6. World port cities as cosmopolitan risk community

    DEFF Research Database (Denmark)

    Blok, Anders; Tschötschel, Robin

    2015-01-01

    Extending Ulrich Beck’s theory of world risk society, this article traces the emergence of a cosmopolitan risk community of world port cities in Europe and East Asia, constituted around shared imaginations of the global risks and opportunities of climate change. Such urban risk imaginations...... indication of this cosmopolitan risk community, in terms of the timing, intensity, priorities and modes of government manifested in the climate policy engagements of 16 major world port cities across the regions of Europe and East Asia. The substantial similarities in such policy engagements, we conclude...

  7. 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

  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...

  9. Developing a risk-based air quality health index

    Science.gov (United States)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  10. Risking Hope in a Worried World

    Science.gov (United States)

    Silin, Jonathan

    2017-01-01

    Hope is at the heart of the educational endeavour. Yet it is a challenge for educators to sustain a sense of hope in a worried world where terrorism, mass migrations, global warming and ultra-right political movements are on the rise. Acknowledging that hopefulness always involves risk, this article identifies three pedagogical practices which…

  11. HEALTHY EATING INDEX AND OVARIAN CANCER RISK

    Science.gov (United States)

    Chandran, Urmila; Bandera, Elisa V.; Williams-King, Melony G.; Paddock, Lisa E.; Rodriguez-Rodriguez, Lorna; Lu, Shou-En; Faulkner, Shameka; Pulick, Katherine; Olson, Sara H.

    2011-01-01

    The evidence for a role of diet on ovarian cancer prevention remains inconclusive. While many studies have evaluated individual foods and food groups, the evaluation of a comprehensive dietary quality index for predicting cancer risk has received little attention. This study investigates the association between the Healthy Eating Index (HEI), which reflects adherence to the current USDA Dietary Guidelines for Americans, and ovarian cancer risk in a population-based case-control study in New Jersey. A total of 205 cases and 390 controls completed the Block 98.2 Food Frequency Questionnaire (FFQ) in addition to reporting on potential risk factors for ovarian cancer. FFQ data were then utilized to calculate the HEI score, and cup, ounce, gram, or caloric equivalents for the 12 different food groups comprising the index. In multivariate models the OR for the highest tertile of the HEI score compared to the lowest (reflecting a better diet compared to a worse diet) was 0.90 (95% CI: 0.55–1.47). There was limited evidence for a statistically significant association between any of the 12 individual food components and ovarian cancer risk. Based on this study’s results, neither individual food groups nor dietary quality showed potential for preventing ovarian cancer. PMID:21286802

  12. Index-based Crop Insurance for Climate Adaptation in the Developing World

    Science.gov (United States)

    Brown, M. E.; Osgood, D. E.; Carriquiry, M. A.

    2011-12-01

    Weather has always presented a challenge to small-scale farmers, particularly in regions where poverty and lack of infrastructure has restricted the development of financial instruments to limit risk. New 'index' insurance innovations in agriculture are beginning to enable even the poorest farmers to unlock major productivity gains (e.g. insuring loans for improved seeds). Although index insurance has the potential to greatly improve productivity in developing country agriculture, the principal technical challenge to up-scaling this product is "data poverty," the absence of weather data in low-income areas needed to design robust and affordable insurance products. Earth science, particularly remote sensing, has the potential to ameliorate data poverty. However, raw use of earth science model output leads to non-optimal indexes and many obstacles remain to transform earth science products into insurance solutions. Estimation uncertainty, limited availability of consistent time series, and difficulties of predicting loses based on remote observations are reviewed in this article. The importance of multidisciplinary approaches addressing the needs of stakeholders in simple to understand indexes is highlighted. The successful use of Earth science data to support the index insurance industry in currently poor and isolated communities in the developing world would transform the ability of small farmers to increase yields, household incomes and regional economies, if the growing gap between earth science and index insurance can be closed.

  13. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Science.gov (United States)

    Prescott, Jennifer; Setiawan, Veronica W; Wentzensen, Nicolas; Schumacher, Fredrick; Yu, Herbert; Delahanty, Ryan; Bernstein, Leslie; Chanock, Stephen J; Chen, Chu; Cook, Linda S; Friedenreich, Christine; Garcia-Closas, Monserrat; Haiman, Christopher A; Le Marchand, Loic; Liang, Xiaolin; Lissowska, Jolanta; Lu, Lingeng; Magliocco, Anthony M; Olson, Sara H; Risch, Harvey A; Shu, Xiao-Ou; Ursin, Giske; Yang, Hannah P; Kraft, Peter; De Vivo, Immaculata

    2015-01-01

    Genome-wide association studies (GWAS) have identified common variants that predispose individuals to a higher body mass index (BMI), an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS) based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002). For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%). However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78). Heterogeneity by BMI did not reach statistical significance (P = 0.06), and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58). In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5). Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  14. High pre-pregnancy body mass index and the risk of poor obstetrics outcomes among Asian women using BMI criteria for Asians by World Health Organization Western Pacific Region (WPRO): a large cohort study.

    Science.gov (United States)

    Somprasit, Charintip; Tanprasertkul, Chamnan; Rattanasiri, Thawanwong; Saksiriwutth, Piyamas; Wongkum, Jamras; Kovavisarach, Ekachai; Jongfueangparinya, Khwanjira; Panichakul, Pritsana; Wuthiwong, Juthawadee

    2015-03-01

    To evaluate the effects of high pre-pregnancy body mass index (BMI) on the risk ofpoor obstetric outcomes among Asian women using BMI criteria by Regional Office for the Western Pacific Region of WHO (WPRO). The present study was a retrospective cohort. Subjects of live birth singletons who had full term delivered atfour tertiary care centers, teaching university hospitals between January and December 2012 were enrolled. All pregnant women with pre-pregnancy BMI 18.5 kg/m2 or over were recruited and categorized into two groups, normal BMI and high BMI Level of BMI at 18.5-22.9 kg/m2 was defined normal BMI, and level at or over than 23 kg/M2 was defined as high BMI, respectively. The association between high pre-pregnancy BMI and poor adverse pregnancy outcomes were evaluated. Two thousands seven hundred and thirty-three pregnant women were recruited. Normal and high pre-pregnancy BMI women were 1,840 and 893, respectively. The average age was 2 7.81 +/- 5.67 and 29.48 +/- 13.03 years old respectively. Most ofsubject were primigravida. Mean BMI of normal group and high BMI group were 20.2 7 +/- 1.42 and 26.66 +/- 3.45 kg/ m2, respectively. In multivariate analysis, high pre-pregnancy BMI pregnant women have significantly higher adjusted risk ratio for gestational diabetes mellitus and preeclampsia, induction of labor prolong second stage of labor, including, caesarean delivery or obstetrics procedures (RR 1.54, 95% CI 1.30-1.84, RR 1.17, 95% CI 1. 12-1.23, RR 1.41, 95% CI 1. 04- 1.90, RR 1.28, 95% CI 1.11-1.48 and RR 1.17, 95% CI 1.05-1.27, respectively). In addition, the adjusted risk ratio of postpartum hemorrhage and neonatal macrosomia were significantly increased (RR 1.86, 95% CI 1.01-3.43 and RR 1.46, 95% CI 1.28-1.65, respectively). This evidence strongly suggested that high pre-pregnancy BMI using WPRO criteria increased the risk of pregnancy complications and adverse pregnancy outcomes. This study was one of the largest studies among Asian populations.

  15. High body mass index and cancer risk

    DEFF Research Database (Denmark)

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

    2016-01-01

    alleles was associated with a 3 % higher BMI (P cancer. In instrumental variable analysis for a 10 kg/m(2) higher genetically determined BMI the odds ratio for any non-skin cancer was 1.16 (0.64-2.09), with a corresponding observational estimate of 0.94 (0.88-1.01). Using......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...... 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...

  16. Risk weighted alpha index – analysis of the ASX50 index

    Directory of Open Access Journals (Sweden)

    Nipun Agarwal

    2013-12-01

    Full Text Available Major stock indexes are developed on the market capitalization or price weighted indexation method. The Australian Stock Exchange 50 (ASX50 index is a market capitalization index of the top 50 Australian stocks. Fundamental indexation, equal weighted index and risk weighted index methods have recently been developed as an alternative to the market cap and price indexes. However, empirical studies do not conclusively prove if these alternate methods are more efficient to the existing market cap or price weighted methods. Also, the fundamental index method provides a higher alpha, while the risk weighted index methods focus on risk reduction through diversification. There is a gap to develop another passive indexation method in order to provide the investor a higher return (alpha and lower volatility. This paper re-weights the ASX50 index using the risk weighted alpha method and provides higher weight to stocks that have increasing returns and lower volatility. The empirical study for ASX50 index from 2002-2012 is undertaken and results show that the risk weighted alpha method provides higher return and has lower systematic risk than the ASX50 index.

  17. External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry.

    Science.gov (United States)

    Winter, Audrey; Féray, Cyrille; Audureau, Etienne; Écochard, René; Jacquelinet, Christian; Roudot-Thoraval, Françoise; Duvoux, Christophe; Daurès, Jean-Pierre; Landais, Paul

    2017-08-01

    A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis. Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. Neither the Donor Risk Index nor the Eurotransplant-Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant-Donor Risk Index appeared unadapted to the French transplant registry. Neither of these risk indexes were suitable to optimize the French liver allocation system. Thus, our next step will be to propose a general adaptive model for a Donor Risk Index. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Directory of Open Access Journals (Sweden)

    Jennifer Prescott

    Full Text Available Genome-wide association studies (GWAS have identified common variants that predispose individuals to a higher body mass index (BMI, an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002. For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%. However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78. Heterogeneity by BMI did not reach statistical significance (P = 0.06, and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58. In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5. Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  19. Index sort algorithm for positive integers | Adewumi | Science World ...

    African Journals Online (AJOL)

    Science World Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 3, No 3 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your Web ...

  20. 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.

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

    Science.gov (United States)

    Reguero, Borja G.; Zamora, Ana R.; Losada, Iñigo J.; Méndez, Fernando J.

    2017-01-01

    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 focus on

  2. Index sort algorithm for positive integers | Adewumi | Science World ...

    African Journals Online (AJOL)

    Index sort algorithm for positive integers. S.E Adewumi. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/swj.v3i3.51816 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for ...

  3. Managing Research in a Risk World

    Science.gov (United States)

    Anton, W.; Havenhill, M.

    2014-01-01

    The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.

  4. The world price of jump and volatility risk

    NARCIS (Netherlands)

    Driessen, J.; Maenhout, P.

    2006-01-01

    Jump and volatility risk are important for understanding equity returns, option pricing and asset allocation. This paper is the first to study international integration of markets for jump and volatility risk, using data on index options for each of the three main global markets: US S&P 500 index

  5. Risk Management in an Increasingly Complex and Interconnected World

    Directory of Open Access Journals (Sweden)

    Thomas C. Wilson

    2016-02-01

    Full Text Available Risk management is especially challenging for risks, which cannot be modelled using historical data due to rapid technological, environmental or social changes in an increasingly complex, interconnected world. This article describes and illustrates the Top Risk Assessments and Scenario Analysis approaches which can be used to complement traditional risk modelling in these instances.

  6. Age Patterns in Risk Taking Across the World.

    Science.gov (United States)

    Duell, Natasha; Steinberg, Laurence; Icenogle, Grace; Chein, Jason; Chaudhary, Nandita; Di Giunta, Laura; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña; Al-Hassan, Suha M; Takash, Hanan M S; Bacchini, Dario; Chang, Lei

    2017-10-19

    Epidemiological data indicate that risk behaviors are among the leading causes of adolescent morbidity and mortality worldwide. Consistent with this, laboratory-based studies of age differences in risk behavior allude to a peak in adolescence, suggesting that adolescents demonstrate a heightened propensity, or inherent inclination, to take risks. Unlike epidemiological reports, studies of risk taking propensity have been limited to Western samples, leaving questions about the extent to which heightened risk taking propensity is an inherent or culturally constructed aspect of adolescence. In the present study, age patterns in risk-taking propensity (using two laboratory tasks: the Stoplight and the BART) and real-world risk taking (using self-reports of health and antisocial risk taking) were examined in a sample of 5227 individuals (50.7% female) ages 10-30 (M = 17.05 years, SD = 5.91) from 11 Western and non-Western countries (China, Colombia, Cyprus, India, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the US). Two hypotheses were tested: (1) risk taking follows an inverted-U pattern across age groups, peaking earlier on measures of risk taking propensity than on measures of real-world risk taking, and (2) age patterns in risk taking propensity are more consistent across countries than age patterns in real-world risk taking. Overall, risk taking followed the hypothesized inverted-U pattern across age groups, with health risk taking evincing the latest peak. Age patterns in risk taking propensity were more consistent across countries than age patterns in real-world risk taking. Results suggest that although the association between age and risk taking is sensitive to measurement and culture, around the world, risk taking is generally highest among late adolescents.

  7. Cardiovascular risk profiles of world masters games participants.

    Science.gov (United States)

    Climstein, Mike; Walsh, Joe; Debeliso, Mark; Heazlewood, Tim; Sevene, Trish; Adams, Kent

    2016-10-11

    Increasing evidence indicates adherence to exercise throughout life is concurrent with improved health. World masters games (WMG) have more participants than any other international sporting competition and is under investigated, particularly with regard to indices of cardiovascular disease risk. Therefore, we chose to investigate selected cardiovascular risk factors in WMG participants. This was a cross-sectional, observational study which utilized a web-based questionnaire to survey cardiovascular risk factors of WMG participants. The survey consisted of three sections: basic demographics, medical history and physiological parameters which included body mass index (BMI), waist circumference (WC), resting blood pressure (BP) and lipids (total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL)). A total of 1,435 participants, 872 male, aged 27-91yrs (mean age 54.99yrs) participated in the study. Key findings included significant differences (p<0.05) between genders in BMI (17.7%, p<0.001), WC (10.6%, p<0.001), resting SBP (5.8%, p<0.001) and resting DBP (4.8%, p<0.001). Significant differences were also found between genders in HDLs (15.2%, p<0.001), TC:HDL ratio (17.2%, p<0.001) and LDL:HDL ratio (19.0%, p<0.001). Significant differences (p<0.001) were also identified when comparing WMG lipid results to the Australian general population (TC p<0.001; HDLs p<0.001; LDLs p<0.001). A high percentage of WMG participants demonstrated optimal values in a number of CVD risk factors when compared to the general population, female WMG participants had better values as compared to males. This reflected a decreased CVD in WMG participants and supports our hypothesis of enhanced health characteristics in an active, but aged cohort.

  8. Index of Human Development: Measurement Problems at the National and World Levels

    Directory of Open Access Journals (Sweden)

    Sarychev Volodymyr I.

    2014-02-01

    Full Text Available The article analyses main modern approaches to measurement of the index of human development at the world level by the UN Development Programme and at the national level in Ukraine. It identifies main components and stages of formation of national methods of measurement of the index of regional human development and also advantages of its renovated modern variant against the background of fighting poverty, analyses key directions of human development, which reflect main possibilities in ensuring the process of life, generalises the “living standard” category definition by works of domestic and foreign scientists, analyses dynamics of indicators of the index of human development of Ukraine for the period 2007 – 2012 and explains main reasons of drop of ratings of Ukraine in the world and conducts comparative analysis of tendencies of changes of the index of human development of Ukrainian regions in recent years.

  9. 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.

  10. Sensitive Index to Assess Risk of Morbidity in Undernutrition | IDRC ...

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

    The Nutrition Foundation of India (NFI) has put forward a new hypotheses: in Indian children, among whom stunting is common, body mass index (BMI) for age is a more sensitive index than stunting and underweight for assessing risk of infection. This grant will allow the NFI to test this hypothesis in a secondary analysis of ...

  11. World Equity Premium based Risk Aversion Estimates

    NARCIS (Netherlands)

    L.C.G. Pozzi (Lorenzo)

    2010-01-01

    textabstractThe equity premium puzzle holds that the coefficient of relative risk aversion estimated from the consumption based CAPM under power utility is excessively high. Moreover, estimates in the literature vary considerably across countries. We gauge the uncertainty pertaining to the country

  12. The de Morton Mobility Index (DEMMI: An essential health index for an ageing world

    Directory of Open Access Journals (Sweden)

    Davidson Megan

    2008-08-01

    Full Text Available Abstract Background Existing instruments for measuring mobility are inadequate for accurately assessing older people across the broad spectrum of abilities. Like other indices that monitor critical aspects of health such as blood pressure tests, a mobility test for all older acute medical patients provides essential health data. We have developed and validated an instrument that captures essential information about the mobility status of older acute medical patients. Methods Items suitable for a new mobility instrument were generated from existing scales, patient interviews and focus groups with experts. 51 items were pilot tested on older acute medical inpatients. An interval-level unidimensional mobility measure was constructed using Rasch analysis. The final item set required minimal equipment and was quick and simple to administer. The de Morton Mobility Index (DEMMI was validated on an independent sample of older acute medical inpatients and its clinimetric properties confirmed. Results The DEMMI is a 15 item unidimensional measure of mobility. Reliability (MDC90, validity and the minimally clinically important difference (MCID of the DEMMI were consistent across independent samples. The MDC90 and MCID were 9 and 10 points respectively (on the 100 point Rasch converted interval DEMMI scale. Conclusion The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients. DEMMI validation studies are underway in other clinical settings and in the community. Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

  13. World Health Report 2000: inequality index and socioeconomic inequalities in mortality

    NARCIS (Netherlands)

    Houweling, T. A.; Kunst, A. E.; Mackenbach, J. P.

    2001-01-01

    Monitoring of inequality in health has become an increasingly important task of development agencies. We compared the inequality index as published in the World Health Report 2000 with available evidence on socioeconomic inequalities in mortality in 15 industrialised and 43 less-developed countries.

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

    African Journals Online (AJOL)

    Numerical computation reveals that 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. However, a modified problem derived from the benchmark problem produced realistic results. The study shows that ...

  15. Stroke risk factors among participants of a world stroke day ...

    African Journals Online (AJOL)

    2015-04-20

    Apr 20, 2015 ... Conclusion: Stroke risk factors such as hypertension and obesity were common among the participants of the world stroke day awareness program in an urban area of Nigeria. Community screening and modification of these risk factors should be intensified in order to reduce stroke morbidity and mortality.

  16. Assessing and managing multiple risks in a changing world ...

    Science.gov (United States)

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological c

  17. A novel spectral index to automatically extract road networks from WorldView-2 satellite imagery

    Directory of Open Access Journals (Sweden)

    Kaveh Shahi

    2015-06-01

    Full Text Available This research develops a spectral index to automatically extract asphalt road networks named road extraction index (REI. This index uses WorldView-2 (WV-2 imagery, which has high spatial resolution and is multispectral. To determine the best bands for WV-2, field spectral data using a field spectroradiometer were collected. These data were then analyzed statistically. The bands were selected through the methodology of stepwise discriminant analysis. The appropriate WV-2 bands were distinguished from one another as per significant wavelengths. The proposed index is based on this classification. By applying REI to WV-2 imagery, we can extract asphalt roads accurately. Results demonstrate that REI is automated, transferable, and efficient in asphalt road extraction from high-resolution satellite imagery.

  18. Development of an operational specific CAT risk (SCATR) index

    Science.gov (United States)

    Keller, J. L.; Haines, P. A.; Luers, J. K.

    1983-01-01

    The original formulations of Roach (1970) and Oard (1974) for the calculation of clear air turbulence (CAT) potential from synoptic scale data were extended. An index which gives a measure of the specific risk of encountering CAT - the specific clear air turbulence risk (SCATR) index - was defined. This index takes into account both the locally and advected contributions to the energy necessary for CAT. The advected contribution is associated with the role of atmospheric gravity waves. The SCATR index was calculated for a number of cases where documented encounters with CAT occurred. Of particular interest were those made for cases involving severe CAT. The results for the two severe CAT cases run were quite impressive and elicited considerable interest from operational aviation meteorologists.

  19. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys.

    Science.gov (United States)

    Borges, Guilherme; Nock, Matthew K; Haro Abad, Josep M; Hwang, Irving; Sampson, Nancy A; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, Maria Elena; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R; Kessler, Ronald C

    2010-12-01

    Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including sociodemographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. © Copyright 2010 Physicians Postgraduate Press, Inc.

  20. The world price of jump and volatility risk

    NARCIS (Netherlands)

    Driessen, J.J.A.G.; Maenhout, P.

    2013-01-01

    We study international integration of markets for jump and volatility risk, using index option data for the main global markets. To explain the cross-section of expected option returns we focus on return-based multi-factor models. For each market separately, we provide evidence that volatility and

  1. CLINICAL RISK INDEX FOR BABIES (CRIB) II SCORE AS A ...

    African Journals Online (AJOL)

    2011-01-01

    Jan 1, 2011 ... Among them is the scoring system Clinical Risk Index for Babies also known as CRIB II score. ... specificity of 75.3%, and a predictive value of 77.7% compared to 72.5, 71.2, and 71.8% respectively for ... 56, 75 and 66% for sensitivity, specificity and predictive values respectively. Conclusion: CRIB II score ...

  2. Premorbid body mass index and risk of amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    O'Reilly, Eilis J.; Wang, Hao; Weisskopf, Marc G.; Fitzgerald, Kathryn C.; Falcone, Guido; McCullough, Marjorie L.; Thun, Michael; Park, Yikyung; Kolonel, Laurence N.; Ascherio, Alberto

    Our objective was to determine if amyotrophic lateral sclerosis (ALS) risk varies according to body mass index (BMI) captured up to three decades earlier. At baseline 537,968 females and 562,942 males in five ongoing cohorts reported height, current weight and weight at age 18/21 years. During 14-28

  3. 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…

  4. '(World) risk society’ or ‘new rationalities of risk’?

    DEFF Research Database (Denmark)

    Rasborg, Klaus

    2012-01-01

    This paper calls attention to some basic problems and inner contradictions in the German sociologist Ulrich Beck’s theory of the ‘(world) risk society’ or reflexive (second) modernity. A main thread in the critique is that of addressing the theoretical ambiguities that seem to characterize Beck...

  5. Empirical behavior of a world stock index from intra-day to monthly time scales

    Science.gov (United States)

    Breymann, W.; Lüthi, D. R.; Platen, E.

    2009-10-01

    Most of the papers that study the distributional and fractal properties of financial instruments focus on stock prices or foreign exchange rates. This typically leads to mixed results concerning the distributions of log-returns and some multi-fractal properties of exchange rates, stock prices, and regional indices. This paper uses a well diversified world stock index as the central object of analysis. Such index approximates the growth optimal portfolio, which is demonstrated under the benchmark approach, it is the ideal reference unit for studying basic securities. When denominating this world index in units of a given currency, one measures the movements of the currency against the entire market. This provides a least disturbed observation of the currency dynamics. In this manner, one can expect to disentangle, e.g., the superposition of the two currencies involved in an exchange rate. This benchmark approach to the empirical analysis of financial data allows us to establish remarkable stylized facts. Most important is the observation that the repeatedly documented multi-fractal appearance of financial time series is very weak and much less pronounced than the deviation of the mono-scaling properties from Brownian-motion type scaling. The generalized Hurst exponent H(2) assumes typical values between 0.55 and 0.6. Accordingly, autocorrelations of log-returns decay according to a power law, and the quadratic variation vanishes when going to vanishing observation time step size. Furthermore, one can identify the Student t distribution as the log-return distribution of a well-diversified world stock index for long time horizons when a long enough data series is used for estimation. The study of dependence properties, finally, reveals that jumps at daily horizon originate primarily in the stock market while at 5min horizon they originate in the foreign exchange market. The principal message of the empirical analysis is that there is evidence that a diffusion model

  6. Genetically Predicted Body Mass Index and Breast Cancer Risk

    DEFF Research Database (Denmark)

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

    2016-01-01

    is inversely associated with the risk of both pre- and postmenopausal breast cancer. The reduced risk of postmenopausal breast cancer associated with genetically predicted BMI observed in this study differs from the positive association reported from studies using measured adult BMI. Understanding the reasons......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 environmental factors. METHODS: We applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated...

  7. 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.

  8. Childhood body mass index trajectories predicting cardiovascular risk in adolescence.

    Science.gov (United States)

    Boyer, Brittany P; Nelson, Jackie A; Holub, Shayla C

    2015-06-01

    The present study compared growth parameters of girls' and boys' body mass index (BMI) trajectories from infancy to middle childhood and evaluated these parameters as predictors of cardiovascular disease (CVD) risk in adolescence. Using 657 children from the NICHD Study of Early Child Care and Youth Development, quadratic growth curve analyses were conducted to establish growth parameters (intercept, slope, and quadratic term) for girls and boys from age 15 months to 10.5 years. Parameters were compared across gender and evaluated as predictors of a CVD risk index at the age of 15 years, controlling for characteristics of the adiposity rebound (AR) including age at which it occurred and children's BMI at the rebound. Boys had more extreme trajectories of growth than girls with higher initial BMI at age 15 months (intercept), more rapid declines in BMI before the AR (slope), and sharper rebound growth in BMI after the rebound (quadratic term). For boys and girls, higher intercept, slope, and quadratic term values predicted higher CVD risk at the age of 15 years, controlling for characteristics of the AR. Findings suggest that individuals at risk for developing CVD later in life may be identified before the AR by elevated BMI at 15 months and slow BMI declines. Because of the importance of early intervention in altering lifelong health trajectories, consistent BMI monitoring is essential in identifying high-risk children. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox.

    Science.gov (United States)

    Shah, Ravi; Gayat, Etienne; Januzzi, James L; Sato, Naoki; Cohen-Solal, Alain; diSomma, Salvatore; Fairman, Enrique; Harjola, Veli-Pekka; Ishihara, Shiro; Lassus, Johan; Maggioni, Aldo; Metra, Marco; Mueller, Christian; Mueller, Thomas; Parenica, Jiri; Pascual-Figal, Domingo; Peacock, William Frank; Spinar, Jindrich; van Kimmenade, Roland; Mebazaa, Alexandre

    2014-03-04

    This study sought to define the relationship between body mass index (BMI) and mortality in heart failure (HF) across the world and to identify specific groups in whom BMI may differentially mediate risk. Obesity is associated with incident HF, but it is paradoxically associated with better prognosis during chronic HF. We studied 6,142 patients with acute decompensated HF from 12 prospective observational cohorts followed-up across 4 continents. Primary outcome was all-cause mortality. Cox proportional hazards models and net reclassification index described associations of BMI with all-cause mortality. Normal-weight patients (BMI 18.5 to 25 kg/m(2)) were older with more advanced HF and lower cardiometabolic risk. Despite worldwide heterogeneity in clinical features across obesity categories, a higher BMI remained associated with decreased 30-day and 1-year mortality (11% decrease at 30 days; 9% decrease at 1 year per 5 kg/m(2); p 75 years; hazard ratio [HR]: 0.82; p = 0.006), decreased cardiac function (ejection fraction obesity paradox" is confined to older persons, with decreased cardiac function, less cardiometabolic illness, and recent-onset HF, suggesting that aging, HF severity/chronicity, and metabolism may explain the obesity paradox. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. 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

  11. Carbohydrate intake, glycemic index and prostate cancer risk.

    Science.gov (United States)

    Vidal, Adriana C; Williams, Christina D; Allott, Emma H; Howard, Lauren E; Grant, Delores J; McPhail, Megan; Sourbeer, Katharine N; Hwa, Lin Pao; Boffetta, Paolo; Hoyo, Cathrine; Freedland, Stephen J

    2015-03-01

    Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N = 262) and black (N = 168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N = 274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. In multivariable analyzes, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR = 0.41, 95% CI 0.21-0.81, P = 0.010), though this only reached significance in white men (p-trend = 0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend = 0.066) and increased PC risk in black men (p-trend = 0.172), however, the associations were not significant. Fiber intake was not associated with PC risk (all p-trends > 0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend = 0.016), but not low-grade PC (p-trend = 0.593). Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings. © 2014 Wiley Periodicals, Inc.

  12. Geriatric nutritional risk index: a mortality predictor in hemodialysis patients.

    Science.gov (United States)

    Edalat-Nejad, Mahnaz; Zameni, Fatemeh; Qlich-Khani, Mahdi; Salehi, Fatemeh

    2015-03-01

    Recently, the Geriatric Nutritional Risk Index (GNRI) has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD) patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years). The GNRI score was estimated by an equation involving serum albumin and individual's weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5) was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI risk factors that predict all-cause mortality in HD patients.

  13. Peaking of world oil production: Impacts, mitigation, & risk management

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, R.L. (SAIC); Bezdek, Roger (MISI); Wendling, Robert (MISI)

    2005-02-01

    The peaking of world oil production presents the U.S. and the world with an unprecedented risk management problem. As peaking is approached, liquid fuel prices and price volatility will increase dramatically, and, without timely mitigation, the economic, social, and political costs will be unprecedented. Viable mitigation options exist on both the supply and demand sides, but to have substantial impact, they must be initiated more than a decade in advance of peaking.... The purpose of this analysis was to identify the critical issues surrounding the occurrence and mitigation of world oil production peaking. We simplified many of the complexities in an effort to provide a transparent analysis. Nevertheless, our study is neither simple nor brief. We recognize that when oil prices escalate dramatically, there will be demand and economic impacts that will alter our simplified assumptions. Consideration of those feedbacks will be a daunting task but one that should be undertaken. Our aim in this study is to-- • Summarize the difficulties of oil production forecasting; • Identify the fundamentals that show why world oil production peaking is such a unique challenge; • Show why mitigation will take a decade or more of intense effort; • Examine the potential economic effects of oil peaking; • Describe what might be accomplished under three example mitigation scenarios. • Stimulate serious discussion of the problem, suggest more definitive studies, and engender interest in timely action to mitigate its impacts.

  14. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission. PMID:26714309

  15. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions.

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Grădinaru Cătălin

    2017-01-01

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

  18. Dietary Glycemic Index and the Risk of Birth Defects

    Science.gov (United States)

    Parker, Samantha E.; Werler, Martha M.; Shaw, Gary M.; Anderka, Marlene; Yazdy, Mahsa M.

    2012-01-01

    Prepregnancy diabetes and obesity have been identified as independent risk factors for several birth defects, providing support for a mechanism that involves hyperglycemia and hyperinsulinemia in the development of malformations. Data from the National Birth Defects Prevention Study from 1997 to 2007 were used to investigate the association between the maternal dietary glycemic index (DGI) and the risk of birth defects among nondiabetic women. DGI was categorized by using spline regression models and quartile distributions. Adjusted odds ratios and 95% confidence intervals were calculated. The joint effect of DGI and obesity was also examined. Among the 53 birth defects analyzed, high DGI, categorized by spline regression, was significantly associated with encephalocele (adjusted odds ratio (aOR) = 2.68), diaphragmatic hernia (aOR = 2.58), small intestinal atresia/stenosis (aOR = 2.97) including duodenal atresia/stenosis (aOR = 2.48), and atrial septal defect (aOR = 1.37). Using quartiles to categorize DGI, the authors identified associations with cleft lip with cleft palate (aOR = 1.23) and anorectal atresia/stenosis (aOR = 1.40). The joint effect of high DGI and obesity provided evidence of a synergistic effect on the risk of selected birth defects. High DGI is associated with an increased risk of a number of birth defects under study. Obesity coupled with high DGI appears to increase the risk further for some birth defects. PMID:23171874

  19. Cardiovascular risk assessment using LOX-index and Self-Rating Depression Scale

    Directory of Open Access Journals (Sweden)

    Nobutaka Inoue

    2016-09-01

    Conclusions: LOX-Index appears to be a comprehensive marker that could evaluate the status of multiple CVD risk factors. The classification with LOX-Index and SDS could contribute to the risk assessment for CVD.

  20. Body mass index of adults with intellectual disability participating in Special Olympics by world region.

    Science.gov (United States)

    Temple, V A; Foley, J T; Lloyd, M

    2014-03-01

    People with intellectual disability (ID) experience poorer health and have more unmet health needs compared with people without ID, and they are often absent from population health surveillance. The aim of this study was to describe the body mass index (BMI) status of adult Special Olympics participants by world region and gender. Additionally, the general influence of age and gender on overweight/obesity of all participants was explored. A total of 11 643 (7150 male and 4493 female) Special Olympics BMI records were available from the Special Olympics International Health Promotion database. BMI was compared by gender and world region. Logistic regression was used to examine whether age and gender were associated with the likelihood of being overweight/obese (BMI ≥ 25.0). Overall, 5.5% of the sample was underweight, 36.1% in the normal range, 24.7% overweight and 32.1% obese, and levels of overweight/obesity were very high in North America. Both age and gender were significant predictors of overweight/obesity (odds ratios 1.06 and 0.59, respectively). Our findings demonstrate that adult Special Olympics participants have high levels of overweight and obesity; particularly among women and those from North America. It is crucial that those who work with, care for, coach and live with adults with ID who participate in Special Olympics increase efforts to promote healthy weight status. © 2013 The Authors. Journal of Intellectual Disability Research © 2013 John Wiley & Sons Ltd, MENCAP & IASSIDD.

  1. Body mass index for athletes participating in swimming at the World Masters Games.

    Science.gov (United States)

    Walsh, J; Climstein, M; Heazlewood, I T; Kettunen, J; Burke, S; Debeliso, M; Adams, K J

    2013-04-01

    Whilst there is growing evidence that physical activity across the lifespan is beneficial for improved health, there are many physiological changes involved with the aging process and subsequently the potential for reduced indices of health. The experimental aim was to gain improved understanding of the nexus between health, physical activity and aging by testing the hypothesis that prevalence of obesity (BMI ≥30 kg/m2) in the World Masters Games swimming cohort would be less than adult national populations. Body mass index (BMI) of 527 (49.7% male, 50.3% female) World Masters Games (WMG) swimmers aged 25-91 yrs (mean 54.3, standard deviation ±12.2) was investigated using a survey tool. Analysis demonstrated significantly (χ2=44.9, Paged ≥18years) Australian as well as other appropriate national populations. Investigation revealed, amongst other findings, that in line with trends shown in the adult Australian population, WMG male swimmers had a significantly higher BMI (mean 25.9 vs. 24.6) than their female counterparts (Z=-5.8, Page.

  2. 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.

  3. 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...

  4. A toxicity risk index, an index for warning idiosyncratic drug toxicity.

    Science.gov (United States)

    Morimoto, Miyoshi; Samizo, Kazuo; Ohta, Shin; Mizuma, Takashi

    2013-09-01

    Drug toxicity impedes drug development and its clinical use. In the present study, a toxicity risk index (TRI), which is an index for warning idiosyncratic drug toxicity (IDT), was proposed. The TRI of drugs was defined as a function of dose, pharmacokinetic parameters, and toxicokinetic data from covalent binding experiment. Twenty drugs, which were classified into three categories by a report (Nakayama S, Atsumi R, Takakusa H, Kobayashi Y, Kurihara A, Nagai Y, Nakai D, Okazaki O. 2009. Drug Metab Dispos 37:1970-1977), were studied with TRI. The three categories were BBW (drugs with a block box warning for IDT), WNG (drugs without a black box warning but with a warning for IDT), and SAFE (drugs without any warning). The TRIs of drugs classified as SAFE were distinctly different from those classified as BBW. The TRI of the SAFE drugs were lower than 0.456 (nmol/mg protein). In contrast, the TRI of the BBW drugs were higher than 1.10 (nmol/mg protein). These results warned us that a drug candidate, where the TRI is higher than 1.0 nmol/mg protein, should be categorized as a BBW drug. Further study with more data of TRI will give a cutoff value with a statistical meaning. Thus, TRI may be useful for decision making in drug development and its clinical use. Copyright © 2013 Wiley Periodicals, Inc.

  5. Extinction risk and conservation of the world's sharks and rays.

    Science.gov (United States)

    Dulvy, Nicholas K; Fowler, Sarah L; Musick, John A; Cavanagh, Rachel D; Kyne, Peter M; Harrison, Lucy R; Carlson, John K; Davidson, Lindsay Nk; Fordham, Sonja V; Francis, Malcolm P; Pollock, Caroline M; Simpfendorfer, Colin A; Burgess, George H; Carpenter, Kent E; Compagno, Leonard Jv; Ebert, David A; Gibson, Claudine; Heupel, Michelle R; Livingstone, Suzanne R; Sanciangco, Jonnell C; Stevens, John D; Valenti, Sarah; White, William T

    2014-01-01

    The rapid expansion of human activities threatens ocean-wide biodiversity. Numerous marine animal populations have declined, yet it remains unclear whether these trends are symptomatic of a chronic accumulation of global marine extinction risk. We present the first systematic analysis of threat for a globally distributed lineage of 1,041 chondrichthyan fishes-sharks, rays, and chimaeras. We estimate that one-quarter are threatened according to IUCN Red List criteria due to overfishing (targeted and incidental). Large-bodied, shallow-water species are at greatest risk and five out of the seven most threatened families are rays. Overall chondrichthyan extinction risk is substantially higher than for most other vertebrates, and only one-third of species are considered safe. Population depletion has occurred throughout the world's ice-free waters, but is particularly prevalent in the Indo-Pacific Biodiversity Triangle and Mediterranean Sea. Improved management of fisheries and trade is urgently needed to avoid extinctions and promote population recovery. DOI: http://dx.doi.org/10.7554/eLife.00590.001.

  6. Incidence and Mortality of Colorectal Cancer and Relationships with the Human Development Index across the World.

    Science.gov (United States)

    Rafiemanesh, Hosein; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Sepehri, Zahra; Shamlou, Reza; Salehiniya, Hamid; Towhidi, Farhad; Makhsosi, Behnam Reza

    2016-01-01

    This study aimed to investigate the standardized incidence and mortality rate of colorectal cancer and its relationship with the human development index (HDI) across the world in 2012. This ecologic study was conducted for assessment of the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its components. Data for SIR and SMR for every country for the year 2012 were obtained from the global cancer project. We used a bivariate method for assessment of the correlation between SIR and SMR and HDI. Statistical significance was assumed at <0.05. Statistical analyses were performed using SPSS (Version 22.0, SPSS Inc.). Countries with the highest SIR of colorectal cancer in the world in 2012, were Republic of Korea, Slovakia, Hungary and countries with the highest SMR were Hungary, Croatia and Slovakia. The correlation between SIR of colorectal cancer and the HDI was 0.712 (P≤0.001), with life expectancy at birth 0.513 (P≤0.001), with mean years of schooling 0.641 (P≤0.001) and with level of income per each person of the population 0.514 (P=0.013). In addition, the correlation between SMR of colorectal cancer and the HDI was 0.628 (P≤0.001), with life expectancy at birth 0.469 (P≤0.001), with mean years of schooling 0.592 (P≤0.001) and with level of income per each person of the population 0.378 (P=0.013). The highest SIR and SMR of colorectal cancer was in the WHO Europe region. There was a positive correlation between HDI and SIR and SMR of colorectal cancer.

  7. Higher body mass index may increase prehypertension risk

    Directory of Open Access Journals (Sweden)

    Rika Rachmawati

    2012-07-01

    Full Text Available Latar belakang: Kegemukan dapat berimplikasi terhadap berbagai masalah kesehatan, salah satunya adalah hipertensi. Banyak penelitian telah membuktikan kaitan erat antara kelebihan berat badan dengan hipertensi. Penelitian ini bertujuan untuk menganalisis besarnya risiko kegemukan berdasarkan indeks massa tubuh (IMT dan lingkar perut terhadap prahipertensi di Indonesia. Metode: Data berasal dari penelitian potong lintang Riskesdas 2007. Analisis dilakukan terhadap subjek berusia 18-60 tahun. Kriteria prahipertensi merujuk pada Joint National Committee on Prevention, Detection, Evaluation, And Treatment of High Blood Pressure, USA (JNC 7, sedangkan kelebihan berat badan dan obesitas berdasarkan Western Pacific Region of WHO (WPRO 2000. Hasil: Dari total 2884 responden yang dianalisis, 1660 (57,6% adalah kelompok tekanan darah prahipertensi dan 1224 (42,4% kelompok tekanan darah normal. Subjek yang kelebihan berat badan dibandingkan dengan normal berisiko 15% lebih besar menderita prahipertensi [risiko relatif suaian (RRa=1,15; 95% interval kepercayaan (CI=1,06-1,24], sedangan yang obes berisiko 25% lebih besar menderita prahipertensi (RRa =1,25; 95% CI=1,16-1,34. Selain itu subjek dengan kadar LDL tinggi dibandingkan dengan yang normal 11% menderita prahipertensi (RRa=1,11; 95% CI=0,99-1,24. Kesimpulan: Kelebihan berat badan, obesitas, dan kadar LDL tinggi meningkatkan risiko prahipertensi. Pemantauan berat badan oleh diri sendiri supaya tetap dalam kategori normal sebaiknya rutin dilakukan. (Health Science Indones 2011;2:21-7 Abstract Background: Obesity can create various health problems, one of which is hypertension. Many studies show a relationship between obesity and hypertension, however few reports on Indonesia. This paper assessed the risk of obesity based on body mass index (BMI and abdominal circumference against the prehypertension in Indonesia. Methods: For this analysis we used data from a cross sectional of Basic Health Research in

  8. Geriatric nutritional risk index: A mortality predictor in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mahnaz Edalat-Nejad

    2015-01-01

    Full Text Available Recently, the Geriatric Nutritional Risk Index (GNRI has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years. The GNRI score was estimated by an equation involving serum albumin and individual′s weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5 was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI <100, serum ferritin ≥ 500 μ g/L and age 65 years or older were significant predictors for mortality (hazard ratio 3.691, 95% CI 1.751-7.779, P = 0.001; hazard ratio 3.105, 95% CI 1.536-6.277, P = 0.002; and hazard ratio 2.806, 95% CI 1.297-6.073, P = 0.009, respectively, after adjustment to gender and vintage time. It can be concluded that, in addition to old age, malnutrition (low GNRI and inflammation (high ferritin are identified as significant independent risk factors that predict all-cause mortality in HD patients.

  9. Incidence and Mortality of Breast Cancer and their Relationship with the Human Development Index (HDI) in the World in 2012.

    Science.gov (United States)

    Ghoncheh, Mahshid; Mirzaei, Maryam; Salehiniya, Hamid

    2015-01-01

    Breast cancer is the most common malignancy in women worldwide and its incidence is generally increasing. In 2012, it was the second most common cancer in the world. It is necessary to obtain information on incidence and mortality for health planning. This study aimed to investigate the relationship between the human development index (HDI), and the incidence and mortality rates of breast cancer in the world in 2012. This ecologic study concerns incidence rate and standardized mortality rates of the cancer from GLOBOCAN in 2012, and HDI and its components extracted from the global bank site. Data were analyzed using correlation tests and regression with SPSS software (version 15). Among the six regions of WHO, the highest breast cancer incidence rate (67.6) was observed in the PAHO, and the lowest incidence rate was 27.8 for SEARO. There was a direct, strong, and meaningful correlation between the standardized incidence rate and HDI (r=0.725, p≤0.001). Pearson correlation test showed that there was a significant correlation between age-specific incidence rate (ASIR) and components of the HDI (life expectancy at birth, mean years of schooling, and GNP). On the other, a non-significant relationship was observed between ASIR and HDI overall (r=0.091, p=0.241). In total, a significant relationship was not found between age-specific mortality rate (ASMR) and components of HDI. Significant positive correlations exist between ASIR and components of the HDI. Socioeconomic status is directly related to the stage of the cancer and patient's survival. With increasing the incidence rate of the cancer, mortality rate from the cancer does not necessariloy increase. This may be due to more early detection and treatment in developed that developing countries. It is necessary to increase awareness of risk factors and early detection in the latter.

  10. The South African Vascular Surgical Cardiac Risk Index (SAVS-CRI ...

    African Journals Online (AJOL)

    The South African Vascular Surgical Cardiac Risk Index (SAVS-CRI): A prospective observational study. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Recent evidence suggests that application of the Revised Cardiac Risk Index (RCRI) for peri-operative cardiovascular risk stratification in vascular surgery patients ...

  11. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients

    Directory of Open Access Journals (Sweden)

    Lim JU

    2017-08-01

    Full Text Available Jeong Uk Lim,1 Jae Ha Lee,2 Ju Sang Kim,3 Yong Il Hwang,4 Tae-Hyung Kim,5 Seong Yong Lim,6 Kwang Ha Yoo,7 Ki-Suck Jung,4 Young Kyoon Kim,8 Chin Kook Rhee8 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, 2Division of Pulmonology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, 3Division of Pulmonary Medicine, Department of Internal Medicine, Incheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, 4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 5Division of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Introduction: A low body mass index (BMI is associated with increased mortality and low health-related quality of life in patients with COPD. The Asia-Pacific classification of BMI has a lower cutoff for overweight and obese categories compared to the World Health Organization (WHO classification. The present study assessed patients with COPD among different BMI categories according to two BMI classification systems: WHO and Asia-Pacific. Patients and methods: Patients with COPD aged 40 years or older from the Korean COPD Subtype Study cohort were selected for evaluation

  12. Childhood body mass index growth trajectories and endometrial cancer risk.

    Science.gov (United States)

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate; Ulrich, Lian G; Sørensen, Thorkild I A; Baker, Jennifer L

    2017-01-15

    Previously, we found that excess weight already in childhood has positive associations with endometrial cancer; however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial cancer and its sub-types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6-14 years and born 1930-1989 formed the analytical population. BMI was transformed to age-specific z scores. Using linear spline multilevel models, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25-7.99, 8.0-10.99, 11.0-14.0 years). Via a link to health registers, 1,020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain in BMI during childhood was positively associated with endometrial cancer but no differences between the different growth periods were detected in models adjusted for baseline BMI. The hazard ratios for the associations with overall growth during childhood per 0.1 z score increase were 1.15 (95% confidence interval [CI]: 1.07-1.24) for all endometrial cancers, 1.12 (95% CI: 1.04-1.21) for estrogen-dependent cancers, 1.16 (95% CI: 1.06-1.26) for endometrioid adenocarcinomas and 1.46 (95% CI: 1.16-1.84) for non-estrogen-dependent cancers. Growth in BMI in early life is positively linked to later endometrial cancer risk. We did not identify any sensitive childhood growth period, which suggests that excess gain in BMI during the entire childhood period should be avoided. © 2016 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  13. A survey of kidney disease and risk-factor information on the World Wide Web.

    Science.gov (United States)

    Calderón, José Luis; Zadshir, Ashraf; Norris, Keith

    2004-11-11

    Chronic kidney disease (CKD) is epidemic, and informing those at risk is a national health priority. However, the discrepancy between the readability of health information and the literacy skills of those it targets is a recognized barrier to communicating health information that may promote good health outcomes. Because the World Wide Web has become one of the most important sources of health information, we sought to assess the readability of commonly available CKD information. Twelve highly cited English-language, kidney disease Web sites were identified with 4 popular search engines. Each Web site was reviewed for the availability of 6 domains of information germane to CKD and risk-factor information. We estimated readability scores with the Flesch-Kincaid and Flesch Reading Ease Index methods. The deviation of readability scores for CKD information from readability appropriate to average literacy skills and the limited literacy skills of vulnerable populations (low socioeconomic status, health disparities, and elderly) were calculated. Eleven Web sites met the inclusion criteria. Six of 11 sites provided information on all 6 domains of CKD and risk-factor information. Mean readability scores for all 6 domains of CKD information exceeded national average literacy skills and far exceeded the fifth-grade-level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. Information on the World Wide Web about CKD and its risk factors may not be readable for comprehension by the general public, especially by underserved minority populations with limited literacy skills. Barriers to health communication may be important contributors to the rising CKD epidemic and disparities in CKD health status experienced by minority populations.

  14. Corporate ethics and risk management in an uncertain world

    OpenAIRE

    Coulson-Thomas, Colin

    2017-01-01

    A conference theme paper, raising issues and questions for directors ahead of the 2017 Global Convention on Corporate Ethics and Risk Management which is being held at the Bombay Stock exchange on the 17th and 18th February 2017. Areas covered include: corporate ethics, risk management, risk governance, corporate conduct, ethics in business decision making, risk prevention and mitigation, risk and return, risk management frameworks, approaches and responsibilities, corporate fraud, unpredicta...

  15. Comprehensive lipid tetrad index, atherogenic index and lipid peroxidation: Surrogate markers for increased cardiovascular risk in psoriasis.

    Science.gov (United States)

    Sunitha, S; Rajappa, Medha; Thappa, Devinder Mohan; Chandrashekar, Laxmisha; Munisamy, Malathi; Revathy, G; Priyadarssini, M

    2015-01-01

    Recently, the concept of "psoriatic march" has come to the fore, in which chronic cutaneous inflammation in psoriasis leads to systemic inflammation which, in conjunction with increased oxidative stress, triggers a cascade of events resulting in increased cardiovascular risk in patients with severe psoriasis. We, therefore, decided to study the levels of some biochemical cardiovascular risk markers: lipid peroxidation (malondialdehyde), lipoprotein (a), lipid indices and atherogenic index, in patients with psoriasis and their association with disease severity. Forty five patients with psoriasis and 45 age and gender-matched healthy controls were included in this cross-sectional study. Disease severity was assessed by the Psoriasis Area Severity Index (PASI). Serum malondialdehyde, lipoprotein (a) and fasting lipid profile were estimated in all study subjects. Lipoprotein ratios were computed using standard formulae. Atherogenic index was calculated as ratio of lipoprotein (a)/high-density lipoprotein. In psoriasis, we observed significantly higher levels of malondialdehyde, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, lipoprotein (a), lipid ratios, atherogenic index and comprehensive lipid tetrad index, compared to controls. These levels were directly proportional to disease severity. Serum levels of malondialdehyde correlated positively with serum lipoprotein (a), comprehensive lipid tetrad index and atherogenic index. Different morphological types of psoriasis were not included and follow-up post-therapy was not done. A larger sample size would have validated the results further. Our results indicate that psoriasis, especially the severe variants, are associated with increased oxidative stress and dyslipidemia, which correlate positively with atherogenic index and hence, an increased cardiovascular risk.

  16. The Financial Stress Index: Identification of Systemic Risk Conditions

    Directory of Open Access Journals (Sweden)

    Mikhail V. Oet

    2015-09-01

    Full Text Available This paper develops a financial stress measure for the United States, the Cleveland Financial Stress Index (CFSI. The index is based on publicly available data describing a six-market partition of the financial system comprising credit, funding, real estate, securitization, foreign exchange, and equity markets. This paper improves upon existing stress measures by objectively selecting between several index weighting methodologies across a variety of monitoring frequencies through comparison against a volatility-based benchmark series. The resulting measure facilitates the decomposition of stress to identify disruptions in specific markets and provides insight into historical stress regimes.

  17. Development of a diet index for older adults and its relation to cardiovascular disease risk factors: the Elderly Dietary Index.

    Science.gov (United States)

    Kourlaba, Georgia; Polychronopoulos, Evangelos; Zampelas, Antonis; Lionis, Christos; Panagiotakos, Demosthenes B

    2009-06-01

    To develop an index that assesses the degree of adherence to nutritional recommendations for older adults (Elderly Dietary Index [EDI]) and investigate its association with risk factors related to cardiovascular disease (CVD). The EDI was constructed using 10 components (ie, questions about the consumption frequency of meat, fish, fruits, vegetables, grains, legumes, olive oil, and alcohol as well as the type of bread and dairy products) according to the Modified MyPyramid for Older Adults and select features of the traditional Mediterranean diet. Scores from 1 to 4 were assigned to all components of the index. The EDI total score had a range between 10 and 40. As a validation procedure, a sample of 668 elderly individuals without known CVD (the MEDIS Study) was used to evaluate the associations between the proposed index and various health outcomes. The overall mean EDI score was 29.2+/-3.5. This score implies that study participants were 73% (ie, 29.2/40) adherent to the nutritional recommendations that the EDI evaluates. Regarding the conventional CVD risk factors, it was found that a 1 unit increase in the EDI score is associated with almost 10% lower odds of being obese or hypertensive or having at least one of the investigated CVD risk factors (Phealth policymakers and other health care professionals to assess diet quality and health status (especially concerning the risk for developing CVD) in older adults.

  18. Developing a new Bayesian Risk Index for risk evaluation of soil contamination.

    Science.gov (United States)

    Albuquerque, M T D; Gerassis, S; Sierra, C; Taboada, J; Martín, J E; Antunes, I M H R; Gallego, J R

    2017-12-15

    Industrial and agricultural activities heavily constrain soil quality. Potentially Toxic Elements (PTEs) are a threat to public health and the environment alike. In this regard, the identification of areas that require remediation is crucial. In the herein research a geochemical dataset (230 samples) comprising 14 elements (Cu, Pb, Zn, Ag, Ni, Mn, Fe, As, Cd, V, Cr, Ti, Al and S) was gathered throughout eight different zones distinguished by their main activity, namely, recreational, agriculture/livestock and heavy industry in the Avilés Estuary (North of Spain). Then a stratified systematic sampling method was used at short, medium, and long distances from each zone to obtain a representative picture of the total variability of the selected attributes. The information was then combined in four risk classes (Low, Moderate, High, Remediation) following reference values from several sediment quality guidelines (SQGs). A Bayesian analysis, inferred for each zone, allowed the characterization of PTEs correlations, the unsupervised learning network technique proving to be the best fit. Based on the Bayesian network structure obtained, Pb, As and Mn were selected as key contamination parameters. For these 3 elements, the conditional probability obtained was allocated to each observed point, and a simple, direct index (Bayesian Risk Index-BRI) was constructed as a linear rating of the pre-defined risk classes weighted by the previously obtained probability. Finally, the BRI underwent geostatistical modeling. One hundred Sequential Gaussian Simulations (SGS) were computed. The Mean Image and the Standard Deviation maps were obtained, allowing the definition of High/Low risk clusters (Local G clustering) and the computation of spatial uncertainty. High-risk clusters are mainly distributed within the area with the highest altitude (agriculture/livestock) showing an associated low spatial uncertainty, clearly indicating the need for remediation. Atmospheric emissions, mainly

  19. Reducing the risk of public health emergencies for the world's largest mass gathering: 2010 World Exposition, Shanghai China.

    Science.gov (United States)

    Sun, Xiaodong; Keim, Mark; He, Yongchao; Mahany, Mollie; Yuan, Zheng'an

    2013-01-01

    Mass Gatherings and Public Health   Mass gatherings are highly visible events with the potential for serious health and political consequences if not managed carefully and effectively.1-4 Mass gatherings have been reported to have significant impact upon public health systems throughout the world.5-10 International mass gathering events, such as those associated with the Olympic Games, often carry high political significance and have a historical risk for terrorist attacks.2 Mass gatherings ranging from the subnational level to international the level have also been associated with outbreaks and subsequent spread of communicable diseases. These events have included outbreaks of foodborne shigellosis occurring at an outdoor music festival in the United States.5,6 The annual Hajj pilgrimage in Saudi Arabia has been plagued by public health threats such as fires, stampedes and an outbreak of meningitis.7,9 Influenza outbreaks were also reported during the 2008 World Youth Day mass gathering in Australia.10 Local, provincial and national public health and medical agencies are frequently involved before, during and after a major event. Therefore, disaster risk reduction is a key element for the effective management of mass gatherings. Disaster Risk Reduction Throughout the world, the overall approach to emergencies and disasters has recently shifted from post-impact activities (i.e., ad hoc relief and reconstruction) to a more systematic and comprehensive process of risk management.11 Disaster risk management includes pre-impact disaster risk reduction (i.e., prevention, preparedness and mitigation) as well as post-impact response and recovery).12 While planners may not always have the ability to prevent health hazards from occurring at mass gathering events, the health sector can play an important role in preventing the public health impact of such hazards. This manuscript describes a comprehensive approach for disaster risk reduction as implemented by those entities

  20. Dietary Glycemic Index, Glycemic Load, and Risk of Cancer: A Prospective Cohort Study

    OpenAIRE

    George, Stephanie Materese; Mayne, Susan T.; Leitzmann, Michael F.; Park, Yikyung; Schatzkin, Arthur; Flood, Andrew; Hollenbeck, Albert; Subar, Amy F.

    2008-01-01

    Previous studies have provided limited evidence for a harmful effect of high glycemic index and dietary glycemic load on cancer. The authors analyzed associations among glycemic index, glycemic load, and risk of cancer in women and men in the National Institutes of Health–AARP Diet and Health Study. Published glycemic index values were assigned to 225 foods/food groups. Glycemic load was calculated by multiplying the glycemic index, carbohydrate content, and intake frequency of individual foo...

  1. [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.

  2. 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.

  3. Mikkeli Osteoporosis Index Identifies Fracture Risk Factors and Osteoporosis and Intervention Thresholds Parallel with FRAX

    OpenAIRE

    Ville Juhana Waris; Sirola, Joonas P.; Kiviniemi, Vesa V.; Tuppurainen, Marjo T.; V. Pekka Waris

    2011-01-01

    Osteoporosis Index (MOI) was developed from Fracture Index (FI), a validated fracture risk score, to identify also osteoporosis. MOI risk factors are age, weight, previous fracture, family history of hip fracture or spinal osteoporosis, smoking, shortening of the stature, and use of arms to rise from a chair. The association of these risk factors with BMD was examined in development cohorts of 300 Finnish postmenopausal women with a fracture and in a population control of 434 women aged 65–72...

  4. Incidence and mortality of kidney cancer and its relationship with HDI (Human Development Index) in the world in 2012.

    Science.gov (United States)

    Mohammadian, Maryam; Pakzad, Reza; Towhidi, Farhad; Makhsosi, Behnam Reza; Ahmadi, Abbas; Salehiniya, Hamid

    2017-01-01

    Kidney cancer is among the cancers that have the highest growth rate in all age and racial groups in the world and is as the most deadly type of urinary tract cancer. Since awareness about this cancer incidence status and mortality is essential for better planning, this study aimed to investigate the incidence and mortality rate of kidney cancer and its relationship with the development index in the world in 2012. This study was an ecological study conducted based on GLOBOCAN project of the World Health Organization (WHO) for the countries in the world. The correlation between Standardized Incidence Rates (SIRs) and Standardized Mortality Rates (SMRs) of kidney cancer with HDI and its components was assessed using SPSS18. In total, 337,860 incidence cases (213,924 were men and 123,936 women) and 143,406 deaths (90,802 cases in men and 52,604 in women) of kidney cancer were recorded in 2012. A positive correlation of 0.731 was seen between SIR of kidney cancer and HDI (p≤0.001). Also, a negative correlation of 0.627 was seen between SMR of kidney cancer and HDI (p≤0.001). The incidence and mortality rate of kidney cancer is higher in developed countries. A significant positive correlation has been seen between the standardized incidence and mortality rate of kidney cancer with the Human Development Index and its components. We need more studies to examine variation in incidence and mortality of kidney cancer and its related factors in the world.

  5. 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 ...

  6. World Health Organization cardiovascular risk stratification and target organ damage.

    Science.gov (United States)

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of 20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

    Coccon, Francesca; Zucchetta, Matteo; Bossi, Giulia; Borrotti, Matteo; Torricelli, Patrizia; Franzoi, Piero

    2015-01-01

    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.

  8. 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.

  9. 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.

  10. Evaluation of the Balloon Analogue Risk Task (BART) as a Predictor of Adolescent Real-World Risk-Taking Behaviors.

    Science.gov (United States)

    Lejuez, C. W.; Aklin, Will M.; Zvolensky, Michael J.; Pedulla, Christina M.

    2003-01-01

    A sample of 26 adolescents tested the utility of the Balloon Analogue Risk Task (BART) as a behavioral measure of risk-taking propensity. Data indicate that riskyness on the BART was related to self-reported engagement in real-world risk-taking behaviors. These data suggest that the BART may be a useful addition to self-report batteries for the…

  11. Human population density and extinction risk in the world's carnivores.

    Science.gov (United States)

    Cardillo, Marcel; Purvis, Andy; Sechrest, Wes; Gittleman, John L; Bielby, Jon; Mace, Georgina M

    2004-07-01

    Understanding why some species are at high risk of extinction, while others remain relatively safe, is central to the development of a predictive conservation science. Recent studies have shown that a species' extinction risk may be determined by two types of factors: intrinsic biological traits and exposure to external anthropogenic threats. However, little is known about the relative and interacting effects of intrinsic and external variables on extinction risk. Using phylogenetic comparative methods, we show that extinction risk in the mammal order Carnivora is predicted more strongly by biology than exposure to high-density human populations. However, biology interacts with human population density to determine extinction risk: biological traits explain 80% of variation in risk for carnivore species with high levels of exposure to human populations, compared to 45% for carnivores generally. The results suggest that biology will become a more critical determinant of risk as human populations expand. We demonstrate how a model predicting extinction risk from biology can be combined with projected human population density to identify species likely to move most rapidly towards extinction by the year 2030. African viverrid species are particularly likely to become threatened, even though most are currently considered relatively safe. We suggest that a preemptive approach to species conservation is needed to identify and protect species that may not be threatened at present but may become so in the near future.

  12. Human population density and extinction risk in the world's carnivores.

    Directory of Open Access Journals (Sweden)

    Marcel Cardillo

    2004-07-01

    Full Text Available Understanding why some species are at high risk of extinction, while others remain relatively safe, is central to the development of a predictive conservation science. Recent studies have shown that a species' extinction risk may be determined by two types of factors: intrinsic biological traits and exposure to external anthropogenic threats. However, little is known about the relative and interacting effects of intrinsic and external variables on extinction risk. Using phylogenetic comparative methods, we show that extinction risk in the mammal order Carnivora is predicted more strongly by biology than exposure to high-density human populations. However, biology interacts with human population density to determine extinction risk: biological traits explain 80% of variation in risk for carnivore species with high levels of exposure to human populations, compared to 45% for carnivores generally. The results suggest that biology will become a more critical determinant of risk as human populations expand. We demonstrate how a model predicting extinction risk from biology can be combined with projected human population density to identify species likely to move most rapidly towards extinction by the year 2030. African viverrid species are particularly likely to become threatened, even though most are currently considered relatively safe. We suggest that a preemptive approach to species conservation is needed to identify and protect species that may not be threatened at present but may become so in the near future.

  13. Stroke Risk Factors among Participants of a World Stroke Day ...

    African Journals Online (AJOL)

    Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. Materials and Methods: We screened 224 volunteers from Ile‑Ife during the 2011 and ...

  14. Money laundering regulatory risk evaluation using Bitmap Index-based Decision Tree

    OpenAIRE

    Jayasree, Vikas; R.V. Siva Balan

    2017-01-01

    This paper proposes to evaluate the adaptability risk in money laundering using Bitmap Index-based Decision Tree (BIDT) technique. Initially, the Bitmap Index-based Decision Tree learning is used to induce the knowledge tree which helps to determine a company’s money laundering risk and improve scalability. A bitmap index in BIDT is used to effectively access large banking databases. In a BIDT bitmap index, account in a table is numbered in sequence with each key value, account number and a b...

  15. 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.

  16. World population: the risks and the prejudices. World Conference on Population and Development.

    Science.gov (United States)

    Goutier, H

    1994-01-01

    The UN Conference on Population and Development in Cairo during September 1994 aimed to find ways of limiting population explosion over the next 20 years (until 2015). Present world population is 5.6 billion and may double in 50 years, which would seriously compromise resources. In this article, abortion is viewed as the most controversial conference topic, which had to be carefully defined as a public health problem rather than a means of birth control. Other issues which generated considerable conflict of opinion included immigration quotas in developed countries and reservations about the "rights" of immigrants to reunite with families. Agreement was reached about the "fair principle" of reuniting families. The nongovernmental organization agenda was unsuccessful in promoting the issue of women's vulnerability to political and economic causes of migration and awareness of women's lack of access to independent refugee status or political asylum for sexual oppression. Every chapter in the UN Conference document had a reference to women. Chapter Eleven's topic on access to education for both boys and girls was diluted from "equal" access to "fair" access due to Muslim objections based on sacred writings. Taboo subjects included women's control over their bodies and premarital sex, human rights, and respect for cultures. The conference never affirmed the free right of women to make decisions about their bodies. Participants would have preferred greater attention to development issues such as the rapid decline in fertility in countries such as Colombia, Zimbabwe, Thailand, and China. The link between economic growth and population control was viewed by the conference as hypothetical. A well-known French demographer stated that the "major squanderers" of world resources are countries with low birth rates. The overpopulation fear is defined as the fear of having to share or restrict even surpluses. The most prominent statement at Cairo was made by Mrs. Bhutto, who said

  17. Assessing and managing multiple risks in a changing world — The Roskilde recommendations

    DEFF Research Database (Denmark)

    Selck, Henriette; Adamsen, Peter B.; Backhaus, Thomas

    2017-01-01

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services......) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk...

  18. 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.

  19. Performance assessment of the risk index category for surgical site infection after colorectal surgery.

    Science.gov (United States)

    Watanabe, Masanori; Suzuki, Hideyuki; Nomura, Satoshi; Hanawa, Hidetsugu; Chihara, Naoto; Mizutani, Satoshi; Yoshino, Masanori; Uchida, Eiji

    2015-02-01

    The traditional National Healthcare Safety Network (previously National Nosocomial Infections Surveillance) risk index is used to predict the risk of surgical site infection across many operative procedures. However, this index may be too simple to predict risk in the various procedures performed in colorectal surgery. The aim of this study was to evaluate the usefulness of the risk index by analyzing the impact of the risk index factors on surgical site infection after abdominal colorectal surgery. Using our surgical site infection surveillance database, we analyzed retrospectively 538 consecutive patients who underwent abdominal colorectal surgery between 2005 and 2010. Correlations between surgical site infection and the following risk index factors were analyzed: length of operation, American Society of Anesthesiologists score, wound classification, and use of laparoscopy. The 75th percentile for length of operation was determined separately for open and laparoscopic surgery in the study model. Univariate analyses showed that surgical site infection was more strongly associated with a >75th percentile length of operation in the study model (odds ratio [OR], 2.07) than in the traditional risk index model (OR, 1.64). Multivariable analysis found that surgical site infection was independently associated with a >75th percentile length of operation in the study model (OR, 2.75; 95% confidence interval [CI], 1.66-4.55), American Society of Anesthesiologists score ≥3 (OR, 2.22; 95% CI, 1.10-4.34), wound classification ≥III (OR, 5.29; 95% CI, 2.62-10.69), and open surgery (OR, 2.21; 95% CI, 1.07-5.17). Performance of the risk index category was improved in the study model compared with the traditional model. The risk index category is sufficiently useful for predicting the risk of surgical site infection after abdominal colorectal surgery. However, the 75th percentile length of operation should be set separately for open and laparoscopic surgery.

  20. Extinction risk and conservation of the world's sharks and rays

    National Research Council Canada - National Science Library

    Dulvy, Nicholas K; Fowler, Sarah L; Musick, John A; Cavanagh, Rachel D; Kyne, Peter M; Harrison, Lucy R; Carlson, John K; Davidson, Lindsay Nk; Fordham, Sonja V; Francis, Malcolm P; Pollock, Caroline M; Simpfendorfer, Colin A; Burgess, George H; Carpenter, Kent E; Compagno, Leonard Jv; Ebert, David A; Gibson, Claudine; Heupel, Michelle R; Livingstone, Suzanne R; Sanciangco, Jonnell C; Stevens, John D; Valenti, Sarah; White, William T

    2014-01-01

    ... these trends are symptomatic of a chronic accumulation of global marine extinction risk. We present the first systematic analysis of threat for a globally distributed lineage of 1,041 chondrichthyan fishes-sharks, rays, and chimaeras...

  1. EXPLAINING THE PERCEPTION OF SMALLHOLDERS TOWARDS WEATHER INDEX MICRO-INSURANCE ALONGSIDE RISKS AND COPING STRATEGIES

    Directory of Open Access Journals (Sweden)

    Hezron Nyarindo Isaboke

    2016-10-01

    Full Text Available Many studies associate smallholders with negative attitudes towards weather index-based micro-insurance. This article analyses the perceptions of small-scale maize producers towards weather index insurance amid common risks and coping strategies. Findings do not strongly suggest a negative attitude towards weather index insurance among smallholders thus controverting hitherto studies. Rather, the study postulates that other risks facing smallholders and their risk responses disposition may distort and override farmers’ attitude towards weather index insurance. Further, results of the Ordered Probit model revealed that Sex of the household head, size of the household, if a farmer experienced crop loss in the previous farming seasons, off-farm income, if a farmer received compensation, the level of education of the household head, if the household head accessed Credit and group membership had a significant influence on the perception of the smallholders towards the index-based micro insurance scheme.

  2. A Risk Prediction Index for Amiodarone-Induced Thyrotoxicosis in Adults with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Marius N. Stan

    2012-01-01

    Full Text Available Amiodarone therapy in adults with congenital heart disease (CHD is associated with a significant risk of amiodarone-induced thyrotoxicosis (AIT. We developed a risk index to identify those patients being considered for amiodarone treatment who are at high risk for AIT. We reviewed the health records of adults with CHD and assessed the association between potential clinical predictors and AIT. Significant predictors were included in multivariate analyses. The parameter estimates from multivariate analysis were subsequently used to develop a risk index. 169 adults met eligibility criteria and 23 developed AIT. The final model included age, cyanotic heart disease and BMI. The risk index developed identified 3 categories of risk. Their AIT likelihood ratios were: 0.37 for low risk (95% CI 0.15–0.92; 1.12 for medium risk (95% CI 0.65–1.91; and 3.47 for high risk (95% CI 1.7–7.11. The AIT predicted risk in our population was 5% for the low risk group, 15% for the medium risk group and 47% for the high risk group. Conclusions. We derived the first model to quantify the risk for developing AIT among adults with CHD. Before using it clinically to help selecting among alternative antiarrhythmic options, it needs validation in an independent population.

  3. 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.

  4. Childhood body mass index and multiple sclerosis risk

    DEFF Research Database (Denmark)

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

    2013-01-01

    was associated with MS risk among 302,043 individuals in the Copenhagen School Health Records Register (CSHRR). Linking the CSHRR with the Danish MS registry yielded 774 MS cases (501 girls, 273 boys). We used Cox proportional hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs......). RESULTS: Among girls, at each age 7-13 years, a one-unit increase in BMI z-score was associated with an increased risk of MS (HRage 7=1.20, 95% CI: 1.10-1.30; HRage 13=1.18, 95% CI: 1.08-1.28). Girls who were ≥95(th) percentile for BMI had a 1.61-1.95-fold increased risk of MS as compared to girls...

  5. Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

    OpenAIRE

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    ♦ Background: The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.

  6. Dietary glycemic load, glycemic index and colorectal cancer risk: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Weijenberg, M.P.; Mullie, P.F.F.; Brants, H.A.M.; Heinen, M.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2008-01-01

    Since hyperinsulinemia is implicated in the development of colorectal cancer, determinants of serum insulin levels, like the glycemic load and the glycemic index of the diet, could influence cancer risk. Our objective was to evaluate whether a diet with a high glycemic load or glycemic index is

  7. 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 dr...... 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....

  8. Incidence and Mortality of Nasopharynx Cancer and Its Relationship With Human Development Index in the World in 2012.

    Science.gov (United States)

    Mahdavifar, Neda; Towhidi, Farhad; Makhsosi, Behnam Reza; Pakzad, Reza; Moini, Ali; Ahmadi, Abbas; Lotfi, Sarah; Salehiniya, Hamid

    2016-12-01

    One of the most common cancers in head and neck is nasopharynx. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study, better planning and prevention. Therefore, this study aimed to determine the incidence and mortality of nasopharynx cancer and its relationship with human development index (HDI) in the world in 2012. This study was an ecological study conducted based on GLOBOCAN project of World Health Organization (WHO) for the countries in world. The correlation between standardized incidence rates (SIRs) and standardized mortality rates (SMRs) of nasopharynx cancer with HDI and its components was assessed with correlation coefficient by using SPSS 15. In 2012, 86,691 nasopharynx cancer cases occurred in the world, so that 60,896 new cases were seen in men and 25,795 new cases in women (sex ratio = 2.36). SIR of the cancer was 1.2 per 100,000 (1.7 in men and 0.7 in women per 100,000) in the world. In 2012, 50,831 nasopharynx death cases occurred in the world, so that 35,756 death cases were seen in men and 15,075 death cases in women (sex ratio = 2.37). SIR of mortality from the cancer was 0.7 per 100,000 (0.7 in women and 1 in men per 100,000) in the world. The results of correlation analysis showed a negative correlation between the SIR and HDI (r = -0.037, P = 0.629), and also the results of correlation analysis showed a negative correlation between the SMR and HDI (r = -0.237, P = 0.002). Nasopharyngeal cancer is native to Southeast Asia and the highest incidence and mortality were seen in countries with moderate and low HDI. It is suggested that studies are conducted on determining the causes of the cancer incidence and mortality in the world and the differences between various regions.

  9. Assessing and managing multiple risks in a changing world – the Roskilde recommendations.

    Science.gov (United States)

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common curre...

  10. 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....

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

  12. Sensitive Index to Assess Risk of Morbidity in Undernutrition | CRDI ...

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

    This grant will allow the NFI to test this hypothesis in a secondary analysis of data from the National Family Health Survey-3. Using a sample of 46 000 preschool children from the survey, researchers will determine the relative risk of morbidity due to infections and undernutrition (stunting, underweight and low BMI for age) ...

  13. Indexing of exoplanets in search for potential habitability: application to Mars-like worlds

    Science.gov (United States)

    Kashyap Jagadeesh, Madhu; Gudennavar, Shivappa B.; Doshi, Urmi; Safonova, Margarita

    2017-08-01

    Study of exoplanets is one of the main goals of present research in planetary sciences and astrobiology. Analysis of huge planetary data from space missions such as CoRoT and Kepler is directed ultimately at finding a planet similar to Earth—the Earth's twin, and answering the question of potential exo-habitability. The Earth Similarity Index (ESI) is a first step in this quest, ranging from 1 (Earth) to 0 (totally dissimilar to Earth). It was defined for the four physical parameters of a planet: radius, density, escape velocity and surface temperature. The ESI is further sub-divided into interior ESI (geometrical mean of radius and density) and surface ESI (geometrical mean of escape velocity and surface temperature). The challenge here is to determine which exoplanet parameter(s) is important in finding this similarity; how exactly the individual parameters entering the interior ESI and surface ESI are contributing to the global ESI. Since the surface temperature entering surface ESI is a non-observable quantity, it is difficult to determine its value. Using the known data for the Solar System objects, we established the calibration relation between surface and equilibrium temperatures to devise an effective way to estimate the value of the surface temperature of exoplanets. ESI is a first step in determining potential exo-habitability that may not be very similar to a terrestrial life. A new approach, called Mars Similarity Index (MSI), is introduced to identify planets that may be habitable to the extreme forms of life. MSI is defined in the range between 1 (present Mars) and 0 (dissimilar to present Mars) and uses the same physical parameters as ESI. We are interested in Mars-like planets to search for planets that may host the extreme life forms, such as the ones living in extreme environments on Earth; for example, methane on Mars may be a product of the methane-specific extremophile life form metabolism.

  14. 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...

  15. Variations of Infant and Under-five Child Mortality Rates around the World, the Role of Human Development Index (HDI

    Directory of Open Access Journals (Sweden)

    Salman Khazaei

    2016-05-01

    Full Text Available Background: The Human Development Index (HDI is a composite statistic of life expectancy, education, and income per capita indicators, which apart from measuring the socio-economic development of countries can predict health outcomes. The current study aimed at determination of the effects of HDI individual components on infant and child mortality. Materials and Methods: At a cross- sectional study,data on infant and child mortality rates and values for HDI individual components were obtained from the World Health Organization (WHO and the World Bank respectively. The effect of HDI individual components on infant and child mortality were derived from linear regression models. Results: During 1990-2015, infant and child mortality have declined in all countries. Most proportion of child mortality is attributed to death in infants. All HDI individual components significantly  inversely were related to infant mortality rate (IMR and among them expected years of schooling has the strongest effect with regression coefficient of β= -5.9 (95% CI: -6.63, -5.13. Conclusion: The highest IMRs have been observed for EMRO and AFRO regions of the WHO. Policies targeting women health and empowerment can have a tremendous impact on reducing child mortality rates around the world.

  16. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world.

    Science.gov (United States)

    Rafiemanesh, Hosein; Mehtarpour, Mojtaba; Khani, Farah; Hesami, Sayed Mohammadali; Shamlou, Reza; Towhidi, Farhad; Salehiniya, Hamid; Makhsosi, Behnam Reza; Moini, Ali

    2016-06-01

    The highest incidence of lung cancer is seen in North America and the lowest incidence in central Africa. Socioeconomic factors of inequality reflect regional disparities in human development. Due to the importance of awareness about incidence and mortality of lung cancer in health programming and the possible role of the human development index (HDI), this study was done with the aim to investigate the epidemiology of lung cancer in the world and its relationship with HDI. The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). Data about the age-specific incidence and mortality rate (ASR) for every country in 2012 were getting from the global cancer project. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. Lung cancer with standardized incidence rate (ASIR) and standardized mortality rate (ASMR), equal to 23.1 and 19.7 (in 100,000 people), respectively. The highest and lowest values of mortality incidence ratio (MIR) for lung cancer due to continents division were 0.93 and 0.71 for Eastern Africa and Australia/New Zealand, respectively. Univariate analysis showed significant relationship (PASMR with life expectancy at birth and mean years of schooling. The highest MIR for lung cancer was for medium human development countries. Linear regression analysis showed a reverse significant relationship between MIR and HDI.

  17. Improving Sharia Risk Compliance: Proposing Daily Index for Mudharaba Contract in Islamic Banks in Indonesia

    Directory of Open Access Journals (Sweden)

    Laode Hasahu

    2012-01-01

    Full Text Available Objective – The objective of this paper is to analyze the profit distribution method applied in Islamic banks in Indonesia and to propose better method in order to improve sharia risk compliance.Methods – Employing a descriptive quantitative method and literature review. This paper evaluate weaknesses of the current profit distribution method and proposes daily revenue index to solve the problems arising from using current method which is unfairness between bank and customers.Results – By the two current profit distribution methods which use monthly revenue index calculated only at the end of the month, there are potential injustices occur. Therefore, instead of using monthly index, daily index is proposed. There are two steps in calculating profit distribution by using daily revenue index: (1 Accumulating Source of Fund (SoF, Reserve Requirement (RR, and Source of Fund after Reserve Requirement (SoFaRR, and (2 Determining Average Financing (AF, Revenue Index (RI, Cost Index (CI, Revenue Sharing Index (RSI, and Profit Sharing Index (PSI.Conclusion - Daily revenue index will solve the unfairness problems arise from current profit distribution method applied in Islamic banks. Daily revenue index is also applicable if Islamic banks apply profit and loss sharing instead of revenue sharing.

  18. Global projections of river flood risk in a warmer world

    Science.gov (United States)

    Alfieri, Lorenzo; Bisselink, Berny; Dottori, Francesco; Naumann, Gustavo; de Roo, Ad; Salamon, Peter; Wyser, Klaus; Feyen, Luc

    2017-02-01

    Rising global temperature has put increasing pressure on understanding the linkage between atmospheric warming and the occurrence of natural hazards. While the Paris Agreement has set the ambitious target to limiting global warming to 1.5°C compared to preindustrial levels, scientists are urged to explore scenarios for different warming thresholds and quantify ranges of socioeconomic impact. In this work, we present a framework to estimate the economic damage and population affected by river floods at global scale. It is based on a modeling cascade involving hydrological, hydraulic and socioeconomic impact simulations, and makes use of state-of-the-art global layers of hazard, exposure and vulnerability at 1-km grid resolution. An ensemble of seven high-resolution global climate projections based on Representative Concentration Pathways 8.5 is used to derive streamflow simulations in the present and in the future climate. Those were analyzed to assess the frequency and magnitude of river floods and their impacts under scenarios corresponding to 1.5°C, 2°C, and 4°C global warming. Results indicate a clear positive correlation between atmospheric warming and future flood risk at global scale. At 4°C global warming, countries representing more than 70% of the global population and global gross domestic product will face increases in flood risk in excess of 500%. Changes in flood risk are unevenly distributed, with the largest increases in Asia, U.S., and Europe. In contrast, changes are statistically not significant in most countries in Africa and Oceania for all considered warming levels.

  19. Temporal constraints on predation risk assessment in a changing world

    Energy Technology Data Exchange (ETDEWEB)

    Chivers, Douglas P., E-mail: doug.chivers@usask.ca [Department of Biology, University of Saskatchewan, Saskatoon, SK S7N 5E2 (Canada); Ramasamy, Ryan A.; McCormick, Mark I.; Watson, Sue-Ann [ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville Qld4811 (Australia); School of Marine and Tropical Biology, James Cook University, Townsville Qld4811 (Australia); Siebeck, Ulrike E. [School of Biomedical Sciences, University of Queensland, Brisbane Qld4072 (Australia); Ferrari, Maud C.O. [Department of Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, SK S7W 5B4 (Canada)

    2014-12-01

    Habitat degradation takes various forms and likely represents the most significant threat to our global biodiversity. Recently, we have seen considerable attention paid to increasing global CO{sub 2} emissions which lead to ocean acidification (OA). Other stressors, such as changing levels of ultraviolet radiation (UVR), also impact biodiversity but have received much less attention in the recent past. Here we examine fundamental questions about temporal aspects of risk assessment by coral reef damselfish and provide critical insights into how OA and UVR influence this assessment. Chemical cues released during a predator attack provide a rich source of information that other prey animals use to mediate their risk of predation and are the basis of the majority of trait-mediated indirect interactions in aquatic communities. However, we have surprisingly limited information about temporal aspects of risk assessment because we lack knowledge about how long chemical cues persist after they are released into the environment. Here, we showed that under ambient CO{sub 2} conditions (∼ 385 μatm), alarm cues of ambon damselfish (Pomacentrus amboinensis) did not degrade within 30 min in the absence of ultraviolet radiation (UVR), but were degraded within 15 min when the CO{sub 2} was increased to ∼ 905 μatm. In experiments that used filters to eliminate UVR, we found minimal degradation of alarm cues within 30 min, whereas under ambient UVR conditions, alarm cues were completely degraded within 15 min. Moreover, in the presence of both UVR and elevated CO{sub 2}, alarm cues were broken down within 5 min. Our results highlight that alarm cues degrade surprisingly quickly under natural conditions and that anthropogenic changes have the potential to dramatically change rates of cue degradation in the wild. This has considerable implications for risk assessment and consequently the importance of trait-mediated indirect interactions in coral-reef communities. - Highlights:

  20. Extinction risk and conservation of the world's sharks and rays

    OpenAIRE

    Dulvy, Nicholas K.; Fowler, Sarah L.; Musick, John A.; Cavanagh, Rachel D.; Kyne, Peter M.; Harrison, Lucy R.; Carlson, John K.; Davidson, Lindsay N.; Fordham, Sonja V.; Francis, Malcolm P.; Pollock, Caroline M.; Simpfendorfer, Colin A.; Burgess, George H.; Carpenter, Kent E.; Compagno, Leonard J.V.

    2014-01-01

    eLife digest Ocean ecosystems are under pressure from overfishing, climate change, habitat destruction and pollution. These pressures have led to documented declines of some fishes in some places, such as those living in coral reefs and on the high seas. However, it is not clear whether these population declines are isolated one-off examples or, instead, if they are sufficiently widespread to risk the extinction of large numbers of species. Most fishes have a skeleton that is made of bone, bu...

  1. Ability to predict the development of surgical site infection in cardiac surgery using the Australian Clinical Risk Index versus the National Nosocomial Infections Surveillance-derived Risk Index.

    Science.gov (United States)

    Figuerola-Tejerina, A; Bustamante, E; Tamayo, E; Mestres, C A; Bustamante-Munguira, J

    2017-06-01

    Surgical site infection (SSI) is a major infectious complication that increases mortality, morbidity, and healthcare costs. There are scores attempting to classify patients for calculating SSI risk. Our objectives were to validate the Australian Clinical Risk Index (ACRI) in a European population after cardiac surgery, comparing it against the National Nosocomial Infections Surveillance-derived risk index (NNIS) and analyzing the predictive power of ACRI for SSI in valvular patients. All the patients that who underwent cardiac surgery in a tertiary university hospital between 2011 and 2015 were analyzed. The patients were divided into valvular and coronary groups, excluding mixed patients. The ACRI score was validated in both groups and its ability to predict SSI was compared to the NNIS risk index. We analyzed 1,657 procedures. In the valvular patient group (n: 1119), a correlation between the ACRI score and SSI development (p < 0.05) was found; there was no such correlation with the NNIS index. The area under the receiver-operating characteristic curve (AUC) was 0.64 (confidence interval [CI] 95%, 0.5-0.7) for ACRI and 0.62 (95% CI, 0.5-0.7) for NNIS. In the coronary group (n: 281), there was a correlation between ACRI and SSI but no between NNIS and SSI. The ACRI AUC was 0.70 (95% CI, 0.5-0.8) and the NNIS AUC was 0.60 (95% CI, 0.4-0.7). The ACRI score has insufficient predictive power, although it predicts SSI development better than the NNIS index, fundamentally in coronary artery bypass grafting (CABG). Further studies analyzing determining factors are needed.

  2. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    Science.gov (United States)

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (pNutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  3. Comparison of Two Prostate Cancer Risk Calculators that Include the Prostate Health Index

    NARCIS (Netherlands)

    M.J. Roobol-Bouts (Monique); M.M. Vedder (Moniek); D. Nieboer (Daan); A. Houlgatte (Alain); S. Vincendeau (Sébastien); M. Lazzeri (Massimo); G. Guazzoni (Giorgio); C. Stephan (Carsten); A. Semjonow (Axel); A. Haese (Alexander); M. Graefen (Markus); E.W. Steyerberg (Ewout)

    2015-01-01

    textabstractBackground: Risk prediction models for prostate cancer (PCa) have become important tools in reducing unnecessary prostate biopsies. The Prostate Health Index (PHI) may increase the predictive accuracy of such models. Objectives: To compare two PCa risk calculators (RCs) that include PHI.

  4. A meta-analysis of the association of fracture risk and body mass index in women

    NARCIS (Netherlands)

    Johansson, Helena; Kanis, John A; Odén, Anders; McCloskey, Eugene; Chapurlat, Roland D; Christiansen, Claus; Cummings, Steve R; Diez-Perez, Adolfo; Eisman, John A; Fujiwara, Saeko; Glüer, Claus-C; Goltzman, David; Hans, Didier; Khaw, Kay-Tee; Krieg, Marc-Antoine; Kröger, Heikki; LaCroix, Andrea Z; Lau, Edith; Leslie, William D; Mellström, Dan; Melton, L Joseph; O'Neill, Terence W; Pasco, Julie A; Prior, Jerilynn C; Reid, David M; Rivadeneira, Fernando; van Staa, Tjerd; Yoshimura, Noriko; Zillikens, M Carola; van Staa, Tjeerd|info:eu-repo/dai/nl/304827762

    Several recent studies suggest that obesity may be a risk factor for fracture. The aim of this study was to investigate the association between body mass index (BMI) and future fracture risk at different skeletal sites. In prospective cohorts from more than 25 countries, baseline data on BMI were

  5. 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.

  6. 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

  7. Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

    OpenAIRE

    Sala Vila, Aleix; Harris, William S.; Cofán Pujol, Montserrat; Pérez-Heras, Ana Maria; Pintó Sala, Xavier; Lamuela Raventós, Rosa Ma.; Covas Planells, María Isabel; Estruch Riba, Ramon; Ros Rahola, Emilio

    2011-01-01

    The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA þ DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac...

  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. LiDAR and WorldView-2 satellite data for Leaf Area Index estimation in the boreal forest

    Science.gov (United States)

    Pope, Graham Wesley

    Leaf Area Index (LAI) is an important input variable for forest ecosystem modeling as it is a factor in predicting productivity and biomass, two key aspects of forest health. Current in situ methods of determining LAI are sometimes destructive and generally very time consuming. Other LAI derivation methods, mainly satellite-based in nature, do not provide sufficient spatial resolution or the precision required by forest managers. This thesis focused on estimating LAI from: i) height and density metrics derived from Light Detection and Ranging (LiDAR); ii) spectral vegetation indices (SVIs), in particular the Normalized Difference Vegetation Index (NDVI); and iii) a combination of these two remote sensing technologies. In situ measurements of LAI were calculated from digital hemispherical photographs (DHPs) and remotely sensed variables were derived from low density LiDAR and high resolution WorldView-2 data. Multiple Linear Regression (MLR) models were created using these variables, allowing forest-wide prediction surfaces to be created. Results from these analyses demonstrated: i) moderate explanatory power (i.e., R2 = 0.54) for LiDAR models incorporating metrics that have proven to be related to canopy structure; ii) no relationship when using SVIs; and iii) no significant improvement of LiDAR models when combining them with SVI variables. The results suggest that LiDAR models in boreal forest environments provide satisfactory estimations of LAI, even with low ranges of LAI for model calibration. On the other hand, it was anticipated that traditional SVI relationships to LAI would be present with WorldView-2 data, a result that is not easily explained. Models derived from low point density LiDAR in a mixedwood boreal environment seem to offer a reliable method of estimating LAI at a high spatial resolution for decision makers in the forestry community.

  10. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia

    OpenAIRE

    Huang, Ya-Kai; Kang, Wei-Ming; Ma, Zhi-Qiang; Liu, Yu-Qin; Zhou, Li; Yu, Jian-Chun

    2016-01-01

    Abstract Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized. A case?control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men ...

  11. [Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children].

    Science.gov (United States)

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-09-01

    To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. 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

  13. 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.

  14. Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

    Science.gov (United States)

    Sala-Vila, Aleix; Harris, William S; Cofán, Montserrat; Pérez-Heras, Ana M; Pintó, Xavier; Lamuela-Raventós, Rosa M; Covas, Maria-Isabel; Estruch, Ramon; Ros, Emilio

    2011-08-01

    The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA+DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac death despite a high prevalence of cardiovascular risk factors, dietary data were acquired from FFQ and blood cell membrane fatty acid composition was measured by GC. The average consumption of EPA+DHA was 0·9 g/d and the mean omega-3 index was 7·1 %. In multivariate models, EPA+DHA intake was the main predictor of the omega-3 index but explained only 12 % of its variability (P lifestyle) remain to be determined. Nevertheless, the high omega-3 index could at least partially explain the paradox of low rates of fatal CHD in Spain despite a high background prevalence of cardiovascular risk factors.

  15. Glycemic Index, Carbohydrates, Glycemic Load, and the Risk of Pancreatic Cancer in a Prospective Cohort Study

    OpenAIRE

    Jiao, Li; Flood, Andrew; Subar, Amy F; Hollenbeck, Albert R.; Schatzkin, Arthur; Stolzenberg-Solomon, Rachael

    2009-01-01

    Diets with high glycemic index and glycemic load have been associated with insulin resistance. Insulin resistance has been implicated in the etiology of pancreatic cancer. We prospectively investigated the associations between glycemic index, carbohydrates, glycemic load, and available carbohydrates dietary constituents (starch and simple sugar) intake and the risk of pancreatic cancer. We followed the participants in the NIH-AARP Diet and Health Study from 1995/1996 through December 2003. A ...

  16. Money laundering regulatory risk evaluation using Bitmap Index-based Decision Tree

    Directory of Open Access Journals (Sweden)

    Vikas Jayasree

    2017-06-01

    Full Text Available This paper proposes to evaluate the adaptability risk in money laundering using Bitmap Index-based Decision Tree (BIDT technique. Initially, the Bitmap Index-based Decision Tree learning is used to induce the knowledge tree which helps to determine a company’s money laundering risk and improve scalability. A bitmap index in BIDT is used to effectively access large banking databases. In a BIDT bitmap index, account in a table is numbered in sequence with each key value, account number and a bitmap (array of bytes used instead of a list of row ids. Subsequently, BIDT algorithm uses the “select” query performance to apply count and bit-wise logical operations on AND. Query result coincides exactly to build a decision tree and more precisely to evaluate the adaptability risk in the money laundering operation. For the root node, the main account of the decision tree, the population frequencies are obtained by simply counting the total number of “1” in the bitmaps constructed on the attribute to predict money laundering and evaluate the risk factor rate. The experiment is conducted on factors such as regulatory risk rate, false positive rate, and risk identification time.

  17. A comparison of the environmental impact of different AOPs: risk indexes.

    Science.gov (United States)

    Giménez, Jaime; Bayarri, Bernardí; González, Óscar; Malato, Sixto; Peral, José; Esplugas, Santiago

    2014-12-31

    Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs) applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil) and on materials and energy consumption. An Environmental Risk Index (E), constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi) for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj) for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP) or aspect (E/NAS) involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

  18. A Comparison of the Environmental Impact of Different AOPs: Risk Indexes

    Directory of Open Access Journals (Sweden)

    Jaime Giménez

    2014-12-01

    Full Text Available Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil and on materials and energy consumption. An Environmental Risk Index (E, constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP or aspect (E/NAS involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

  19. Informing Early Childhood Policy: An Analysis of the Sensitivity of a School Readiness Risk Index to Changes in Indicator Selection

    Science.gov (United States)

    Schumacher, Krista S.

    2015-01-01

    The importance of school readiness to both the future of an individual child and society as a whole has given rise to several state-specific indexes designed to measure county-level risk for starting school unprepared to learn. One such index is the Oklahoma School Readiness Risk Index (OK SRRI), comprised of indicators known to be associated with…

  20. 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.

  1. 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.

  2. MAPO index for risk assessment of patient manual handling in hospital wards: a validation study.

    Science.gov (United States)

    Battevi, N; Menoni, O; Ricci, M Grazia; Cairoli, S

    2006-06-10

    Manual handling of disabled patients - as regards movement - is one of the major factors affecting acute low back pain of exposed nursing staff. In the absence of quantitative methods assessing this kind of risk, the Research Unit Ergonomics of Posture and Movement of Milan developed in 1997 a risk assessment method called Movement and Assistance of Hospital Patients (MAPO), which is applicable in hospital wards.A first study conducted in 1999 allowed the identification of three levels of MAPO index corresponding with increasing probabilities of being affected by acute low back pain. In accordance with the well-known traffic light model, for MAPO index values between 0 and 1.5 the risk is considered to be absent or negligible. For values between 1.51 and 5.00 the risk is considered to be moderate. For values exceeding 5.00 the risk is considered to be high. In view of the limitations of the previous study, the results needed confirmation and so, in 2000-2001, another cross-sectional study was carried out, which included 191 hospital wards for acute and chronic patients and 2603 exposed subjects. This paper presents the analytical results of the association between the MAPO index and acute low back pain in this new data sample. The agreement between results of the two studies indicates that the MAPO index can be used as a risk index, although with some caution, as detailed in the paper. It can assess the risk exposure level of patient manual handling in wards and can be a useful tool for planning effective preventive actions to reduce the risk of work-related musculoskeletal disorders in health-care workers looking after disabled patients.

  3. A priori-defined diet quality indexes and risk of type 2 diabetes: the Multiethnic Cohort.

    Science.gov (United States)

    Jacobs, Simone; Harmon, Brook E; Boushey, Carol J; Morimoto, Yukiko; Wilkens, Lynne R; Le Marchand, Loic; Kröger, Janine; Schulze, Matthias B; Kolonel, Laurence N; Maskarinec, Gertraud

    2015-01-01

    Dietary patterns have been associated with the incidence of type 2 diabetes, but little is known about the impact of ethnicity on this relationship. This study evaluated the association between four a priori dietary quality indexes and risk of type 2 diabetes among white individuals, Japanese-Americans and Native Hawaiians in the Hawaii component of the Multiethnic Cohort. After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases of type 2 diabetes). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific HRs were calculated for the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) and the Dietary Approaches to Stop Hypertension (DASH). We observed significant inverse associations between higher DASH index scores and risk of type 2 diabetes in white men and women, as well as in Japanese-American women and Native Hawaiian men, with respective risk reductions of 37%, 31%, 19% and 21% (in the highest compared with the lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13-28% lower risk of type 2 diabetes in white participants but not in other ethnic groups. No significant associations with risk of type 2 diabetes were observed for the HEI-2010 index. The small ethnic differences in risk of type 2 diabetes associated with scores of a priori-defined dietary patterns may be due to a different consumption pattern of food components and the fact that the original indexes were not based on diets typical for Asians and Pacific Islanders.

  4. 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.

  5. Impact of Geriatric Nutritional Risk Index on cardiovascular outcomes in patients with stable coronary artery disease.

    Science.gov (United States)

    Kunimura, Ayako; Ishii, Hideki; Uetani, Tadayuki; Aoki, Toshijirou; Harada, Kazuhiro; Hirayama, Kenshi; Negishi, Yosuke; Shibata, Yohei; Sumi, Takuya; Kawashima, Kazuhiro; Tatami, Yosuke; Kawamiya, Toshiki; Yamamoto, Dai; Suzuki, Susumu; Amano, Tetsuya; Murohara, Toyoaki

    2017-01-01

    The association between malnutrition and cardiovascular prognosis in patients with stable coronary artery disease remains unclear. The aim of this study was to evaluate the association between Geriatric Nutritional Risk Index (GNRI), a simple tool to assess nutritional risk, and long-term outcomes after elective percutaneous coronary intervention (PCI). This study consisted of 802 patients (age, 70±10 years, male, 69%) who underwent elective PCI. GNRI was calculated at baseline as follows: GNRI=[14.89×serum albumin (g/dl)+[41.7×(body weight/body weight at body mass index of 22)

  6. 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

  7. Body mass index and risk of gastric cancer: a meta-analysis.

    Science.gov (United States)

    Lin, Xue-Jun; Wang, Chun-Peng; Liu, Xiao-Dong; Yan, Kang-Kang; Li, Shuang; Bao, Hong-Hong; Zhao, Long-Yu; Liu, Xin

    2014-09-01

    Overweight and obesity, indicated as increased body mass index, are associated with the risk of some cancers. We carried out a meta-analysis on published cohort and case-control studies to assess the strength of association between body mass index and gastric cancer. Relevant studies were identified through PubMed, Web of Science and Medline electronic databases. Adjusted relative risks (odds ratios) with 95% confidence interval were used to assess the strength of association between body mass index and gastric cancer. Sixteen eligible studies were included in this meta-analysis. Overall, obesity (body mass index ≥ 30 kg/m(2)) was associated with an increased risk of gastric cancer (odds ratio = 1.13, 95% confidence interval = 1.03-1.24) compared with normal weight (body mass index = 18.5 to obesity and the increased risk of gastric cancer for males (odds ratio = 1.27, 95% confidence interval = 1.09-1.48), non-Asians (odds ratio = 1.14, 95% confidence interval = 1.02-1.28) and both cohort studies (odds ratio = 1.10, 95% confidence interval = 1.00-1.22) and case-control studies (odds ratio = 1.29, 95% confidence interval = 1.03-1.60). Both overweight (odds ratio = 1.22, 95% confidence interval = 1.05-1.42) and obesity (odds ratio = 1.61, 95% confidence interval = 1.15-2.24) were associated with the increased risk of gastric cardia cancer. The results indicated that obesity was associated with the risk of gastric cancer, especially for males and among non-Asians. Both overweight and obesity were associated with the risk of gastric cardia cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. 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 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 components has been

  9. Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression.

    Science.gov (United States)

    Markhus, Maria Wik; Skotheim, Siv; Graff, Ingvild Eide; Frøyland, Livar; Braarud, Hanne Cecilie; Stormark, Kjell Morten; Malde, Marian Kjellevold

    2013-01-01

    Depression is a common disorder affecting 10-15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28(th) gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum.

  10. Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression.

    Directory of Open Access Journals (Sweden)

    Maria Wik Markhus

    Full Text Available Depression is a common disorder affecting 10-15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy.In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28(th gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression.In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles.In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum.

  11. Risk factors of normal ankle-brachial index and low toe-brachial index in hemodialysis patients.

    Science.gov (United States)

    Morimoto, Satoshi; Nakajima, Fumitaka; Yurugi, Takatomi; Morita, Tatsuyori; Jo, Fusakazu; Nishikawa, Mitsushige; Iwasaka, Toshiji; Maki, Kei

    2009-04-01

    The prevalence of peripheral arterial occlusive disease is high in patients with terminal renal failure, and it is a major problem in those on dialysis. A low ankle-brachial index (ABI) suggests the presence of arterial stenotic lesions between the aorta and the ankle joint, while a low toe-brachial index (TBI) suggests stenotic lesions between the aorta and the toes. Therefore, a normal ABI (> or =0.9) and a low TBI ( or =0.6) (N group) were compared. Low ankle-brachial and toe-brachial indices were detected in 13% and 22% of the patients, respectively. Comparison of the background factors and laboratory data between the N and L groups showed that the ratio of diabetes mellitus, interdialytic body weight gain, and Hb(A1c) values were significantly higher in the L group than in the N group. It was clarified that diabetes and excess body weight gain are involved as risk factors in dialysis patients with normal ABI/low TBI.

  12. Risk of symptomatic dengue for foreign visitors to the 2014 FIFA World Cup in Brazil.

    Science.gov (United States)

    Massad, Eduardo; Wilder-Smith, Annelies; Ximenes, Raphael; Amaku, Marcos; Lopez, Luis Fernandez; Coutinho, Francisco Antonio Bezerra; Coelho, Giovanini Evelim; Silva, Jarbas Barbosa da; Struchiner, Claudio José; Burattini, Marcelo Nascimento

    2014-06-01

    Brazil will host the FIFA World Cup™, the biggest single-event competition in the world, from June 12-July 13 2014 in 12 cities. This event will draw an estimated 600,000 international visitors. Brazil is endemic for dengue. Hence, attendees of the 2014 event are theoretically at risk for dengue. We calculated the risk of dengue acquisition to non-immune international travellers to Brazil, depending on the football match schedules, considering locations and dates of such matches for June and July 2014. We estimated the average per-capita risk and expected number of dengue cases for each host-city and each game schedule chosen based on reported dengue cases to the Brazilian Ministry of Health for the period between 2010-2013. On the average, the expected number of cases among the 600,000 foreigner tourists during the World Cup is 33, varying from 3-59. Such risk estimates will not only benefit individual travellers for adequate pre-travel preparations, but also provide valuable information for public health professionals and policy makers worldwide. Furthermore, estimates of dengue cases in international travellers during the World Cup can help to anticipate the theoretical risk for exportation of dengue into currently non-infected areas.

  13. 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

  14. Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor.

    Science.gov (United States)

    Walter, S; Glymour, M M; Koenen, K; Liang, L; Tchetgen Tchetgen, E J; Cornelis, M; Chang, S-C; Rewak, M; Rimm, E; Kawachi, I; Kubzansky, L D

    2015-01-01

    Obesity and anxiety are often linked but the direction of effects is not clear. Using genetic instrumental variable (IV) analyses in 5911 female participants from the Nurses' Health Study (NHS, initiated 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated 1986), we aimed to determine whether obesity increases symptoms of phobic anxiety. As instrumental variables we used the fat mass and obesity-associated (FTO) gene, the melanocortin 4 receptor (MC4R) gene and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms (SNPs) that significantly predict body mass index (BMI). 'Functional' GRSs corresponding with specific biological pathways that shape BMI (adipogenesis, appetite and cardiopulmonary) were considered. The main outcome was phobic anxiety measured by the Crown Crisp Index (CCI) in 2004 in the NHS and in 2000 in the HPFS. In observational analysis, a 1-unit higher BMI was associated with higher phobic anxiety symptoms [women: β = 0.05, 95% confidence interval (CI) 0.030-0.068; men: β = 0.04, 95% CI 0.016-0.071). IV analyses showed that BMI was associated with higher phobic anxiety symptoms in the FTO-instrumented analysis (p = 0.005) but not in the GRS-instrumented analysis (p = 0.256). Functional GRSs showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms. Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, and hence that obesity and phobic anxiety may share common genetic determinants.

  15. Human health risk assessment: selected Internet and world wide web resources.

    Science.gov (United States)

    Patterson, Jacqueline; Hakkinen, P J Bert; Wullenweber, Andrea E

    2002-04-25

    The world wide web (WWW) has become a valuable source of 24 hour-a-day access to information needed by human health risk assessors. Various web sites and other Internet resources provide information needed for human hazard identification, dose-response evaluation, exposure assessment, risk characterization, and risk management. Information on risk communication is also available. Substantial collections of information on multiple aspects of risk assessment are found in sites sponsored by RiskWorld, the (US) EPA's National Center for Environmental Assessment (NCEA), the (US) National Library of Medicine's TOXNET, the (US) Agency for Toxic Substances and Disease Registry (ATSDR), and the International Programme on Chemical Safety (IPCS). Also valuable are various web sites providing information on the physical and chemical properties of chemicals, the environmental fate and transport of chemicals, government regulations, and guidance and training for performing risk assessments. Several professional societies and other organizations have web sites addressing risk assessment issues and information, and there are Internet mailing lists for online help and for sharing information and perspectives. We classify selected web sites according to user needs and provide the reader with a collection of selected sites that can serve as entry points to risk assessment-related web resources.

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

    OpenAIRE

    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 ...

  17. Dietary inflammatory index and risk of pancreatic cancer in an Italian case–control study

    OpenAIRE

    Shivappa, Nitin; Bosetti, Cristina; Zucchetto, Antonella; Serraino, Diego; La Vecchia, Carlo; Hébert, James R.

    2014-01-01

    Previous studies have shown that various dietary components may be implicated in the aetiology of pancreatic cancer. However, the possible relationship between diet-related inflammation and the risk of pancreatic cancer has not yet been investigated. We examined the ability of a newly developed literature-derived dietary inflammatory index (DII) to predict the risk of pancreatic cancer in a case–control study conducted in Italy between 1991 and 2008. This included 326 incident cases and 652 c...

  18. A psychosocial risk index for poor glycemic control in children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Schwartz, David D; Axelrad, Marni E; Anderson, Barbara J

    2014-05-01

    The aim of this study was to develop and validate a psychosocial screening tool to predict risk for poor glycemic control in children with type 1 diabetes. Participants seen for psychological screening were 196 children aged 3-18 yr at diabetes diagnosis. A psychosocial risk index was developed to predict poor glycemic control [mean hemoglobin A1c (HbA1c) ≥ 9.5%; 80 mmol/mol] 1-4 yr post diagnosis. Cutoff scores were derived for multiple levels of risk from receiver operating characteristic (ROC) curves and likelihood ratios (LRs). Discrimination and calibration were examined in the sample, and validated in 1000 bootstrap samples. Ability to predict diabetes-related emergency-room (ER) visits and diabetic ketoacidosis (DKA) was also tested. The risk index accounted for 16.2% of variance in mean HbA1c, discriminated between children with and without poor glycemic control [area under the receiver operating characteristic curve (AUC) = 0.814, 0.713-0.915; p glycemic control of approximately 10% (LRs = 1.7, 3.2, 5.8, and 9.3). Sensitivity and specificity were 0.68 (0.43-0.86) and 0.79 (0.72-0.84) for detecting patients at moderate risk, and 0.53 (0.29-0.75) and 0.91 (0.85-0.95) for detecting high-risk patients. The index performed equally well in validation samples. This paper presents the first psychosocial risk index for poor glycemic control in children newly diagnosed with type 1 diabetes. It is brief, easily administered, and provides a single score that translates directly into an estimate of risk that can help guide routine diabetes care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Glycemic index, carbohydrates, glycemic load, and the risk of pancreatic cancer in a prospective cohort study.

    Science.gov (United States)

    Jiao, Li; Flood, Andrew; Subar, Amy F; Hollenbeck, Albert R; Schatzkin, Arthur; Stolzenberg-Solomon, Rachael

    2009-04-01

    Diets with high glycemic index and glycemic load have been associated with insulin resistance. Insulin resistance has been implicated in the etiology of pancreatic cancer. We prospectively investigated the associations between glycemic index, carbohydrates, glycemic load, and available carbohydrates dietary constituents (starch and simple sugar) intake and the risk of pancreatic cancer. We followed the participants in the NIH-AARP Diet and Health Study from 1995/1996 through December 2003. A baseline self-administered food frequency questionnaire was used to assess the dietary intake and exposure information. A total of 1,151 exocrine pancreatic cancer cases were identified from 482,362 participants after excluding first-year of follow-up. We used multivariate Cox proportional hazards regression models to calculate relative risks (RR) and 95% confidence intervals (95% CI) for pancreatic cancer. There were no associations between glycemic index, total or available carbohydrates, gycemic load, and pancreatic cancer risk. Participants with high free fructose and glucose intake were at a greater risk of developing pancreatic cancer (highest compared with lowest quintile, RR, 1.29; 95% CI, 1.04-1.59; P trend = 0.004 and RR, 1.35; 95% CI, 1.10-1.67; P trend = 0.005, respectively). There were no statistically significant interactions by body mass index, physical activity, or smoking status. Our results do not support an association between glycemic index, total or available carbohydrate intake, and glycemic load and pancreatic cancer risk. The higher risk associated with high free fructose intake needs further confirmation and elucidation.

  20. An index of risk as a measure of biodiversity conservation achieved through land reform.

    Science.gov (United States)

    Walker, Susan; Price, Robbie; Stephens, R T Theo

    2008-02-01

    We measured the net progress of land reform in achieving a national policy goal for biodiversity conservation in the context of ongoing clearing of native vegetation and additions of land to a highly nonrepresentative (residual) reserve network, interior South Island, New Zealand. We used systematic conservation-planning approaches to develop a spatially explicit index of risk of biodiversity loss (RBL). The index incorporated information from national data sets that describe New Zealand's remaining indigenous land cover, legal protection, and land environments and modeled risk to biodiversity on the basis of stated assumptions about the effects of past habitat loss and legal protection. The index identified irreplaceable and vulnerable native habitats in lowland environments as the most at risk of biodiversity loss, and risk was correlated with the density of threatened plant records. To measure achievement, we used changes in the index that reflected gains made and opportunity costs incurred by legal protection and privatization. Application of the index to measure the difference made by land reform showed it had caused a net increase in the risk of biodiversity loss because most land vulnerable to habitat modification and rich in threatened plant species was privatized and land at least risk of biodiversity loss was protected. The application revealed that new high-elevation reserves did little to mitigate biodiversity decline, that privatization of low-elevation land further jeopardized the most vulnerable biodiversity in lowland native habitats, and that outcomes of land reform for biodiversity deteriorated over time. Further development of robust achievement measures is needed to encourage more accountable biodiversity conservation decisions.

  1. 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.

  2. [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.

  3. 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

    BACKGROUND: The revised cardiac risk index (RCRI) holds a central role in preoperative cardiac risk stratification in noncardiac surgery. Its performance in unselected populations, including different age groups, has, however, not been systematically investigated. We assessed the relationship.......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...

  4. Twelve Month Prevalence of and Risk Factors for Suicide Attempts in the WHO World Mental Health Surveys

    Science.gov (United States)

    Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, Maria Elena; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.

    2009-01-01

    Objective Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiological survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method Data come from the WHO World Mental Health (WMH) Surveys (conducted 2001–2007) in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview (CIDI). The survey assessed suicidal behaviors and potential risk factors across multiple domains including: socio-demographics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results Twelve-month prevalence estimates of suicide ideation, plans and attempts are 2.0%, 0.6% and 0.3% respectively for developed countries and 2.1%, 0.7% and 0.4% for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include: female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (AUC=.74–.80). Conclusion Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. PMID:20816034

  5. Theory and methodology of social, political and economic processes risks determining in different countries of the world

    Directory of Open Access Journals (Sweden)

    Yashina Nadezhda, I.

    2015-06-01

    Full Text Available The study deals with the problems of the theory and methodology of social, political and economic processes risks in different countries with relative indicators of the socio-economic development level, as well as the size and condition of the public debt. Developed by the authors the methodology of determining the risks of social, political and economic processes of public policy around the world revealed close relationship between socio-economic situation of the countries and their public debt. Within the framework of this methodology two groups of factors characterizing the socio-political and economic processes in the country are being developed. After that each exponent and indicator are being processed, using expert procedures. Maximum statutory values for tentatively referenced countries with effective and ineffective government policies are identified. Then standardization (specification and definition of integral (generalized indexes of socio-political and economic processes in the country are taking place. After that the ranking of countries by aggregated standardized ratio is arranged, taking into account the significance of the developed indicators. The final phase of implementation methodology is identifying risks of social, political and economic processes of public policy around the world. This is the ranking of countries by ratio of stability in public policy (stability of economic and socio-political processes in the country. As the result of implementation methodology the following output was received: what really makes a difference is not the amount of the country's debt, but how effectively it manages this debt, whether it has a goal to improve social and economic indicators. Practical testing methodology has proven that studied indicators fully characterize the development of the countries, their political, social and economic situation on the world stage.

  6. 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.

  7. Insurance World in Transition: Changes in Global Risk Taking and Risk Assessment

    Science.gov (United States)

    Michel, Gero; Tiampo, Kristy

    2015-04-01

    Catastrophe insurance risk assessment, risk taking, and regulation has evolved over the last 20 years and is gearing up for significant further change in the years ahead. Changes in regulation and influx of capital have put profit margins for catastrophe risk products under pressure despite the fact that changes in climate as well as increasing insurance penetration is expected to heighten demand. As a result, reinsurance strategies are moving away from catastrophe risk. In addition, lower margins require cheaper and more efficient risk assessment methods and processes which are contrary to evolving analytical tools and methods that had increased expenses in line with growing margins over the last decade. New capital providers are less familiar with and less willing to accept complex supply chains for risk management, relationship-driven business and tedious data exchange and management processes. Risk takers claim new measures and ask for more flexibility in the use of tools. The current concepts of catastrophe insurance risk assessment are hence under thorough scrutiny. This presentation deals with the changing landscape in catastrophe insurance risk assessment and risk hedging and discusses changes in catastrophe risk assessment products and demand. How likely is it that private, small and nimble hazard and risk consulting groups - increasingly emanating from larger science organizations - will replace large established firms in their role to assess risk? What role do public-private academic partnerships play in assuming risk for catastrophe insurance and what role could they play in the future? What are the opportunities and downsides of the current changes in risk taking and hedging? What is needed from the scientific community in order to fill the gaps in risk management and who is likely to take advantage of the current changes?

  8. Epidemiology, Incidence and Mortality of Bladder Cancer and their Relationship with the Development Index in the World.

    Science.gov (United States)

    Mahdavifar, Neda; Ghoncheh, Mahshid; Pakzad, Reza; Momenimovahed, Zohre; Salehiniya, Hamid

    2016-01-01

    Bladder cancer is an international public health problem. It is the ninth most common cancer and the fourteenth leading cause of death due to cancer worldwide. Given aging populations, the incidence of this cancer is rising. Information on the incidence and mortality of the disease, and their relationship with level of economic development is essential for better planning. The aim of the study was to investigate bladder cancer incidence and mortality rates, and their relationship with the the Human Development Index (HDI) in the world. Data were obtained from incidence and mortality rates presented by GLOBOCAN in 2012. Data on HDI and its components were extracted from the global bank site. The number and standardized incidence and mortality rates were reported by regions and the distribution of the disease were drawn in the world. For data analysis, the relationship between incidence and death rates, and HDI and its components was measured using correlation coefficients and SPSS software. The level of significance was set at 0.05. In 2012, 429,793 bladder cancer cases and 165,084 bladder death cases occurred in the world. Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. Five countries that had the highest age-standardized death rates were Turkey 6.6 per 100,000, Egypt 6.5/100,000, Iraq 6.3/100,000, Lebanon 6.3/100,000, and Mali 5.2/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, Pincidence rate with life expectancy at birth, average years of schooling, and the level of income per person of population. A positive linear relationship was also noted between the standardized mortality rate and HDI (r=0.308, Pincidence of bladder cancer in developed countries and parts of Africa was higher, while the highest mortality rate was observed in the countries of North Africa and the

  9. An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements

    Directory of Open Access Journals (Sweden)

    Nir Y. Krakauer

    2016-01-01

    Full Text Available Body mass index (BMI can be considered an application of a power law model to express body weight independently of height. Based on the same power law principle, we previously introduced a body shape index (ABSI to be independent of BMI and height. Here, we develop a new hip index (HI whose normalized value is independent of height, BMI, and ABSI. Similar to BMI, HI demonstrates a U-shaped relationship to mortality in the Third National Health and Nutrition Examination Survey (NHANES III population. We further develop a new anthropometric risk index (ARI by adding log hazard ratios from separate nonlinear regressions of the four indicators, height, BMI, ABSI, and HI, against NHANES III mortality hazard. ARI far outperforms any of the individual indicators as a linear mortality predictor in NHANES III. The superior performance of ARI also holds for predicting mortality hazard in the independent Atherosclerosis Risk in Communities (ARIC cohort. Thus, HI, along with BMI and ABSI, can capture the risk profile associated with body size and shape. These can be combined in a risk indicator that utilizes complementary information from height, weight, and waist and hip circumference. The combined ARI is promising for further research and clinical applications.

  10. 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

  11. 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.

  12. Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth

    Science.gov (United States)

    Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

    2013-01-01

    Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

  13. 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.…

  14. 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 s...

  15. 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

  16. Geriatric nutritional risk index accurately predicts cardiovascular mortality in incident hemodialysis patients.

    Science.gov (United States)

    Takahashi, Hiroshi; Ito, Yasuhiko; Ishii, Hideki; Aoyama, Toru; Kamoi, Daisuke; Kasuga, Hirotake; Yasuda, Kaoru; Maruyama, Shoichi; Matsuo, Seiichi; Murohara, Toyoaki; Yuzawa, Yukio

    2014-07-01

    Cardiovascular disease (CVD) is a leading cause of death in end-stage renal disease (ESRD) patients. Protein-energy wasting (PEW) or malnutrition is common in this population, and is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk, and is associated with mortality not only in elderly patients but also in ESRD patients. However, whether the GNRI could predict the mortality due to CVD remains unclear in this population. We investigated the prognostic value of GNRI at initiation of hemodialysis (HD) therapy for CVD mortality in a large cohort of ESRD patients. Serum albumin, body weight, and height for calculating GNRI were measured in 1568 ESRD patients. Thereafter, the patients were divided into quartiles according to GNRI levels [quartile 1 (Q1): 97.3], and were followed up for up to 10 years. GNRI levels independently correlated with serum C-reactive-protein levels (β = -0.126, p index was also greater in an established CVD risk model with GNRI (0.749) compared to that with albumin (0.730), body mass index (0.732), and alone (0.710). Similar results were observed for all-cause mortality. GNRI at initiation of HD therapy could predict CVD mortality with incremental value of the predictability compared to serum albumin and body mass index in ESRD patients. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  17. 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.

  18. Phenology Information Contributes to Reduce Temporal Basis Risk in Agricultural Weather Index Insurance.

    Science.gov (United States)

    Dalhaus, Tobias; Musshoff, Oliver; Finger, Robert

    2018-01-08

    Weather risks are an essential and increasingly important driver of agricultural income volatility. Agricultural insurances contribute to support farmers to cope with these risks. Among these insurances, weather index insurances (WII) are an innovative tool to cope with climatic risks in agriculture. Using WII, farmers receive an indemnification not based on actual yield reductions but are compensated based on a measured weather index, such as rainfall at a nearby weather station. The discrepancy between experienced losses and actual indemnification, basis risk, is a key challenge. In particular, specifications of WII used so far do not capture critical plant growth phases adequately. Here, we contribute to reduce basis risk by proposing novel procedures how occurrence dates and shifts of growth phases over time and space can be considered and test for their risk reducing potential. Our empirical example addresses drought risks in the critical growth phase around the anthesis stage in winter wheat production in Germany. We find spatially explicit, public and open databases of phenology reports to contribute to reduce basis risk and thus improve the attractiveness of WII. In contrast, we find growth stage modelling based on growing degree days (thermal time) not to result in significant improvements.

  19. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  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...... the mechanisms require further investigation, our findings provide additional evidence for the long-term health risks of childhood obesity....... oesophageal adenocarcinoma in a cohort from the Copenhagen School Health Records Register. Analyses included 255 053 children born during 1930-1971. Danish Cancer Registry linkage provided outcomes. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression...

  1. Body mass index and risk of subtypes of head-neck cancer: the Netherlands Cohort Study

    OpenAIRE

    Maasland, Denise H. E.; van den Brandt, Piet A.; Bernd Kremer; Schouten, Leo J.

    2015-01-01

    Low body mass index (BMI) has been associated with risk of head-neck cancer (HNC), but prospective data are scarce. We investigated the association between BMI, BMI at age 20 years and change in BMI during adulthood with risk of HNC and HNC subtypes. 120,852 participants completed a questionnaire on diet and other cancer risk factors, including anthropometric measurements, at baseline in 1986. After 20.3 years of follow-up, 411 HNC (127 oral cavity cancer (OCC), 84 oro-/hypopharyngeal cancer ...

  2. Glycemic Index, Glycemic Load, and Lung Cancer Risk in Non-Hispanic Whites

    Science.gov (United States)

    Melkonian, Stephanie C; Daniel, Carrie R.; Ye, Yuanqing; Pierzynski, Jeanne A.; Roth, Jack A.; Wu, Xifeng

    2016-01-01

    Background Postprandial glucose (PPG) and insulin responses play a role in carcinogenesis. We evaluated the association between dietary glycemic index (GI) and glycemic load (GL), markers of carbohydrate intake and PPG, and lung cancer risk in non-Hispanic whites. Methods GL and GI were assessed among 1,905 newly diagnosed lung cancer cases recruited from the University of Texas MD Anderson Cancer Center in Houston, Texas and 2,413 healthy controls recruited at Kelsey-Seybold Clinics in Houston. We assessed associations between quintiles of GI/GL and lung cancer risk and effect modification by various risk factors. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using multivariable logistic regression. Results We observed a significant association between GI (5th vs 1st quintile (Q)) OR = 1.49, 95% CI: 1.21–1.83, P-trend glycemic index and other lung cancer risk factors may jointly and independently influence lung cancer etiology. Impact Understanding the role of glycemic index in lung cancer could inform prevention strategies and elucidate biological pathways related to lung cancer risk. PMID:26944871

  3. Correlations between geriatric nutritional risk index and peripheral artery disease in elderly coronary artery disease patients.

    Science.gov (United States)

    Kawamiya, Toshiki; Suzuki, Susumu; Ishii, Hideki; Hirayama, Kenshi; Harada, Kazuhiro; Shibata, Yohei; Tatami, Yosuke; Harata, Shingo; Kawashima, Kazuhiro; Kunimura, Ayako; Takayama, Yohei; Shimbo, Yusaku; Osugi, Naohiro; Yamamoto, Dai; Ota, Tomoyuki; Kono, Chikao; Murohara, Toyoaki

    2017-07-01

    Malnutrition is associated with the development of atherosclerosis and an increased risk of cardiovascular mortality in elderly patients. The present study aimed to investigate the association between the Geriatric Nutritional Risk Index (GNRI), a simple nutritional assessment tool, and the prevalence of peripheral artery disease (PAD) in elderly coronary artery disease patients. We evaluated 228 elderly coronary artery disease patients (mean age 74.0 ± 5.7 years). Ankle-brachial index (ABI) measurements were routinely carried out to investigate the prevalence of lower extremity PAD. Patients showing ABI risk of having PAD than those with high GNRI and low C-reactive protein levels. GNRI values showed a strong relationship with PAD in elderly coronary artery disease patients. These data reinforce the utility of GNRI as a screening tool in clinical practice. Geriatr Gerontol Int 2017; 17: 1057-1062. © 2016 Japan Geriatrics Society.

  4. Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients.

    Science.gov (United States)

    Bo, Yacong; Yao, Mingjie; Zhang, Ling; Bekalo, Wolde; Lu, Weiquan; Lu, Quanjun

    2015-01-01

    We designed this study to determine the predictive value of Nutritional Risk Index (NRI) for postoperative survival time of patients who had undergone hepatectomy for primary liver cancer. The 620 patients who underwent hepatectomy for primary liver cancer (PLC) in the Department of Hepatobiliary Surgery, Cancer Hospital of Henan Province, Zhengzhou, China from December 1, 2008 to December 1, 2012 were followed up. A nutritional risk index (NRI) was used to screen the patients with malnutrition (NRI100) patients had longer postoperative survival time compared with malnourished patients. NRI values>100 was sig-nificantly associated with longer postoperative survival time. Cox proportional hazards model showed that NRI was an independent predictor of postoperative survival time and that NRI varied inversely with the risk of death. The patients with NRI values>100 survived longer than those with NRI values

  5. The SCREEN I (Seniors in the Community: Risk Evaluation for Eating and Nutrition) index adequately represents nutritional risk.

    Science.gov (United States)

    Keller, Heather H

    2006-08-01

    Nutrition risk is a difficult and complex construct to define and measure. Exploratory factor analysis has been completed on SCREEN I, a nutrition risk screening index for community-living seniors. This analysis was completed to confirm this structure and further validate the index as a plausible measure of nutritional risk. As part of the Bringing Nutrition Screening to Seniors demonstration project, 1,218 seniors completed SCREEN I. Using structural equation modeling (Amos version 5 software), the original and alternative two-, three-, and four-factor structures were modeled and compared. The best-fitting model was a four-factor structure based on the original exploratory model. Unlike the original model, however, several SCREEN I items cross-loaded on more than one factor, demonstrating the complexity of the construct 'nutritional risk.' SCREEN I appears to represent adequately the construct 'nutritional risk' with four factors: Food Intake, Physiologic, Adaptation, and Functional. Further work should be conducted to further elucidate the complex nature of 'nutritional risk' by identifying indirect and direct relationships among the screen items and this construct.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Kristine Marceau

    Full Text Available 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.

  8. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients.

    Science.gov (United States)

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2012-11-01

    The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.

  9. World Health Organization regional assessments of the risks of poliovirus outbreaks.

    Science.gov (United States)

    Lowther, Sara A; Roesel, Sigrun; O'Connor, Patrick; Landaverde, Mauricio; Oblapenko, George; Deshevoi, Sergei; Ajay, Goel; Buff, Ann; Safwat, Hala; Salla, Mbaye; Tangermann, Rudi; Khetsuriani, Nino; Martin, Rebecca; Wassilak, Steven

    2013-04-01

    While global polio eradication requires tremendous efforts in countries where wild polioviruses (WPVs) circulate, numerous outbreaks have occurred following WPV importation into previously polio-free countries. Countries that have interrupted endemic WPV transmission should continue to conduct routine risk assessments and implement mitigation activities to maintain their polio-free status as long as wild poliovirus circulates anywhere in the world. This article reviews the methods used by World Health Organization (WHO) regional offices to qualitatively assess risk of WPV outbreaks following an importation. We describe the strengths and weaknesses of various risk assessment approaches, and opportunities to harmonize approaches. These qualitative assessments broadly categorize risk as high, medium, or low using available national information related to susceptibility, the ability to rapidly detect WPV, and other population or program factors that influence transmission, which the regions characterize using polio vaccination coverage, surveillance data, and other indicators (e.g., sanitation), respectively. Data quality and adequacy represent a challenge in all regions. WHO regions differ with respect to the methods, processes, cut-off values, and weighting used, which limits comparisons of risk assessment results among regions. Ongoing evaluation of indicators within regions and further harmonization of methods between regions are needed to effectively plan risk mitigation activities in a setting of finite resources for funding and continued WPV circulation. © 2013 Society for Risk Analysis.

  10. 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.

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

    Science.gov (United States)

    Rodríguez-Martin, Carmela; Alonso-Domínguez, Rosario; Patino-Alonso, María C; Gómez-Marcos, Manuel A; Maderuelo-Fernández, José A; Martin-Cantera, Carlos; García-Ortiz, Luis; Recio-Rodríguez, José I

    2017-04-08

    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). 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. 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 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.

  12. 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.

  13. Combined detection of depression and anxiety in epilepsy patients using the Neurological Disorders Depression Inventory for Epilepsy and the World Health Organization well-being index

    DEFF Research Database (Denmark)

    Hansen, Christian Pilebæk; Amiri, Moshgan

    2015-01-01

    PURPOSE: To validate the Danish version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and compare it with the World Health Organization index for psychological well-being (WHO-5) as screening tests for depression and anxiety in epilepsy patients. METHODS: Epilepsy...

  14. The Healthy Eating Index 2005 and risk for pancreatic cancer in the NIH-AARP study.

    Science.gov (United States)

    Arem, Hannah; Reedy, Jill; Sampson, Josh; Jiao, Li; Hollenbeck, Albert R; Risch, Harvey; Mayne, Susan T; Stolzenberg-Solomon, Rachael Z

    2013-09-04

    Dietary pattern analyses characterizing combinations of food intakes offer conceptual and statistical advantages over food- and nutrient-based analyses of disease risk. However, few studies have examined dietary patterns and pancreatic cancer risk and none focused on the 2005 Dietary Guidelines for Americans. We used the Healthy Eating Index 2005 (HEI-2005) to estimate the association between meeting those dietary guidelines and pancreatic cancer risk. We calculated the HEI-2005 score for 537 218 men and women in the National Institutes of Health-American Association of Retired Persons Diet and Health Study using responses to food frequency questionnaires returned in 1995 and 1996. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer according to HEI-2005 quintiles and explored effect modification by known risk factors. P interaction values were calculated using the Wald test. All statistical tests were two-sided. We identified 2383 incident, exocrine pancreatic cancer cases (median = 10.5 years follow-up). Comparing participants who met the most dietary guidelines (Q5) with those who met the fewest guidelines (Q1), we observed a reduced risk of pancreatic cancer (HR = 0.85, 95% CI = 0.74 to 0.97). Among men there was an interaction by body mass index (P interaction = .03), with a hazard ratio of 0.72 (95% CI = 0.59 to 0.88) comparing Q5 vs Q1 in overweight/obese men (body mass index ≥ 25 kg/m(2)) but no association among normal weight men. Our findings support the hypothesis that consuming a high-quality diet, as scored by the HEI-2005, may reduce the risk of pancreatic cancer.

  15. Managing the financial risk of low water levels in Great Lakes with index-based contracts

    Science.gov (United States)

    Meyer, E.; Characklis, G. W.; Brown, C. M.; Moody, P.

    2014-12-01

    Low water levels in the Great Lakes have recently had significant financial impacts on the region's commercial shipping, responsible for transporting millions of dollars' worth of bulk goods each year. Low lake levels can significantly affect shipping firms, as cargo capacity is a function of draft, or the distance between water level and the ship's bottom. Draft increases with weight, and lower lake levels force ships to reduce cargo to prevent running aground in shallow harbors, directly impacting the finances of shipping companies. Risk transfer instruments may provide adaptable, yet unexplored, alternatives for managing these financial risks, at significantly less expense than more traditional solutions (e.g., dredging). Index-based financial instruments can be particularly attractive as contract payouts are directly linked to well-defined transparent metrics (e.g., lake levels), eliminating the need for subjective adjustors, as well as concerns over moral hazard. In developing such instruments, a major challenge is identifying an index that is well correlated with financial losses, and thus a contract that reliably pays out when losses are experienced (low basis risk). In this work, a relationship between lake levels and shipping revenues is developed, and actuarial analyses of the frequency and magnitude of revenue losses is completed using this relationship and synthetic water level data. This analysis is used to develop several types of index-based contracts. A standardized suite of binary contracts is developed, with each indexed to lake levels and priced according to predefined thresholds. These are combined to form portfolios with different objectives (e.g. options, collars), with optimal portfolio structure and length of coverage determined by limiting basis risk and contract cost, using simulations over the historic dataset. Results suggest that portfolios of these binary contracts can substantially reduce the risk of financial losses during periods of

  16. 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

    2017-12-26

    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. Published by

  17. Multiple antibiotic resistance indexing of coliforms to identify high risk contamination sites in aquatic environment.

    Science.gov (United States)

    Chitanand, M P; Kadam, T A; Gyananath, G; Totewad, N D; Balhal, D K

    2010-06-01

    Bacteriological analysis of the water samples collected from upstream, midstream and downstream points along the bank of the river revealed high populations of Escherichia coli, Citrobacter freundii, Citrobacter diversus, Enterobacter aerogens and Klebsiella species. All these isolates were screened against eight antibiotics to determine the prevalence of multiple antibiotic resistance among isolates at different sites of the river. The study revealed that multiple antibiotic resistance was prominently seen in coliforms at downstream sites (Average multiple antibiotic resistance index, MAR Index = 0.43) while it was low in coliforms at upstream sites (MAR Index = 0.15). These differences in MAR indices provide a method for distinguishing high risk contamination sites in aquatic environment.

  18. Personalized Risk Index for Neurocognitive Decline Among People With Well-Controlled HIV Infection.

    Science.gov (United States)

    Yuen, Tracy; Brouillette, Marie-Josée; Fellows, Lesley K; Ellis, Ronald J; Letendre, Scott; Heaton, Robert; Mayo, Nancy

    2017-09-01

    Little is known about the predictors of neurocognitive decline in HIV+ individuals with good virological control. Identification of modifiable risk factors would allow targeted interventions to reduce the risk of decline in higher risk individuals. The objective of this study was to develop a risk index to predict neurocognitive decline over 3 years in aviremic HIV+ individuals. As part of the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study, HIV+ adults completed clinical evaluation and neuropsychological tests every 6 months. Group-based trajectory analysis was used to detect patterns of neurocognitive change; individuals who deteriorated ≥ 0.5 SD on at least one neuropsychological test were considered decliners. Multiple logistic regression was used to identify baseline sociodemographic, clinical, biological, and lifestyle factors associated with decline in the subgroup that was consistently aviremic during the first 3 years. A risk index was developed using the beta-coefficients from the final regression model. Neurocognitive decline occurred in 23 of 191 (12%) participants followed longitudinally. The baseline factors that predicted decline were glomerular filtration rate ≤50 mL/min, known duration of HIV infection ≥15 years, education ≤12 years, and cerebrospinal fluid protein >45 mg/dL. Using this analytic approach, neurocognitive decline was uncommon in this sample of aviremic HIV+ individuals. The 3-year risk of decline ranged from 2% in those with no risk factors to 95% in those with all 4. The strongest predictor was glomerular filtration rate, also a predictor of cardiovascular disease. This raises the possibility that controlling vascular risk factors could reduce the risk of neurocognitive decline.

  19. Subclinical atherosclerosis and metabolic risk: role of body mass index and waist circumference.

    Science.gov (United States)

    Camhi, Sarah M; Katzmarzyk, Peter T; Broyles, Stephanie T; Srinivasan, Sathanur R; Chen, Wei; Bouchard, Claude; Berenson, Gerald S

    2011-04-01

    Carotid artery intima-media thickness (IMT) is greater in adults with elevated metabolic risk profiles. However, the influence of body mass index (BMI) or waist circumference (WC) on the relationship between IMT and metabolic risk is unclear. Adults from the Bogalusa Heart Study were classified as normal weight, overweight, or obese and into WC categories (men, low women, low <80 cm, moderate 80-87.9 cm, high ≥88 cm). Elevated metabolic risk was defined by cardiovascular risk factor clustering (≥2 abnormal risk factors or insulin resistance (upper quartile of homeostasis model of insulin resistance). Carotid ultrasound measurements were obtained and mean IMT was calculated. General linear models compared IMT between elevated versus normal metabolic risk groups, adjusting for sex, age, race/ethnicity, and either BMI or WC category. Adults were 24-43 years of age (n = 991) and 41% had elevated metabolic risk (42% male, 28% African American, 38% obese). IMT (mm) was greater in adults with elevated metabolic risk (0.83 ± 0.007) versus normal risk (0.80 ± 0.006) whether adjusted by BMI or WC (both P < 0.0005). IMT was greater in adults with elevated compared to normal metabolic risk within normal-weight (0.84 ± 0.016 vs. 0.79 ± 0.008; P = 0.002), and obese adults (0.86 ± 0.009 vs. 0.80 ± 0.01; P = 0.03), but not significantly different between risk groups in overweight adults. Similar results were found when stratified by WC category. Adults with elevated metabolic risk have greater IMT than those with normal risk in normal-weight, overweight, low WC, and high WC, but not significant for overweight or moderate WC categories.

  20. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

    Blum, Johannes; Lockwood, Diana N. J.; Visser, Leo; Harms, Gundel; Bailey, Mark S.; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P. A. M.; Morizot, Gloria; Hatz, Christoph; Buffet, Pierre

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  1. Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients.

    Science.gov (United States)

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

  2. Derivation and Validation of a Geriatric-Sensitive Perioperative Cardiac Risk Index.

    Science.gov (United States)

    Alrezk, Rami; Jackson, Nicholas; Al Rezk, Mohanad; Elashoff, Robert; Weintraub, Nancy; Elashoff, David; Fonarow, Gregg C

    2017-11-16

    Surgical patients aged 65 and over face a higher risk of cardiac complications from noncardiac surgery. The Revised Cardiac Risk Index (RCRI) and the Gupta Myocardial Infarction or Cardiac Arrest (MICA) calculator are widely used to predict this risk, but they are not specifically designed to predict MICA in geriatric patients. Our hypothesis is that a new geriatric-sensitive index, derived from geriatric data, will capture this population's unique response to risk factors. The model was developed using the NSQIP (National Surgical Quality Improvement Program) 2013 geriatric cohort (N=584,931) (210,914 age ≥65) and validated on the NSQIP 2012 geriatric cohort (N= 485,426) (172,905 age ≥65). Least Angle Shrinkage and Selection Operator regression was used for initial variable selection. The Geriatric-Sensitive Cardiac Risk Index (GSCRI) was then evaluated in the 2012 data set. The area under the curve (AUC) was compared among the GSCRI, RCRI, and Gupta MICA in the 2012 data set. The GSCRI had an AUC of 0.76 in the validation cohort among geriatric patients. When the Gupta MICA was tested on geriatric patients in the validation cohort, a significant deterioration (≈17%) was noted, as well as a significant underestimation of the risk. The GSCRI AUC of 0.76 in the geriatric subset was significantly greater (Pgeriatric patients by 13% and 6%, respectively, with a ΔAUC and P-value of 0.13 (Pgeriatric patients undergoing noncardiac surgery. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. Entomological and ecological index for risk of infection causing lyme disease in territory of Vojvodina, Serbia

    Directory of Open Access Journals (Sweden)

    Potkonjak Aleksandar

    2013-01-01

    Full Text Available In Europe, of all the vector transmitted diseases, the occurrence of lyme disease is the one most often registered, and the most significant vector Borrelia burgdorferi is the tick Ixodes ricinus. Both humans and animals contract lyme disease. The risk of the occurrence of lyme disease is in correlation with potential exposure to tick bites and depends on the density of the tick population in the endemic area, the percentage of ticks infected with the cause of lyme disease, the duration and the nature of the activity of the susceptible population in a certain area. The objective of these investigations was to determine the entomological and the ecological risk index, as well as to assess the risk of transmission of the cause of lyme disease in the territory of Vojvodina Province in the Republic of Serbia. Ticks were collected at 12 locations in the South Bačka District of Vojvodina. A total of 1400 ticks were identified up to the level of species. After establishing the infection of ticks with the cause of lyme disease, the entomological and the ecological index was determined for the given regions using microscopic examination in a dark field. Two species of ticks aere identified in this geographic region (Ixodes ricinus and Dermacentor marginatus. Examining I. ricinus, the prevalence of infection B. burgdorferi was established, ranging up to 33.1%. The ecological risk index indicates that there is a potential risk of humans and animals becoming infected at 8 localities. It was determined for 3 localities that there is a definite actual risk of the transferrence of causes of lyme disease.

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

    Science.gov (United States)

    Merry, Audrey H H; Schouten, Leo J; Goldbohm, R Alexandra; van den Brandt, Piet A

    2007-11-01

    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. The Netherlands Cohort Study was initiated in 1986. All participants (n = 120,852), aged 55-69 years, completed a self administered questionnaire. Cases were identified through annual record linkage with the Netherlands Cancer Registry. After 13.3 years of follow-up, excluding the first follow-up year, complete data from 4552 subcohort members, 133 oesophageal and 163 gastric cardia adenocarcinomas were available for case-cohort analyses. Incidence rate ratios (RRs) and corresponding 95% confidence intervals were estimated using Cox proportional hazard models. The RRs (95% CI) of oesophageal adenocarcinoma were 1.40 (0.95 to 2.04) and 3.96 (2.27 to 6.88) for overweight (BMI 25.0-29.9 kg/m(2)) and obese subjects (BMI >or=30.0 kg/m(2)), respectively, compared to subjects with normal weight (BMI 20.0-24.9 kg/m(2)). For gastric cardia adenocarcinoma, these RRs were 1.32 (0.94 to 1.85) and 2.73 (1.56 to 4.79). Also change in BMI during adulthood was positively associated with the risk of oesophageal and gastric cardia adenocarcinoma (p trend 0.001 and 0.02, respectively), while no association was found with BMI in early adulthood (p trend 0.17 and 0.17, respectively). None of the tumour types investigated was significantly associated with height. These results confirm higher risks of oesophageal and gastric cardia adenocarcinoma with increasing BMI. This implies that the increasing prevalence of obesity may be one of the explanations for the rising incidence of oesophageal and gastric cardia adenocarcinoma in the Western world.

  5. 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

  6. 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.

  7. Clinical Risk Index for Babies (Crib) Ii Score as a Predictor of ...

    African Journals Online (AJOL)

    Clinical Risk Index for Babies (Crib) Ii Score as a Predictor of Neonatal Mortality among Low Birth Weight Babies at Kenyatta National Hospital. ... Using a cut off point of 4, CRIB II score was found to have a sensitivity of 80.6%, specificity of 75.3%, and a predictive value of 77.7% compared to 72.5, 71.2, and 71.8% ...

  8. Getting RID of the blues: Formulating a Risk Index for Depression (RID) using structural equation modeling.

    Science.gov (United States)

    Dipnall, Joanna F; Pasco, Julie A; Berk, Michael; Williams, Lana J; Dodd, Seetal; Jacka, Felice N; Meyer, Denny

    2017-11-01

    While risk factors for depression are increasingly known, there is no widely utilised depression risk index. Our objective was to develop a method for a flexible, modular, Risk Index for Depression using structural equation models of key determinants identified from previous published research that blended machine-learning with traditional statistical techniques. Demographic, clinical and laboratory variables from the National Health and Nutrition Examination Study (2009-2010, N = 5546) were utilised. Data were split 50:50 into training:validation datasets. Generalised structural equation models, using logistic regression, were developed with a binary outcome depression measure (Patient Health Questionnaire-9 score ⩾ 10) and previously identified determinants of depression: demographics, lifestyle-environs, diet, biomarkers and somatic symptoms. Indicative goodness-of-fit statistics and Areas Under the Receiver Operator Characteristic Curves were calculated and probit regression checked model consistency. The generalised structural equation model was built from a systematic process. Relative importance of the depression determinants were diet (odds ratio: 4.09; 95% confidence interval: [2.01, 8.35]), lifestyle-environs (odds ratio: 2.15; 95% CI: [1.57, 2.94]), somatic symptoms (odds ratio: 2.10; 95% CI: [1.58, 2.80]), demographics (odds ratio:1.46; 95% CI: [0.72, 2.95]) and biomarkers (odds ratio:1.39; 95% CI: [1.00, 1.93]). The relationships between demographics and lifestyle-environs and depression indicated a potential indirect path via somatic symptoms and biomarkers. The path from diet was direct to depression. The Areas under the Receiver Operator Characteristic Curves were good (logistic:training = 0.850, validation = 0.813; probit:training = 0.849, validation = 0.809). The novel Risk Index for Depression modular methodology developed has the flexibility to add/remove direct/indirect risk determinants paths to depression using a

  9. Low, medium, and high glycaemic index carbohydrates and risk of type 2 diabetes in men

    OpenAIRE

    Similä, Minna E.; Valsta, Liisa M.; Kontto, Jukka P.; Albanes, Demetrius; Virtamo, Jarmo

    2010-01-01

    Findings on dietary glycaemic index (GI) and glycaemic load (GL) as risk factors for type 2 diabetes have been controversial. We examined the associations of dietary GI and GL and the associations of substitution of lower GI carbohydrates for higher GI carbohydrates with diabetes risk in a cohort of Finnish men. The cohort consisted of 25 943 male smokers aged 50–69 years. Diet was assessed, at baseline, using a validated diet history questionnaire. During a 12-year follow-up, 1 098 incident ...

  10. [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...

  11. 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.

  12. 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.

  13. Fuzzy risk index for power transformer failures due to external short-circuits

    Energy Technology Data Exchange (ETDEWEB)

    Flores, Wilfredo C.; Ratta, Giuseppe [Instituto de Energia Electrica, National University of San Juan, Av. Libertador San Martin, 1109 (oeste), J5400ARL, San Juan (Argentina); Mombello, Enrique [CONICET, at Instituto de Energia Electrica, National University of San Juan, Av. Libertador San Martin, 1109 (oeste), J5400ARL, San Juan (Argentina); Jardini, Jose A. [University of Sao Paulo, Department of Engineering of Energy and Electric Automation (Brazil)

    2009-04-15

    A novel methodology to assess the risk of power transformer failures caused by external faults, such as short-circuit, taking the paper insulation condition into account, is presented. The risk index is obtained by contrasting the insulation paper condition with the probability that the transformer withstands the short-circuit current flowing along the winding during an external fault. In order to assess the risk, this probability and the value of the degree of polymerization of the insulating paper are regarded as inputs of a type-2 fuzzy logic system (T2-FLS), which computes the fuzzy risk level. A Monte Carlo simulation has been used to find the survival function of the currents flowing through the transformer winding during a single-phase or a three-phase short-circuit. The Roy Billinton Test System and a real power system have been used to test the results. (author)

  14. Interaction between smoking and body mass index and risk of oral clefts

    DEFF Research Database (Denmark)

    Wehby, George L; Uribe, Lina M Moreno; Wilcox, Allen J

    2017-01-01

    PURPOSE: To examine maternal smoking and body mass index (BMI) interactions in contributing to risk of oral clefts. METHODS: We studied 4935 cases and 10,557 controls from six population-based studies and estimated a pooled logistic regression of individual-level data, controlling for study fixed...... for cleft lip only and cleft palate only. CONCLUSIONS: Our findings suggest that the risk of oral clefts associated with maternal smoking is largest among underweight mothers, although the smoking-BMI interaction is strongest for cleft lip only and cleft palate only. BMI was not protective for the effects...... effects and individual-level risk factors. RESULTS: We found a significant negative smoking-BMI interaction, with cleft risk with smoking generally declining with higher BMI. For all clefts combined, the odds ratio for smoking was 1.61 (95% confidence interval [CI]: 1.39-1.86) at BMI 17 (underweight), 1...

  15. The Geriatric Nutritional Risk Index Independently Predicts Mortality in Diabetic Foot Ulcers Patients Undergoing Amputations.

    Science.gov (United States)

    Xie, Yuanyuan; Zhang, Hailing; Ye, Tingting; Ge, Shengjie; Zhuo, Ruyi; Zhu, Hong

    2017-01-01

    Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients. Patients were divided into two groups according to a GNRI cutoff value of 92, and characteristics and mortality were compared between the two groups. Cox proportional hazard analysis was performed to explore the association between GNRI and mortality. Result. GNRI (p risk factors. Conclusion. GNRI on admission might be a novel clinical predictor for the incidence of death in patients with diabetic foot ulcers who were undergoing amputations.

  16. Environmental risk index: a tool to assess the safety of dams for leachate.

    Science.gov (United States)

    Colomer Mendoza, Francisco J; Gallardo Izquierdo, Antonio

    2009-02-15

    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.

  17. Dietary Carbohydrate, Glycemic Index, Glycemic Load, and Breast Cancer Risk Among Mexican Women.

    Science.gov (United States)

    Amadou, Amina; Degoul, Julie; Hainaut, Pierre; Chajes, Veronique; Biessy, Carine; Torres Mejia, Gabriela; Huybrechts, Inge; Moreno Macia, Hortensia; Ortega, Caro; Angeles-Llerenas, Anjélica; Romieu, Isabelle

    2015-11-01

    Very few studies have focused on the relationship among dietary carbohydrates, glycemic index (GI), glycemic load (GL), and breast cancer risk in Latin American women. Our objective was to assess the associations among dietary carbohydrate, GI, GL, and risk of breast cancer, and to further investigate these associations by levels of overweight/obesity and physical activity. We used data from a Mexican population-based case-control study. We recruited a 1,000 women with incident breast cancer and 1,074 matched control women ages 35 to 69 years between 2004 and 2007. We used conditional logistic regression models and energy-adjusted carbohydrates, GI, and GL using the residual method. Total carbohydrate intake was associated with an increased risk of breast cancer among premenopausal women. The odds ratio in the highest versus the lowest quartile was 1.3 (95% confidence interval = 1.0, 1.7; P trend = 0.03). In stratified analyses by body mass index (BMI), the positive association between carbohydrate and risk of premenopausal breast cancer was only observed among overweight women. The odds ratio comparing the top with the bottom quartile was 1.9 (95% confidence interval = 1.2, 3.0; P trend = 0.01) among women with BMI ≥ 25 kg/m. No association was observed among women with BMI carbohydrate diets are associated with an increased risk of breast cancer among premenopausal Mexican women.

  18. Geriatric Nutritional Risk Index (GNRI) Independently Predicts Amputation Inchronic Criticallimb Ischemia (CLI).

    Science.gov (United States)

    Luo, Han; Yang, Hongliu; Huang, Bin; Yuan, Ding; Zhu, Jingqiang; Zhao, Jichun

    2016-01-01

    General malnutrition usually occurs in critical limb ischemia (CLI) patients because of shortness of appetite and sleeplessness leaded by chronic pain. And amputation frequently is end-point of CLI patients. So the aim of this study was to assess the predictive ability of Geriatric nutritional risk index (GNRI) for predicting amputation in patients with CLI. A retrospective study was designed. Demographics, history, comorbidity, and risk factors for peripheral vascular disease of admitted patients, and laboratory study were documented. Patients' height, weight and BMI were recorded. Amputation was identified as end-point during follow-up. Patients' amputation-free survival (AFS) was recorded. 172 patients were identified, with mean age 71.98±3.12. Geriatric nutritional risk index (GNRI) = 90 was taken as cutoff value of high risk of amputation for CLI patients via using receiver operating characteristic (ROC) curve. Span of follow-up was 12-48 months. During follow-up, 60 patients (36.04%) received amputation surgery. And analyzed by Cox proportional hazards model, it is found that GNRI was the independent predictive factor for amputation in long term. This study revealed that GNRI was a reliable and effective predictive marker for AFS. GNRI could identify patients with high risk for amputation in early time.

  19. 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

  20. Glycemic index, glycemic load and carbohydrate intake in association with risk of renal cell carcinoma.

    Science.gov (United States)

    Zhu, Jingfen; Tu, Huakang; Matin, Surena F; Tannir, Nizar M; Wood, Christopher G; Wu, Xifeng

    2017-10-26

    Carbohydrate intake affects postprandial glucose levels and insulin response, which plays a role in carcinogenesis. The relationship between carbohydrate intake, dietary glycemic index (GI) and glycemic load (GL), and risk of renal cell carcinoma (RCC) remains unclear. We conducted a case-control study including 854 patients with newly diagnosed RCC (cases) and 1255 healthy participants (controls) recruited since 2002. GI, GL and carbohydrate intake were obtained via a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, adjusting for potential confounders. We found that higher GI was significantly associated with RCC risk with an OR of 1.32 (95% CI, 0.99-1.74; Ptrend = 0.026) (the highest versus the lowest quartiles). We also observed an inverse association between fiber intake and RCC risk with OR of 0.70 (95% CI = 0.50-0.99) as well as between starch intake and risk of RCC with OR of 0.65 (95% CI = 0.49-0.87). Individuals with a high-GI diet and hypertension or high body mass index (BMI) had a 2.7 times (OR = 2.67, 95% CI = 1.96-3.64) and two times (OR = 1.95, 95% CI = 1.29-2.92) higher RCC risk, respectively, than those without these factors. Our findings suggest that a high-GI diet is associated with an increased risk of RCC, whereas increased fiber and starch intakes appear to be associated with a decreased risk of RCC. We found that reducing GI levels and increasing fiber intake could be a dietary strategy to decrease RCC risk, especially for individuals with hypertension or high BMI. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Concepts and Metrics for Climate Change Risk and Development - Towards an index for Climate Resilient Development

    OpenAIRE

    Miola, Apollonia; SIMONET CATHERINE

    2014-01-01

    The threats posed by climate change are increasingly seen as a major problem for the future of nature and humanity, and significant improvements are needed to set the world on a climate change resilient path to the future. At global, regional and local level there is an increasing demand from both policy makers and the business sector for understanding relationships between the determinants of climate change risk (hazards, exposure, vulnerability, and adaptation) as well as metrics and policy...

  2. Assessment of the water chemical quality improvement based on human health risk indexes: Application to a drinking water treatment plant incorporating membrane technologies.

    Science.gov (United States)

    López-Roldán, Ramón; Rubalcaba, Alicia; Martin-Alonso, Jordi; González, Susana; Martí, Vicenç; Cortina, Jose Luis

    2016-01-01

    A methodology has been developed in order to evaluate the potential risk of drinking water for the health of the consumers. The methodology used for the assessment considered systemic and carcinogenic effects caused by oral ingestion of water based on the reference data developed by the World Health Organisation (WHO) and the Risk Assessment Information System (RAIS) for chemical contaminants. The exposure includes a hypothetical dose received by drinking this water according to the analysed contaminants. An assessment of the chemical quality improvement of produced water in the Drinking Water Treatment Plant (DWTP) after integration of membrane technologies was performed. Series of concentration values covering up to 261 chemical parameters over 5 years (2008-2012) of raw and treated water in the Sant Joan Despí DWTP, at the lower part of the Llobregat River basin (NE Spain), were used. After the application of the methodology, the resulting global indexes were located below the thresholds except for carcinogenic risk in the output of DWTP, where the index was slightly above the threshold during 2008 and 2009 before the upgrade of the treatment works including membrane technologies was executed. The annual evolution of global indexes showed a reduction in the global values for all situations: HQ systemic index based on RAIS dropped from 0.64 to 0.42 for surface water and from 0.61 to 0.31 for drinking water; the R carcinogenic index based on RAIS was negligible for input water and varied between 4.2×10(-05) and 7.4×10(-06) for drinking water; the W systemic index based on the WHO data varied between 0.41 and 0.16 for surface water and between 0.61 and 0.31 for drinking water. A specific analysis for the indexes associated with trihalomethanes (THMs) showed the same pattern. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. 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.

  4. An integrated vulnerability index for socio-climate risk assessment over the continental United States

    Science.gov (United States)

    Batıbeniz, Fulden; Ashfaq, Moetasim; Preston, Ben; Pagan, Brianna; Rastogi, Deeksha

    2017-04-01

    There is no clear knowledge towards the collective risk associated with multivariate extremes for natural and human systems, as the research thus far has not taken into account the combined impact of changes in hot, cold, wet and dry extremes. Concurrently, not all the factors influencing human vulnerability to climate change are related with natural system's response to climate forcing as future changes in both the magnitude and the distribution of human population and income levels can potentially multiply or reduce the risk of human exposure to climatic changes. For a comprehensive socio-climate risk assessment, a county-level integrated vulnerability index is developed in this study to provide an estimate of future exposure to both changes in climate extremes and socioeconomic conditions over the continental United States. The integrated vulnerability index is based on the combination of a unified climate extremes indices, which summarize overall exposure to multivariate and multidimensional climate extremes, including hot, cold, wet and dry, and shared socioeconomic pathways, which identify communities at risk based on projected population and income levels. We will present results from the application of the proposed integrated vulnerability index on a high-resolution (4km) 11-member ensemble of regional climate simulations and multiple socioeconomic pathways, aggregated at county scale, which cover 1966-2005 in the baseline and 2011-2050 in the near-term future climate under Representative Concentration Pathway 8.5. Overall, this research should help advance robust strategies for assessing the risk and vulnerability associated with projected changes in temperature and precipitation characteristics, as well as socioeconomic conditions.

  5. Comparison of UAV and WorldView-2 imagery for mapping leaf area index of mangrove forest

    Science.gov (United States)

    Tian, Jinyan; Wang, Le; Li, Xiaojuan; Gong, Huili; Shi, Chen; Zhong, Ruofei; Liu, Xiaomeng

    2017-09-01

    Unmanned Aerial Vehicle (UAV) remote sensing has opened the door to new sources of data to effectively characterize vegetation metrics at very high spatial resolution and at flexible revisit frequencies. Successful estimation of the leaf area index (LAI) in precision agriculture with a UAV image has been reported in several studies. However, in most forests, the challenges associated with the interference from a complex background and a variety of vegetation species have hindered research using UAV images. To the best of our knowledge, very few studies have mapped the forest LAI with a UAV image. In addition, the drawbacks and advantages of estimating the forest LAI with UAV and satellite images at high spatial resolution remain a knowledge gap in existing literature. Therefore, this paper aims to map LAI in a mangrove forest with a complex background and a variety of vegetation species using a UAV image and compare it with a WorldView-2 image (WV2). In this study, three representative NDVIs, average NDVI (AvNDVI), vegetated specific NDVI (VsNDVI), and scaled NDVI (ScNDVI), were acquired with UAV and WV2 to predict the plot level (10 × 10 m) LAI. The results showed that AvNDVI achieved the highest accuracy for WV2 (R2 = 0.778, RMSE = 0.424), whereas ScNDVI obtained the optimal accuracy for UAV (R2 = 0.817, RMSE = 0.423). In addition, an overall comparison results of the WV2 and UAV derived LAIs indicated that UAV obtained a better accuracy than WV2 in the plots that were covered with homogeneous mangrove species or in the low LAI plots, which was because UAV can effectively eliminate the influence from the background and the vegetation species owing to its high spatial resolution. However, WV2 obtained a slightly higher accuracy than UAV in the plots covered with a variety of mangrove species, which was because the UAV sensor provides a negative spectral response function(SRF) than WV2 in terms of the mangrove LAI estimation.

  6. Strong influence of El Niño Southern Oscillation on flood risk around the world

    Science.gov (United States)

    Ward, Philip J.; Jongman, B; Kummu, M.; Dettinger, Mike; Sperna Weiland, F.C; Winsemius, H.C

    2014-01-01

    El Niño Southern Oscillation (ENSO) is the most dominant interannual signal of climate variability and has a strong influence on climate over large parts of the world. In turn, it strongly influences many natural hazards (such as hurricanes and droughts) and their resulting socioeconomic impacts, including economic damage and loss of life. However, although ENSO is known to influence hydrology in many regions of the world, little is known about its influence on the socioeconomic impacts of floods (i.e., flood risk). To address this, we developed a modeling framework to assess ENSO’s influence on flood risk at the global scale, expressed in terms of affected population and gross domestic product and economic damages. We show that ENSO exerts strong and widespread influences on both flood hazard and risk. Reliable anomalies of flood risk exist during El Niño or La Niña years, or both, in basins spanning almost half (44%) of Earth’s land surface. Our results show that climate variability, especially from ENSO, should be incorporated into disaster-risk analyses and policies. Because ENSO has some predictive skill with lead times of several seasons, the findings suggest the possibility to develop probabilistic flood-risk projections, which could be used for improved disaster planning. The findings are also relevant in the context of climate change. If the frequency and/or magnitude of ENSO events were to change in the future, this finding could imply changes in flood-risk variations across almost half of the world’s terrestrial regions.

  7. Assessment of Suicide Risk: Validation of the Nurses' Global Assessment of Suicide Risk Index for the Portuguese Population.

    Science.gov (United States)

    Façanha, Jorge; Santos, Jose Carlos; Cutcliffe, John

    2016-08-01

    Mental health problems, particularly depression, are a major risk factor for suicide. Currently, there is no way to predict, with 100% accuracy, who will make a suicide attempt, but during a clinical interview, it is possible to assess the risk presented by each patient based on the investigation of risk and protective factors. The assessment of these factors helps health care professionals make decisions on the interventions to put into practice, thus contributing to reducing risk. The use of suicide risk assessment tools, properly validated for the population under consideration facilitate communication and information gathering, with clinical nurse specialists in mental health playing an important role. Because of the shortage of suicide risk assessment tools properly validated for the Portuguese population, it was our aim to translate, adapt and validate the Nurses Global Assessment of Suicide Risk (NGASR) for the Portuguese population. In this study, a questionnaire was applied to a sample of 109 patients with depressive symptoms and risk factors for suicidal behaviors. The analysis of the results showed that most sample participants had a very high risk of suicide. The study of the psychometric properties of the NGASR showed moderate internal consistency and good content and criterion validity. Content validity, obtained through a panel of experts, was consensual. The NGASR index had good criterion validity, showing strong correlation with the SIQ, BDI and DASS-21 (R=0.830, p<0.05). The principal components analysis showed 6 factors, and the 15 predictive variables explained 66.92% of the total variance. These results are similar to those obtained in studies conducted in other countries and, therefore, the application of the NGASR is believed to be reliable for the Portuguese population. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. 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 nutritional risk (83.5 ≤ NRI nutritional 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.

  9. Dietary carbohydrate intake, glycemic index, and glycemic load and endometrial cancer risk: a prospective cohort study.

    Science.gov (United States)

    Coleman, Helen G; Kitahara, Cari M; Murray, Liam J; Dodd, Kevin W; Black, Amanda; Stolzenberg-Solomon, Rachael Z; Cantwell, Marie M

    2014-01-01

    Endometrial cancer risk has been directly associated with glycemic load. However, few studies have investigated this link, and the etiological role of specific dietary carbohydrate components remains unclear. Our aim was to investigate associations of carbohydrate intake, glycemic index, and glycemic load with endometrial cancer risk in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Recruitment took place in 1993-2001. Over a median of 9.0 years of follow-up through 2009, 386 women developed endometrial cancer among 36,115 considered in the analysis. Dietary intakes were assessed using a 124-item diet history questionnaire. Cox proportional hazards models were applied to calculate hazard ratios and 95% confidence intervals. Significant inverse associations were detected between endometrial cancer risk and total available carbohydrate intake (hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.49, 0.90), total sugars intake (HR = 0.71, 95% CI: 0.52, 0.96), and glycemic load (HR = 0.63, 95% CI: 0.46, 0.84) when women in the highest quartile of intake were compared with those in the lowest. These inverse associations were strongest among overweight and obese women. No associations with endometrial cancer risk were observed for glycemic index or dietary fiber. Our findings contrast with previous evidence and suggest that high carbohydrate intakes and glycemic loads are protective against endometrial cancer development. Further clarification of these associations is warranted.

  10. Nutritional Risk Index predicts mortality in hospitalized advanced heart failure patients.

    Science.gov (United States)

    Adejumo, Oluwayemisi L; Koelling, Todd M; Hummel, Scott L

    2015-11-01

    Hospitalized advanced heart failure (HF) patients are at high risk for malnutrition and death. The Nutritional Risk Index (NRI) is a simple, well-validated tool for identifying patients at risk for nutrition-related complications. We hypothesized that, in advanced HF patients from the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) trial, the NRI would improve risk discrimination for 6-month all-cause mortality. We analyzed the 160 ESCAPE index admission survivors with complete follow-up and NRI data, calculated as follows: NRI = (1.519 × discharge serum albumin [in g/dl]) + (41.7 × discharge weight [in kg] / ideal body weight [in kg]); as in previous studies, if discharge weight is greater than ideal body weight (IBW), this ratio was set to 1. The previously developed ESCAPE mortality model includes: age; 6-minute walk distance; cardiopulmonary resuscitation/mechanical ventilation; discharge β-blocker prescription and diuretic dose; and discharge serum sodium, blood urea nitrogen and brain natriuretic peptide levels. We used Cox proportional hazards modeling for the outcome of 6-month all-cause mortality. Thirty of 160 patients died within 6 months of hospital discharge. The median NRI was 96 (IQR 91 to 102), reflecting mild-to-moderate nutritional risk. The NRI independently predicted 6-month mortality, with adjusted HR 0.60 (95% CI 0.39 to 0.93, p = 0.02) per 10 units, and increased Harrell's c-index from 0.74 to 0.76 when added to the ESCAPE model. Body mass index and NRI at hospital admission did not predict 6-month mortality. The discharge NRI was most helpful in patients with high (≥ 20%) predicted mortality by the ESCAPE model, where observed 6-month mortality was 38% in patients with NRI 100 (p = 0.04). The NRI is a simple tool that can improve mortality risk stratification at hospital discharge in hospitalized patients with advanced HF. Published by Elsevier Inc.

  11. Injury risk curves for the WorldSID 50th male dummy.

    Science.gov (United States)

    Petitjean, Audrey; Trosseille, Xavier; Petit, Philippe; Irwin, Annette; Hassan, Joe; Praxl, Norbert

    2009-11-01

    The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/SC12/TC22/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. More than 45 organizations from all around the world have contributed to this effort including governmental agencies, research institutes, car manufacturers and dummy manufacturers. The first production version of the WorldSID 50th male dummy was released in March 2004 and demonstrated an improved biofidelity over existing side impact dummies. Full scale vehicle tests covering a wide range of side impact test procedures were performed worldwide with the WorldSID dummy. However, the vehicle safety performance could not be assessed due to lack of injury risk curves for this dummy. The development of these curves was initiated in 2004 within the framework of ISO/SC12/TC22/WG6 (Injury criteria). In 2008, the ACEA- Dummy Task Force (TFD) decided to contribute to this work and offered resources for a project manager to coordinate of the effort of a group of volunteer biomechanical experts from international institutions (ISO, EEVC, VRTC/NHTSA, JARI, Transport Canada), car manufacturers (ACEA, Ford, General Motors, Honda, Toyota, Chrysler) and universities (Wayne State University, Ohio State University, John Hopkins University, Medical College of Wisconsin) to develop harmonized injury risk curves. An in-depth literature review was conducted. All the available PMHS datasets were identified, the test configurations and the quality of the results were checked. Criteria were developed for inclusion or exclusion of PMHS tests in the development of the injury risk curves. Data were processed to account for differences in mass and age of the subjects. Finally, injury risk curves were developed using the following statistical techniques, the certainty method, the Mertz/Weber method, the

  12. Regression coefficient-based scoring system should be used to assign weights to the risk index.

    Science.gov (United States)

    Mehta, Hemalkumar B; Mehta, Vinay; Girman, Cynthia J; Adhikari, Deepak; Johnson, Michael L

    2016-11-01

    Some previously developed risk scores contained a mathematical error in their construction: risk ratios were added to derive weights to construct a summary risk score. This study demonstrates the mathematical error and derived different versions of the Charlson comorbidity score (CCS) using regression coefficient-based and risk ratio-based scoring systems to further demonstrate the effects of incorrect weighting on performance in predicting mortality. This retrospective cohort study included elderly people from the Clinical Practice Research Datalink. Cox proportional hazards regression models were constructed for time to 1-year mortality. Weights were assigned to 17 comorbidities using regression coefficient-based and risk ratio-based scoring systems. Different versions of CCS were compared using Akaike information criteria (AIC), McFadden's adjusted R(2), and net reclassification improvement (NRI). Regression coefficient-based models (Beta, Beta10/integer, Beta/Schneeweiss, Beta/Sullivan) had lower AIC and higher R(2) compared to risk ratio-based models (HR/Charlson, HR/Johnson). Regression coefficient-based CCS reclassified more number of people into the correct strata (NRI range, 9.02-10.04) compared to risk ratio-based CCS (NRI range, 8.14-8.22). Previously developed risk scores contained an error in their construction adding ratios instead of multiplying them. Furthermore, as demonstrated here, adding ratios fail to even work adequately from a practical standpoint. CCS derived using regression coefficients performed slightly better than in fitting the data compared to risk ratio-based scoring systems. Researchers should use a regression coefficient-based scoring system to develop a risk index, which is theoretically correct. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. 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.

  14. 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......, height and systolic blood pressure in both age groups with few gender differences. Associations between AIx and cardiovascular risk factors further differed by age: In young subjects AIx was associated with cholesterol, high-sensitive C-reactive protein, current smoking, low weight, poor education...... in Denmark. All subjects had AIx measured non-invasively by the SphygmoCor device (SphygmoCor, West Ryde, Australia). To analyse the association between AIx and CVD risk factors multiple linear regression analyses were used stratified by gender and age. The main determinants of AIx were age, heart rate...

  15. Estimation of option-implied risk-neutral into real-world density by using calibration function

    Science.gov (United States)

    Bahaludin, Hafizah; Abdullah, Mimi Hafizah

    2017-04-01

    Option prices contain crucial information that can be used as a reflection of future development of an underlying assets' price. The main objective of this study is to extract the risk-neutral density (RND) and the risk-world density (RWD) of option prices. A volatility function technique is applied by using a fourth order polynomial interpolation to obtain the RNDs. Then, a calibration function is used to convert the RNDs into RWDs. There are two types of calibration function which are parametric and non-parametric calibrations. The density is extracted from the Dow Jones Industrial Average (DJIA) index options with a one month constant maturity from January 2009 until December 2015. The performance of RNDs and RWDs extracted are evaluated by using a density forecasting test. This study found out that the RWDs obtain can provide an accurate information regarding the price of the underlying asset in future compared to that of the RNDs. In addition, empirical evidence suggests that RWDs from a non-parametric calibration has a better accuracy than other densities.

  16. Surgical risk index and surgical site infection in postpartum women submitted to cesarean section.

    Directory of Open Access Journals (Sweden)

    Luana Machado Chianca

    2015-01-01

    Full Text Available Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI for assessment of Surgical Site Infection (SSI in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8% women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%. The medical consultation in the post-partum period occurred with 188 (37.08% women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39 after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1% were classified as superficial SSI, 5 (23.8% as deep and 4 (19.1% as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. KEYWORDS: Cesarean Section; Surgical Wound Infection; Epidemiological Surveillance; Infection Control; Risk Index; Disease Notification.

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

    Directory of Open Access Journals (Sweden)

    Hao Hu

    Full Text Available 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 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.

  18. Body mass index and risk of subtypes of head-neck cancer: the Netherlands Cohort Study.

    Science.gov (United States)

    Maasland, Denise H E; van den Brandt, Piet A; Kremer, Bernd; Schouten, Leo J

    2015-12-04

    Low body mass index (BMI) has been associated with risk of head-neck cancer (HNC), but prospective data are scarce. We investigated the association between BMI, BMI at age 20 years and change in BMI during adulthood with risk of HNC and HNC subtypes. 120,852 participants completed a questionnaire on diet and other cancer risk factors, including anthropometric measurements, at baseline in 1986. After 20.3 years of follow-up, 411 HNC (127 oral cavity cancer (OCC), 84 oro-/hypopharyngeal cancer (OHPC), and 197 laryngeal cancer (LC)) cases and 3,980 subcohort members were available for case-cohort analysis using Cox proportional hazards models. BMI at baseline was inversely associated with risk of HNC overall, with a multivariate rate ratio of 3.31 (95% CI 1.40-7.82) for subjects with a BMI < 18.5 kg/m(2), compared to participants with a BMI of 18.5 to 25 kg/m(2). Among HNC subtypes, this association was strongest for OCC and OHPC. The association between BMI at age 20 and HNC risk appeared to be positive. In this large prospective cohort study, we found an inverse association between BMI at baseline and HNC risk. For BMI at age 20, however, a positive rather than inverse association was found.

  19. Mendelian randomization study of body mass index and colorectal cancer risk

    Science.gov (United States)

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike; Chang-Claude, Jenny; Rudolph, Anja; Slattery, Martha L.; Chan, Andrew T.; Locke, Adam E.; Kahali, Bratati; Justice, Anne E.; Pers, Tune H.; Gallinger, Steven; Hayes, Richard B; Baron, John A.; Caan, Bette J.; Ogino, Shuji; Berndt, Sonja I.; Chanock, Stephen J.; Casey, Graham; Haile, Robert W.; Du, Mengmeng; Harrison, Tabitha A.; Thornquist, Mark; Duggan, David J.; Le Marchand, Loïc; Lindor, Noralane M.; Seminara, Daniela; Song, Mingyang; Wu, Kana; Thibodeau, Stephen N.; Cotterchio, Michelle; Win, Aung Ko; Jenkins, Mark A.; Hopper, John L.; Ulrich, Cornelia M.; Potter, John D.; Newcomb, Polly A.; Hoffmeister, Michael; Brenner, Hermann; White, Emily; Hsu, Li; Campbell, Peter T.

    2015-01-01

    Background High body mass index (BMI) is consistently linked to increased risk of colorectal cancer (CRC) 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 CRC. Methods We used data from 10,226 CRC 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 with higher BMI, as an instrumental variable (IV). We compared the IV odds ratio (IV-OR) with the OR obtained using a conventional covariate-adjusted analysis. Results Individuals carrying greater numbers of BMI-increasing alleles had higher CRC risk (per weighted allele OR, 1.31; 95% confidence interval [CI], 1.10–1.57). Our IV estimation results support the hypothesis that genetically influenced BMI is directly associated with risk for CRC (IV-OR per 5 kg/m2, 1.50; 95% CI, 1.13–2.01). In the sex-specific IV analyses higher BMI was associated with higher risk of CRC among women (IV-OR per 5 kg/m2, 1.82; 95% CI, 1.26–2.61). For men, genetically influenced BMI was not associated with CRC (IV-OR per 5 kg/m2, 1.18; 95% CI, 0.73–1.92). Conclusions High BMI was associated with increased CRC risk for women. Whether abdominal obesity, 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 CRC. PMID:25976416

  20. The Geriatric Nutritional Risk Index Predicts Survival in Elderly Esophageal Squamous Cell Carcinoma Patients with Radiotherapy.

    Science.gov (United States)

    Bo, Yacong; Wang, Kunlun; Liu, Yang; You, Jie; Cui, Han; Zhu, Yiwei; Lu, Quanjun; Yuan, Ling

    2016-01-01

    The impact of nutritional status on survival among elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radiotherapy is unclear. In this study, we aimed at validating the performance of the geriatric nutritional risk index (GNRI) in predicting overall survival time in elderly ESCC patients with radiotherapy. A retrospective cohort study was conducted on 239 ESCC patients aged 60 and over admitted consecutively from January 2008 to November 2014 in the Department of Radiotherapy, Henan Tumor Hospital (Affiliated Tumor Hospital of Zhengzhou University), Zhengzhou, Henan, China. All patients were subjected to nutritional screening using GNRI, and were followed for the occurrence of lymphatic node metastasis, radiation complication and mortality. The Kaplan-Meier method with Log-rank test was used to estimate survival curves. Univariable Cox regression analysis was used to identify variables associated with overall survival time. Among the 239 patients, 184 patients (76.9%) took no nutritional risk, 32 patients (13.4%) took moderate risk of malnutrition, and 23 patients (9.7%) took a high risk of malnutrition. Univariable Cox regression showed that both high nutritional risk group and moderate nutritional risk group were significantly less likely to survive than no nutritional risk patients (hazard ratio (HR) = 1.688, 95% confidence interval (CI) = 1.019-2.798 for moderate risk group, and HR = 2.699, 95% CI = 1.512-4.819 for high risk group, respectively). The GNRI is an independent prognostic factor for overall survival time in elderly ESCC patients with radiotherapy. A GNRI ≤98 can be suggested as an indicator of surviving less.

  1. 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.

  2. Cancer risk and prevention in a globalised world: solving the public policy mismatch.

    Science.gov (United States)

    Sullivan, R; Homberg, L; Purushotham, A D

    2012-09-01

    The world faces an unprecedented growth in cancer incidence over the next fifty years, the majority of the burden falling on low-middle income countries. At the same time as the changing demographic profiles, including global population ageing we are also seeing the rapid globalisation of pro-cancer behaviours and commodities such as tobacco. The human and economic impact will continue to be severe unless radical changes occur to current public policy mismatches in cancer prevention. At the same time high level political actions through bodies such as the UN suggest that supra-national approaches are needed to solve these issues. However, we argue that only local nation-state approaches can fundamentally address cancer risk and enhance prevention in a globalised world. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Carbohydrates, glycemic index, glycemic load, and breast cancer risk: a systematic review and dose-response meta-analysis of prospective studies.

    Science.gov (United States)

    Schlesinger, Sabrina; Chan, Doris S M; Vingeliene, Snieguole; Vieira, Ana R; Abar, Leila; Polemiti, Elli; Stevens, Christophe A T; Greenwood, Darren C; Aune, Dagfinn; Norat, Teresa

    2017-06-01

    The investigation of dose-response associations between carbohydrate intake, glycemic index, glycemic load, and risk of breast cancer stratified by menopausal status, hormone receptor status, and body mass index (BMI) remains inconclusive. A systematic review and dose-response meta-analyses was conducted to investigate these associations. As part of the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, PubMed was searched up to May 2015 for relevant studies on these associations. Prospective studies reporting associations between carbohydrate intake, glycemic index, or glycemic load and breast cancer risk were included. Two investigators independently extracted data from included studies. Random-effects models were used to summarize relative risks (RRs) and 95%CIs. Heterogeneity between subgroups, including menopausal status, hormone receptor status, and BMI was explored using meta-regression. Nineteen publications were included. The summary RRs (95%CIs) for breast cancer were 1.04 (1.00-1.07) per 10 units/d for glycemic index, 1.01 (0.98-1.04) per 50 units/d for glycemic load, and 1.00 (0.96-1.05) per 50 g/d for carbohydrate intake. For glycemic index, the association appeared slightly stronger among postmenopausal women (summary RR per 10 units/d, 1.06; 95%CI, 1.02-1.10) than among premenopausal women, though the difference was not statistically significant (Pheterogeneity = 0.15). Glycemic load and carbohydrate intake were positively associated with breast cancer among postmenopausal women with estrogen-negative tumors (summary RR for glycemic load, 1.28; 95%CI, 1.08-1.52; and summary RR for carbohydrates, 1.13; 95%CI, 1.02-1.25). No differences in BMI were detected. Menopausal and hormone receptor status, but not BMI, might be potential influencing factors for the associations between carbohydrate intake, glycemic index, glycemic load, and breast cancer.

  4. Dietary glycemic index, glycemic load, and cardiovascular disease risk factors: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Hosseinpour-Niazi, Somayeh; Sohrab, Golbon; Asghari, Golaleh; Mirmiran, Parvin; Moslehi, Nazanin; Azizi, Fereidoun

    2013-07-01

    Data available on the effect of quality (glycemic index [GI]) and quantity (glycemic load [GL]) of carbohydrates on the risk factors of cardiovascular disease (CVD) are inconsistent. The objective of this study was to examine the association between dietary GI, GL, and CVD risk factors among Tehranian adults, the participants of the Tehran Lipid and Glucose Study. This population- based cross-sectional study was conducted on 2457 subjects (46% men and 54% women), aged 19 to 84 years. Dietary GI and GL were measured using a validated 168- item semiquantitative food frequency questionnaire. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured. The mean intakes of GI and GL were 68.3 and 244.8, respectively. Rice (26.6%) and bread (19.0%) were the major contributors to dietary GI and GL, respectively. Higher dietary GI and GL were associated with high intakes of carbohydrate, fiber, refined grain, fruits, simple sugar, snack, and desserts. After adjustment for lifestyle and dietary variables, a higher dietary GI was positively associated with triglycerides and high-density lipoprotein (HDL) cholesterol concentrations among obese subjects. Dietary GL was positively associated with fasting and 2-h blood glucose among nonobese subjects, after adjustment for confounders.   Dietary GI and GL were associated with a few CVD risk factors, and body mass index levels may modulate these associations.

  5. Geriatric nutritional risk index correlates with length of hospital stay and inflammatory markers in older inpatients.

    Science.gov (United States)

    Gärtner, Simone; Kraft, Matthias; Krüger, Janine; Vogt, Lena J; Fiene, Michael; Mayerle, Julia; Aghdassi, Ali A; Steveling, Antje; Völzke, Henry; Baumeister, Sebastian E; Lerch, Markus M; Simon, Peter

    2017-08-01

    Malnutrition is a prevalent condition in older inpatients and has been shown to increase morbidity and direct medical costs. A number of established tools to assess malnutrition are available but malnourished patients rarely receive adequate nutritional assessment and treatment. The medical and economic consequences of malnutrition in hospitalized patients are therefore often underestimated. This study investigates whether the Geriatric Nutritional Risk Index (GNRI) predicts hospital mortality, correlates with length of hospital stay (LOS) and inflammatory markers in older inpatients. We conducted a prospective monocentric study in 500 hospital patients over 65 years of age (female: 248; male: 252; age: 76.3 ± 0.31 years). GNRI was correlated to C-reactive protein (CRP), lymphocyte count, LOS and all-cause mortality, adjusted for potential confounders. The median body mass index was 24.1 (25th percentile: 21.1; 75th percentile: 27.8) kg/m(2) and the mean GNRI 82.2 ± 0.56. A higher risk GNRI was associated with increased CRP levels (p risk GNRI and length of hospital stay, whereas, the association with in-hospital mortality was not significant. The GNRI correlates well with indicators of inflammation and the length of hospital stay. The routine implementation of the GNRI for the nutritional assessment of older patients could have a significant medical and socio-economic impact. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. [Interest of Geriatric Nutritional Risk Index for mortality prediction in hemodialysis patients: preliminary study].

    Science.gov (United States)

    Sirajedine, Khaled; Fardous, Rida; Al Adib, Mohamad; Colomb, Henry; Maurin, Audrey

    2012-07-01

    Geriatric Nutritional Risk Index (GNRI) is a simple and quantitative method (based on three objective measurements: weight, height, albumin) for screening patients at risk for malnutrition. However no data are available regarding its relation with mortality in Caucasian hemodialysis patients. We tested the predictive value of GNRI on mortality in a hemodialysis population followed up prospectively for 18 months. A total of 46 stable prevalent (mean age: 76 ± 11 years, range: 42-95) hemodialysis patients from one center were included in the study. GNRI with other nutritional parameters were evaluated for all patients. Sixteen patients (35%) died during the 18 months of follow-up. Multiple logistic model showed that GNRI and Charlson co-morbidity score were significant predictors of mortality. Age and gender were not significant. Our preliminary study carried out on a series of prevalent hemodialysis patients suggests that GNRI is predictor of mortality. To recommend the use of this index for the screening of hemodialysis patients with malnutrition at risk of mortality, our results should be confirmed by a large cohort study. Copyright © 2012 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  7. The Aftershock Risk Index - quantification of aftershock impacts during ongoing strong-seismic sequences

    Science.gov (United States)

    Schaefer, Andreas; Daniell, James; Khazai, Bijan; Wenzel, Friedemann

    2016-04-01

    The occurrence and impact of strong earthquakes often triggers the long-lasting impact of a seismic sequence. Strong earthquakes are generally followed by many aftershocks or even strong subsequently triggered ruptures. The Nepal 2015 earthquake sequence is one of the most recent examples where aftershocks significantly contributed to human and economic losses. In addition, rumours about upcoming mega-earthquakes, false predictions and on-going cycles of aftershocks induced a psychological burden on the society, which caused panic, additional casualties and prevented people from returning to normal life. This study shows the current phase of development of an operationalised aftershock intensity index, which will contribute to the mitigation of aftershock hazard. Hereby, various methods of earthquake forecasting and seismic risk assessments are utilised and an integration of the inherent aftershock intensity is performed. A spatio-temporal analysis of past earthquake clustering provides first-hand data about the nature of aftershock occurrence. Epidemic methods can additionally provide time-dependent variation indices of the cascading effects of aftershock generation. The aftershock hazard is often combined with the potential for significant losses through the vulnerability of structural systems and population. A historical database of aftershock socioeconomic effects from CATDAT has been used in order to calibrate the index based on observed impacts of historical events and their aftershocks. In addition, analytical analysis of cyclic behaviour and fragility functions of various building typologies are explored. The integration of many different probabilistic computation methods will provide a combined index parameter which can then be transformed into an easy-to-read spatio-temporal intensity index. The index provides daily updated information about the probability of the inherent seismic risk of aftershocks by providing a scalable scheme fordifferent aftershock

  8. Risk of dengue for tourists and teams during the World Cup 2014 in Brazil.

    Directory of Open Access Journals (Sweden)

    Willem G van Panhuis

    Full Text Available This year, Brazil will host about 600,000 foreign visitors during the 2014 FIFA World Cup. The concern of possible dengue transmission during this event has been raised given the high transmission rates reported in the past by this country.We used dengue incidence rates reported by each host city during previous years (2001-2013 to estimate the risk of dengue during the World Cup for tourists and teams. Two statistical models were used: a percentile rank (PR and an Empirical Bayes (EB model. Expected IR's during the games were generally low (<10/100,000 but predictions varied across locations and between models. Based on current ticket allocations, the mean number of expected symptomatic dengue cases ranged from 26 (PR, 10th-100th percentile: 5-334 cases to 59 (EB, 95% credible interval: 30-77 cases among foreign tourists but none are expected among teams. These numbers will highly depend on actual travel schedules and dengue immunity among visitors. Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively.The risk of dengue among tourists during the World Cup is expected to be small due to immunity among the Brazil host population provided by last year's epidemic with the same DENV serotypes. Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.

  9. 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....... METHODS: From the Copenhagen School Health Records Register, 155 505 girls born 1930-1989 with measured weights and heights from 7 to 13 years were linked to health registers. BMI and height were transformed to age-specific z-scores. Hazard ratios (HRs) and 95% confidence intervals were estimated by Cox...

  10. 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

    OBJECTIVE: To illuminate the possible associations between height, weight, and body mass index (BMI) during early adulthood and the development of schizophrenia. METHOD: This prospective study is based on an all-male sample of 3210 individuals from the Copenhagen Perinatal Cohort, comprising...... 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...

  11. 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...... with either outcome. In women no clear association between overall GI and heart disease was found, whereas positive non-linear associations were found for GL: at very high levels of GL, increase in GL was associated with increasing CVD and CHD morbidity. Conclusions In men low-GI diets were associated...

  12. World Alliance for Risk Factor Surveillance White Paper on Surveillance and Health Promotion

    Directory of Open Access Journals (Sweden)

    Stefano Campostrini

    2015-02-01

    Full Text Available This is not a research paper on risk factor surveillance. It is an effort by a key group of researchers and practitioners of risk factor surveillance to define the current state of the art and to identify the key issues involved in the current practice of behavioral risk factor surveillance. Those of us who are the principal authors have worked and carried out research in this area for some three decades. As a result of a series of global meetings beginning in 1999 and continuing every two years since then, a collective working group of the International Union of Health Promotion and Education (IUHPE was formed under the name World Alliance of Risk Factor Surveillance (WARFS. Under this banner the organization sought to write a comprehensive statement on the importance of surveillance to health promotion and public health. This paper, which has been revised and reviewed by established peers in the field, is the result. It provides the reader with a clear summary of the major issues that need to be considered by any and all seeking to carry out behavioral risk factor surveillance.

  13. Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Baykam, Mehmet Murat; Aktas, Binhan Kagan; Bulut, Suleyman; Ozden, Cuneyt; Deren, Tagmac; Tagci, Suleyman; Gokkaya, Cevdet Serkan; Memis, Ali

    2015-04-01

    We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors. Copyright © 2015. Published by Elsevier Taiwan.

  14. 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.

  15. Risk Level Assessment in Construction Projects Using the Schedule Performance Index

    Directory of Open Access Journals (Sweden)

    Roberto Barbosa dos Santos

    2016-01-01

    Full Text Available Construction projects are risky in both physical implementation and management. The characteristics of the risk reinforce the necessity of efficient management to increase the chances of success without commitment to its goals. This study explores the correlation of delay and the schedule performance index (SPI to evaluate the risk of a construction project completed with time overruns. The hypothesis that the SPI of projects with a delay is distinct from those projects without a delay is assumed. A database with 19 elements was used to test this hypothesis and to calculate limit values to the SPI. Therefore, the risk of delay will be small when the observed SPI is greater than the superior limit and large when the SPI is below the inferior limit. The simplicity involved in the calculation of these values showed an advantage in comparison with other methods of risk evaluation. Another strong point observed is that any company can determine the value of risk by considering its own history and support decisions like doing corrective actions.

  16. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System

    OpenAIRE

    Bere, Tone Tufte; Kruczynski, Jacek; Veintimilla, Nadege; Hamu, Yuichiro; Bahr, Roald

    2015-01-01

    Background: Little is known about the rate and pattern of injuries in international volleyball competition. Objective: To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). Methods: The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup...

  17. 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

    OBJECTIVE: To illuminate the possible associations between height, weight, and body mass index (BMI) during early adulthood and the development of schizophrenia. METHOD: This prospective study is based on an all-male sample of 3210 individuals from the Copenhagen Perinatal Cohort, comprising...... 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....

  18. 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.

  19. The geriatric nutritional risk index may predict healthcare costs and health transitions during hemodialysis in China.

    Science.gov (United States)

    Dou, Yanna; Wang, Pei; Yuan, Fangfang; Liang, Xianhui; Liu, Dong; Xiao, Jing; Zhao, Zhanzheng; Liu, Zhangsuo

    2017-01-01

    The aim of the present study was to retrospectively analyze the relationship between the Geriatric Nutritional Risk Index (GNRI) at baseline and healthcare costs of three-month as well as the risk of quality-of-life score at the 6-month follow-up for Chinese hemodialysis patients. One hundred patients who had been on maintenance hemodialysis were enrolled in this study. The general characteristics, laboratory test results and GNRI of the patients at baseline were recorded. The healthcare costs and quality-of-life scores were determined at the follow-up examination. Patients were divided into two groups according to their median GNRI at baseline: a lower GNRI group (GNRI 86.4). The patients in the lower GNRI group exhibited reduced hemoglobin (74.7±13.1 g/dL vs 82.3±15.2 g/dL, prisk of higher future healthcare costs as well as worse health.

  20. 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

    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...... 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...

  1. Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk.

    Science.gov (United States)

    Bojicic, Katherine M; Beaulieu, Mélanie L; Imaizumi Krieger, Daniel Y; Ashton-Miller, James A; Wojtys, Edward M

    2017-02-01

    While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Case-control study; Level of evidence, 3. Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System's archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. PTS (P = .043) and MCS (P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture (P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or MCS were associated with an increased risk of ACL tear.

  2. Is body mass index a risk factor for sport injury in adolescents?

    Science.gov (United States)

    Richmond, Sarah A; Kang, Jian; Emery, Carolyn A

    2013-09-01

    To investigate the relationship between sport injury and body mass index in adolescents (12-19 years). Secondary analysis of data collected in junior and senior high school surveys in Alberta, Canada. Participants (n=4339) included students from 59 schools. All sport injury was defined as injury reported in the past one year. Medically treated injury, as any more serious sport related injury reported in the last year that required medical attention. Overweight, obese, and healthy was defined using international cut points, as the exposure. Multivariate logistic regression analysis controlling for clustering by school, and adjusting for potential risk factors was used. There was a 34% increased risk for all sport injury in obese adolescents compared to healthy adolescents [odds ratio (OR)=1.34 (95% CI: 1.02-1.80)]. There was increased risk for all sport injury and medically treated injury with hours of participation, where the highest group had a 4-fold increase in risk (OR=4.17, 95%CI: 2.77-6.30 and OR=3.80, 95%CI: 2.54-5.69, respectively). There was also increased risk for both all sport injury and medically treated injury in Caucasians compared to non-Caucasians [OR=1.45 (95%CI: 1.15-1.82), OR=1.94 (95%CI: 1.59-2.37), respectively], as well as for club/team play compared to less elite play [OR=1.87 (95%CI: 1.43-2.44) and OR=2.12 (95%CI: 1.57-2.87), respectively]. The risk of sustaining a sport injury in obese adolescents was greater compared to those of healthy weight. There is also a greater risk with increasing hours of play, in Caucasian adolescents, and those that play at a higher sporting level. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. 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.

  4. Body mass index, waist circumference, physical activity, and risk of hearing loss in women.

    Science.gov (United States)

    Curhan, Sharon G; Eavey, Roland; Wang, Molin; Stampfer, Meir J; Curhan, Gary C

    2013-12-01

    Acquired hearing loss is highly prevalent, but prospective data on potentially modifiable risk factors are limited. In cross-sectional studies, higher body mass index (BMI), larger waist circumference, and lower physical activity have been associated with poorer hearing, but these have not been examined prospectively. We examined the independent associations between BMI, waist circumference, and physical activity, and self-reported hearing loss in 68,421 women in the Nurses' Health Study II from 1989 to 2009. Baseline and updated information on BMI, waist circumference, and physical activity was obtained from biennial questionnaires. After more than 1.1 million person-years of follow-up, 11,286 cases of hearing loss were reported to have occurred. Higher BMI and larger waist circumference were associated with increased risk of hearing loss. Compared with women with BMI 88 cm was 1.27 (95% CI, 1.17-1.38). Higher physical activity was related inversely to risk; compared with women in the lowest quintile of physical activity, the multivariate-adjusted RR for women in the highest quintile was 0.83 (95% CI, 0.78-0.88). Walking 2 hours per week or more was associated inversely with risk. Simultaneous adjustment for BMI, waist circumference, and physical activity slightly attenuated the associations but they remained statistically significant. Higher BMI and larger waist circumference are associated with increased risk, and higher physical activity is associated with reduced risk of hearing loss in women. These findings provide evidence that maintaining healthy weight and staying physically active, potentially modifiable lifestyle factors, may help reduce the risk of hearing loss. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Donor Body Mass Index as a Risk Factor for Delayed Onset of Graft Function.

    Science.gov (United States)

    Miklušica, Juraj; Dedinská, Ivana; Palkoci, Blažej; Sendrey, Alexander; Lajčiaková, Mariana; Vojtko, Martin; Osinová, Denisa; Laca, L'udovít

    2018-01-01

    Delayed graft function continues to pose a significant challenge to clinicians in the context of kidney transplantation. The objective of this retrospective, 5-year analysis is to identify the parameters of beating heart donors and those of recipients that affect the delayed development of graft function. The monitored group was composed of 152 beating heart donors and 179 recipients. Delayed graft function was identified in 32 (17%) patients. The predictor for development of delayed graft function was the body mass index of the donor (odds ratio: 1.1473; 95% confidence interval [CI]: 1.0017-1.3140; P = .0472), and the independent risk factors were donor body mass index 30 to 34.9 kg/m 2 (hazard ratio [HR]: 6.0215; 95% CI: 1.4188-25.556; P = .0149), donor body mass index ≥35 kg/m 2 (HR: 13.5484; 95% CI: 1.4575-125.938; P = .0220), and abuse of alcohol in the donor's history (HR: 1.779; 95% CI: 1.0679-2.964; P = .0270).

  6. 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

    2017-09-01

    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.

  7. 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.

  8. Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI).

    Science.gov (United States)

    Durán Alert, P; Milà Villarroel, R; Formiga, F; Virgili Casas, N; Vilarasau Farré, C

    2012-01-01

    Elderly subjects are considered a vulnerable group and they have more risk of nutritional problems. The risk of malnutrition increases in hospitalized geriatric patients. To compare the correlation between MNA and GNRI with anthropometric, biochemical and Barthel Index in hospitalized geriatric patients and to test the concordance between MNA and GNRI and between Mini Nutritional Assessment Short Form (MNA-SF) and MNA. It was a cross-sectional study on a sample of 40 hospitalized geriatric patients. For determination nutritional status we used MNA and GNRI; we evaluated the correlation between this both test with biochemical and anthropometric parameters and functional questionnaires. We used Pearson's simple correlation model, oneway ANOVA and multiple logistic regression to evaluate the relationship between MNA and GNRI. According to MNA, 17 patients (42.5%) were malnourished and according to GNRI, 13 patients (32.5%) had high risk of nutritional complications. The concordance of MNA and GNRI was 39% and between MNA-SF and MNA was 81%. The most significant differences were detected in weight, BMI, arm and calf circumference and weight loss parameters. Barthel index was significantly different in both tests. The MNA and GRNI had significant correlations with albumin, total protein, transferring, arm and calf circumference, weight loss and BMI parameters. In conclusion, it would be reasonable to use GRNI in cases where MNA is not applicable, or even use GRNI as a complement to MNA in hospitalized elderly patients. There is no reason why they should be deemed incompatible, and patients could benefit from more effective nutritional intervention.

  9. Birth weight, childhood body mass index and risk of coronary heart disease in adults: combined historical cohort studies

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Ängquist, Lars Henrik; Eriksson, Johan G

    2010-01-01

    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.......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....

  10. Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

    Directory of Open Access Journals (Sweden)

    Miguel A Martínez-González

    Full Text Available Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR, waist circumference (WC, body mass index (BMI and height with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years and 57% were women (60 to 80 years. All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70 were 1.02 (0.78-1.34, 1.30 (0.97-1.75 and 1.55 (1.06-2.26. When we used WC (cut-off points: 100, 105 and 110 cm, the multivariable adjusted Hazard Ratios (HRs for mortality were 1.18 (0.88-1.59, 1.02 (0.74-1.41 and 1.57 (1.19-2.08. In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.Controlled-Trials.com ISRCTN35739639.

  11. Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

    Science.gov (United States)

    Martínez-González, Miguel A.; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J. Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

    2014-01-01

    Background Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Trial

  12. Detection performance and risk stratification using a model-based shape index characterizing heart rate turbulence.

    Science.gov (United States)

    Martínez, Juan Pablo; Cygankiewicz, Iwona; Smith, Danny; Bayés de Luna, Antonio; Laguna, Pablo; Sörnmo, Leif

    2010-10-01

    A detection-theoretic approach to quantify heart rate turbulence (HRT) following a ventricular premature beat is proposed and validated using an extended integral pulse frequency modulation (IPFM) model which accounts for HRT. The modulating signal of the extended IPFM model is projected into a three-dimensional subspace spanned by the Karhunen-Loève basis functions, characterizing HRT shape. The presence or absence of HRT is decided by means of a likelihood ratio test, the Neyman-Pearson detector, resulting in a quadratic detection statistic. Using a labeled dataset built from different interbeat interval series, detection performance is assessed and found to outperform the two widely used indices: turbulence onset (TO) and turbulence slope (TS). The ability of the proposed method to predict the risk of cardiac death is evaluated in a population of patients (n = 90) with ischemic cardiomyopathy and mild-to-moderate congestive heart failure. While both TS and the novel HRT index differ significantly in survivors and cardiac death patients, mortality analysis shows that the latter index exhibits much stronger association with risk of cardiac death (hazard ratio = 2.8, CI = 1.32-5.97, p = 0.008). It is also shown that the model-based shape indices, but not TO and TS, remain predictive of cardiac death in our population when computed from 4-h instead of 24-h ambulatory ECGs.

  13. Integrated Risk Index of Chemical Aquatic Pollution (IRICAP): case studies in Iberian rivers.

    Science.gov (United States)

    Fàbrega, Francesc; Marquès, Montse; Ginebreda, Antoni; Kuzmanovic, Maja; Barceló, Damià; Schuhmacher, Marta; Domingo, José L; Nadal, Martí

    2013-12-15

    The hazard of chemical compounds can be prioritized according to their PBT (persistence, bioaccumulation, toxicity) properties by using Self-Organizing Maps (SOM). The objective of the present study was to develop an Integrated Risk Index of Chemical Aquatic Pollution (IRICAP), useful to evaluate the risk associated to the exposure of chemical mixtures contained in river waters. Four Spanish river basins were considered as case-studies: Llobregat, Ebro, Jucar and Guadalquivir. A SOM-based hazard index (HI) was estimated for 205 organic compounds. IRICAP was calculated as the product of the HI by the concentration of each pollutant, and the results of all substances were aggregated. Finally, Pareto distribution was applied to the ranked lists of compounds in each site to prioritize those chemicals with the most significant incidence on the IRICAP. According to the HI outcomes, perfluoroalkyl substances, as well as specific illicit drugs and UV filters, were among the most hazardous compounds. Xylazine was identified as one of the chemicals with the highest contribution to the total IRICAP value in the different river basins, together with other pharmaceutical products such as loratadine and azaperol. These organic compounds should be proposed as target chemicals in the implementation of monitoring programs by regulatory organizations. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children.

    Science.gov (United States)

    Zhang, Xinyu; Zhu, Yanna; Cai, Li; Ma, Lu; Jing, Jin; Guo, Li; Jin, Yu; Ma, Yinghua; Chen, Yajun

    2016-04-01

    The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

  15. Increased risk of injury following red and yellow cards, injuries and goals in FIFA World Cups.

    Science.gov (United States)

    Ryynänen, Jaakko; Dvorak, Jiri; Peterson, Lars; Kautiainen, Hannu; Karlsson, Jón; Junge, Astrid; Börjesson, Mats

    2013-10-01

    To study the relationship between potentially game-disrupting incidents (PGDIs; red and yellow cards, goals and injuries) and the injury incidence in football. Prospective injury surveillance during three FIFA World Cups in 2002, 2006 and 2010. Official match statistics were obtained for all the matches played in the three tournaments. 2002, 2006 and 2010 FIFA World Cups. Team physicians at the 2002, 2006 and 2010 FIFA World Cups. Injury incidences and incidence rate ratios (IRRs). The injury incidence was significantly higher during match periods within the minute of, or during a five-minute period following a yellow card, red card, another injury or a goal (PGDIs) than during other match periods (76.7/1000 match hours; 95% CI (66.6 to 87.9) vs 54.0/1000 match hours (46.9 to 61.9), p<0.001). There were significant differences in injury incidence between different match periods, with the highest injury incidence seen in the last 15 min of the first half (p<0.001). The PGDIs (other than injury) had a tendency to increase towards the end of the game and the most frequent PGDI was a yellow card. There was a risk ratio of 1.17 (95% CI 1.08 to 1.26) for injury, per PGDI (other injuries excluded) (p<0.001), and 1.15 (95% CI 1.06 to 1.24) after adjusted match time (p<0.001). The injury incidence is high within the five minutes following a PGDI. For both team management and players, being aware of the increased risk of injury directly after a PGDI may be of clinical relevance, as it may enable them to take precautions in order to prevent injuries. There are significant differences in injury incidence between different match periods and game-related factors, such as PGDIs, appear partly to contribute to this variation.

  16. Utility of the hypertriglyceridemic waist phenotype in the cardiometabolic risk assessment of youth stratified by body mass index.

    Science.gov (United States)

    Buchan, D S; Boddy, L M; Despres, J-P; Grace, F M; Sculthorpe, N; Mahoney, C; Baker, J S

    2016-08-01

    It is unclear whether the hypertriglyceridemic waist phenotype (HTWP) can be used to identify those at most risk of cardiometabolic disorders. The utility of the HTWP as a useful predictor of cardiometabolic risk in youth stratified by body mass index was assessed. Three hundred and eighty-seven children (12-17.5 years) were used within this cross-sectional study. Participants were classified as normal weight or overweight/obese according to the International Obesity Task Force criteria. The HTWP phenotype was defined as having a waist circumference ≥90th percentile for age and gender with concomitant triglyceride concentrations ≥1.24 mmol L(-1) . Cardiometabolic risk profiles were compared using MANCOVA. Normal weight participants with the HTWP had significantly higher levels of C-reactive protein 2.6 ± 0.4 vs. 1.6 ± 0.3 mg L(-1) (P < 0.05) and cardiometabolic risk scores (1.3 ± 0.3 vs. -0.7 ± 0.2 and 2.1 ± 0.4 vs. -0.5 ± 0.2; both P < 0.05) compared with those of a normal weight without the HTWP. Overweight/obese participants with the HTWP had significantly higher C-reactive protein levels (3.5 ± 0.6 vs. 2.6 ± 0.5; P < 0.05) as well as both cardiometabolic risk scores (1.6 ± 0.6 vs. 0.9 ± 0.2 and 2.2 ± 0.6 vs. 0.8 ± 0.2; both P < 0.001) when compared with overweight/obese participants without the HTWP. The HTWP may serve as a simple and clinically useful approach to identify youth at increased cardiometabolic risk. © 2015 World Obesity.

  17. Associated Risk Factors for Abnormal Ankle-brachial Index in Hemodialysis Patients in a Hospital

    Directory of Open Access Journals (Sweden)

    Szu-Chia Chen

    2008-09-01

    Full Text Available Ankle-brachial index (ABI is a marker for peripheral artery disease and can predict mortality in hemodialysis patients. However, it is seldom studied in southern Taiwan, an area with high prevalence of end-stage renal disease (ESRD. The aim of this study was to investigate the prevalence and associated risk factors for peripheral artery disease in the ESRD population in a hospital. All routine hemodialysis patients in one regional hospital were included except for six patients who refused ABI examinations and four patients with atrial fibrillation. Finally, 225 patients formed our study group. ABI was measured using an ABI-form device (Colin VP1000. The prevalence of ABI < 0.9 and 3 1.3 was 15.6% and 5.8%, respectively. ABI < 0.9 was independently associated with advanced age (p = 0.027, increased pulse pressure (p = 0.005, increased hemat-ocrit (p = 0.008 and decreased serum albumin level (p = 0.009. In addition, ABI 3 1.3 was significantly associated with diabetes mellitus (p = 0.019. This study demonstrated the associated risk factors of peripheral artery disease in patients with hemodialysis in a hospital. ESRD patients of advanced age and with increased pulse pressure, increased hematocrit and decreased serum albumin level had a relatively high risk for ABI < 0.9 and patients with diabetes had a relatively high risk for ABI 3 1.3.

  18. 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.

  19. Association of dietary glycemic index and glycemic load with endometrial cancer risk among Chinese women

    Science.gov (United States)

    Xu, Wang Hong; Xiang, Yong-Bing; Zhang, Xianglan; Ruan, Zhixian; Cai, Hui; Zheng, Wei; Shu, Xiao-Ou

    2017-01-01

    We evaluated the association of dietary glycemic-index (GI) and glycemic-load (GL) with the risk of endometrial cancer in a population-based, case-control study of 1,199 endometrial cancer patients and 1,212 age-frequency-matched controls in urban Shanghai, China, where diets are typically high in carbohydrates and have a high GL. Information on dietary habits, physical activity, and other relevant information was collected using a validated questionnaire, and anthropometric measurements were taken. Logistic regression was applied in the analysis. Dietary GI was independently associated with risk for endometrial cancer but GL and carbohydrate intake was unrelated to the risk. Multivariable-adjusted odds ratios (ORs) for increasing quartiles of intake were 1.0, 1.2, 1.4, and 1.4 (95% CI: 1.0–2.0) for dietary GI (Ptrend: 0.07). High intake of staples, especially rice, was positively associated with endometrial cancer. The association with GI was more evident among lean and normal weight women, although the test for interaction was not significant. This study suggests that intake of high GI foods, but not carbohydrates per se, may increase risk for endometrial cancer. PMID:25495185

  20. Body mass index, waist circumference, and cardiovascular risk factors in adolescents.

    Science.gov (United States)

    Messiah, Sarah E; Arheart, Kristopher L; Lipshultz, Steven E; Miller, Tracie L

    2008-12-01

    To determine optimal threshold values for body mass index (BMI) and waist circumference (WC) for detecting cardiovascular disease (CVD) risk (as defined with >/=3 CVD risk factors [RFs]) in adolescents. The 1999-2004 National Health and Nutrition Examination Surveys (NHANES) cross-sectional data for 12- to 19-year-old adolescents (n = 2581) was analyzed. Main outcome measures were >/=3 age-adjusted CVD RFs (high- and low-density lipoprotein cholesterol level, triglyceride level, glucose level, insulin level, and systolic and diastolic blood pressure). The presence of >/=3 RFs was predicted from age- and sex-adjusted BMI and WC values with receiver operating characteristics analyses. The proportion of adolescents at risk for >/=3 RFs ranged from 17% to 19%. Both BMI and WC had good diagnostic accuracy, ranging from 0.73 to 0.83, and good sensitivity and specificity, ranging from 0.68 to 0.77. The BMI cutoff points ranged from 19.5 to 25.0 kg/m(2) for boys and from 19.4 to 27.0 kg/m(2) for girls, and WC cutoff points ranged from 66.8 to 87.5 cm for boys and from 71.5 to 87.2 cm for girls. Age-, sex-, and ethnicity/race-specific threshold values for BMI and WC may have significant clinical usefulness in identifying adolescents and teenagers at risk for later CVD onset.

  1. 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...... cancer among women (IV-OR per 5 kg/m2, 1.82; 95% CI, 1.26–2.61). For men, genetically influenced BMI was not associated with colorectal cancer (IV-OR per 5 kg/m2, 1.18; 95% CI, 0.73–1.92). Conclusions: High BMI was associated with increased colorectal cancer risk for women. Whether abdominal obesity...

  2. Association of dietary glycemic index and glycemic load with endometrial cancer risk among Chinese women.

    Science.gov (United States)

    Xu, Wang Hong; Xiang, Yong-Bing; Zhang, Xianglan; Ruan, Zhixian; Cai, Hui; Zheng, Wei; Shu, Xiao-Ou

    2015-01-01

    We evaluated the association of dietary glycemic index (GI) and glycemic load (GL) with the risk of endometrial cancer in a population-based, case-control study of 1199 endometrial cancer patients and 1212 age-frequency-matched controls in urban Shanghai, China, where diets are typically high in carbohydrates and have a high GL. Information on dietary habits, physical activity, and other relevant information was collected using a validated questionnaire, and anthropometric measurements were taken. Logistic regression was applied in the analysis. Dietary GI and GL were independently associated with risk for endometrial cancer but carbohydrate intake was unrelated to risk. Multivariable-adjusted odds ratios (ORs) for increasing quartiles of intake were 1.0, 1.3, 1.4, and 2.2 [95% confidence interval (CI): 1.2-4.0] for dietary GL (P(trend) = 0.02) and 1.0, 1.2, 1.4, and 1.4 (95% CI: 1.0-2.0) for dietary GI (P(trend) = 0.02). High intake of staples, especially rice, was positively associated with endometrial cancer. The association with GI was more evident among lean and normal weight women, although the test for interaction was not significant. This study suggests that intake of high GL or GI foods, but not carbohydrates per se, may increase risk for endometrial cancer.

  3. Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults.

    Science.gov (United States)

    Sahyoun, Nadine R; Anderson, Amy L; Tylavsky, Frances A; Lee, Jung Sun; Sellmeyer, Deborah E; Harris, Tamara B

    2008-01-01

    It is unclear whether immediate dietary effects on blood glucose influence the risk of developing type 2 diabetes. The objective of this study was to examine whether the dietary glycemic index (GI) and glycemic load (GL) were associated with the risk of type 2 diabetes in older adults. The Health, Aging, and Body Composition Study is a prospective cohort study of 3075 adults who were 70-79 y old at baseline (n=1898 for this analysis). The intakes of specific nutrients and food groups and the risk of type 2 diabetes over a 4-y period were examined according to dietary GI and GL. Dietary GI was positively associated with dietary carbohydrate and negatively associated with the intakes of protein, total fat, saturated fat, alcohol, vegetables, and fruit. Dietary GL was positively associated with dietary carbohydrate, fruit, and fiber and negatively associated with the intakes of protein, total fat, saturated fat, and alcohol. Persons in the higher quintiles of dietary GI or GL did not have a significantly greater incidence of type 2 diabetes. These findings do not support a relation between dietary GI or GL and the risk of type 2 diabetes in older adults. Because dietary GI and GL show strong nutritional correlates, the overall dietary pattern should be considered.

  4. Malnutrition Identified by the Nutritional Risk Index and Poor Prognosis in Advanced Epithelial Ovarian Carcinoma.

    Science.gov (United States)

    Yim, Ga Won; Eoh, Kyung Jin; Kim, Sang Wun; Nam, Eun Ji; Kim, Young Tae

    2016-07-01

    Ovarian cancer is a chronic disease with a risk of malnutrition. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess the nutritional status. We sought to explore the prevalence of malnutrition and its association with survival in ovarian cancer. A retrospective study was conducted in 213 advanced ovarian cancer patients. NRI was calculated before and at the end of treatment using patients' body weight and serum albumin level. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier method, and associations were assessed using a Cox proportional hazards analysis adjusted for known prognostic variables. Moderate to severely malnourished patients had lower 5-yr OS (45.3%) compared to normal to mild group (64.0%), respectively (P = 0.024). Adjusted for covariates, the relative risk of death was 5.8 times higher in moderate/severely malnourished group identified at the last course of chemotherapy (HR = 5.896, 95% CI = 2.723-12.764, P risk group (median 15 vs. 28 months, P = 0.011). Malnutrition is prevalent among ovarian cancer patients and is found to be a significant predictor for mortality.

  5. Interaction between geriatric nutritional risk index and decoy receptor 3 predicts mortality in chronic hemodialysis patients.

    Science.gov (United States)

    Tsai, Ming-Tsun; Hu, Fen-Hsiang; Lien, Tse-Jen; Chen, Ping-Jen; Huang, Tung-Po; Tarng, Der-Cherng

    2014-01-01

    Protein-energy wasting (PEW) is common and associated with poor outcome in hemodialysis patients. In hemodialysis patients, geriatric nutritional risk index (GNRI) and decoy receptor 3 (DcR3) have been shown as the nutritional and inflammatory markers, respectively. The present study aimed to assess the predictive ability of GNRI and DcR3 for PEW status and long-term outcomes in chronic hemodialysis patients. A prospective cohort of 318 hemodialysis patients was conducted with a median follow-up of 54 months. Malnutrition-inflammation score (MIS) was used as the reference standard for the presence of PEW. Endpoints were cardiovascular and all-cause mortality. Baseline GNRI had a strong negative correlation with DcR3 and MIS score. For patients with age risk factors, GNRI together with DcR3 further significantly improved the predictability for overall mortality (c statistic, 0.823). Low GNRI and high DcR3 were the alternatives for identifying hemodialysis patients at risk of PEW and overall mortality. Further studies are needed to verify whether timely recognition of hemodialysis patients with a high malnutrition-inflammation risk could reduce their mortality by appropriate interventional strategies.

  6. 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.

  7. Body mass index and myocardium at risk in patients with acute coronary syndrome.

    Science.gov (United States)

    Arrebola-Moreno, A L; Marfil-Alvarez, R; Catena, A; García-Retamero, R; Arrebola, J P; Melgares-Moreno, R; Ramirez-Hernández, J A; Kaski, J C

    2014-04-01

    Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome. Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient. Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71. An increased body weight is associated with an increased area of myocardium at risk in patients with ACS. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. A reduction in body mass index lowers risk for bilateral slipped capital femoral epiphysis.

    Science.gov (United States)

    Nasreddine, Adam Y; Heyworth, Benton E; Zurakowski, David; Kocher, Mininder S

    2013-07-01

    Slipped capital femoral epiphysis (SCFE) is occurring in greater numbers, at increasingly younger ages, and more frequently bilaterally (BL-SCFE). Obesity is one risk factor for SCFE. However, it is unclear whether postoperative decreases or increases in body mass index (BMI) alter the risk of subsequent contralateral SCFE. We therefore determined whether (1) BMI percentile was a risk factor for BL-SCFE; and (2) postoperative increases and/or decreases in BMI percentile influenced the risk for BL-SCFE. We retrospectively reviewed the records of 502 patients surgically treated for SCFE and identified 138 (27%) with BL-SCFE and 364 (73%) with unilateral SCFE (UL-SCFE); 173 patients, 60 (35%) with BL-SCFE and 113 (65%) with UL-SCFE met our inclusion criteria. Risk factors included sex, age, slip stability, slip chronicity, slip angle, and obesity. Percentile BMI was recorded at the time of first SCFE surgery, at the time of last followup for patients undergoing UL-SCFE, and at the time of second SCFE surgery for patients undergoing BL-SCFE. Sex, age, slip stability, and slip angle were not associated with BL-SCFE. Postoperative obesity (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.2-9.7) and acute slip chronicity (OR, 2.9; 95% CI, 1.3-6.7) had higher risks for sequential BL-SCFE. Obese patients who became nonobese postoperatively had a decreased risk of sequential BL-SCFE compared with those who remained obese (OR, 0.16; 95% CI, 1.2-116.5). Only postoperative obesity and an acute slip were risk factors for sequential BL-SCFE. BMI reduction to lower than the 95% percentile after SCFE surgery was associated with lower risk for BL-SCFE development. The data suggest early supervised therapeutic weight management programs for patients treated for UL-SCFE are important to reduce risk of subsequent SCFE. Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

  9. Obesity-risk behaviors 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

    The purpose of the paper was to describe obesity-risk behaviors (diet, physical activity, and sedentary behavior) and examine the relationships of the obesity-risk behaviors 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 behaviors in Korean American children. A cross-sectional study. Obesity-risk behaviors 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 analyzed 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 5 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 less than 2 hours of recreational screen time per day. Sixty percent and 88.8% of children met the recommendation of sleep on a weekday and weekend, respectively. Only screen time was positively associated with child BMI Z-score (β=0.08; pobesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviors, especially sedentary behavior, in Korean American children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. 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.

  11. [Association between body mass index and risk feeding behaviors to develop eating disorders in Mexican adolescents].

    Science.gov (United States)

    Sámano, Reyna; Zelonka, Rosa; Martínez-Rojano, Hugo; Sánchez-Jiménez, Bernarda; Ramírez, Cristina; Ovando, Georgina

    2012-06-01

    The body self-perception and its dissatisfaction are related with the risk for developing abnormal eating behaviors (AEB), especially in eating disorders (ED) in adolescents. The objective of this study was to identify the relationship between dietary habits and the risk for AEB and their association with body mass index (BMI) in a group of adolescents in the metropolitan area of Mexico City. It was a descriptive cross-sectional study conducted with a sample of 671 adolescents, both sex, between 12 and 15 years. A validated questionnaire was used to assess the risk for developing AEB. BMI was obtained, and information from the practice and knowledge of food consumption was available. The prevalence of the risk for developing AEB in this study was 12%. It showed that 48% of participants were overweight or obese, 20% did not eat breakfast, 16% took their food without doing other activity simultaneously (p = 0.012). The variables associated with the risk AEB, for developing of ED were doing any activity simultaneously with food intake (OR: 4.23 p = 0.006), overweight-obesity (OR: 2.59 p = 0001), eating without company (OR: 2.04 p = 0.005), not eating fruit (OR: 1.96 = 0.008) or milk (OR:1.79 p = 0.026), being female (OR: 1.74 p = 0.024) and skipping breakfast (OR: 1.57 p = 0,035). Food intake differed with what themselves recommended being healthy, which was lower in vegetables, fruits, leguminous and higher in sugars, fats and soda. We conclude there is a relationship between BMI and the risk for developing AEB. There was no consistency between what adolescents say they should eat to be healthy and what they eat.

  12. Body mass index and risk of diabetic retinopathy: A meta-analysis and systematic review.

    Science.gov (United States)

    Zhou, Yue; Zhang, Yuezhi; Shi, Ke; Wang, Changyun

    2017-06-01

    Diabetic retinopathy (DR) is a frequent cause of acquired blindness worldwide. Various studies have reported the effects of body mass index (BMI) on the risk of DR, but the results remain controversial. Therefore, a meta-analysis was performed to evaluate the relationship between BMI and the risk of DR.A systematic search was performed using the Cochrane Library, PubMed, and Embase databases to obtain articles published through December 2016. Articles regarding the association between BMI and the risk of DR were retrieved. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were included and then pooled with a random effects model.A total of 27 articles were included in this meta-analysis. When BMI was analyzed as a categorical variable, neither being overweight (OR = 0.89, 95% CI 0.75-1.07; P = .21; I = 65%) nor obesity (OR = 0.97, 95% CI 0.73-1.30; P = .86) were associated with an increased risk of DR when compared with normal weight. When BMI was analyzed as a continuous variable, a higher BMI was not associated with an increased risk of DR (OR = 0.99, 95% CI 0.97-1.01; P = .25; I2 = 79%). The pooled results did not significantly change after the sensitivity analysis.Based on the current publications, neither being overweight nor obesity is associated with an increased risk of DR. Further studies should confirm these findings.

  13. Association between dietary carbohydrate intake, glycemic index and glycemic load, and risk of gastric cancer.

    Science.gov (United States)

    Ye, Yao; Wu, Yihua; Xu, Jinming; Ding, Kefeng; Shan, Xiaoyun; Xia, Dajing

    2017-04-01

    The association between dietary carbohydrate intake, glycemic index (GI) and glycemic load (GL), and risk of gastric cancer (GC) has been investigated by many studies. However, the results of these studies were controversial. The aim of our study was to systematically assess this issue. PUBMED and EMBASE were searched up to March 2015, and either a fixed- or a random-effects model was adopted to estimate overall relative risks (RRs). Dose-response, meta-regression, subgroup, and publication bias analyses were applied. Twenty-six studies with approximately 540,000 participants were finally included in this meta-analysis. High level of dietary carbohydrate intake (pooled RR 1.17, 95 % CI 0.91-1.50), GI (pooled RR 1.17, 95 % CI 0.80-1.69), and GL (pooled RR 1.06, 95 % CI 0.90-1.26) were all nonsignificantly associated with incidence of GC. In addition, no significant dose-response relationship was observed between carbohydrate intake, GI and GL, and the risk of GC. However, further subgroup analyses based on gender and geographic region suggested a significant association between higher carbohydrate intake (pooled RR 1.52, 95 % CI 1.10-2.08), GL (pooled RR 1.41, 95 % CI 1.04-1.92), and GC risk in males subgroup, and between higher carbohydrate intake (pooled RR 1.69, 95 % CI 1.36-2.09) and GC risk in Asian studies. No significant association was found between dietary carbohydrate intake, GI and GL, and risk of GC. However, significantly positive association was observed in the males subgroup and Asian studies.

  14. The poor quality of information about laparoscopy on the World Wide Web as indexed by popular search engines.

    Science.gov (United States)

    Allen, J W; Finch, R J; Coleman, M G; Nathanson, L K; O'Rourke, N A; Fielding, G A

    2002-01-01

    This study was undertaken to determine the quality of information on the Internet regarding laparoscopy. Four popular World Wide Web search engines were used with the key word "laparoscopy." Advertisements, patient- or physician-directed information, and controversial material were noted. A total of 14,030 Web pages were found, but only 104 were unique Web sites. The majority of the sites were duplicate pages, subpages within a main Web page, or dead links. Twenty-eight of the 104 pages had a medical product for sale, 26 were patient-directed, 23 were written by a physician or group of physicians, and six represented corporations. The remaining 21 were "miscellaneous." The 46 pages containing educational material were critically reviewed. At least one of the senior authors found that 32 of the pages contained controversial or misleading statements. All of the three senior authors (LKN, NAO, GAF) independently agreed that 17 of the 46 pages contained controversial information. The World Wide Web is not a reliable source for patient or physician information about laparoscopy. Authenticating medical information on the World Wide Web is a difficult task, and no government or surgical society has taken the lead in regulating what is presented as fact on the World Wide Web.

  15. Risks of Myocardial Infarction, Death, and Diabetes in Identical Twin Pairs With Different Body Mass Indexes.

    Science.gov (United States)

    Nordström, Peter; Pedersen, Nancy L; Gustafson, Yngve; Michaëlsson, Karl; Nordström, Anna

    2016-10-01

    Observational studies have shown that obesity is a major risk factor for cardiovascular disease and death. The extent of genetic confounding in these associations is unclear. To compare the risk of myocardial infarction (MI), type 2 diabetes, and death in monozygotic (MZ) twin pairs discordant for body mass index (BMI). A cohort of 4046 MZ twin pairs with discordant BMIs (difference >0.01) was identified using the nationwide Swedish twin registry. The study was conducted from March 17, 1998, to January 16, 2003, with follow-up regarding incident outcomes until December 31, 2013. The combined primary end point of death or MI and the secondary end point of incident diabetes were evaluated in heavier compared with leaner twins in a co-twin control analysis using multivariable conditional logistic regression. Mean (SD) baseline age for both cohorts was 57.6 (9.5) years (range, 41.9-91.8 years). During a mean follow-up period of 12.4 (2.5) years, 203 MIs (5.0%) and 550 deaths (13.6%) occurred among heavier twins (mean [SD] BMI, 25.9 [3.6] [calculated as weight in kilograms divided by height in meters squared]) compared with 209 MIs (5.2%) and 633 deaths (15.6%) among leaner twins (mean [SD] BMI, 23.9 [3.1]; combined multivariable adjusted odds ratio [OR], 0.75; 95% CI, 0.63-0.91). Even in twin pairs with BMI discordance of 7.0 or more (mean [SE], 9.3 [0.7]), where the heavier twin had a BMI of 30.0 or more (n = 65 pairs), the risk of MI or death was not greater in heavier twins (OR, 0.42; 95% CI, 0.15-1.18). In contrast, in the total cohort of twins, the risk of incident diabetes was greater in heavier twins (OR, 2.14; 95% CI, 1.61-2.84). Finally, increases in BMI since 30 years before baseline were not associated with the later risk of MI or death (OR, 0.97; 95% CI, 0.89-1.05) but were associated with the risk of incident diabetes (OR, 1.13; 95% CI, 1.01-1.26). In MZ twin pairs, higher BMI was not associated with an increased risk of MI or death but was associated

  16. A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients.

    Science.gov (United States)

    Richardson, Robin A; Wiest, Katharina

    2015-07-01

    Poor nutritional health among opioid-dependent individuals is well established, yet no nutritional screening tool exists for this specific population. The utility of "Determine Your Nutritional Health" developed by the Nutrition Screening Initiative is considered. The study examines the questionnaire's relevance in patients beginning opioid dependence treatment at a methadone-assisted treatment program (N = 140) by examining nutritional risk factor prevalence, body mass index, and association between nutritional risk level and treatment retention. The majority of patients reported at least one nutritional risk factor (89 %) and 59 % were at high nutritional risk. Body mass index was not related to nutritional risk; however, a trend was identified between increasing nutritional risk and decreased retention in treatment. These preliminary findings suggest the need for incorporation of nutritional screening at intake in opioid treatment programs, consideration of the effect of dietary risk on treatment retention, and the potential utility of this screening tool.

  17. 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

  18. The Heat Exposure Integrated Deprivation Index (HEIDI): A data-driven approach to quantifying neighborhood risk during extreme hot weather.

    Science.gov (United States)

    Krstic, Nikolas; Yuchi, Weiran; Ho, Hung Chak; Walker, Blake B; Knudby, Anders J; Henderson, Sarah B

    2017-12-01

    Mortality attributable to extreme hot weather is a growing concern in many urban environments, and spatial heat vulnerability indexes are often used to identify areas at relatively higher and lower risk. Three indexes were developed for greater Vancouver, Canada using a pool of 20 potentially predictive variables categorized to reflect social vulnerability, population density, temperature exposure, and urban form. One variable was chosen from each category: an existing deprivation index, senior population density, apparent temperature, and road density, respectively. The three indexes were constructed from these variables using (1) unweighted, (2) weighted, and (3) data-driven Heat Exposure Integrated Deprivation Index (HEIDI) approaches. The performance of each index was assessed using mortality data from 1998-2014, and the maps were compared with respect to spatial patterns identified. The population-weighted spatial correlation between the three indexes ranged from 0.68-0.89. The HEIDI approach produced a graduated map of vulnerability, whereas the other approaches primarily identified areas of highest risk. All indexes performed best under extreme temperatures, but HEIDI was more useful at lower thresholds. Each of the indexes in isolation provides valuable information for public health protection, but combining the HEIDI approach with unweighted and weighted methods provides richer information about areas most vulnerable to heat. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Successful prediction of cardiovascular risk by new non-invasive vascular indexes using suprasystolic cuff oscillometric waveform analysis.

    Science.gov (United States)

    Sasaki-Nakashima, Rie; Kino, Tabito; Chen, Lin; Doi, Hiroshi; Minegishi, Shintaro; Abe, Kaito; Sugano, Teruyasu; Taguri, Masataka; Ishigami, Tomoaki

    2017-01-01

    Recently, new non-invasive vascular indexes named arterial velocity pulse index (AVI) and arterial pressure volume index (API), which is evaluated by a multifunctional blood pressure monitoring device, were developed using cuff oscillometric technologies and suprasystolic cuff oscillometric wave measurement. However, although a few studies including a computational model have been performed, data on subjects with cardiovascular diseases in actual outpatient clinics remain scant. We examined a total 252 consecutive outpatients and analyzed two vascular indexes with various clinical parameters to explore potential utilities of these two indexes in actual clinical settings. Although we found that two indexes were correlated with each other, the clinical implications of these indexes seemed to differ. Our analyses showed that AVI significantly correlated with augmentation index, but not with flow-mediated dilatation, and multivariate analyses suggested that enhanced AVI represents increased workload on the heart with elevated central blood pressure. In contrast, although the results of analyses performed to identify clinical parameters independently related to API were obscure and non-specific, after adjustment for multiple clinical variables, API was found to be significantly and independently associated with both Framingham Cardiovascular Risk Score and the Suita Score, suggesting that API is a useful predictor of future cardiovascular events. These two new vascular indexes might be useful in actual clinical settings to evaluate cardiovascular risks with various clinical backgrounds. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  20. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement.

    Science.gov (United States)

    Kowalski, Marek L; Ansotegui, Ignacio; Aberer, Werner; Al-Ahmad, Mona; Akdis, Mubeccel; Ballmer-Weber, Barbara K; Beyer, Kirsten; Blanca, Miguel; Brown, Simon; Bunnag, Chaweewan; Hulett, Arnaldo Capriles; Castells, Mariana; Chng, Hiok Hee; De Blay, Frederic; Ebisawa, Motohiro; Fineman, Stanley; Golden, David B K; Haahtela, Tari; Kaliner, Michael; Katelaris, Connie; Lee, Bee Wah; Makowska, Joanna; Muller, Ulrich; Mullol, Joaquim; Oppenheimer, John; Park, Hae-Sim; Parkerson, James; Passalacqua, Giovanni; Pawankar, Ruby; Renz, Harald; Rueff, Franziska; Sanchez-Borges, Mario; Sastre, Joaquin; Scadding, Glenis; Sicherer, Scott; Tantilipikorn, Pongsakorn; Tracy, James; van Kempen, Vera; Bohle, Barbara; Canonica, G Walter; Caraballo, Luis; Gomez, Maximiliano; Ito, Komei; Jensen-Jarolim, Erika; Larche, Mark; Melioli, Giovanni; Poulsen, Lars K; Valenta, Rudolf; Zuberbier, Torsten

    2016-01-01

    One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing), deliberate induction in the office of allergic symptoms to offending compounds (provocation tests) or intentional application of potentially dangerous substances (allergy vaccine) to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established practices and experience as well

  1. Body Size, Extinction Risk and Knowledge Bias in New World Snakes

    Science.gov (United States)

    Vilela, Bruno; Villalobos, Fabricio; Rodríguez, Miguel Ángel; Terribile, Levi Carina

    2014-01-01

    Extinction risk and body size have been found to be related in various vertebrate groups, with larger species being more at risk than smaller ones. We checked whether this was also the case for snakes by investigating extinction risk–body size relationships in the New World's Colubroidea species. We used the IUCN Red List risk categories to assign each species to one of two broad levels of threat (Threatened and Non-Threatened) or to identify it as either Data Deficient or Not-Evaluated by the IUCN. We also included the year of description of each species in our analysis as this could affect the level of threat assigned to it (earlier described species had more time to gather information about them, which might have facilitated their evaluation). Also, species detectability could be a function of body size, with larger species tending to be described earlier, which could have an impact in extinction risk–body size relationships. We found a negative relationship between body size and description year, with large-bodied species being described earlier. Description year also varied among risk categories, with Non-Threatened species being described earlier than Threatened species and both species groups earlier than Data Deficient species. On average, Data Deficient species also presented smaller body sizes, while no size differences were detected between Threatened and Non-Threatened species. So it seems that smaller body sizes are related with species detectability, thus potentially affecting both when a species is described (smaller species tend to be described more recently) as well as the amount of information gathered about it (Data Deficient species tend to be smaller). Our data also indicated that if Data Deficient species were to be categorized as Threatened in the future, snake body size and extinction risk would be negatively related, contrasting with the opposite pattern commonly observed in other vertebrate groups. PMID:25409293

  2. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement

    Directory of Open Access Journals (Sweden)

    Marek L. Kowalski

    2016-10-01

    Full Text Available Abstract One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing, deliberate induction in the office of allergic symptoms to offending compounds (provocation tests or intentional application of potentially dangerous substances (allergy vaccine to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO, representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established

  3. 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

  4. Association between body mass index and risk of breast cancer in Tunisian women.

    Science.gov (United States)

    Msolly, Awatef; Awatef, Msolly; Gharbi, Olfa; Olfa, Gharbi; Mahmoudi, Kacem; Kacem, Mahmoudi; Limem, Sami; Sami, Limem; Hochlef, Makram; Makram, Hochlef; Ben Ahmed, Slim; Slim, Ben Ahmed

    2011-01-01

    The number of breast cancer in women has increased dramatically in Tunisia. The cause is perceived to stem from adaptation to a westernized life style which increases body mass index (BMI). This study aimed to investigate the association between BMI and breast cancer among Tunisian women. Hospital-based case control study of breast cancer patients seen between November 2006 and April 2009 at the University College Hospital Farhat Hached in Sousse, Tunisia. Standardized questionnaires concerning BMI and other anthropometric data were completed on 400 breast cancer cases and 400 controls. The controls were frequency-matched to the cases by age. BMI at diagnosis was positively correlated with the risk of breast cancer among postmenopausal women (P<.001 for trend). When compared with women with a low BMI (<19), women with a BMI of 23-27 and 27-31 had a 1.7-fold (95% CI, 1.1-2.9) and 2.1-fold (95% CI, 1.1-3.9) increased risk of breast cancer, respectively, after adjustment for non-anthropometric risk factors. BMI at diagnosis was not related to the risk of breast cancer among premenopausal women. The odds ratios for premenopausal women with a BMI of 23-27 and 27-31 were 1.5 (95% CI, 0.8-2.8) and 1.3 (95% CI, 0.4-4.5), respectively. Furthermore, present BMI was not associated with breast cancer risk in either pre- and postmenopausal women. Weight control in obese women may be an effective measure of breast cancer prevention in postmenopausal women.

  5. Incidence and Mortality of Liver Cancer and their Relationship with the Human Development Index in the World

    Directory of Open Access Journals (Sweden)

    Masoumeh Arabsalmani

    2016-09-01

    Full Text Available Background: Information on the incidence and mortality of liver cancer can be useful for health programs and research activities, and with regard to the possible role of the HDI and liver cancer, this study aimed to investigate incidence and mortality from the cancer and their relationship with the indicator and its components in 2012 in world. Methods: In this ecologic study, data were extracted from GLOBOCAN in 2012. Data on HDI and its components were extracted from the World Bank. The number and standardized incidence and mortality rates of liver cancer were reported by regions in the world. Data were analyzed by SPSS software and Correlation coefficient test. Results: There was a total of 782,451 incidence cases. Of these patients, 228, 082 cases (29.15 % were women and 554, 369 cases (70.85 % men, and there were 745,533 deaths. Of the deaths, 224, 492 cases (30.11 % occurred in women and 521, 041 cases (69.89 % men were recorded in the world in 2012. Results showed that there was a significant inverse correlation between age-specific incidence rate ( ASIR and HDI (r=-0.345, p and #8804;0.001, as well significant inverse correlation was seen between age-specific mortality rate (ASMR, and HDI and its components. Conclusion: Liver cancer incidence and mortality are higher in the medium HDI countries. The relationship between the standardized incidence and mortality of liver cancer with HDI and its components, including life expectancy at birth, mean years of schooling and income level per person was significantly negative. [Biomed Res Ther 2016; 3(9.000: 800-807

  6. Banding the World Together; The Global Growth of Control Banding and Qualitative Occupational Risk Management

    Energy Technology Data Exchange (ETDEWEB)

    Zalk, David M.; Heussen, Ga Henri

    2011-12-01

    Control Banding (CB) strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into ergonomics and injury prevention. CB is an action-oriented qualitative risk assessment strategy offering solutions and control measures to users through “toolkits”. Chemical CB toolkits are user-friendly approaches used to achieve workplace controls in the absence of firm toxicological and quantitative exposure information. The model (technical) validation of these toolkits is well described, however firm operational analyses (implementation aspects) are lacking. Consequentially, it is often not known if toolkit use leads to successful interventions at individual workplaces. This might lead to virtual safe workplaces without knowing if workers are truly protected. Upcoming international strategies from the World Health Organization Collaborating Centers request assistance in developing and evaluating action-oriented procedures for workplace risk assessment and control. It is expected that to fulfill this strategy’s goals, CB approaches will continue its important growth in protecting workers.

  7. Banding the World Together; The Global Growth of Control Banding and Qualitative Occupational Risk Management

    Directory of Open Access Journals (Sweden)

    David M. Zalk

    2011-12-01

    Full Text Available Control Banding (CB strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into ergonomics and injury prevention. CB is an action-oriented qualitative risk assessment strategy offering solutions and control measures to users through “toolkits”. Chemical CB toolkits are user-friendly approaches used to achieve workplace controls in the absence of firm toxicological and quantitative exposure information. The model (technical validation of these toolkits is well described, however firm operational analyses (implementation aspects are lacking. Consequentially, it is often not known if toolkit use leads to successful interventions at individual workplaces. This might lead to virtual safe workplaces without knowing if workers are truly protected. Upcoming international strategies from the World Health Organization Collaborating Centers request assistance in developing and evaluating action-oriented procedures for workplace risk assessment and control. It is expected that to fulfill this strategy’s goals, CB approaches will continue its important growth in protecting workers.

  8. A World at Risk: Aggregating Development Trends to Forecast Global Habitat Conversion.

    Directory of Open Access Journals (Sweden)

    James R Oakleaf

    Full Text Available A growing and more affluent human population is expected to increase the demand for resources and to accelerate habitat modification, but by how much and where remains unknown. Here we project and aggregate global spatial patterns of expected urban and agricultural expansion, conventional and unconventional oil and gas, coal, solar, wind, biofuels and mining development. Cumulatively, these threats place at risk 20% of the remaining global natural lands (19.68 million km2 and could result in half of the world's biomes becoming >50% converted while doubling and tripling the extent of land converted in South America and Africa, respectively. Regionally, substantial shifts in land conversion could occur in Southern and Western South America, Central and Eastern Africa, and the Central Rocky Mountains of North America. With only 5% of the Earth's at-risk natural lands under strict legal protection, estimating and proactively mitigating multi-sector development risk is critical for curtailing the further substantial loss of nature.

  9. Effectiveness of Palivizumab in Preventing RSV Hospitalization in High Risk Children: A Real-World Perspective

    Directory of Open Access Journals (Sweden)

    Nusrat Homaira

    2014-01-01

    Full Text Available Infection with respiratory syncytial virus (RSV is one of the major causes globally of childhood respiratory morbidity and hospitalization. Palivizumab, a humanized monoclonal antibody, has been recommended for high risk infants to prevent severe RSV-associated respiratory illness. This recommendation is based on evidence of efficacy when used under clinical trial conditions. However the real-world effectiveness of palivizumab outside of clinical trials among different patient populations is not well established. We performed a systematic review focusing on postlicensure observational studies of the protective effect of palivizumab prophylaxis for reducing RSV-associated hospitalizations in infants and children at high risk of severe infection. We searched studies published in English between 1 January 1999 and August 2013 and identified 420 articles, of which 20 met the inclusion criteria. This review supports the recommended use of palivizumab for reducing RSV-associated hospitalization rates in premature infants born at gestational age < 33 weeks and in children with chronic lung and heart diseases. Data are limited to allow commenting on the protective effect of palivizumab among other high risk children, including those with Down syndrome, cystic fibrosis, and haematological malignancy, indicating further research is warranted in these groups.

  10. Associated risk factors for abnormal ankle-brachial index in hemodialysis patients in a hospital.

    Science.gov (United States)

    Chen, Szu-Chia; Su, Ho-Ming; Mai, Hsiu-Chin; Chen, Jui-Hsin; Chen, Chiu-Yueh; Chang, Jer-Ming; Chen, Hung-Chun

    2008-09-01

    Ankle-brachial index (ABI) is a marker for peripheral artery disease and can predict mortality in hemodialysis patients. However, it is seldom studied in southern Taiwan, an area with high prevalence of end-stage renal disease (ESRD). The aim of this study was to investigate the prevalence and associated risk factors for peripheral artery disease in the ESRD population in a hospital. All routine hemodialysis patients in one regional hospital were included except for six patients who refused ABI examinations and four patients with atrial fibrillation. Finally, 225 patients formed our study group. ABI was measured using an ABI-form device (Colin VP1000). The prevalence of ABI or = 1.3 was 15.6% and 5.8%, respectively. ABI or = 1.3 was significantly associated with diabetes mellitus (p = 0.019). This study demonstrated the associated risk factors of peripheral artery disease in patients with hemodialysis in a hospital. ESRD patients of advanced age and with increased pulse pressure, increased hematocrit and decreased serum albumin level had a relatively high risk for ABI or = 1.3.

  11. Dietary inflammatory index and ovarian cancer risk in a New Jersey case-control study.

    Science.gov (United States)

    Shivappa, Nitin; Hébert, James R; Paddock, Lisa E; Rodriguez-Rodriguez, Lorna; Olson, Sara H; Bandera, Elisa V

    2018-02-01

    Diet may influence the development of ovarian cancer. Although it has been shown that inflammation plays an important etiologic role in ovarian carcinogenesis, little is known about the influence of the inflammatory potential of food consumption. The aim of this study was to evaluate the effect of a proinflammatory diet, as indicated by a high dietary inflammatory index (DII ® ) score, on ovarian cancer risk, in a New Jersey population. Data from a case-control study conducted in New Jersey were used to estimate the relation between DII score and the risk for ovarian cancer. The study consisted of 205 cases with incident, histologically confirmed ovarian cancer, and 390 controls identified by random-digit dialing, based on Centers for Medicare & Medicaid Service lists, and area sampling. Computation of the DII was based on the intake of selected dietary factors assessed by a validated food frequency questionnaire (FFQ). Logistic regression models were fit to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potential covariates. Although there was no significant association observed in pre- and perimenopausal women, a significant association was observed between the most proinflammatory DII scores and ovarian cancer among postmenopausal women (OR Quartile4 vs1 , 1.89; 95% CI, 1.02-3.52; P trend  = 0.03). Findings from the present study suggested that a proinflammatory diet may increase risk for ovarian cancer among postmenopausal women, and warrants further study to confirm this association. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. 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 met...... of glucose metabolism one to two decades after the pregnancy complicated by GDM....... 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...... 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). CONCLUSIONS: Lower PI is associated with increased risk of GDM. In women with previous GDM, lower BW is associated with a more severe impairment...

  13. [Spanish productivity in smoking research relative to world and European union productivity from 1999 through 2003, analyzed with the science citation index].

    Science.gov (United States)

    de Granda-Orive, José Ignacio; García Río, Francisco; Aleixandre Benavent, Rafael; Valderrama Zurían, Juan Carlos; Jiménez Ruiz, Carlos A; Solano Reina, Segismundo; Villanueva Serrano, Santiago; Alonso-Arroyo, Adolfo

    2007-04-01

    To analyze Spanish scientific productivity from 1999 through 2003 in the area of smoking research, in comparison with world and European Union research, based on data in the Science Citation (SCI) Index. This bibliometric study was carried out by searching the title field of the Science Citation Index Expanded. Descriptive statistics with 95% confidence intervals (CI) were compiled. Two-hundred ninety-two documents on smoking by Spanish authors were located. The most productive subspecialties were the group comprised of public health, education and health economics with 57 articles, and areas of the respiratory system, experimental research, and internal medicine with 36 articles each. The journals that published the largest number of articles located were Medicina Clínica, with 35 articles (12%) and Archivos de Bronconeumología with 20 (6.8%). International collaboration was undertaken with institutions in the United States of America and other European Union countries. The mean (SD) number of citations received was 5.12 (8.6) (range 59-0). Spain contributed 8.34% of the SCI-indexed smoking research overall and 12.85% of SCI-indexed smoking research from the European Union. Smoking research is developing appropriately in Spain and has high impact, even though output is modest. Factors associated with increased citation are international collaboration, language (being written in English), and having a non-Spanish first author.

  14. Improving index-based drought insurance in varying topography: evaluating basis risk based on perceptions of Nicaraguan hillside farmers.

    Directory of Open Access Journals (Sweden)

    André Kost

    Full Text Available This paper discusses a methodology to model precipitation indices and premium prices for index-based drought insurance for smallholders. Spatial basis risk, which is borne by the insured, is a problem, especially in variable topography. Also, site-specific drought risk needs to be estimated accurately in order to offer effective insurance cover and ensure financial sustainability of the insurance scheme. We explore farmers' perceptions on drought and spatial climate variability and draw conclusions concerning basis risk with regards to the proposed methodology. There are technically many options to represent natural heterogeneity in index insurance contracts while serving the customer adequately and keeping transaction costs low.

  15. The impact of body mass index on treatment outcomes for patients with low-intermediate risk prostate cancer.

    Science.gov (United States)

    Yamoah, Kosj; Zeigler-Johnson, Charnita M; Jeffers, Abra; Malkowicz, Bruce; Spangler, Elaine; Park, Jong Y; Whittemore, Alice; Rebbeck, Timothy R

    2016-07-29

    Little is known about the relationship between preoperative body mass index and need for adjuvant radiation therapy (RT) following radical prostatectomy. The goal of this study was to evaluate the utility of body mass index in predicting adverse clinical outcomes which require adjuvant RT among men with organ-confined prostate cancer (PCa). We used a prospective cohort of 1,170 low-intermediate PCa risk men who underwent radical prostatectomy and evaluated the effect of body mass index on adverse pathologic features and freedom from biochemical failure (FFbF). Clinical and pathologic variables were compared across the body mass index groups using an analysis of variance model for continuous variables or χ(2) for categorical variables. Factors related to adverse pathologic features were examined using logistic regression models. Time to biochemical recurrence was compared across the groups using a log-rank survivorship analysis. Multivariable analysis predicting biochemical recurrence was conducted with a Cox proportional hazards model. Patients with elevated body mass index (defined as body mass index ≥25 kg/m(2)) had greater extraprostatic extension (p = 0.004), and positive surgical margins (p = 0.01). Elevated body mass index did not correlate with preoperative risk groupings (p = 0.94). However, when compared with non-obese patients (body mass index <30 kg/m(2)), obese patients (body mass index ≥30 kg/m(2)) were much more likely to have higher rate of adverse pathologic features (p = 0.006). In patients with low- and intermediate- risk disease, obesity was strongly associated with rate of pathologic upgrading of tumors (p = 0.01 and p = 0.02), respectively. After controlling for known preoperative risk factors, body mass index was independently associated with ≥2 adverse pathologic features (p = 0.002), an indicator for adjuvant RT as well as FFbF (p = 0.001). Body mass index of ≥30 kg/m(2) is independently

  16. Geriatric nutritional risk index as a nutritional and survival risk assessment tool in stable outpatients with systolic heart failure.

    Science.gov (United States)

    Sargento, L; Vicente Simões, A; Rodrigues, J; Longo, S; Lousada, N; Palma Dos Reis, R

    2017-05-01

    Malnutrition is frequent in heart failure (HF). However, the best tool for evaluating malnutrition in geriatric patients with HF with reduced ejection fraction (HFrEF) is unknown. This study aimed to evaluate the incremental prognostic value of the geriatric nutritional risk index (GNRI) in stable geriatric outpatients with HFrEF compared with a clinical/laboratory prognostic model. A total of 143 outpatients with HFrEF, aged >65 years, a LVEF patients were at risk of malnutrition (GNRI ≤98). Deceased patients had a lower GNRI (113.6 ± 9.1 vs. 105.6 ± 9.2; p 98 (hazard ratio = 0.29, 95% CI 0.15-0.57; p geriatric outpatients with HFrEF is a strong independent predictor of survival. The GNRI adds significant prognostic information to the clinical/laboratory model. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  17. Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

    NARCIS (Netherlands)

    Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Elena Medina-Mora, Maria; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.

    2010-01-01

    Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence

  18. 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

    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....... 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...... and zygosity, men: OR = 1.70 (1.07-2.70), P = 0.026; women: OR = 1.88 (1.24-2.85), P = 0.003. In this analysis, BMI remained a highly significant predictor for asthma independently of diabetes status in women, P

  19. Relationship between Geriatric Nutritional Risk Index and total lymphocyte count and mortality of hemodialysis patients.

    Science.gov (United States)

    Jung, Yeon Soon; You, Gain; Shin, Ho Sik; Rim, Hark

    2014-01-01

    We examined the relationships between Geriatric Nutritional Risk Index (GNRI), total lymphocyte count (TLC), and mortality in hemodialysis (HD) patients. We examined GNRI and TLC in 120 maintenance HD patients and followed these patients for 120 months. Predictors of all-cause death were examined using life table analysis and the Cox proportional hazards model. TLC marginally correlated with GNRI (r = 0.176; p = 0.090) and significantly with phosphorus levels (r = 0.206; p = 0.026). Life table analysis revealed that subjects with a GNRI nutritional tool, but may not be a predictor of mortality in HD patients. These findings require confirmation by further studies. © 2013 International Society for Hemodialysis.

  20. 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

  1. Epidemiology in a changing world: variation, causation and ubiquitous risk factors.

    Science.gov (United States)

    Pearce, Neil

    2011-04-01

    We are all living in the era of globalization and, like it or not, it is going to change the way we practise epidemiology, the kinds of questions we ask and the methods we use to answer them. However, the methods, and ways of thinking about the health of populations, that will be required for epidemiology in the 21st century are in some instances quite different from the standard epidemiological techniques that are taught in most textbooks and courses today. As we develop epidemiological methods for addressing the scientific and public health problems of the 21st century, it is important that we consider, once again, the distinction between the analysis of variance and the analysis of causes. This has primarily been considered with respect to genetic research, and also with regard to the problems of making comparisons between different populations and environments at the same point in time. It has not been considered in depth with regard to the issues of conducting epidemiological research in a world that is changing over time. In this article, I first consider the statistical and scientific issues involved in the distinction between the analysis of variance and the analysis of causes. I then discuss some examples of the implications of this distinction for the theory and practice of epidemiology in a changing world, particularly with regard to risk factors that become ubiquitous over time. Sometimes the most important causes of disease are invisible because they are everywhere.

  2. Body mass index and obesity- and diabetes-associated genotypes and risk for pancreatic cancer.

    Science.gov (United States)

    Tang, Hongwei; Dong, Xiaoqun; Hassan, Manal; Abbruzzese, James L; Li, Donghui

    2011-05-01

    The genetic factors predisposing individuals with obesity or diabetes to pancreatic cancer have not been identified. To investigate the hypothesis that obesity- and diabetes-related genes modify the risk of pancreatic cancer. We genotyped 15 single nucleotide polymorphisms of fat mass and obesity-associated (FTO), peroxisome proliferators-activated receptor gamma (PPARγ), nuclear receptor family 5 member 2 (NR5A2), AMPK, and ADIPOQ genes in 1,070 patients with pancreatic cancer and 1,175 cancer-free controls. Information on risk factors was collected by personal interview. Adjusted ORs (AOR) and 95% CIs were calculated using unconditional logistic regression. The PPARγ P12A GG genotype was inversely associated with risk of pancreatic cancer (AOR, 0.21; 95% CI, 0.07-0.62). Three NR5A2 variants that were previously identified in a genome-wide association study were significantly associated with reduced risk of pancreatic cancer, AORs ranging from 0.57 to 0.79. Two FTO gene variants and one ADIPOQ variant were differentially associated with pancreatic cancer according to levels of body mass index (BMI; P(interaction) = 0.0001, 0.0015, and 0.03). For example, the AOR (95% CI) for FTO IVS1-2777AC/AA genotype was 0.72 (0.55-0.96) and 1.54 (1.14-2.09) in participants with a BMI of less than 25 or 25 kg/m(2) or more, respectively. We observed no significant association between AMPK genotype and pancreatic cancer and no genotype interactions with diabetes or smoking. Our findings suggest the PPARγ P12A GG genotype and NR5A2 variants may reduce the risk for pancreatic cancer. A positive association of FTO and ADIPOQ gene variants with pancreatic cancer may be limited to persons who are overweight. The discovery of genetic factors modifying the risk of pancreatic cancer may help to identify high-risk individuals for prevention efforts. ©2011 AACR.

  3. Association between Pollen Risk Indexes, Air Pollutants, and Allergic Diseases in Korea.

    Science.gov (United States)

    Kim, Hoseob; Park, Yoonhyung; Park, Kwanjun; Yoo, Byoungin

    2016-06-01

    This study, different from the past researches, has been conducted in all age groups to understand the association between air pollutants, pollen risk indexes, and outpatients with allergic rhinitis (AR), asthma, and atopic dermatitis (AD). Data on air pollutants, pollen risk indexes, and outpatients with each disease were collected from 2003 through 2011 to verify the association between them. All data are time-series materials that have been observed by time (day) and region, and are in a nonlinear shape. In particular, the total number of outpatients per day is a count data that had a Poisson distribution as the response variable. SAS 9.3 was used to make a statistical model, generalized additive model, with lag effects for the analysis. For allergic diseases during spring (April-May) and fall (September-October), a significant association was shown between the variables of air pollutants, pollens, and the number of outpatients. Especially, the estimates of NO2 [AR (43.00967 ± 0.11284), asthma (52.01837 ± 0.06452), AD (52.01837 ± 0.06452), p allergic diseases are being conducted. However, not many studies related to similar studies. In the need of creating grounds to back up these efforts, additional studies on allergic diseases, as well as researches utilizing pollen data, air pollution data, and claims data provided by the Health Insurance Corporation that has no problem in the representativeness of the data that have close relationships to the allergic disease will be needed.

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

    Science.gov (United States)

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

    2016-04-01

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

  5. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    Science.gov (United States)

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    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. PMID:25250626

  6. Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood

    Directory of Open Access Journals (Sweden)

    Kellen Cristine Silva

    Full Text Available Abstract Objective: To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. Methods: Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil. Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (p<0.05. Results: The prevalence of overweight by body mass index was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04. No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. Conclusions: The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study.

  7. Ankle-brachial index and incident diabetes mellitus: the atherosclerosis risk in communities (ARIC) study.

    Science.gov (United States)

    Hua, Simin; Loehr, Laura R; Tanaka, Hirofumi; Heiss, Gerardo; Coresh, Josef; Selvin, Elizabeth; Matsushita, Kunihiro

    2016-12-07

    Individuals with peripheral artery disease (PAD) often have reduced physical activity, which may increase the future risk of diabetes mellitus. Although diabetes is a risk factor for PAD, whether low ankle-brachial index (ABI) predates diabetes has not been studied. We examined the association of ABI with incident diabetes using Cox proportional hazards models in the ARIC Study. ABI was measured in 12,247 black and white participants without prevalent diabetes at baseline (1987-1989). Incident diabetes cases were identified by blood glucose levels at three subsequent visits (1990-92, 1993-95, and 1996-98) or self-reported physician diagnosis or medication use at those visits or during annual phone interview afterward through 2011. A total of 3305 participants developed diabetes during a median of 21 years of follow-up. Participants with low (≤0.90) and borderline low (0.91-1.00) ABI had 30-40% higher risk of future diabetes as compared to those with ABI of 1.10-1.20 in the demographically adjusted model. The associations were attenuated after further adjustment for other potential confounders but remained significant for ABI 0.91-1.00 (HR = 1.17, 95% CI 1.04-1.31) and marginally significant for ABI ≤ 0.90 (HR = 1.19, 0.99-1.43). Although the association was largely consistent across subgroups, a stronger association was seen in participants without hypertension, those with normal fasting glucose, and those with a history of stroke compared to their counterparts. Low ABI was modestly but independently associated with increased risk of incident diabetes in the general population. Clinical attention should be paid to the glucose trajectory among people with low ABI but without diabetes.

  8. Dietary inflammatory index and risk of pancreatic cancer in an Italian case-control study.

    Science.gov (United States)

    Shivappa, Nitin; Bosetti, Cristina; Zucchetto, Antonella; Serraino, Diego; La Vecchia, Carlo; Hébert, James R

    2015-01-28

    Previous studies have shown that various dietary components may be implicated in the aetiology of pancreatic cancer. However, the possible relationship between diet-related inflammation and the risk of pancreatic cancer has not yet been investigated. We examined the ability of a newly developed literature-derived dietary inflammatory index (DII) to predict the risk of pancreatic cancer in a case-control study conducted in Italy between 1991 and 2008. This included 326 incident cases and 652 controls admitted to the major teaching and general hospitals for non-neoplastic diseases, frequency-matched to cases by study centre, sex and age. The DII was computed based on dietary intake assessed using a validated and reproducible seventy-eight-item FFQ. Logistic regression models were used to estimate multivariable OR adjusted for age, sex, study centre, education, BMI, smoking status, alcohol drinking and history of diabetes. Energy adjustment was performed using the residual method. Subjects with higher DII scores (i.e., representing a more pro-inflammatory diet) had a higher risk of pancreatic cancer, with the DII being used as both a continuous variable (ORcontinuous 1.24, 95% CI 1.11, 1.38) and a categorical variable (i.e., compared with the subjects in the lowest quintile of the DII, those in the second, third, fourth and fifth quintiles had, respectively, OR(quintile2 v. 1) 1.70, 95% CI 1.02, 2.80; OR(quintile3 v. 1) 1.91, 95% CI 1.16, 3.16; OR(quintile4 v. 1) 1.98, 95% CI 1.20, 3.27; OR(quintile5 v. 1) 2.48, 95% CI 1.50, 4.10; P trend= 0.0015). These data suggest that a pro-inflammatory diet increases the risk of pancreatic cancer.

  9. Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients.

    Science.gov (United States)

    Komatsu, Mizuki; Okazaki, Masayuki; Tsuchiya, Ken; Kawaguchi, Hiroshi; Nitta, Kosaku

    2015-01-01

    Malnutrition is common in hemodialysis (HD) patients, and it is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The aim of this study was to examine the reliability of the GNRI as a mortality predictor in a Japanese HD cohort. We prospectively examined the GNRI of 332 maintenance HD patients aged 65.4 ± 13.2, 213 males, and followed up on them for 36 months. The patients were divided into quartiles (Q) according to GNRI values (Q1: 102.3). Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. The GNRI presented a normal distribution. During the follow-up period of 36 months, 76 patients died. The overall mortality at the end of the 3-year observational period was 22.3%. At the 3-year follow-up period, Kaplan-Meier survival rates for all-cause mortality were 72.3, 79.3, 84.9 and 92.6% in Q1, Q2, Q3, and Q4, respectively (p = 0.0067). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (HR 0.958; 95% CI 0.929-0.989, p = 0.0073). The results of the present study demonstrate that the GNRI is a strong predictor of overall mortality in HD patients. However, cardiovascular mortality was not associated with GNRI values, and did not differ among the GNRI quartiles. The GNRI score can be considered a simple and reliable marker of predictor for mortality risk in Japanese HD patients. © 2015 S. Karger AG, Basel.

  10. Risks and Uncertainties in Virtual Worlds: An Educators' Perspective

    Science.gov (United States)

    Farahmand, Fariborz; Yadav, Aman; Spafford, Eugene H.

    2013-01-01

    Virtual worlds present tremendous advantages to cyberlearning. For example, in virtual worlds users can socialize with others, build objects and share them, customize parts of the world and hold lectures, do experiments, or share data. However, virtual worlds pose a wide range of security, privacy, and safety concerns. This may lead educators to…

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

    Directory of Open Access Journals (Sweden)

    Ayush Giri

    2017-07-01

    Full Text Available 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

  12. 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

  13. Epidemiology of burns throughout the world. Part I: Distribution and risk factors.

    Science.gov (United States)

    Peck, Michael D

    2011-11-01

    Globally in 2004, the incidence of burns severe enough to require medical attention was nearly 11 million people and ranked fourth in all injuries, higher than the combined incidence of tuberculosis and HIV infections. Fortunately, although burns and fires account for over 300,000 deaths each year throughout the world, the vast majority of burns are not fatal. Nonetheless, fire-related burns are also among the leading causes of disability-adjusted life years (DALYs) lost in low- and middle-income countries (LMIC). Morbidity and mortality due to fire and flames has declined worldwide in the past decades. However, 90% of burn deaths occur in LMIC, where prevention programs are uncommon and the quality of acute care is inconsistent. Even in high-income countries, burns occur disproportionately to racial and ethnic minorities such that socioeconomic status--more than cultural or educational factors--account for most of the increased burn susceptibility. Risk factors for burns include those related to socioeconomic status, race and ethnicity, age, and gender, as well as those factors pertaining to region of residence, intent of injury, and comorbidity. Both the epidemiology and risk factors of burns injuries worldwide are reviewed in this paper. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  14. Association of a Genetic Risk Score With Body Mass Index Across Different Birth Cohorts.

    Science.gov (United States)

    Walter, Stefan; Mejía-Guevara, Iván; Estrada, Karol; Liu, Sze Y; Glymour, M Maria

    2016-07-05

    Many genetic variants are associated with body mass index (BMI). Associations may have changed with the 20th century obesity epidemic and may differ for black vs white individuals. Using birth cohort as an indicator for exposure to obesogenic environment, to evaluate whether genetic predisposition to higher BMI has a larger magnitude of association among adults from more recent birth cohorts, who were exposed to the obesity epidemic at younger ages. Observational study of 8788 adults in the US national Health and Retirement Study who were aged 50 years and older, born between 1900 and 1958, with as many as 12 BMI assessments from 1992 to 2014. A multilocus genetic risk score for BMI (GRS-BMI), calculated as the weighted sum of alleles of 29 single nucleotide polymorphisms associated with BMI, with weights equal to the published per-allele effects. The GRS-BMI represents how much each person's BMI is expected to differ, based on genetic background (with respect to these 29 loci), from the BMI of a sample member with median genetic risk. The median-centered GRS-BMI ranged from -1.68 to 2.01. BMI based on self-reported height and weight. GRS-BMI was significantly associated with BMI among white participants (n = 7482; mean age at first assessment, 59 years; 3373 [45%] were men; P obesogenic environments.

  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...... (95% CI) of adult liver cancer was 1.20 (1.07-1.33) and 1.30 (1.16-1.46) per 1-unit BMI z-score at 7 years and 13 years of age, respectively. Similar associations were found in boys and girls, for hepatocellular carcinoma only, across years of birth, and after accounting for diagnoses of viral...... of 285,884 boys and girls, born 1930 through 1980, who attended school in Copenhagen, were followed from 1977 to 31 December 2010. Their heights and weights were measured by school doctors or nurses at ages 7 through 13 years. Body mass index (BMI) z-scores were calculated from an internal age- and sex...

  16. Analysis of drought condition and risk in Peninsular Malaysia using Standardised Precipitation Index

    Science.gov (United States)

    Zin, Wan Zawiah Wan; Jemain, Abdul Aziz; Ibrahim, Kamarulzaman

    2013-02-01

    Contrary to the belief that Peninsular Malaysia experiences wet condition throughout the year, prolonged dry condition has lately become a recurrent phenomenon in this region. As a result, country's agricultural sector and water resources have been under severe constraints from this situation. To get a clearer picture of the dry condition in Peninsular Malaysia, the Standardised Precipitation Index, based on the data of monthly rainfall from 50 stations, is derived. Spatial analysis is used to illustrate the percentage of occurrences of dry and very dry events. To evaluate the potential risk due to the dry conditions, we modelled the joint distribution of severity and duration of dry condition by means of bivariate copula. Several copula models were tested, and the model, which best represents the relationship between severity and duration, is determined using Akaike information criterion. Based on the results, the return period for the drought severity, based on the longest duration of drought at each station, can be estimated. This enables the drought risk to be calculated, thus planning on the measures to minimise the impact of a prolonged drought to the societies, which can be done by the relevant authorities.

  17. Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

    Directory of Open Access Journals (Sweden)

    Daniela Luisa Maggi

    2014-04-01

    Full Text Available Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI. This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease. A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial. A total of 115 patients were included, most were females (57.4%, aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%, physical inactivity (48.7% and family history (58.3%. The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

  18. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy.

    Science.gov (United States)

    Oh, Cheong Ah; Kim, Dae Hoon; Oh, Seung Jong; Choi, Min Gew; Noh, Jae Hyung; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung

    2012-02-21

    To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications. From January 2008 through June 2008, 669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study. Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates. The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications. Patients with other postoperative complications were excluded from the study. On the 5th postoperative day, the NRI sh-owed a malnutrition rate of 84.6% among postoperative patients. However, postoperative wound complications occurred in only 66/669 (9.86%) patients. Of the patients with wound complications, 62/66 (94%) belonged to the malnourished group (NRI < 97.5), and 4/66 (6%) patients to the non-malnourished group (NRI ≥ 97.5). The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI < 97.5: 0.653; 95% confidence interval: 0.326-0.974; P = 0.014) according to univariate analysis as well as multivariate analysis. This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.

  19. Predicting outcome in patients with left ventricular systolic chronic heart failure using a nutritional risk index.

    Science.gov (United States)

    Al-Najjar, Yahya; Clark, Andrew L

    2012-05-01

    Mortality in patients with chronic heart failure (CHF) is high and associated with body mass. However, the best method of assessing nutritional status in patients with CHF is not clear. We sought to demonstrate the prognostic use of a nutritional risk index (NRI) in ambulatory patients with CHF. Consecutive patients attending their first quarterly review appointment in the HF clinic were recruited. All patients had systolic left ventricular (LV) dysfunction. An NRI was calculated as: (1.5 × serum albumin [grams per liter]) + (current body weight/ideal weight). Patients were followed up every 4 months. Of the 538 patients enrolled in the study 75% were men. The patients' age was 71 ± 10 years (mean ± SD) and total median follow-up in survivors was 68 months (interquartile range 54 to 74). New York Heart Association classes II and III accounted for 60% and 27%, respectively, with 80% having moderate LV impairment or worse. Based on the NRI 23% of patients were at risk of malnutrition. Severely malnourished patients were older. There was no relation between NRI and LV function. The NRI was a univariable predictor of mortality (chi-square 25, p nutritional status in trials of dietary supplementation in CHF. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. The role of Body Mass Index in child pedestrian injury risk.

    Science.gov (United States)

    O'Neal, Elizabeth E; Plumert, Jodie M; McClure, Leslie A; Schwebel, David C

    2016-05-01

    The goal of the current investigation was to examine obesity as a potential risk factor for childhood pedestrian injury. A racially diverse sample of 7- and 8-year-old children completed a road-crossing task in a semi-immersive virtual environment and two pedestrian route selection tasks. Multiple linear regression analyses revealed that children with a higher Body Mass Index (BMI) waited less before crossing, had a smaller temporal buffer between themselves and oncoming traffic while crossing, and had more collisions with traffic. Girls were more cautious than boys when crossing the virtual roadway. Unlike the results from the virtual road-crossing task, BMI was not associated with risky route selection. Instead, race emerged as the strongest predictor, with African-American children selecting riskier routes for crossing. Together, these findings suggest overweight and obese children may be at increased risk for pedestrian injury. The discussion considers explanations for why obese children may exhibit riskier road-crossing behavior. Published by Elsevier Ltd.

  1. A meta-analysis of the association between body mass index and risk of vertebral fracture.

    Science.gov (United States)

    Kaze, A D; Rosen, H N; Paik, J M

    2018-01-01

    We conducted a meta-analysis of prospective studies to assess the association between BMI and incident vertebral fracture. We found that as body mass index (BMI) increases, the risk of vertebral fracture decreases in men, but not in women, suggesting possible gender differences in the relationship of BMI with risk of vertebral fracture. Recent evidence suggests that the relationship between BMI and fracture risk may be site-specific. We conducted a systematic review and meta-analysis of prospective studies to investigate the association between BMI and risk of incident vertebral fracture. PubMed and Embase were searched for relevant articles published from inception through February 15, 2017. Extracted relative risks (RR) from the prospective studies were pooled using random-effects meta-analysis. Six studies were included, with a total of 105,129 participants followed for 3 to 19 years. The pooled RR (95% confidence interval [CI]) for vertebral fracture per each standard deviation increase in BMI was 0.94 (95% CI = 0.80-1.10) with significant heterogeneity (I 2 = 88.0%, p < 0.001). In subgroup analysis by gender, we found a significant inverse association between BMI and risk of vertebral fracture in men (RR = 0.85, 95% CI = 0.73-0.98, n = 25,617 participants) but not in women (RR = 0.98, 95% CI = 0.81-1.20, n = 79,512 participants). Across studies of women not adjusting for bone mineral density (BMD), there was no significant association between BMI and risk of vertebral fracture (RR = 0.91, 95% CI = 0.80-1.04, p = 0.18, n = 72,755 participants). However, BMI was associated with an increased risk of vertebral fracture in studies of women that adjusted for BMD (RR = 1.28, 95% CI = 1.17-1.40, p < 0.001, n = 6757 participants). Substantial heterogeneity was found among studies of women (I 2 = 90.1%, p < 0.001), which was partly explained by the adjustment for BMD (adjusted R 2 = 61%). We found no evidence of publication bias

  2. A Hazard Assessment and Proposed Risk Index for Art, Architecture, Archive and Artifact Protection: Case Studies for Assorted International Museums

    Science.gov (United States)

    Kirk, Clara J.

    This study proposes a hazard/risk index for environmental, technological, and social hazards that may threaten a museum or other place of cultural storage and accession. This index can be utilized and implemented to measure the risk at the locations of these storage facilities in relationship to their geologic, geographic, environmental, and social settings. A model case study of the 1966 flood of the Arno River and its impact on the city of Florence and the Uffizi Gallery was used as the index focus. From this focus an additional eleven museums and their related risk were assessed. Each index addressed a diverse range of hazards based on past frequency and magnitude. It was found that locations nearest a hazard had exceptionally high levels of risk, however more distant locations could have influences that would increase their risk to levels similar to those locations near the hazard. Locations not normally associated with a given natural hazard can be susceptible should the right conditions be met and this research identified, complied and assessed those factions found to influence natural hazard risk at these research sites.

  3. 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 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.

  4. Model or Myopia? Exploiting Water Markets to Address Population and Drought Risks in a Changing World

    Science.gov (United States)

    Reed, P. M.

    2012-12-01

    Climate change, population demands, and evolving land-use represent strong risks to the sustainable development and stability of world-wide urban water supplies. There is a growing consensus that non-structural supply management instruments such as water markets have significant potential to reduce the risks and vulnerabilities in complex urban water systems. This paper asks a common question, what are the tradeoffs for a city using water market supply instruments?. This question emerges quickly in policy and management, but its answer is deceptively difficult to attain using traditional planning tools and management frameworks. This research demonstrates new frameworks that facilitate rapid evaluation of hypotheses on the reliability, resiliency, adaptability, and cost-effectiveness of urban water supply systems. This study considers a broader exploration of the issues of "nonstationarity" and "uncertainty" in urban water planning. As we invest in new information and prediction frameworks for the coupled human-natural systems that define our water, our problem definitions (i.e., objectives, constraints, preferences, and hypotheses) themselves evolve. From a formal mathematical perspective, this means that our management problems are structurally uncertain and nonstationary (i.e., the definition of optimality changes across regions, times, and stakeholders). This uncertainty and nonstationarity in our problem definitions needs to be more explicitly acknowledged in adaptive management and integrated water resources management. This study demonstrates the potential benefits of exploring these issues in the context of a city in the Lower Rio Grande Valley (LRGV) of Texas, USA determining how to use its regional water market to manage population and drought risks.

  5. [Risk factors for Abacavir-induced hypersensibility syndrome in the "real world"].

    Science.gov (United States)

    Chirouze, C; Hustache-Mathieu, L; Rougeot, C; Drobacheff, C; Gil, H; Faller, J P; Lebrun, C; Estavoyer, J M; Hénon, T; Hoen, B

    2004-11-01

    Abacavir (ABC) is a generally well-tolerated NRTI. However, up to 5% of patients may develop hypersensitivity syndrome (HSS) within the first weeks of treatment. The objectives of this study were to describe the side effects of ABC, to evaluate the incidence of the ABC-HSS, and to identify the risk factors of HSS after first exposure to ABC in a cohort of patients followed up in a university HIV clinic. The charts of all HIV-infected patients who started ABC between February 1998 and May 2002 were reviewed. HSS was defined as the onset, within 8 weeks of ABC initiation, of either a skin rash associated with at least one of the following symptoms (fever, gastrointestinal symptoms, respiratory symptoms, myalgia, malaise) or at least three of the above symptoms in the absence of rash. A multivariate logistic regression analysis was performed to identify risk factors of HSS. Of the 191 patients studied (134 M, 57 F, mean age 39 years), 53 (27.8%) presented with manifestations that were regarded as potential side-effects of ABC. Ten (5.2%) developed HSS, none of whom died. Two factors were independently associated with an increased risk of HSS: history of allergy to nevirapine (OR 8.1, 95% CI 1.6-40.5, p = 0.02), and being naïve to ART (OR 5.8, 95% CI 1.2-28.5, p = 0.04). This study "in the real world" confirms that the incidence of ABC-induced HSS is of about 5%. It also confirms that HSS occurs more frequently in patients with a history of allergy to nevirapine and in ART-naïve patients.

  6. High glycemic index and glycemic load are associated with moderately increased cancer risk.

    Science.gov (United States)

    Turati, Federica; Galeone, Carlotta; Gandini, Sara; Augustin, Livia S; Jenkins, David J A; Pelucchi, Claudio; La Vecchia, Carlo

    2015-07-01

    To obtain an up-to-date quantification of the association between dietary glycemic index (GI) and glycemic load (GL) and the risk of cancer. We conducted a systematic review and meta-analysis of observational studies updated to January 2015. Summary relative risks (RRs) were derived using random effects models. Seventy-five reports were evaluated in the systematic review (147,090 cases), and 72 were included in the meta-analyses by cancer site. Considering hormone-related cancers, summary RRs comparing the highest versus the lowest GI and GL intake were, respectively, 1.05 and 1.07 for breast, 1.13 and 1.17 for endometrial, 1.11 and 1.19 for ovarian, and 1.06 and 1.04 for prostate cancers. Considering digestive-tract cancers, summary RRs for GI and GL were, respectively, 1.46 and 1.25 for esophageal (squamous cell carcinoma), 1.17 and 1.10 for stomach, 1.16 (significant) and 1.10 for colorectal, 1.11 and 1.14 for liver, and 1.10 and 1.01 for pancreatic cancers. In most of these meta-analyses, significant heterogeneity among studies was observed. In subgroup analyses, case-control studies and studies from Europe tended to estimate higher RRs. High-GI and high-GL diets are related to moderately increased risk of cancer at several common sites. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. IIHS side crash test ratings and occupant death risk in real-world crashes.

    Science.gov (United States)

    Teoh, Eric R; Lund, Adrian K

    2011-10-01

    To evaluate how well the Insurance Institute for Highway Safety (IIHS) side crash test ratings predict real-world occupant death risk in side-impact crashes. The IIHS has been evaluating passenger vehicle side crashworthiness since 2003. In the IIHS side crash test, a vehicle is impacted perpendicularly on the driver's side by a moving deformable barrier simulating a typical sport utility vehicle (SUV) or pickup. Injury ratings are computed for the head/neck, torso, and pelvis/leg, and vehicles are rated based on their ability to protect occupants' heads and resist occupant compartment intrusion. Component ratings are combined into an overall rating of good, acceptable, marginal, or poor. A driver-only rating was recalculated by omitting rear passenger dummy data. Data were extracted from the Fatality Analysis Reporting System (FARS) and National Automotive Sampling System/General Estimates System (NASS/GES) for the years 2000-2009. Analyses were restricted to vehicles with driver side air bags with head and torso protection as standard features. The risk of driver death was computed as the number of drivers killed (FARS) divided by the number involved (NASS/GES) in left-side impacts and was modeled using logistic regression to control for the effects of driver age and gender and vehicle type and curb weight. Death rates per million registered vehicle years were computed for all outboard occupants and compared by overall rating. Based on the driver-only rating, drivers of vehicles rated good were 70 percent less likely to die when involved in left-side crashes than drivers of vehicles rated poor, after controlling for driver and vehicle factors. Compared with vehicles rated poor, driver death risk was 64 percent lower for vehicles rated acceptable and 49 percent lower for vehicles rated marginal. All 3 results were statistically significant. Among components, vehicle structure rating exhibited the strongest relationship with driver death risk. The vehicle

  8. 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

  9. [Absolute risk for fracture and WHO guideline. Fracture risk assessments recommended by World Health Organization and Japanese guidelines for prevention and treatment of osteoporosis 2006].

    Science.gov (United States)

    Nakamura, Toshitaka

    2007-07-01

    Bone mineral density (BMD) is a strong predictor of osteoporotic fractures. However, the increase in fracture risk is not steep, rather gentle, for the decline in BMD values. Postmenopausal women with osteopenia (T scores between - 2.5 and - 1.0) may also be at risk. Case finding strategies such as the combination of BMD and appropriate clinical risk factors for fracture are shown to identify subjects at high fracture risk. World Health Organization developed a fracture risk assessment tool, recommending its exploitation in the case findings. Under these circumstances, Japan guideline 2006 provided new criteria for the pharmacological intervention to prevent fragility fracture, besides the conventional criteria for diagnosing osteoporosis.

  10. Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood

    Science.gov (United States)

    Silva, Kellen Cristine; Nobre, Luciana Neri; Vicente, Sofia Emanuelle de Castro Ferreira; Moreira, Lidiane Lopes; Lessa, Angelina do Carmo; Lamounier, Joel Alves

    2016-01-01

    Abstract Objective: To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. Methods: Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil). Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (pindex was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04). No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. Conclusions: The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study. PMID:27215968

  11. Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood.

    Science.gov (United States)

    Silva, Kellen Cristine; Neri Nobre, Luciana; Emanuelle de Castro Ferreira Vicente, Sofia; Lopes Moreira, Lidiane; do Carmo Lessa, Angelina; Alves Lamounier, Joel

    2016-09-01

    To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil). Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (pindex was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04). No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force.

    Science.gov (United States)

    Cavazzotto, Timothy Gustavo; Brasil, Marcos Roberto; Oliveira, Vinicius Machado; da Silva, Schelyne Ribas; Ronque, Enio Ricardo V; Queiroga, Marcos Roberto; Serassuelo Junior, Helio

    2014-03-01

    To investigate the agreement between two international criteria for classification of children and adolescents nutritional status. The study included 778 girls and 863 boys aged from six to 13 years old. Body mass and height were measured and used to calculate the body mass index. Nutritional status was classified according to the cut-off points defined by the World Health Organization and the International Obesity Task Force. The agreement was evaluated using Kappa statistic and weighted Kappa. In order to classify the nutritional status, the agreement between the criteria was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index varied according to age. When the nutritional status was classified in only two categories--appropriate (thinness + accentuated thinness + eutrophy) and overweight (overweight + obesity + severe obesity)--, the Kappa index presented higher values than those related to the classification in six categories. A substantial agreement was observed between the criteria, being higher in males and varying according to the age.

  13. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia

    Science.gov (United States)

    Huang, Ya-Kai; Kang, Wei-Ming; Ma, Zhi-Qiang; Liu, Yu-Qin; Zhou, Li; Yu, Jian-Chun

    2016-01-01

    Abstract Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized. A case–control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted. After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24–2.81) and women (adjusted OR = 2.72, 95% CI = 1.44–5.16). The 2 highest BMI categories (27.5–29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5–29.9: adjusted OR = 1.78, 95% CI = 1.02–3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27–5.08) and women (BMI = 27.5–29.9: adjusted OR = 2.88, 95% CI = 1.27–6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36–5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25–3.14) and women (adjusted OR = 2.88, 95% CI = 1.43–5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25–2.69) in women. Increased BMI was associated with an increased risk

  14. Past and future trends in cancer and biomedical research: a comparison between Egypt and the World using PubMed-indexed publications

    Directory of Open Access Journals (Sweden)

    Zeeneldin Ahmed Abdelmabood

    2012-07-01

    Full Text Available Abstract Background PubMed is a free web literature search service that contains almost 21 millions of abstracts and publications with almost 5 million user queries daily. The purposes of the study were to compare trends in PubMed-indexed cancer and biomedical publications from Egypt to that of the world and to predict future publication volumes. Methods The PubMed was searched for the biomedical publications between 1991 and 2010 (publications dates. Affiliation was then limited to Egypt. Further limitation was applied to cancer, human and animal publications. Poisson regression model was used for prediction of future number of publications between 2011 and 2020. Results Cancer publications contributed 23% to biomedical publications both for Egypt and the world. Egyptian biomedical and cancer publications contributed about 0.13% to their world counterparts. This contribution was more than doubled over the study period. Egyptian and world’s publications increased from year to year with rapid rise starting the year 2003. Egyptian as well as world’s human cancer publications showed the highest increases. Egyptian publications had some peculiarities; they showed some drop at the years 1994 and 2002 and apart from the decline in the animal: human ratio with time, all Egyptian publications in the period 1991-2000 were significantly more than those in 2001-2010 (P  Conclusions The Egyptian contribution to world’s biomedical and cancer publications needs significant improvements through research strategic planning, setting national research priorities, adequate funding and researchers’ training.

  15. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  16. Vulnerability Index to Climate Change and its Application for Community-level Risk Assessment in Thailand

    Directory of Open Access Journals (Sweden)

    Atsamon Limsakul

    2014-06-01

    Full Text Available On the basis of the vulnerability-led approach, the Prevalent Community-level Vulnerability Index (PCVI was developed as a simple composite index used to represent community-level vulnerability to climate change in the socioeconomic and hazard contexts. The PCVI consists of three major components which are Exposure & hazard, Socioeconomic-ecological fragility and Coping capacity. All of these components are further comprised of different indicators, representing different aspects of biophysical and social vulnerability of grass-root communities. Based on the results analyzed in the provincial pilot sites, the PCVI could represent both spatial patterns and magnitudes of vulnerability of each community in consistence with the local economic-social-environmental contexts. It generally reflects the differences in the local contexts and factors that determine overall vulnerability of each community. For the ease in calculating the PCVI especially for the provincial operating staffs and general public, the PREvalent Community Climate Change Vulnerability Tool (RECCC was further developed as a user-friendly, Excel-based program. In conclusions, the outputs of this study that include the PCVI and its database as well as the RECCC program are useful not only for analyzing vulnerability and assessing risks of community to climate change, but also for supporting decision-making process in developing and implementing adaptation activities at provincial level. These outputs were also designed for further integrating as a supplementary part of Provincial�s Decision Supporting System (DSS, with the purpose of promoting the participation of local organizations and stakeholders in coping with the adverse impacts of climate change. However, additional development of ERCCC program, together with dissemination of the vulnerability framework as well as the use of ERCCC program to local organizations needs to be continued.

  17. TIMI Risk Index as a Predictor of 30-Day Outcomes in Patients With Acute Pulmonary Embolism.

    Science.gov (United States)

    Zuin, Marco; Conte, Luca; Picariello, Claudio; Pastore, Gianni; Vassiliev, Dobrin; Lanza, Daniela; Zonzin, Pietro; Zuliani, Giovanni; Rigatelli, Gianluca; Roncon, Loris

    2018-02-01

    Available studies have already identified age, heart rate (HR) and systolic blood pressure (SBP) as strong predictors of early mortality in acute pulmonary embolism (PE). One-hundred-seventy patients, with acute PE confirmed on computed tomography angiography (CTA) were enrolled. Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) was calculated using the formula [heart rate (HR) x (AGE/102)/ systolic blood pressure (SBP)]. Study outcomes were 30-day mortality and/or clinical deterioration. Receiver operating characteristics (ROC) curve revealed that a TRI ≥45 was highly specific for both outcomes (AUC 0.91, 95% CI 0.83-0.98, p<0.0001) with a positive predictive value (PPV) and negative predictive value (NPV) of 8.3 and 96% for 30-day mortality while PPV and NPV for 30-day mortality and/or clinical deterioration were 21.1 and 98.2%, respectively. Multivariate regression analysis showed that TRI ≥45 was an independent predictor of 30-day mortality (O.R. 22.24, 95% CI 2.54-194.10, p=0.005) independently from positive cTnI and RVD (O.R. 9.57, 95% CI 1.88-48.78, p=0.007; OR 24.99, 95% CI 2.84-219.48, p=0.004). Similarly, 30-day mortality and/or clinical deterioration was predicted by TRI ≥45 (O.R. 11.57, 95% CI 2.36-56.63, p=0.003) and thrombolysis (3.83, 95% CI 1.04-14.09, p=0.043), independently from age, RVD and positive cTnI. Cox regression analysis confirmed the role of TRI as independent predictor for both outcomes. Mantel-Cox analysis showed that after 30-day follow-up there was a statistically significant difference in the distribution of survival between patients with and without TRI ≥45 [log rank (Mantel-Cox) chi-square 17.04, p<0.0001]. Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) predicted both 30-days mortality (all-causes) and/or clinical deterioration in patients with acute PE. Copyright © 2017. Published by Elsevier B.V.

  18. Body Mass Index and Risk of Nonalcoholic Fatty Liver Disease: Two Electronic Health Record Prospective Studies

    Science.gov (United States)

    Kabadi, Shaum; Preiss, David; Hyde, Craig; Bonato, Vinicius; St. Louis, Matthew; Desai, Jigar; Gill, Jason M. R.; Welsh, Paul; Waterworth, Dawn

    2016-01-01

    Context: The relationship between rising body mass index (BMI) and prospective risk of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is virtually absent. Objective: Determine the extent of the association between BMI and risk of future NAFLD diagnosis, stratifying by sex and diabetes. Design: Two prospective studies using Humedica and Health Improvement Network (THIN) with 1.54 and 4.96 years of follow-up, respectively. Setting: Electronic health record databases. Participants: Patients with a recorded BMI measurement between 15 and 60 kg/m2, and smoking status, and 1 year of active status before baseline BMI. Patients with a diagnosis or history of chronic diseases were excluded. Interventions: None. Main Outcome Measure: Recorded diagnosis of NAFLD/NASH during follow-up (Humedica International Classification of Diseases, Ninth Revision code 571.8, and read codes for NAFLD and NASH in THIN). Results: Hazard ratios (HRs) were calculated across BMI categories using BMI of 20–22.5 kg/m2 as the reference category, adjusting for age, sex, and smoking status. Risk of recorded NAFLD/NASH increased linearly with BMI and was approximately 5-fold higher in Humedica (HR = 4.78; 95% confidence interval, 4.17–5.47) and 9-fold higher in THIN (HR = 8.93; 7.11–11.23) at a BMI of 30–32.5 kg/m2 rising to around 10-fold higher in Humedica (HR = 9.80; 8.49–11.32) and 14-fold higher in THIN (HR = 14.32; 11.04–18.57) in the 37.5- to 40-kg/m2 BMI category. Risk of NAFLD/NASH was approximately 50% higher in men and approximately double in those with diabetes. Conclusions: These data quantify the consistent and strong relationships between BMI and prospectively recorded diagnoses of NAFLD/NASH and emphasize the importance of weight reduction strategies for prevention and management of NAFLD. PMID:26672639

  19. Epidemiology, incidence and mortality of oral cavity and lips cancer and their relationship with the human development index in the world

    Directory of Open Access Journals (Sweden)

    Fariba Ramezani Siakholak

    2016-10-01

    Full Text Available Introduction: According to the importance of knowledge about incidence and mortality of oral cavity and lip cancer in health planning, this study was performed with the aim of investigating the incidence and mortality rate of oral cavity and lip cancer and its relation with the Human Development Index in the world in 2012. Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components. Data about the age-specific incidence and mortality rate (ASR for every country in 2012 were getting from the global cancer project. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. Results: In 2012, 300373 cases of oral cavity and lip cancer and 145353 cases of death from it have occurred in the world. A positive correlation of 0.221 was seen between the standardized incidence rate of oral cavity and lip cancer and HDI but this correlation was not statistically significant (p=0.114. On the other side, a correlation of 0.295 was seen between the standardized mortality rate of oral cavity and lip cancer with HDI that this correlation was statistically significant (p<0.001. Conclusion: The incidence and mortality of oral cavity cancer is high in the Asian countries especially south eastern of Asia. Performing preventive plans in high incidence and mortality rate regions and also obtaining etiological studies in these regions is recommended for diagnosing the causes of high incidence and mortality rates. [Biomed Res Ther 2016; 3(10.000: 872-888

  20. Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study.

    Science.gov (United States)

    van Dam, R M; Visscher, A W; Feskens, E J; Verhoef, P; Kromhout, D

    2000-09-01

    To examine whether a high dietary glycemic index is associated with hyperinsulinemia, hyperglycemia, dyslipidemia and coronary heart disease (CHD) risk in elderly men. Prospective study of incidence of major CHD (non-fatal myocardial infarction or death due to CHD) between 1985 and 1995 in 646 men, and a cross-sectional analysis of metabolic risk factors in 1990 in 394 men. Population based study in the Dutch town Zutphen. Men aged 64-84 y in 1985 without a history of CHD or diabetes, whose diet was assessed with the cross-check dietary history method. The dietary glycemic index was positively correlated with consumption (g carbohydrate) of wheat bread (r=0.47) and sugar products (r=0.41) and inversely with fruit (r=-0.37) and milk (r=-0.40) consumption. During 4527 person-years of follow-up, 94 cases of CHD were documented. The risk ratio for CHD was 1.11 (95% CI, 0.66-1.87) for the highest as compared to the lowest tertile of glycemic index after correction for age, body mass index, physical activity, cigarette smoking, and dietary factors (P (trend)=0.70). Furthermore, the glycemic index was not appreciably associated with blood concentrations of total cholesterol, HDL-cholesterol, triacylglycerols or (fasting or postload) insulin or glucose. Our findings do not support the hypothesis that a high-glycemic-index diet unfavorably affects metabolic risk factors or increases risk for CHD in elderly men without a history of diabetes or CHD.

  1. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies.

    Science.gov (United States)

    Aune, D; Chan, D S M; Lau, R; Vieira, R; Greenwood, D C; Kampman, E; Norat, T

    2012-04-01

    Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. We searched the PubMed database for prospective studies of carbohydrate, glycemic index, and glycemic load and colorectal cancer risk, up to October 2011. Summary relative risks were estimated by the use of a random effects model. We identified 14 cohort studies that could be included in the meta-analysis of carbohydrate, glycemic index, and glycemic load and colorectal cancer risk. The summary RR for high versus low intake was 1.00 (95% CI: 0.87-1.14, I2 = 31%) for carbohydrate, 1.07 (95% CI: 0.99-1.16, I2 = 28%) for glycemic index, and 1.00 (95% CI: 0.91-1.10, I2 = 39%) for glycemic load. In the dose-response analysis, the summary RR was 0.95 (95% CI: 0.84-1.07, I2 = 58%) per 100 grams of carbohydrate per day, 1.07 (95% CI: 0.99-1.15, I2 = 39%) per 10 glycemic index units, and 1.01 (95% CI: 0.95-1.08, I2 = 47%) per 50 glycemic load units. Exclusion of one or two outlying studies reduced the heterogeneity, but the results were similar. This meta-analysis of cohort studies does not support an independent association between diets high in carbohydrate, glycemic index, or glycemic load and colorectal cancer risk.

  2. The risk of malignancy index (RMI) in women with adnexal masses in Wales.

    Science.gov (United States)

    Abdulrahman, Ganiy Opeyemi; McKnight, Liam; Lutchman Singh, Kerryn

    2014-09-01

    To evaluate the accuracy of the risk of malignancy index (RMI) which combines serum CA-125 levels, ultrasound score, and menopausal state, in discriminating between benign and malignant adnexal masses in the Welsh population. Two hundred and forty-seven women with pelvic masses discussed consecutively at the South West Wales Gynaecological Oncology multidisciplinary meeting between January 2010 and June 2011 were included in this retrospective study. The main outcomes were surgical and pathological findings. The sensitivity and specificity of CA-125 at 35kU/L were 76% and 67%, respectively. CA-125 was found to be a relevant predictor of malignancy but the area under the receiver operating characteristic curve for each of the risk of malignancy indices was greater than the area for the CA-125 serum levels alone. Each of the RMIs has a different optimal threshold, however using a threshold of 200, RMI 1 had a sensitivity of 66% and a specificity of 91%; RMI 2 had a sensitivity of 74% and a specificity of 79%; and RMI 3 had a sensitivity of 68% and a specificity of 85%. This is the first study in Wales to evaluate the RMI in triaging women with pelvic masses. Overall, RMI 1 and RMI 2 are better malignancy predictors than RMI 3. It would be recommended that RMI 1 and RMI 2 be compared in a head-to-head prospective study, although we suspect that RMI 1 is likely to be the overall best malignancy predictor. Copyright © 2014. Published by Elsevier B.V.

  3. 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

  4. High glycemic index diet as a risk factor for depression: analyses from the Women's Health Initiative.

    Science.gov (United States)

    Gangwisch, James E; Hale, Lauren; Garcia, Lorena; Malaspina, Dolores; Opler, Mark G; Payne, Martha E; Rossom, Rebecca C; Lane, Dorothy

    2015-08-01

    The consumption of sweetened beverages, refined foods, and pastries has been shown to be associated with an increased risk of depression in longitudinal studies. However, any influence that refined carbohydrates has on mood could be commensurate with their proportion in the overall diet; studies are therefore needed that measure overall intakes of carbohydrate and sugar, glycemic index (GI), and glycemic load. We hypothesized that higher dietary GI and glycemic load would be associated with greater odds of the prevalence and incidence of depression. This was a prospective cohort study to investigate the relations between dietary GI, glycemic load, and other carbohydrate measures (added sugars, total sugars, glucose, sucrose, lactose, fructose, starch, carbohydrate) and depression in postmenopausal women who participated in the Women's Health Initiative Observational Study at baseline between 1994 and 1998 (n = 87,618) and at the 3-y follow-up (n = 69,954). We found a progressively higher dietary GI to be associated with increasing odds of incident depression in fully adjusted models (OR for the fifth compared with first quintile: 1.22; 95% CI: 1.09, 1.37), with the trend being statistically significant (P = 0.0032). Progressively higher consumption of dietary added sugars was also associated with increasing odds of incident depression (OR for the fifth compared with first quintile: 1.23; 95% CI: 1.07, 1.41; P-trend = 0.0029). Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression, and nonwhole/refined grain consumption was associated with increased odds of depression. The results from this study suggest that high-GI diets could be a risk factor for depression in postmenopausal women. Randomized trials should be undertaken to examine the question of whether diets rich in low-GI foods could serve as treatments and primary preventive measures for depression in postmenopausal women.

  5. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey

    Science.gov (United States)

    2012-01-01

    Background Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. Methods This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002–2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Results Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Conclusions Disaggregated analysis of the prevalence of non

  6. Health risks of climate change in the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

    Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

  7. 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.

  8. Saturated Fat Intake Modulates the Association between an Obesity Genetic Risk Score and Body Mass Index in Two US Populations

    OpenAIRE

    P. Casas-Agustench; Arnett, Dk; Smith, CE; Lai, CQ; Parnell, LD; Borecki, IB; Frazier-Wood, AC; Allison, M; Chen, YDI; Taylor, Kd; Rich, SS; Rotter, JI; Lee, YC; Ordovás, JM

    2014-01-01

    © 2014 Academy of Nutrition and Dietetics. 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 D...

  9. Development of a Risk Index for Serious Prescription Opioid‐Induced Respiratory Depression or Overdose in Veterans’ Health Administration Patients

    Science.gov (United States)

    Xie, Lin; Wang, Li; Joyce, Andrew; Vick, Catherine; Brigham, Janet; Kariburyo, Furaha; Baser, Onur; Murrelle, Lenn

    2015-01-01

    Abstract Objective Develop a risk index to estimate the likelihood of life‐threatening respiratory depression or overdose among medical users of prescription opioids. Subjects, Design, and Methods A case‐control analysis of administrative health care data from the Veterans’ Health Administration identified 1,877,841 patients with a pharmacy record for an opioid prescription between October 1, 2010 and September 30, 2012. Overdose or serious opioid‐induced respiratory depression (OSORD) occurred in 817. Ten controls were selected per case (n = 8,170). Items for an OSORD risk index (RIOSORD) were selected through logistic regression modeling, with point values assigned to each predictor. Modeling of risk index scores produced predicted probabilities of OSORD; risk classes were defined by the predicted probability distribution. Results Fifteen variables most highly associated with OSORD were retained as items, including mental health disorders and pharmacotherapy; impaired drug metabolism or excretion; pulmonary disorders; specific opioid characteristics; and recent hospital visits. The average predicted probability of experiencing OSORD ranged from 3% in the lowest risk decile to 94% in the highest, with excellent agreement between predicted and observed incidence across risk classes. The model's C‐statistic was 0.88 and Hosmer–Lemeshow goodness‐of‐fit statistic 10.8 (P > 0.05). Conclusion RIOSORD performed well in identifying medical users of prescription opioids within the Veterans’ Health Administration at elevated risk of overdose or life‐threatening respiratory depression, those most likely to benefit from preventive interventions. This novel, clinically practical, risk index is intended to provide clinical decision support for safer pain management. It should be assessed, and refined as necessary, in a more generalizable population, and prospectively evaluated. PMID:26077738

  10. Development of a Risk Index for Serious Prescription Opioid-Induced Respiratory Depression or Overdose in Veterans' Health Administration Patients.

    Science.gov (United States)

    Zedler, Barbara; Xie, Lin; Wang, Li; Joyce, Andrew; Vick, Catherine; Brigham, Janet; Kariburyo, Furaha; Baser, Onur; Murrelle, Lenn

    2015-08-01

    Develop a risk index to estimate the likelihood of life-threatening respiratory depression or overdose among medical users of prescription opioids. A case-control analysis of administrative health care data from the Veterans' Health Administration identified 1,877,841 patients with a pharmacy record for an opioid prescription between October 1, 2010 and September 30, 2012. Overdose or serious opioid-induced respiratory depression (OSORD) occurred in 817. Ten controls were selected per case (n = 8,170). Items for an OSORD risk index (RIOSORD) were selected through logistic regression modeling, with point values assigned to each predictor. Modeling of risk index scores produced predicted probabilities of OSORD; risk classes were defined by the predicted probability distribution. Fifteen variables most highly associated with OSORD were retained as items, including mental health disorders and pharmacotherapy; impaired drug metabolism or excretion; pulmonary disorders; specific opioid characteristics; and recent hospital visits. The average predicted probability of experiencing OSORD ranged from 3% in the lowest risk decile to 94% in the highest, with excellent agreement between predicted and observed incidence across risk classes. The model's C-statistic was 0.88 and Hosmer-Lemeshow goodness-of-fit statistic 10.8 (P > 0.05). RIOSORD performed well in identifying medical users of prescription opioids within the Veterans' Health Administration at elevated risk of overdose or life-threatening respiratory depression, those most likely to benefit from preventive interventions. This novel, clinically practical, risk index is intended to provide clinical decision support for safer pain management. It should be assessed, and refined as necessary, in a more generalizable population, and prospectively evaluated. © 2015 The Authors Pain Medicine published by Wiley Periodicals, Inc. on behalf of American Academy of Pain Medicine.

  11. Dietary glycemic index and load in relation to cardiovascular disease risk factors in Cuban American population.

    Science.gov (United States)

    Huffman, Fatma G; Zarini, Gustavo G; Cooper, Vanessa

    2010-11-01

    To examine whether dietary glycemic index (GI) or glycemic load (GL) had an effect on the cardiovascular disease (CVD) risk factors and whether the effects were dependent on the diabetes status in the Cuban American population. A case–control, single-time-point study. A total of 324 middle-aged Cuban American adults had completed data on fasting blood lipids, physical activity level and usual dietary intake using a validated food frequency questionnaire. Published GI values were assigned to food items and average dietary GI and GL were calculated per participant. Subjects without type 2 diabetes (T2D) were 3.3 times more likely to be in the recommended, highest high-density lipoprotein-cholesterol category if they were in the second dietary GL tertile as compared with those in the first dietary GL tertile (P = 0.042, 95% confidence interval = 1.94, 10.78). The results of the present study suggest that in this sample of Cuban Americans a high GI or GL diet do not adversely affects blood lipids, especially among subjects without T2D.

  12. 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.

  13. Body mass index and depressive symptoms: instrumental-variables regression with genetic risk score.

    Science.gov (United States)

    Jokela, M; Elovainio, M; Keltikangas-Järvinen, L; Batty, G D; Hintsanen, M; Seppälä, I; Kähönen, M; Viikari, J S; Raitakari, O T; Lehtimäki, T; Kivimäki, M

    2012-11-01

    The causal role of obesity in the development of depression remains uncertain. We applied instrumental-variables regression (Mendelian randomization) to examine the association of adolescent and adult body mass index (BMI) with adult depressive symptoms. Participants were from the Young Finns prospective cohort study (n = 1731 persons, 2844 person-observations), with repeated measurements of BMI and depressive symptoms (modified Beck's Depression Inventory). Genetic risk score of 31 single nucleotide polymorphisms previously identified as robust genetic markers of body weight was used as a proxy for variation in BMI. In standard linear regression analysis, higher adult depressive symptoms were predicted by higher adolescent BMI (B = 0.33, CI = 0.06-0.60, P = 0.017) and adult BMI (B = 0.47, CI = 0.32-0.63, P regression (P = 0.04). These findings provide additional evidence to support a causal role for high BMI in increasing symptoms of depression. However, the present analysis also demonstrates potential limitations of applying Mendelian randomization when using complex phenotypes. © 2012 The Authors. Genes, Brain and Behavior © 2012 Blackwell Publishing Ltd and International Behavioural and Neural Genetics Society.

  14. 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.

  15. 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.

  16. Diagnostic Performance of Body Mass Index Using the Western Pacific Regional Office of World Health Organization Reference Standards for Body Fat Percentage

    OpenAIRE

    Yoon, Jong Lull; Cho, Jung Jin; Park, Kyung Mi; Noh, Hye Mi; Park, Yong Soon

    2015-01-01

    Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic pe...

  17. Quantitative Evaluation and Case Study of Risk Degree for Underground Goafs with Multiple Indexes considering Uncertain Factors in Mines

    Directory of Open Access Journals (Sweden)

    Longjun Dong

    2017-01-01

    Full Text Available The accidents caused by underground goafs are frequent and destructive due to irregular geometric shapes and complex spatial distributions, which caused severe damage to the environment and public health. Based on the theories of uncertainty measurement evaluation (WME and analytic hierarchy process (AHP, the comprehensive risk evaluation of underground goafs was carried out using multiple indexes. Considering the hydrogeological conditions, mining status, and engineering parameters of underground goafs, the evaluation index system was established to evaluate the risk degrees considering quantified uncertain factors. The single index measurement values were solved by the semiridge measurement function. The weights for evaluation vectors were calculated through the entropy theory and AHP. Finally, the risk level was evaluated according to the credible degree recognition criterion (CDRC and the maximum membership principle. The risk levels of 37 underground goafs in Dabaoshan mine were evaluated using 4 coupled methods. The order for underground goafs risk degrees was ranked and classified on account of the uncertainty important degree. According to the ranked order, the reasonability of 4 coupled methods was evaluated quantitatively. Results show that the UME-CDRC can be applied in the practical engineering, which provides an efficient guidance to both reduce the accident risk and improve the mining environment.

  18. Activity of 30 different cheeses on cholesterol plasma levels and Oxidative Balance Risk Index (OBRI) in a rat model.

    Science.gov (United States)

    Cornelli, Umberto; Bondiolotti, Gianpietro; Battelli, Giovanna; Zanoni, Giuseppe; Finco, Annarosa; Recchia, Martino

    2015-01-01

    Cheese is considered to increase the total cholesterol levels (CH) due to the high-saturated fat content. New models are needed to measure the relationship between cholesterol and cheese. Thirty different cheeses produced in Val Brembana, Italy ("furmai da mut", "caprino" and "stracchino"), were added to the diet of 30 groups of 4 rats. Cheeses were analyzed to differentiate the volatile organic compounds (VOCs) and the cholesterol content (Ch(f)). The body weight, CH, urine volume and oxidative balance were measured. Three new indexes in relation to CH were calculated: OI (oxidative index), PI (protective index) and OBRI (oxidative balance risk index). None of the cheeses increased CH. Some of the "furmai de mut" were significantly decreasing CH and improved the oxidative balance. Ch(f) was not affecting the CH levels in plasma. In terms of VOCs, the acetic acid content was correlated (p cheese can reduce significantly CH levels and improve the antioxidant capacity.

  19. 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

    . 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......OBJECTIVE: To develop and validate a new feasible comorbidity index based on self-reported information suited for preoperative risk assessment of ovarian cancer patients. METHODS: The study was based on patient self-reported data from ovarian cancer patients registered in the Danish Gynecological...... survival in the development cohort, and regression coefficients were used to construct a new weighted comorbidity index. The index was applied to the validation cohort, and its predictive ability in regard to overall and cancer-specific five-year-survival was investigated. Finally, the performance...

  20. Body Mass Index Increases Risk of Colorectal Adenomas in Men With Lynch Syndrome : The GEOLynch Cohort Study

    NARCIS (Netherlands)

    Botma, Akke; Nagengast, Fokko M.; Braem, Marieke G. M.; Hendriks, Jan C. M.; Kleibeuker, Jan H.; Vasen, Hans F. A.; Kampman, Ellen

    2010-01-01

    Purpose High body mass index (BMI) is an established risk factor for sporadic colorectal cancer. Still, the influence of BMI on hereditary colorectal cancer (eg, Lynch syndrome [LS]), is unknown. The objective of this study was to assess whether BMI is associated with colorectal adenoma occurrence

  1. Body mass index increases risk of colorectal adenomas in men with lunch syndrome: the GEOLynch cohort study

    NARCIS (Netherlands)

    Botma, A.; Nagengast, F.M.; Braem, M.G.M.; Hendriks, J.C.M.; Kleibeuker, J.H.; Vasen, H.F.A.; Kampman, E.

    2010-01-01

    Purpose: High body mass index (BMI) is an established risk factor for sporadic colorectal cancer. Still, the influence of BMI on hereditary colorectal cancer (eg, Lynch syndrome [LS]), is unknown. The objective of this study was to assess whether BMI is associated with colorectal adenoma occurrence

  2. Diagnostic accuracy of risk of malignancy index in predicting complete tumor removal at primary debulking surgery for ovarian cancer patients

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Håkansson, Fanny; Antonsen, Sofie L

    2013-01-01

    to investigate whether the risk of malignancy index (RMI) was a useful marker for this evaluation. RMI and surgical outcome were investigated in 164 patients, 49 of whom had no residual tumor after PDS. The receiver operating characteristic curve showed an area under the curve of 0.72 (confidence interval: 0...

  3. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European prospective investigation into cancer and nutrition cohort

    NARCIS (Netherlands)

    Cust, Anne E.; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Noethlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quiros, J. Ramon; Jakszyn, Paula; Sanchez, Maria Jose; Larranaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfalt, Elisabet; Berglund, Goran; Lundin, Eva; Hallmans, Goeran; Bueno-de-Mesquita, H. Bas; Du, Huaidong; Peeters, Petra H. M.; Bingham, Shelia; Khaw, Kay-Tee; Allen, Naomi E.; Key, Timothy J.; Jenab, Mazda; Riboli, Elio

    2007-01-01

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004),

  4. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies.

    NARCIS (Netherlands)

    Aune, D.; Chan, D.S.; Lau, R.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    BACKGROUND: Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. METHODS: We searched the PubMed database for

  5. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk : a systematic review and meta-analysis of cohort studies

    NARCIS (Netherlands)

    Aune, D.; Chan, D.S.M.; Lau, R.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    Background Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. Methods We searched the PubMed database for prospective

  6. The Nursing Home Pneumonia Risk Index: A Simple, Valid MDS-Based Method of Identifying 6-Month Risk for Pneumonia and Mortality.

    Science.gov (United States)

    Sloane, Philip D; Zimmerman, Sheryl; Ward, Kimberly; Reed, David; Preisser, John S; Weber, David J

    2017-09-01

    Pneumonia is the leading infectious cause of hospitalization and death for nursing home (NH) residents; however, diagnosis is often delayed because classic signs of infection are not present. We sought to identify NH residents at high risk for pneumonia, to identify persons to target for more intensive surveillance and preventive measures. Based on a literature review, we identified key risk factors for pneumonia and compiled them for use as prediction tool, limiting risk factors to those available on the Minimum Data Set (MDS). Next, we tested the tool's ability to predict 6-month pneumonia incidence and mortality rates in a sample of 674 residents from 7 NHs, evaluating it both as a continuous and a dichotomous variable, and applying both logistic regression and survival analysis to calculate estimates. NH Pneumonia Risk Index scores ranged from -1 to 6, with a mean of 2.1, a median of 2, and a mode of 2. For the outcome of pneumonia, a 1-point increase in the index was associated with a risk odds ratio of 1.26 (P = .038) or a hazard ratio of 1.24 (P = .037); using it as a dichotomous variable (≤2 vs ≥3), the corresponding figures were a risk odds ratio of 1.78 (P = .045) and a hazard ratio of 1.82 (P = .025). For the outcome of mortality, a 1-point increase in the NH Pneumonia Risk Index was associated with a risk odds ratio of 1.58 (P = .002) and a hazard ratio of 1.45 (P = .013); using the index as a dichotomous variable, the corresponding figures were a risk odds ratio of 3.71 (P < .001) and a hazard ratio of 3.29 (P = .001). The NH Pneumonia Risk Index can be used by NH staff to identify residents for whom to apply especially intensive preventive measures and surveillance. Because of its strong association with mortality, the index may also be valuable in care planning and discussion of advance directives. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. Perceived key injury risk factors in World Cup alpine ski racing--an explorative qualitative study with expert stakeholders.

    Science.gov (United States)

    Spörri, Jörg; Kröll, Josef; Amesberger, Günter; Blake, Ollie M; Müller, Erich

    2012-12-01

    There is limited knowledge about key injury risk factors in alpine ski racing, particularly for World Cup (WC) athletes. This study was undertaken to compile and explore perceived intrinsic and extrinsic risk factors for severe injuries in WC alpine ski racing. Qualitative study. Interviews were conducted with 61 expert stakeholders of the WC ski racing community. Experts' statements were collected, paraphrased and loaded into a database with inductively derived risk factor categories (Risk Factor Analysis). At the end of the interviews, experts were asked to name those risk factors they believed to have a high potential impact on injury risk and to rank them according to their priority of impact (Risk Factor Rating). In total, 32 perceived risk factors categories were derived from the interviews within the basic categories Athlete, Course, Equipment and Snow. Regarding their perceived impact on injury risk, the experts' top five categories were: system ski, binding, plate and boot; changing snow conditions; physical aspects of the athletes; speed and course setting aspects and speed in general. Severe injuries in WC alpine ski racing can have various causes. This study compiled a list of perceived intrinsic and extrinsic risk factors and explored those factors with the highest believed impact on injury risk. Hence, by using more detailed hypotheses derived from this explorative study, further studies should verify the plausibility of these factors as true risk factors for severe injuries in WC alpine ski racing.

  8. Perceived key injury risk factors in World Cup alpine ski racing—an explorative qualitative study with expert stakeholders

    Science.gov (United States)

    Spörri, Jörg; Kröll, Josef; Amesberger, Günter; Blake, Ollie M; Müller, Erich

    2012-01-01

    Background There is limited knowledge about key injury risk factors in alpine ski racing, particularly for World Cup (WC) athletes. Objective This study was undertaken to compile and explore perceived intrinsic and extrinsic risk factors for severe injuries in WC alpine ski racing. Methods Qualitative study. Interviews were conducted with 61 expert stakeholders of the WC ski racing community. Experts’ statements were collected, paraphrased and loaded into a database with inductively derived risk factor categories (Risk Factor Analysis). At the end of the interviews, experts were asked to name those risk factors they believed to have a high potential impact on injury risk and to rank them according to their priority of impact (Risk Factor Rating). Results In total, 32 perceived risk factors categories were derived from the interviews within the basic categories Athlete, Course, Equipment and Snow. Regarding their perceived impact on injury risk, the experts’ top five categories were: system ski, binding, plate and boot; changing snow conditions; physical aspects of the athletes; speed and course setting aspects and speed in general. Conclusions Severe injuries in WC alpine ski racing can have various causes. This study compiled a list of perceived intrinsic and extrinsic risk factors and explored those factors with the highest believed impact on injury risk. Hence, by using more detailed hypotheses derived from this explorative study, further studies should verify the plausibility of these factors as true risk factors for severe injuries in WC alpine ski racing. PMID:22872684

  9. 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 obesity grade I (BMI 30.0 to obesity grade II (BMI 35.0 to obesity grade III (BMI≥40.0), 1.82 (95% CI, 1.46-2.26). The rates of 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

  10. 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.

  11. [Assessment of the prevalence of atherosclerotic lower limb arteriopathy in France as a systolic index in a vascular risk population].

    Science.gov (United States)

    Boccalon, H; Lehert, P; Mosnier, M

    2000-02-01

    Obliterative arteriopathy of the lower limbs is a severe disease. History taking often underestimates prevalence. In studies using the Rose questionnaire and examining the prevalence of symptomatic arteriopathy defined by the presence of intermittent claudication, prevalence has been rather constant, around 2% in the general population in industrialized countries. A more clinical approach searching for physical anomalies (absence of distal pulse) generally gives higher rates. The most recent data led us to conduct a study focusing on screening for arterial disease using the systolic index (the systolic index is the ratio between the ankle and humeral systolic pressure). A systolic index below 0.90 would be a sign of defective perfusion, increasing in severity with poorly compensated arterial lesions. A survey was performed in a random sample of 150 practitioners using an allocation procedure to the nearest colleague in case of refusal. A data sheet containing demographic data and the main risk factors was established for each consulting patient aged from 40 to 80 years. The systolic index was measured in each patient with at least one vascular risk or who consulted for pain in the lower limbs. A simple sequential non-randomized patient recruitment scheme was used. The survey population included nearly 9,000 patients (8,987), 46% men and 54% women, mean age 64 years (table I). Patient risk factors including smoking, diabetes, hypertension, and physical exercise were adjusted for sex and age (table II-VI, IX). The systolic index was recorded in 41% of the population who had a vascular risk factor. Among these patients, nearly one-fourth had a systolic index under 0.90, giving a prevalence in the sample population of 11% (table VII). This rate was also assessed by age and sex (table VIII). Logistic regression evidenced a prognostic value (fig. 1) for smoking, hypertension and sedentary activity, and to a lesser extent, for age and sex. There was a significant

  12. Glycemic Index, Carbohydrates, Glycemic Load, and the Risk of Pancreatic Cancer in a Prospective Cohort Study

    National Research Council Canada - National Science Library

    Li Jiao; Andrew Flood; Amy F. Subar; Albert R. Hollenbeck; Arthur Schatzkin; Rachael Stolzenberg-Solomon

    2009-01-01

    .... Insulin resistance has been implicated in the etiology of pancreatic cancer. We prospectively investigated the associations between glycemic index, carbohydrates, glycemic load, and available carbohydrates dietary constituents...

  13. 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 ...

  14. 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...

  15. Health effects of World Trade Center (WTC) Dust: An unprecedented disaster's inadequate risk management.

    Science.gov (United States)

    Lippmann, Morton; Cohen, Mitchell D; Chen, Lung-Chi

    2015-07-01

    The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings' huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80-90% of the settled WTC Dust, ranging in particle size from ∼2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures.

  16. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children.

    Science.gov (United States)

    Marković-Jovanović, Snežana R; Stolić, Radojica V; Jovanović, Aleksandar N

    2015-05-01

    Body mass index (BMI) is the most widespread and the simplest method for the evaluation of body mass; it is often used as a sole technique in the diagnosis of obesity in children. The objective of the study was to evaluate the relationship between anthropometric and biochemical parameters and the incidence of the metabolic syndrome in obese children. A total of 110 children, aged 2-17 years, participated in the study. No overweight children (BMI 85-95 percentiles) were included. BMI was interpreted using the 2000 Centers for Disease Control and Prevention Growth Charts. The skinfold measurements were performed using an John Bull British Indicators Ltd. calipers, and interpreted using an the reference table values. In addition to lower sensitivity (mentioned in several earlier studies), BMI also shows a lower specificity in the diagnosis of obesity in children: BMI showed at least 10% of non-concomitance with skinfold thickness and waist circumferences and 8% with waist-to-height ratio. In addition, subscapular skinfold thickness, waist circumference, and waist/height ratio showed stronger correlations with serum insulin levels, low-density lipoprotein cholesterol, and family history than BMI itself. The unreliability of BMI as the sole parameter for diagnosing obesity in children was found in our study. Even when overweight children were excluded from the study, the lack of specificity of BMI was demonstrated. We propose utilization of waist circumference and waist/height ratio along with the BMI for definitive diagnosis instead of relying on BMI only. In addition, waist circumference and subscapular fold thickness may be even better in estimation of metabolic risk than BMI.

  17. 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.

  18. 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

  19. 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.

  20. Hedging Weather Risk for Corn Production in Northeastern China: The Efficiency of Weather-indexed Insurance

    NARCIS (Netherlands)

    Sun, Baojing; Guo, Changhao; Kooten, van G.C.

    2014-01-01

    Purpose – The paper analyzes the hedging efficiency of weather-indexed insurance for corn production in Northeast of China. The purpose of this paper is to identify the potential weather variables that impact corn yields and to analyze the efficiency of weather-indexed insurance under varying

  1. Hazards of Nature, Risks to Development : An IEG Evaluation of World Bank Assistance for Natural Disasters

    OpenAIRE

    Independent Evaluation Group

    2006-01-01

    The World Bank's Independent Evaluation Group examined the World Bank's experience in disaster prevention and response over the past 20 years and found that the scale of Bank operations has grown over the period. The report found that the Bank has demonstrated considerable flexibility in its approach, but actions have tended to be more reactive than proactive, with disaster response taking...

  2. Worlds Fantastic, Worlds Familiar

    Science.gov (United States)

    Buratti, Bonnie J.

    2017-02-01

    Introduction; 1. Mercury: the hottest little place; 2. Venus: an even hotter place; 3. Mars: the abode of life?; 4. Asteroids and comets: sweat the small stuff; 5. Galileo's treasures: worlds of fire and ice; 6. Enceladus: an active iceball in space; 7. Titan: an Earth in deep freeze?; 8. Iapetus and its friends: the weirdest 'planets' in the Solar System; 9. Pluto: the first view of the 'third zone'; 10. Earths above: the search for exoplanets and life in the universe; Epilogue; Glossary; Acknowledgements; Index.

  3. Design and methods of the GLYNDIET study; assessing the role of glycemic index on weight loss and metabolic risk markers.

    Science.gov (United States)

    Juanola-Falgarona, Martí; Ibarrola-Jurado, Núria; Salas-Salvadó, Jordi; Rabassa-Soler, Antoni; Bulló, Mònica

    2013-01-01

    Glycemic index and/or glycemic load have been explored as an alternative for the prevention and/or management of obesity, cardiovascular disease, type 2 diabetes mellitus, and cancer. The purpose of the manuscript is to describe the design and methods used in the GLYNDIET Project, a study designed to simultaneously address the questions related to the exactly role of low glycaemic index carbohydrates has on weight loss. This study was designed as a 6-months randomized, parallel, controlled clinical trial aiming to evaluate the effect of the dietary glycemic index on weightloss, satiety, glucose and insulin metabolism, lipid profile, inflammation and other emergent metabolic risk markers. Eligible subjects were community-dwelling men and women aged between 30 and 60 years, with a body mass index between 27 and 35 kg/m2. Subjects were randomly assigned to three different dietary intervention groups (low glycemic index diet, high glycemic index diet or low-fat diet), that were isocaloric, and did not differ in the amount of dietary fibre. Monthly, study subjects were scheduled for control visits where anthropometry, blood pressure, dietary habits, satiety and physical activity were assessed. Blood, urine and subcutaneous adipose tissue samples were collected at baseline and at the end of the study to further molecular and biochemical measurements. The GLYNDIET study was designed to determine if there is a greater effectiveness of a carbohydrate restricted diet with low glycemic index compared to an isocaloric diet with carbohydrates of high glycemic index or low-fat diet on weight loss in middle long-term. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  4. Skinfolds and coronary heart disease risk factors are more strongly associated with BMI than with the body adiposity index.

    Science.gov (United States)

    Freedman, David S; Ogden, Cynthia L; Goodman, Alyson B; Blanck, Heidi M

    2013-01-01

    A recent, cross-sectional analysis of adults found that the hip circumference divided by height(1.5) minus 18 (the body adiposity index, BAI) was strongly correlated (r = 0.79) with percent body fat determined by dual energy X-ray absorptiometry. The BAI was proposed as a more accurate index of body fatness than BMI. We examined whether BAI was more strongly related, than was BMI and waist circumference, to skinfold thicknesses and levels of various risk factors for coronary heart disease. Cross-sectional analyses of adults (n = 14,263 for skinfold thickness; n=6291 for fasting lipid levels) in the National Health and Nutrition Examination Survey (NHANES) III, 1988-1994. As compared with BMI and waist circumference, we found that BAI was less strongly associated with the skinfold sum and with risk factor levels. For example, correlations with the skinfold sum were r = 0.79 (BMI) vs. r = 0.70 (BAI) among men, and r = 0.86 (BMI) vs. r = 0.79 (BAI) among women; p BMI and waist circumference than BAI in analyses stratified by sex, race-ethnicity and age. Multivariable analyses indicated that if BMI was known, BAI provided little additional information on risk factor levels. Based on the observed associations with risk factor levels and skinfold thicknesses, we conclude that BAI is unlikely to be a better index of adiposity than BMI. Copyright © 2012 The Obesity Society.

  5. 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.

  6. 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.

  7. A dynamic process of health risk assessment for business continuity management during the World Exposition Shanghai, China, 2010.

    Science.gov (United States)

    Sun, Xiaodong; Keim, Mark; Dong, Chen; Mahany, Mollie; Guo, Xiang

    2014-01-01

    Reports of health issues related to mass gatherings around the world have indicated a potential for public health and medical emergencies to occur on a scale that could place a significant impact on business continuity for national and international organisations. This paper describes a risk assessment process for business continuity management that was performed as part of the planning efforts related to the World Expo 2010 Shanghai China (Expo), the world's largest mass gathering to date. Altogether, 73 million visitors attended the Expo, generating over US$2bn of revenue. During 2008 to 2010, the Shanghai Municipal Center for Disease Control and Prevention performed a dynamic series of four disaster risk assessments before and during the Expo. The purpose of this assessment process was to identify, analyse and evaluate risks for public health security during different stages of the Expo. This paper describes an overview of the novel approach for this multiple and dynamic process of assessment of health security risk for ensuring business continuity.

  8. [Ankle-brachial index screening for peripheral artery disease in high cardiovascular risk patients. Prospective observational study of 370 asymptomatic patients at high cardiovascular risk].

    Science.gov (United States)

    Rada, C; Oummou, S; Merzouk, F; Amarir, B; Boussabnia, G; Bougrini, H; Benzaroual, D; Elkarimi, S; Elhattaoui, M

    2016-12-01

    Peripheral arterial disease is a marker of systemic atherosclerosis; it is associated with a high risk of cardiovascular disease. The aim of our study was to assess the prevalence of peripheral arterial disease by measuring the ankle-brachial pressure index in patients at high cardiovascular risk and to study the risk factors associated with this disease. This was a descriptive and analytic cross-sectional study which focused on 370 patients seen at the medical consultation for atherosclerosis prevention. The ankle-brachial index was measured with a portable Doppler (BIDOP 3) using 4 and 8Hz dual frequency probes. The standards were: normal ankle-brachial index 0.9 to 1.3; peripheral artery obstructive disease ankle-brachial index less than 0.9; poorly compressible artery (medial arterial calcification) ankle-brachial index greater than 1.3. Cardiovascular risk factors were also studied. Three hundred and seventy subjects (mean age 65.5±8.7years) were screened Cardiovascular risk factors were: sedentary lifestyle (91.5 %), hypertension (68.1 %), elevated LDL-cholesterolemia (36.3 %), diabetes (48.3 %) and tobacco smoking (33.8 %). The prevalence of peripheral artery disease was 32.4 % of which 77.5 % were asymptomatic. We found a significant correlation with smoking, diabetes, dyslipidemia and the presence of coronary artery disease or vascular cerebral disease. Screening for peripheral arterial disease (PAD) with the ankle-brachial index has increased the percentage of polyvascular patients from 6.2 to 29 %. Factors independently associated with PAD were advanced age, presence of cardiovascular disease, smoking and glycated hemoglobin. PAD is a common condition in people at high cardiovascular risk, the frequency of asymptomatic forms justifies the screening with pocket Doppler which is a simple, inexpensive and effective test to assess the overall cardiovascular risk. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition cohort.

    Science.gov (United States)

    Cust, Anne E; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Nöthlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quirós, J Ramón; Jakszyn, Paula; Sánchez, María José; Larrañaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfält, Elisabet; Berglund, Göran; Lundin, Eva; Hallmans, Göran; Bueno-de-Mesquita, H Bas; Du, Huaidong; Peeters, Petra H M; Bingham, Sheila; Khaw, Kay-Tee; Allen, Naomi E; Key, Timothy J; Jenab, Mazda; Riboli, Elio

    2007-10-15

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates p(heterogeneity) = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy.

  10. WORLD PORT INDEX Nineteenth Edition

    Science.gov (United States)

    2009-01-01

    the port. FIRST PORT OF ENTRY – A port where a vessel may enter and clear foreign goods and personnel through Customs and Immigration . For vessels...01 L Y Y 9865 PUERTO COLON PM 0922N 07953W 148 26068 M CB E N N N Y N H H M Y Y 9875 BAHIA DE LAS MINAS PM 0924N 07949W 148 26066 S RN F N N N Y N J D...08358W 147 27104 V OR G N N N Y N N N N 01 M Y N 10070 BAHIA HONDA CU 2258N 08310W 147 27102 M CN P Y N N Y N L J N 01 M Y Y 10080 CABANAS CU 2300N

  11. Risk of self-reported symptoms or diagnosis of active tuberculosis in relationship to low body mass index, diabetes and their co-occurrence.

    Science.gov (United States)

    Prince, L; Andrews, J R; Basu, S; Goldhaber-Fiebert, J D

    2016-10-01

    Globally, tuberculosis prevalence has declined, but its risk factors have varied across place and time - low body mass index (BMI) has persisted while diabetes has increased. Using India's National Family Health Survey (NFHS), wave 3 and World Health Survey (WHS) data, we examined their relationships to support projection of future trends and targeted control efforts. Multivariate logistic regressions at the individual level with and without diabetes/BMI interactions assessed the relationship between tuberculosis, diabetes and low BMI and the importance of risk factor co-occurrence. Population-level analyses examined how tuberculosis incidence and prevalence varied with diabetes/low BMI co-occurrence. In NFHS, diabetic individuals had higher predicted tuberculosis risks (diabetic vs. non-diabetic: 2.50% vs. 0.63% at low BMI; 0.81% vs. 0.20% at normal BMI; 0.37% vs. 0.09% at high BMI), which were not significantly different when modelled independently or allowing for risk modification with diabetes/low BMI co-occurrence. WHS findings were generally consistent. Population-level analysis found that diabetes/low BMI co-occurrence may be associated with elevated tuberculosis risk, although its predicted effect on tuberculosis incidence/prevalence was generally ≤0.2 percentage points and not robustly statistically significant. Concerns about the additional elevation of tuberculosis risk from diabetes/low BMI co-occurrence and hence the need to coordinate tuberculosis control efforts around the nexus of co-occurring diabetes and low BMI may be premature. However, study findings robustly support the importance of individually targeting low BMI and diabetes as part of ongoing tuberculosis control efforts. © 2016 John Wiley & Sons Ltd.

  12. Baseline risk has greater influence over behavioral attrition on the real-world clinical effectiveness of cardiac rehabilitation.

    Science.gov (United States)

    Biswas, Aviroop; Oh, Paul I; Faulkner, Guy E; Alter, David A

    2016-11-01

    Few studies have examined the correlates of real-world cardiac rehabilitation (CR) effectiveness. The objective of this study was to determine the relationship between baseline risk, behavioral attrition, and the number needed to treat (NNT) associated with CR. A retrospective study was conducted among 16,061 CR patients between 1995 and 2011 in Canada. Multiple logistic regression models were derived from patient characteristics and measured baseline risk (individual's risk of death within 3 years) and behavioral attrition (individual's risk of premature dropout). We examined the treatment efficacy of CR among nondropouts using a 20% relative risk reduction. Further sensitivity analyses were performed to assess the robustness of our assumptions. We assumed no efficacy among dropouts. Both baseline risk and behavioral attrition were independently associated with NNT, although baseline risk had a stronger association with NNT than behavioral attrition. Increasing age, lower baseline fitness, history of diabetes, hypertension, and greater comorbidities were associated with lower NNT. Being female, living alone, living in the lowest neighborhood income quintile, and greater adiposity were associated with higher NNT. The clinical effectiveness of CR is largely driven by the baseline risk rather than the behavioral attrition of the populations they serve. These findings have implications for risk stratification among those with greatest survival yields and programmatic needs. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women : a population-based follow-up study

    NARCIS (Netherlands)

    Beulens, Joline W. J.; de Bruijne, Leonie M.; Stolk, Ronald P.; Peeters, Petra H. M.; Bots, Michiel L.; Grobbee, Diederick E.; van der Schouw, Yvonne T.

    2007-01-01

    Objectives The goal of this work was to assess whether high dietary glycemic load and glycemic index are associated with an increased risk of cardiovascular disease (CVD). Background The associations of dietary glycemic index and glycemic load with risk of CVD are not well established, particularly

  14. 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....

  15. Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

    Science.gov (United States)

    Sacks, Frank M.; Carey, Vincent J.; Anderson, Cheryl A. M.; Miller, Edgar R.; Copeland, Trisha; Charleston, Jeanne; Harshfield, Benjamin J.; Laranjo, Nancy; McCarron, Phyllis; Swain, Janis; White, Karen; Yee, Karen; Appel, Lawrence J.

    2015-01-01

    IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. DESIGN, SETTING, AND PARTICIPANTS Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120–159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. INTERVENTIONS (1) A high–glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low–glycemic index (40%), high-carbohydrate diet; (3) a high–glycemic index, low-carbohydrate diet (40% energy); and (4) a low–glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. RESULTS At high dietary carbohydrate content, the low– compared with high–glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (−20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ≤ .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the

  16. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index.

    Science.gov (United States)

    Beckmann, Marianne; Jacomella, Vincenzo; Kohler, Malcom; Lachat, Mario; Salem, Amr; Amann-Vesti, Beatrice; Husmann, Marc

    2015-01-01

    Central augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures. To assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA). cAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease. In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006). Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease.

  17. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index.

    Directory of Open Access Journals (Sweden)

    Marianne Beckmann

    Full Text Available Central augmentation index (cAIx is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures.To assess and compare cAIx in patients with peripheral arterial disease (PAD and / or abdominal aortic aneurysm (AAA.cAIx was assessed by radial applanation tonometry (Sphygmocor in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease.In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (% was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55 than males (28.4 ± 8.2, n = 129, and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22 than in those under 80 years (30.0 ± 8.2, n = 162. Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5. cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006.Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease.

  18. Geriatric nutritional risk index, muscle function, quality of life and clinical outcome in hemodialysis patients.

    Science.gov (United States)

    Beberashvili, Ilia; Azar, Ada; Sinuani, Inna; Shapiro, Gregory; Feldman, Leonid; Sandbank, Judith; Stav, Kobi; Efrati, Shai

    2016-12-01

    The geriatric nutritional risk index (GNRI) has been reported as a useful predictor of prognosis in maintenance hemodialysis (MHD) patients, demonstrating GNRI less than 90 as a marker of a poorer nutritional status and significantly increased mortality. We tested whether GNRI as a whole associated stronger with clinical and laboratory surrogates of nutrition and inflammation, muscle function, health-related quality of life (QoL), and predicts all-cause and cardiovascular (CV) morbidity and mortality in this population better than its individual components (albumin and body weight to ideal body weight ratio). A prospective observational study with a median follow-up of 30 months (interquartile range - 19-41 months) was performed on 352 MHD outpatients (38.0% women) with a mean age of 67.4 ± 13.2 years. All-cause and cardiovascular hospitalization and mortality, GNRI, handgrip strength (HGS), body composition parameters (anthropometry and bioimpedance) and short form 36 (SF-36) quality-of-life scores were measured. Multivariate linear regression analyses were performed to obtain adjusted correlations. Receiver operating characteristic (ROC) curves were generated and multivariate Cox proportional hazards models were applied to identify the predictive value of GNRI and its components separately. GNRI positively correlated with total score (r = 0.15, P patients didn't stand up to multivariable adjustments. For each one unit increase in baseline GNRI levels, the first hospitalization hazard ratio (HR) after adjustments for confounders was 0.98 (95% confidence interval (CI), 0.97 to 0.99) and the first CV event HR was 0.98 (95% CI, 0.97 to 0.99); all-cause death HR was 0.97 (95% CI, 0.96 to 0.99) and CV death HR was 0.97 (95% CI, 0.95-0.99). Albumin was related to QoL and clinical outcomes with higher strength and magnitude than GNRI. Despite the significant relationship with clinical outcomes and QOL, GNRI is not better and is even slightly worse than albumin

  19. Leaf Area Index (LAI Estimation in Boreal Mixedwood Forest of Ontario, Canada Using Light Detection and Ranging (LiDAR and WorldView-2 Imagery

    Directory of Open Access Journals (Sweden)

    Paul Treitz

    2013-10-01

    Full Text Available Leaf Area Index (LAI is an important input variable for forest ecosystem modeling as it is a factor in predicting productivity and biomass, two key aspects of forest health. Current in situ methods of determining LAI are sometimes destructive and generally very time consuming. Other LAI derivation methods, mainly satellite-based in nature, do not provide sufficient spatial resolution or the precision required by forest managers for tactical planning. This paper focuses on estimating LAI from: (i height and density metrics derived from Light Detection and Ranging (LiDAR; (ii spectral vegetation indices (SVIs, in particular the Normalized Difference Vegetation Index (NDVI; and (iii a combination of these methods. For the Hearst Forest of Northern Ontario, in situ measurements of LAI were derived from digital hemispherical photographs (DHPs while remote sensing variables were derived from low density LiDAR (i.e., 1 m−2 and high spatial resolution WorldView-2 data (2 m. Multiple Linear Regression (MLR models were generated using these variables. Results from these analyses demonstrate: (i moderate explanatory power (i.e., R2 = 0.53 for LiDAR height and density metrics that have proven to be related to canopy structure; (ii no relationship when using SVIs; and (iii no significant improvement of LiDAR models when combining them with SVI variables. The results suggest that LiDAR models in boreal forest environments provide satisfactory estimations of LAI, even with narrow ranges of LAI for model calibration. Models derived from low point density LiDAR in a mixedwood boreal environment seem to offer a reliable method of estimating LAI at high spatial resolution for decision makers in the forestry community. This method can be easily incorporated into simultaneous modeling efforts for forest inventory variables using LiDAR.

  20. Dietary Carbohydrate, Glycemic Index, and Glycemic Load in Relation to Colorectal Cancer Risk in the Women’s Health Initiative

    Science.gov (United States)

    Kabat, Geoffrey C.; Shikany, James M.; Beresford, Shirley A. A.; Caan, Bette; Neuhouser, Marian L.; Tinker, Lesley F.; Rohan, Thomas E.

    2013-01-01

    Evidence implicating hyperinsulinemia and insulin resistance in the etiology of colorectal cancer suggests that a diet characterized by a high glycemic index and load may increase the risk of this disease, but previous studies have yielded inconsistent results. We assessed the association between intake of total carbohydrates, sugars, fiber, and the glycemic index (GI) and glycemic load (GL) of individual diets, and risk of developing colorectal cancer among 158,800 participants in the Women’s Health Initiative (WHI). We used a GI/GL database developed specifically for the WHI food-frequency questionnaire. Over an average of 7.8 years of follow-up, 1,476 incident cases of colorectal cancer were identified. Cox proportional hazards models were used to estimate the association between dietary factors classified by quintiles and risk of colorectal cancer, with adjustment for covariates. Total carbohydrate intake, glycemic index, glycemic load, and intake of sugars and fiber showed no association with colorectal cancer. Analyses by cancer subsite yielded null results, with the exception of a borderline positive association between glycemic load and rectal cancer (HR for the highest vs. lowest quintile 1.84, 95% confidence interval 0.95–3.56, p for trend 0.05). Analyses stratified by tertiles of body mass index and physical activity showed no evidence of effect modification by these factors. Results of this large study do not support of a role of a diet characterized by a high glycemic index or load in colorectal carcinogenesis in postmenopausal women. PMID:18618276

  1. Risk of Active Tuberculosis among Index Case of Householders-A Long-Term Assessment after the Conventional Contacts Study.

    Science.gov (United States)

    Puma, Daniela V; Pérez-Quílez, Olga; Roure, Sílvia; Martínez-Cuevas, Octavio; Bocanegra, Cristina; Feijoo-Cid, Maria; Valerio, Lluís

    2017-03-01

    The aim of this study was to determine the incidence of active tuberculosis (TB) among household contacts of TB-index cases diagnosed during a 7-year period in a public Primary Care Center located in a high-incidence area. A retrospective cohort study was performed. Data collection was based on the capture-recapture method; the two main sources crossed information from TB-index and contact cases from the El Fondo Primary Care Center (Santa Coloma de Gramenet, Spain) and their reports to the National Epidemiologic Surveillance Service. Variables were divided into demographic and health data (result of the Mantoux test, chest X-ray, presence of risk factors, and indication for chemoprophylaxis). Community nurses identified 103 household contacts that underwent the conventional contact study. Overall, 60.19% were male; the mean age was 29.08 years. Only one case of secondary active TB was found, representing an incidence of 0.56% per TB-index case and year. The incidence of new secondary TB among household contacts with TB-index cases was of a case. Nevertheless, a long-term follow-up of these householders beyond the conventional contacts study should be considered in areas with higher incidences of TB or among specific high-risk populations. © 2016 Wiley Periodicals, Inc.

  2. Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants

    OpenAIRE

    Lin, Pao-Hwa; Chen, Chuhe; Young, Deborah R.; Mitchell, Diane; Elmer, Patricia; Wang, Yanfang; Batch, Bryan; Champagne, Catherine

    2012-01-01

    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 par...

  3. Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women.

    OpenAIRE

    Lajous, Martin; Boutron-Ruault, Marie-Christine; Fabre, Alban; Clavel-Chapelon, Françoise; Romieu, Isabelle

    2008-01-01

    International audience; BACKGROUND: Diets high in carbohydrates may result in chronically elevated insulin concentrations and may affect breast cancer risk by stimulation of insulin receptors or through insulin-like growth factor I (IGF-I)-mediated mitogenesis. Insulin response to carbohydrate intake is increased in insulin-resistant states such as obesity. OBJECTIVE: We sought to evaluate carbohydrate intake, glycemic index (GI), and glycemic load (GL) and subsequent overall and hormone-rece...

  4. Continuous metabolic syndrome risk score, body mass index percentile, and leisure time physical activity in American children.

    Science.gov (United States)

    Okosun, Ike S; Boltri, John M; Lyn, Rodney; Davis-Smith, Monique

    2010-08-01

    The objective of this study was to determine independent and joint association of body mass index (BMI) percentile and leisure time physical activity (LTPA) with continuous metabolic syndrome (cMetS) risk score in 12- to 17-year-old American children. The 2003 to 2004 US National Health and Nutrition Examination Survey data were used for this investigation. LTPA was determined by self-report. cMetS risk score was calculated using standardized residuals of arterial blood pressure, triglycerides, glucose, waist circumference, and high-density lipoprotein cholesterol. Multiple linear regression analysis was used to evaluate association of BMI percentile and LTPA with cMetS risk score, adjusting for confounders. Increased BMI percentile and LTPA were each associated with increased and decreased cMetS risk score, respectively ((Pmetabolic syndrome in US children. (c) 2010 Wiley Periodicals, Inc.

  5. 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).

  6. 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.

  7. Bridging Two Worlds: Reconciling Practical Risk Assessment Methodologies with Theory of Attack Trees

    NARCIS (Netherlands)

    Gadyatskaya, Olga; Harpes, Carlo; Mauw, Sjouke; Muller, Cedric; Muller, Steve

    2016-01-01

    Security risk treatment often requires a complex cost-benefit analysis to be carried out in order to select countermeasures that optimally reduce risks while having minimal costs. According to ISO/IEC 27001, risk treatment relies on catalogues of countermeasures, and the analysts are expected to

  8. 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....

  9. Posttraumatic stress symptoms and body mass index among World Trade Center disaster-exposed smokers: A preliminary examination of the role of anxiety sensitivity.

    Science.gov (United States)

    Farris, Samantha G; Paulus, Daniel J; Gonzalez, Adam; Mahaffey, Brittain L; Bromet, Evelyn J; Luft, Benjamin J; Kotov, Roman; Zvolensky, Michael J

    2016-07-30

    Among individuals exposed to the World Trade Center (WTC) disaster on September 11, 2001, posttraumatic stress disorder (PTSD) and symptoms are both common and associated with increased cigarette smoking and body mass. However, there is little information on the specific processes underlying the relationship of PTSD symptoms with body mass. The current study is an initial exploratory test of anxiety sensitivity, the fear of internal bodily sensations, as a possible mechanism linking PTSD symptom severity and body mass index (BMI). Participants were 147 adult daily smokers (34.0% female) exposed to the WTC disaster (via rescue/recovery work or direct witness). The direct and indirect associations between PTSD symptom severity and BMI via anxiety sensitivity (total score and subscales of physical, cognitive, and social concerns) were examined. PTSD symptom severity was related to BMI indirectly via anxiety sensitivity; this effect was specific to physical concerns about the meaning of bodily sensations. Interventions focusing on anxiety sensitivity reduction (specifically addressing physical concerns about bodily sensations) may be useful in addressing elevated BMI among trauma-exposed persons. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15.

    Directory of Open Access Journals (Sweden)

    Laura D Howe

    2010-12-01

    Full Text Available Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and/or by vascular and metabolic changes from childhood overweight that persist into adulthood. Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence, and explore the extent to which these are mediated by fat mass at age 15.Using data from the Avon Longitudinal Study of Parents and Children, we estimated individual trajectories of ponderal index (PI from 0-2 years and BMI from 2-10 years using random-effects linear spline models (N = 4601. We explored associations between PI/BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years (systolic and diastolic blood pressure, fasting LDL- and HDL-cholesterol, triglycerides, C-reactive protein, glucose, insulin with and without adjustment for confounders. Changes in PI/BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15. BMI changes in childhood, but not PI changes from 0-2 years, were associated with most cardiovascular risk factors in adolescence; associations tended to be strongest for BMI changes in later childhood (ages 8.5-10, and were largely mediated by fat mass at age 15.Changes in PI/BMI from 0-10 years were associated with greater fat-mass at age 15. Greater increases in BMI from age 8.5-10 years are most strongly associated with cardiovascular risk factors at age 15, with much of these associations mediated by fat-mass at this age. We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk. This study suggests that associations between early overweight and subsequent adverse cardiovascular health are largely due to

  11. Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15.

    Science.gov (United States)

    Howe, Laura D; Tilling, Kate; Benfield, Li; Logue, Jennifer; Sattar, Naveed; Ness, Andy R; Smith, George Davey; Lawlor, Debbie A

    2010-12-08

    Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and/or by vascular and metabolic changes from childhood overweight that persist into adulthood. Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence, and explore the extent to which these are mediated by fat mass at age 15. Using data from the Avon Longitudinal Study of Parents and Children, we estimated individual trajectories of ponderal index (PI) from 0-2 years and BMI from 2-10 years using random-effects linear spline models (N = 4601). We explored associations between PI/BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years (systolic and diastolic blood pressure, fasting LDL- and HDL-cholesterol, triglycerides, C-reactive protein, glucose, insulin) with and without adjustment for confounders. Changes in PI/BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15. BMI changes in childhood, but not PI changes from 0-2 years, were associated with most cardiovascular risk factors in adolescence; associations tended to be strongest for BMI changes in later childhood (ages 8.5-10), and were largely mediated by fat mass at age 15. Changes in PI/BMI from 0-10 years were associated with greater fat-mass at age 15. Greater increases in BMI from age 8.5-10 years are most strongly associated with cardiovascular risk factors at age 15, with much of these associations mediated by fat-mass at this age. We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk. This study suggests that associations between early overweight and subsequent adverse cardiovascular health are largely due to overweight

  12. Using the World Health Organization Measles Programmatic Risk Assessment Tool for Monitoring of Supplemental Immunization Activities in the Philippines.

    Science.gov (United States)

    Ducusin, Maria Joyce U; de Quiroz-Castro, Maricel; Roesel, Sigrun; Garcia, Luzviminda C; Cecilio-Elfa, Dulce; Schluter, W William; Goodson, James L; Lam, Eugene

    2017-06-01

    In 2012, the World Health Organization Regional Committee for the Western Pacific Region (WPR) reaffirmed its commitment to eliminate measles and urged WPR member states to interrupt endemic measles virus transmission as rapidly as possible. In 2013, a large measles outbreak occurred in the Philippines despite implementation of measles elimination strategies including a nationwide supplemental immunization activity (SIA) in 2011 using measles- and rubella-containing vaccine and targeting children aged nine months to seven years. To prevent future measles outbreaks a new tool was developed to assess district-level risk for measles outbreaks, based on the WPR polio risk assessment tool previously applied in the Philippines. Risk was assessed as a function of combined indicator scores from four data input categories: population immunity, surveillance quality, program performance, and threat assessment. On the basis of the overall score, the tool assigned each district a risk category of low, medium, high, or very high. Of the 122 districts and highly urbanized cities in the Philippines, 58 (48%) were classified as high risk or very high risk, including the district of the Metro Manila area and Region 4A where the outbreak began in 2013. Risk assessment results were used to guide the monitoring and supervision during the nationwide SIA conducted in 2014. The initial tool drafted in the Philippines served as a template for development of the global risk assessment tool. Regular annual measles programmatic risk assessments can be used to help plan risk mitigation activities and measure progress toward measles elimination. © 2015 Society for Risk Analysis.

  13. Obesity, ultrasound indexes of fat depots and lipid goal attainment in patients with high and very high cardiovascular risk: A novel approach towards better risk reduction.

    Science.gov (United States)

    Haberka, M; Okopień, B; Gąsior, Z

    2016-02-01

    Our aim was to assess the attainment of primary (low density lipoprotein cholesterol; LDL-C) and secondary (non-high density lipoprotein cholesterol; non-HDL-C) lipid therapeutic goals in relation to obesity, clinical measures of adiposity and ultrasound indexes of fat depots, including the novel index of periarterial adipose tissue (PAT): carotid artery extra media thickness (EMT). High and very high cardiovascular (CV) risk patients (n = 420; F/M: 34/66%; age: 61.2 ± 7 years) with prior statin treatment (≥ 18 months) were enrolled into this cross-sectional study. All patients had a detailed assessment with several anthropometric measures and ultrasound indexes of fat depots indexed to BMI: abdominal (Intra-abdominal Fat Thickness; IAT and Pre-peritoneal Fat Thickness; PreFT), paracardial (Epicardial Fat Thickness; EFT and Pericardial Fat Thickness; PFT) and the new index corresponding to PAT (carotid EMT). Lipid goals attainment in the study group was as follows: 34% (LDL-C goal), 39% (non-HDL-C goal) and 35% (both LDL and non-HDL-C goals). Among ultrasound indexes, patients with both lipid goals attainment revealed significantly lower carotid EMT/BMI (LDL-C goal: 25.2 ± 4.2 vs 27.5 ± 4.1, p obesity and most clinical measures of adiposity, carotid EMT and abdominal IAT, but not other ultrasound indexes of fat depots revealed associations independent from BMI with lipid goal attainment and may help identify patients requiring more aggressive lipid management. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  14. Estimation of the Cardiovascular Risk Using World Health Organization/International Society of Hypertension (WHO/ISH Risk Prediction Charts in a Rural Population of South India

    Directory of Open Access Journals (Sweden)

    Arun Gangadhar Ghorpade

    2015-08-01

    Full Text Available Background World Health Organization/International Society of Hypertension (WHO/ISH charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pretested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1 years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion Categorizing people as low (20% risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

  15. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System

    Science.gov (United States)

    Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

    2015-01-01

    Background Little is known about the rate and pattern of injuries in international volleyball competition. Objective To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). Methods The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). Results The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Conclusions Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. PMID:26194501

  16. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System.

    Science.gov (United States)

    Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

    2015-09-01

    Little is known about the rate and pattern of injuries in international volleyball competition. To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. The Volcanic Hazards Assessment Support System for the Online Hazard Assessment and Risk Mitigation of Quaternary Volcanoes in the World

    Directory of Open Access Journals (Sweden)

    Shinji Takarada

    2017-12-01

    Full Text Available Volcanic hazards assessment tools are essential for risk mitigation of volcanic activities. A number of offline volcanic hazard assessment tools have been provided, but in most cases, they require relatively complex installation procedure and usage. This situation causes limited usage of volcanic hazard assessment tools among volcanologists and volcanic hazards communities. In addition, volcanic eruption chronology and detailed database of each volcano in the world are essential key information for volcanic hazard assessment, but most of them are isolated and not connected to and with each other. The Volcanic Hazard Assessment Support System aims to implement a user-friendly, WebGIS-based, open-access online system for potential hazards assessment and risk-mitigation of Quaternary volcanoes in the world. The users can get up-to-date information such as eruption chronology and geophysical monitoring data of a specific volcano using the direct link system to major volcano databases on the system. Currently, the system provides 3 simple, powerful and notable deterministic modeling simulation codes of volcanic processes, such as Energy Cone, Titan2D and Tephra2. The system provides deterministic tools because probabilistic assessment tools are normally much more computationally demanding. By using the volcano hazard assessment system, the area that would be affected by volcanic eruptions in any location near the volcano can be estimated using numerical simulations. The system is being implemented using the ASTER Global DEM covering 2790 Quaternary volcanoes in the world. The system can be used to evaluate volcanic hazards and move this toward risk-potential by overlaying the estimated distribution of volcanic gravity flows or tephra falls on major roads, houses and evacuation areas using the GIS-enabled systems. The system is developed for all users in the world who need volcanic hazards assessment tools.

  18. [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.

  19. Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction.

    Science.gov (United States)

    Kinugasa, Yoshiharu; Kato, Masahiko; Sugihara, Shinobu; Hirai, Masayuki; Yamada, Kensaku; Yanagihara, Kiyotaka; Yamamoto, Kazuhiro

    2013-01-01

    The clinical significance of nutritional risk assessment in patients with heart failure with preserved ejection fraction (HFpEF) remains undefined. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly subjects. Its predictive value was evaluated in patients with HFpEF, a common HF phenotype in the elderly population. The present study enrolled 152 consecutive patients (mean age, 77 ± 11 years; male, 53.9%) who were hospitalized with HFpEF at the authors' institution. GNRI on admission was calculated as follows: 14.89 × serum albumin (g/dl)+41.7×body mass index/22. Characteristics and mortality (median follow-up of 2.1 years) were compared between 2 groups: low GNRI (nutritional risk; and high GNRI (≥ 92) with no or low nutritional risk. Patients in the low-GNRI group were more often female, and had lower serum hemoglobin and sodium, but higher serum blood urea nitrogen (BUN), C-reactive protein, and B-type natriuretic peptide (BNP) compared to those in the high-GNRI group (Pindex was significantly lower in the low-GNRI group than the high-GNRI group (P<0.05). On Cox hazard analysis, lower GNRI predicted increased mortality independent of age, gender, prior HF hospitalization, and higher BUN and BNP (P<0.01).  GNRI may be useful for predicting functional dependency and mortality in patients with HFpEF.  

  20. FACTORS OF FOREIGN MILITARY INTERVENTION RISK ASSESSMENT IN THE MODERN WORLD

    Directory of Open Access Journals (Sweden)

    A. A. Ivanov

    2016-01-01

    Full Text Available The starting point of the conclusions of politicians and experts was the recognition of the changed nature of threats to the New World Order. In post-Westfalia system of international relations the main actors are not sovereigns, but transnational actors of world politics, including transnational terrorist and criminal networks. In this situation, the support of global security threat serves the underground world – terrorists, shady business structures, failed states. The unconventional nature of the threat to peace and stability of the New World Order requires an equally innovative response which transcends the formal constraints of international law and the traditional doctrine of deterrence. An analysis of the U.S. foreign policy concepts suggests that today’s academic and political community has promoted consensus of neoliberals and neoconservatives, supporters of the institutional functionalism and representatives of the school of Realpolitik. This consensus was based on the recognition of the admissibility of pre-emptive strikes on the territory of failed states, sponsoring international terrorism, or the implementation of open interference in the internal affairs of “rogue states” for human rights and democratic freedoms guarantee.

  1. The Swiss "Willensnation" at Risk: Teachers in the Cultural Gap during the First World War

    Science.gov (United States)

    Brühwiler, Ingrid

    2015-01-01

    As a neutral and multilingual country, Switzerland struggled with major domestic political conflicts during the First World War due to the two cultures of the French-speaking and German-speaking parts of the country. The divided cultural loyalties ("fossé moral", "Röstigraben"), consisting of Swiss-Germans supporting Germany…

  2. Self-reported symptoms and risk factors for digital ischaemia among international world-class beach volleyball players.

    Science.gov (United States)

    Van De Pol, Daan; Alaeikhanehshir, Sena; Maas, Mario; Kuijer, P Paul F M

    2016-01-01

    The prevalence of ischaemia-related symptoms is remarkably high among elite indoor volleyball players. Since the exposure to sport-specific demands may be higher in beach volleyball compared to indoor volleyball, the aim of this study was to assess the prevalence of ischaemia-related symptoms and associated risk factors among world-class beach volleyball players. Therefore, a questionnaire survey was performed among beach volleyball players active during the 2013 Grand Slam Beach Volleyball in the Netherlands. In total, 60 of the 128 beach volleyball players (47%) participated: 26 males and 34 females from 17 countries. The self-reported prevalence of cold or blue or pale digits in the dominant hand during or immediately after practice or competition was 38% (n = 23). Two risk factors were independently associated with symptoms of blue or pale digits: more than 14 years playing volleyball (odds ratio (OR) 4.42, 90% confidence interval (90% CI) 1.30-15.07) and sex (female) (OR 4.62, 90% CI 1.15-18.57). In conclusion, the prevalence of symptoms associated with digital ischaemia is high among international world-class beach volleyball players. Female sex and the length of the volleyball career were independently associated with an increased risk of ischaemia-related symptoms. The high prevalence of these seemingly innocuous symptoms and possible associated risk factors warrant regular monitoring since early detection can potentially prevent thromboembolic complications and irreversible tissue damage.

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

    African Journals Online (AJOL)

    userpc

    ABSTRACT. The lack of regular Control of pollution pr the environment. Vegetable Amaranth and of heavy metals (Mn, Zn, Cr, Fe, Cd, Pb, N selected areas in Kano state, Nigeria. Ato analyze the samples obtained. Six (6) para. Rate (DIR), Average daily Dose (ADD), Canc. Index (HI), were computed. 60, 05, 30, 50, found to ...

  4. BODE INDEX AND THE RISK OF OSTEOPOROTIC FRACTURES IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

    Directory of Open Access Journals (Sweden)

    E. V. Kochetova

    2016-01-01

    Full Text Available The goal of the study: to define theoretic correlation between BODE index in men with chronic obstructive pulmonary disease (COPD and risk of osteoporotic fractures assessed as per bone mineral density and FRAX integral rate.Materials and methods. 125 men suffering from COPD smoking for a long period of time (the smoker index of 240 and time of smoking (packs/years of 40 were included into the study. 10 year risk of osteoporotic fractures was assessed by FRAX software. The respiratory function was evaluated by the multi-module unit of MasterLab/Jaeger type. BODE index was defined in the patients.Results. The minimum level of BODE was observed in those suffering from COPD of the 2nd stage – 2.23 ± 0.88. In case of the 3rd stage of COPD BODE made 5.05 ± 1.19, in the 4th stage of COPD it made 7.0 ± 1.0. The maximum risk of fractures was detected in the patients of the 4th stage of COPD. The minimum risk of fractures was diagnosed in the patients of the 2nd stage of COPD. The confident correlations were found between BODE and bone mineral density (r = -0.71, p < 0.005, as well as confident correlations between BODE and the risk of fractures (r = -0.54, p < 0.05. Conclusions. The correlation has been found between BODE index and the risk of fractures. 

  5. 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

    2017-10-25

    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.

  6. Association of Gestational Weight Gain and Maternal Body Mass Index in Early Pregnancy With Risk for Nonaffective Psychosis in Offspring.

    Science.gov (United States)

    Mackay, Euan; Dalman, Christina; Karlsson, Håkan; Gardner, Renee M

    2017-04-01

    Prenatal exposure to famine is associated with a 2-fold risk for nonaffective psychoses. Less is known about whether maternal nutrition states during pregnancy modify offspring risk for nonaffective psychoses in offspring in well-fed populations. To determine whether gestational weight gain (GWG) during pregnancy and maternal body mass index (BMI) in early pregnancy are associated with risk for nonaffective psychoses in offspring. This population-based cohort study used data from Swedish health and population registers to follow up 526 042 individuals born from January 1, 1982, through December 31, 1989, from 13 years of age until December 31, 2011. Cox proportional hazards regression models adjusted for socioeconomic status and potential risk factors were used to examine the risk for developing nonaffective psychoses. Family-based study designs were used to further test causality. Data were analyzed from February 1 to May 14, 2016. Gestational weight gain during pregnancy, maternal body mass index at the first antenatal visit, and paternal body mass index at the time of conscription into the Swedish military (at 18 years of age). Hazard ratios (HRs) for the diagnosis of nonaffective psychoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20 to F29 and International Classification of Diseases, Ninth Revision [ICD-9] codes 295, 297 and 298, except 298A and 298B) and narrowly defined schizophrenia (ICD-9 code 295 and ICD-10 code F20). The 526 042 individuals in the cohort (48.52% female and 51.47% male; mean [SD] age, 26 [2.3] years) included 2910 persons with nonaffective psychoses at the end of follow-up, of whom 704 had narrowly defined schizophrenia. Among the persons with nonaffective psychosis, 184 (6.32%) had mothers with extremely inadequate GWG (early pregnancy was weakly associated with an increased risk for nonaffective psychosis in offspring (HR for BMI≥17.0 and <18.5, 1.21; 95% CI

  7. Flood risk in a changing world - a coupled transdisciplinary modelling framework for flood risk assessment in an Alpine study area

    Science.gov (United States)

    Huttenlau, Matthias; Schneeberger, Klaus; Winter, Benjamin; Pazur, Robert; Förster, Kristian; Achleitner, Stefan; Bolliger, Janine

    2017-04-01

    Devastating flood events have caused substantial economic damage across Europe during past decades. Flood risk management has therefore become a topic of crucial interest across state agencies, research communities and the public sector including insurances. There is consensus that mitigating flood risk relies on impact assessments which quantitatively account for a broad range of aspects in a (changing) environment. Flood risk assessments which take into account the interaction between the drivers climate change, land-use change and socio-economic change might bring new insights to the understanding of the magnitude and spatial characteristic of flood risks. Furthermore, the comparative assessment of different adaptation measures can give valuable information for decision-making. With this contribution we present an inter- and transdisciplinary research project aiming at developing and applying such an impact assessment relying on a coupled modelling framework for the Province of Vorarlberg in Austria. Stakeholder engagement ensures that the final outcomes of our study are accepted and successfully implemented in flood management practice. The study addresses three key questions: (i) What are scenarios of land- use and climate change for the study area? (ii) How will the magnitude and spatial characteristic of future flood risk change as a result of changes in climate and land use? (iii) Are there spatial planning and building-protection measures which effectively reduce future flood risk? The modelling framework has a modular structure comprising modules (i) climate change, (ii) land-use change, (iii) hydrologic modelling, (iv) flood risk analysis, and (v) adaptation measures. Meteorological time series are coupled with spatially explicit scenarios of land-use change to model runoff time series. The runoff time series are combined with impact indicators such as building damages and results are statistically assessed to analyse flood risk scenarios. Thus, the

  8. Climate Change, Disaster Risk, and the Urban Poor : Cities Building Resilience for a Changing World

    OpenAIRE

    Baker, Judy L.

    2012-01-01

    Poor people living in slums are at particularly high risk from the impacts of climate change and natural hazards. They live on the most vulnerable land within cities, typically areas deemed undesirable by others and thus affordable. This study analyzes the key challenges facing the urban poor, given the risks associated with climate change and disasters, particularly with regard to the del...

  9. Asthma predictive index and associated risk factors in under five-year-old children with recurrent wheezes

    Directory of Open Access Journals (Sweden)

    Mercedes Silva Rojas

    2016-01-01

    Full Text Available Background:children under five years old show frequent bronchial obstruction and many of them have transient wheezes without necessarily being asthmatic.Objective: to identify the predictive index criteria of bronchial asthma with recurrent wheezes and their associated risk factors in children under five years of age who were treated in “Aleida Fernández Chardiet” Teaching General Hospital in Güines, Mayabeque province.Methods: a descriptive and cross-sectional study was carried out to identify the predictive index criteria of bronchial asthma and their associated risk factors in all the children under five years old who were admitted because of recurrent wheezes in the respiratory diseases ward of the mentioned hospital from April, 2014 to April, 2015.Results: wheeze was most frequent in children under one year old (48,8 %, with a slight predominance of males (54,1 %. First line family history of bronchial asthma (48,1 %, atopic dermatitis (42,7 %, three or more episodes of wheezes not related to acute respiratory infections (60,3 %, and eosinophilia upper than 4 % (44,3 % showed the highest incidence. The most frequent associated risk factors were: nonexclusive breastfeeding up to six months (61 %, recurrent acute respiratory infections (60,3 %, inside home pollutants (90,8 % and environmental pollution (83,2 %.Conclusions: the predictive index criteria of bronchial asthma and their associated risk factors were identified in the children population studied. That will permit an adequate diagnosis, follow-up, therapeutics, and promoting actions to modify them.

  10. 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.

  11. 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.

  12. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  14. Relationship of nutritional risk, Body Mass Index (BMI), and cognitive functioning in preschoolers

    Science.gov (United States)

    Objective: To determine the relationships, if any, between nutritional risk, BMI z-score, and cognitive function in preschoolers. Background: Excessive adipose tissue found in obesity places children at increased health risk. Considerable research has documented that obesity leads to increased ri...

  15. 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

  16. Variation in the risk of progression between glycemic stages across different levels of body mass index: evidence from a United States electronic health records system.

    Science.gov (United States)

    Blume, Steven W; Li, Qian; Huang, Joanna C; Hammer, Mette; Graf, Thomas R

    2015-01-01

    The purpose of this study was to assess how the risks of glycemic stage transitions observed in clinical practice vary with body mass index (BMI). These transitions included progression from euglycemia ('normal') to prediabetes (PreD) and from PreD to type 2 diabetes (T2D), as well as from normal directly to T2D, and reversions from PreD to normal. We examined the Geisinger Health System electronic health records and insurance claims data, segmenting a subject's medical history into normal, PreD, and/or T2D glycemic stages via diagnosis codes, glycosylated hemoglobin A1c (HbA1c) or fasting plasma glucose lab results, and use of anti-diabetic drugs. Weibull survival models, adjusted for age, gender, race, and smoking, were used to estimate the glycemic progression hazard ratios for BMI categories relative to normal BMI. The sample included 32,864 adults with normal glycemic levels at baseline and 4483 with PreD. The adjusted hazard ratios for normal to PreD progression ranged from 1.8 (25 ≤ BMI glycemic transitions may be recognized after the true onset since periodic glycemic testing was not required across the study population. A positive association between the risks of progression along the glycemic continuum and BMI levels was observed in a real-world United States practice setting.

  17. 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.

  18. Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy.

    Science.gov (United States)

    Shinkawa, Hiroji; Takemura, Shigekazu; Uenishi, Takahiro; Sakae, Masayuki; Ohata, Kazunori; Urata, Yorihisa; Kaneda, Kazuhisa; Nozawa, Akinori; Kubo, Shoji

    2013-03-01

    Malnutrition has been considered a risk factor for the development of a surgical site infection (SSI). The aim of this study was to determine the relationship between preoperative nutritional screening scores and the development of SSI after pancreaticoduodenectomy. We examined 64 patients who had undergone pancreaticoduodenectomy. Their clinical data, nutritional risk index (NRI), and nutritional risk screening 2002 (NRS-2002) score were recorded. SSIs were diagnosed according to the definitions of wound infection established by the Center for Disease Control and Prevention and were confirmed by a microbiological examination. Data were analyzed using the Fisher exact probability method and a multivariate logistic regression analysis. SSIs developed in 21 patients (33 %). Eleven patients had wound infections, and 14 patients had an intra-abdominal abscess. A univariate analysis of perioperative factors revealed that a pancreatic fistula, the NRS-2002, and the NRI were significantly associated with the development of SSI (p risk factors for SSI. By analyzing the pre- and intra-operative factors after excluding the 11 patients with pancreatic fistulas, the NRI was still an independent risk factor for SSI. The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreaticoduodenectomy.

  19. Risk of large-for-gestational-age newborns in women with gestational diabetes by race and ethnicity and body mass index categories.

    Science.gov (United States)

    Sridhar, Sneha B; Ferrara, Assiamira; Ehrlich, Samantha F; Brown, Susan D; Hedderson, Monique M

    2013-06-01

    To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between 1995 and 2006 at Kaiser Permanente Northern California. The racial and ethnic groups were non-Hispanic white, African American, Hispanic, Asian, and Filipina. The BMI was classified using the World Health Organization International guidelines (normal, 18.50-24.99; overweight, 25.00-29.99; obese, 30.00-34.99; obese class II, 35.00 or higher). Having an LGA newborn was defined as birth weight more than 90th percentile for the study population's race or ethnicity and gestational age--specific birth weight distribution. Logistic regression was used to estimate odds of having an LGA newborn by BMI and race and ethnicity. Overall prevalence of LGA newborns was highest in African American women (25.1%), lowest in Asians (13.9%), and intermediate among Hispanic (17.3%), white (16.4%), and Filipina women (15.3%). The highest increased risk of LGA newborns was observed among women with class II obesity in most racial and ethnic groups, and African American and Asian women with class II obesity had a four-fold increased risk of LGA newborns compared with women of normal weight in the same racial and ethnic group. African American women with GDM have a greater risk of LGA newborns at a lower BMI than other racial and ethnic groups. Clinicians should be aware that among women with GDM, there may be significant racial and ethnic differences in the risk of LGA newborns by BMI threshold.

  20. 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.