Extreme rainfall, vulnerability and risk: a continental-scale assessment for South America

USGS Publications Warehouse

Vorosmarty, Charles J.; de Guenni, Lelys Bravo; Wollheim, Wilfred M.; Pellerin, Brian A.; Bjerklie, David M.; Cardoso, Manoel; D'Almeida, Cassiano; Colon, Lilybeth

2013-01-01

Extreme weather continues to preoccupy society as a formidable public safety concern bearing huge economic costs. While attention has focused on global climate change and how it could intensify key elements of the water cycle such as precipitation and river discharge, it is the conjunction of geophysical and socioeconomic forces that shapes human sensitivity and risks to weather extremes. We demonstrate here the use of high-resolution geophysical and population datasets together with documentary reports of rainfall-induced damage across South America over a multi-decadal, retrospective time domain (1960–2000). We define and map extreme precipitation hazard, exposure, affectedpopulations, vulnerability and risk, and use these variables to analyse the impact of floods as a water security issue. Geospatial experiments uncover major sources of risk from natural climate variability and population growth, with change in climate extremes bearing a minor role. While rural populations display greatest relative sensitivity to extreme rainfall, urban settings show the highest rates of increasing risk. In the coming decades, rapid urbanization will make South American cities the focal point of future climate threats but also an opportunity for reducing vulnerability, protecting lives and sustaining economic development through both traditional and ecosystem-based disaster risk management systems.

Familial correlates of extreme weight control behaviors among adolescents.

PubMed

Fonseca, Helena; Ireland, Marjorie; Resnick, Michael D

2002-12-01

To identify familial factors associated with extreme weight control among adolescents. Analysis of a comprehensive 1996 health survey of Connecticut students. Familial factors among extreme dieters who deliberately vomited, took diet pills, laxatives, or diuretics were compared with youth reporting none of these behaviors, using logistic regression controlling for age and body mass index. Nearly 7% of adolescents reported engaging in extreme weight control behaviors. Boys' risk factors included high parental supervision/monitoring and sexual abuse history. Protective factors included high parental expectations, maternal presence, and connectedness with friends and other adults. The only significant risk factor for girls was sexual abuse history. Protective factors included family connectedness, positive family communication, parental supervision/monitoring, and maternal presence. Extreme dieting appears to be less an expression of body composition than of psychosocial issues. That connectedness to family, other adults, and friends is protective further demonstrates interrelationships of extreme weight control behaviors with family/social issues. Copyright 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 441-448, 2002.

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

PubMed

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

2007-08-01

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

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding.

PubMed

Yuan, Xiao-Gang; Xie, Chuan; Chen, Jiang; Xie, Yong; Zhang, Kun-He; Lu, Nong-Hua

2015-01-01

A close association has been established between climate and peptic ulcer bleeding (PUB). The incidence of PUB in cold climates is significantly higher than that in hot climates. In this study, gastric mucosal damage and its barrier function (through associated barrier factors) in extreme climate conditions were examined to investigate the pathogenesis of PUB in extreme cold climates. Gastric juice and biopsy specimens were collected from 176 patients with peptic ulcer. Conventional hematoxylin and eosin staining was used to exclude malignant ulcers. Helicobacter pylori infections were detected by modified Giemsa staining. pH values of the gastric juice samples were obtained on-site by precise pH dipstick readings. The protein expression levels of heat shock protein (HSP) 70, occludin, nitric oxide synthase (NOS), epidermal growth factor (EGF) and EGF receptor (EGFR) in the gastric mucosa were detected by immunohistochemistry. No significant differences were identified between the high and low bleeding risk groups in the rates of H. pylori infection and the pH values of the gastric juices in the extreme hot or cold climates. Furthermore, no statistically significant differences were identified in the protein expression levels of occludin, NOS, EGF and EGFR between the high and low bleeding risk groups. In the extreme cold climate, the expression of HSP70 and the mucus thickness of the gastric antrum in the high bleeding risk group were significantly lower than those in the low bleeding risk group. The protein expression levels of occludin, HSP70, NOS and EGFR in the extreme cold climate were significantly lower than those in the extreme hot climate, whereas the gastric acid secretion was significantly higher in the extreme cold climate than that in the extreme hot climate. In conclusion, low expression of HSP70 in the gastric mucosa and reduced gastric mucus thickness may play key roles in the mechanism of PUB in extreme cold climates. The significant decrease in barrier factors and increase in damage in extreme cold climates may be associated with the seasonal pattern of peptic ulcers.

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding

PubMed Central

YUAN, XIAO-GANG; XIE, CHUAN; CHEN, JIANG; XIE, YONG; ZHANG, KUN-HE; LU, NONG-HUA

2015-01-01

A close association has been established between climate and peptic ulcer bleeding (PUB). The incidence of PUB in cold climates is significantly higher than that in hot climates. In this study, gastric mucosal damage and its barrier function (through associated barrier factors) in extreme climate conditions were examined to investigate the pathogenesis of PUB in extreme cold climates. Gastric juice and biopsy specimens were collected from 176 patients with peptic ulcer. Conventional hematoxylin and eosin staining was used to exclude malignant ulcers. Helicobacter pylori infections were detected by modified Giemsa staining. pH values of the gastric juice samples were obtained on-site by precise pH dipstick readings. The protein expression levels of heat shock protein (HSP) 70, occludin, nitric oxide synthase (NOS), epidermal growth factor (EGF) and EGF receptor (EGFR) in the gastric mucosa were detected by immunohistochemistry. No significant differences were identified between the high and low bleeding risk groups in the rates of H. pylori infection and the pH values of the gastric juices in the extreme hot or cold climates. Furthermore, no statistically significant differences were identified in the protein expression levels of occludin, NOS, EGF and EGFR between the high and low bleeding risk groups. In the extreme cold climate, the expression of HSP70 and the mucus thickness of the gastric antrum in the high bleeding risk group were significantly lower than those in the low bleeding risk group. The protein expression levels of occludin, HSP70, NOS and EGFR in the extreme cold climate were significantly lower than those in the extreme hot climate, whereas the gastric acid secretion was significantly higher in the extreme cold climate than that in the extreme hot climate. In conclusion, low expression of HSP70 in the gastric mucosa and reduced gastric mucus thickness may play key roles in the mechanism of PUB in extreme cold climates. The significant decrease in barrier factors and increase in damage in extreme cold climates may be associated with the seasonal pattern of peptic ulcers. PMID:25452787

Extreme Consumption Drinking Gaming and Prepartying among High School Students

ERIC Educational Resources Information Center

Tomaso, Cara C.; Zamboanga, Byron L.; Haas, Amie L.; Kenney, Shannon R.; Ham, Lindsay S.; Borsari, Brian

2016-01-01

Drinking games and prepartying (i.e., drinking before going to a social gathering/event) have emerged as high-risk drinking behaviors in high school students. The present study examines the current prepartying behaviors of high school students who report current participation in extreme-consumption games (e.g., chugging) with those who do not.…

Extremely preterm infants who are small for gestational age have a high risk of early hypophosphatemia and hypokalemia.

PubMed

Boubred, F; Herlenius, E; Bartocci, M; Jonsson, B; Vanpée, M

2015-11-01

Electrolyte balances have not been sufficiently evaluated in extremely preterm infants after early parenteral nutrition. We investigated the risk of early hypophosphatemia and hypokalemia in extremely preterm infants born small for gestational age (SGA) who received nutrition as currently recommended. This prospective, observational cohort study included all consecutive extremely preterm infants born at 24-27 weeks who received high amino acids and lipid perfusion from birth. We evaluated the electrolyte levels of SGA infants and infants born appropriate for gestational age (AGA) during the first five days of life. The 12 SGA infants had lower plasma potassium levels from Day One compared to the 36 AGA infants and were more likely to have hypokalemia (58% vs 17%, p = 0.001) and hypophosphatemia (40% vs 9%, p < 0.01) during the five-day observation period. After adjusting for perinatal factors, SGA remained significantly associated with hypophosphatemia (odds ratio 1.39, confidence intervals 1.07-1.81, p = 0.01). Extremely preterm infants born SGA who were managed with currently recommended early parenteral nutrition had a high risk of early hypokalemia and hypophosphatemia. Potassium and phosphorus intakes should be set at sufficient levels from birth onwards, especially in SGA infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Applying GIS to develop a model for forest fire risk: A case study in Espírito Santo, Brazil.

PubMed

Eugenio, Fernando Coelho; dos Santos, Alexandre Rosa; Fiedler, Nilton Cesar; Ribeiro, Guido Assunção; da Silva, Aderbal Gomes; dos Santos, Áureo Banhos; Paneto, Greiciane Gaburro; Schettino, Vitor Roberto

2016-05-15

A forest fire risk map is a basic element for planning and protecting forested areas. The main goal of this study was to develop a statistical model for preparing a forest fire risk map using GIS. Such model is based on assigning weights to nine variables divided into two classes: physical factors of the site (terrain slope, land-use/occupation, proximity to roads, terrain orientation, and altitude) and climatic factors (precipitation, temperature, water deficit, and evapotranspiration). In regions where the climate is different from the conditions of this study, the model will require an adjustment of the variables weights according to the local climate. The study area, Espírito Santo State, exhibited approximately 3.81% low risk, 21.18% moderate risk, 30.10% high risk, 41.50% very high risk, and 3.40% extreme risk of forest fire. The areas classified as high risk, very high and extreme, contemplated a total of 78.92% of heat spots. Copyright © 2016 Elsevier Ltd. All rights reserved.

Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients.

PubMed

Yi, Xiao-lei; Chen, Jie; Li, Jia; Feng, Liang; Wang, Yan; Zhu, Jia-An; Shen, E; Hu, Bing

2014-03-01

To investigate the incidence and risk factors for peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer. With the widespread use of peripherally inserted central venous catheters, peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer leads to increasing morbidity and mortality. It is very important to further explore the incidence and risk factors for peripherally inserted central venous catheters-related venous thrombosis. Consecutive patients with cancer who were scheduled to receive peripherally inserted central venous catheters, between September 2009 and May 2012, were prospectively studied in our centre. They were investigated for venous thrombosis by Doppler sonography three times a day within 30 days after catheter insertion. Univariable and multivariable logistic regressions' analyses were performed to identify the risk factors for peripherally inserted central venous catheters-related thrombosis. A total of 89 patients with cancer were studied in our research. Of these, 81 patients were followed up within one month. The mean interval between catheter insertion and the onset of thrombosis was 12.45 ± 6.17 days. The multivariable analyses showed that chemotherapy history, less activities and diabetes were the key risk factors for thrombosis. Peripherally inserted central venous catheters-related upper extremity venous thrombosis had high incidence rate, and most cases had no significant symptoms. The history of chemotherapy, less activities and diabetes were found to be the key risk factors. It should be routinely scanned in high-risk patients every 3-5 days after catheter insertion, which would then find blood clots in time and reduce the incidence of pulmonary embolism. Risk factors associated with peripherally inserted central venous catheters-related upper extremity venous thrombosis are of critical importance in improving the quality of patients' life. It is very important to grasp the indications to reduce the incidence rate of peripherally inserted central venous catheters-related upper extremity venous thrombosis. © 2013 John Wiley & Sons Ltd.

A Review of Recent Advances in Research on Extreme Heat Events

NASA Technical Reports Server (NTRS)

Horton, Radley M.; Mankin, Justin S.; Lesk, Corey; Coffel, Ethan; Raymond, Colin

2016-01-01

Reviewing recent literature, we report that changes in extreme heat event characteristics such as magnitude, frequency, and duration are highly sensitive to changes in mean global-scale warming. Numerous studies have detected significant changes in the observed occurrence of extreme heat events, irrespective of how such events are defined. Further, a number of these studies have attributed present-day changes in the risk of individual heat events and the documented global-scale increase in such events to anthropogenic-driven warming. Advances in process-based studies of heat events have focused on the proximate land-atmosphere interactions through soil moisture anomalies, and changes in occurrence of the underlying atmospheric circulation associated with heat events in the mid-latitudes. While evidence for a number of hypotheses remains limited, climate change nevertheless points to tail risks of possible changes in heat extremes that could exceed estimates generated from model outputs of mean temperature. We also explore risks associated with compound extreme events and nonlinear impacts associated with extreme heat.

Adverse events during air and ground neonatal transport: 13 years' experience from a neonatal transport team in Northern Sweden.

PubMed

van den Berg, Johannes; Olsson, Linn; Svensson, Amelie; Håkansson, Stellan

2015-07-01

To study the prevalence of adverse events (AEs) associated with neonatal transport, and to categorize, classify and assess the risk estimation of these events. Written comments in 1082 transport records during the period 1999-2011 were reviewed. Comments related to events that infringed on patient and staff safety were included as AEs, and categorized and further classified as complaint, imminent risk of incident/negative event, actual incident or actual negative event. AEs were also grouped into emergency or planned transports, and risk estimation was calculated according to a risk assessment tool and defined as low, intermediate, high or extreme risk. AEs (N = 883) were divided into five categories: logistics (n = 337), organization (n = 177), equipment (n = 165), vehicle (n = 129) and medical/nursing care (n = 75). Eighty-five percent of AEs were classified as incidents or negative events. The majority of AEs were estimated to be of low or intermediate risk in both planned and emergency transports. AEs estimated to be of high or extreme risk were significantly more frequent in emergency transports (OR = 10.1; 95% CI: 5.0-20.9; p < 0.001). AEs are common in both planned and emergency neonatal transport, often related to imperfect transport logistics or equipment failure. AEs of high or extreme risk were more frequent in emergency transports.

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

NASA Astrophysics Data System (ADS)

Rokita, Pawel

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

Impacts of Extreme Events on Human Health. Chapter 4

NASA Technical Reports Server (NTRS)

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

[Evidence of work-related musculo-skeletal disorders of the upper extremities and current methods of risk assessment: can Charlie Chaplin give us any suggestions in "modern times"].

PubMed

Apostoli, P; Sala, Emma

2009-01-01

in some sequences of the film "Modern Times" Chaplin is clearly involved in activities at high risk for work-related musculo-skeletal disorders of the upper extremities (UEWMSDs), but evidence and perception of any complaint are not evident. To evaluate the extent of the biomechanical risk using current risk assessment methods and discuss the possible reasons for lack of complaints. we made an analysis using six of the current methods for ergonomic risk assessment (State of Washington, check list OCRA, HAL by ACGIH, RULA Strain Index, OREGE). All the methods applied demonstrated high-to-very high levels of biomechanical risk for the upper extremities, with evident psychic effects but without apparent musculo-skeletal disorders. The discrepancy between evident psychological disorders ad apparent absence of UEWMSDs are discussed as being due to either: an artistic choice by Charlie Chaplin who focused on the aspects thought to be more immediately and easily comic; the short duration of the physical load exertion; or because of a different perception of muscular work and fatigue that was also typical until the 1970's and 1980's, which also confirmed the principles and practices of our preventive and medical disciplines at that time.

Using the theory of planned behavior to explain the drinking motivations of social, high-risk, and extreme drinkers on game day.

PubMed

Glassman, Tavis; Braun, Robert E; Dodd, Virginia; Miller, Jeffrey M; Miller, E Maureen

2010-04-01

This study assessed the extent to which the Theory of Planned Behavior (TPB) correctly predicted college student's motivation to consume alcohol on game day based on alcohol consumption rates. Three cohorts of 1,000 participants each (N = 3,000) were randomly selected and invited to complete an anonymous web-based survey the Monday following one of three designated college home football games. Path analyses were conducted to determine which of the TPB constructs were most effective in predicting Behavioral Intention and alcohol consumption among social, high-risk, and extreme drinkers. Social drinkers, high-risk, and those drinkers who engage in Extreme Ritualistic Alcohol Consumption (ERAC) were defined as males who consumed 1-4, 5-9, or 10 or more drinks on game day (1-3, 4-8, or nine or more drinks for females), respectively. Attitude Towards the Behavior and Subjective Norm constructs predicted participant's intentions to consume alcohol and corresponding behavior among all three classifications of drinkers; whereas the Perceived Behavioral Control (PBC) construct inconsistently predicted intention and alcohol consumption. Based on Behavioral Intention, the proportion of variance the TPB model explained decreased as participants alcohol consumption increased. It appears that the TPB constructs Attitude Toward the Behavior and Subjective Norm can effectively be utilized when designing universal prevention interventions targeting game day alcohol consumption among college students. However, the applicability of the PBC construct remains in question. While select constructs in the TPB appear to have predictive ability, the usefulness of the complete theoretical framework is limited when trying to predict high-risk drinking and ERAC. These findings suggest that other behavioral theories should be considered when addressing the needs of high-risk and extreme drinkers.

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

PubMed Central

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

2007-01-01

Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale “worrying” the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale “worrying” (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. PMID:17410376

[Risk assessment for the development of occupational diseases among railroad workers].

PubMed

Kaptsov, V A; Pankova, V B; Stepanov, S A; Belikova, N A

1998-01-01

An attempt was made to asses the actual risk of occupational diseases among various railway specialists having harmful and adverse working conditions. The risk was found to be high, suggesting that there are harmful and extremely harmful working conditions and high undetection of patients with occupational diseases.

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

PubMed

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

2000-12-01

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

Services for Families of Infants and Toddlers Experiencing Trauma. A Research-to-Practice Brief. OPRE Report 2015-14

ERIC Educational Resources Information Center

Harden, Branda Jones

2015-01-01

Infancy is a time of extreme opportunity, but it is also a time of extreme vulnerability, particularly for those reared in high-risk environments. Although infant exposure to any risk is important to understand, this brief focuses on the experience and impact of "trauma," defined as witnessing or experiencing an event that poses a real…

Predictive Modeling of Risk Associated with Temperature Extremes over Continental US

NASA Astrophysics Data System (ADS)

Kravtsov, S.; Roebber, P.; Brazauskas, V.

2016-12-01

We build an extremely statistically accurate, essentially bias-free empirical emulator of atmospheric surface temperature and apply it for meteorological risk assessment over the domain of continental US. The resulting prediction scheme achieves an order-of-magnitude or larger gain of numerical efficiency compared with the schemes based on high-resolution dynamical atmospheric models, leading to unprecedented accuracy of the estimated risk distributions. The empirical model construction methodology is based on our earlier work, but is further modified to account for the influence of large-scale, global climate change on regional US weather and climate. The resulting estimates of the time-dependent, spatially extended probability of temperature extremes over the simulation period can be used as a risk management tool by insurance companies and regulatory governmental agencies.

Preventing lower extremity injury in elite orienteerers: study protocol for a randomised controlled trial

PubMed Central

Halvarsson, Bodil

2018-01-01

Background The high physical load associated with running through uneven terrain contributes toorienteerers being exposed to high injury risk, where the majority of injuries are located in the lower extremities. Specific training programmes have been effective at reducing injury risk in sports. Yet no trial has been conducted in elite orienteering. The aim of this study is to investigate the effectiveness of a specific training programme in preventing lower extremity injury in adult elite orienteerers. Study design Randomised controlled trial (RCT). Methods Seventy-two Swedish elite orienteerers, aged 18–40 years, are allocated to an intervention or control group. The intervention group performs four specific exercises, with three difficult levels intensified every second week over the first 4 weeks, targeting strength, flexibility and coordination of the lower extremity. The exercises are completed four times a week (10 min per session) in conjunction with normal training over 14 weeks. Injury data are collected every second week using a valid injury questionnaire distributed by text messages over 14 weeks. The primary outcome is number of substantial injuries in the lower extremity. The secondary outcomes are incidence of ankle sprains and the average substantial injury prevalence across 14 weeks. Discussion Due to high injury risk and lack of injury prevention trials in orienteering, an RCT investigating the effect of a specific exercise programme in preventing lower extremity injury is warranted. The results of this trial will be beneficial to orienteerers, clubs and federations, and increase our understanding on how lower extremity injuries can be prevented in a physically challenging sport. Trial registration number NCT03408925. PMID:29707231

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

PubMed

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

2014-06-01

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

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

PubMed

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

2015-05-19

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

Using damage data to estimate the risk from summer convective precipitation extremes

NASA Astrophysics Data System (ADS)

Schroeer, Katharina; Tye, Mari

2017-04-01

This study explores the potential added value from including loss and damage data to understand the risks from high-intensity short-duration convective precipitation events. Projected increases in these events are expected even in regions that are likely to become more arid. Such high intensity precipitation events can trigger hazardous flash floods, debris flows, and landslides that put people and local assets at risk. However, the assessment of local scale precipitation extremes is hampered by its high spatial and temporal variability. In addition to this, not only are extreme events rare, but such small-scale events are likely to be underreported where they do not coincide with the observation network. Reports of private loss and damage on a local administrative unit scale (LAU 2 level) are used to explore the relationship between observed rainfall events and damages reportedly related to hydro-meteorological processes. With 480 Austrian municipalities located within our south-eastern Alpine study region, the damage data are available on a much smaller scale than the available rainfall data. Precipitation is recorded daily at 185 gauges and 52% of these stations additionally deliver sub-hourly rainfall information. To obtain physically plausible information, damage and rainfall data are grouped and analyzed on a catchment scale. The data indicate that rainfall intensities are higher on days that coincide with a damage claim than on days for which no damage was reported. However, approximately one third of the damages related to hydro-meteorological hazards were claimed on days for which no rainfall was recorded at any gauge in the respective catchment. Our goal is to assess whether these events indicate potential extreme events missing in the observations. Damage always is a consequence of an asset being exposed and susceptible to a hazardous process, and naturally, many factors influence whether an extreme rainfall event causes damage. We set up a statistical model to test whether the relationship between extreme rainfall events and damages is robust enough to estimate a potential underrepresentation of high intensity rainfall events in ungauged areas. Risk-relevant factors of socio-economic vulnerability, land cover, streamflow data, and weather type information are included to improve and sharpen the analysis. Within this study, we first aim to identify which rainfall events are most damaging and which factors affect the damages - seen as a proxy for the vulnerability - related to summer convective rainfall extremes in different catchment types. Secondly, we aim to detect potentially unreported damaging rainfall events and estimate the likelihood of such cases. We anticipate this damage perspective on summertime extreme convective precipitation to be beneficial for risk assessment, uncertainty management, and decision making with respect to weather and climate extremes on the regional-to-local level.

In extremely preterm infants, do the Movement Assessment of Infants and the Alberta Infant Motor Scale predict 18-month outcomes using the Bayley-III?

PubMed

Lefebvre, Francine; Gagnon, Marie-Michèle; Luu, Thuy Mai; Lupien, Geneviève; Dorval, Véronique

2016-03-01

Extremely preterm infants are at high-risk for neurodevelopmental disabilities. The Movement Assessment of Infants (MAI) and the Alberta Infant Motor Scale (AIMS) have been designed to predict outcome with modest accuracy with the Bayley-I or Bayley-II. To examine and compare the predictive validity of the MAI and AIMS in determining neurodevelopmental outcome with the Bayley-III. Retrospective cohort study of 160 infants born at ≤ 28 weeks gestation. At their corrected age, infants underwent the MAI at 4 months, the AIMS at 4 and 10-12 months, and the Bayley-III and neurological examination at 18 months. Sensitivity and specificity were calculated. Infants had a mean gestation of 26.3 ± 1.4 weeks and birth weight of 906 ± 207 g. A high-risk score (≥ 14) for adverse outcome was obtained by 57% of infants on the MAI. On the AIMS, a high-risk score (<5th percentile) was obtained by 56% at 4 months and 30% at 10-12 months. At 18 months, infants with low-risk scores on either the MAI or AIMS had higher cognitive, language, and motor Bayley-III scores than those with high-risk scores. They were less likely to have severe neurodevelopmental impairment. To predict Bayley-III scores <70, sensitivity and specificity were 91% and 49%, respectively, for the MAI and 78% and 48%, respectively, for the AIMS. Extremely preterm infants with low-risk MAI at 4 months or AIMS scores at 4 or 10-12 months had better outcomes than those with high-risk scores. However, both tests lack specificity to predict individual neurodevelopmental status at 18 months. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Kristina, S.; Wijaya, B. M.

2017-12-01

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

Extreme risk assessment based on normalized historic loss data

NASA Astrophysics Data System (ADS)

Eichner, Jan

2017-04-01

Natural hazard risk assessment and risk management focuses on the expected loss magnitudes of rare and extreme events. Such large-scale loss events typically comprise all aspects of compound events and accumulate losses from multiple sectors (including knock-on effects). Utilizing Munich Re's NatCatSERVICE direct economic loss data, we beriefly recap a novel methodology of peril-specific loss data normalization which improves the stationarity properties of highly non-stationary historic loss data (due to socio-economic growth of assets prone to destructive forces), and perform extreme value analysis (peaks-over-threshold method) to come up with return level estimates of e.g. 100-yr loss event scenarios for various types of perils, globally or per continent, and discuss uncertainty in the results.

Bipolar vulnerability and extreme appraisals of internal states: a computerized ratings study.

PubMed

Dodd, Alyson L; Mansell, Warren; Morrison, Anthony P; Tai, Sara

2011-01-01

A recent integrative cognitive model proposed that multiple, extreme, personalized, positive and negative appraisals of internal states predispose to maintain and exacerbate bipolar symptoms. This study aimed to directly assess conviction in a range of positive and negative appraisals of internal states suggested by the model, by using a laboratory-based computerized task. In a student sample (n = 68), a history of hypomania was associated with more positive and less negative appraisals of internal states, and a history of depression was associated with more negative appraisals and less positive appraisals of internal states. The sample was then split into three groups for comparison: bipolar risk (n = 18), depression risk (n = 20) and controls (n  = 30). Relative to controls, the bipolar risk group made more extreme ratings of catastrophic appraisals of low activation states and tended to make more extreme ratings of appraisals of high activation states. The depression risk group scored higher on a range of negative appraisals of low activation states. These findings provide tentative support for the role of both positive and negative, extreme, personalized appraisals of internal states in hypomania and depression. Copyright © 2011 John Wiley & Sons, Ltd.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Increasing stress on disaster-risk finance due to large floods

NASA Astrophysics Data System (ADS)

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

2014-04-01

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

Increasing stress on disaster risk finance due to large floods

NASA Astrophysics Data System (ADS)

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

2014-05-01

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

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

PubMed

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

2017-08-22

Accurately identifying women with dense breasts (Breast Imaging Reporting and Data System [BI-RADS] heterogeneously or extremely dense) who are at high breast cancer risk will facilitate discussions of supplemental imaging and primary prevention. We examined the independent contribution of dense breast volume and BI-RADS breast density to predict invasive breast cancer and whether dense breast volume combined with Breast Cancer Surveillance Consortium (BCSC) risk model factors (age, race/ethnicity, family history of breast cancer, history of breast biopsy, and BI-RADS breast density) improves identifying women with dense breasts at high breast cancer risk. We conducted a case-control study of 1720 women with invasive cancer and 3686 control subjects. We calculated ORs and 95% CIs for the effect of BI-RADS breast density and Volpara™ automated dense breast volume on invasive cancer risk, adjusting for other BCSC risk model factors plus body mass index (BMI), and we compared C-statistics between models. We calculated BCSC 5-year breast cancer risk, incorporating the adjusted ORs associated with dense breast volume. Compared with women with BI-RADS scattered fibroglandular densities and second-quartile dense breast volume, women with BI-RADS extremely dense breasts and third- or fourth-quartile dense breast volume (75% of women with extremely dense breasts) had high breast cancer risk (OR 2.87, 95% CI 1.84-4.47, and OR 2.56, 95% CI 1.87-3.52, respectively), whereas women with extremely dense breasts and first- or second-quartile dense breast volume were not at significantly increased breast cancer risk (OR 1.53, 95% CI 0.75-3.09, and OR 1.50, 95% CI 0.82-2.73, respectively). Adding continuous dense breast volume to a model with BCSC risk model factors and BMI increased discriminatory accuracy compared with a model with only BCSC risk model factors (C-statistic 0.639, 95% CI 0.623-0.654, vs. C-statistic 0.614, 95% CI 0.598-0.630, respectively; P < 0.001). Women with dense breasts and fourth-quartile dense breast volume had a BCSC 5-year risk of 2.5%, whereas women with dense breasts and first-quartile dense breast volume had a 5-year risk ≤ 1.8%. Risk models with automated dense breast volume combined with BI-RADS breast density may better identify women with dense breasts at high breast cancer risk than risk models with either measure alone.

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

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2013-04-01

Europe's coast faces a variety of climate change threats from extreme high tides, storm surges and rising sea levels. In particular, it is very likely that mean sea level rise will contribute to upward trends in extreme coastal high water levels, thus posing higher risks to coastal locations currently experiencing coastal erosion and inundation processes. In 2007 the European Commission approved the Flood Directive (2007/60/EC), which has the main purpose to establish a framework for the assessment and management of flood risks for inland and coastal areas, thus reducing the adverse consequences for human health, the environment, cultural heritage and economic activities. Improvements in scientific understanding are thus needed to inform decision-making about the best strategies for mitigating and managing storm surge risks in coastal areas. The CLIMDAT project is aimed at improving the understanding of the risks related to extreme storm surge events in the coastal area of the North Adriatic Sea (Italy), considering potential climate change scenarios. The project implements a Regional Risk Assessment (RRA) methodology developed in the FP7 KULTURisk project for the assessment of physical/environmental impacts posed by flood hazards and employs the DEcision support SYstem for Coastal climate change impact assessment (DESYCO) for the application of the methodology to the case study area. The proposed RRA methodology is aimed at the identification and prioritization of targets and areas at risk from water-related natural hazards in the considered region at the meso-scale. To this aim, it integrates information about extreme storm surges with bio-geophysical and socio-economic information (e.g. vegetation cover, slope, soil type, population density) of the analyzed receptors (i.e. people, economic activities, cultural heritages, natural and semi-natural systems). Extreme storm surge hazard scenarios are defined using tide gauge time series coming from 28 tide gauge stations located in the North Adriatic coastal areas from 1989 to 2011. These data, together with the sea-level rise scenarios for the considered future timeframe, represent the input for the application of the Joint Probability method (Pugh and Vassie, 1979), which allows the evaluation of the maximum height of extreme storm surge events with different return period and the number of extreme events per year. The methodology uses Geographic Information Systems to manage, process, analyse, and visualize data and employs Multi-Criteria Decision Analysis to integrate stakeholders preferences and experts judgments into the analysis in order to obtain a total risk index in the considered region. The final outputs are represented by GIS-based risk maps which allow the communication of the potential consequences of extreme storm surge to decision makers and stakeholders. Moreover, they can support the establishment of relative priorities for intervention through the identification of suitable areas for human settlements, infrastructures and economic activities. Finally the produced output can represent a basis for definition of storm surge hazard and storm surge risk management plans according to the Floods Directive. The preliminary results of the RRA application in the CLIMDAT project will be here presented and discussed.

Global predictability of temperature extremes

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

Mental disease-related emergency admissions attributable to hot temperatures.

PubMed

Lee, Suji; Lee, Hwanhee; Myung, Woojae; Kim, E Jin; Kim, Ho

2018-03-01

The association between high temperature and mental disease has been the focus of several studies worldwide. However, no studies have focused on the mental disease burden attributable to hot temperature. Here, we aim to quantify the risk attributed to hot temperatures based on the exposure-lag-response relationship between temperature and mental diseases. From data on daily temperature and emergency admissions (EA) for mental diseases collected from 6 major cities (Seoul, Incheon, Daejeon, Daegu, Busan, and Gwangju in South Korea) over a period of 11years (2003-2013), we estimated temperature-disease associations using a distributed lag non-linear model, and we pooled the data by city through multivariate meta-analysis. Cumulative relative risk and attributable risks were calculated for extreme hot temperatures, defined as the 99th percentile relative to the 50th percentile of temperatures. The strongest association between mental disease and high temperature was seen within a period of 0-4days of high temperature exposure. Our results reveal that 14.6% of EA for mental disease were due to extreme hot temperatures, and the elderly were more susceptible (19.1%). Specific mental diseases, including anxiety, dementia, schizophrenia, and depression, also showed significant risk attributed to hot temperatures. Of all EA for anxiety, 31.6% were attributed to extremely hot temperatures. High temperature was responsible for an attributable risk for mental disease, and the burden was higher in the elderly. This finding has important implications for designing appropriate public health policies to minimize the impact of high temperature on mental health. Copyright © 2017 Elsevier B.V. All rights reserved.

Data informatics for the Detection, Characterization, and Attribution of Climate Extremes

NASA Astrophysics Data System (ADS)

Collins, W.; Wehner, M. F.; O'Brien, T. A.; Paciorek, C. J.; Krishnan, H.; Johnson, J. N.; Prabhat, M.

2015-12-01

The potential for increasing frequency and intensity of extremephenomena including downpours, heat waves, and tropical cyclonesconstitutes one of the primary risks of climate change for society andthe environment. The challenge of characterizing these risks is thatextremes represent the "tails" of distributions of atmosphericphenomena and are, by definition, highly localized and typicallyrelatively transient. Therefore very large volumes of observationaldata and projections of future climate are required to quantify theirproperties in a robust manner. Massive data analytics are required inorder to detect individual extremes, accumulate statistics on theirproperties, quantify how these statistics are changing with time, andattribute the effects of anthropogenic global warming on thesestatistics. We describe examples of the suite of techniques the climate communityis developing to address these analytical challenges. The techniquesinclude massively parallel methods for detecting and trackingatmospheric rivers and cyclones; data-intensive extensions togeneralized extreme value theory to summarize the properties ofextremes; and multi-model ensembles of hindcasts to quantify theattributable risk of anthropogenic influence on individual extremes.We conclude by highlighting examples of these methods developed by ourCASCADE (Calibrated and Systematic Characterization, Attribution, andDetection of Extremes) project.

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

PubMed

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

2017-02-01

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

Potential Risk Assessment of Mountain Torrent Disasters on Sloping Fields in China

NASA Astrophysics Data System (ADS)

GAO, X.

2017-12-01

China's sloping fields have the problems of low production and serious soil erosion, and mountain torrent disasters will bring more serious soil and water loss to traditional extensive exploitation of sloping field resources. In this paper, China's sloping fields were classified into three grades, such as slightly steep, steep and very steep grade. According to the geological hazards prevention and control regulation, the historical data of China's mountain torrent disasters were spatially interpolated and divided into five classes, such as extremely low, low, middle, high and extremely high level. And the risk level map of mountain torrents was finished in ArcGIS. By using overlaying analysis on sloping fields and risk level map, the potential risk regionalization map of sloping fields in various slope grades was obtained finally. The results shows that the very steep and steep sloping fields are mainly distributed in the first or second stage terraces in China. With the increase of hazard risk level, the area of sloping fields decreases rapidly and the sloping fields in extremely low and low risk levels of mountain torrents reach 98.9%. With the increase of slope grade, the area of sloping fields in various risk levels also declines sharply. The sloping fields take up approximately 60 65% and 26 30% in slightly steep and steep grade areas separately at different risk level. The risk regionalization map can provide effective information for returning farmland to forests or grassland and reducing water and soil erosion of sloping fields in the future.

Biomechanical investigation of head impacts in football

PubMed Central

Withnall, C; Shewchenko, N; Gittens, R; Dvorak, J

2005-01-01

Objectives: This study sought to measure the head accelerations induced from upper extremity to head and head to head impact during the game of football and relate this to the risk of mild traumatic brain injury using the Head Impact Power (HIP) index. Furthermore, measurement of upper neck forces and torques will indicate the potential for serious neck injury. More stringent rules or punitive sanctions may be warranted for intentional impact by the upper extremity or head during game play. Methods: Game video of 62 cases of head impact (38% caused by the upper extremity and 30% by the head of the opposing player) was provided by F-MARC. Video analysis revealed the typical impact configurations and representative impact speeds. Upper extremity impacts of elbow strike and lateral hand strike were re-enacted in the laboratory by five volunteer football players striking an instrumented Hybrid III pedestrian model crash test manikin. Head to head impacts were re-enacted using two instrumented test manikins. Results: Elbow to head impacts (1.7–4.6 m/s) and lateral hand strikes (5.2–9.3 m/s) resulted in low risk of concussion (<5%) and severe neck injury (<5%). Head to head impacts (1.5–3.0 m/s) resulted in high concussion risk (up to 67%) but low risk of severe neck injury (<5%). Conclusion: The laboratory simulations suggest little risk of concussion based on head accelerations and maximum HIP. There is no biomechanical justification for harsher penalties in this regard. However, deliberate use of the head to impact another player's head poses a high risk of concussion, and justifies a harsher position by regulatory bodies. In either case the risk of serious neck injury is very low. PMID:16046356

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2013-10-01

study will recruit wounded warriors with severe extremity trauma, which places them at high risk for heterotopic ossification (HO); bone formation at...involved in HO; 2) to define accurate and practical methods to predict where HO will develop; and 3) to define potential therapies for prevention or...elicit HO. These tools also need to provide effective methods for early diagnosis or risk assessment (prediction) so that therapies for prevention or

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

NASA Astrophysics Data System (ADS)

Ludwig, R.

2017-12-01

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

Dialogue on Climate, Water, Energy and Human Security in Africa

DTIC Science & Technology

2014-07-01

winter periods.  The influence of the  ocean  mass on the coastal areas can be seen, with slightly lower increases in  average temperatures.       Figure 1...adaptation 1 1’ ~ + -foradaptllion m \\...A..AJ to reduce risk .... :’\\: " -••• \\ Warming Extreme Extreme Damaging Ocean Sea surface I Precipitation Sea...level Risk level with Risk level with trend temperature precipitation cyclone acidification temperature high adaptation cuJTentadaptation Institutions

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

PubMed

Schwager, Monika; Johst, Karin; Jeltsch, Florian

2006-06-01

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

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk

PubMed Central

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E.

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient. PMID:26346128

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk.

PubMed

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient.

High-pressure injection injuries to the upper extremity: a review of the literature.

PubMed

Hogan, Christopher J; Ruland, Robert T

2006-07-01

The purpose of this review was to identify the relative impact of injected material, location of injury, time to debridement, injection pressure, infection, and the use of adjuvant steroid medication upon the need for amputation after high-pressure injection injuries to the upper extremity. A Medline literature search extending from 1966 to December 2003 was performed, referencing the key words "high-pressure injection injury," "grease gun injury," "paint gun injury," "pressure gun injury," and "high-pressure injection." The results were limited to the English language and to reports involving human subjects. Each abstract was reviewed to confirm that the described injury had occurred in the upper extremity and that it had truly been a high-pressure injection. The reference pages from each of the papers were reviewed to identify additional reports of high-pressure injection injury. Manuscripts describing injuries resulting from hand held syringes or other low-pressure mechanisms were excluded. All of the manuscripts were analyzed to identify the clinical outcome, age, hand dominance, site of injection, substance injected, injection pressure, elapsed time to wide debridement, use of steroids, and incidence of infection. These variables were subjected to a Pearson chi test to determine their impact upon the need for amputation. Four hundred thirty-five cases of high-pressure injection injury to the upper extremity were identified. The amputation rate after these injuries was 30%. The location of the injury and the material injected contributed significantly to the need for amputation. For injections of paint, paint thinner, gasoline, oil, or jet fuel (organic solvents), the amputation risk was lower if wide surgical debridement occurred within 6 hours of injury. Steroids did not impact the amputation rate or incidence of infection. The presence of infection did not affect the incidence of amputation. The risk of amputation after high-pressure injection injury to the upper extremity is highest with organic solvent injection into the fingers. Injections into the thumb or palm result in a much lower frequency of tissue loss. Emergent surgical debridement reduces the amputation risk after injections of organic solvents. From the available data, no conclusions could be reached regarding functional outcomes, other than amputation, after high-pressure injection injury.

The influence of weather on health-related help-seeking behavior of senior citizens in Hong Kong.

PubMed

Wong, Ho Ting; Chiu, Marcus Yu Lung; Wu, Cynthia Sau Ting; Lee, Tsz Cheung

2015-03-01

It is believed that extreme hot and cold weather has a negative impact on general health conditions. Much research focuses on mortality, but there is relatively little community health research. This study is aimed at identifying high-risk groups who are sensitive to extreme weather conditions, in particular, very hot and cold days, through an analysis of the health-related help-seeking patterns of over 60,000 Personal Emergency Link (PE-link) users in Hong Kong relative to weather conditions. In the study, 1,659,716 PE-link calls to the help center were analyzed. Results showed that females, older elderly, people who did not live alone, non-subsidized (relatively high-income) users, and those without medical histories of heart disease, hypertension, stroke, and diabetes were more sensitive to extreme weather condition. The results suggest that using official government weather forecast reports to predict health-related help-seeking behavior is feasible. An evidence-based strategic plan could be formulated by using a method similar to that used in this study to identify high-risk groups. Preventive measures could be established for protecting the target groups when extreme weather conditions are forecasted.

The influence of weather on health-related help-seeking behavior of senior citizens in Hong Kong

NASA Astrophysics Data System (ADS)

Wong, Ho Ting; Chiu, Marcus Yu Lung; Wu, Cynthia Sau Ting; Lee, Tsz Cheung

2015-03-01

It is believed that extreme hot and cold weather has a negative impact on general health conditions. Much research focuses on mortality, but there is relatively little community health research. This study is aimed at identifying high-risk groups who are sensitive to extreme weather conditions, in particular, very hot and cold days, through an analysis of the health-related help-seeking patterns of over 60,000 Personal Emergency Link (PE-link) users in Hong Kong relative to weather conditions. In the study, 1,659,716 PE-link calls to the help center were analyzed. Results showed that females, older elderly, people who did not live alone, non-subsidized (relatively high-income) users, and those without medical histories of heart disease, hypertension, stroke, and diabetes were more sensitive to extreme weather condition. The results suggest that using official government weather forecast reports to predict health-related help-seeking behavior is feasible. An evidence-based strategic plan could be formulated by using a method similar to that used in this study to identify high-risk groups. Preventive measures could be established for protecting the target groups when extreme weather conditions are forecasted.

Evolving trends in aortic valve replacement: A statewide experience.

PubMed

Kim, Karen M; Shannon, Francis; Paone, Gaetano; Lall, Shelly; Batra, Sanjay; Boeve, Theodore; DeLucia, Alphonse; Patel, Himanshu J; Theurer, Patricia F; He, Chang; Clark, Melissa J; Sultan, Ibrahim; Deeb, George Michael; Prager, Richard L

2018-06-17

Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for the treatment of aortic stenosis in patients at intermediate, high, and extreme risk for mortality from SAVR. We examined recent trends in aortic valve replacement (AVR) in Michigan. The Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) database was used to determine the number of SAVR and TAVR cases performed from January 2012 through June 2017. Patients were divided into low, intermediate, high, and extreme risk groups based on STS predicted risk of mortality (PROM). TAVR patients in the MSTCVS-QC database were also matched with those in the Transcatheter Valve Therapy Registry to determine their Heart Team-designated risk category. During the study period 9517 SAVR and 4470 TAVR cases were performed. Total annual AVR volume increased by 40.0% (from 2086 to 2920), with a 13.3% decrease in number of SAVR cases (from 1892 to 1640) and a 560% increase in number of TAVR cases (from 194 to 1280). Greater than 90% of SAVR patients had PROM ≤8%. While >70% of TAVR patients had PROM ≤ 8%, they were mostly designated as high or extreme risk by a Heart Team. During the study period, SAVR volume gradually declined and TAVR volume dramatically increased. This was mostly due to a new group of patients with lower STS PROM who were designated as higher risk by a Heart Team due to characteristics not completely captured by the STS PROM score. © 2018 Wiley Periodicals, Inc.

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

PubMed

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

2001-11-01

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

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

PubMed Central

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

2015-01-01

Objective: Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. Methods: We collected data from Beijing and Shanghai, China, during 2007–2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. Results: For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0–27, while the hot effects reached the strongest at lag 0–14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. Conclusion: People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days. PMID:26703637

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

PubMed

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

2015-12-21

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

Wildfire risk in the wildland-urban interface: A simulation study in northwestern Wisconsin

USGS Publications Warehouse

Bar-Massada, A.; Radeloff, V.C.; Stewart, S.I.; Hawbaker, T.J.

2009-01-01

The rapid growth of housing in and near the wildland-urban interface (WUI) increases wildfire risk to lives and structures. To reduce fire risk, it is necessary to identify WUI housing areas that are more susceptible to wildfire. This is challenging, because wildfire patterns depend on fire behavior and spread, which in turn depend on ignition locations, weather conditions, the spatial arrangement of fuels, and topography. The goal of our study was to assess wildfire risk to a 60,000 ha WUI area in northwestern Wisconsin while accounting for all of these factors. We conducted 6000 simulations with two dynamic fire models: Fire Area Simulator (FARSITE) and Minimum Travel Time (MTT) in order to map the spatial pattern of burn probabilities. Simulations were run under normal and extreme weather conditions to assess the effect of weather on fire spread, burn probability, and risk to structures. The resulting burn probability maps were intersected with maps of structure locations and land cover types. The simulations revealed clear hotspots of wildfire activity and a large range of wildfire risk to structures in the study area. As expected, the extreme weather conditions yielded higher burn probabilities over the entire landscape, as well as to different land cover classes and individual structures. Moreover, the spatial pattern of risk was significantly different between extreme and normal weather conditions. The results highlight the fact that extreme weather conditions not only produce higher fire risk than normal weather conditions, but also change the fine-scale locations of high risk areas in the landscape, which is of great importance for fire management in WUI areas. In addition, the choice of weather data may limit the potential for comparisons of risk maps for different areas and for extrapolating risk maps to future scenarios where weather conditions are unknown. Our approach to modeling wildfire risk to structures can aid fire risk reduction management activities by identifying areas with elevated wildfire risk and those most vulnerable under extreme weather conditions. ?? 2009 Elsevier B.V.

Somatotype of the individuals with lower extremity amputation and its association with cardiovascular risk.

PubMed

Mozumdar, Arupendra; Roy, Subrata K

2008-03-01

Anthropometric somatotyping is one of the methods to describe the shape of the human body, which shows some associations with an individual's health and disease condition, especially with cardiovascular diseases (CVD). Individuals with lower extremity amputation (LEA) are known to be more vulnerable to the cardiovascular risk. The objectives of the present study are to report the somatotype of the individuals having lower extremity amputation, to study the possible variation in somatotype between two groups of amputated individuals, and to study the association between cardiovascular disease risk factor and somatotype components among individuals with locomotor disability. 102 adult male individuals with unilateral lower-extremity amputation residing in Calcutta and adjoining areas were investigated. The anthropometric data for somatotyping and data on cardiovascular risk traits (such as body mass index, blood pressure measurements, blood lipids) have been collected. The somatotyping technique of Carter & Heath (1990) has been followed. The result shows high mean values of endomorphy and mesomorphy components and a low mean value of the ectomorphy component among the amputated individuals having cardiovascular risks. The results of both discriminant analysis and logistic regression analysis show a significant relationship between somatotype components and CVD risk among the individuals with LEA. The findings of the present study support the findings of similar studies conducted on the normal population. Diagnosis of CVD risk condition through somatotyping can be utilized in prevention/treatment management for the individuals with LEA.

Increasing extreme water level flood risk as a result of future sea-level rise: A case study on a coastal city in China

NASA Astrophysics Data System (ADS)

Feng, A.; Wu, S.

2016-12-01

Extreme water levels, caused by the joint occurrence of storm surges and high tides, always lead to super floods along coastlines. In the context of climate change, this study explored the impact of future sea-level rise on the flood risk of extreme water levels. Using Rongcheng City in Shandong Province, China as a case study, flooded area, expected direct damage losses, and affected population and GDP were assessed for 2050 and 2100 under three greenhouse gas concentration Representative Concentration Pathways (RCP) scenarios, 2.6, 4.5, and 8.5. Results indicate that, as a result of sea-level rise induced by climate change, the flooded areas of Rongcheng City would increase by 3.23% to 10.64% in 2050 and by as much as 4.98% to 19.87% in 2100, compared with current recurrence periods. Residential land and farmland are at greatest risk of flooding in terms of exposure and losses than other land-use types, and under a high degree RCP 8.5 scenario, expected damage losses would be between 59.84 billion and 86.45 billion in 2050. Results show that the increase in total direct damage losses would reach an average of 60% in 2100 as a result of a 0.82 m sea-level rise. Similarly, affected population and GDP would increase by between 4.95% and 13.87% and between 3.66% and 10.95% in 2050, and by as much as 7.69% to 29.01% and 5.30% to 20.50% in 2100. This study shows that sea-level rise significantly shortens recurrence periods of extreme water levels, makes extreme flood events more frequent, and exacerbates the risk of future flooding. Our results suggest that, if there is no adaptation, sea-level rise will greatly increase the risk of flooding and severely impact human habitability along coastlines.

Wildfire risk in the wildland-urban interface: A simulation study in northwestern Wisconsin

USGS Publications Warehouse

Massada, Avi Bar; Radeloff, Volker C.; Stewart, Susan I.; Hawbaker, Todd J.

2009-01-01

The rapid growth of housing in and near the wildland–urban interface (WUI) increases wildfirerisk to lives and structures. To reduce fire risk, it is necessary to identify WUI housing areas that are more susceptible to wildfire. This is challenging, because wildfire patterns depend on fire behavior and spread, which in turn depend on ignition locations, weather conditions, the spatial arrangement of fuels, and topography. The goal of our study was to assess wildfirerisk to a 60,000 ha WUI area in northwesternWisconsin while accounting for all of these factors. We conducted 6000 simulations with two dynamic fire models: Fire Area Simulator (FARSITE) and Minimum Travel Time (MTT) in order to map the spatial pattern of burn probabilities. Simulations were run under normal and extreme weather conditions to assess the effect of weather on fire spread, burn probability, and risk to structures. The resulting burn probability maps were intersected with maps of structure locations and land cover types. The simulations revealed clear hotspots of wildfire activity and a large range of wildfirerisk to structures in the study area. As expected, the extreme weather conditions yielded higher burn probabilities over the entire landscape, as well as to different land cover classes and individual structures. Moreover, the spatial pattern of risk was significantly different between extreme and normal weather conditions. The results highlight the fact that extreme weather conditions not only produce higher fire risk than normal weather conditions, but also change the fine-scale locations of high risk areas in the landscape, which is of great importance for fire management in WUI areas. In addition, the choice of weather data may limit the potential for comparisons of risk maps for different areas and for extrapolating risk maps to future scenarios where weather conditions are unknown. Our approach to modeling wildfirerisk to structures can aid fire risk reduction management activities by identifying areas with elevated wildfirerisk and those most vulnerable under extreme weather conditions.

Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas

PubMed Central

Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

2015-01-01

Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area. PMID:26580644

Spatiotemporal influence of temperature, air quality, and urban environment on cause-specific mortality during hazy days.

PubMed

Ho, Hung Chak; Wong, Man Sing; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Bilal, Muhammad; Chan, Ta-Chien

2018-03-01

Haze is an extreme weather event that can severely increase air pollution exposure, resulting in higher burdens on human health. Few studies have explored the health effects of haze, and none have investigated the spatiotemporal interaction between temperature, air quality and urban environment that may exacerbate the adverse health effects of haze. We investigated the spatiotemporal pattern of haze effects and explored the additional effects of temperature, air pollution and urban environment on the short-term mortality risk during hazy days. We applied a Poisson regression model to daily mortality data from 2007 through 2014, to analyze the short-term mortality risk during haze events in Hong Kong. We evaluated the adverse effect on five types of cause-specific mortality after four types of haze event. We also analyzed the additional effect contributed by the spatial variability of urban environment on each type of cause-specific mortality during a specific haze event. A regular hazy day (lag 0) has higher all-cause mortality risk than a day without haze (odds ratio: 1.029 [1.009, 1.049]). We have also observed high mortality risks associated with mental disorders and diseases of the nervous system during hazy days. In addition, extreme weather and air quality contributed to haze-related mortality, while cold weather and higher ground-level ozone had stronger influences on mortality risk. Areas with a high-density environment, lower vegetation, higher anthropogenic heat, and higher PM 2.5 featured stronger effects of haze on mortality than the others. A combined influence of haze, extreme weather/air quality, and urban environment can result in extremely high mortality due to mental/behavioral disorders or diseases of the nervous system. In conclusion, we developed a data-driven technique to analyze the effects of haze on mortality. Our results target the specific dates and areas with higher mortality during haze events, which can be used for development of health warning protocols/systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Özgen, Ali, E-mail: draliozgen@hotmail.com; Sanioğlu, Soner; Bingöl, Uğur Anıl

2016-08-15

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

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific knowledge, particularly during the early warning phase, can reduce disasters. This suggests that a strong global monitoring system for geohazards is needed, not least to support the early detection of extreme hazards. Secondly, low risk awareness combined with poverty, corruption, and a lack of building codes and informed land use management creates the conditions to turn hazards into disasters throughout much of the developing world. Democratizing knowledge about extreme geohazards is very important in order to inform deliberations of disaster risks and community strategies that can reduce the disaster risk by increasing resilience and adaptive capacities without compromising the livelihood of communities. We use a four-order scheme to define disaster risk outcomes and associated societal processes. This framework can be implemented in the context of deliberative democracy and governance with participation of the community. The current dialog between science and society is not fully capable of supporting deliberative governance and a democratizing of knowledge. Most scientific knowledge is created independent of those who could put it to use, and a transition to co-design and co-development of knowledge involving a broad stakeholder base is necessary to address the disaster risk associated with extreme events. This transition may have the consequence of more responsibility and even liability for science.

Social and Emotional Components of Book Reading between Caregivers and Their Toddlers in a High-Risk Sample

ERIC Educational Resources Information Center

Cross, Jennifer Riedl; Fletcher, Kathryn L.; Speirs Neumeister, Kristie L.

2011-01-01

In this collective case study of caregiver behaviors with their toddlers, two-minute videotaped reading interactions were analyzed using a constant comparative method. Twenty-four caregiver-toddler dyads from a high-risk sample of children prenatally exposed to cocaine were selected from a larger sample because they represented the extremes of…

Socioeconomic indicators of heat-related health risk supplemented with remotely sensed data

PubMed Central

Johnson, Daniel P; Wilson, Jeffrey S; Luber, George C

2009-01-01

Background Extreme heat events are the number one cause of weather-related fatalities in the United States. The current system of alert for extreme heat events does not take into account intra-urban spatial variation in risk. The purpose of this study is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature derived from thermal remote sensing data. Results Comparison of logistic regression models indicates that supplementing known sociodemographic risk factors with remote sensing estimates of land surface temperature improves the delineation of intra-urban variations in risk from extreme heat events. Conclusion Thermal remote sensing data can be utilized to improve understanding of intra-urban variations in risk from extreme heat. The refinement of current risk assessment systems could increase the likelihood of survival during extreme heat events and assist emergency personnel in the delivery of vital resources during such disasters. PMID:19835578

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

PubMed Central

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

2016-01-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1 years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4 minutes 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4x/week for 8 weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001) respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. PMID:27346646

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

PubMed

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

2016-09-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001), respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. Copyright © 2016 Elsevier Inc. All rights reserved.

Extremely preterm birth affects boys more and socio-economic and neonatal variables pose sex-specific risks.

PubMed

Månsson, Johanna; Fellman, Vineta; Stjernqvist, Karin

2015-05-01

The early identification of at-risk extremely preterm (EPT) children could improve long-term outcomes. This study sought to investigate sex differences in developmental outcomes and to identify sex-specific predictors at two and a half years of age. We assessed 217 boys and 181 girls born before 27-week gestation using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), as a part of the Extremely Preterm Infants in Sweden Study. Sex-specific differences were calculated. Socio-economic, birth and neonatal factors were calculated separately for boys and girls using regression models. Girls scored significantly higher than boys on all Bayley-III indices. In both sexes, brain injury, long-term ventilator treatment and foreign-born mothers predicted lower scores. Receiving breast milk by hospital discharge predicted higher scores. Severe retinopathy of prematurity was the strongest predictor of cognitive and language deficits in boys. High parental education predicted higher cognitive and language scores in girls, whereas severe bronchopulmonary dysplasia was the strongest predictor of motor deficits. Extreme prematurity seems to affect boys more than girls. Socio-economic and neonatal factors confer similar risks or protections on both sexes, but some variables pose sex-specific risks. An awareness of risk factors may provide the basis for treatment and follow-up guidelines. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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

PubMed

Parikh, Nehal A; Kennedy, Kathleen A; Lasky, Robert E; Tyson, Jon E

2015-01-01

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

Extreme value modelling of Ghana stock exchange index.

PubMed

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

2015-01-01

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

Measuring daily Value-at-Risk of SSEC index: A new approach based on multifractal analysis and extreme value theory

NASA Astrophysics Data System (ADS)

Wei, Yu; Chen, Wang; Lin, Yu

2013-05-01

Recent studies in the econophysics literature reveal that price variability has fractal and multifractal characteristics not only in developed financial markets, but also in emerging markets. Taking high-frequency intraday quotes of the Shanghai Stock Exchange Component (SSEC) Index as example, this paper proposes a new method to measure daily Value-at-Risk (VaR) by combining the newly introduced multifractal volatility (MFV) model and the extreme value theory (EVT) method. Two VaR backtesting techniques are then employed to compare the performance of the model with that of a group of linear and nonlinear generalized autoregressive conditional heteroskedasticity (GARCH) models. The empirical results show the multifractal nature of price volatility in Chinese stock market. VaR measures based on the multifractal volatility model and EVT method outperform many GARCH-type models at high-risk levels.

Risk factors for lower extremity injuries among male marathon runners.

PubMed

Van Middelkoop, M; Kolkman, J; Van Ochten, J; Bierma-Zeinstra, S M A; Koes, B W

2008-12-01

The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance <40 km a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.

Spatial patterns of frequent floods in Switzerland

NASA Astrophysics Data System (ADS)

Schneeberger, Klaus; Rössler, Ole; Weingartner, Rolf

2017-04-01

Information about the spatial characteristics of high and extreme streamflow is often needed for an accurate analysis of flood risk and effective co-ordination of flood related activities, such as flood defence planning. In this study we analyse the spatial dependence of frequent floods in Switzerland across different scales. Firstly, we determine the average length of high and extreme flow events for 56 runoff time series of Swiss rivers. Secondly, a dependence measure expressing the probability that streamflow peaks are as high as peaks at a conditional site is used to describe and map the spatial extend of joint occurrence of frequent floods across Switzerland. Thirdly, we apply a cluster analysis to identify groups of sites that are likely to react similarly in terms of joint occurrence of high flow events. The results indicate that a time interval with a length of 3 days seems to be most appropriate to characterise the average length of high streamflow events across spatial scales. In the main Swiss basins, high and extreme streamflows were found to be asymptotically independent. In contrast, at the meso-scale distinct flood regions, which react similarly in terms of occurrence of frequent flood, were found. The knowledge about these regions can help to optimise flood defence planning or to estimate regional flood risk properly.

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

PubMed

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

2011-09-01

Range of motion deficits in shoulder external rotation (ER), internal rotation (IR), total rotation range of motion (ER + IR), and horizontal adduction (HA) have been retrospectively associated with overhand athletes' arm injuries. The authors expected the incidence of upper extremity injury in high school softball and baseball players with side-to-side shoulder range of motion deficits to be greater than the incidence of upper extremity injury in players with normal shoulder range of motion. Cohort study (prognosis); Level of evidence, 2. High school softball and baseball players (N = 246) participated. Before the start of the season, passive shoulder ER, IR, and HA were assessed at 90° of abduction with the scapula stabilized. Relative risk (RR) was calculated to examine range of motion measure, by categorical criteria, and risk of upper extremity injury. Twenty-seven shoulder and elbow injuries (9 softball, 18 baseball) were observed during the season. The dominant shoulder of all injured players and baseball players displayed a significant decrease in HA (P = .05) and IR (P = .04). The dominant shoulder total rotation of injured baseball players displayed a significant decrease (mean difference = 8.0° ± 0.1°; P = .05) as compared with the dominant shoulder of uninjured baseball players. Players who displayed a decrease of ≥25° of IR in the dominant shoulder were at 4 times greater risk of upper extremity injury compared with players with a <25° decrease in IR, especially for baseball players. While we observed a 1.5 to 2 times increased risk of injury for the 10° to 20° loss in rotational range of motion for the overall sample and baseball, the risk estimates were not statistically significant (P > .05). There are large mean deficits in shoulder IR and HA between injured and noninjured players, but not in ER or total rotation. Passive shoulder IR loss ≥25° as compared bilaterally was predictive of arm injury. Shoulder range of motion deficits differed between sports and appeared more predictive of injury for baseball players.

Compassion satisfaction, compassion fatigue, and critical incident stress management.

PubMed

Wee, David; Myers, Diane

2003-01-01

This study examines the potential for compassion satisfaction, compassion fatigue, and burnout in a sample of persons attending a workshop on Prevention of Compassion Fatigue at an international conference of providers of Critical Incident Stress Management (CISM) services. In the study, more than half (58%) of the respondents reported experiencing psychological reactions after providing CISM services, including an array of behavioral, emotional, cognitive, and physical symptoms of psychological stress. Forty percent of respondents were found to have moderate, high, or extremely high risk for compassion fatigue. At the same time, 89% of respondents were found to have a good, high, or extremely high potential for compassion satisfaction, and 87% were found to be at extremely low risk for burnout. The results appear to indicate that, while the CISM practitioners recognize the stress associated with their work (as reflected in the reported symptoms), the work provides significant rewards (as measured by compassion satisfaction) that outweigh the stress and mitigate against burnout. Likewise, while 40% tested positive for compassion fatigue (or secondary traumatic stress) as a result of their empathy with CISM recipients, the rewards of the work again appear to mitigate the negative effects of the work. Implications for future research and practice are presented.

Effects of Balance Training on Postural Sway, Leg Extensor Strength, and Jumping Height in Adolescents

ERIC Educational Resources Information Center

Granacher, Urs; Gollhofer, Albert; Kriemler, Susi

2010-01-01

Deficits in strength of the lower extremities and postural control have been associated with a high risk of sustaining sport-related injuries. Such injuries often occur during physical education (PE) classes and mostly affect the lower extremities. Thus, the objectives of this study were to investigate the effects of balance training on postural…

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

Treesearch

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

2017-01-01

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

The Relationship of Parental Knowledge to the Development of Extremely Low Birth Weight Infants.

ERIC Educational Resources Information Center

Dichtelmiller, Margo; And Others

1992-01-01

This study found that mothers (n=40) of extremely high-risk infants (averaging 1000 grams birthweight and 28 weeks gestational age) called upon the same experiences and sources of information as mothers of full-term infants. Infants of mothers with above average knowledge about infancy scored significantly higher on tests of infant development at…

High Temperature Extremes - Will They Transform Structure of Avian Assemblages in the Desert Southwest?

NASA Astrophysics Data System (ADS)

Mutiibwa, D.; Albright, T. P.; Wolf, B. O.; Mckechnie, A. E.; Gerson, A. R.; Talbot, W. A.; Sadoti, G.; O'Neill, J.; Smith, E.

2014-12-01

Extreme weather events can alter ecosystem structure and function and have caused mass mortality events in animals. With climate change, high temperature extremes are increasing in frequency and magnitude. To better understand the consequences of climate change, scientists have frequently employed correlative models based on species occurrence records. However, these approaches may be of limited utility in the context of extremes, as these are often outside historical ranges and may involve strong non-linear responses. Here we describe work linking physiological response informed by experimental data to geospatial climate datasets in order to mechanistically model the dynamics of dehydration risk to dessert passerine birds. Specifically, we modeled and mapped the occurrence of current (1980-2013) high temperature extremes and evaporative water loss rates for eight species of passerine birds ranging in size from 6.5-75g in the US Southwest portion of their range. We then explored the implications of a 4° C warming scenario. Evaporative water loss (EWL) across a range of high temperatures was measured in heat-acclimated birds captured in the field. We used the North American Land Data Assimilation System 2 dataset to obtain hourly estimates of EWL with a 14-km spatial grain. Assuming lethal dehydration occurs when water loss reaches 15% of body weight, we then produced maps of total daily EWL and time to lethal dehydration based on both current data and future scenarios. We found that milder events capable of producing dehydration in passerine birds over four or more hours were not uncommon over the Southwest, but rapid dehydration conditions (<3 hours) were rare. Under the warming scenario, the frequency and extent of dehydration events expanded greatly, often affecting areas several times larger than in present-day climate. Dehydration risk was especially high among smaller bodied passerines due to their higher mass-specific rates of water loss. Even after accounting for the moderating effects of microsite and topoclimatic refugia, the increase in occurrence of lethal dehydration risk is cause for concern. In particular, our results suggest that smaller bodied passerines may have difficulty in avoiding extirpation over portions of their current range in the desert southwest.

Application of an extreme winter storm scenario to identify vulnerabilities, mitigation options, and science needs in the Sierra Nevada mountains, USA

USGS Publications Warehouse

Albano, Christine M.; Dettinger, Michael; McCarthy, Maureen; Schaller, Kevin D.; Wellborn, Toby; Cox, Dale A.

2016-01-01

In the Sierra Nevada mountains (USA), and geographically similar areas across the globe where human development is expanding, extreme winter storm and flood risks are expected to increase with changing climate, heightening the need for communities to assess risks and better prepare for such events. In this case study, we demonstrate a novel approach to examining extreme winter storm and flood risks. We incorporated high-resolution atmospheric–hydrologic modeling of the ARkStorm extreme winter storm scenario with multiple modes of engagement with practitioners, including a series of facilitated discussions and a tabletop emergency management exercise, to develop a regional assessment of extreme storm vulnerabilities, mitigation options, and science needs in the greater Lake Tahoe region of Northern Nevada and California, USA. Through this process, practitioners discussed issues of concern across all phases of the emergency management life cycle, including preparation, response, recovery, and mitigation. Interruption of transportation, communications, and interagency coordination were among the most pressing concerns, and specific approaches for addressing these issues were identified, including prepositioning resources, diversifying communications systems, and improving coordination among state, tribal, and public utility practitioners. Science needs included expanding real-time monitoring capabilities to improve the precision of meteorological models and enhance situational awareness, assessing vulnerabilities of critical infrastructure, and conducting cost–benefit analyses to assess opportunities to improve both natural and human-made infrastructure to better withstand extreme storms. Our approach and results can be used to support both land use and emergency planning activities aimed toward increasing community resilience to extreme winter storm hazards in mountainous regions.

Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis.

PubMed

Asdourian, Maria S; Skolny, Melissa N; Brunelle, Cheryl; Seward, Cara E; Salama, Laura; Taghian, Alphonse G

2016-09-01

Precautionary recommendations conveyed to survivors of cancer by health-care practitioners to reduce the risk of breast cancer-related lymphoedema are indispensable aspects of clinical care, yet remain unsubstantiated by high-level scientific evidence. By reviewing the literature, we identified 31 original research articles that examined whether lifestyle-associated risk factors (air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and skin infections-eg, cellulitis) increase the risk of breast cancer-related lymphoedema. Among the few studies that lend support to precautionary guidelines, most provide low-level (levels 3-5) or inconclusive evidence of an association between lymphoedema and these risk factors, and only four level 2 studies show a significant association. Skin infections and previous infection or inflammation on the ipsilateral arm were among the most clearly defined and well established risk factors for lymphoedema. The paucity of high-level evidence and the conflicting nature of the existing literature make it difficult to establish definitive predictive factors for breast cancer-related lymphoedema, which could be a considerable source of patient distress and anxiety. Along with further research into these risk factors, continued discussion regarding modification of the guidelines and adoption of a risk-adjusted approach is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Trait-based Affective Processes in Alcohol-Involved Risk Behaviors

PubMed Central

Wray, Tyler B.; Simons, Jeffrey S.; Dvorak, Robert D.; Gaher, Raluca M.

2012-01-01

This study tested a theoretical model of alcohol use, markers of extreme intoxication, and risk behavior as a function of trait affect, distress tolerance, and affect-based behavior dysregulation. Positive affective pathways to risk behavior were primarily expected to be indirect via high levels of alcohol use, while negative affect paths were expected to be more directly associated with engagement in risk behavior. In addition, we expected trait affectivity and distress tolerance would primarily exhibit relationships with alcohol use and problems through behavioral dysregulation occurring during extreme affective states. To evaluate these hypotheses, we tested a SEM with three alcohol–related outcomes: “Typical” alcohol use, “blackout” drinking,” and risk behavior. Results were complex, but generally supported the hypotheses. High trait negative affect and low tolerance for affective distress contribute to difficulty controlling behavior when negatively aroused and this is directly associated with increased risk behavior when drinking. In contrast, associations between positive urgency and risk behaviors are indirect via increased alcohol consumption. Positive affectivity exhibited both inverse and positive effects in the model, with the net effect on alcohol outcomes being insignificant. These findings contribute important information about the distinct pathways between affect, alcohol use, and alcohol-involved risk behavior among college students. PMID:22770825

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

PubMed

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

2013-08-01

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

The Extreme Climate Index: a novel and multi-hazard index for extreme weather events.

NASA Astrophysics Data System (ADS)

Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

2017-04-01

In this presentation we introduce the Extreme Climate Index (ECI): an objective, multi-hazard index capable of tracking changes in the frequency or magnitude of extreme weather events in African countries, thus indicating that a shift to a new climate regime is underway in a particular area. This index has been developed in the context of XCF (eXtreme Climate Facilities) project lead by ARC (African Risk Capacity, specialised agency of the African Union), and will be used in the payouts triggering mechanism of an insurance programme against risks related to the increase of frequency and magnitude of extreme weather events due to climate regimes' changes. The main hazards covered by ECI will be extreme dry, wet and heat events, with the possibility of adding region-specific risk events such as tropical cyclones for the most vulnerable areas. It will be based on data coming from consistent, sufficiently long, high quality historical records and will be standardized across broad geographical regions, so that extreme events occurring under different climatic regimes in Africa can be comparable. The first step to construct such an index is to define single hazard indicators. In this first study we focused on extreme dry/wet and heat events, using for their description respectively the well-known SPI (Standardized Precipitation Index) and an index developed by us, called SHI (Standardized Heat-waves Index). The second step consists in the development of a computational strategy to combine these, and possibly other indices, so that the ECI can describe, by means of a single indicator, different types of climatic extremes. According to the methodology proposed in this paper, the ECI is defined by two statistical components: the ECI intensity, which indicates whether an event is extreme or not; the angular component, which represent the contribution of each hazard to the overall intensity of the index. The ECI can thus be used to identify "extremes" after defining a suitable threshold above which the events can be held as extremes. In this presentation, after describing the methodology we used for the construction of the ECI, we present results obtained on different African regions, using NCEP Reanalysis dataset for air temperature at sig995 level and CHIRP dataset for precipitations. Particular attention will be devoted to 2015/2016 Malawi drought, which received some media attention due to the failure of the risk assessment model used to trigger due payouts: it will be shown how, on the contrary, combination of hydrological and temperature data used in ECI succeed in evaluating the extremeness of this event.

ENVIRONMENTAL SCIENCE. Profiling risk and sustainability in coastal deltas of the world.

PubMed

Tessler, Z D; Vörösmarty, C J; Grossberg, M; Gladkova, I; Aizenman, H; Syvitski, J P M; Foufoula-Georgiou, E

2015-08-07

Deltas are highly sensitive to increasing risks arising from local human activities, land subsidence, regional water management, global sea-level rise, and climate extremes. We quantified changing flood risk due to extreme events using an integrated set of global environmental, geophysical, and social indicators. Although risks are distributed across all levels of economic development, wealthy countries effectively limit their present-day threat by gross domestic product-enabled infrastructure and coastal defense investments. In an energy-constrained future, such protections will probably prove to be unsustainable, raising relative risks by four to eight times in the Mississippi and Rhine deltas and by one-and-a-half to four times in the Chao Phraya and Yangtze deltas. The current emphasis on short-term solutions for the world's deltas will greatly constrain options for designing sustainable solutions in the long term. Copyright © 2015, American Association for the Advancement of Science.

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

PubMed Central

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

2018-01-01

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

Risk Factor Analysis of Freestyle Propeller Flaps.

PubMed

Paik, Joo Myong; Pyon, Jai-Kyong

2017-01-01

Background  Freestyle propeller flaps have been widely used as a reconstructive option for both trunk and extremities. It offers the advantage of "like-with-like" reconstruction with an adjacent tissue with no dissection to the source vessels. However, there is the risk of vascular complications. In the present study, the authors investigated the incidence of vascular complications and their risk factors following freestyle propeller flap in the trunk and extremities. Methods  The authors conducted a retrospective review of 50 patients who underwent soft tissue reconstruction of the trunk and the extremities with 55 freestyle propeller flaps from 2004 to 2015. Data regarding patient demographics, surgical details, including the arc of rotation, and flap complications were collected from a prospectively maintained database and analyzed. Results  There were 10 flap complications (18.2%), including 7 superficial partial necrosis, 2 full-thickness partial necrosis, and 1 total necrosis from the 55 freestyle propeller flaps harvested. Previous irradiation was a significant risk factor for flap complications and the propeller flap harvested from the extremities showed a significantly higher rate of complications compared with those harvested from the trunk. Complication rates were higher in flaps with the arc of rotation between 150 and 180 degrees with marginal significance compared with flaps with the arc of rotation less than 150 degrees. Conclusions  Freestyle propeller flaps proved to be a valid and reliable option for reconstruction of defects in the trunk, while complication rate was quite high in the extremities. A prudent preoperative evaluation and preparation may be necessary before performing this surgical technique in the extremities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

PubMed

Onozuka, Daisuke; Hagihara, Akihito

2017-03-15

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

Identifying Patterns in Extreme Precipitation Risk and the Related Impacts

NASA Astrophysics Data System (ADS)

Schroeer, K.; Tye, M. R.

2017-12-01

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

Extreme Geohazards: Reducing Disaster Risk and Increasing Resilience

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Campus, Paola

2014-05-01

Extreme natural hazards have the potential to cause global disasters and to lead to an escalation of the global sustainability crisis. Floods and droughts pose threats that could reach planetary extent, particularly through secondary economic and social impacts. Earthquakes and tsunamis cause disasters that could exceed the immediate coping capacity of the global economy, particularly in hazardous areas containing megacities, that can be particularly vulnerable to natural hazards if proper emergency protocols and infrastructures are not set in place. Recent events illustrate the destruction extreme hazards can inflict, both directly and indirectly, through domino effects resulting from the interaction with the built environment. Unfortunately, the more humanity learns to cope with relatively frequent (50 to 100 years) natural hazard events, the less concerns remain about the low-probability (one in a few hundred or more years) high-impact events. As a consequence, threats from low-probability extreme floods, droughts, and volcanic eruptions are not appropriately accounted for in Disaster Risk Reduction (DRR) discussions. With the support of the European Science Foundation (ESF), the Geohazards Community of Practice (GHCP) of the Group on Earth Observations (GEO) has developed a White Paper (WP) on the risk associated with low-probability, high-impact geohazards. These events are insufficiently addressed in risk management, although their potential impacts are comparable to those of a large asteroid impact, a global pandemic, or an extreme drought. The WP aims to increase awareness of the risk associated with these events as a basis for a comprehensive risk management. Extreme geohazards have occurred regularly throughout the past, but mostly did not cause major disasters because the exposure of human assets to such hazards and the global population density were much lower than today. The most extreme events during the last 2,000 years would cause today unparalleled damage on a global scale for a globally connected and stressed society. In particular, large volcanic eruptions could impact climate, damage anthropogenic infrastructure and interrupt resource supplies on a global scale. The occurrence of one or more of the largest volcanic eruptions that took place during the last 2,000 years under today's conditions would likely cause global disasters or catastrophes challenging civilization. Integration of these low-probability, high-impact events in DRR requires an approach focused on resilience and antifragility, as well as the ability to cope with, and recover from failure of infrastructures and social systems. Resilience results from social capital even more than from the robustness of infrastructure. While it is important to understand the hazards through the contribution of geosciences, it is equally important to understand through the contribution of social sciences and engineering the societal processes involved with coping with hazards or leading to failure. For comprehensive development of resilience to natural hazards and, in particular, extreme geohazards, synergy between geosciences, engineering and social sciences, jointed to an improved science-policy relationship is key to success. For example, a simple cost-benefit analysis shows that a comprehensive monitoring system that could identify the onset of an extreme volcanic eruption with sufficient lead time to allow for a globally coordinated preparation makes economic sense. The WP recommends implementation of such a monitoring system with global coverage, assesses the existing assets in current monitoring systems, and illustrates many benefits, besides providing early warning for extreme volcanic eruptions. However, such a monitoring system can provide resilience only via the capability of the global community to react to early warnings. The WP recommends achieving this through the establishment of a global coordination platform comparable to IPCC's role in addressing climate-change related issues to assess knowledge and related adaptive capabilities for disasters due to extreme geohazards.

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

Assessment of Coastal and Urban Flooding Hazards Applying Extreme Value Analysis and Multivariate Statistical Techniques: A Case Study in Elwood, Australia

NASA Astrophysics Data System (ADS)

Guimarães Nobre, Gabriela; Arnbjerg-Nielsen, Karsten; Rosbjerg, Dan; Madsen, Henrik

2016-04-01

Traditionally, flood risk assessment studies have been carried out from a univariate frequency analysis perspective. However, statistical dependence between hydrological variables, such as extreme rainfall and extreme sea surge, is plausible to exist, since both variables to some extent are driven by common meteorological conditions. Aiming to overcome this limitation, multivariate statistical techniques has the potential to combine different sources of flooding in the investigation. The aim of this study was to apply a range of statistical methodologies for analyzing combined extreme hydrological variables that can lead to coastal and urban flooding. The study area is the Elwood Catchment, which is a highly urbanized catchment located in the city of Port Phillip, Melbourne, Australia. The first part of the investigation dealt with the marginal extreme value distributions. Two approaches to extract extreme value series were applied (Annual Maximum and Partial Duration Series), and different probability distribution functions were fit to the observed sample. Results obtained by using the Generalized Pareto distribution demonstrate the ability of the Pareto family to model the extreme events. Advancing into multivariate extreme value analysis, first an investigation regarding the asymptotic properties of extremal dependence was carried out. As a weak positive asymptotic dependence between the bivariate extreme pairs was found, the Conditional method proposed by Heffernan and Tawn (2004) was chosen. This approach is suitable to model bivariate extreme values, which are relatively unlikely to occur together. The results show that the probability of an extreme sea surge occurring during a one-hour intensity extreme precipitation event (or vice versa) can be twice as great as what would occur when assuming independent events. Therefore, presuming independence between these two variables would result in severe underestimation of the flooding risk in the study area.

Gis-Based Multi-Criteria Decision Analysis for Forest Fire Risk Mapping

NASA Astrophysics Data System (ADS)

Akay, A. E.; Erdoğan, A.

2017-11-01

The forested areas along the coastal zone of the Mediterranean region in Turkey are classified as first-degree fire sensitive areas. Forest fires are major environmental disaster that affects the sustainability of forest ecosystems. Besides, forest fires result in important economic losses and even threaten human lives. Thus, it is critical to determine the forested areas with fire risks and thereby minimize the damages on forest resources by taking necessary precaution measures in these areas. The risk of forest fire can be assessed based on various factors such as forest vegetation structures (tree species, crown closure, tree stage), topographic features (slope and aspect), and climatic parameters (temperature, wind). In this study, GIS-based Multi-Criteria Decision Analysis (MCDA) method was used to generate forest fire risk map. The study was implemented in the forested areas within Yayla Forest Enterprise Chiefs at Dursunbey Forest Enterprise Directorate which is classified as first degree fire sensitive area. In the solution process, "extAhp 2.0" plug-in running Analytic Hierarchy Process (AHP) method in ArcGIS 10.4.1 was used to categorize study area under five fire risk classes: extreme risk, high risk, moderate risk, and low risk. The results indicated that 23.81 % of the area was of extreme risk, while 25.81 % was of high risk. The result indicated that the most effective criterion was tree species, followed by tree stages. The aspect had the least effective criterion on forest fire risk. It was revealed that GIS techniques integrated with MCDA methods are effective tools to quickly estimate forest fire risk at low cost. The integration of these factors into GIS can be very useful to determine forested areas with high fire risk and also to plan forestry management after fire.

Working postures of dental students: ergonomic analysis using the Ovako Working Analysis System and rapid upper limb assessment.

PubMed

Petromilli Nordi Sasso Garcia, Patrícia; Polli, Gabriela Scatimburgo; Campos, Juliana Alvares Duarte Bonini

2013-01-01

As dentistry is a profession that demands a manipulative precision of hand movements, musculoskeletal disorders are among the most common occupational diseases. This study estimated the risk of musculoskeletal disorders developing in dental students using the Ovako Working Analysis System (OWAS) and Rapid Upper Limb Assessment (RULA) methods, and estimated the diagnostic agreement between the 2 methods. Students (n = 75), enrolled in the final undergraduate year at the Araraquara School of Dentistry--UNESP--were studied. Photographs were taken of students while performing diverse clinical procedures (n = 283) using a digital camera, which were assessed using OWAS and RULA. A risk score was attributed following each procedure performed by the student. The prevalence of the risk of musculoskeletal disorders was estimated per point and for a 95% CI. To assess the agreement between the 2 methods, Kappa statistics with linear weighting were used. The level of significance adopted was 5%. There was a high prevalence of the mean score for risk of musculoskeletal disorders in the dental students evaluated according to the OWAS method (p = 97.88%; 95% CI: 96.20-99.56%), and a high prevalence of the high score (p = 40.6; 95% CI: 34.9-46.4%) and extremely high risk (p = 59.4%; 95% CI: 53.6-65.1%) according to RULA method Null agreement was verified (k = 0) in the risk di agnosis of the tested methods. The risk of musculoskeletal disorders in dental students estimated by the OWAS method was medium, whereas the same risk by the RULA method was extremely high. There was no diagnostic agreement between the OWAS and RULA methods.

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

Polygenic determinants in extremes of high-density lipoprotein cholesterol.

PubMed

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

2017-11-01

HDL cholesterol (HDL-C) remains a superior biochemical predictor of CVD risk, but its genetic basis is incompletely defined. In patients with extreme HDL-C concentrations, we concurrently evaluated the contributions of multiple large- and small-effect genetic variants. In a discovery cohort of 255 unrelated lipid clinic patients with extreme HDL-C levels, we used a targeted next-generation sequencing panel to evaluate rare variants in known HDL metabolism genes, simultaneously with common variants bundled into a polygenic trait score. Two additional cohorts were used for validation and included 1,746 individuals from the Montréal Heart Institute Biobank and 1,048 individuals from the University of Pennsylvania. Findings were consistent between cohorts: we found rare heterozygous large-effect variants in 18.7% and 10.9% of low- and high-HDL-C patients, respectively. We also found common variant accumulation, indicated by extreme polygenic trait scores, in an additional 12.8% and 19.3% of overall cases of low- and high-HDL-C extremes, respectively. Thus, the genetic basis of extreme HDL-C concentrations encountered clinically is frequently polygenic, with contributions from both rare large-effect and common small-effect variants. Multiple types of genetic variants should be considered as contributing factors in patients with extreme dyslipidemia. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

Time-varying Concurrent Risk of Extreme Droughts and Heatwaves in California

NASA Astrophysics Data System (ADS)

Sarhadi, A.; Diffenbaugh, N. S.; Ausin, M. C.

2016-12-01

Anthropogenic global warming has changed the nature and the risk of extreme climate phenomena such as droughts and heatwaves. The concurrent of these nature-changing climatic extremes may result in intensifying undesirable consequences in terms of human health and destructive effects in water resources. The present study assesses the risk of concurrent extreme droughts and heatwaves under dynamic nonstationary conditions arising from climate change in California. For doing so, a generalized fully Bayesian time-varying multivariate risk framework is proposed evolving through time under dynamic human-induced environment. In this methodology, an extreme, Bayesian, dynamic copula (Gumbel) is developed to model the time-varying dependence structure between the two different climate extremes. The time-varying extreme marginals are previously modeled using a Generalized Extreme Value (GEV) distribution. Bayesian Markov Chain Monte Carlo (MCMC) inference is integrated to estimate parameters of the nonstationary marginals and copula using a Gibbs sampling method. Modelled marginals and copula are then used to develop a fully Bayesian, time-varying joint return period concept for the estimation of concurrent risk. Here we argue that climate change has increased the chance of concurrent droughts and heatwaves over decades in California. It is also demonstrated that a time-varying multivariate perspective should be incorporated to assess realistic concurrent risk of the extremes for water resources planning and management in a changing climate in this area. The proposed generalized methodology can be applied for other stochastic nature-changing compound climate extremes that are under the influence of climate change.

Neurodevelopmental Outcomes of Extremely Preterm Infants Randomized to Stress Dose Hydrocortisone

PubMed Central

Parikh, Nehal A.; Kennedy, Kathleen A.; Tyson, Jon E.

2015-01-01

Objective To compare the effects of stress dose hydrocortisone therapy with placebo on survival without neurodevelopmental impairments in high-risk preterm infants. Study Design We recruited 64 extremely low birth weight (birth weight ≤1000g) infants between the ages of 10 and 21 postnatal days who were ventilator-dependent and at high-risk for bronchopulmonary dysplasia. Infants were randomized to a tapering 7-day course of stress dose hydrocortisone or saline placebo. The primary outcome at follow-up was a composite of death, cognitive or language delay, cerebral palsy, severe hearing loss, or bilateral blindness at a corrected age of 18–22 months. Secondary outcomes included continued use of respiratory therapies and somatic growth. Results Fifty-seven infants had adequate data for the primary outcome. Of the 28 infants randomized to hydrocortisone, 19 (68%) died or survived with impairment compared with 22 of the 29 infants (76%) assigned to placebo (relative risk: 0.83; 95% CI, 0.61 to 1.14). The rates of death for those in the hydrocortisone and placebo groups were 31% and 41%, respectively (P = 0.42). Randomization to hydrocortisone also did not significantly affect the frequency of supplemental oxygen use, positive airway pressure support, or need for respiratory medications. Conclusions In high-risk extremely low birth weight infants, stress dose hydrocortisone therapy after 10 days of age had no statistically significant effect on the incidence of death or neurodevelopmental impairment at 18–22 months. These results may inform the design and conduct of future clinical trials. Trial Registration ClinicalTrials.gov NCT00167544 PMID:26376074

Mortality, Disenrollment, and Spending Persistence in Medicaid and CHIP.

PubMed

DeLia, Derek

2017-03-01

Research on spending persistence has not focused on Medicaid and the Children's Health Insurance Program (Medicaid/CHIP), which includes a complex and growing population. The objective of the study was to describe patterns of expenditure persistence, mortality, and disenrollment among nondually eligible Medicaid/CHIP enrollees and identify factors predicting these outcomes. The study is based on New Jersey Medicaid/CHIP claims data from 2011 to 2014. Descriptive and multinomial regression methods were used to characterize persistently extreme spenders, defined as those appearing in the top 1% of statewide spending every year, according to demographics, Medicaid/CHIP eligibility, nursing facility residence, patient risk scores, and clinical diagnostic categories measured in 2011. Similar analyses were done for persistently high spenders (ie, always in the top 10% but not always top 1%) as well as decedents, disenrollees, and moderate spenders (ie, at least 1 year outside of the top 10%). Nondually eligible NJ Medicaid/CHIP enrollees in 2011. One fourth of extreme spenders in 2011 remained in that category throughout 2011-2014. Almost all (89.3%) of the persistently extreme spenders were aged, blind, or disabled. Within the aged, blind, or disabled population, the strongest predictors of persistently extreme spending were diagnoses involving developmental disability, HIV/AIDS, central nervous system conditions, psychiatric disorders, type 1 diabetes, and renal conditions. Individuals in nursing facilities and those with very high risk scores were more likely to die or have persistently high spending than to have persistently extreme spending. The study highlights unique features of spending persistence within Medicaid/CHIP and provides methodological contributions to the broader persistence literature.

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

NASA Astrophysics Data System (ADS)

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

2015-06-01

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

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

PubMed Central

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

2015-01-01

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

Common Injuries in Professional Football Quarterbacks.

PubMed

Kirsch, Jacob M; Burrus, M Tyrrell; Bedi, Asheesh

2018-03-01

Professional football quarterbacks are at particular risk for upper extremity injuries due to the physical demands of their position coupled with the inherent risks associated with professional football. This review sought to evaluate current clinical literature to better characterize the injury profile unique to this athletic population. Shoulder injuries are the most prevented upper extremity injury among professional football quarterbacks. The quarterback position is disproportionately impacted by shoulder injuries when compared to professional athletes at other positions. Moreover, contrary to other professional throwing athletes, the majority of upper extremity injuries in the professional quarterback result from direct contact as opposed to the throwing motion. The injury profile among professional quarterbacks is unique compared to other positions and other overhead professional throwing athletes. Overall, a paucity of high quality clinical evidence exists to support the management of injuries in this elite population.

Mountain Biking Injuries.

PubMed

Ansari, Majid; Nourian, Ruhollah; Khodaee, Morteza

With the increasing popularity of mountain biking, also known as off-road cycling, and the riders pushing the sport into extremes, there has been a corresponding increase in injury. Almost two thirds of acute injuries involve the upper extremities, and a similar proportion of overuse injuries affect the lower extremities. Mountain biking appears to be a high-risk sport for severe spine injuries. New trends of injury patterns are observed with popularity of mountain bike trail parks and freeride cycling. Using protective gear, improving technical proficiency, and physical fitness may somewhat decrease the risk of injuries. Simple modifications in bicycle-rider interface areas and with the bicycle (bike fit) also may decrease some overuse injuries. Bike fit provides the clinician with postural correction during the sport. In this review, we also discuss the importance of race-day management strategies and monitoring the injury trends.

An Examination of the Reliability, Data Screening Procedures, and Extreme Response Patterns for the Youth Risk Behavior Surveillance Survey

ERIC Educational Resources Information Center

Furlong, Michael J.; Sharkey, Jill D.; Bates, Michael P.; Smith, Douglas C.

2004-01-01

This article explores psychometric characteristics of the Youth Risk Behavior Surveillance Survey (YRBS), one of the most widely used instruments to assess the prevalence of violent and other high-risk behaviors in secondary school settings. Response patterns were analyzed for a subset of 414 youths who indicated that they had carried a weapon to…

Analysis of present and future potential compound flooding risk along the European coast

NASA Astrophysics Data System (ADS)

Bevacqua, Emanuele; Maraun, Douglas; Voukouvalas, Evangelos; Vousdoukas, Michalis I.; Widmann, Martin; Manning, Colin; Vrac, Mathieu

2017-04-01

The coastal zone is the natural border between the sea and the mainland, and it is constantly under the influence of marine and land-based natural and human-induced pressure. Compound floods are extreme events occurring in coastal areas where the interaction of joint high sea level and large amount of precipitation causes extreme floodings. Typically the risk of flooding in coastal areas is defined analysing either sea level or precipitation driven floodings, however compound floods should be considered to avoid an underestimation of the risk. In the future, the human pressure at the coastal zone is expected to increase, urging for a comprehensive analysis of the compound flooding risk under different climate change scenarios. In this study we introduce the concept of "potential risk" as we investigate how often large amount of precipitation and high sea level may co-occur, and not the effective impact due to the interaction of these two hazards. The effective risk of compound flooding in a specific place depends also on the local orography and on the existing protections. The estimation of the potential risk of compound flooding is useful to individuate places where an effective risk of compound flooding may exist, and where further studies would be useful to get more precise information on the local risk. We estimate the potential risk of compound flooding along the European coastal zone incorporating the ERA-Interim meteorological reanalysis for the past and present state, and the future projections from two RCP scenarios (namely the RCP4.5 and RCP8.5 scenarios) as derived from 8 CMIP5 models of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Sea level data are estimated by forcing the hydrodynamic model Delft3D-Flow with 6-hourly wind and atmospheric pressure fields. Based on sea level (storm surge and astronomical tide) and precipitation joint occurrence analysis, a map of the potential compound flooding risk along the European coast is proposed and critical places with high potential risk are identified. For these critical places, we plan to asses the potential compound flood risk driven by coinciding extreme values of sea level and river discharge. Finally, we analyse the atmospheric large scale processes that lead to compound floods and their variation under future climate change scenarios.

Risk factors for lower extremity injuries in elite female soccer players.

PubMed

Nilstad, Agnethe; Andersen, Thor Einar; Bahr, Roald; Holme, Ingar; Steffen, Kathrin

2014-04-01

The incidence of lower extremity injuries in female soccer players is high, but the risk factors for injuries are unknown. To investigate risk factors for lower extremity injuries in elite female soccer players. Cohort study; Level of evidence, 3. Players in the Norwegian elite female soccer league (N = 12 teams) participated in baseline screening tests before the 2009 competitive soccer season. The screening included tests assessing maximal lower extremity strength, dynamic balance, knee valgus angles in a drop-jump landing, knee joint laxity, generalized joint laxity, and foot pronation. Also included was a questionnaire to collect information on demographic data, elite-level experience, and injury history. Time-loss injuries and exposure in training and matches were recorded prospectively in the subsequent soccer season using weekly text messaging. Players reporting an injury were contacted to collect data regarding injury circumstances. Univariate and multivariate regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for ±1 standard deviation of change. In total, 173 players underwent complete screening tests and registration of injuries and exposure throughout the season. A total of 171 injuries in 107 players (62%) were recorded; ligament and muscle injuries were the most frequent. Multivariate analyses showed that a greater body mass index (BMI) (OR, 1.51; 95% CI, 1.21-1.90; P = .001) was the only factor significantly associated with new lower extremity injuries. A greater BMI was associated with new thigh injuries (OR, 1.51; 95% CI, 1.08-2.11; P = .01), a lower knee valgus angle in a drop-jump landing was associated with new ankle injuries (OR, 0.64; 95% CI, 0.41-1.00; P = .04), and a previous knee injury was associated with new lower leg and foot injuries (OR, 3.57; 95% CI, 1.27-9.99; P = .02), whereas none of the factors investigated influenced the risk of new knee injuries. A greater BMI was associated with lower extremity injuries in elite female soccer players. Increased knowledge on risk factors for lower extremity injuries enables more targeted prevention strategies with the aim of reducing injury rates in female soccer players.

Upper extremity interaction with a helicopter side airbag: injury criteria for dynamic hyperextension of the female elbow joint.

PubMed

Duma, Stefan M; Hansen, Gail A; Kennedy, Eric A; Rath, Amber L; McNally, Craig; Kemper, Andrew R; Smith, Eric P; Brolinson, P Gunnar; Stitzel, Joel D; Davis, Martin B; Bass, Cameron R; Brozoski, Frederick T; McEntire, B Joseph; Alem, Nabih M; Crowley, John S

2004-11-01

This paper describes a three part analysis to characterize the interaction between the female upper extremity and a helicopter cockpit side airbag system and to develop dynamic hyperextension injury criteria for the female elbow joint. Part I involved a series of 10 experiments with an original Army Black Hawk helicopter side airbag. A 5(th) percentile female Hybrid III instrumented upper extremity was used to demonstrate side airbag upper extremity loading. Two out of the 10 tests resulted in high elbow bending moments of 128 Nm and 144 Nm. Part II included dynamic hyperextension tests on 24 female cadaver elbow joints. The energy source was a drop tower utilizing a three-point bending configuration to apply elbow bending moments matching the previously conducted side airbag tests. Post-test necropsy showed that 16 of the 24 elbow joint tests resulted in injuries. Injury severity ranged from minor cartilage damage to more moderate joint dislocations and severe transverse fractures of the distal humerus. Peak elbow bending moments ranged from 42.4 Nm to 146.3 Nm. Peak bending moment proved to be a significant indicator of any elbow injury (p = 0.02) as well as elbow joint dislocation (p = 0.01). Logistic regression analyses were used to develop single and multiple variate injury risk functions. Using peak moment data for the entire test population, a 50% risk of obtaining any elbow injury was found at 56 Nm while a 50% risk of sustaining an elbow joint dislocation was found at 93 Nm for the female population. These results indicate that the peak elbow bending moments achieved in Part I are associated with a greater than 90% risk for elbow injury. Subsequently, the airbag was re-designed in an effort to mitigate this as well as the other upper extremity injury risks. Part III assessed the redesigned side airbag module to ensure injury risks had been reduced prior to implementing the new system. To facilitate this, 12 redesigned side airbag deployments were conducted using the same procedures as Part I. Results indicate that the re-designed side airbag has effectively mitigated elbow injury risks induced by the original side airbag design. It is anticipated that this study will provide researchers with additional injury criteria for assessing upper extremity injury risk caused by both military and automotive side airbag deployments.

A Top Pilot Tunnel Preconditioning Method for the Prevention of Extremely Intense Rockbursts in Deep Tunnels Excavated by TBMs

NASA Astrophysics Data System (ADS)

Zhang, Chuanqing; Feng, Xiating; Zhou, Hui; Qiu, Shili; Wu, Wenping

2012-05-01

The headrace tunnels at the Jinping II Hydropower Station cross the Jinping Mountain with a maximum overburden depth of 2,525 m, where 80% of the strata along the tunnels consist of marble. A number of extremely intense rockbursts occurred during the excavation of the auxiliary tunnels and the drainage tunnel. In particular, a tunnel boring machine (TBM) was destroyed by an extremely intense rockburst in a 7.2-m-diameter drainage tunnel. Two of the four subsequent 12.4-m-diameter headrace tunnels will be excavated with larger size TBMs, where a high risk of extremely intense rockbursts exists. Herein, a top pilot tunnel preconditioning method is proposed to minimize this risk, in which a drilling and blasting method is first recommended for the top pilot tunnel excavation and support, and then the TBM excavation of the main tunnel is conducted. In order to evaluate the mechanical effectiveness of this method, numerical simulation analyses using the failure approaching index, energy release rate, and excess shear stress indices are carried out. Its construction feasibility is discussed as well. Moreover, a microseismic monitoring technique is used in the experimental tunnel section for the real-time monitoring of the microseismic activities of the rock mass in TBM excavation and for assessing the effect of the top pilot tunnel excavation in reducing the risk of rockbursts. This method is applied to two tunnel sections prone to extremely intense rockbursts and leads to a reduction in the risk of rockbursts in TBM excavation.

Engineered nanoconstructs for the multiplexed and sensitive detection of high-risk pathogens

NASA Astrophysics Data System (ADS)

Seo, Youngmin; Kim, Ji-Eun; Jeong, Yoon; Lee, Kwan Hong; Hwang, Jangsun; Hong, Jongwook; Park, Hansoo; Choi, Jonghoon

2016-01-01

Many countries categorize the causative agents of severe infectious diseases as high-risk pathogens. Given their extreme infectivity and potential to be used as biological weapons, a rapid and sensitive method for detection of high-risk pathogens (e.g., Bacillus anthracis, Francisella tularensis, Yersinia pestis, and Vaccinia virus) is highly desirable. Here, we report the construction of a novel detection platform comprising two units: (1) magnetic beads separately conjugated with multiple capturing antibodies against four different high-risk pathogens for simple and rapid isolation, and (2) genetically engineered apoferritin nanoparticles conjugated with multiple quantum dots and detection antibodies against four different high-risk pathogens for signal amplification. For each high-risk pathogen, we demonstrated at least 10-fold increase in sensitivity compared to traditional lateral flow devices that utilize enzyme-based detection methods. Multiplexed detection of high-risk pathogens in a sample was also successful by using the nanoconstructs harboring the dye molecules with fluorescence at different wavelengths. We ultimately envision the use of this novel nanoprobe detection platform in future applications that require highly sensitive on-site detection of high-risk pathogens.

Risk and dynamics of unprecedented hot months in South East China

NASA Astrophysics Data System (ADS)

Thompson, Vikki; Dunstone, Nick J.; Scaife, Adam A.; Smith, Doug M.; Hardiman, Steven C.; Ren, Hong-Li; Lu, Bo; Belcher, Stephen E.

2018-06-01

The Yangtze region of South East China has experienced several extreme hot summer months in recent years. Such events can have devastating socio-economic impacts. We use a large ensemble of initialised climate simulations to assess the current chance of unprecedented hot summer months in the Yangtze River region. We find a 10% chance of an unprecedented hot summer month each year. Our simulations suggest that monthly mean temperatures up to 3 °C hotter than the current record are possible. The dynamics of these unprecedented extremes highlights the occurrence of a stationary atmospheric wave, the Silk Road Pattern, in a significant number of extreme hot events. We present evidence that this atmospheric wave is driven by variability in the Indian summer monsoon. Other extreme events are associated with a westward shift in the western North Pacific subtropical high. The most extreme simulated events exhibit combined characteristics of both the Silk Road Pattern and the shifted western North Pacific subtropical high.

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

PubMed

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

2018-05-18

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

[Risk factors associated with the severity of pulmonary embolism in patients with acute deep venous thrombosis of lower extremities].

PubMed

Luo, Xiaoyun; Zhang, Fuxian; Zhang, Changming; Hu, Lu; Feng, Yaping; Liang, Gangzhu; Niu, Luyuan; Zhang, Huan; Cheng, Long; Qi, Haoshan

2015-08-01

To identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities. This prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital. There were 101 male and 107 female patients, with a mean age of (59 ± 16) years. Gender, age, extension, side of lower extremities of deep venous thrombosis was analyzed by χ² test. Ordinal Logistic regression was used to determine risk factors associated with severity of pulmonary embolism. There were 83 patients with iliofemoral deep venous thrombosis, 102 patients with femoropopliteal and 23 patients with calf deep venous thrombosis. Pulmonary embolism was detected in 70 patients with the incidence of 33.7%. Pulmonary embolism was significantly correlated with extension (χ² = 17.286, P = 0.004) and sides (χ² = 15.602, P = 0.008) of deep venous thrombosis, not with age (χ² = 7.099, P = 0.260), gender (χ² = 7.014, P = 0.067), thrombotic risk factors (χ² = 3.335, P = 0.345) in univariate analysis. Results of multivariate ordinal logistic regression showed that iliofemoral vein thrombosis (OR = 6.172, 95% CI: 1.590 to 23.975, P = 0.009) and bilateral venous thrombosis (OR = 7.140, 95% CI: 2.406 to 24.730, P = 0.001) are associated with more serious pulmonary embolism. Incidence of pulmonary embolism is still high in patients with deep venous thrombosis. Extensive iliofemoral and bilateral vein thrombosis may increase risk of severity of pulmonary embolism. Clinicians should pay more attention to these high-risk patients.

Frequency of extreme weather events and increased risk of motor vehicle collision in Maryland.

PubMed

Liu, Ann; Soneja, Sutyajeet I; Jiang, Chengsheng; Huang, Chanjuan; Kerns, Timothy; Beck, Kenneth; Mitchell, Clifford; Sapkota, Amir

2017-02-15

Previous studies have shown increased precipitation to be associated with higher frequency of traffic collisions. However, data regarding how extreme weather events, projected to grow in frequency, intensity, and duration in response to a changing climate, might affect the risk of motor vehicle collisions is particularly limited. We investigated the association between frequency of extreme heat and precipitation events and risk of motor vehicle collision in Maryland between 2000 and 2012. Motor vehicle collision data was obtained from the Maryland Automated Accident Reporting System. Each observation in the data set corresponded to a unique collision event. This data was linked to extreme heat and precipitation events that were calculated using location and calendar day specific thresholds. A time-stratified case-crossover analysis was utilized to assess the association between exposure to extreme heat and precipitation events and risk of motor vehicle collision. Additional stratified analyses examined risk by road condition, season, and collisions involving only one vehicle. Overall, there were over 1.28 million motor vehicle collisions recorded in Maryland between 2000 and 2012, of which 461,009 involved injuries or death. There was a 23% increase in risk of collision for every 1-day increase in extreme precipitation event (Odds Ratios (OR) 1.23, 95% Confidence Interval (CI): 1.22, 1.27). This risk was considerably higher for collisions on roads with a defect or obstruction (OR: 1.46, 95% CI: 1.40, 1.52) and those involving a single vehicle (OR: 1.41, 95% CI: 1.39, 1.43). Change in risk associated with extreme heat events was marginal at best. Extreme precipitation events are associated with an increased risk of motor vehicle collisions in Maryland. Copyright © 2016 Elsevier B.V. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

The critical role of uncertainty in projections of hydrological extremes

NASA Astrophysics Data System (ADS)

Meresa, Hadush K.; Romanowicz, Renata J.

2017-08-01

This paper aims to quantify the uncertainty in projections of future hydrological extremes in the Biala Tarnowska River at Koszyce gauging station, south Poland. The approach followed is based on several climate projections obtained from the EURO-CORDEX initiative, raw and bias-corrected realizations of catchment precipitation, and flow simulations derived using multiple hydrological model parameter sets. The projections cover the 21st century. Three sources of uncertainty are considered: one related to climate projection ensemble spread, the second related to the uncertainty in hydrological model parameters and the third related to the error in fitting theoretical distribution models to annual extreme flow series. The uncertainty of projected extreme indices related to hydrological model parameters was conditioned on flow observations from the reference period using the generalized likelihood uncertainty estimation (GLUE) approach, with separate criteria for high- and low-flow extremes. Extreme (low and high) flow quantiles were estimated using the generalized extreme value (GEV) distribution at different return periods and were based on two different lengths of the flow time series. A sensitivity analysis based on the analysis of variance (ANOVA) shows that the uncertainty introduced by the hydrological model parameters can be larger than the climate model variability and the distribution fit uncertainty for the low-flow extremes whilst for the high-flow extremes higher uncertainty is observed from climate models than from hydrological parameter and distribution fit uncertainties. This implies that ignoring one of the three uncertainty sources may cause great risk to future hydrological extreme adaptations and water resource planning and management.

Quantile-based bias correction and uncertainty quantification of extreme event attribution statements

DOE PAGES

Jeon, Soyoung; Paciorek, Christopher J.; Wehner, Michael F.

2016-02-16

Extreme event attribution characterizes how anthropogenic climate change may have influenced the probability and magnitude of selected individual extreme weather and climate events. Attribution statements often involve quantification of the fraction of attributable risk (FAR) or the risk ratio (RR) and associated confidence intervals. Many such analyses use climate model output to characterize extreme event behavior with and without anthropogenic influence. However, such climate models may have biases in their representation of extreme events. To account for discrepancies in the probabilities of extreme events between observational datasets and model datasets, we demonstrate an appropriate rescaling of the model output basedmore » on the quantiles of the datasets to estimate an adjusted risk ratio. Our methodology accounts for various components of uncertainty in estimation of the risk ratio. In particular, we present an approach to construct a one-sided confidence interval on the lower bound of the risk ratio when the estimated risk ratio is infinity. We demonstrate the methodology using the summer 2011 central US heatwave and output from the Community Earth System Model. In this example, we find that the lower bound of the risk ratio is relatively insensitive to the magnitude and probability of the actual event.« less

Violent aggression predicted by multiple pre-adult environmental hits.

PubMed

Mitjans, Marina; Seidel, Jan; Begemann, Martin; Bockhop, Fabian; Moya-Higueras, Jorge; Bansal, Vikas; Wesolowski, Janina; Seelbach, Anna; Ibáñez, Manuel Ignacio; Kovacevic, Fatka; Duvar, Oguzhan; Fañanás, Lourdes; Wolf, Hannah-Ulrike; Ortet, Generós; Zwanzger, Peter; Klein, Verena; Lange, Ina; Tänzer, Andreas; Dudeck, Manuela; Penke, Lars; van Elst, Ludger Tebartz; Bittner, Robert A; Schmidmeier, Richard; Freese, Roland; Müller-Isberner, Rüdiger; Wiltfang, Jens; Bliesener, Thomas; Bonn, Stefan; Poustka, Luise; Müller, Jürgen L; Arias, Bárbara; Ehrenreich, Hannelore

2018-05-24

Early exposure to negative environmental impact shapes individual behavior and potentially contributes to any mental disease. We reported previously that accumulated environmental risk markedly decreases age at schizophrenia onset. Follow-up of matched extreme group individuals (≤1 vs. ≥3 risks) unexpectedly revealed that high-risk subjects had >5 times greater probability of forensic hospitalization. In line with longstanding sociological theories, we hypothesized that risk accumulation before adulthood induces violent aggression and criminal conduct, independent of mental illness. We determined in 6 independent cohorts (4 schizophrenia and 2 general population samples) pre-adult risk exposure, comprising urbanicity, migration, physical and sexual abuse as primary, and cannabis or alcohol as secondary hits. All single hits by themselves were marginally associated with higher violent aggression. Most strikingly, however, their accumulation strongly predicted violent aggression (odds ratio 10.5). An epigenome-wide association scan to detect differential methylation of blood-derived DNA of selected extreme group individuals yielded overall negative results. Conversely, determination in peripheral blood mononuclear cells of histone-deacetylase1 mRNA as 'umbrella mediator' of epigenetic processes revealed an increase in the high-risk group, suggesting lasting epigenetic alterations. Together, we provide sound evidence of a disease-independent unfortunate relationship between well-defined pre-adult environmental hits and violent aggression, calling for more efficient prevention.

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

NASA Astrophysics Data System (ADS)

Nissen, Katrin; Ulbrich, Uwe

2016-04-01

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

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

PubMed

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

2018-04-10

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

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

NASA Astrophysics Data System (ADS)

Huttenlau, Matthias; Stötter, Johann

2010-05-01

Reinsurance companies are stating a high increase in natural hazard related losses, both insured and economic losses, within the last decades on a global scale. This ongoing trend can be described as a product of the dynamic in the natural and in the anthroposphere. To analyze the potential impact of natural hazard process to a certain insurance portfolio or to the society in general, reinsurance companies or risk management consultants have developed loss models. However, those models are generally not fitting the scale dependent demand on regional scales like it is appropriate (i) for analyses on the scale of a specific province or (ii) for portfolio analyses of regional insurance companies. Moreover, the scientific basis of most of the models is not transparent documented and therefore scientific evaluations concerning the methodology concepts are not possible (black box). This is contrary to the scientific principles of transparency and traceability. Especially in mountain regions like the European Alps with their inherent (i) specific characteristic on small scales, (ii) the relative high process dynamics in general, (iii) the occurrence of gravitative mass movements which are related to high relief energy and thus only exists in mountain regions, (iv) the small proportion of the area of permanent settlement on the overall area, (v) the high value concentration in the valley floors, (vi) the exposition of important infrastructures and lifelines, and others, analyses must consider these circumstances adequately. Therefore, risk-based analyses are methodically estimating the potential consequences of hazard process on the built environment standardized with the risk components (i) hazard, (ii) elements at risk, and (iii) vulnerability. However, most research and progress have been made in the field of hazard analyses, whereas the other both components are not developed accordingly. Since these three general components are influencing factors without any weighting within the risk concept, this has sufficient implications on the results of risk analyses. Thus, an equal and scale appropriated balance of those risk components is a fundamental key factor for effective natural hazard risk analyses. The results of such analyses inform especially decision makers in the insurance industry, the administration, and politicians on potential consequences and are the basis for appropriate risk management strategies. Thereby, results (i) on an annual or probabilistic risk comprehension have to be distinguished from (ii) scenario-based analyses. The first analyses are based on statistics of periodically or episodically occurring events whereas the latter approach is especially applied for extreme, non-linear, stochastic events. Focusing on the needs especially of insurance companies, the first approaches are appropriate for premium pricing and reinsurance strategies with an annual perspective, whereas the latter is focusing on events with extreme loss burdens under worst-case criteria to guarantee accordant reinsurance coverage. Moreover, the demand of adequate loss model approaches and methods is strengthened by the risk-based requirements of the upcoming capital requirement directive Solvency II. The present study estimates the potential elements at risk, their corresponding damage potentials and the Probable Maximum Losses (PMLs) of extreme natural hazards events in Tyrol (Austria) and considers adequatly the scale dependency and balanced application of the introduced risk components. Beside the introduced analysis an additionally portfolio analysis of a regional insurance company was executed. The geocoded insurance contracts of this portfolio analysis were the basis to estimate spatial, socio-economical and functional differentiated mean insurance values for the different risk categories of (i) buildings, (ii) contents or inventory, (iii) vehicles, and (iv) persons in the study area. The estimated mean insurance values were incorporated with additional GIS and statistic data to a comprehensive property-by-property geodatabase of the existing elements and values. This stock of elements and values geodatabase is furthermore the consistent basis for all natural hazard analyses and enables the comparison of the results. The study follows the general accepted moduls (i) hazard analysis, (ii) exposition analysis, and (iii) consequence analysis, whereas the exposition analysis estimates the elements at risk with their corresponding damage potentials and the consequence analysis estimates the PMLs. This multi-hazard analysis focuses on process types with a high to extreme potential of negative consequences on a regional scale. In this context, (i) floodings, (ii) rockslides with the potential of corresponding consequence effects (backwater ponding and outburst flood), (iii) earthquakes, (iv) hail events, and (v) winter storms were considered as hazard processes. Based on general hazard analyses (hazard maps) concrete scenarios and their spatial affectedness were determined. For the different hazard processes, different vulnerability approaches were considered to demonstrate their sensitivity and implication on the results. Thus, no absolute values of losses but probable loss ranges were estimated. It can be shown, that the most serious amount of losses would arise from extreme earthquake events with loss burdens up to more than € 7 bn. solely on buildings and inventory. Possible extreme flood events could lead to losses between € 2 and 2.5 bn., whereas a severe hail swath which affects the central Inn valley could result in losses of ca. € 455 mill. (thereof € 285 mill. on vehicles). The potential most serious rockslide with additional consequence effects would result in losses up to ca. € 185 mill. and extreme winter storms can induce losses between € 100 mill. and 150 mill..

Forearm fracture bending risk functin for the 50th percentile male.

PubMed

Santago, Anthony C; Cormier, Joseph M; Duma, Stefan M; Yoganandan, Narayan; Pintar, Frank A

2008-01-01

The increase in upper extremity injuries in automobile collisions, because of the widespread implantation of airbags, has lead to a better understanding of forearm injury criteria. Risk functions for upper extremity injury that can be used in instrumented upper extremities would be useful. This paper presents a risk function for forearm injury for the 50th percentile male based on bending fracture moment data gathered from previous studies. The data was scaled using two scaling factors, one for orientation and one for mass, and the Weibull survival analysis model was then used to develop the risk function. It was determined that a 25% risk of injury corresponds to an 82 Nm bending load, a 50% risk of injury corresponds to a 100 Nm bending load, and a 75% risk of injury corresponds to a 117 Nm bending load. It is believed the risk function can be used with an instrumented upper extremity during vehicle testing.

Humerus fracture bending risk function for the 50th percentile male.

PubMed

Santago, Anthony C; Cormier, Joseph M; Duma, Stefan M

2008-01-01

The increase in upper extremity injuries in automobile collisions, because of the widespread implantation of airbags, has lead to an increased focus in humerus injury criteria. Risk functions for upper extremity injury that can be used in instrumented upper extremities would be useful. This paper presents a risk function for humerus injury for the 50th percentile male based on bending fracture moment data gathered from previous studies. The data was scaled using two scaling factors, one for mass and one for rate, and the Weibull survival analysis model was then used to develop the risk function. It was determined that a 25% risk of injury corresponds to a 214 Nm bending load, a 50% risk of injury corresponds to a 257 Nm bending load, and a 75% risk of injury corresponds to a 296 Nm bending load. It is believed the risk function can be used with an instrumented upper extremity during vehicle testing.

Operational early warning platform for extreme meteorological events

NASA Astrophysics Data System (ADS)

Mühr, Bernhard; Kunz, Michael

2015-04-01

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

Care and handling of container plants from storage to outplanting

Treesearch

Thomas D. Landis; R. Kasten Dumroese

2011-01-01

Nursery plants are in a period of high risk from the time they leave the protected environment of the nursery to when they are outplanted. During handling and shipping, nursery stock may be exposed to many damaging stresses, including extreme temperatures, desiccation, mechanical injuries, and storage molds. This is also the period of greatest financial risk, because...

Human papilloma virus genotype diversity of anal infection among trans (male to female transvestites, transsexuals or transgender) sex workers in Argentina.

PubMed

dos Ramos Farías, María Sol; Picconi, María Alejandra; Garcia, María Noé; González, Joaquín V; Basiletti, Jorge; Pando, María de los Ángeles; Avila, María Mercedes

2011-06-01

Reports on the prevalence and genotypes of HPV among trans (male to female transvestites, transsexuals or transgender) sex workers (TSW) are scarce in the literature. The aim of the study was to determine the infecting HPV genotypes among TSW in Argentina. 119 TSW were recruited. Anal cells were self collected with a cytobrush. HPV DNA detection was carried out by PCR and genotyping was performed by RLB. HPV prevalence was 97.4%. 103/111 HPV positive samples were genotyped. High risk genotypes were detected in 82.5%. Two or more coinfecting HPV genotypes were found in 70.9%. One case showed up to 10 different coinfecting types. The number of genotypes was not related to condom usage. Infection rates were similar for HIV positive (100%) and HIV negative (95.8%) participants. However, 18.8% of HIV negative had 4-9 different genotypes, while among HIV positive this percentage raised to 46.2% (p=0.006). Prevalence of high risk genotypes and the frequency of each high risk type were similar between HIV positive and HIV negative groups. According to the participants' answers HIV status showed no association with condom usage. The high HPV prevalence, the coinfection with multiple genotypes and the high frequency of high risk genotypes detected, together with a situation of extreme social marginalization, discrimination and stigmatization make this population to be of extreme vulnerability. Copyright © 2011 Elsevier B.V. All rights reserved.

Censored rainfall modelling for estimation of fine-scale extremes

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

Risking Your Life without a Second Thought: Intuitive Decision-Making and Extreme Altruism

PubMed Central

Rand, David G.; Epstein, Ziv G.

2014-01-01

When faced with the chance to help someone in mortal danger, what is our first response? Do we leap into action, only later considering the risks to ourselves? Or must instinctive self-preservation be overcome by will-power in order to act? We investigate this question by examining the testimony of Carnegie Hero Medal Recipients (CHMRs), extreme altruists who risked their lives to save others. We collected published interviews with CHMRs where they described their decisions to help. We then had participants rate the intuitiveness versus deliberativeness of the decision-making process described in each CHMR statement. The statements were judged to be overwhelmingly dominated by intuition; to be significantly more intuitive than a set of control statements describing deliberative decision-making; and to not differ significantly from a set of intuitive control statements. This remained true when restricting to scenarios in which the CHMRs had sufficient time to reflect before acting if they had so chosen. Text-analysis software found similar results. These findings suggest that high-stakes extreme altruism may be largely motivated by automatic, intuitive processes. PMID:25333876

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

PubMed

Rand, David G; Epstein, Ziv G

2014-01-01

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

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

PubMed

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

2016-11-01

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

Risk factors for lower extremity injury: a review of the literature

PubMed Central

Murphy, D; Connolly, D; Beynnon, B

2003-01-01

Prospective studies on risk factors for lower extremity injury are reviewed. Many intrinsic and extrinsic risk factors have been implicated; however, there is little agreement with respect to the findings. Future prospective studies are needed using sufficient sample sizes of males and females, including collection of exposure data, and using established methods for identifying and classifying injury severity to conclusively determine addtional risk factors for lower extremity injury. PMID:12547739

Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score

PubMed Central

Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun

2017-01-01

Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region. PMID:29137199

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2013-10-01

therapies for prevention or mitigation of HO can be optimally targeted. This study seeks to contribute to advancement in each of these key areas...NOTES 14. ABSTRACT This study will recruit wounded warriors with severe extremity trauma, which places them at high risk for heterotopic... therapies for prevention or mitigation of HO. 15. SUBJECT TERMS Wound healing 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2013-10-01

so that therapies for prevention or mitigation of HO can be optimally targeted. This study seeks to contribute to advancement in each of these key...SUPPLEMENTARY NOTES 14. ABSTRACT This study will recruit wounded warriors with severe extremity trauma, which places them at high risk for...define potential therapies for prevention or mitigation of HO. 15. SUBJECT TERMS Wound healing 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF

Randomized clinical trial of negative pressure wound therapy for high-risk groin wounds in lower extremity revascularization.

PubMed

Lee, Kevin; Murphy, Patrick B; Ingves, Matthew V; Duncan, Audra; DeRose, Guy; Dubois, Luc; Forbes, Thomas L; Power, Adam

2017-12-01

The surgical site infection (SSI) rate in vascular surgery after groin incision for lower extremity revascularization can lead to significant morbidity and mortality. This trial was designed to study the effect of negative pressure wound therapy (NPWT) on SSI in closed groin wounds after lower extremity revascularization in patients at high risk for SSI. A single-center, randomized, controlled trial was performed at an academic tertiary medical center. Patients with previous femoral artery surgical exposure, body mass index of >30 kg/m 2 or the presence of ischemic tissue loss were classified as a high-risk patient for SSI. All wounds were closed primarily and patients were randomized to either NPWT or standard dressing. The primary outcome of the trial was postoperative 30-day SSI in the groin wound. The secondary outcomes included 90-day SSI, hospital duration of stay, readmissions or reoperations for SSI, and mortality. A total of 102 patients were randomized between August 2014 and December 2015. Patients were classified as at high risk owing to the presence of previous femoral artery cut down (29%), body mass index of >30 kg/m 2 (39%) or presence of ischemic tissue loss (32%). Revascularization procedures performed included femoral to distal artery bypass (57%), femoral endarterectomy (18%), femoral to femoral artery crossover (17%), and other procedures (8%). The primary outcome of 30-day SSI was 11% in NPWT group versus 19% in standard dressing group (P = .24). There was a statistically significant shorter mean duration of hospital stay in the NPWT group (6.4 days) compared with the standard group (8.9 days; P = .01). There was no difference in readmission or reoperation for SSI or mortality between the two groups. This study demonstrated a nonsignificant lower rate of groin SSI in high-risk revascularization patients with NPWT compared with standard dressing. Owing to a lower than expected infection rate, the study was underpowered to detect a difference at the prespecified level. The NPWT group did show significantly shorter mean hospital duration of stay compared with the standard dressing group. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Applying the change vector analysis technique to assess the desertification risk in the south-west of Romania in the period 1984-2011.

PubMed

Vorovencii, Iosif

2017-09-26

The desertification risk affects around 40% of the agricultural land in various regions of Romania. The purpose of this study is to analyse the risk of desertification in the south-west of Romania in the period 1984-2011 using the change vector analysis (CVA) technique and Landsat thematic mapper (TM) satellite images. CVA was applied to combinations of normalised difference vegetation index (NDVI)-albedo, NDVI-bare soil index (BI) and tasselled cap greenness (TCG)-tasselled cap brightness (TCB). The combination NDVI-albedo proved to be the best in assessing the desertification risk, with an overall accuracy of 87.67%, identifying a desertification risk on 25.16% of the studied period. The classification of the maps was performed for the following classes: desertification risk, re-growing and persistence. Four degrees of desertification risk and re-growing were used: low, medium, high and extreme. Using the combination NDVI-albedo, 0.53% of the analysed surface was assessed as having an extreme degree of desertification risk, 3.93% a high degree, 8.72% a medium degree and 11.98% a low degree. The driving forces behind the risk of desertification are both anthropogenic and climatic causes. The anthropogenic causes include the destruction of the irrigation system, deforestation, the destruction of the forest shelterbelts, the fragmentation of agricultural land and its inefficient management. Climatic causes refer to increase of temperatures, frequent and prolonged droughts and decline of the amount of precipitation.

Estimated injury risk for specific injuries and body regions in frontal motor vehicle crashes.

PubMed

Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Schoell, Samantha L; Swett, Katrina R; Stitzel, Joel D

2015-01-01

Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data. Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15-105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate. Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4-4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4.6-9.9% risk). The 6 body region curves with the highest risks were for AIS 2+ lower extremity, upper extremity, thorax, and head injury and AIS 3+ lower extremity and thorax injury (15.9-43.8% risk). These injury risk curves can be implemented into advanced automatic crash notification (AACN) algorithms that utilize vehicle EDR measurements to predict occupant injury immediately following a MVC. Through integration with AACN, these injury risk curves can provide emergency medical services (EMS) and other patient care providers with information on suspected occupant injuries to improve injury detection and patient triage.

Managing the Risks of Extreme Events and Disasters in a Changing Climate: Lessons for Adaptation to Climate Change (Invited)

NASA Astrophysics Data System (ADS)

Mastrandrea, M.; Field, C. B.; Mach, K. J.; Barros, V.

2013-12-01

The IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation, published in 2012, integrates expertise in climate science, disaster risk reduction, and adaptation to inform discussions on how to reduce and manage the risks of extreme events and disasters in a changing climate. Impacts and the risks of disasters are determined by the interaction of the physical characteristics of weather and climate events with the vulnerability of exposed human society and ecosystems. The Special Report evaluates the factors that make people and infrastructure vulnerable to extreme events, trends in disaster losses, recent and future changes in the relationship between climate change and extremes, and experience with a wide range of options used by institutions, organizations, and communities to reduce exposure and vulnerability, and improve resilience, to climate extremes. Actions ranging from incremental improvements in governance and technology to more transformational changes are assessed. The Special Report provides a knowledge base that is also relevant to the broader context of managing the risks of climate change through mitigation, adaptation, and other responses, assessed in the IPCC's Fifth Assessment Report (AR5), to be completed in 2014. These themes include managing risks through an iterative process involving learning about risks and the effectiveness of responses, employing a portfolio of actions tailored to local circumstances but with links from local to global scales, and considering additional benefits of actions such as improving livelihoods and well-being. The Working Group II contribution to the AR5 also examines the ways that extreme events and their impacts contribute to understanding of vulnerabilities and adaptation deficits in the context of climate change, the extent to which impacts of climate change are experienced through changes in the frequency and severity of extremes as opposed to mean changes, and the emergence of risks that are place-based vs. systemic.

Extremely Preterm Infant Skin Care: A Transformation of Practice Aimed to Prevent Harm.

PubMed

Johnson, Deanna E

2016-10-01

The skin of extremely preterm infants is underdeveloped and has poor barrier function. Skin maintenance interventions initiated in the neonatal intensive care unit (NICU) have immediate and lifelong implications when the potential for infection, allergen sensitization, and altered aesthetic outcomes are considered. In addition, the high-level medical needs of extremely preterm infants demand skin-level medical interventions that too often result in unintended skin harm. We describe the use of a harm prevention, or consequence-centered, approach to skin care, which facilitates safer practice for extremely premature infants. Neonatal and pediatric Advanced Practice Registered Nurses (APRN) came together for monthly meetings to review the evidence around best skin care practices for extremely preterm infants, with an emphasis on reduction of skin harm. Findings were focused on the population of interest and clinical implementation strategies. Skin care for extremely preterm infants remains overlooked by current literature. However, clinical practice pearls were extracted and applied in a manner that promotes safer skin care practices in the NICU. Gentle adhesives, such as silicone tapes and hydrogel-backed electrodes, can help to reduce medical adhesive-related skin injuries. Diaper wipes are not appropriate for use among extremely preterm infants, as many ingredients may contain potential allergens. Skin cleansers should be pH neutral to the skin and the prophylactic use of petrolatum-based emollients should be avoided. Further exploration and understanding of skin care practices that examine issues of true risk versus hypothetical risk of harm.

The spatial domain of wildfire risk and response in the wildland urban interface in Sydney, Australia

NASA Astrophysics Data System (ADS)

Price, O. F.; Bradstock, R. A.

2013-12-01

In order to quantify the risks from fire at the wildland urban interface (WUI), it is important to understand where fires occur and their likelihood of spreading to the WUI. For each of the 999 fires in the Sydney region we calculated the distance between the ignition and the WUI, the fire's weather and wind direction and whether it spread to the WUI. The likelihood of burning the WUI was analysed using binomial regression. Weather and distance interacted such that under mild weather conditions, the model predicted only a 5% chance that a fire starting >2.5 km from the interface would reach it, whereas when the conditions are extreme the predicted chance remained above 30% even at distances >10 km. Fires were more likely to spread to the WUI if the wind was from the west and in the western side of the region. We examined whether the management responses to wildfires are commensurate with risk by comparing the distribution of distance to the WUI of wildfires with roads and prescribed fires. Prescribed fires and roads were concentrated nearer to the WUI than wildfires as a whole, but further away than wildfires that burnt the WUI under extreme weather conditions (high risk fires). Overall, 79% of these high risk fires started within 2 km of the WUI, so there is some argument for concentrating more management effort near the WUI. By substituting climate change scenario weather into the statistical model, we predicted a small increase in the risk of fires spreading to the WUI, but the increase will be greater under extreme weather. This approach has a variety of uses, including mapping fire risk and improving the ability to match fire management responses to the threat from each fire. They also provide a baseline from which a cost-benefit analysis of complementary fire management strategies can be conducted.

The spatial domain of wildfire risk and response in the Wildland Urban Interface in Sydney, Australia

NASA Astrophysics Data System (ADS)

Price, O. F.; Bradstock, R. A.

2013-09-01

In order to quantify the risks from fire at the Wildland Urban Interface (WUI), it is important to understand where fires occur and their likelihood of spreading to the WUI. For each of 999 fires in the Sydney region we calculated the distance between the ignition and the WUI, the fire weather and wind direction and whether it spread to the WUI. The likelihood of burning the WUI was analysed using binomial regression. Weather and distance interacted such that under mild weather conditions, the model predicted only a 5% chance that a fire starting more than 2.5 km from the interface would reach it, whereas when the conditions are extreme the predicted chance remained above 30% even at distances further than 10 km. Fires were more likely to spread to the WUI if the wind was from the west and in the western side of the region. We examined whether the management responses to wildfires are commensurate with risk by comparing the distribution of distance to the WUI of wildfires with roads and prescribed fires. Prescribed fires and roads were concentrated nearer to the WUI than wildfires as a whole, but further away than wildfires that burnt the WUI under extreme weather conditions (high risk fires). 79% of these high risk fires started within 2 km of the WUI, so there is some argument for concentrating more management effort near the WUI. By substituting climate change scenario weather into the statistical model, we predicted a small increase in the risk of fires spreading to the WUI, but the increase will be greater under extreme weather. This approach has a variety of uses, including mapping fire risk and improving the ability to match fire management responses to the threat from each fire. They also provide a baseline from which a cost-benefit analysis of complementary fire management strategies can be conducted.

Health impacts of workplace heat exposure: an epidemiological review.

PubMed

Xiang, Jianjun; Bi, Peng; Pisaniello, Dino; Hansen, Alana

2014-01-01

With predicted increasing frequency and intensity of extremely hot weather due to changing climate, workplace heat exposure is presenting an increasing challenge to occupational health and safety. This article aims to review the characteristics of workplace heat exposure in selected relatively high risk occupations, to summarize findings from published studies, and ultimately to provide suggestions for workplace heat exposure reduction, adaptations, and further research directions. All published epidemiological studies in the field of health impacts of workplace heat exposure for the period of January 1997 to April 2012 were reviewed. Finally, 55 original articles were identified. Manual workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress, especially those in low-middle income countries in tropical regions. At risk workers include farmers, construction workers, fire-fighters, miners, soldiers, and manufacturing workers working around process-generated heat. The potential impacts of workplace heat exposure are to some extent underestimated due to the underreporting of heat illnesses. More studies are needed to quantify the extent to which high-risk manual workers are physiologically and psychologically affected by or behaviourally adapt to workplace heat exposure exacerbated by climate change.

Health Impacts of Workplace Heat Exposure: An Epidemiological Review

PubMed Central

XIANG, Jianjun; BI, Peng; PISANIELLO, Dino; HANSEN, Alana

2013-01-01

With predicted increasing frequency and intensity of extremely hot weather due to changing climate, workplace heat exposure is presenting an increasing challenge to occupational health and safety. This article aims to review the characteristics of workplace heat exposure in selected relatively high risk occupations, to summarize findings from published studies, and ultimately to provide suggestions for workplace heat exposure reduction, adaptations, and further research directions. All published epidemiological studies in the field of health impacts of workplace heat exposure for the period of January 1997 to April 2012 were reviewed. Finally, 55 original articles were identified. Manual workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress, especially those in low-middle income countries in tropical regions. At risk workers include farmers, construction workers, fire-fighters, miners, soldiers, and manufacturing workers working around process-generated heat. The potential impacts of workplace heat exposure are to some extent underestimated due to the underreporting of heat illnesses. More studies are needed to quantify the extent to which high-risk manual workers are physiologically and psychologically affected by or behaviourally adapt to workplace heat exposure exacerbated by climate change. PMID:24366537

Silent Aircraft Initiative Concept Risk Assessment

NASA Technical Reports Server (NTRS)

Nickol, Craig L.

2008-01-01

A risk assessment of the Silent Aircraft Initiative's SAX-40 concept design for extremely low noise has been performed. A NASA team developed a list of 27 risk items, and evaluated the level of risk for each item in terms of the likelihood that the risk would occur and the consequences of the occurrence. The following risk items were identified as high risk, meaning that the combination of likelihood and consequence put them into the top one-fourth of the risk matrix: structures and weight prediction; boundary-layer ingestion (BLI) and inlet design; variable-area exhaust and thrust vectoring; displaced-threshold and continuous descent approach (CDA) operational concepts; cost; human factors; and overall noise performance. Several advanced-technology baseline concepts were created to serve as a basis for comparison to the SAX-40 concept. These comparisons indicate that the SAX-40 would have significantly greater research, development, test, and engineering (RDT&E) and production costs than a conventional aircraft with similar technology levels. Therefore, the cost of obtaining the extremely low noise capability that has been estimated for the SAX-40 is significant. The SAX-40 concept design proved successful in focusing attention toward low noise technologies and in raising public awareness of the issue.

Technology Risk Mitigation Research and Development for the Matter-Radiation Interactions in Extremes (MaRIE) Project

NASA Astrophysics Data System (ADS)

Barnes, Cris W.; Fernández, Juan; Hartsfield, Thomas; Sandberg, Richard; Sheffield, Richard; Tapia, John P.; Wang, Zhehui

2017-06-01

NNSA does not have a capability to understand and test the response of materials and conditions necessary to determine the linkages between microstructure of materials and performance in extreme weapons-relevant environments. Required is an x-ray source, coherent to optimize imaging capability, brilliant and high repetition-rate to address all relevant time scales, and with high enough energy to see into and through the amount of material in the middle or mesoscale where microstructure determines materials response. The Department of Energy has determined there is a mission need for a MaRIE Project to deliver this capability. There are risks to the Project to successfully deliver all the technology needed to provide the capability for the mission need and to use those photons to control the time-dependent production and performance of materials. The present technology risk mitigation activities for the MaRIE project are: developing ultrafast high-energy x-ray detectors, combining the data from several imaging probes to obtain multi-dimensional information about the sample, and developing techniques for bulk dynamic measurements of temperature. This talk will describe these efforts and other critical technology elements requiring future investment by the project.

Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults

PubMed Central

Carver, Charles S.

2010-01-01

During euthymia people with bipolar disorder and their unaffected family members accomplish more than the general population. People with bipolar disorder, or those who are at risk for it, also set higher goals in laboratory tasks than other people. The work reported here examines whether persons vulnerable to mania set elevated goals in their lives. In two studies, a measure of lifetime vulnerability to mania was related to traits bearing on incentive sensitivity, and also to endorsement of high ambitions for fame, wealth, and political influence (assessed by a new measure). Relations were weaker to ambitions for other kinds of extreme goals. The effects were independent of current symptoms of mania and depression and lifetime depression. There was also evidence that incentive sensitivity and elevated aspirations made independent contributions to variance in the measure of manic risk. Discussion focuses on the implications of high goal setting for understanding goal dysregulation and mania. PMID:20198117

Detection and attribution of extreme weather disasters

NASA Astrophysics Data System (ADS)

Huggel, Christian; Stone, Dáithí; Hansen, Gerrit

2014-05-01

Single disasters related to extreme weather events have caused loss and damage on the order of up to tens of billions US dollars over the past years. Recent disasters fueled the debate about whether and to what extent these events are related to climate change. In international climate negotiations disaster loss and damage is now high on the agenda, and related policy mechanisms have been discussed or are being implemented. In view of funding allocation and effective risk reduction strategies detection and attribution to climate change of extreme weather events and disasters is a key issue. Different avenues have so far been taken to address detection and attribution in this context. Physical climate sciences have developed approaches, among others, where variables that are reasonably sampled over climatically relevant time periods and related to the meteorological characteristics of the extreme event are examined. Trends in these variables (e.g. air or sea surface temperatures) are compared between observations and climate simulations with and without anthropogenic forcing. Generally, progress has been made in recent years in attribution of changes in the chance of some single extreme weather events to anthropogenic climate change but there remain important challenges. A different line of research is primarily concerned with losses related to the extreme weather events over time, using disaster databases. A growing consensus is that the increase in asset values and in exposure are main drivers of the strong increase of economic losses over the past several decades, and only a limited number of studies have found trends consistent with expectations from climate change. Here we propose a better integration of existing lines of research in detection and attribution of extreme weather events and disasters by applying a risk framework. Risk is thereby defined as a function of the probability of occurrence of an extreme weather event, and the associated consequences, with consequences being a function of the intensity of the physical weather event, the exposure and value of assets, and vulnerabilities. We have examined selected major extreme events and disasters, including superstorm Sandy in 2012, the Pakistan floods and the heat wave in Russia in 2010, the 2010 floods in Colombia and the 2011 floods in Australia. We systematically analyzed to what extent (anthropogenic) climate change may have contributed to intensity and frequency of the event, along with changes in the other risk variables, to eventually reach a more comprehensive understanding of the relative role of climate change in recent loss and damage of extreme weather events.

Consumption of meat in relation to physical functioning in the Seniors-ENRICA cohort.

PubMed

Struijk, Ellen A; Banegas, José R; Rodríguez-Artalejo, Fernando; Lopez-Garcia, Esther

2018-04-05

Meat is an important source of high-quality protein and vitamin B but also has a relatively high content of saturated and trans fatty acids. Although protein and vitamin B intake seems to protect people from functional limitations, little is known about the effect of habitual meat consumption on physical function. The objective of this study was to examine the prospective association between the intake of meat (processed meat, red meat, and poultry) and physical function impairment in older adults. Data were collected for 2982 participants in the Seniors-ENRICA cohort, who were aged ≥60 years and free of physical function impairment. In 2008-2010, their habitual diet was assessed through a validated computer-assisted face-to-face diet history. Study participants were followed up through 2015 to assess self-reported incident impairment in agility, mobility, and performance-based lower-extremity function. Over a median follow-up of 5.2 years, we identified 625 participants with impaired agility, 455 with impaired mobility, and 446 with impaired lower-extremity function. After adjustment for potential confounders, processed meat intake was associated with a higher risk of impaired agility (hazard ratio [HR] for highest vs. lowest tertile: 1.33; 95% confidence interval [CI]: 1.08-1.64; p trend = 0.01) and of impaired lower-extremity function (HR for highest vs. lowest tertile: 1.31; 95% CI: 1.02-1.68; p trend = 0.04). No significant associations were found for red meat and poultry. Replacing one serving per day of processed meat with one serving per day of red meat, poultry, or with other important protein sources (fish, legumes, dairy, and nuts) was associated with lower risk of impaired agility and lower-extremity function. A higher consumption of processed meat was associated with a higher risk of impairment in agility and lower-extremity function. Replacing processed meat by other protein sources may slow the decline in physical functioning in older adults.

A Spatiotemporal Analysis of Extreme Heat Vulnerability Across the United States using Geospatial Techniques

NASA Astrophysics Data System (ADS)

Schoessow, F. S.; Li, Y.; Howe, P. D.

2016-12-01

Extreme heat events are the deadliest natural hazard in the United States and are expected to increase in both severity and frequency in the coming years due to the effects of climate change. The risks of climate change and weather-related events such as heat waves to a population can be more comprehensively assessed by coupling the traditional examination of natural hazards using remote sensing and geospatial analysis techniques with human vulnerability factors and individual perceptions of hazards. By analyzing remote-sensed and empirical survey data alongside national hazards advisories, this study endeavors to establish a nationally-representative baseline quantifying the spatiotemporal variation of individual heat vulnerabilities at multiple scales and between disparate population groups affected by their unique socioenvironmental factors. This is of immediate academic interest because the study of heat waves risk perceptions remains relatively unexplored - despite the intensification of extreme heat events. The use of "human sensors", georeferenced & timestamped individual response data, provides invaluable contextualized data at a high spatial resolution, which will enable policy-makers to more effectively implement targeted strategies for risk prevention, mitigation, and communication. As climate change risks are further defined, this cognizance will help identify vulnerable populations and enhance national hazard preparedness and recovery frameworks.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Flood frequency analysis and generation of flood hazard indicator maps in a semi-arid environment, case of Ourika watershed (western High Atlas, Morocco)

NASA Astrophysics Data System (ADS)

El Alaoui El Fels, Abdelhafid; Alaa, Noureddine; Bachnou, Ali; Rachidi, Said

2018-05-01

The development of the statistical models and flood risk modeling approaches have seen remarkable improvements in their productivities. Their application in arid and semi-arid regions, particularly in developing countries, can be extremely useful for better assessment and planning of flood risk in order to reduce the catastrophic impacts of this phenomenon. This study focuses on the Setti Fadma region (Ourika basin, Morocco) which is potentially threatened by floods and is subject to climatic and anthropogenic forcing. The study is based on two main axes: (i) the extreme flow frequency analysis, using 12 probability laws adjusted by Maximum Likelihood method and (ii) the generation of the flood risk indicator maps are based on the solution proposed by the Nays2DFlood solver of the Hydrodynamic model of two-dimensional Saint-Venant equations. The study is used as a spatial high-resolution digital model (Lidar) in order to get the nearest hydrological simulation of the reality. The results showed that the GEV is the most appropriate law of the extreme flows estimation for different return periods. Taking into consideration the mapping of 100-year flood area, the study revealed that the fluvial overflows extent towards the banks of Ourika and consequently, affects some living areas, cultivated fields and the roads that connects the valley to the city of Marrakech. The aim of this study is to propose new technics of the flood risk management allowing a better planning of the flooded areas.

Managing the risks of extreme events and disasters to advance climate change adaptation. Special report of the Intergovernmental Panel on Climate Change (IPCC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Field, C.B.; Barros, V.; Stocker, T.F.

2012-07-01

This Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX) has been jointly coordinated by Working Groups I (WGI) and II (WGII) of the Intergovernmental Panel on Climate Change (IPCC). The report focuses on the relationship between climate change and extreme weather and climate events, the impacts of such events, and the strategies to manage the associated risks. This Special Report, in particular, contributes to frame the challenge of dealing with extreme weather and climate events as an issue in decision making under uncertainty, analyzing response in the context of risk management.more » The report consists of nine chapters, covering risk management; observed and projected changes in extreme weather and climate events; exposure and vulnerability to as well as losses resulting from such events; adaptation options from the local to the international scale; the role of sustainable development in modulating risks; and insights from specific case studies. (LN)« less

Disaster Risks Reduction for Extreme Natural Hazards

NASA Astrophysics Data System (ADS)

Plag, H.; Jules-Plag, S.

2013-12-01

Mega disasters associated with extreme natural hazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Floods and droughts are major threats that potentially could reach planetary extent, particularly through secondary economic and social impacts. Earthquakes and tsunamis frequently cause disasters that eventually could exceed the immediate coping capacity of the global economy, particularly since we have built mega cities in hazardous areas that are now ready to be harvested by natural hazards. Unfortunately, the more we learn to cope with the relatively frequent hazards (50 to 100 years events), the less we are worried about the low-probability, high-impact events (a few hundred and more years events). As a consequence, threats from the 500 years flood, drought, volcano eruption are not appropriately accounted for in disaster risk reduction (DRR) discussions. Extreme geohazards have occurred regularly throughout the past, but mostly did not cause major disasters because exposure of human assets to hazards was much lower in the past. The most extreme events that occurred during the last 2,000 years would today cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. Recent extreme earthquakes have illustrated the destruction they can inflict, both directly and indirectly through tsunamis. Large volcano eruptions have the potential to impact climate, anthropogenic infrastructure and resource supplies on global scale. During the last 2,000 years several large volcano eruptions occurred, which under today's conditions are associated with extreme disaster risk. The comparison of earthquakes and volcano eruptions indicates that large volcano eruptions are the low-probability geohazards with potentially the highest impact on our civilization. Integration of these low-probability, high-impact events in DRR requires an approach focused on resilience and antifragility, as well as the ability to cope with, and recover from failure of infrastructure and social systems. Resilience does not primarily result from the robustness of infrastructure but mainly is a function of the social capital. While it is important to understand the hazards (the contribution of geosciences), it is equally important to understand the processes that let us cope with the hazards, or lead to failure (the contribution of social sciences and engineering). For the latter, we need a joint effort of social sciences and engineering and a revised science-policy relationship. Democratizing knowledge about extreme geohazards is very important in order to inform deliberations of DRR through increased resilience and reduced fragility. The current science-society dialog is not fully capable of supporting deliberative governance. Most scientific knowledge is created independent of those who could put it to use, and a transition to co-design and co-development of knowledge involving a broad stakeholder base is necessary for DRR, particularly for extreme events. This transition may have the consequence of more responsibility and even liability for science.

Quantifying the effect of interannual ocean variability on the attribution of extreme climate events to human influence

NASA Astrophysics Data System (ADS)

Risser, Mark D.; Stone, Dáithí A.; Paciorek, Christopher J.; Wehner, Michael F.; Angélil, Oliver

2017-11-01

In recent years, the climate change research community has become highly interested in describing the anthropogenic influence on extreme weather events, commonly termed "event attribution." Limitations in the observational record and in computational resources motivate the use of uncoupled, atmosphere/land-only climate models with prescribed ocean conditions run over a short period, leading up to and including an event of interest. In this approach, large ensembles of high-resolution simulations can be generated under factual observed conditions and counterfactual conditions that might have been observed in the absence of human interference; these can be used to estimate the change in probability of the given event due to anthropogenic influence. However, using a prescribed ocean state ignores the possibility that estimates of attributable risk might be a function of the ocean state. Thus, the uncertainty in attributable risk is likely underestimated, implying an over-confidence in anthropogenic influence. In this work, we estimate the year-to-year variability in calculations of the anthropogenic contribution to extreme weather based on large ensembles of atmospheric model simulations. Our results both quantify the magnitude of year-to-year variability and categorize the degree to which conclusions of attributable risk are qualitatively affected. The methodology is illustrated by exploring extreme temperature and precipitation events for the northwest coast of South America and northern-central Siberia; we also provides results for regions around the globe. While it remains preferable to perform a full multi-year analysis, the results presented here can serve as an indication of where and when attribution researchers should be concerned about the use of atmosphere-only simulations.

Global coastal flood hazard mapping

NASA Astrophysics Data System (ADS)

Eilander, Dirk; Winsemius, Hessel; Ward, Philip; Diaz Loaiza, Andres; Haag, Arjen; Verlaan, Martin; Luo, Tianyi

2017-04-01

Over 10% of the world's population lives in low-lying coastal areas (up to 10m elevation). Many of these areas are prone to flooding from tropical storm surges or extra-tropical high sea levels in combination with high tides. A 1 in 100 year extreme sea level is estimated to expose 270 million people and 13 trillion USD worth of assets to flooding. Coastal flood risk is expected to increase due to drivers such as ground subsidence, intensification of tropical and extra-tropical storms, sea level rise and socio-economic development. For better understanding of the hazard and drivers to global coastal flood risk, a globally consistent analysis of coastal flooding is required. In this contribution we present a comprehensive global coastal flood hazard mapping study. Coastal flooding is estimated using a modular inundation routine, based on a vegetation corrected SRTM elevation model and forced by extreme sea levels. Per tile, either a simple GIS inundation routine or a hydrodynamic model can be selected. The GIS inundation method projects extreme sea levels to land, taking into account physical obstructions and dampening of the surge level land inwards. For coastlines with steep slopes or where local dynamics play a minor role in flood behavior, this fast GIS method can be applied. Extreme sea levels are derived from the Global Tide and Surge Reanalysis (GTSR) dataset. Future sea level projections are based on probabilistic sea level rise for RCP 4.5 and RCP 8.5 scenarios. The approach is validated against observed flood extents from ground and satellite observations. The results will be made available through the online Aqueduct Global Flood Risk Analyzer of the World Resources Institute.

Understanding risks in the light of uncertainty: low-probability, high-impact coastal events in cities

NASA Astrophysics Data System (ADS)

Abadie, Luis Maria; Galarraga, Ibon; Sainz de Murieta, Elisa

2017-01-01

A quantification of present and future mean annual losses due to extreme coastal events can be crucial for adequate decision making on adaptation to climate change in coastal areas around the globe. However, this approach is limited when uncertainty needs to be accounted for. In this paper, we assess coastal flood risk from sea-level rise and extreme events in 120 major cities around the world using an alternative stochastic approach that accounts for uncertainty. Probability distributions of future relative (local) sea-level rise have been used for each city, under three IPPC emission scenarios, RCP 2.6, 4.5 and 8.5. The approach allows a continuous stochastic function to be built to assess yearly evolution of damages from 2030 to 2100. Additionally, we present two risk measures that put low-probability, high-damage events in the spotlight: the Value at Risk (VaR) and the Expected Shortfall (ES), which enable the damages to be estimated when a certain risk level is exceeded. This level of acceptable risk can be defined involving different stakeholders to guide progressive adaptation strategies. The method presented here is new in the field of economics of adaptation and offers a much broader picture of the challenges related to dealing with climate impacts. Furthermore, it can be applied to assess not only adaptation needs but also to put adaptation into a timeframe in each city.

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

NASA Astrophysics Data System (ADS)

Cheng, L.; Du, J.

2015-12-01

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

Compound flooding: examples, methods, and challenges

NASA Astrophysics Data System (ADS)

Wahl, T.

2017-12-01

When different climatic extremes occur simultaneously or in close succession, the impacts to the environment, built infrastructure and society at large are often significantly escalated. These events are collectively referred to as "compound" events. Although they are typically regarded as highly "surprising" when they occur, the dependencies and multi-scale nature of many climate phenomena mean that such events occur much more likely than might be expected by random chance alone. However, despite their high impacts, compound extremes are not, or only poorly covered in current risk analysis frameworks and policy agendas. Floods in particular, which are among the most dangerous and costly natural hazards, are rarely a function of just one driver. Rather, they often arise through the joint occurrence of different source mechanisms. This can include oceanographic drivers such as tides, storm surges, or waves, as well as hydrologic drivers such as rainfall runoff (pluvial) or river discharge (fluvial). Often, two or more of these flood drivers affect the same region and are correlated with each other, which needs to be accounted for in flood risk assessments. This presentation will briefly introduce the different types of compound flooding along with recent examples from around the globe where those high impact events led to substantial damages and loss of lives. A broad overview will be provided of existing statistical modelling tools to identify and simulate dependencies between flood drivers, for example when calculating joint probabilities. Finally, some of the most pressing challenges in developing improved strategies to assess and mitigate the risks of climatic compound extremes, and compound flooding in particular, will be discussed.

Heat Vulnerability Index Mapping for Milwaukee and Wisconsin.

PubMed

Christenson, Megan; Geiger, Sarah Dee; Phillips, Jeffrey; Anderson, Ben; Losurdo, Giovanna; Anderson, Henry A

Extreme heat waves elevate the population's risk for heat-related morbidity and mortality, specifically for vulnerable groups such as older adults and young children. In this context, we developed 2 Heat Vulnerability Indices (HVIs), one for the state of Wisconsin and one for the Milwaukee metropolitan area. Through the creation of an HVI, state and local agencies will be able to use the indices as a planning tool for extreme heat events. Data used for the HVIs were grouped into 4 categories: (1) population density; (2) health factors; (3) demographic and socioeconomic factors; and (4) natural and built environment factors. These categories were mapped at the Census block group level. Unweighted z-score data were used to determine index scores, which were then mapped by quantiles ranging from "high" to "low" vulnerability. Statewide, Menominee County exhibited the highest vulnerability to extreme heat. Milwaukee HVI findings indicated high vulnerability in the city's inner core versus low vulnerability along the lakeshore. Visualization of vulnerability could help local public health agencies prepare for future extreme heat events.

A Neglected Population: Drug-Using Women and Women's Methods of HIV/STI Prevention

ERIC Educational Resources Information Center

Gollub, Erica L.

2008-01-01

Women drug users are at extremely high risk of HIV and sexually transmitted infections (STIs) from sexual transmission, but remain seriously neglected in intervention research promoting women-initiated methods of HIV/STI prevention. Sparse available data indicate a high interest and enthusiasm for women-initiated methods among these women.…

Lesbian, Gay, Bisexual and Transgender Students: Perceived Social Support in the High School Environment

ERIC Educational Resources Information Center

Munoz-Plaza, Corrine; Quinn, Sandra Crouse; Rounds, Kathleen A.

2002-01-01

Lesbian, gay, bisexual and transgender youth (LGBT) continue to face extreme discrimination within the school environment. Existing literature suggests that LGBT youth are at high risk for a number of health problems, including suicide ideation and attempts, harassment, substance abuse, homelessness, and declining school performance. This…

Added Value of Physical Performance Measures in Predicting Adverse Health-Related Events: Results from the Health, Aging, and Body Composition Study

PubMed Central

Cesari, Matteo; Kritchevsky, Stephen B; Newman, Anne B; Simonsick, Eleanor M; Harris, Tamara B; Penninx, Brenda W; Brach, Jennifer S; Tylavsky, Frances A; Satterfield, Suzanne; Bauer, Doug C; Rubin, Susan M; Visser, Marjolein; Pahor, Marco

2009-01-01

Objectives To determine how three different physical performance measures (PPM) combine for added utility in predicting adverse health events in elders. Design Prospective cohort study. Setting Health, Aging, and Body Composition Study. Participants 3,024 well-functioning older persons (mean age 73.6 years). Measurements Timed gait, repeated chair stands and balance (semi- and full-tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high and low risk participants using the previously established 1 m/sec cut-point. The same population-percentile (21.3%) was used to identify cut-points for repeated chair stands (17.05 sec) and balance (53 sec) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPM in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow-up. Results Risk estimates for developing adverse health-related events were similarly large for each of the three high risk groups considered separately. A greater number of PPM scores at the high risk level was associated with a greater risk of developing adverse health-related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significant higher risk of (severe) lower extremity and mortality events. Conclusion Although gait speed is considered the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable. PMID:19207142

Applying the partitioned multiobjective risk method (PMRM) to portfolio selection.

PubMed

Reyes Santos, Joost; Haimes, Yacov Y

2004-06-01

The analysis of risk-return tradeoffs and their practical applications to portfolio analysis paved the way for Modern Portfolio Theory (MPT), which won Harry Markowitz a 1992 Nobel Prize in Economics. A typical approach in measuring a portfolio's expected return is based on the historical returns of the assets included in a portfolio. On the other hand, portfolio risk is usually measured using volatility, which is derived from the historical variance-covariance relationships among the portfolio assets. This article focuses on assessing portfolio risk, with emphasis on extreme risks. To date, volatility is a major measure of risk owing to its simplicity and validity for relatively small asset price fluctuations. Volatility is a justified measure for stable market performance, but it is weak in addressing portfolio risk under aberrant market fluctuations. Extreme market crashes such as that on October 19, 1987 ("Black Monday") and catastrophic events such as the terrorist attack of September 11, 2001 that led to a four-day suspension of trading on the New York Stock Exchange (NYSE) are a few examples where measuring risk via volatility can lead to inaccurate predictions. Thus, there is a need for a more robust metric of risk. By invoking the principles of the extreme-risk-analysis method through the partitioned multiobjective risk method (PMRM), this article contributes to the modeling of extreme risks in portfolio performance. A measure of an extreme portfolio risk, denoted by f(4), is defined as the conditional expectation for a lower-tail region of the distribution of the possible portfolio returns. This article presents a multiobjective problem formulation consisting of optimizing expected return and f(4), whose solution is determined using Evolver-a software that implements a genetic algorithm. Under business-as-usual market scenarios, the results of the proposed PMRM portfolio selection model are found to be compatible with those of the volatility-based model. However, under extremely unfavorable market conditions, results indicate that f(4) can be a more valid measure of risk than volatility.

GESTATIONAL AGE AT BIRTH AND RISK OF TESTICULAR CANCER

PubMed Central

Crump, Casey; Sundquist, Kristina; Winkleby, Marilyn A.; Sieh, Weiva; Sundquist, Jan

2011-01-01

Most testicular germ cell tumors originate from carcinoma in situ cells in fetal life, possibly related to sex hormone imbalances in early pregnancy. Previous studies of association between gestational age at birth and testicular cancer have yielded discrepant results and have not examined extreme preterm birth. Our objective was to determine whether low gestational age at birth is independently associated with testicular cancer in later life. We conducted a national cohort study of 354,860 men born in Sweden in 1973–1979, including 19,214 born preterm (gestational age <37 weeks) of whom 1,279 were born extremely preterm (22–29 weeks), followed for testicular cancer incidence through 2008. A total of 767 testicular cancers (296 seminomas and 471 nonseminomatous germ cell tumors) were identified in 11.2 million person-years of follow-up. Extreme preterm birth was associated with an increased risk of testicular cancer (hazard ratio 3.95; 95% CI, 1.67–9.34) after adjusting for other perinatal factors, family history of testicular cancer, and cryptorchidism. Only five cases (three seminomas and two nonseminomas) occurred among men born extremely preterm, limiting the precision of risk estimates. No association was found between later preterm birth, post-term birth, or low or high fetal growth and testicular cancer. These findings suggest that extreme but not later preterm birth may be independently associated with testicular cancer in later life. They are based on a small number of cases and will need confirmation in other large cohorts. Elucidation of the key prenatal etiologic factors may potentially lead to preventive interventions in early life. PMID:22314417

Upper extremity pain and computer use among engineering graduate students.

PubMed

Schlossberg, Eric B; Morrow, Sandra; Llosa, Augusto E; Mamary, Edward; Dietrich, Peter; Rempel, David M

2004-09-01

The objective of this study was to investigate risk factors associated with persistent or recurrent upper extremity and neck pain among engineering graduate students. A random sample of 206 Electrical Engineering and Computer Science (EECS) graduate students at a large public university completed an online questionnaire. Approximately 60% of respondents reported upper extremity or neck pain attributed to computer use and reported a mean pain severity score of 4.5 (+/-2.2; scale 0-10). In a final logistic regression model, female gender, years of computer use, and hours of computer use per week were significantly associated with pain. The high prevalence of upper extremity pain reported by graduate students suggests a public health need to identify interventions that will reduce symptom severity and prevent impairment.

Control of dynamic foot-ground interactions in male and female soccer athletes: females exhibit reduced dexterity and higher limb stiffness during landing.

PubMed

Lyle, Mark A; Valero-Cuevas, Francisco J; Gregor, Robert J; Powers, Christopher M

2014-01-22

Controlling dynamic interactions between the lower limb and ground is important for skilled locomotion and may influence injury risk in athletes. It is well known that female athletes sustain anterior cruciate ligament (ACL) tears at higher rates than male athletes, and exhibit lower extremity biomechanics thought to increase injury risk during sport maneuvers. The purpose of this study was to examine whether lower extremity dexterity (LED)--the ability to dynamically control endpoint force magnitude and direction as quantified by compressing an unstable spring with the lower limb at submaximal forces--is a potential contributing factor to the "at-risk" movement behavior exhibited by female athletes. We tested this hypothesis by comparing LED-test performance and single-limb drop jump biomechanics between 14 female and 14 male high school soccer players. We found that female athletes exhibited reduced LED-test performance (p=0.001) and higher limb stiffness during landing (p=0.008) calculated on average within 51 ms of foot contact. Females also exhibited higher coactivation at the ankle (p=0.001) and knee (p=0.02) before landing. No sex differences in sagittal plane joint angles and center of mass velocity at foot contact were observed. Collectively, our results raise the possibility that the higher leg stiffness observed in females during landing is an anticipatory behavior due in part to reduced lower extremity dexterity. The reduced lower extremity dexterity and compensatory stiffening strategy may contribute to the heightened risk of ACL injury in this population. © 2013 Published by Elsevier Ltd.

A comparative study of European insurance schemes for extreme weather risks and incentives for risk reduction

NASA Astrophysics Data System (ADS)

de Ruiter, Marleen; Hudson, Paul; de Ruig, Lars; Kuik, Onno; Botzen, Wouter

2017-04-01

This paper provides an analysis of the insurance schemes that cover extreme weather events in twelve different EU countries and the risk reduction incentives offered by these schemes. Economic impacts of extreme weather events in many regions in Europe and elsewhere are on the rise due to climate change and increasing exposure as driven by urban development. In an attempt to manage impacts from extreme weather events, natural disaster insurance schemes can provide incentives for taking measures that limit weather-related risks. Insurance companies can influence public risk management policies and risk-reducing behaviour of policyholders by "rewarding behaviour that reduces risks and potential damages" (Botzen and Van den Bergh, 2008, p. 417). Examples of insurance market systems that directly or indirectly aim to incentivize risk reduction with varying degrees of success are: the U.S. National Flood Insurance Programme; the French Catastrophes Naturelles system; and the U.K. Flood Re program which requires certain levels of protection standards for properties to be insurable. In our analysis, we distinguish between four different disaster types (i.e. coastal and fluvial floods, droughts and storms) and three different sectors (i.e. residential, commercial and agriculture). The selected case studies also provide a wide coverage of different insurance market structures, including public, private and public-private insurance provision, and different methods of coping with extreme loss events, such as re-insurance, governmental aid and catastrophe bonds. The analysis of existing mechanisms for risk reduction incentives provides recommendations about incentivizing adaptive behaviour, in order to assist policy makers and other stakeholders in designing more effective insurance schemes for extreme weather risks.

[Validation of a scale measuring coping with extreme risks].

PubMed

López-Vázquez, Esperanza; Marván, María Luisa

2004-01-01

The objective of this study was to validate, in Mexico, the French coping scale "Echelle Toulousaine de Coping". In the fall of 2001, the scale questionnaire was applied to 209 subjects living in different areas of Mexico, exposed to five different types of extreme natural or industrial risks. The discriminatory capacity of the items, as well as the factorial structure and internal consistency of the scale, were analyzed using Mann-Whitney's U test, principal components factorial analysis, and Cronbach's alpha. The final scale was composed of 26 items forming two groups: active coping and passive coping. Internal consistency of the instrument was high, both in the total sample and in the subsample of natural and industrial risks. The coping scale is reliable and valid for the Mexican population. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Moral Reasoning in Violent Contexts: Displaced and Non-Displaced Colombian Children's Evaluations of Moral Transgressions, Retaliation, and Reconciliation

ERIC Educational Resources Information Center

Ardila-Rey, Alicia; Killen, Melanie; Brenick, Alaina

2009-01-01

In order to assess the effects of displacement and exposure to violence on children's moral reasoning, Colombian children exposed to minimal violence (non-displaced or low risk; N = 99) and to extreme violence (displaced or high risk; N = 94), evenly divided by gender at 6, 9, and 12 years of age, were interviewed regarding their evaluation of…

Electric shocks at work in Europe: development of a job exposure matrix.

PubMed

Huss, Anke; Vermeulen, Roel; Bowman, Joseph D; Kheifets, Leeka; Kromhout, Hans

2013-04-01

Electric shocks have been suggested as a potential risk factor for neurological disease, in particular for amyotrophic lateral sclerosis. While actual exposure to shocks is difficult to measure, occurrence and variation of electric injuries could serve as an exposure proxy. We assessed risk of electric injury, using occupational accident registries across Europe to develop an electric shock job-exposure-matrix (JEM). Injury data were obtained from five European countries, and the number of workers per occupation and country from EUROSTAT was compiled at a 3-digit International Standard Classification of Occupations 1988 level. We pooled accident rates across countries with a random effects model and categorised jobs into low, medium and high risk based on the 75th and 90th percentile. We next compared our JEM to a JEM that classified extremely low frequency magnetic field exposure of jobs into low, medium and high. Of 116 job codes, occupations with high potential for electric injury exposure were electrical and electronic equipment mechanics and fitters, building frame workers and finishers, machinery mechanics and fitters, metal moulders and welders, assemblers, mining and construction labourers, metal-products machine operators, ships' decks crews and power production and related plant operators. Agreement between the electrical injury and magnetic field JEM was 67.2%. Our JEM classifies occupational titles according to risk of electric injury as a proxy for occurrence of electric shocks. In addition to assessing risk potentially arising from electric shocks, this JEM might contribute to disentangling risks from electric injury from those of extremely low frequency magnetic field exposure.

High-grade extremity soft tissue sarcomas: factors predictive of local recurrence and its effect on morbidity and mortality.

PubMed

Eilber, Fritz C; Rosen, Gerald; Nelson, Scott D; Selch, Michael; Dorey, Frederick; Eckardt, Jeffery; Eilber, Frederick R

2003-02-01

To identify patient characteristics associated with the development of local recurrence and the effect of local recurrence on subsequent morbidity and mortality in patients with intermediate- to high-grade extremity soft tissue sarcomas. Numerous studies on extremity soft tissue sarcomas have consistently shown that presentation with locally recurrent disease is associated with the development of subsequent local recurrences and that large tumor size and high histologic grade are significant factors associated with decreased survival. However, the effect of local recurrence on patient survival remains unclear. From 1975 to 1997, 753 patients with intermediate- to high-grade extremity soft tissue sarcomas were treated at UCLA. Treatment outcomes and patient characteristics were analyzed to identify factors associated with both local recurrence and survival. Patients with locally recurrent disease were at a significantly increased risk of developing a subsequent local recurrence. Local recurrence was a morbid event requiring amputation in 38% of the cases. The development of a local recurrence was the most significant factor associated with decreased survival. Once a patient developed a local recurrence, he or she was about three times more likely to die of disease compared to similar patients who had not developed a local recurrence. Local recurrence in patients with intermediate- to high-grade extremity soft tissue sarcomas is associated with the development of subsequent local recurrences, a morbid event decreasing functional outcomes and the most significant factor associated with decreased survival. Although 85% to 90% of patients with high-grade extremity soft tissue sarcomas are treatable with a limb salvage approach, patients who develop a local recurrence need aggressive treatment and should be considered for trials of adjuvant systemic therapy.

Dietary fiber intake and risk of breast cancer defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study.

PubMed

Narita, Saki; Inoue, Manami; Saito, Eiko; Abe, Sarah K; Sawada, Norie; Ishihara, Junko; Iwasaki, Motoki; Yamaji, Taiki; Shimazu, Taichi; Sasazuki, Shizuka; Shibuya, Kenji; Tsugane, Shoichiro

2017-06-01

Epidemiological studies have suggested a protective effect of dietary fiber intake on breast cancer risk while the results have been inconsistent. Our study aimed to investigate the association between dietary fiber intake and breast cancer risk and to explore whether this association is modified by reproductive factors and hormone receptor status of the tumor. A total of 44,444 women aged 45 to 74 years from the Japan Public Health Center-based Prospective Study were included in analyses. Dietary intake assessment was performed using a validated 138-item food frequency questionnaire (FFQ). Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer incidence were calculated by multivariate Cox proportional hazards regression models. During 624,423 person-years of follow-up period, 681 breast cancer cases were identified. After adjusting for major confounders for breast cancer risk, inverse trends were observed but statistically non-significant. Extremely high intake of fiber was associated with decreased risk of breast cancer but this should be interpreted with caution due to limited statistical power. In stratified analyses by menopausal and hormone receptor status, null associations were observed except for ER-PR- status. Our findings suggest that extreme high fiber intake may be associated with decreased risk of breast cancer but the level of dietary fiber intake among Japanese population might not be sufficient to examine the association between dietary fiber intake and breast cancer risk.

[Sports and extreme conditions. Cardiovascular incidence in long term exertion and extreme temperatures (heat, cold)].

PubMed

Melin, B; Savourey, G

2001-06-30

During ultra-endurance exercise, both increase in body temperature and dehydration due to sweat losses, lead to a decrease in central blood volume. The heart rate drift allows maintaining appropriate cardiac output, in order to satisfy both muscle perfusion and heat transfer requirements by increasing skin blood flow. The resulting dehydration can impair thermal regulation and increase the risks of serious accidents as heat stroke. Endurance events, lasting more than 8 hours, result in large sweat sodium chloride losses. Thus, ingestion of large amounts of water with poor salt intake can induce symptomatic hyponatremia (plasma sodium < 130 mEq/L) which is also a serious accident. Heat environment increases the thermal constraint and when the air humidity is high, evaporation of sweat is compromise. Thus, thermal stress becomes uncompensable which increases the risk of cardiovascular collapse. Cold exposure induces physiological responses to maintain internal temperature by both limiting thermal losses and increasing metabolic heat production. Cold can induce accidental hypothermia and local frost-bites; moreover, it increases the risk of arrhythmia during exercise. Some guidelines (cardiovascular fitness, water and electrolyte intakes, protective clothing) are given for each extreme condition.

When personality and culture clash: the psychological distress of allocentrics in an individualist culture and idiocentrics in a collectivist culture.

PubMed

Caldwell-Harris, Catherine L; Ayçiçegi, Ayse

2006-09-01

Because humans need both autonomy and interdependence, persons with either an extreme collectivist orientation (allocentrics) or extreme individualist values (idiocentrics) may be at risk for possession of some features of psychopathology. Is an extreme personality style a risk factor primarily when it conflicts with the values of the surrounding society? Individualism-collectivism scenarios and a battery of clinical and personality scales were administered to nonclinical samples of college students in Boston and Istanbul. For students residing in a highly individualistic society (Boston), collectivism scores were positively correlated with depression, social anxiety, obsessive-compulsive disorder and dependent personality. Individualism scores, particularly horizontal individualism, were negatively correlated with these same scales. A different pattern was obtained for students residing in a collectivist culture, Istanbul. Here individualism (and especially horizontal individualism) was positively correlated with scales for paranoid, schizoid, narcissistic, borderline and antisocial personality disorder. Collectivism (particularly vertical collectivism) was associated with low report of symptoms on these scales. These results indicate that having a personality style which conflicts with the values of society is associated with psychiatric symptoms. Having an orientation inconsistent with societal values may thus be a risk factor for poor mental health.

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

PubMed

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

2015-05-01

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

Urine albumin/creatinine ratio, high sensitivity C-reactive protein and N-terminal pro brain natriuretic peptide--three new cardiovascular risk markers--do they improve risk prediction and influence treatment?

PubMed

Olsen, Michael H; Sehestedt, Thomas; Lyngbaek, Stig; Hansen, Tine W; Rasmussen, Susanne; Wachtell, Kristian; Torp-Pedersen, Christian; Hildebrandt, Per R; Ibsen, Hans

2010-01-01

In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt-proBNP), related to hemodynamic cardiovascular risk factors, high sensitivity C-reactive protein (hsCRP), related to metabolic cardiovascular risk factors and urine albumin/creatinine ratio (UACR), related to hemodynamic as well as metabolic risk factors. In healthy subjects with a 10-year risk of cardiovascular death lower than 5% based on HeartScore and therefore not eligible for primary prevention, the actual 10-year risk of cardiovascular death exceeded 5% in a small subgroup of subjects with UACR higher than the 95-percentile of approximately 1.6 mg/mmol. Combined use of high UACR or high hsCRP identified a larger subgroup of 16% with high cardiovascular risk in which primary prevention may be advised despite low-moderate cardiovascular risk based on HeartScore. Furthermore, combined use of high UACR or high Nt-proBNP in subjects with known cardiovascular disease or diabetes identified a large subgroup of 48% with extremely high cardiovascular risk who should be referred for specialist care to optimize treatment.

Risk factors associated with upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy.

PubMed

Wu, Feng L; Sun, Yu; Pan, Sheng F; Zhang, Li; Liu, Zhong J

2014-06-01

Postoperative paresis, so-called C5 palsy, of the upper extremities is a common complication of cervical surgery. There have been several reports about upper extremity palsy after cervical laminoplasty for patients with cervical myelopathy. However, the possible risk factors remain unclear. To investigate the factors associated with the development of upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy. A retrospective review of medical records. A total of 102 patients (76 men and 26 women) were eligible for analysis in this study. The mean age of the patients was 58.7 years (range 35-81 years). Sixteen patients (13 men and 3 women, average age 62.8 years) with palsy were categorized as Group P, and eighty-six patients (63 men and 23 women, average age 57.8 years) without palsy as Group C. The demographic data collected from both groups were age, sex, duration of symptoms, disease, and type of surgical procedure. Cervical curvature index, width of the intervertebral foramen (WIF) at C5, anterior protrusion of the superior articular process (APSAP), number of compressed segments, high-signal intensity zone at the level corresponding to C3-C5 (HIZ:C3-C5), and posterior shift of the spinal cord (PSSC) were also evaluated. Upper extremity palsy was defined as weakness of Grade 4 or less of the key muscles in the upper extremity by manual muscle test without any deterioration of myelopathic symptoms after surgery. Comparisons were made with screen for the parameters with significant differences, and then we further analyzed these parameters by logistic regression analysis (the forward method) to verify the risk factors of the upper extremity palsy. Significant differences in diagnosis, the type of procedure, WIF, APSAP, and HIZ:C3-C5 were observed between the two groups. No statistical difference in PSSC between the groups was noted (2.06 vs. 2.53 mm, p=.247). In logistic regression analysis, ossification of the posterior longitudinal ligament (OPLL), cervical open-door laminoplasty together with posterior instrumented fusion (CLP+PIF), and WIF were found to be significant risk factors for postoperative upper extremity palsy. Patients with preoperative foraminal stenosis, OPLL, and additional iatrogenic foraminal stenosis because of CLP+PIF were more likely to develop postoperative upper extremity palsy. Attention should be given to the WIF determined on preoperative computed tomography of the C5 root. To prevent iatrogenic foraminal stenosis, appropriate distraction between spine segments should be provided during placement of the rod. Copyright © 2014 Elsevier Inc. All rights reserved.

Postoperative complications after lower extremity arterial bypass increase the risk of new deep venous thrombosis.

PubMed

Aziz, Faisal; Lehman, Erik; Blebea, John; Lurie, Fedor

2017-01-01

Background Deep venous thrombosis after any surgical operations is considered a preventable complication. Lower extremity bypass surgery is a commonly performed operation to improve blood flow to lower extremities in patients with severe peripheral arterial disease. Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease. The purpose of this study is to identify the clinical risk factors associated with development of deep venous thrombosis after lower extremity bypass surgery. Methods The American College of Surgeons' NSQIP database was utilized and all lower extremity bypass procedures performed in 2013 were examined. Patient and procedural characteristics were evaluated. Univariate and multivariate logistic regression analysis was used to determine independent risk factors for the development of postoperative deep venous thrombosis. Results A total of 2646 patients (65% males and 35% females) underwent lower extremity open revascularization during the year 2013. The following factors were found to be significantly associated with postoperative deep venous thrombosis: transfusion >4 units of packed red blood cells (odds ratio (OR) = 5.21, confidence interval (CI) = 1.29-22.81, p = 0.03), postoperative urinary tract infection (OR = 12.59, CI = 4.12-38.48, p < 0.01), length of hospital stay >28 days (OR = 9.30, CI = 2.79-30.92, p < 0.01), bleeding (OR = 2.93, CI = 1.27-6.73, p = 0.01), deep wound infection (OR = 3.21, CI = 1.37-7.56, p < 0.01), and unplanned reoperation (OR = 4.57, CI = 2.03-10.26, p < 0.01). Of these, multivariable analysis identified the factors independently associated with development of deep venous thrombosis after lower extremity bypass surgery to be unplanned reoperation (OR = 3.57, CI = 1.54-8.30, p < 0.01), reintubation (OR = 8.93, CI = 2.66-29.97, p < 0.01), and urinary tract infection (OR = 7.64, CI = 2.27-25.73, p < 0.01). Presence of all three factors was associated with a 54% incidence of deep venous thrombosis. Conclusions Development of deep venous thrombosis after lower extremity bypass is a serious but infrequent complication. Patients who require unplanned return to the operating room, reintubation, or develop a postoperative urinary tract are at high risk for developing postoperative deep venous thrombosis. Increased monitoring of these patients and ensuring adequate deep venous thrombosis prophylaxis for such patients is suggested.

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

PubMed

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

2017-04-01

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

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

PubMed Central

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

2017-01-01

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

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

NASA Astrophysics Data System (ADS)

Möller, Jens; Heinrich, Hartmut

2017-04-01

As a consequence of climate change atmospheric and oceanographic extremes and their potential impacts on coastal regions are of growing concern for governmental authorities responsible for the transportation infrastructure. Highest risks for shipping as well as for rail and road traffic originate from combined effects of extremes of storm surges and heavy rainfall which sometimes lead to insufficient dewatering of inland waterways. The German Ministry of Transport and digital Infrastructure therefore has tasked its Network of Experts to investigate the possible evolutions of extreme threats for low lands and especially for Kiel Canal, which is an important shortcut for shipping between the North and Baltic Seas. In this study we present results of a comparison of an Extreme Value Analysis (EVA) carried out on gauge observations and values derived from a coupled Regional Ocean-Atmosphere Climate Model (MPI-OM). High water levels at the coasts of the North and Baltic Seas are one of the most important hazards which increase the risk of flooding of the low-lying land and prevents such areas from an adequate dewatering. In this study changes in the intensity (magnitude of the extremes) and duration of extreme water levels (above a selected threshold) are investigated for several gauge stations with data partly reaching back to 1843. Different methods are used for the extreme value statistics, (1) a stationary general Pareto distribution (GPD) model as well as (2) an instationary statistical model for better reproduction of the impact of climate change. Most gauge stations show an increase of the mean water level of about 1-2 mm/year, with a stronger increase of the highest water levels and a decrease (or lower increase) of the lowest water levels. Also, the duration of possible dewatering time intervals for the Kiel-Canal was analysed. The results for the historical gauge station observations are compared to the statistics of modelled water levels from the coupled atmosphere-ocean climate model MPI-OM for the time interval from 1951 to 2000. We demonstrate that for high water levels the observations and MPI-OM results are in good agreement, and we provide an estimate on the decreasing dewatering potential for Kiel Canal until the end of the 21st century.

Extreme Events and Disaster Risk Reduction - a Future Earth KAN initiative

NASA Astrophysics Data System (ADS)

Frank, Dorothea; Reichstein, Markus

2017-04-01

The topic of Extreme Events in the context of global environmental change is both a scientifically challenging and exciting topic, and of very high societal relevance. The Future Earth Cluster initiative E3S organized in 2016 a cross-community/co-design workshop on Extreme Events and Environments from Climate to Society (http://www.e3s-future-earth.eu/index.php/ConferencesEvents/ConferencesAmpEvents). Based on the results, co-design research strategies and established network of the workshop, and previous activities, E3S is thriving to establish the basis for a longer-term research effort under the umbrella of Future Earth. These led to an initiative for a Future Earth Knowledge Action Network on Extreme Events and Disaster Risk Reduction. Example initial key question in this context include: What are meaningful indices to describe and quantify impact-relevant (e.g. climate) extremes? Which system properties yield resistance and resilience to extreme conditions? What are the key interactions between global urbanization processes, extreme events, and social and infrastructure vulnerability and resilience? The long-term goal of this KAN is to contribute to enhancing the resistance, resilience, and adaptive capacity of socio-ecological systems across spatial, temporal and institutional scales, in particular in the light of hazards affected by ongoing environmental change (e.g. climate change, global urbanization and land use/land cover change). This can be achieved by enhanced understanding, prediction, improved and open data and knowledge bases for detection and early warning decision making, and by new insights on natural and societal conditions and governance for resilience and adaptive capacity.

Mapping Dependence Between Extreme Rainfall and Storm Surge

NASA Astrophysics Data System (ADS)

Wu, Wenyan; McInnes, Kathleen; O'Grady, Julian; Hoeke, Ron; Leonard, Michael; Westra, Seth

2018-04-01

Dependence between extreme storm surge and rainfall can have significant implications for flood risk in coastal and estuarine regions. To supplement limited observational records, we use reanalysis surge data from a hydrodynamic model as the basis for dependence mapping, providing information at a resolution of approximately 30 km along the Australian coastline. We evaluated this approach by comparing the dependence estimates from modeled surge to that calculated using historical surge records from 79 tide gauges around Australia. The results show reasonable agreement between the two sets of dependence values, with the exception of lower seasonal variation in the modeled dependence values compared to the observed data, especially at locations where there are multiple processes driving extreme storm surge. This is due to the combined impact of local bathymetry as well as the resolution of the hydrodynamic model and its meteorological inputs. Meteorological drivers were also investigated for different combinations of extreme rainfall and surge—namely rain-only, surge-only, and coincident extremes—finding that different synoptic patterns are responsible for each combination. The ability to supplement observational records with high-resolution modeled surge data enables a much more precise quantification of dependence along the coastline, strengthening the physical basis for assessments of flood risk in coastal regions.

Preparing for International Travel and Global Medical Care.

PubMed

Mahadevan, Swaminatha V; Strehlow, Matthew C

2017-05-01

Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries. Consideration should also be given to other high-risk travel scenarios, including the provision of health care overseas, adventure and extreme sports, water environments and diving, high altitude, and terrorism/unstable political situations. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-term visual outcomes in extremely low-birth-weight children (an American Ophthalmological Society thesis).

PubMed

Spencer, Rand

2006-01-01

The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at >/=36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 +/- 36 months, and 183 eyes had recognition acuity testing at 76 +/- 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were /=3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at >/=3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at 28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of

Valuing happiness is associated with bipolar disorder.

PubMed

Ford, Brett Q; Mauss, Iris B; Gruber, June

2015-04-01

Although people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for bipolar disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1 and 2), increased likelihood of past diagnosis of BD (Studies 2 and 3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1-3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health. (c) 2015 APA, all rights reserved).

Valuing happiness is associated with bipolar disorder

PubMed Central

Ford, Brett Q.; Mauss, Iris B.; Gruber, June

2015-01-01

While people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for Bipolar Disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1–2), increased likelihood of past diagnosis of BD (Studies 2–3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1–3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health. PMID:25603134

[Crossing borders. The motivation of extreme sportsmen].

PubMed

Opaschowski, H W

2005-08-01

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

Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports.

PubMed

Gosteli, Gaël; Yersin, Bertrand; Mabire, Cédric; Pasquier, Mathieu; Albrecht, Roland; Carron, Pierre-Nicolas

2016-07-01

Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations. Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs. This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008. ES were classified into three categories of practice, according to the type of risk at the time of the fall. Among the 616 cases meeting inclusion criteria, 219 (36%) were clearly high-risk ES accidents; 69 (11%) and 328 (53%) were related to potential ES, but with respectively low or indeterminate risk at the time of the fall. In the high-risk ES group, the median age was 32 years and 80% were male. Mortality at 48h was 11%, almost ten times higher than in the other two groups. The proportion of potentially life-threatening injuries (the National Advisory Committee for Aeronautics (NACA) score≥4) was 39% in the high-risk ES group and 13% in the other two groups. Thirty per cent of the cases in the high-risk ES group presented an Injury Severity Score (ISS) >15, compared with 7% in the other groups. Thoracolumbar vertebral fractures were the most common injuries with 32% of all cases having at least one, involving the T12-L2 junction in 56% of cases. The other most frequent injuries were traumatic brain injuries (16%), rib fractures (9%), pneumothorax (8%) and femoral (7%), cervical (7%), ankle (5%) and pelvic (5%) fractures. Median time on site for rescue teams was higher in the confirmed high-risk ES group, with 50% of prehospital missions including at least one environmental difficulty. High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12-L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

High Resolution Hydro-climatological Projections for Western Canada

NASA Astrophysics Data System (ADS)

Erler, Andre Richard

Accurate identification of the impact of global warming on water resources and hydro-climatic extremes represents a significant challenge to the understanding of climate change on the regional scale. Here an analysis of hydro-climatic changes in western Canada is presented, with specific focus on the Fraser and Athabasca River basins and on changes in hydro-climatic extremes. The analysis is based on a suite of simulations designed to characterize internal variability, as well as model uncertainty. A small ensemble of Community Earth System Model version 1 (CESM1) simulations was employed to generate global climate projections, which were downscaled to 10 km resolution using the Weather Research and Forecasting model (WRF V3.4.1) with several sets of physical parameterizations. Downscaling was performed for a historical validation period and a mid- and end-21st-century projection period, using the RCP8.5 greenhouse gas trajectory. Daily station observations and monthly gridded datasets were used for validation. Changes in hydro-climatic extremes are characterized using Extreme Value Analysis. A novel method of aggregating data from climatologically similar stations was employed to increase the statistical power of the analysis. Changes in mean and extreme precipitation are found to differ strongly between seasons and regions, but (relative) changes in extremes generally follow changes in the (seasonal) mean. At the end of the 21st century, precipitation and precipitation extremes are projected to increase by 30% at the coast in fall and land-inwards in winter, while the projected increase in summer precipitation is smaller and changes in extremes are often not statistically significant. Reasons for the differences between seasons, the role of precipitation recycling in atmospheric water transport, and the sensitivity to physics parameterizations are discussed. Major changes are projected for the Fraser River basin, including earlier snowmelt and a 50% reduction in peak runoff. Combined with higher evapotranspiration, a significant increase in late summer drought risk is likely, but increasing fall precipitation might also increase the risk of moderate flooding. In the Athabasca River basin, increasing winter precipitation and snowmelt is balanced by increasing evapotranspiration in summer and no significant change in flood or drought risk is projected.

Final Report: Synthesis of aquatic climate change vulnerability assessments for the Interior West

Treesearch

Megan M. Friggens; Carly K. Woodlief

2015-01-01

Water is a critical resource for humans and ecological systems in the western United States. Aquatic ecosystems including lakes, rivers, riparian areas and wetlands, are at high risk of climate impacts because they experience relatively high exposure to climate fluctuations and extremes. In turn, impacts arising from climate change are far reaching because these...

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Abdominal Circumference Versus Body Mass Index as Predictors of Lower Extremity Overuse Injury Risk.

PubMed

Nye, Nathaniel S; Kafer, Drew S; Olsen, Cara; Carnahan, David H; Crawford, Paul F

2018-02-01

Abdominal circumference (AC) is superior to body mass index (BMI) as a measure of risk for various health outcomes. Our objective was to compare AC and BMI as predictors of lower extremity overuse injury (LEOI) risk. Retrospective review of electronic medical records of 79,868 US Air Force personnel over a 7-year period (2005-2011) for incidence of new LEOI. Subjects were stratified by BMI and AC. Injury risk for BMI/AC subgroups was calculated using Kaplan-Meier curves and Cox proportional-hazards regression. Receiver operating characteristic curves with area under the curve were used to compare each model's predictive value. Cox proportional-hazards regression showed significant risk association between elevated BMI, AC, and all injury types, with hazard ratios ranging 1.230-3.415 for obese versus normal BMI and 1.665-3.893 for high-risk versus low-risk AC (P < .05 for all measures). Receiver operating characteristic curves with area under the curve showed equivalent performance between BMI and AC for predicting all injury types. However, the combined model (AC and BMI) showed improved predictive ability over either model alone for joint injury, overall LEOI, and most strongly for osteoarthritis. Although AC and BMI alone performed similarly well, a combined approach using BMI and AC together improved risk estimation for LEOI.

[Ecological risk assessment of dam construction for terrestrial plant species in middle reach of Lancangjiang River, Southwest China].

PubMed

Li, Xiao-Yan; Dong, Shi-Kui; Liu, Shi-Liang; Peng, Ming-Chun; Li, Jin-Peng; Zhao, Qing-He; Zhang, Zhao-Ling

2012-08-01

Taking the surrounding areas of Xiaowan Reservoir in the middle reach of Lancangjiang River as study area, and based on the vegetation investigation at three sites including electricity transmission area (site 1), electricity-transfer substation and roadsides to the substation (site 2), and emigration area (site 3) in 1997 (before dam construction), another investigation was conducted on the vegetation composition, plant coverage, and dominant species at the same sites in 2010 (after dam construction), aimed to evaluate the ecological risk of the dam construction for the terrestrial plant species in middle reach of Lancangjiang River. There was an obvious difference in the summed dominance ratio of dominant species at the three sites before and after the dam construction. According the types of species (dominant and non-dominant species) and the changes of plant dominance, the ecological risk (ER) for the plant species was categorized into 0 to IV, i.e., no or extremely low ecological risk (0), low ecological risk (I), medium ecological risk (II), high ecological risk (III), and extremely high ecological risk (IV). As affected by the dam construction, the majority of the species were at ER III, and a few species were at ER IV. The percentage of the plant species at ER III and ER IV at site 3 was higher than that at sites 1 and 2. The decrease or loss of native plants and the increase of alien or invasive plants were the major ecological risks caused by the dam construction. Effective protection strategies should be adopted to mitigate the ecological risk of the dam construction for the terrestrial plants at species level.

Developing Effective Communications about Extreme Weather Risks.

NASA Astrophysics Data System (ADS)

Bruine de Bruin, W.

2014-12-01

Members of the general public often face complex decisions about the risks that they face, including those associated with extreme weather and climate change adaptation. Scientific experts may be asked to develop communications with the goal of improving people's understanding of weather and climate risks, and informing people's decisions about how to protect against these risks. Unfortunately, scientific experts' communication efforts may fail if they lack information about what people need or want to know to make more informed decisions or what wording people prefer use to describe relevant concepts. This presentation provides general principles for developing effective risk communication materials that aim for widespread dissemination, such as brochures and websites. After a brief review of the social science evidence on how to design effective risk communication materials, examples will focus on communications about extreme weather events and climate change. Specifically, data will be presented from ongoing projects on flood risk perception, public preparedness for heat waves, and public perceptions of climate change. The presentation will end with specific recommendations about how to improve recipients' understanding about risks and inform decisions. These recommendations should be useful to scientific experts who aim to communicate about extreme weather, climate change, or other risks.

Cumulative hazard: The case of nuisance flooding

NASA Astrophysics Data System (ADS)

Moftakhari, Hamed R.; AghaKouchak, Amir; Sanders, Brett F.; Matthew, Richard A.

2017-02-01

The cumulative cost of frequent events (e.g., nuisance floods) over time may exceed the costs of the extreme but infrequent events for which societies typically prepare. Here we analyze the likelihood of exceedances above mean higher high water and the corresponding property value exposure for minor, major, and extreme coastal floods. Our results suggest that, in response to sea level rise, nuisance flooding (NF) could generate property value exposure comparable to, or larger than, extreme events. Determining whether (and when) low cost, nuisance incidents aggregate into high cost impacts and deciding when to invest in preventive measures are among the most difficult decisions for policymakers. It would be unfortunate if efforts to protect societies from extreme events (e.g., 0.01 annual probability) left them exposed to a cumulative hazard with enormous costs. We propose a Cumulative Hazard Index (CHI) as a tool for framing the future cumulative impact of low cost incidents relative to infrequent extreme events. CHI suggests that in New York, NY, Washington, DC, Miami, FL, San Francisco, CA, and Seattle, WA, a careful consideration of socioeconomic impacts of NF for prioritization is crucial for sustainable coastal flood risk management.

Epidemiology: Malaria in a warmer West Africa

NASA Astrophysics Data System (ADS)

Caminade, C.; Jones, A. E.

2016-11-01

Malaria risk in West Africa is expected to fall (western region) or remain the same (eastern region) in response to climate change over the twenty-first century. This is primarily due to extreme temperature conditions projected under a high greenhouse gas emissions scenario.

Is Knee Separation During a Drop Jump Associated With Lower Extremity Injury in Adolescent Female Soccer Players?

PubMed

O'Kane, John W; Tencer, Allan; Neradilek, Moni; Polissar, Nayak; Sabado, Lori; Schiff, Melissa A

2016-02-01

Knee injuries are common in older adolescent and adult female soccer players, and abnormal valgus knee appearance characterized by low normalized knee separation (NKS) is a proposed injury risk factor. What constitutes normal NKS in younger adolescents and whether low NKS is an injury risk factor are unknown. To determine the normal range of NKS using a drop-jump test in female perimenarchal youth soccer players and whether low NKS contributes to lower extremity injuries or knee injuries. Cohort study; Level of evidence, 2. From 2008 to 2012, a total of 351 female elite youth soccer players (age range, 11-14 years) were followed for 1 season, with complete follow-up on 92.3% of players. Baseline drop-jump testing was performed preseason. Lower extremity injuries during the season were identified using a validated, Internet-based injury surveillance system with weekly email reporting. Normalized knee separation at prelanding, landing, and takeoff was categorized 2 ways: as ≤10th percentile (most extreme valgus appearance) compared with >10th percentile and as a continuous measure of 1 SD. Poisson regression modeling with adjustment for clustering by team estimated the relative risk (RR) and 95% confidence interval (CI) of the association between the NKS and the risk of lower extremity and knee injury, stratified by menarche. Of the study participants, 134 players experienced 173 lower extremity injuries, with 43 (24.9%) knee injuries. For postmenarchal players (n = 210), those with NKS ≤10th percentile were at 92% increased risk of lower extremity injury (RR, 1.92; 95% CI, 1.17-3.15) and a 3.62-fold increased risk of knee injury (RR, 3.62; 95% CI, 1.18-11.09) compared with NKS >10th percentile at prelanding and landing, respectively. Among postmenarchal players, there was an 80% increased risk of knee injury (RR, 1.80; 95% CI, 1.01-3.23) with a decrease of 1 SD in landing NKS and a 66% increased risk of knee injury (RR, 1.66; 95% CI, 1.04-2.64) with a decrease of 1 SD in takeoff NKS. Among premenarchal players (n = 141), there was no statistically significant association between the NKS at prelanding, landing, and takeoff and the risk of lower extremity or knee injury. Low NKS was associated with increased risk of lower extremity and knee injury only among postmenarchal players. © 2015 The Author(s).

Delineation of Spatial Variability in the Temperature-Mortality Relationship on Extremely Hot Days in Greater Vancouver, Canada.

PubMed

Ho, Hung Chak; Knudby, Anders; Walker, Blake Byron; Henderson, Sarah B

2017-01-01

Climate change has increased the frequency and intensity of extremely hot weather. The health risks associated with extemely hot weather are not uniform across affected areas owing to variability in heat exposure and social vulnerability, but these differences are challenging to map with precision. We developed a spatially and temporally stratified case-crossover approach for delineation of areas with higher and lower risks of mortality on extremely hot days and applied this approach in greater Vancouver, Canada. Records of all deaths with an extremely hot day as a case day or a control day were extracted from an administrative vital statistics database spanning the years of 1998-2014. Three heat exposure and 11 social vulnerability variables were assigned at the residential location of each decedent. Conditional logistic regression was used to estimate the odds ratio for a 1°C increase in daily mean temperature at a fixed site with an interaction term for decedents living above and below different values of the spatial variables. The heat exposure and social vulnerability variables with the strongest spatially stratified results were the apparent temperature and the labor nonparticipation rate, respectively. Areas at higher risk had values ≥ 34.4°C for the maximum apparent temperature and ≥ 60% of the population neither employed nor looking for work. These variables were combined in a composite index to quantify their interaction and to enhance visualization of high-risk areas. Our methods provide a data-driven framework for spatial delineation of the temperature--mortality relationship by heat exposure and social vulnerability. The results can be used to map and target the most vulnerable areas for public health intervention. Citation: Ho HC, Knudby A, Walker BB, Henderson SB. 2017. Delineation of spatial variability in the temperature-mortality relationship on extremely hot days in greater Vancouver, Canada. Environ Health Perspect 125:66-75; http://dx.doi.org/10.1289/EHP224.

Delineation of Spatial Variability in the Temperature–Mortality Relationship on Extremely Hot Days in Greater Vancouver, Canada

PubMed Central

Ho, Hung Chak; Knudby, Anders; Walker, Blake Byron; Henderson, Sarah B.

2016-01-01

Background: Climate change has increased the frequency and intensity of extremely hot weather. The health risks associated with extemely hot weather are not uniform across affected areas owing to variability in heat exposure and social vulnerability, but these differences are challenging to map with precision. Objectives: We developed a spatially and temporally stratified case-crossover approach for delineation of areas with higher and lower risks of mortality on extremely hot days and applied this approach in greater Vancouver, Canada. Methods: Records of all deaths with an extremely hot day as a case day or a control day were extracted from an administrative vital statistics database spanning the years of 1998–2014. Three heat exposure and 11 social vulnerability variables were assigned at the residential location of each decedent. Conditional logistic regression was used to estimate the odds ratio for a 1°C increase in daily mean temperature at a fixed site with an interaction term for decedents living above and below different values of the spatial variables. Results: The heat exposure and social vulnerability variables with the strongest spatially stratified results were the apparent temperature and the labor nonparticipation rate, respectively. Areas at higher risk had values ≥ 34.4°C for the maximum apparent temperature and ≥ 60% of the population neither employed nor looking for work. These variables were combined in a composite index to quantify their interaction and to enhance visualization of high-risk areas. Conclusions: Our methods provide a data-driven framework for spatial delineation of the temperature-–mortality relationship by heat exposure and social vulnerability. The results can be used to map and target the most vulnerable areas for public health intervention. Citation: Ho HC, Knudby A, Walker BB, Henderson SB. 2017. Delineation of spatial variability in the temperature–mortality relationship on extremely hot days in greater Vancouver, Canada. Environ Health Perspect 125:66–75; http://dx.doi.org/10.1289/EHP224 PMID:27346526

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

PubMed

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

2012-12-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

PubMed Central

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

2012-01-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively. PMID:23255857

Influence of risk factors and past events on flood resilience in coastal megacities: Comparative analysis of NYC and Shanghai.

PubMed

Xian, Siyuan; Yin, Jie; Lin, Ning; Oppenheimer, Michael

2018-01-01

Coastal flood protection measures have been widely implemented to improve flood resilience. However, protection levels vary among coastal megacities globally. This study compares the distinct flood protection standards for two coastal megacities, New York City and Shanghai, and investigates potential influences such as risk factors and past flood events. Extreme value analysis reveals that, compared to NYC, Shanghai faces a significantly higher flood hazard. Flood inundation analysis indicates that Shanghai has a higher exposure to extreme flooding. Meanwhile, Shanghai's urban development, population, and economy have increased much faster than NYC's over the last three decades. These risk factors provide part of the explanation for the implementation of a relatively high level of protection (e.g. reinforced concrete sea-wall designed for a 200-year flood return level) in Shanghai and low protection (e.g. vertical brick and stone walls and sand dunes) in NYC. However, individual extreme flood events (typhoons in 1962, 1974, and 1981) seem to have had a greater impact on flood protection decision-making in Shanghai, while NYC responded significantly less to past events (with the exception of Hurricane Sandy). Climate change, sea level rise, and ongoing coastal development are rapidly changing the hazard and risk calculus for both cities and both would benefit from a more systematic and dynamic approach to coastal protection. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between temperature and maternal stress during pregnancy.

PubMed

Lin, Yanfen; Hu, Wenjing; Xu, Jian; Luo, Zhongcheng; Ye, Xiaofang; Yan, Chonghuai; Liu, Zhiwei; Tong, Shilu

2017-10-01

Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy. In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress. After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (< P5, 1.4-10.5℃, lag 0-1 days, 0-2 days and 0-5 days) and extremely high temperatures (≥ P95, 31.2-34.1℃, lag 0-1 days and 0-2 days), and acute exposures to extremely low (lag day 0, 1, 2 and 3) and high (lag day 0, 1) temperatures, all induced higher risks of high GSI (the highest tertile), compared to the risk induced by exposed to an optimal temperature range (20-25℃) (P< 0.05). Increased temperature difference was associated with high maternal GSI (P< 0.05). However, non-significant associations were observed between daily average temperatures/temperature differences and maternal log-transferred LESPW scores. Cumulative and acute exposures to extremely low/high temperatures may both induce emotional stress during pregnancy. Copyright © 2017 Elsevier Inc. All rights reserved.

Sport participation, risk taking, and health risk behaviors.

PubMed

Patel, D R; Luckstead, E F

2000-02-01

Adolescents participate in sports for a variety of reasons. Some seem to enjoy participating in what some might consider very-high-risk or "extreme" sports activities. For some adolescents risk taking becomes pervasive and can be detrimental to normal health and development. The majority of adolescents will do well in the context of athletics, and the many positive benefits of regular physical activity and sports participation should be appropriately emphasized. However, a subset of adolescents may be at greater risk for adverse consequences. This article reviews the reasons for participation and attrition from sports, the phenomenon of thrill seeking in sports, certain risk-taking behaviors of athletes, and studies comparing health risk behaviors in athletes and non-athletes.

Risk-Taking and the Feedback Negativity Response to Loss among At-Risk Adolescents

PubMed Central

Crowley, Michael J.; Wu, Jia; Crutcher, Clifford; Bailey, Christopher A.; Lejuez, C.W.; Mayes, Linda C.

2009-01-01

Event-related brain potentials were examined in 32 adolescents (50% female) from a high-risk sample, who were exposed to cocaine and other drugs prenatally. Adolescents were selected for extreme high- or low-risk behavior on the Balloon Analog Risk Task, a measure of real-world risk-taking propensity. The feedback error-related negativity (fERN), an event-related potential (ERP) that occurs when an expected reward does not occur, was examined in a game in which choices lead to monetary gains and losses with feedback delayed 1 or 2 s. The fERN was clearly visible in the fronto-central scalp region in this adolescent sample. Feedback type, feedback delay, risk status, and sex were all associated with fERN variability. Monetary feedback also elicited a P300-like component, moderated by delay and sex. Delaying reward feedback may provide a means for studying complementary functioning of dopamine and norepinephrine systems. PMID:19372694

Risk factors for upper-extremity musculoskeletal disorders in the working population

PubMed Central

Roquelaure, Yves; Ha, Catherine; Rouillon, Clarisse; Fouquet, Natacha; Leclerc, Annette; Descatha, Alexis; Touranchet, Annie; Goldberg, Marcel; Imbernon, Ellen

2009-01-01

SUMMARY Objective The study aimed to assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders (UEMSDs) in the working population. Methods A total of 3,710 workers (58% of men) participating in a surveillance program of MSDs in a French region in 2002–2005 were included. UEMSDs were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between MSDs, personal and occupational factors were analyzed using logistic regression modeling. Results A total of 472 workers suffered from at least one UEMSD. The risk of UEMSDs increased with age for both genders (P<0.001) (O.R. up to 4.9 in men and 5.0 and in women) and in cases of prior history of UEMSDs (OR 3.1 and 5.0, P<0.001). In men, UEMSDs were associated with obesity (OR 2.2, P=0.014), high level of physical demand (OR 2.0, P<0.001), high repetitiveness of the task (OR 1.5, P=0.027), postures with the arms at or above shoulder level (OR 1.7, P=0.009) or with full elbow flexion (OR 1.6, P=0.006), and high psychological demand (O.R. 1.5, P=0.005). In women, UEMSDs were associated with diabetes mellitus (O.R. 4.9, P=0.001), postures with extreme wrist bending (OR 2.0, P<0.001), use of vibrating hand tools (O.R. 2.2, P=0.025) and low level of decision authority (OR 1.4, P=0.042). Conclusion The study showed that personal and work-related physical and psychosocial factors were strongly associated with clinically-diagnosed UEMSDs. PMID:19790112

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

PubMed

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

2017-08-01

Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age <65 years (odds ratio = 1.22), Elixhauser score of 1 to 2 compared with zero (odds ratio = 1.17), end-stage renal disease (versus no kidney disease; odds ratio = 2.63), history of any deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Integrating new indicators of predictors that shape the public's perception of local extreme temperature in China.

PubMed

Ban, Jie; Huang, Lei; Chen, Chen; Guo, Yuming; He, Mike Z; Li, Tiantian

2017-02-01

The public's risk perception of local extreme heat or cold plays a critical role in community health and prevention under climate change. However, there is limited evidence on such issues in China where extreme weather is occurring more frequently due to climate change. Here, a total of 2500 residents were selected using a three-step sampling method and investigated by a questionnaire in two representative cities. We investigated risk perception of extreme heat in Beijing and extreme cold in Harbin in 2013, aiming to examine their possible correlations with multiple epidemiological factors. We found that exposure, vulnerability, and adaptive ability were significant predictors in shaping public risk perceptions of local extreme temperature. In particular, a 1°C increase in daily temperature resulted in an increased odds of perceiving serious extreme heat in Beijing (OR=1.091; 95% CI: 1.032, 1.153), while a 1°C increase in daily temperature resulted in a decreased odds of perceiving serious extreme cold in Harbin (OR=0.965; 95% CI: 0.939, 0.992). Therefore for both extreme heat and cold, frequent local extreme temperature exposure may amplify a stronger communication. Health interventions for extreme temperature should consider exposure, vulnerability, and adaptive ability factors. This will help improve the public's perception of climatic changes and their willingness to balance adaption and mitigation appropriately. Copyright © 2016 Elsevier B.V. All rights reserved.

Resilience and suicidality among homeless youth.

PubMed

Cleverley, Kristin; Kidd, Sean A

2011-10-01

Homeless and street-involved youth are considered an extremely high risk group, with many studies highlighting trajectories characterized by abusive, neglectful, and unstable family histories, victimization and criminal involvement while on the streets, high rates of physical and mental illness, and extremely high rates of mortality. While there exists a substantial body of knowledge regarding risk, in recent years attention has been increasingly shifting to the examination of resilience, intervention, and service delivery models for these young people. The present study describes the findings from a quantitative examination of personal and street-related demographics, psychological distress, self-esteem, resilience, and suicidality among 47 homeless and street-involved youth. Key findings indicate that the apparent erosion of mental health variables, including resilience, occurs as a function of how long the youths have been without stable housing. Finally, those youths' perceived resilience was associated with less suicidal ideation whereas higher psychological distress was associated with higher suicidal ideation, even when accounting for resiliency. Copyright © 2010 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Compensatory strategies during manual wheelchair propulsion in response to weakness in individual muscle groups: A simulation study.

PubMed

Slowik, Jonathan S; McNitt-Gray, Jill L; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R

2016-03-01

The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness using individual muscle mechanical power and stress as measures of upper extremity demand. The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users. Copyright © 2016 Elsevier Ltd. All rights reserved.

Compensatory Strategies during Manual Wheelchair Propulsion in Response to Weakness in Individual Muscle Groups: A Simulation Study

PubMed Central

Slowik, Jonathan S.; McNitt-Gray, Jill L.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

Background The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among the individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Methods Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness, using individual muscle mechanical power and stress as measures of upper extremity demand. Findings The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. Interpretation These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users. PMID:26945719

Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study.

PubMed

Goerger, Benjamin M; Marshall, Stephen W; Beutler, Anthony I; Blackburn, J Troy; Wilckens, John H; Padua, Darin A

2015-02-01

Information as to how anterior cruciate ligament (ACL) injury and reconstructive surgery (ACLR) alter lower extremity biomechanics may improve rehabilitation and return to play guidelines, reducing the risk for repeat ACL injury. To compare lower extremity biomechanics before ACL injury and after subsequent ACLR for the injured and uninjured leg. Baseline unilateral lower extremity biomechanics were collected on the dominant leg of participants without ACL injury when they entered the Joint Undertaking to Monitor and Prevent ACL (JUMP-ACL) study. Thirty-one participants with subsequent ACL injury, reconstructive surgery and full return to physical activity completed repeat, follow-up biomechanical testing, as did 39 uninjured, matched controls. Not all injured participants suffered injury to the dominant leg, requiring separation of those with ACL injury into two groups: ACLR-injured leg group (n=12) and ACLR-uninjured leg group (n=19). We compared the landing biomechanics of these three groups (ACLR-injured leg, ACLR-uninjured leg, control) before ACL injury (baseline) with biomechanics after ACL injury, surgery and return to physical activity (follow-up). ACL injury and ACLR altered lower extremity biomechanics, as both ACLR groups demonstrated increases in frontal plane movement (increased hip adduction and knee valgus). The ACLR-injured leg group also exhibited decreased sagittal plane loading (decreased anterior tibial shear force, knee extension moment and hip flexion moment). No high-risk biomechanical changes were observed in control group participants. ACL injury and ACLR caused movement pattern alterations of the injured and uninjured leg that have previously shown to increase the risk for future non-contact ACL injury. 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.

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

PubMed

Smolka, Anselm

2006-08-15

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

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

NASA Astrophysics Data System (ADS)

Smolka, Anselm

2006-08-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

Extracting additional risk managers information from a risk assessment of Listeria monocytogenes in deli meats.

PubMed

Pérez-Rodríguez, F; van Asselt, E D; Garcia-Gimeno, R M; Zurera, G; Zwietering, M H

2007-05-01

The risk assessment study of Listeria monocytogenes in ready-to-eat foods conducted by the U.S. Food and Drug Administration is an example of an extensive quantitative microbiological risk assessment that could be used by risk analysts and other scientists to obtain information and by managers and stakeholders to make decisions on food safety management. The present study was conducted to investigate how detailed sensitivity analysis can be used by assessors to extract more information on risk factors and how results can be communicated to managers and stakeholders in an understandable way. The extended sensitivity analysis revealed that the extremes at the right side of the dose distribution (at consumption, 9 to 11.5 log CFU per serving) were responsible for most of the cases of listeriosis simulated. For concentration at retail, values below the detection limit of 0.04 CFU/g and the often used limit for L. monocytogenes of 100 CFU/g (also at retail) were associated with a high number of annual cases of listeriosis (about 29 and 82%, respectively). This association can be explained by growth of L. monocytogenes at both average and extreme values of temperature and time, indicating that a wide distribution can lead to high risk levels. Another finding is the importance of the maximal population density (i.e., the maximum concentration of L. monocytogenes assumed at a certain temperature) for accurately estimating the risk of infection by opportunistic pathogens such as L. monocytogenes. According to the obtained results, mainly concentrations corresponding to the highest maximal population densities caused risk in the simulation. However, sensitivity analysis applied to the uncertainty parameters revealed that prevalence at retail was the most important source of uncertainty in the model.

A new framework for estimating return levels using regional frequency analysis

NASA Astrophysics Data System (ADS)

Winter, Hugo; Bernardara, Pietro; Clegg, Georgina

2017-04-01

We propose a new framework for incorporating more spatial and temporal information into the estimation of extreme return levels. Currently, most studies use extreme value models applied to data from a single site; an approach which is inefficient statistically and leads to return level estimates that are less physically realistic. We aim to highlight the benefits that could be obtained by using methodology based upon regional frequency analysis as opposed to classic single site extreme value analysis. This motivates a shift in thinking, which permits the evaluation of local and regional effects and makes use of the wide variety of data that are now available on high temporal and spatial resolutions. The recent winter storms over the UK during the winters of 2013-14 and 2015-16, which have caused wide-ranging disruption and damaged important infrastructure, provide the main motivation for the current work. One of the most impactful natural hazards is flooding, which is often initiated by extreme precipitation. In this presentation, we focus on extreme rainfall, but shall discuss other meteorological variables alongside potentially damaging hazard combinations. To understand the risks posed by extreme precipitation, we need reliable statistical models which can be used to estimate quantities such as the T-year return level, i.e. the level which is expected to be exceeded once every T-years. Extreme value theory provides the main collection of statistical models that can be used to estimate the risks posed by extreme precipitation events. Broadly, at a single site, a statistical model is fitted to exceedances of a high threshold and the model is used to extrapolate to levels beyond the range of the observed data. However, when we have data at many sites over a spatial domain, fitting a separate model for each separate site makes little sense and it would be better if we could incorporate all this information to improve the reliability of return level estimates. Here, we use the regional frequency analysis approach to define homogeneous regions which are affected by the same storms. Extreme value models are then fitted to the data pooled from across a region. We find that this approach leads to more spatially consistent return level estimates with reduced uncertainty bounds.

Effects of BMI on the risk and frequency of AIS 3+ injuries in motor-vehicle crashes.

PubMed

Rupp, Jonathan D; Flannagan, Carol A C; Leslie, Andrew J; Hoff, Carrie N; Reed, Matthew P; Cunningham, Rebecca M

2013-01-01

Determine the effects of BMI on the risk of serious-to-fatal injury (Abbreviated Injury Scale ≥ 3 or AIS 3+) to different body regions for adults in frontal, nearside, farside, and rollover crashes. Multivariate logistic regression analysis was applied to a probability sample of adult occupants involved in crashes generated by combining the National Automotive Sampling System (NASS-CDS) with a pseudoweighted version of the Crash Injury Research and Engineering Network database. Logistic regression models were applied to weighted data to estimate the change in the number of occupants with AIS 3+ injuries if no occupants were obese. Increasing BMI increased risk of lower-extremity injury in frontal crashes, decreased risk of lower-extremity injury in nearside impacts, increased risk of upper-extremity injury in frontal and nearside crashes, and increased risk of spine injury in frontal crashes. Several of these findings were affected by interactions with gender and vehicle type. If no occupants in frontal crashes were obese, 7% fewer occupants would sustain AIS 3+ upper-extremity injuries, 8% fewer occupants would sustain AIS 3+ lower-extremity injuries, and 28% fewer occupants would sustain AIS 3+ spine injuries. Results of this study have implications on the design and evaluation of vehicle safety systems. Copyright © 2013 The Obesity Society.

Nest predation risk modifies nestlings' immune function depending on the level of threat.

PubMed

Roncalli, Gianluca; Colombo, Elisa; Soler, Manuel; Tieleman, B Irene; Versteegh, Maaike A; Ruiz-Raya, Fran; Gómez Samblas, Mercedes; Ibáñez-Álamo, Juan Diego

2018-05-20

Predation risk is thought to modify the physiology of prey mainly through the stress response. However, little is known about its potential effects on the immunity of animals, particularly in young individuals, despite the importance of overcoming wounding and pathogen aggression following a predator attack. We investigated the effect of four progressive levels of nest predation risk on several components of the immune system in common blackbird ( Turdus merula ) nestlings by presenting them with four different calls during 1 h: non-predator calls, predator calls, parental alarm calls and conspecific distress calls to induce a null, moderate, high and extreme level of risk, respectively. Nest predation risk induced an increase in ovotransferrin, immunoglobulin and the number of lymphocytes and eosinophils. Thus, the perception of a potential predator per se could stimulate the mobilization of a nestling's immune function and enable the organism to rapidly respond to the immune stimuli imposed by a predator attack. Interestingly, only high and extreme levels of risk caused immunological changes, suggesting that different immunological parameters are modulated according to the perceived level of threat. We also found a mediator role of parasites (i.e. Leucocytozoon ) and the current health status of the individual, as only nestlings not parasitized or in good body condition were able to modify their immune system. This study highlights a previously unknown link between predation risk and immunity, emphasizing the complex relationship among different selective pressures (predation, parasitism) in developing organisms and accentuating the importance of studying predation from a physiological point of view. © 2018. Published by The Company of Biologists Ltd.

Adaptation to flood risk: Results of international paired flood event studies

NASA Astrophysics Data System (ADS)

Kreibich, Heidi; Di Baldassarre, Giuliano; Vorogushyn, Sergiy; Aerts, Jeroen C. J. H.; Apel, Heiko; Aronica, Giuseppe T.; Arnbjerg-Nielsen, Karsten; Bouwer, Laurens M.; Bubeck, Philip; Caloiero, Tommaso; Chinh, Do T.; Cortès, Maria; Gain, Animesh K.; Giampá, Vincenzo; Kuhlicke, Christian; Kundzewicz, Zbigniew W.; Llasat, Maria Carmen; Mârd, Johanna; Matczak, Piotr; Mazzoleni, Maurizio; Molinari, Daniela; Dung, Nguyen V.; Petrucci, Olga; Schröter, Kai; Slager, Kymo; Thieken, Annegret H.; Ward, Philip J.; Merz, Bruno

2017-10-01

As flood impacts are increasing in large parts of the world, understanding the primary drivers of changes in risk is essential for effective adaptation. To gain more knowledge on the basis of empirical case studies, we analyze eight paired floods, that is, consecutive flood events that occurred in the same region, with the second flood causing significantly lower damage. These success stories of risk reduction were selected across different socioeconomic and hydro-climatic contexts. The potential of societies to adapt is uncovered by describing triggered societal changes, as well as formal measures and spontaneous processes that reduced flood risk. This novel approach has the potential to build the basis for an international data collection and analysis effort to better understand and attribute changes in risk due to hydrological extremes in the framework of the IAHSs Panta Rhei initiative. Across all case studies, we find that lower damage caused by the second event was mainly due to significant reductions in vulnerability, for example, via raised risk awareness, preparedness, and improvements of organizational emergency management. Thus, vulnerability reduction plays an essential role for successful adaptation. Our work shows that there is a high potential to adapt, but there remains the challenge to stimulate measures that reduce vulnerability and risk in periods in which extreme events do not occur.

Attribution of the 2015 record high sea surface temperatures over the central equatorial Pacific and tropical Indian Ocean

NASA Astrophysics Data System (ADS)

Park, In-Hong; Min, Seung-Ki; Yeh, Sang-Wook; Weller, Evan; Kim, Seon Tae

2017-04-01

This study assessed the anthropogenic contribution to the 2015 record-breaking high sea surface temperatures (SSTs) observed in the central equatorial Pacific and tropical Indian Ocean. Considering a close link between extreme warm events in these regions, we conducted a joint attribution analysis using a fraction of attributable risk approach. Probability of occurrence of such extreme anomalies and long-term trends for the two oceanic regions were compared between CMIP5 multi-model simulations with and without anthropogenic forcing. Results show that the excessive warming in both regions is well beyond the range of natural variability and robustly attributable to human activities due to greenhouse gas increase. We further explored associated mechanisms including the Bjerknes feedback and background anthropogenic warming. It is concluded that background warming was the main contribution to the 2015 extreme SST event over the central equatorial Pacific Ocean on a developing El Niño condition, which in turn induced the extreme SST event over the tropical Indian Ocean through the atmospheric bridge effect.

A failure of preoperative duplex imaging to diagnose a lower extremity venous aneurysm in a patient with severe chronic venous insufficiency.

PubMed

Jones, Roy Wesley; Parkerson, Godfrey Ross; Ottinger, Mary; Rodriguez, Eduardo; Park, Brian

2017-01-01

We present a case of recurrent bilateral lower extremity venous stasis ulcers in association with a superficial venous aneurysm at the right saphenofemoral junction that was misdiagnosed on preoperative duplex scanning. A 53-year-old female presented to our clinic with 6-year history of bilateral lower extremity venous stasis ulcers. Her past medical history was significant for refractory venous stasis ulcers of the bilateral lower extremities present for 6 years and morbid obesity. Preoperative venous duplex demonstrated severe venous insufficiency of the superficial and deep systems, but a venous aneurysm was not appreciated. During the high ligation of the right saphenofemoral junction, a 3 × 4 × 5 cm aneurysm was encountered. Repair consisted of aneurysm resection, high ligation of the greater saphenous vein, dissociation of the great saphenous and anterior saphenous veins, and stab phlebectomy of large varicose veins of the thigh and lower leg. The patient recovered uneventfully and experienced complete healing of the venous stasis ulcer in several weeks. Superficial venous aneurysms of the lower extremity are rare and can be often missed on preoperative duplex ultrasound imaging. Large diameter measurements of the proximal greater saphenous vein and obesity increase the risk of misdiagnosing venous aneurysms with duplex imaging; therefore, clinical suspicion must remain high. These aneurysms can be associated with significant symptoms for which repair is indicated.

Comparison Of Downscaled CMIP5 Precipitation Datasets For Projecting Changes In Extreme Precipitation In The San Francisco Bay Area.

NASA Technical Reports Server (NTRS)

Milesi, Cristina; Costa-Cabral, Mariza; Rath, John; Mills, William; Roy, Sujoy; Thrasher, Bridget; Wang, Weile; Chiang, Felicia; Loewenstein, Max; Podolske, James

2014-01-01

Water resource managers planning for the adaptation to future events of extreme precipitation now have access to high resolution downscaled daily projections derived from statistical bias correction and constructed analogs. We also show that along the Pacific Coast the Northern Oscillation Index (NOI) is a reliable predictor of storm likelihood, and therefore a predictor of seasonal precipitation totals and likelihood of extremely intense precipitation. Such time series can be used to project intensity duration curves into the future or input into stormwater models. However, few climate projection studies have explored the impact of the type of downscaling method used on the range and uncertainty of predictions for local flood protection studies. Here we present a study of the future climate flood risk at NASA Ames Research Center, located in South Bay Area, by comparing the range of predictions in extreme precipitation events calculated from three sets of time series downscaled from CMIP5 data: 1) the Bias Correction Constructed Analogs method dataset downscaled to a 1/8 degree grid (12km); 2) the Bias Correction Spatial Disaggregation method downscaled to a 1km grid; 3) a statistical model of extreme daily precipitation events and projected NOI from CMIP5 models. In addition, predicted years of extreme precipitation are used to estimate the risk of overtopping of the retention pond located on the site through simulations of the EPA SWMM hydrologic model. Preliminary results indicate that the intensity of extreme precipitation events is expected to increase and flood the NASA Ames retention pond. The results from these estimations will assist flood protection managers in planning for infrastructure adaptations.

Improving the Accuracy of Estimation of Climate Extremes

NASA Astrophysics Data System (ADS)

Zolina, Olga; Detemmerman, Valery; Trenberth, Kevin E.

2010-12-01

Workshop on Metrics and Methodologies of Estimation of Extreme Climate Events; Paris, France, 27-29 September 2010; Climate projections point toward more frequent and intense weather and climate extremes such as heat waves, droughts, and floods, in a warmer climate. These projections, together with recent extreme climate events, including flooding in Pakistan and the heat wave and wildfires in Russia, highlight the need for improved risk assessments to help decision makers and the public. But accurate analysis and prediction of risk of extreme climate events require new methodologies and information from diverse disciplines. A recent workshop sponsored by the World Climate Research Programme (WCRP) and hosted at United Nations Educational, Scientific and Cultural Organization (UNESCO) headquarters in France brought together, for the first time, a unique mix of climatologists, statisticians, meteorologists, oceanographers, social scientists, and risk managers (such as those from insurance companies) who sought ways to improve scientists' ability to characterize and predict climate extremes in a changing climate.

PROSPECTIVE FUNCTIONAL PERFORMANCE TESTING AND RELATIONSHIP TO LOWER EXTREMITY INJURY INCIDENCE IN ADOLESCENT SPORTS PARTICIPANTS

PubMed Central

DePhillipo, Nick; Kimura, Iris; Kocher, Morgan; Hetzler, Ronald

2017-01-01

Background Due to the high number of adolescent athletes and subsequent lower extremity injuries, improvements of injury prevention strategies with emphasis on clinic-based and practical assessments are warranted. Purpose The purpose of this study was to prospectively investigate if a battery of functional performance tests (FPT) could be used as a preseason-screening tool to identify adolescent athletes at risk for sports-related acute lower extremity injury via comparison of injured and uninjured subjects. Methods One hundred adolescent volleyball, basketball and soccer athletes (female, n=62; male, n=38; mean age = 14.4 ± 1.6) participated. The FPT assessment included: triple hop for distance, star excursion balance test, double leg lowering maneuver, drop jump video test, and multi-stage fitness test. Composite scores were calculated using a derived equation. Subjects were monitored throughout their designated sport season(s), which consisted of a six-month surveillance period. The schools certified athletic trainer (ATC) recorded all injuries. Subjects were categorized into groups according to sex and injury incidence (acute lower extremity injury vs. uninjured) for analysis. Results Mean FPT composite scores were significantly lower for the injured compared to the uninjured groups in both sexes (males: 19.06 ± 3.59 vs. 21.90 ± 2.44; females: 19.48 ± 3.35 vs. 22.10 ± 3.06 injured and uninjured, respectively)(p < .05). The receiver-operator characteristic analysis determined the cut-off score at ≤ 20 for both genders (sensitivity=.71, specificity=.81, for males; sensitivity=.67, specificity=.69, for females)(p<.05) for acute noncontact lower extremity injuries. Significant positive correlations were found between the FPT composite score and the multi-stage fitness test in male subjects (r=.474, p=.003), suggesting a relationship between functional performance, aerobic capacity, and potential injury risk. Conclusion A comprehensive assessment of functional performance tests may be beneficial to identify high-injury risk adolescents prior to athletic participation. PMID:28515975

Flooding Risk for Coastal Infrastructure: a Stakeholder-Oriented Approach

NASA Astrophysics Data System (ADS)

Plater, A. J.; Prime, T.; Brown, J. M.; Knight, P. J.; Morrissey, K.

2015-12-01

A flood risk assessment for coastal energy infrastructure in the UK with respect to long-term sea-level rise and extreme water levels has been conducted using a combination of numerical modelling approaches (LISFLOOD-FP, SWAB, XBeach-G, POLCOMS). Model outputs have been incorporated into a decision-support tool that enables users from a wide spectrum of coastal stakeholders (e.g. nuclear energy, utility providers, local government, environmental regulators, communities) to explore the potential impacts of flooding on both operational (events to 10 years) and strategic (10 to 50 years) timescales. Examples illustrate the physical and economic impacts of flooding from combined extreme water levels, wave overtopping and high river flow for Fleetwood, NW England; changes in the extent of likely flooding arising from an extreme event due to sea-level rise for Oldbury, SW England; and the relative vulnerability to overtopping and breaching of sea defences for Dungeness, SE England. The impacts of a potential large-scale beach recharge scheme to mitigate coastal erosion and flood risk along the southern shoreline of Dungeness are also examined using a combination of coastal evolution and particle-tracking modelling. The research goal is to provide an evidence base for resource allocation, investment in interventions, and communication and dialogue in relation to sea-level rise to 2500 AD.

A systematic review of hypofractionation for primary management of prostate cancer.

PubMed

Koontz, Bridget F; Bossi, Alberto; Cozzarini, Cesare; Wiegel, Thomas; D'Amico, Anthony

2015-10-01

Technological advances in radiation therapy delivery have permitted the use of high-dose-per-fraction radiation therapy (RT) for early-stage prostate cancer (PCa). Level 1 evidence supporting the safety and efficacy of hypofractionated RT is evolving as this modality becomes more widely utilized and refined. To perform a systematic review of the current evidence on the safety and efficacy of hypofractionated RT for early-stage PCa and to provide in-context recommendations for current application of this technology. Embase, PubMed, and Scopus electronic databases were queried for English-language articles from January 1990 through June 2014. Prospective studies with a minimum of 50 patients were included. Separate consideration was made for studies involving moderate hypofractionation (doses of 2.5-4Gy per fraction) and extreme hypofractionation (5-10Gy in 4-7 fractions). Six relatively small superiority designed randomized trials of standard fractionation versus moderate hypofractionation in predominantly low- and intermediate-risk PCa have been published with follow-up ranging from 4 to 8 yr, noting similar biochemical control (5-yr freedom from biochemical failure in modern studies is >80% for low-risk and intermediate-risk patients) and late grade ≥2 genitourinary and gastrointestinal toxicities (between 2% and 20%). Noninferiority studies are pending. In prospective phase 2 studies, extreme hypofractionation has promising 2- to 5-yr biochemical control rates of >90% for low-risk patients. Results from a randomized trial are expected in 2015. Moderate hypofractionation has 5-yr data to date establishing safety compared with standard fractionation, but 10-yr outcomes and longer follow-up are needed to establish noninferiority for clinical effectiveness. Extreme hypofractionation is promising but as yet requires reporting of randomized data prior to application outside of a clinical protocol. Hypofractionation for prostate cancer delivers relatively high doses of radiation per treatment. Prospective studies support the safety of moderate hypofractionation, while extreme fractionation may have greater toxicity. Both show promising cancer control but long-term results of noninferiority studies of both methods are required before use in routine treatment outside of clinical protocols. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Assessment of choke valve erosion in a high-pressure, high-temperature gas condensate well using TLA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Birchenough, P.M.; Cornally, D.; Dawson, S.G.B.

1994-12-31

Many planned new developments in the North Sea will involve the exploitation of hostile high pressure, high temperature gas condensate reserves. The extremely high pressure letdown over the wellhead choke leads to very high flow velocities, and consequent risks of erosion damage occurring to the choke internals. In a recent study, measurements of erosion have been performed during an offshore well test under flowing conditions using advanced Thin Layer Activation techniques and scaled Laboratory tests.

Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate.

PubMed

Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

2016-01-01

Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta's biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as 'extremely invasive', with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is 'extremely invasive' with a 64% increase in suitable habitat, and alkali swainsonpea is 'highly invasive' with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change.

Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate

PubMed Central

Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

2016-01-01

Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta’s biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as ‘extremely invasive’, with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is ‘extremely invasive’ with a 64% increase in suitable habitat, and alkali swainsonpea is ‘highly invasive’ with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change. PMID:27768758

Risk assessment of precipitation extremes in northern Xinjiang, China

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

Science-Driven Approach to Disaster Risk and Crisis Management

NASA Astrophysics Data System (ADS)

Ismail-Zadeh, A.

2014-12-01

Disasters due to natural extreme events continue to grow in number and intensity. Disaster risk and crisis management requires long-term planning, and to undertake that planning, a science-driven approach is needed to understand and assess disaster risks and to help in impact assessment and in recovery processes after a disaster. Science is used in assessments and rapid modeling of the disaster impact, in forecasting triggered hazards and risk (e.g., a tsunami or a landslide after a large earthquake), in contacts with and medical treatment of the affected population, and in some other actions. At the stage of response to disaster, science helps to analyze routinely the disaster happened (e.g., the physical processes led to this extreme event; hidden vulnerabilities; etc.) At the stage of recovery, natural scientists improve the existing regional hazard assessments; engineers try to use new science to produce new materials and technologies to make safer houses and infrastructure. At the stage of disaster risk mitigation new scientific methods and approaches are being developed to study natural extreme events; vulnerability of society is periodically investigated, and the measures for increasing the resilience of society to extremes are developed; existing disaster management regulations are improved. At the stage of preparedness, integrated research on disaster risks should be developed to understand the roots of potential disasters. Enhanced forecasting and early warning systems are to be developed reducing predictive uncertainties, and comprehensive disaster risk assessment is to be undertaken at local, regional, national and global levels. Science education should be improved by introducing trans-disciplinary approach to disaster risks. Science can help society by improving awareness about extreme events, enhancing risk communication with policy makers, media and society, and assisting disaster risk management authorities in organization of local and regional training and exercises.

Extreme Weather Risk Assessment: The Case of Jiquilisco, El Salvador

NASA Astrophysics Data System (ADS)

Melendez, Karla; Ceppi, Claudia; Molero, Juanjo; Rios Insua, David

2014-05-01

All major climate models predict increases in both global and regional mean temperatures throughout this century, under different scenarios concerning future trends in population growth or economic and technological development. This consistency of results across models has strengthened the evidence about global warming. Despite the convincing facts and findings of climate researchers, there is still a great deal of skepticism around climate change. There is somewhat less consensus about some of the consequences of climate change, for example in reference to extreme weather changes, in particular as regards more local scales. However, such changes seem to have already considerable impact in many regions across the world in terms of lives, economic losses, and required changes in lifestyles. This may demand appropriate policy responses both at national and local levels. Our work provides a framework for extreme weather multithreat risk management, based on probabilistic risk assessment (PRA). This may be useful in comparing the effectiveness of different actions to manage risks and inform judgment concerning the appropriate resource allocation to mitigate the risks. The methodology has been applied to the case study of the "El Marillo II" community, located in the municipality of Jiquilisco in El Salvador. There, the main problem related with extreme weather conditions are the frequent floods caused by rainfall, hurricanes , and water increases in the Lempa river nearby located. However, droughts are also very relevant. Based on several sources like SNET, newspapers, field visits to the region and interviews, we have built a detailed database that comprises extreme weather daily data from January 1971 until December 2011. Forecasting models for floods and droughts were built suggesting the need to properly manage the risks. We subsequently obtained the optimal portfolio of countermeasures, given the budget constraints. KEYWORDS: CLIMATE CHANGE, EXTREME WEATHER, RISK ANALYSIS, DECISION ANALYSIS, EL SALVADOR.

Adolescent Gender-Related Abuse, Androphilia, and HIV Risk Among Transfeminine People of Color in New York City

PubMed Central

Hwahng, Sel J.; Nuttbrock, Larry

2014-01-01

Public health research has indicated extremely high HIV seroprevalence (13–63%) among low-income transfeminine people of color of African, Latina, and Asian descent living in the U.S. This paper combines two data sets. One set is based on an ethnographic study (N=50, 120 hours of participant observation). The other set longitudinal quantitative study (baseline N=600, N=275 followed for 3 years). Transfeminine people of color are much more likely to be androphilic and at high HIV risk. A greater understanding of adolescent gender-related abuse and trauma-impacted androphilia contributes towards a holistic conceptual model of HIV risk. A theoretical model is proposed that incorporates findings from both studies and integrates sociostructural, interpersonal, and intrapsychic levels of HIV risk. PMID:24294927

Double Exposure and the Climate Gap: Changing demographics and extreme heat in Ciudad Juárez, Mexico

PubMed Central

Collins, Timothy W.; McDonald, Yolanda J.; Aldouri, Raed; Aboargob, Faraj; Eldeb, Abdelatif; Aguilar, María de Lourdes Romo; Velázquez-Angulo, Juárez Gilberto

2013-01-01

Scholars have recognized a climate gap, wherein poor communities face disproportionate impacts of climate change. Others have noted that climate change and economic globalization may mutually affect a region or social group, leading to double exposure. This paper investigates how current and changing patterns of neighborhood demographics are associated with extreme heat in the border city of Juárez, Mexico. Many Juárez neighborhoods are at-risk to triple exposures, in which residents suffer due to the conjoined effects of the global recession, drug war violence, and extreme heat. Due to impacts of the recession on maquiladora employment and the explosion of drug violence (since 2008), over 75% of neighborhoods experienced decreasing population density between 2000 and 2010 and the average neighborhood saw a 40% increase in the proportion of older adults. Neighborhoods with greater drops in population density and increases in the proportion of older residents over the decade are at significantly higher risk to extreme heat, as are neighborhoods with lower population density and lower levels of education. In this context, triple exposures are associated with a climate gap that most endangers lower socioeconomic status and increasingly older aged populations remaining in neighborhoods from which high proportions of residents have departed. PMID:25642135

Double Exposure and the Climate Gap: Changing demographics and extreme heat in Ciudad Juárez, Mexico.

PubMed

Grineski, Sara E; Collins, Timothy W; McDonald, Yolanda J; Aldouri, Raed; Aboargob, Faraj; Eldeb, Abdelatif; Aguilar, María de Lourdes Romo; Velázquez-Angulo, Juárez Gilberto

2015-02-01

Scholars have recognized a climate gap, wherein poor communities face disproportionate impacts of climate change. Others have noted that climate change and economic globalization may mutually affect a region or social group, leading to double exposure. This paper investigates how current and changing patterns of neighborhood demographics are associated with extreme heat in the border city of Juárez, Mexico. Many Juárez neighborhoods are at-risk to triple exposures, in which residents suffer due to the conjoined effects of the global recession, drug war violence, and extreme heat. Due to impacts of the recession on maquiladora employment and the explosion of drug violence (since 2008), over 75% of neighborhoods experienced decreasing population density between 2000 and 2010 and the average neighborhood saw a 40% increase in the proportion of older adults. Neighborhoods with greater drops in population density and increases in the proportion of older residents over the decade are at significantly higher risk to extreme heat, as are neighborhoods with lower population density and lower levels of education. In this context, triple exposures are associated with a climate gap that most endangers lower socioeconomic status and increasingly older aged populations remaining in neighborhoods from which high proportions of residents have departed.

A narrative insight into disability pensioners' work experiences in highly gender-segregated occupations.

PubMed

Reinholdt, Sofia; Alexanderson, Kristina

2009-01-01

This study examined some plausible explanations for the higher rates of ill-health seen in extremely gender-segregated occupations. The focus was on the work experiences of disability pensioners with last jobs prior to pensioning characterized by segregated conditions (i.e., less than 10% of the employees of their own sex). Seven interviews were subjected to qualitative content analyses focusing on aspects of health selection, gender differences in work tasks, and in the work situation. The results show a negative health selection into occupations in which the participants constitute an extreme minority. There were some differences in work tasks between the gender in extreme minority and the other gender. Exposure to different stress factors related to the minority status included increased visibility, performance pressure, and harassment. Gender had been of main importance for differences in exposure, for assigning work tasks, and for interaction dynamics between the groups in majority and extreme minority. A combination of negative health selection, gender marking of work tasks, and group interaction dynamics related to group proportions and gender may play a role in cumulative health risks. Additional longitudinal studies are needed to identify mechanisms and interactions in this context in order to better understand possible relationships between occupational gender segregation and increased health risks.

Modeling Compound Flood Hazards in Coastal Embayments

NASA Astrophysics Data System (ADS)

Moftakhari, H.; Schubert, J. E.; AghaKouchak, A.; Luke, A.; Matthew, R.; Sanders, B. F.

2017-12-01

Coastal cities around the world are built on lowland topography adjacent to coastal embayments and river estuaries, where multiple factors threaten increasing flood hazards (e.g. sea level rise and river flooding). Quantitative risk assessment is required for administration of flood insurance programs and the design of cost-effective flood risk reduction measures. This demands a characterization of extreme water levels such as 100 and 500 year return period events. Furthermore, hydrodynamic flood models are routinely used to characterize localized flood level intensities (i.e., local depth and velocity) based on boundary forcing sampled from extreme value distributions. For example, extreme flood discharges in the U.S. are estimated from measured flood peaks using the Log-Pearson Type III distribution. However, configuring hydrodynamic models for coastal embayments is challenging because of compound extreme flood events: events caused by a combination of extreme sea levels, extreme river discharges, and possibly other factors such as extreme waves and precipitation causing pluvial flooding in urban developments. Here, we present an approach for flood risk assessment that coordinates multivariate extreme analysis with hydrodynamic modeling of coastal embayments. First, we evaluate the significance of correlation structure between terrestrial freshwater inflow and oceanic variables; second, this correlation structure is described using copula functions in unit joint probability domain; and third, we choose a series of compound design scenarios for hydrodynamic modeling based on their occurrence likelihood. The design scenarios include the most likely compound event (with the highest joint probability density), preferred marginal scenario and reproduced time series of ensembles based on Monte Carlo sampling of bivariate hazard domain. The comparison between resulting extreme water dynamics under the compound hazard scenarios explained above provides an insight to the strengths/weaknesses of each approach and helps modelers choose the appropriate scenario that best fit to the needs of their project. The proposed risk assessment approach can help flood hazard modeling practitioners achieve a more reliable estimate of risk, by cautiously reducing the dimensionality of the hazard analysis.

Spring Break versus Spring Broken: Predictive Utility of Spring Break Alcohol Intentions and Willingness at Varying Levels of Extremity

PubMed Central

Litt, Dana M.; Lewis, Melissa A.; Patrick, Megan E.; Rodriguez, Lindsey; Neighbors, Clayton; Kaysen, Debra L.

2013-01-01

Objective Within the domain of risk-related behavior, many times the decision to engage is not a product of premeditation or intention. The Prototype Willingness model was created to capture and explain the unintended element of risk behavior. The present study aimed to evaluate the importance of willingness versus intention, two important constructs within the Prototype Willingness model, in relation to Spring Break drinking behavior when assessed at both high and low extremities. Method College undergraduates (N = 275) completed questionnaires prior to Spring Break regarding their anticipated Spring Break activities. Willingness and intention were assessed for different levels of risk. Specifically, participants indicated the extent to which they intended to (a) get drunk and (b) drink enough to black out or pass out; and the extent to which they were willing to (a) get drunk and (b) drink enough to black out or pass out. When classes resumed following Spring Break, the students indicated the extent to which they actually (a) got drunk and (b) drank enough to black out or pass out. Results Results demonstrated that when the health-related risk was lower (i.e., getting drunk), intention was a stronger predictor of behavior than was willingness. However, as the level of risk increased (i.e., getting drunk enough to black out or pass out), willingness more strongly predicted behavior. Conclusion The present study suggests that willingness and intentions differentially predict Spring Break alcohol-related behavior depending on the extremity of behavior in question. Implications regarding alcohol interventions are discussed. PMID:23404667

Pre-Kidney Transplant Lower Extremity Impairment and Post-Kidney Transplant Mortality.

PubMed

Nastasi, A J; McAdams-DeMarco, M A; Schrack, J; Ying, H; Olorundare, I; Warsame, F; Mountford, A; Haugen, C E; González Fernández, M; Norman, S P; Segev, D L

2018-01-01

Prediction models for post-kidney transplantation mortality have had limited success (C-statistics ≤0.70). Adding objective measures of potentially modifiable factors may improve prediction and, consequently, kidney transplant (KT) survival through intervention. The Short Physical Performance Battery (SPPB) is an easily administered objective test of lower extremity function consisting of three parts (balance, walking speed, chair stands), each with scores of 0-4, for a composite score of 0-12, with higher scores indicating better function. SPPB performance and frailty (Fried frailty phenotype) were assessed at admission for KT in a prospective cohort of 719 KT recipients at Johns Hopkins Hospital (8/2009 to 6/2016) and University of Michigan (2/2013 to 12/2016). The independent associations between SPPB impairment (SPPB composite score ≤10) and composite score with post-KT mortality were tested using adjusted competing risks models treating graft failure as a competing risk. The 5-year posttransplantation mortality for impaired recipients was 20.6% compared to 4.5% for unimpaired recipients (p < 0.001). Impaired recipients had a 2.30-fold (adjusted hazard ratio [aHR] 2.30, 95% confidence interval [CI] 1.12-4.74, p = 0.02) increased risk of postkidney transplantation mortality compared to unimpaired recipients. Each one-point decrease in SPPB score was independently associated with a 1.19-fold (95% CI 1.09-1.30, p < 0.001) higher risk of post-KT mortality. SPPB-derived lower extremity function is a potentially highly useful and modifiable objective measure for pre-KT risk prediction. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Risk for Mania and Positive Emotional Responding: Too Much of a Good Thing?

PubMed Central

Gruber, June; Oveis, Christopher; Keltner, Dacher; Johnson, Sheri L.

2010-01-01

Although positive emotion research has begun to flourish, the extremes of positive emotion remain understudied. The present research used a multimethod approach to examine positive emotional disturbance by comparing participants at high and low risk for episodes of mania, which involves elevations in positive emotionality. Ninety participants were recruited into a high or low mania risk group according to responses on the Hypomanic Personality Scale. Participants’ subjective, expressive, and physiological emotional responses were gathered while they watched two positive, two negative, and one neutral film clip. Results suggested that participants at high risk for mania reported elevated positive emotion and irritability and also exhibited elevated cardiac vagal tone across positive, negative, and neutral films. Discussion focuses on the implications these findings have for the diagnosis and prevention of bipolar disorder, as well as for the general study of positive emotion. PMID:18266513

Risk for mania and positive emotional responding: too much of a good thing?

PubMed

Gruber, June; Johnson, Sheri L; Oveis, Christopher; Keltner, Dacher

2008-02-01

Although positive emotion research has begun to flourish, the extremes of positive emotion remain understudied. The present research used a multimethod approach to examine positive emotional disturbance by comparing participants at high and low risk for episodes of mania, which involves elevations in positive emotionality. Ninety participants were recruited into a high or low mania risk group according to responses on the Hypomanic Personality Scale. Participants' subjective, expressive, and physiological emotional responses were gathered while they watched two positive, two negative, and one neutral film clip. Results suggested that participants at high risk for mania reported elevated positive emotion and irritability and also exhibited elevated cardiac vagal tone across positive, negative, and neutral films. Discussion focuses on the implications these findings have for the diagnosis and prevention of bipolar disorder, as well as for the general study of positive emotion.

Prognostic value of proliferation in pleomorphic soft tissue sarcomas: a new look at an old measure.

PubMed

Seinen, Jojanneke M; Jönsson, Mats; Bendahl, Pär-Ola O; Baldetorp, Bo; Rambech, Eva; Åkerman, Måns; Rydholm, Anders; Nilbert, Mef; Carneiro, Ana

2012-12-01

Though proliferation has repeatedly shown a prognostic role in sarcomas, it has not reached clinical application. We performed a comprehensive evaluation of the prognostic role of 5 proliferation measures in a large series of soft tissue sarcomas of the extremities and the trunk wall. One hundred ninety-six primary soft tissue sarcomas of the extremities and the trunk wall were subjected to DNA flow cytometry for quantification of S-phase fraction and to immunohistochemical evaluation of Ki-67, Top2a, p21, and p27Kip1. In univariate analysis, positive expression of Ki-67 (hazard ratio = 4.5, CI = 1.6-12.1), Top2a (hazard ratio = 2.2, CI = 1.2-3.5) and high S-phase fraction (hazard ratio = 1.8, CI = 1.2-3.7) significantly correlated with risk for metastasis. When combined with currently used prognostic factors, Ki-67, S-phase fraction and Top2a fraction contributed to refined identification of prognostic risk groups. Proliferation, as assessed by expression of Ki-67 and Top2a and evaluation of S-phase fraction and applied to statistical decision-tree models, provides prognostic information in soft tissue sarcomas of the extremity and trunk wall. Though proliferation contributes independently to currently applied prognosticators, its role is particularly strong when few other factors are available, which suggests a role in preoperative decision-making related to identification of high-risk individuals who would benefit from neoadjuvant therapy. Copyright © 2012 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-12-01

Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; <26 +0 weeks' gestation). A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11years of age (the EPICure Study). IQ, mathematics and reading attainment, executive function, visuospatial processing and sensorimotor skills were assessed using standardised tests, and curriculum-based attainment and special educational needs (SEN) using teacher reports. Overall, 75 (47%) EP children and 7 (4.6%) controls had ID or LD (RR 10.12; 95% CI 4.81, 21.27). Comorbidity in ID/LD was more common among EP children than controls (24% vs. 0%). EP children with comorbid ID/LD had significantly poorer neuropsychological abilities and curriculum-based attainment than EP children with an isolated disability or no disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Footwear traction and lower extremity noncontact injury.

PubMed

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

2013-11-01

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

The importance of risk-aversion as a measurable psychological parameter governing risk-taking behaviour

NASA Astrophysics Data System (ADS)

Thomas, P. J.

2013-09-01

A utility function with risk-aversion as its sole parameter is developed and used to examine the well-known psychological phenomenon, whereby risk averse people adopt behavioural strategies that are extreme and apparently highly risky. The pioneering work of the psychologist, John W. Atkinson, is revisited, and utility theory is used to extend his mathematical model. His explanation of the psychology involved is improved by regarding risk-aversion not as a discrete variable with three possible states: risk averse, risk neutral and risk confident, but as continuous and covering a large range. A probability distribution is derived, the "motivational density", to describe the process of selecting tasks of different degrees of difficulty. An assessment is then made of practicable methods for measuring risk-aversion.

How Confident can we be in Flood Risk Assessments?

NASA Astrophysics Data System (ADS)

Merz, B.

2017-12-01

Flood risk management should be based on risk analyses quantifying the risk and its reduction for different risk reduction strategies. However, validating risk estimates by comparing model simulations with past observations is hardly possible, since the assessment typically encompasses extreme events and their impacts that have not been observed before. Hence, risk analyses are strongly based on assumptions and expert judgement. This situation opens the door for cognitive biases, such as `illusion of certainty', `overconfidence' or `recency bias'. Such biases operate specifically in complex situations with many factors involved, when uncertainty is high and events are probabilistic, or when close learning feedback loops are missing - aspects that all apply to risk analyses. This contribution discusses how confident we can be in flood risk assessments, and reflects about more rigorous approaches towards their validation.

Extreme sea levels on the rise along Europe's coasts

NASA Astrophysics Data System (ADS)

Vousdoukas, Michalis I.; Mentaschi, Lorenzo; Voukouvalas, Evangelos; Verlaan, Martin; Feyen, Luc

2017-03-01

Future extreme sea levels (ESLs) and flood risk along European coasts will be strongly impacted by global warming. Yet, comprehensive projections of ESL that include mean sea level (MSL), tides, waves, and storm surges do not exist. Here, we show changes in all components of ESLs until 2100 in view of climate change. We find that by the end of this century, the 100-year ESL along Europe's coastlines is on average projected to increase by 57 cm for Representative Concentration Pathways (RCP)4.5 and 81 cm for RCP8.5. The North Sea region is projected to face the highest increase in ESLs, amounting to nearly 1 m under RCP8.5 by 2100, followed by the Baltic Sea and Atlantic coasts of the UK and Ireland. Relative sea level rise (RSLR) is shown to be the main driver of the projected rise in ESL, with increasing dominance toward the end of the century and for the high-concentration pathway. Changes in storm surges and waves enhance the effects of RSLR along the majority of northern European coasts, locally with contributions up to 40%. In southern Europe, episodic extreme events tend to stay stable, except along the Portuguese coast and the Gulf of Cadiz where reductions in surge and wave extremes offset RSLR by 20-30%. By the end of this century, 5 million Europeans currently under threat of a 100-year ESL could be annually at risk from coastal flooding under high-end warming. The presented dataset is available through this link: http://data.jrc.ec.europa.eu/collection/LISCOAST.

Assessing the impact of future climate extremes on the US corn and soybean production

NASA Astrophysics Data System (ADS)

Jin, Z.

2015-12-01

Future climate changes will place big challenges to the US agricultural system, among which increasing heat stress and precipitation variability were the two major concerns. Reliable prediction of crop productions in response to the increasingly frequent and severe extreme climate is a prerequisite for developing adaptive strategies on agricultural risk management. However, the progress has been slow on quantifying the uncertainty of computational predictions at high spatial resolutions. Here we assessed the risks of future climate extremes on the US corn and soybean production using the Agricultural Production System sIMulator (APSIM) model under different climate scenarios. To quantify the uncertainty due to conceptual representations of heat, drought and flooding stress in crop models, we proposed a new strategy of algorithm ensemble in which different methods for simulating crop responses to those extreme climatic events were incorporated into the APSIM. This strategy allowed us to isolate irrelevant structure differences among existing crop models but only focus on the process of interest. Future climate inputs were derived from high-spatial-resolution (12km × 12km) Weather Research and Forecasting (WRF) simulations under Representative Concentration Pathways 4.5 (RCP 4.5) and 8.5 (RCP 8.5). Based on crop model simulations, we analyzed the magnitude and frequency of heat, drought and flooding stress for the 21st century. We also evaluated the water use efficiency and water deficit on regional scales if farmers were to boost their yield by applying more fertilizers. Finally we proposed spatially explicit adaptation strategies of irrigation and fertilizing for different management zones.

Climate change, extreme events and increased risk of salmonellosis in Maryland, USA: Evidence for coastal vulnerability.

PubMed

Jiang, Chengsheng; Shaw, Kristi S; Upperman, Crystal R; Blythe, David; Mitchell, Clifford; Murtugudde, Raghu; Sapkota, Amy R; Sapkota, Amir

2015-10-01

Salmonella is a leading cause of acute gastroenteritis worldwide. Patterns of salmonellosis have been linked to weather events. However, there is a dearth of data regarding the association between extreme events and risk of salmonellosis, and how this risk may disproportionately impact coastal communities. We obtained Salmonella case data from the Maryland Foodborne Diseases Active Surveillance Network (2002-2012), and weather data from the National Climatic Data Center (1960-2012). We developed exposure metrics related to extreme temperature and precipitation events using a 30 year baseline (1960-1989) and linked them with county-level salmonellosis data. Data were analyzed using negative binomial Generalized Estimating Equations. We observed a 4.1% increase in salmonellosis risk associated with a 1 unit increase in extreme temperature events (incidence rate ratio (IRR):1.041; 95% confidence interval (CI):1.013-1.069). This increase in risk was more pronounced in coastal versus non-coastal areas (5.1% vs 1.5%). Likewise, we observed a 5.6% increase in salmonellosis risk (IRR:1.056; CI:1.035-1.078) associated with a 1 unit increase in extreme precipitation events, with the impact disproportionately felt in coastal areas (7.1% vs 3.6%). To our knowledge, this is the first empirical evidence showing that extreme temperature/precipitation events-that are expected to be more frequent and intense in coming decades-are disproportionately impacting coastal communities with regard to salmonellosis. Adaptation strategies need to account for this differential burden, particularly in light of ever increasing coastal populations. Copyright © 2015. Published by Elsevier Ltd.

NSTS Orbiter auxiliary power unit turbine wheel cracking risk assessment

NASA Technical Reports Server (NTRS)

Cruse, T. A.; Mcclung, R. C.; Torng, T. Y.

1992-01-01

The present investigation of turbine-wheel cracking problems in the hydrazine-fueled APU turbine wheel of the Space Shuttle Orbiter's Main Engines has indicated the efficacy of systematic probabilistic risk assessment in flight certification and safety resolution. Nevertheless, real crack-initiation and propagation problems do not lend themselves to purely analytical studies. The high-cycle fatigue problem is noted to generally be unsuited to probabilistic modeling, due to its extremely high degree of intrinsic scatter. In the case treated, the cracks appear to trend toward crack arrest in a low cycle fatigue mode, due to a detuning of the resonance model.

Electronic Health Record-Related Safety Concerns: A Cross-Sectional Survey of Electronic Health Record Users

PubMed Central

Pajunen, Tuuli; Saranto, Kaija; Lehtonen, Lasse

2016-01-01

Background The rapid expansion in the use of electronic health records (EHR) has increased the number of medical errors originating in health information systems (HIS). The sociotechnical approach helps in understanding risks in the development, implementation, and use of EHR and health information technology (HIT) while accounting for complex interactions of technology within the health care system. Objective This study addresses two important questions: (1) “which of the common EHR error types are associated with perceived high- and extreme-risk severity ratings among EHR users?”, and (2) “which variables are associated with high- and extreme-risk severity ratings?” Methods This study was a quantitative, non-experimental, descriptive study of EHR users. We conducted a cross-sectional web-based questionnaire study at the largest hospital district in Finland. Statistical tests included the reliability of the summative scales tested with Cronbach’s alpha. Logistic regression served to assess the association of the independent variables to each of the eight risk factors examined. Results A total of 2864 eligible respondents provided the final data. Almost half of the respondents reported a high level of risk related to the error type “extended EHR unavailability”. The lowest overall risk level was associated with “selecting incorrectly from a list of items”. In multivariate analyses, profession and clinical unit proved to be the strongest predictors for high perceived risk. Physicians perceived risk levels to be the highest (P<.001 in six of eight error types), while emergency departments, operating rooms, and procedure units were associated with higher perceived risk levels (P<.001 in four of eight error types). Previous participation in eLearning courses on EHR-use was associated with lower risk for some of the risk factors. Conclusions Based on a large number of Finnish EHR users in hospitals, this study indicates that HIT safety hazards should be taken very seriously, particularly in operating rooms, procedure units, emergency departments, and intensive care units/critical care units. Health care organizations should use proactive and systematic assessments of EHR risks before harmful events occur. An EHR training program should be compulsory for all EHR users in order to address EHR safety concerns resulting from the failure to use HIT appropriately. PMID:27154599

Freezing and frostbite on mount everest: new insights into wind chill and freezing times at extreme altitude.

PubMed

Moore, G W K; Semple, J L

2011-01-01

Cold injury is an acknowledged risk factor for those who venture into high altitude regions. There is, however, little quantitative information on this risk that can be used to implement mitigation strategies. Here we provide the first characterization of the risk of cold injury near the summit of Mount Everest. This is accomplished through the application of a meteorological dataset that has been demonstrated to characterize conditions in the region as inputs to new parameterizations of wind chill equivalent temperature (WCT) and facial frostbite time (FFT). Throughout the year, the typical WCT near the summit of Everest is always <-30°C, and the typical FFT is always less than 20 min. During the spring climbing season, WCTs of -50°C and FFTs of 5 min are typical; during severe storms, they approach -60°C and 1 min, respectively; values typically found during the winter. Further, we show that the summit barometric pressure is an excellent predictor of summit WCT and FFT. Our results provide the first quantitative characterization of the risk of cold injury on Mount Everest and also allow for the possibility of using barometric pressure, an easily observed parameter, in real time to characterize this risk and to implement mitigation strategies. The results also provide additional confirmation as to the extreme environment experienced by those attempting to summit Mount Everest and other high mountains.

Mortality risks during extreme temperature events (ETEs) using a distributed lag non-linear model

NASA Astrophysics Data System (ADS)

Allen, Michael J.; Sheridan, Scott C.

2018-01-01

This study investigates the relationship between all-cause mortality and extreme temperature events (ETEs) from 1975 to 2004. For 50 U.S. locations, these heat and cold events were defined based on location-specific thresholds of daily mean apparent temperature. Heat days were defined by a 3-day mean apparent temperature greater than the 95th percentile while extreme heat days were greater than the 97.5th percentile. Similarly, calculations for cold and extreme cold days relied upon the 5th and 2.5th percentiles. A distributed lag non-linear model assessed the relationship between mortality and ETEs for a cumulative 14-day period following exposure. Subsets for season and duration effect denote the differences between early- and late-season as well as short and long ETEs. While longer-lasting heat days resulted in elevated mortality, early season events also impacted mortality outcomes. Over the course of the summer season, heat-related risk decreased, though prolonged heat days still had a greater influence on mortality. Unlike heat, cold-related risk was greatest in more southerly locations. Risk was highest for early season cold events and decreased over the course of the winter season. Statistically, short episodes of cold showed the highest relative risk, suggesting unsettled weather conditions may have some relationship to cold-related mortality. For both heat and cold, results indicate higher risk to the more extreme thresholds. Risk values provide further insight into the role of adaptation, geographical variability, and acclimatization with respect to ETEs.

Mindful Organizing as a Paradigm to Develop Managers

ERIC Educational Resources Information Center

Gebauer, Annette

2013-01-01

How can managers prepare for extreme but exceptional events and for the challenge of managing complexity and uncertainty in their daily business? Confronted with the challenge of achieving high and reliable performance in risk-prone, fast-paced, and unpredictable environments, managers and management scholars can learn a lot from the organizing…

Applying Incremental Sampling Methodology to Soils Containing Heterogeneously Distributed Metallic Residues to Improve Risk Analysis.

PubMed

Clausen, J L; Georgian, T; Gardner, K H; Douglas, T A

2018-01-01

This study compares conventional grab sampling to incremental sampling methodology (ISM) to characterize metal contamination at a military small-arms-range. Grab sample results had large variances, positively skewed non-normal distributions, extreme outliers, and poor agreement between duplicate samples even when samples were co-located within tens of centimeters of each other. The extreme outliers strongly influenced the grab sample means for the primary contaminants lead (Pb) and antinomy (Sb). In contrast, median and mean metal concentrations were similar for the ISM samples. ISM significantly reduced measurement uncertainty of estimates of the mean, increasing data quality (e.g., for environmental risk assessments) with fewer samples (e.g., decreasing total project costs). Based on Monte Carlo resampling simulations, grab sampling resulted in highly variable means and upper confidence limits of the mean relative to ISM.

Composite Flood Risk for Virgin Island

EPA Pesticide Factsheets

The Composite Flood Risk layer combines flood hazard datasets from Federal Emergency Management Agency (FEMA) flood zones, NOAA's Shallow Coastal Flooding, and the National Hurricane Center SLOSH model for Storm Surge inundation for category 1, 2, and 3 hurricanes.Geographic areas are represented by a grid of 10 by 10 meter cells and each cell has a ranking based on variation in exposure to flooding hazards: Moderate, High and Extreme exposure. Geographic areas in each input layers are ranked based on their probability of flood risk exposure. The logic was such that areas exposed to flooding on a more frequent basis were given a higher ranking. Thus the ranking incorporates the probability of the area being flooded. For example, even though a Category 3 storm surge has higher flooding elevations, the likelihood of the occurrence is lower than a Category 1 storm surge and therefore the Category 3 flood area is given a lower exposure ranking. Extreme exposure areas are those areas that are exposed to relatively frequent flooding.The ranked input layers are then converted to a raster for the creation of the composite risk layer by using cell statistics in spatial analysis. The highest exposure ranking for a given cell in any of the three input layers is assigned to the corresponding cell in the composite layer.For example, if an area (a cell) is rank as medium in the FEMA layer, moderate in the SLOSH layer, but extreme in the SCF layer, the cell will be considere

Extreme weather events and infectious disease outbreaks.

PubMed

McMichael, Anthony J

2015-01-01

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

The Extremes of the Bell Curve: Excellent and Poor School Performance and Risk for Severe Mental Disorders. Maudsley Series

ERIC Educational Resources Information Center

MacCabe, James H.

2010-01-01

It has long been claimed that there is a strong association between high intelligence, or exceptional creativity, and mental illness. In this book, James MacCabe investigates this claim, using evidence from Swedish population data. He finds evidence that children who achieve either exceptionally high, or very low grades at school, are at greater…

Identification of an updated set of prescribing-safety indicators for GPs

PubMed Central

Spencer, Rachel; Bell, Brian; Avery, Anthony J; Gookey, Gill; Campbell, Stephen M

2014-01-01

Background Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting RAND/UCLA consensus development of indicators in UK general practice. Method Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety. PMID:24686882

[Rate of human papillomavirus infection in rural areas diagnosed by direct visualization with acetic acid and lugol].

PubMed

José Daniel, Flores-Alatriste; Karla Georgina, Saldivar-Gutiérrez; Josué Sarmiento-Ángeles; Jaime Claudio, Granados-Marin; Marco Antonio, Olaya-Rivera; Stark, Carlotta; Hugo, Flores-Navarro; Jaroslav, Stern-Colin

2015-07-01

Infection by HPV is a major global health problem and the main risk factor for cervical cancer with high morbidity and mortality. Simple diagnostic methods, such as visual inspection with the naked eye of the cervix with acetic acid application 5% (VAT) or solution of iodine (tincture of iodine) are simple to detect early lesions, sensitivity varies from 87 to 99% and specificity varies from 23 to 87%. To find the proportion of infection by human papillomavirus in a population of extreme poverty. Linear, observational and descriptive pilot study was done in patients of marginalized communities in extreme poverty in Chiapas (Mexico), from 1 to 30 November 2013. The existence of acetowhite lesions suggestive of virus was verified human papillomavirus, and medical history of all patients was formed for the incidence of risk factors. 214 women with age limits of 19 and 78 years, median age of 37 years were studied. Of the total, 66 (31%) had acetowhite lesions consistent with human papillomavirus at the time of the study. Marginalized populations have a higher risk of infection with human papillomavirus, consequently high rate of progression to cervical cancer due to sociodemographic characteristics, risk factors and lack of resources in health. Diagnostic tests like the simple display with acetic acid are ideal for people such as this.

A Cluster of Exertional Rhabdomyolysis Cases in a ROTC Program Engaged in an Extreme Exercise Program.

PubMed

Raleigh, Meghan F; Barrett, John P; Jones, Brent D; Beutler, Anthony I; Deuster, Patricia A; O'Connor, Francis G

2018-03-01

Exertional rhabdomyolysis (ER) is on the rise among service members and high school and college athletes. Reported risk factors for ER include fitness level, sudden increase in exercise intensity and duration, and eccentric predominant exercise. This study examined an ER cluster among Reserve Officer Training Corps cadets who participated in a mandatory, timed, extreme conditioning program (ECP) workout. Forty-four cadets participated in this ECP; 11 were subsequently hospitalized with ER. Thirty-five cadets, including all who developed ER, completed a questionnaire to assess ECP times, prior fitness scores, and other ER risk factors. Cadets completed the ECP workout as individuals or in teams. Nine of 29 (31%) individual and two of 15 (13%) team participants were hospitalized with ER. Among the cadets, no associations were noted between hospitalization for ER and finish time, previous fitness scores, or dietary supplement use. The relative risk of developing ER was significantly increased in those who consumed alcohol in the week preceding the ECP (RR = 4.20; 95% CI 1.95, 9.03). In this cohort of Reserve Officer Training Corps cadets, an ECP resulted in a high rate of hospitalization for ER. Contrary to reported ER risk factors, higher baseline fitness was not protective. Rather, cadet knowledge that ECP performance was strongly linked to final cadet ranking greatly influenced intensity of effort.

Extreme deep white matter hyperintensity volumes are associated with African American race.

PubMed

Nyquist, Paul A; Bilgel, Murat S; Gottesman, Rebecca; Yanek, Lisa R; Moy, Taryn F; Becker, Lewis C; Cuzzocreo, Jennifer; Prince, Jerry; Yousem, David M; Becker, Diane M; Kral, Brian G; Vaidya, Dhananjay

2014-01-01

African Americans (AAs) have a higher prevalence of extreme ischemic white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) than do European Americans (EAs) based on the Cardiovascular Health Study (CHS) score. Ischemic white matter disease, limited to the deep white matter, may be biologically distinct from disease in other regions and may reflect a previously observed trend toward an increased risk of subcortical lacunar infarcts in AAs. We hypothesized that extreme deep WMH volume (DWMV) or periventricular volume (PV) may also have a higher prevalence in AAs. Thus, we studied extreme CHS scores and extreme DWMV and PV in a healthy population enriched for cardiovascular disease risk factors. We imaged the brains of 593 subjects who were first-degree relatives of probands with early onset coronary disease prior to 60 years of age. WMHs were manually delineated on 3-tesla cranial MRI by a trained radiology reader; the location and volume of lesions were characterized using automated software. DWMV and PV were measured directly with automated software, and the CHS score was determined by a neuroradiologist. Volumes were characterized as being in the upper 25% versus lower 75% of total lesion volume. Volumes in the upper versus the remaining quartiles were examined for AA versus EA race using multiple logistic regression (generalized estimating equations adjusted for family relatedness) and adjusted for major vascular disease risk factors including age ≥55 years versus <55, sex, current smoking, obesity, hypertension, diabetes and low-density lipoprotein >160 mg/dl. Participants were 58% women and 37% AAs, with a mean age of 51.5 ± 11.0 years (range, 29-74 years). AAs had significantly higher odds of having extreme DWMVs (odds ratio, OR, 1.8; 95% confidence interval, CI, 1.2-2.9; p = 0.0076) independently of age, sex, hypertension and all other risk factors. AAs also had significantly higher odds of having extreme CHS scores ≥3 (OR, 1.3; 95% CI, 1.1-3.6; p = 0.025). Extreme PV was not significantly associated with AA race (OR, 1.3; 95% CI, 0.81-2.1; p = 0.26). AAs from families with early-onset cardiovascular disease are more likely to have extreme DWMVs (a subclinical form of cerebrovascular disease) and an extreme CHS score, but not extreme PV, independently of age and other cardiovascular disease risk factors. These findings suggest that this AA population is at an increased risk for DWMV and may be at an increased risk for future subcortical stroke. Longitudinal studies are required to see if DWMV is predictive of symptomatic subcortical strokes in this population. © 2014 S. Karger AG, Basel.

Control of dynamic foot-ground interactions in male and female soccer athletes: Females exhibit reduced dexterity and higher limb stiffness during landing

PubMed Central

Lyle, Mark A.; Valero-Cuevas, Francisco J.; Gregor, Robert J.; Powers, Christopher M.

2014-01-01

Controlling dynamic interactions between the lower limb and ground is important for skilled locomotion and may influence injury risk in athletes. It is well known that female athletes sustain anterior cruciate ligament (ACL) tears at higher rates than male athletes, and exhibit lower extremity biomechanics thought to increase injury risk during sport maneuvers. The purpose of this study was to examine whether lower extremity dexterity (LED) – the ability to dynamically control endpoint force magnitude and direction as quantified by compressing an unstable spring with the lower limb at submaximal forces – is a potential contributing factor to the “at-risk” movement behavior exhibited by female athletes. We tested this hypothesis by comparing LED-test performance and single-limb drop jump biomechanics between 14 female and 14 male high school soccer players. We found that female athletes exhibited reduced LED-test performance (p=0.001) and higher limb stiffness during landing (p=0.008) calculated on average within 51 ms of foot contact. Females also exhibited higher coactivation at the ankle (p=0.001) and knee (p=0.02) before landing. No sex differences in sagittal plane joint angles and center of mass velocity at foot contact were observed. Collectively, our results raise the possibility that the higher leg stiffness observed in females during landing is an anticipatory behavior due in part to reduced lower extremity dexterity. The reduced lower extremity dexterity and compensatory stiffening strategy may contribute to the heightened risk of ACL injury in this population. PMID:24275440

Changing risks of resonance in extreme weather events for higher atmospheric greenhouse gas concentrations

NASA Astrophysics Data System (ADS)

Huntingford, Chris; Mitchell, Dann; Osprey, Scott

2015-04-01

A recent paper by Petoukhov et al (2013) demonstrates that many of the recent major extreme events in the NH may have been caused by resonant conditions driving very high meridional winds around slowly moving centres-of-action. Besides high amplitudes of planetary wave numbers 6,7 and 8, additional features are identified through 4 further conditions that trigger system resonance. These make the potential for high amplitude waves more likely as well as the possibility of more persistent events. A concern is that human-induced climate change could create conditions more conducive to tropospheric Rossby wave resonance, thereby forcing any periods of extreme weather to become more commonplace and longer lasting. Whilst the CMIP5 ensemble provides much information on expected changes, to fully address changing probabilities of extreme event occurrence - which by definition are relatively rare - is, though, best approached through a massive ensemble modeling framework. The climateprediction-dot-net citizen-science massive ensemble GCM modeling framework provides order 104 simulations for sea-surface temperature, sea-ice extent and atmospheric gas composition representative of both pre-industrial and contemporary conditions. Here we present what these families of simulations imply in terms of the changing likelihood of conditions for mid-latitude resonance, and implications for amplitudes of Rossby waves

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

PubMed

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

2018-05-01

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

Extreme maternal education and preterm birth: time-to-event analysis of age and nativity-dependent risks.

PubMed

Auger, Nathalie; Abrahamowicz, Michal; Park, Alison L; Wynant, Willy

2013-01-01

Increasing numbers of women achieve extremely high education, but the association with preterm birth (PTB) is poorly understood, especially over the life course. We sought to determine how very high educational attainment is associated with PTB, and to assess differences by maternal age and nativity. Data included singleton live births to mothers aged ≥ 20 years in metropolitan areas of Québec, Canada, from 1995 to 2005 (n = 537,525). Hazard ratios of PTB (<37 gestational weeks) were estimated over the continuous range of education (0-30 years) according to maternal age (20-24, 25-29, 30-34, ≥ 35 years) and nativity in a flexible survival model. The relationship between education and PTB was not linear, but suggested that extremely high education was not as protective against PTB as slightly lower education. Education thresholds that offered maximum protection increased with maternal age, and were lower for Canadian-born (17-21 years of education) than foreign-born (22-25 years of education) mothers. Extremely high education did not confer more protection against PTB than slightly lower education, and associations varied over the life course. The threshold number of years of education most protective against PTB: (1) increased with maternal age, especially for Canadian-born mothers, and (2) was higher for foreign-born mothers. Copyright © 2013 Elsevier Inc. All rights reserved.

Antibiotic treatment of bacterial vaginosis in pregnancy: multiple meta-analyses and dilemmas in interpretation.

PubMed

Varma, Rajesh; Gupta, Janesh K

2006-01-01

There is considerable evidence to show an association between genital tract infections, such as bacterial vaginosis (BV), and preterm delivery (PTD). Meta-analyses to date have shown screening and treating BV in pregnancy does not prevent PTD. This casts doubt on a cause and effect relationship between BV and PTD. However, the meta-analyses reported significant clinical, methodological and statistical heterogeneity of the included studies. We therefore undertook a repeat meta-analysis, included recently published trials, and applied strict criteria on data extraction. We meta-analysed low and high-risk pregnancies separately. We found that screening and treating BV in low-risk pregnancies produced a statistically significant reduction in spontaneous PTD (RR 0.73; 95% CI 0.55-0.98). This beneficial effect was not observed in high-risk or combined risk groups. The differences in antibiotic sensitivity between high and low risk groups may suggest differing causal contributions of the infectious process to PTD. The evidence, along with prior knowledge of differing predisposing factors and prognosis between these risk groups, supports the hypothesis that PTD in high and low risk pregnant women are different entities and not linear extremes of the same syndrome.

LONG-TERM VISUAL OUTCOMES IN EXTREMELY LOW-BIRTH-WEIGHT CHILDREN (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

PubMed Central

Spencer, Rand

2006-01-01

Purpose The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. Methods This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at ≥36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Results Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 ± 36 months, and 183 eyes had recognition acuity testing at 76 ± 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were ≤20/200. Abnormal early grating acuity testing was predictive of abnormal grating (P < .0001) and recognition (P = .0001) acuity testing at ≥3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at ≥3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at ≤28 weeks gestational age had 4.1 times greater risk for abnormal recognition acuity than did those of children born at >28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Conclusions Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of ≤ 28 weeks was associated with a higher risk of an abnormal long-term outcome. PMID:17471358

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

A Risk Score for Predicting Multiple Sclerosis.

PubMed

Dobson, Ruth; Ramagopalan, Sreeram; Topping, Joanne; Smith, Paul; Solanky, Bhavana; Schmierer, Klaus; Chard, Declan; Giovannoni, Gavin

2016-01-01

Multiple sclerosis (MS) develops as a result of environmental influences on the genetically susceptible. Siblings of people with MS have an increased risk of both MS and demonstrating asymptomatic changes in keeping with MS. We set out to develop an MS risk score integrating both genetic and environmental risk factors. We used this score to identify siblings at extremes of MS risk and attempted to validate the score using brain MRI. 78 probands with MS, 121 of their unaffected siblings and 103 healthy controls were studied. Personal history was taken, and serological and genetic analysis using the illumina immunochip was performed. Odds ratios for MS associated with each risk factor were derived from existing literature, and the log values of the odds ratios from each of the risk factors were combined in an additive model to provide an overall score. Scores were initially calculated using log odds ratio from the HLA-DRB1*1501 allele only, secondly using data from all MS-associated SNPs identified in the 2011 GWAS. Subjects with extreme risk scores underwent validation studies. MRI was performed on selected individuals. There was a significant difference in the both risk scores between people with MS, their unaffected siblings and healthy controls (p<0.0005). Unaffected siblings had a risk score intermediate to people with MS and controls (p<0.0005). The best performing risk score generated an AUC of 0.82 (95%CI 0.75-0.88). The risk score demonstrates an AUC on the threshold for clinical utility. Our score enables the identification of a high-risk sibling group to inform pre-symptomatic longitudinal studies.

Extreme Precipitation and Beach Closures in the Great Lakes Region: Evaluating Risk among the Elderly

PubMed Central

Bush, Kathleen F.; Fossani, Cheryl L.; Li, Shi; Mukherjee, Bhramar; Gronlund, Carina J.; O’Neill, Marie S.

2014-01-01

As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk of gastrointestinal illness (GI)-related hospital admissions among individuals 65 and older in 12 Great Lakes cities from 2000 to 2006. Poisson regression models were fit in each city, controlling for temperature and long-term time trends. City-specific estimates were combined to form an overall regional risk estimate. Approximately 40,000 GI-related hospital admissions and over 100 beach closure days were recorded from May through September during the study period. Extreme precipitation (≥90th percentile) occurring the previous day (lag 1) is significantly associated with beach closures in 8 of the 12 cities (p < 0.05). However, no association was observed between beach closures and GI-related hospital admissions. These results support previous work linking extreme precipitation to compromised recreational water quality. PMID:24534768

Flood protection diversification to reduce probabilities of extreme losses.

PubMed

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

2012-11-01

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

Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program

PubMed Central

Carow, Scott D.; Haniuk, Eric M.; Cameron, Kenneth L.; Padua, Darin A.; Marshall, Stephen W.; DiStefano, Lindsay J.; de la Motte, Sarah J.; Beutler, Anthony I.; Gerber, John P.

2016-01-01

Context: Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk. Objective: To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets. Design: Cluster-randomized controlled trial. Setting: Cadet Basic Training at USMA. Patients or Other Participants: Participants were 1313 cadets (1070 men, 243 women). Intervention(s): Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks. Main Outcome Measure(s): Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups. Results: No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group. Conclusions: We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant, indicate that professional supervision may be a factor in the success of injury-prevention programs. PMID:25117875

Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program.

PubMed

Carow, Scott D; Haniuk, Eric M; Cameron, Kenneth L; Padua, Darin A; Marshall, Stephen W; DiStefano, Lindsay J; de la Motte, Sarah J; Beutler, Anthony I; Gerber, John P

2016-11-01

 Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk.  To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets.  Cluster-randomized controlled trial.  Cadet Basic Training at USMA.  Participants were 1313 cadets (1070 men, 243 women).  Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks.  Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups.  No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group.  We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant, indicate that professional supervision may be a factor in the success of injury-prevention programs.

Occupation and metabolic syndrome: is there correlation? A cross sectional study in different work activity occupations of German firefighters and office workers.

PubMed

Strauß, Markus; Foshag, Peter; Przybylek, Bianca; Horlitz, Marc; Lucia, Alejandro; Sanchis-Gomar, Fabian; Leischik, Roman

2016-01-01

The treatment and prevention of the metabolic syndrome (MetS) is currently one of the major challenges in medicine. The impact of working conditions on metabolic risk has not been adequately studied. Our objective was to compare the prevalence of MetS and metabolic risk in two extremely different occupational groups: firefighters and office workers. A total of 143 male subjects (97 firefighters and 46 office workers) from Germany participated in the study. Anthropometric characteristics, metabolic risk parameters as well as laboratory parameters were collected. MetS was diagnosed according to criteria of the International Diabetes Federation. Sedentary occupation showed a significant tendency towards obesity. Abdominal waist circumference was significantly greater in office workers than in firefighters [5.08 CI (1.44-8.71), p = 0.007]. Concerning metabolic risk factors, abnormal HDL, triglycerides, BMI, blood pressure and waist circumference values were more frequently found in office workers than in firefighters. The MetS was detected in almost 33 % of office workers as compared with only 14 % in firefighters (p = 0.015). Regarding MetS in an international comparison, the prevalence of MetS in German office workers was high and in firefighters it was extremely low. Sedentary occupation as an office worker is associated with a high risk of MetS. Both groups need to be made aware of the metabolic risks, and health promoting concepts such as corporate sports activities or education in healthy nutrition need to be implemented to counteract the development of the MetS and cardiovascular risk factors.

Environmental health risk assessment and management for global climate change

NASA Astrophysics Data System (ADS)

Carter, P.

2014-12-01

This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline from 2015 (CAN International 2014), and if policy makers are limited to the IPCC AR5 we recommend RCP2.6, with emissions declining by 2020.

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

PubMed

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

2011-05-12

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

Risky Adaptation: The Effect of Temperature Extremes on HIV Prevalence

NASA Astrophysics Data System (ADS)

Baker, R.

2016-12-01

Previous work has linked rainfall shock to an increase in HIV prevalence in Sub-Saharan Africa. In this paper we take advantage of repeated waves of the Demographic and Health Survey (DHS) and a new high resolution climate dataset for the African continent to test the non-linear relationship between temperature and HIV. We find a strong and significant relationship between recent high temperatures and increases in HIV prevalence in a region. We then test the effect of temperature on risk factors that may contribute to this increase. High temperatures are linked to an increase in sexual violence, number of partners and a decrease in condom usage - all of which may contribute to the uptake in HIV rate. This paper contributes to the literature on adaptation from two standpoints. First, we suggest that some behavioral changes that are classed as adaptations, in the sense that they allow for consumption smoothing in the face of extreme temperatures, may carry unexpected risks to the individuals involved. Second, we find preliminary evidence that the relationship between temperature and these risky behaviors is diminished in regions prone to higher temperatures, suggesting some adaptation is possible in the long run.

Hydrological and hydroclimatic regimes in the Ouergha watershed

NASA Astrophysics Data System (ADS)

Msatef, Karim; Benaabidate, Lahcen; Bouignane, Aziz

2018-05-01

This work consists in studying the hydrological and hydroclimatic regime of the Ouergha watershed and frequency analysis of extreme flows and extreme rainfall for peak estimation and return periods, in order to prevention and forecasting against risks (flood...). Hydrological regime analysis showed a regime of the rain type, characterized by rainfed abundance with very high winter flows, so strong floods. The annual module and the different coefficients show hydroclimatic fluctuations in relation to a semihumid climate. The water balance has highlighted the importance of the volumes of water conveyed upstream than downstream, thus confirming the morphometric parameters of watershed and the lithological nature. Frequency study of flows and extreme rainfall showed that these flows governed by dissymmetrical laws based on methods Gumbel, GEV, Gamma and Log Pearson III.

Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis.

PubMed

Ding, Zan; Guo, Pi; Xie, Fang; Chu, Huifang; Li, Kun; Pu, Jingbo; Pang, Shaojie; Dong, Hongli; Liu, Yahui; Pi, Fuhua; Zhang, Qingying

2015-09-01

Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age ≥75 years. The effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

Extreme Storm Surges in the North Sea

NASA Astrophysics Data System (ADS)

Goennert, G.; Buß, Th.; Mueller, O.; Thumm, S.

2009-04-01

Extreme Storm Surges in the North Sea Gabriele Gönnert, Olaf Müller, Thomas Buß and Sigrid Thumm Climate Change will cause a rise of the sea level and probably more frequent and more violent storm surges. This has serious consequences for the safety of people as well as for their values and assets behind the dikes. It is therefore inevitable to first assess how sea level rise and an extreme storm surge event designes. In a second step it is possible to determine the risk for specific locations and develop strategies. The Project XtremRisk - Extreme Storm Surges at the North Sea Coast and in Estuaries. Risk calculation and risk strategies, funded by the German Federal Government will help answering these questions. The „Source-Pathway-Receptor" Concept will be used as a basis for risk analysis and development of new strategies. The Project offers methods to assess the development of extreme events under the conditions of today. Under conditions reflecting the climate change it will be tried to design an extreme event. For these three main points will be considered: a) Analysis and calculation of each factor, which produce a storm surge and its maximum level occurring in the last 100 years. These are: - maximum surge level: surge (due to the wind), - influence of the tide and the interaction between surge and tide, - influence of external surges , b) The hydrodynamics of a storm surge cause nonlinear effects in the interaction of the named factors. These factors and effects will both be taken into account to calculate the magnitude of the extreme storm surge. This step is very complex and need additional examination by numerical models. c) Analysis of the different scenarios to mean sea level rise and to the increase of wind speed due to the climate change. The presentation will introduce methods and show first results of the analysis of extreme events and the mean sea level rise.

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014

PubMed Central

Sim, Won Yong; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Background Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. Methods This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ Results The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Conclusion Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors. PMID:28197330

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014.

PubMed

Sim, Won Yong; Cho, Young Gyu; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. 'Unhealthy weight control behaviors' were subcategorized into 'extreme weight control behaviors' and 'less extreme weight control behaviors.' The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

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

NASA Astrophysics Data System (ADS)

Qi, Wei

2017-11-01

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

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

NASA Technical Reports Server (NTRS)

Patterson, Richard; Hammoud, Ahmad; Elbuluk, Malik

2008-01-01

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

Variability of temperature sensitivity of extreme precipitation from a regional-to-local impact scale perspective

NASA Astrophysics Data System (ADS)

Schroeer, K.; Kirchengast, G.

2016-12-01

Relating precipitation intensity to temperature is a popular approach to assess potential changes of extreme events in a warming climate. Potential increases in extreme rainfall induced hazards, such as flash flooding, serve as motivation. It has not been addressed whether the temperature-precipitation scaling approach is meaningful on a regional to local level, where the risk of climate and weather impact is dealt with. Substantial variability of temperature sensitivity of extreme precipitation has been found that results from differing methodological assumptions as well as from varying climatological settings of the study domains. Two aspects are consistently found: First, temperature sensitivities beyond the expected consistency with the Clausius-Clapeyron (CC) equation are a feature of short-duration, convective, sub-daily to sub-hourly high-percentile rainfall intensities at mid-latitudes. Second, exponential growth ceases or reverts at threshold temperatures that vary from region to region, as moisture supply becomes limited. Analyses of pooled data, or of single or dispersed stations over large areas make it difficult to estimate the consequences in terms of local climate risk. In this study we test the meaningfulness of the scaling approach from an impact scale perspective. Temperature sensitivities are assessed using quantile regression on hourly and sub-hourly precipitation data from 189 stations in the Austrian south-eastern Alpine region. The observed scaling rates vary substantially, but distinct regional and seasonal patterns emerge. High sensitivity exceeding CC-scaling is seen on the 10-minute scale more than on the hourly scale, in storms shorter than 2 hours duration, and in shoulder seasons, but it is not necessarily a significant feature of the extremes. To be impact relevant, change rates need to be linked to absolute rainfall amounts. We show that high scaling rates occur in lower temperature conditions and thus have smaller effect on absolute precipitation intensities. While reporting of mere percentage numbers can be misleading, scaling studies can add value to process understanding on the local scale, if the factors that influence scaling rates are considered from both a methodological and a physical perspective.

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

PubMed

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

2015-01-01

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

Green and Smart: Hydrogels to Facilitate Independent Practical Learning

ERIC Educational Resources Information Center

Hurst, Glenn A.

2017-01-01

A laboratory experiment was developed to enable students to investigate the use of smart hydrogels for potential application in targeted drug delivery. This is challenging for students to explore practically because of the extremely high risks of handling cross-linking agents such as glutaraldehyde. Genipin is a safe and green alternative that has…

Reactive gaseous mercury is generated from chloralkali factories resulting in extreme concentrations of mercury in hair of workers

EPA Science Inventory

Occupational exposure of chloralkali workers to highly concentrated mercury (Hg) vapour has been linked to an increased risk of renal dysfunction and behavioural changes. It is generally believed that these workers are exposed to elemental Hg, which is used in abundance during th...

Classwide Peer Tutoring for Elementary and High School Students at Risk: Listening to Students' Voices

ERIC Educational Resources Information Center

Ayvazo, Shiri; Aljadeff-Abergel, Elian

2014-01-01

Teaching has become a very challenging profession with the requirements to provide appropriate individualised instruction in large and diverse classes. Problem behaviours displayed by students with special needs exacerbate the difficulties. This is especially true and intense in physical education, where students are exposed to extreme emotional…

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience.

PubMed

Chung, Amy S Y; Luk, W H; Lo, Adrian X N; Lo, C F

2015-04-01

To determine the prevalence and characteristics of sonographically evident upper-extremity deep vein thrombosis in symptomatic Chinese patients and identify its associated risk factors. Regional hospital, Hong Kong. Data on patients undergoing upper-extremity venous sonography examinations during a 13-year period from November 1999 to October 2012 were retrieved. Variables including age, sex, history of smoking, history of lower-extremity deep vein thrombosis, major surgery within 30 days, immobilisation within 30 days, cancer (history of malignancy), associated central venous or indwelling catheter, hypertension, diabetes mellitus, sepsis within 30 days, and stroke within 30 days were tested using binary logistic regression to understand the risk factors for upper-extremity deep vein thrombosis. The presence of upper-extremity deep vein thrombosis identified. Overall, 213 patients with upper-extremity sonography were identified. Of these patients, 29 (13.6%) had upper-extremity deep vein thrombosis. The proportion of upper-extremity deep vein thrombosis using initial ultrasound was 0.26% of all deep vein thrombosis ultrasound requests. Upper limb swelling was the most common presentation seen in a total of 206 (96.7%) patients. Smoking (37.9%), history of cancer (65.5%), and hypertension (27.6%) were the more prevalent conditions among patients in the upper-extremity deep vein thrombosis-positive group. No statistically significant predictor of upper-extremity deep vein thrombosis was noted if all variables were included. After backward stepwise logistic regression, the final model was left with only age (P=0.119), female gender (P=0.114), and history of malignancy (P=0.024) as independent variables. History of malignancy remained predictive of upper-extremity deep vein thrombosis. Upper-extremity deep vein thrombosis is uncommon among symptomatic Chinese population. The most common sign is swelling and the major risk factor for upper-extremity deep vein thrombosis identified in this study is malignancy.

Effects of temperature and precipitation variability on the risk of violence in sub-Saharan Africa, 1980–2012

PubMed Central

O’Loughlin, John; Linke, Andrew M.; Witmer, Frank D. W.

2014-01-01

Ongoing debates in the academic community and in the public policy arena continue without clear resolution about the significance of global climate change for the risk of increased conflict. Sub-Saharan Africa is generally agreed to be the region most vulnerable to such climate impacts. Using a large database of conflict events and detailed climatological data covering the period 1980–2012, we apply a multilevel modeling technique that allows for a more nuanced understanding of a climate–conflict link than has been seen heretofore. In the aggregate, high temperature extremes are associated with more conflict; however, different types of conflict and different subregions do not show consistent relationship with temperature deviations. Precipitation deviations, both high and low, are generally not significant. The location and timing of violence are influenced less by climate anomalies (temperature or precipitation variations from normal) than by key political, economic, and geographic factors. We find important distinctions in the relationship between temperature extremes and conflict by using multiple methods of analysis and by exploiting our time-series cross-sectional dataset for disaggregated analyses. PMID:25385621

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

PubMed Central

2018-01-01

Objective To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. Methods A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. Results There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Conclusion Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture. PMID:29560330

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

PubMed

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

2018-02-01

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

Risk analysis for the flood control capacity of dikes under climate change

NASA Astrophysics Data System (ADS)

Wei, Hsiao Ping; Yeh, Keh-Chia; Hsiao, Yi-Hua

2017-04-01

Climate change is the major reason for many extreme disaster events. In recent years, scientists have revealed many findings and most of them agree that the frequency of extreme weather and its corresponding hydrological impact will increase due to climate change. In such situation, the current hydrologic designs based upon historical observation, which could be changed, are necessary to review again under the scenario of climate change. It is for this reason that this study uses Kao-Ping River Basin as an example, using high resolution dynamical downscaling data (base period, near future, and end of the century) to simulate changes in hourly flow rate of typhoon events in each of the three 25-year periods. Results are further compared with the design flow rate announced by the competent authority of water resources, as well as recorded river water levels of the most severe typhoon event in history and risk analysis basic on factors, to evaluate the risk and impact of river flooding under climate change.From the simulation results, the frequency of exceeding design discharge in Kao-ping river catchment will increase in the end of century. The water level at these LI-LIN BRIDGE and SAN-TI-MEN gauges could be obviously influenced due to the extreme rainfall events, so that their flood control capacity should be assessed and improved.

IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation

NASA Astrophysics Data System (ADS)

Field, C. B.; Stocker, T. F.; Barros, V. R.; Qin, D.; Ebi, K. L.; Midgley, P. M.

2011-12-01

The Summary for Policy Makers of the IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation will be approved by the world governments in November 2011. The focus of the Special Report is on climate change and its role in altering the frequency, severity, and impact of extreme events or disasters, and on the costs of both impacts and the actions taken to prepare for, respond to, and recover from extreme events and disasters. The emphasis is on understanding the factors that make people and infrastructure vulnerable to extreme events, on recent and future changes in the relationship between climate change and extremes, and on managing the risks of disasters over a wide range of spatial and temporal scales. The assessment considers a broad suite of adaptations and explores the limits to adaptation. The assessment was designed to build durable links and foundations for partnerships between the stakeholder communities focused on climate change and those focused on disaster risk reduction. The Special Report begins with material that frames the issues, followed by an assessment of the reasons that communities are vulnerable. Two chapters assess the role of past and future climate change in altering extremes and the impact of these on the physical environment and human systems. Three chapters assess available knowledge on impacts and adaptation, with separate chapters considering the literature, stakeholder relationships, and potential policy tools relevant to the local, national, and international scales. Longer-term components of adaptation to weather and climate extremes and disasters are assessed in the context of moving toward sustainability. The final chapter provides case studies that integrate themes across several chapters or are so unique that they need to be considered separately.

Prevention and management of infections associated with combat-related extremity injuries.

PubMed

Murray, Clinton K; Hsu, Joseph R; Solomkin, Joseph S; Keeling, John J; Andersen, Romney C; Ficke, James R; Calhoun, Jason H

2008-03-01

Orthopedic injuries suffered by casualties during combat constitute approximately 65% of the total percentage of injuries and are evenly distributed between upper and lower extremities. The high-energy explosive injuries, environmental contamination, varying evacuation procedures, and progressive levels of medical care make managing combat-related injuries challenging. The goals of orthopedic injury management are to prevent infection, promote fracture healing, and restore function. It appears that 2% to 15% of combat-related extremity injuries develop osteomyelitis, although lower extremity injuries are at higher risk of infections than upper extremity. Management strategies of combat-related injuries primarily focus on early surgical debridement and stabilization, antibiotic administration, and delayed primary closure. Herein, we provide evidence-based recommendations from military and civilian data to the management of combat-related injuries of the extremity. Areas of emphasis include the utility of bacterial cultures, antimicrobial therapy, irrigation fluids and techniques, timing of surgical care, fixation, antibiotic impregnated beads, wound closure, and wound coverage with negative pressure wound therapy. Most of the recommendations are not supported by randomized controlled trials or adequate cohorts studies in a military population and further efforts are needed to answer best treatment strategies.

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

PubMed Central

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

2014-01-01

Across the tropics, smallholder farmers already face numerous risks to agricultural production. Climate change is expected to disproportionately affect smallholder farmers and make their livelihoods even more precarious; however, there is limited information on their overall vulnerability and adaptation needs. We conducted surveys of 600 households in Madagascar to characterize the vulnerability of smallholder farmers, identify how farmers cope with risks and explore what strategies are needed to help them adapt to climate change. Malagasy farmers are particularly vulnerable to any shocks to their agricultural system owing to their high dependence on agriculture for their livelihoods, chronic food insecurity, physical isolation and lack of access to formal safety nets. Farmers are frequently exposed to pest and disease outbreaks and extreme weather events (particularly cyclones), which cause significant crop and income losses and exacerbate food insecurity. Although farmers use a variety of risk-coping strategies, these are insufficient to prevent them from remaining food insecure. Few farmers have adjusted their farming strategies in response to climate change, owing to limited resources and capacity. Urgent technical, financial and institutional support is needed to improve the agricultural production and food security of Malagasy farmers and make their livelihoods resilient to climate change. PMID:24535397

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

PubMed

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

2014-04-05

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

Difficult Decisions Made Easier

NASA Technical Reports Server (NTRS)

2006-01-01

NASA missions are extremely complex and prone to sudden, catastrophic failure if equipment falters or if an unforeseen event occurs. For these reasons, NASA trains to expect the unexpected. It tests its equipment and systems in extreme conditions, and it develops risk-analysis tests to foresee any possible problems. The Space Agency recently worked with an industry partner to develop reliability analysis software capable of modeling complex, highly dynamic systems, taking into account variations in input parameters and the evolution of the system over the course of a mission. The goal of this research was multifold. It included performance and risk analyses of complex, multiphase missions, like the insertion of the Mars Reconnaissance Orbiter; reliability analyses of systems with redundant and/or repairable components; optimization analyses of system configurations with respect to cost and reliability; and sensitivity analyses to identify optimal areas for uncertainty reduction or performance enhancement.

Deadly heat waves projected in the densely populated agricultural regions of South Asia.

PubMed

Im, Eun-Soon; Pal, Jeremy S; Eltahir, Elfatih A B

2017-08-01

The risk associated with any climate change impact reflects intensity of natural hazard and level of human vulnerability. Previous work has shown that a wet-bulb temperature of 35°C can be considered an upper limit on human survivability. On the basis of an ensemble of high-resolution climate change simulations, we project that extremes of wet-bulb temperature in South Asia are likely to approach and, in a few locations, exceed this critical threshold by the late 21st century under the business-as-usual scenario of future greenhouse gas emissions. The most intense hazard from extreme future heat waves is concentrated around densely populated agricultural regions of the Ganges and Indus river basins. Climate change, without mitigation, presents a serious and unique risk in South Asia, a region inhabited by about one-fifth of the global human population, due to an unprecedented combination of severe natural hazard and acute vulnerability.

Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours

PubMed Central

Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Barr, Margo; Raphael, Beverley; Jorm, Louisa

2009-01-01

Background To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. Methods The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Results Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32–3.35, p < 0.001) to think that a terrorist attack is very or extremely likely to occur in Australia and also more likely (OR = 3.62, 95%CI:2.25–5.83, p < 0.001) to be very or extremely concerned that they or a family member would be directly affected, compared to those with a university-level qualification. Speaking a language other than English at home predicted high concern (very/extremely) that self or family would be directly affected (OR = 3.02, 95%CI:2.02–4.53, p < 0.001) and was the strongest predictor of having made associated changes in living (OR = 3.27, 95%CI:2.17–4.93, p < 0.001). Being female predicted willingness to evacuate from public facilities. Speaking a language other than English at home predicted low willingness to evacuate. Conclusion Low education level is a risk factor for high terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness. PMID:19323842

Parasite risk factors for stunting in grade 5 students in a community of extreme poverty in Peru.

PubMed

Casapía, Martin; Joseph, Serene A; Núñez, Carmen; Rahme, Elham; Gyorkos, Theresa W

2006-06-01

Malnutrition in school-age children is common in developing countries and includes both stunting and underweight. Stunting, which represents a chronic state of nutritional stress, leads to adverse health, educational and cognitive effects. Although much research is focused on preschool-age children, recent studies show both the high prevalence of stunting and the effectiveness of interventions in school-age children. The objectives of the current study were to determine the risk factors for stunting only, and stunting and underweight. A survey was conducted in 1074 grade 5 children (mean age 10 years) from 17 schools in Belen, Peru, a community of extreme poverty. Prevalence of underweight and stunting were 10.5 and 34.5%, respectively, co-prevalence was 9.3%. Based on multivariable logistic regression analyses, significant independent risk factors (odds ratio: OR) for stunting and underweight were: age (per 1 year increment) (OR=1.55; 95% confidence interval (CI): 1.33, 1.81); diarrhoea in the last week (OR=1.96; 95% CI: 1.17, 3.29) and hookworm infection (OR=1.74; 95% CI: 1.05, 2.86). Significant independent risk factors for stunting only were: age (per 1 year increment) (OR=1.51; 95% CI: 1.35, 1.70); anaemia (OR=1.98; 95% CI: 1.26, 3.11); and moderate and heavy Trichuris and Ascaris co-infection (OR=1.95; 95% CI: 1.35, 2.82). Our results indicate a high prevalence of stunting, in addition to other adverse health indicators, in the study population. Due to the interrelation between many of these health and nutrition problems, interventions at both the school and community levels, including de-worming, feeding programs and health and hygiene education, are needed to reduce malnutrition in this and other similar populations living in conditions of extreme poverty.

Regional flood impact assessment for Kiel and Eckernförde, Germany

NASA Astrophysics Data System (ADS)

Shustikova, Iuliia; Viavattene, Christophe; Seiß, Guntram

2017-04-01

It is well-observed that extreme flood events bring considerable destruction to coastal communities. The estimates of damage increases when direct and indirect losses are both considered in the assessment. This study applied the INtegrated DisRuption Assessment (INDRA) model which is designed to estimate and compare not only tangible but also intangible losses such as risk to life, recovery mechanisms and household displacement. Multi-criteria analysis (MCA) was performed in order to compare hotspots of high flood risk on the regional scale and detect which impact indicators influence results the most. INDRA allowed assessing the following impact indicators: direct damages to buildings and roads, transport disruption, risk to life and financial recovery mechanisms of private households and businesses. The focus was on two hotspots of flood risk, where direct and indirect impacts from 200 years flood were assessed and analyzed in terms of relative importance to the region. The region here was defined as municipalities located on the Baltic Sea coast within the Schleswig-Holstein state, Germany. The hotspots are the towns of Kiel and Eckernförde. They are urban areas with a high concentration of people and assets, which previously experienced extreme flood events. From the performed investigation it was found out that modeled flood differently impacts Kiel and Eckernförde. The results produced by MCA show that the scores of direct and indirect damage are slightly higher in Eckernförde than in Kiel. Transport disruption is a compelling element in the performed regional impact assessment and demonstrated immense weight. Extreme events may pose significant direct and indirect impacts on the coastal roads, obstructing not only the access to important landmarks such as hospitals, train stations, harbors, etc. but also to contiguous municipalities. Yet, the analysis showed that other impact indicators are rather of local importance and would not cause vast damage on a regional scale. Nonetheless, the study suggests, that these effects should not be underestimated in terms of losses.

Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours.

PubMed

Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Barr, Margo; Raphael, Beverley; Jorm, Louisa

2009-03-27

To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32-3.35, p < 0.001) to think that a terrorist attack is very or extremely likely to occur in Australia and also more likely (OR = 3.62, 95%CI:2.25-5.83, p < 0.001) to be very or extremely concerned that they or a family member would be directly affected, compared to those with a university-level qualification. Speaking a language other than English at home predicted high concern (very/extremely) that self or family would be directly affected (OR = 3.02, 95%CI:2.02-4.53, p < 0.001) and was the strongest predictor of having made associated changes in living (OR = 3.27, 95%CI:2.17-4.93, p < 0.001). Being female predicted willingness to evacuate from public facilities. Speaking a language other than English at home predicted low willingness to evacuate. Low education level is a risk factor for high terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness.

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

PubMed

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

2010-10-01

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

Dependence of drivers affects risks associated with compound events

NASA Astrophysics Data System (ADS)

Zscheischler, Jakob; Seneviratne, Sonia I.

2017-04-01

Compound climate extremes are receiving increasing attention because of their disproportionate impacts on humans and ecosystems. Risks assessments, however, generally focus on univariate statistics even when multiple stressors are considered. Concurrent extreme droughts and heatwaves have been observed to cause a suite of extreme impacts on natural and human systems alike. For example, they can substantially affect vegetation health, prompting tree mortality, and thereby facilitating insect outbreaks and fires. In addition, hot droughts have the potential to trigger and intensify fires and can cause severe economical damage. By promoting disease spread, extremely hot and dry conditions also strongly affect human health. We analyse the co-occurrence of dry and hot summers and show that these are strongly correlated for many regions, inducing a much higher frequency of concurrent hot and dry summers than what would be assumed from the independent combination of the univariate statistics. Our results demonstrate how the dependence structure between variables affects the occurrence frequency of multivariate extremes. Assessments based on univariate statistics can thus strongly underestimate risks associated with given extremes, if impacts depend on multiple (dependent) variables. We conclude that a multivariate perspective is necessary in order to appropriately assess changes in climate extremes and their impacts, and to design adaptation strategies.

Extreme Weather and Climate: Workshop Report

NASA Technical Reports Server (NTRS)

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

Urban Heat Wave Hazard Assessment

NASA Astrophysics Data System (ADS)

Quattrochi, D. A.; Jedlovec, G.; Crane, D. L.; Meyer, P. J.; LaFontaine, F.

2016-12-01

Heat waves are one of the largest causes of environmentally-related deaths globally and are likely to become more numerous as a result of climate change. The intensification of heat waves by the urban heat island effect and elevated humidity, combined with urban demographics, are key elements leading to these disasters. Better warning of the potential hazards may help lower risks associated with heat waves. Moderate resolution thermal data from NASA satellites is used to derive high spatial resolution estimates of apparent temperature (heat index) over urban regions. These data, combined with demographic data, are used to produce a daily heat hazard/risk map for selected cities. MODIS data are used to derive daily composite maximum and minimum land surface temperature (LST) fields to represent the amplitude of the diurnal temperature cycle and identify extreme heat days. Compositing routines are used to generate representative daily maximum and minimum LSTs for the urban environment. The limited effect of relative humidity on the apparent temperature (typically 10-15%) allows for the use of modeled moisture fields to convert LST to apparent temperature without loss of spatial variability. The daily max/min apparent temperature fields are used to identify abnormally extreme heat days relative to climatological values in order to produce a heat wave hazard map. Reference to climatological values normalizes the hazard for a particular region (e.g., the impact of an extreme heat day). A heat wave hazard map has been produced for several case study periods and then computed on a quasi-operational basis during the summer of 2016 for Atlanta, GA, Chicago, IL, St. Louis, MO, and Huntsville, AL. A hazard does not become a risk until someone or something is exposed to that hazard at a level that might do harm. Demographic information is used to assess the urban risk associated with the heat wave hazard. Collectively, the heat wave hazard product can warn people in urban regions who do not have the means to provide air conditioning or take other means to stay cool. The heat wave risk product is conveyed to users via a website that describes current and historical heat wave information and is updated in real time as needed. These risk maps can be used for better monitoring of public health risk from extreme heat events in urban areas.

Extreme temperatures and paediatric emergency department admissions.

PubMed

Xu, Zhiwei; Hu, Wenbiao; Su, Hong; Turner, Lyle R; Ye, Xiaofang; Wang, Jiajia; Tong, Shilu

2014-04-01

Children are particularly vulnerable to the effects of extreme temperatures. To examine the relationship between extreme temperatures and paediatric emergency department admissions (EDAs) in Brisbane, Australia, during 2003-2009. A quasi-Poisson generalised linear model combined with a distributed lag non-linear model was used to examine the relationships between extreme temperatures and age-, gender- and cause-specific paediatric EDAs, while controlling for air pollution, relative humidity, day of the week, influenza epidemics, public holiday, season and long-term trends. The model residuals were checked to identify whether there was an added effect due to heat waves or cold spells. There were 131 249 EDAs among children during the study period. Both high (RR=1.27; 95% CI 1.12 to 1.44) and low (RR=1.81; 95% CI 1.66 to 1.97) temperatures were significantly associated with an increase in paediatric EDAs in Brisbane. Male children were more vulnerable to temperature effects. Children aged 0-4 years were more vulnerable to heat effects and children aged 10-14 years were more sensitive to both hot and cold effects. High temperatures had a significant impact on several paediatric diseases, including intestinal infectious diseases, respiratory diseases, endocrine, nutritional and metabolic diseases, nervous system diseases and chronic lower respiratory diseases. Low temperatures were significantly associated with intestinal infectious diseases, respiratory diseases and endocrine, nutritional and metabolic diseases. An added effect of heat waves on childhood chronic lower respiratory diseases was seen, but no added effect of cold spells was found. As climate change continues, children are at particular risk of a variety of diseases which might be triggered by extremely high temperatures. This study suggests that preventing the effects of extreme temperature on children with respiratory diseases might reduce the number of EDAs.

A comparison of subjective and objective measures of physical activity and fitness in identifying associations with cardiometabolic risk factors.

PubMed

Schmidt, Michael D; Cleland, Verity J; Thomson, Russell J; Dwyer, Terence; Venn, Alison J

2008-05-01

To compare the ability of alternative measures of physical activity and fitness to quantify associations with health outcomes. Associations between a range of subjective and objective physical activity and fitness measures and cardiometabolic risk factors were examined using data from 1,631 Australians aged 26-36 years. Anthropometry, fitness, blood pressure, and fasting blood glucose, insulin, and lipids were measured at study clinics. Participants completed the International Physical Activity Questionnaire (IPAQ) and 7-day pedometer diaries; they also reported sedentary behavior (sitting, television viewing). In men and women, associations were strongest for fitness, with those in the highest (vs. lowest) fitness quarter having a 75% to 80% lower prevalence of two or more primary risk factors (waist circumference, high-density lipoprotein cholesterol, and insulin resistance). In men, a 60% to 70% reduced prevalence of two or more risk factors was observed across extreme quarters of IPAQ leisure, IPAQ vigorous, sitting duration, and pedometer measures. Similar reductions in prevalence were observed only across extreme quarters of pedometer activity and television viewing in women. Associations between alternative measures and cardiometabolic risk were relatively independent, suggesting that a range of physical activity and fitness measures may be needed to most accurately quantify associations between physical activity and health.

Outcomes for extremely premature infants.

PubMed

Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

2015-06-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages.The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, because therapy and supportive care continue to change, the outcomes of extremely low birth weight infants are ever evolving. Efforts to minimize injury, preserve growth, and identify interventions focused on antioxidant and anti-inflammatory pathways are now being evaluated. Thus, treating and preventing long-term deficits must be developed in the context of a "moving target."

Evaluation on uncertainty sources in projecting hydrological changes over the Xijiang River basin in South China

NASA Astrophysics Data System (ADS)

Yuan, Fei; Zhao, Chongxu; Jiang, Yong; Ren, Liliang; Shan, Hongcui; Zhang, Limin; Zhu, Yonghua; Chen, Tao; Jiang, Shanhu; Yang, Xiaoli; Shen, Hongren

2017-11-01

Projections of hydrological changes are associated with large uncertainties from different sources, which should be quantified for an effective implementation of water management policies adaptive to future climate change. In this study, a modeling chain framework to project future hydrological changes and the associated uncertainties in the Xijiang River basin, South China, was established. The framework consists of three emission scenarios (ESs), four climate models (CMs), four statistical downscaling (SD) methods, four hydrological modeling (HM) schemes, and four probability distributions (PDs) for extreme flow frequency analyses. Direct variance method was adopted to analyze the manner by which uncertainty sources such as ES, CM, SD, and HM affect the estimates of future evapotranspiration (ET) and streamflow, and to quantify the uncertainties of PDs in future flood and drought risk assessment. Results show that ES is one of the least important uncertainty sources in most situations. CM, in general, is the dominant uncertainty source for the projections of monthly ET and monthly streamflow during most of the annual cycle, daily streamflow below the 99.6% quantile level, and extreme low flow. SD is the most predominant uncertainty source in the projections of extreme high flow, and has a considerable percentage of uncertainty contribution in monthly streamflow projections in July-September. The effects of SD in other cases are negligible. HM is a non-ignorable uncertainty source that has the potential to produce much larger uncertainties for the projections of low flow and ET in warm and wet seasons than for the projections of high flow. PD contributes a larger percentage of uncertainty in extreme flood projections than it does in extreme low flow estimates. Despite the large uncertainties in hydrological projections, this work found that future extreme low flow would undergo a considerable reduction, and a noticeable increase in drought risk in the Xijiang River basin would be expected. Thus, the necessity of employing effective water-saving techniques and adaptive water resources management strategies for drought disaster mitigation should be addressed.

Climatology of extreme daily precipitation in Colorado and its diverse spatial and seasonal variability

USGS Publications Warehouse

Mahoney, Kelly M.; Ralph, F. Martin; Walter, Klaus; Doesken, Nolan; Dettinger, Michael; Gottas, Daniel; Coleman, Timothy; White, Allen

2015-01-01

The climatology of Colorado’s historical extreme precipitation events shows a remarkable degree of seasonal and regional variability. Analysis of the largest historical daily precipitation totals at COOP stations across Colorado by season indicates that the largest recorded daily precipitation totals have ranged from less than 60 mm day−1 in some areas to more than 250 mm day−1 in others. East of the Continental Divide, winter events are rarely among the top 10 events at a given site, but spring events dominate in and near the foothills; summer events are most common across the lower-elevation eastern plains, while fall events are most typical for the lower elevations west of the Divide. The seasonal signal in Colorado’s central mountains is complex; high-elevation intense precipitation events have occurred in all months of the year, including summer, when precipitation is more likely to be liquid (as opposed to snow), which poses more of an instantaneous flood risk. Notably, the historic Colorado Front Range daily rainfall totals that contributed to the damaging floods in September 2013 occurred outside of that region’s typical season for most extreme precipitation (spring–summer). That event and many others highlight the fact that extreme precipitation in Colorado has occurred historically during all seasons and at all elevations, emphasizing a year-round statewide risk.

Satellite-Enhanced Dynamical Downscaling of Extreme Events

NASA Astrophysics Data System (ADS)

Nunes, A.

2015-12-01

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

Changes in Concurrent Risk of Warm and Dry Years under Impact of Climate Change

NASA Astrophysics Data System (ADS)

Sarhadi, A.; Wiper, M.; Touma, D. E.; Ausín, M. C.; Diffenbaugh, N. S.

2017-12-01

Anthropogenic global warming has changed the nature and the risk of extreme climate phenomena. The changing concurrence of multiple climatic extremes (warm and dry years) may result in intensification of undesirable consequences for water resources, human and ecosystem health, and environmental equity. The present study assesses how global warming influences the probability that warm and dry years co-occur in a global scale. In the first step of the study a designed multivariate Mann-Kendall trend analysis is used to detect the areas in which the concurrence of warm and dry years has increased in the historical climate records and also climate models in the global scale. The next step investigates the concurrent risk of the extremes under dynamic nonstationary conditions. A fully generalized multivariate risk framework is designed to evolve through time under dynamic nonstationary conditions. In this methodology, Bayesian, dynamic copulas are developed to model the time-varying dependence structure between the two different climate extremes (warm and dry years). The results reveal an increasing trend in the concurrence risk of warm and dry years, which are in agreement with the multivariate trend analysis from historical and climate models. In addition to providing a novel quantification of the changing probability of compound extreme events, the results of this study can help decision makers develop short- and long-term strategies to prepare for climate stresses now and in the future.

An Assessment of Direct and Indirect Economic Losses of Climatic Extreme Events

NASA Astrophysics Data System (ADS)

Otto, C.; Willner, S. N.; Wenz, L.; Levermann, A.

2015-12-01

Risk of extreme weather events like storms, heat extremes, and floods has already risen due to anthropogenic climate change and is likely to increase further under future global warming. Additionally, the structure of the global economy has changed importantly in the last decades. In the process of globalization, local economies have become more and more interwoven forming a complex network. Together with a trend towards lean production, this has resulted in a strong dependency of local manufacturers on global supply and value added chains, which may render the economic network more vulnerable to climatic extremes; outages of local manufacturers trigger indirect losses, which spread along supply chains and can even outstrip direct losses. Accordingly, in a comprehensive climate risk assessment these inter-linkages should be considered. Here, we present acclimate, an agent based dynamic damage propagation model. Its agents are production and consumption sites, which are interlinked by economic flows accounting for the complexity as well as the heterogeneity of the global supply network. Assessing the economic response on the timescale of the adverse event, the model permits to study temporal and spatial evolution of indirect production losses during the disaster and in the subsequent recovery phase of the economy. In this study, we focus on the dynamic economic resilience defined here as the ratio of direct to total losses. This implies that the resilience of the system under consideration is low if the high indirect losses are high. We find and assess a nonlinear dependence of the resilience on the disaster size. Further, we analyze the influence of the network structure upon resilience and discuss the potential of warehousing as an adaptation option.

Long-term results of a phase 2 study of neoadjuvant chemotherapy and radiotherapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514.

PubMed

Kraybill, William G; Harris, Jonathan; Spiro, Ira J; Ettinger, David S; DeLaney, Thomas F; Blum, Ronald H; Lucas, David R; Harmon, David C; Letson, G Douglas; Eisenberg, Burton

2010-10-01

The use of neoadjuvant and adjuvant chemotherapy in soft tissue sarcomas is controversial. This is a report of long-term (≥5 years) follow-up in patients with high-grade, high-risk soft tissue sarcomas treated with neoadjuvant chemotherapy, preoperative radiotherapy (RT), and adjuvant chemotherapy. Patients with high-grade soft tissue sarcoma≥8 cm in diameter of the extremities and body wall received 3 cycles of neoadjuvant chemotherapy (mesna, doxorubicin, ifosfamide, and dacarbazine) and preoperative RT (44 grays administered in split courses), and 3 cycles of postoperative chemotherapy (mesna, doxorubicin, ifosfamide, and dacarbazine). Sixty-four of 66 patients were analyzed. After chemotherapy and RT, 61 patients had surgery; 58 had R0 resections (5 amputations), and 3 had R1 resections. Ninety-seven percent experienced grade 3 or higher toxicity, including 3 deaths. These toxicities were short term. With a median follow-up of 7.7 years in surviving patients, the 5-year rates of locoregional failure (including amputation), and distant metastasis were 22.2% (95% confidence interval [CI], 11.8-32.6) and 28.1% (95% CI, 17.0-39.2). The most common site of metastasis was lung. Estimated 5-year rates of disease-free survival, distant disease-free survival, and overall survival were 56.1% (95% CI, 43.9-68.3), 64.1% (95% CI, 52.3-75.8), and 71.2% (95% CI, 60.0-82.5), respectively. Although the toxicity was significant, it was limited in its course and for the most part resolved by 1 year. The long-term outcome was better than might be expected in such high-risk tumors. Copyright © 2010 American Cancer Society.

Spontaneous Coronary Artery Dissection

MedlinePlus

... blood vessels. Fibromuscular dysplasia occurs more often in women than it does in men. Extreme physical exercise. People who recently participated in extreme or intense exercises, such as extreme aerobic activities, may be at higher risk of SCAD. Severe ...

Risk of aggression and criminal behaviour among adolescents living in Alexandria Governorate, Egypt.

PubMed

Wahdan, I; El-Nimr, N; Kotb, R; Wahdan, A

2014-05-01

Adolescent risk-taking and aggressive behaviours are among the most visible forms of violence in society. A study was carried out to identify the prevalence and risk factors for aggression, violence and criminal behaviour among adolescents in Alexandria, Egypt. Using multistage, cluster sampling of families from all health districts in Alexandria, the mothers of 783 adolescents aged 11-19 years answered an Arabic version of the Mentor Research Institute screening questionnaire. Overall 26.9% of adolescents were assessed to be at high risk and 20.2% at extremely high risk of aggression and criminal behaviour. Living in urban/slum areas, male sex, low level of parents' education/occupation, exposure to violence within the family and changes in behaviour of any family member were associated with risk of aggression/violence. In multivariate analysis, the significant independent variables were adolescents' sex, presence of behavioural changes in the family, violence against brothers and sisters and substance abuse by any family member.

Health risk assessment of cadmium pollution emergency for urban populations in Foshan City, China.

PubMed

Dou, Ming; Zhao, Peipei; Wang, Yanyan; Li, Guiqiu

2017-03-01

With rapid socioeconomic development, water pollution emergency has become increasingly common and could potentially harm the environment and human health, especially heavy metal pollution. In this paper, we investigate the Cd pollution emergency that occurred in the Pearl River network, China, in 2005, and we build a migration and transformation model for heavy metals to simulate the spatiotemporal distribution of Cd concentrations under various scenarios of Cd pollution emergency in Foshan City. Moreover, human health hazard and carcinogenic risk for local residents of Foshan City were evaluated. The primary conclusions were as follows: (1) the number of carcinogen-affected people per year under scenario 1 reached 254.41 when the frequency was 0.1 year/time; specifically, the number of people with cancer per year in the area of the Datang, Lubao, and Nanbian waterworks was 189.36 accounting for 74% of the total number per year; (2) at the frequency of 5 years/time, the Lubao waterwork is the only one in extremely high- or high-risk grade, while besides it, the risk grade in the Datang, Nanbian, Xinan, Shitang, and Jianlibao waterworks is in the extremely high or high grade when the frequency is 0.1 year/time; (3) when Cd pollution accidents with the same level occurs again, Cd concentration decreases to a low level in the water only if the migration distance of Cd is at least 40-50 km. Based on the health risk assessment of Cd pollution, this study gives the recommendation that the distance should keep above 50 km in tidal river network of the Pearl River Delta between those factories existing the possibility of heavy metal pollution and the drinking water source. Only then can the public protect themselves from hazardous effects of higher levels of heavy metal.

Technology perspectives in the future exploration of extreme environments

NASA Astrophysics Data System (ADS)

Cutts, J.; Balint, T.; Kolawa, El.; Peterson, C.

2007-08-01

Solar System exploration is driven by high priority science goals and objectives at diverse destinations, as described in the NRC Decadal Survey and in NASA's 2006 Solar System Exploration (SSE) Roadmap. Proposed missions to these targets encounter extreme environments, including high or low temperatures, high pressure, corrosion, high heat flux, radiation and thermal cycling. These conditions are often coupled, such as low temperature and high radiation at Europa; and high temperature and high pressure near the surface of Venus. Mitigation of these environmental conditions frequently reaches beyond technologies developed for terrestrial applications, for example, by the automotive and oil industries. Therefore, space agencies require dedicated technology developments to enable these future missions. Within NASA, proposed missions are divided into three categories. Competed small (Discovery class) and medium (New Frontiers class) missions are cost capped, thus limiting significant technology developments. Therefore, large (Flagship class) missions are required not only to tackle key science questions which can't be addressed by smaller missions, but also to develop mission enabling technologies that can feed forward to smaller missions as well. In a newly completed extreme environment technology assessment at NASA, we evaluated technologies from the current State of Practice (SoP) to advanced concepts for proposed missions over the next decades. Highlights of this report are discussed here, including systems architectures, such as hybrid systems; protection systems; high temperature electronics; power generation and storage; mobility technologies; sample acquisition and mechanisms; and the need to test these technologies in relevant environments. It is expected that the findings - documented in detail in NASA's Extreme Environments Technologies report - would help identifying future technology investment areas, and in turn enable or enhance planned SSE missions, while reducing mission cost and risk.

A New Time-varying Concept of Risk in a Changing Climate.

PubMed

Sarhadi, Ali; Ausín, María Concepción; Wiper, Michael P

2016-10-20

In a changing climate arising from anthropogenic global warming, the nature of extreme climatic events is changing over time. Existing analytical stationary-based risk methods, however, assume multi-dimensional extreme climate phenomena will not significantly vary over time. To strengthen the reliability of infrastructure designs and the management of water systems in the changing environment, multidimensional stationary risk studies should be replaced with a new adaptive perspective. The results of a comparison indicate that current multi-dimensional stationary risk frameworks are no longer applicable to projecting the changing behaviour of multi-dimensional extreme climate processes. Using static stationary-based multivariate risk methods may lead to undesirable consequences in designing water system infrastructures. The static stationary concept should be replaced with a flexible multi-dimensional time-varying risk framework. The present study introduces a new multi-dimensional time-varying risk concept to be incorporated in updating infrastructure design strategies under changing environments arising from human-induced climate change. The proposed generalized time-varying risk concept can be applied for all stochastic multi-dimensional systems that are under the influence of changing environments.

Debunking vaccination myths: strong risk negations can increase perceived vaccination risks.

PubMed

Betsch, Cornelia; Sachse, Katharina

2013-02-01

Information about risks is often contradictory, especially in the health domain. A vast amount of bizarre information on vaccine-adverse events (VAE) can be found on the Internet; most are posted by antivaccination activists. Several actors in the health sector struggle against these statements by negating claimed risks with scientific explanations. The goal of the present work is to find optimal ways of negating risk to decrease risk perceptions. In two online experiments, we varied the extremity of risk negations and their source. Perception of the probability of VAE, their expected severity (both variables serve as indicators of perceived risk), and vaccination intentions. Paradoxically, messages strongly indicating that there is "no risk" led to a higher perceived vaccination risk than weak negations. This finding extends previous work on the negativity bias, which has shown that information stating the presence of risk decreases risk perceptions, while information negating the existence of risk increases such perceptions. Several moderators were also tested; however, the effect occurred independently of the number of negations, recipient involvement, and attitude. Solely the credibility of the information source interacted with the extremity of risk negation: For credible sources (governmental institutions), strong and weak risk negations lead to similar perceived risk, while for less credible sources (pharmaceutical industries) weak negations lead to less perceived risk than strong negations. Optimal risk negation may profit from moderate rather than extreme formulations as a source's trustworthiness can vary.

Development of an Ergonomics Checklist for Investigation of Work-Related Whole-Body Disorders in Farming - AWBA: Agricultural Whole-Body Assessment.

PubMed

Kong, Y K; Lee, S J; Lee, K S; Kim, G R; Kim, D M

2015-10-01

Researchers have been using various ergonomic tools to study occupational musculoskeletal diseases in industrial contexts. However, in agricultural work, where the work environment is poorer and the socio-psychological stress is high due to the high labor intensities of the industry, current research efforts have been scarce, and the number of available tools is small. In our preliminary studies, which focused on a limited number of body parts and other working elements, we developed separate evaluation tools for the upper and lower extremities. The current study was conducted to develop a whole-body ergonomic assessment tool for agricultural work that integrates the existing assessment tools for lower and upper extremities developed in the preliminary studies and to verify the relevance of the integrated assessment tool. To verify the relevance of the Agricultural Whole-Body Assessment (AWBA) tool, we selected 50 different postures that occur frequently in agricultural work. Our results showed that the AWBA-determined risk levels were similar to the subjective risk levels determined by experts. In addition, as the risk level increased, the average risk level increased to a similar extent. Moreover, the differences in risk levels between the AWBA and expert assessments were mostly smaller than the differences in risk levels between other assessment tools and the expert assessments in this study. In conclusion, the AWBA tool developed in this study was demonstrated to be appropriate for use as a tool for assessing various postures commonly assumed in agricultural work. Moreover, we believe that our verification of the assessment tools will contribute to the enhancement of the quality of activities designed to prevent and control work-related musculoskeletal diseases in other industries.

Exchangeability, extreme returns and Value-at-Risk forecasts

NASA Astrophysics Data System (ADS)

Huang, Chun-Kai; North, Delia; Zewotir, Temesgen

2017-07-01

In this paper, we propose a new approach to extreme value modelling for the forecasting of Value-at-Risk (VaR). In particular, the block maxima and the peaks-over-threshold methods are generalised to exchangeable random sequences. This caters for the dependencies, such as serial autocorrelation, of financial returns observed empirically. In addition, this approach allows for parameter variations within each VaR estimation window. Empirical prior distributions of the extreme value parameters are attained by using resampling procedures. We compare the results of our VaR forecasts to that of the unconditional extreme value theory (EVT) approach and the conditional GARCH-EVT model for robust conclusions.

Associations between extreme precipitation and acute gastro-intestinal illness due to cryptosporidiosis and giardiasis in an urban Canadian drinking water system (1997-2009).

PubMed

Chhetri, Bimal K; Takaro, Tim K; Balshaw, Robert; Otterstatter, Michael; Mak, Sunny; Lem, Marcus; Zubel, Marc; Lysyshyn, Mark; Clarkson, Len; Edwards, Joanne; Fleury, Manon D; Henderson, Sarah B; Galanis, Eleni

2017-10-01

Drinking water related infections are expected to increase in the future due to climate change. Understanding the current links between these infections and environmental factors is vital to understand and reduce the future burden of illness. We investigated the relationship between weekly reported cryptosporidiosis and giardiasis (n = 7,422), extreme precipitation (>90th percentile), drinking water turbidity, and preceding dry periods in a drinking water system located in greater Vancouver, British Columbia, Canada (1997-2009) using distributed lag non-linear Poisson regression models adjusted for seasonality, secular trend, and the effect of holidays on reporting. We found a significant increase in cryptosporidiosis and giardiasis 4-6 weeks after extreme precipitation. The effect was greater following a dry period. Similarly, extreme precipitation led to significantly increased turbidity only after prolonged dry periods. Our results suggest that the risk of cryptosporidiosis and giardiasis increases with extreme precipitation, and that the effects are more pronounced after a prolonged dry period. Given that extreme precipitation events are expected to increase with climate change, it is important to further understand the risks from these events, develop planning tools, and build resilience to these future risks.

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

NASA Astrophysics Data System (ADS)

Giannakaki, Paraskevi; Calanca, Pierluigi

2017-04-01

Russia has become one of the leading wheat exporters worldwide. Major breakdowns in Russian wheat production induced by extreme weather events are therefore of high significance not only for the domestic but also for the global market. Wheat production in south-western Russia, the main growing area, suffers in particular from the adverse effects of drought and heat waves. For this reason knowledge of the occurrence of this type of extreme events and of the processes that lead to adverse conditions is of paramount importance for risk management. The negative impacts of heat waves and drought are particularly severe when anomalous conditions persist in time. As an example, a blocking event in summer 2010 resulted in one of the warmest and worst drought conditions in Russia's recent history. The latter caused a decline in Russian wheat production by more than 30%, which in turn prompted the Russian government to issue an export ban that lasted until summer 2011. In view of this, the question of course arises of how much of the negative variations in Russian wheat production levels can be explained by blocking events and other features of the large-scale atmospheric circulation. Specific questions are: how often are blocking events over Russia associated with extreme high temperatures and dry conditions? Which of the teleconnection patterns are correlated with drought and heat stress conditions in the area? Answering these questions can contribute to a develop strategies for agricultural risk management. In this contribution we present results of a study that aims at characterizing the occurrence of adverse weather conditions in south-western Russia in relation to atmospheric blocking and teleconnection patterns such as East Atlantic/Western Russia pattern, the Polar/Eurasia pattern, the North Atlantic Oscillation and the Scandinavia pattern. The analysis relies on weather data for 1980-2014 from 130 stations distributed across the wheat production area. The account for similarities in the occurrence of extreme heat, stations are clustered according to 90th percentile of daily maximum temperature. The results indicate that adverse conditions in the area are significantly correlated with the occurrence of blocking events and with the phase of some teleconnection patterns.

Adolescent peer crowd affiliation: linkages with health-risk behaviors and close friendships.

PubMed

La Greca, A M; Prinstein, M J; Fetter, M D

2001-01-01

To examine adolescents' peer crowd affiliation and its linkages with health-risk behaviors, their friends' health-risk behaviors, the presence of close friends in the same peer crowd, and adolescents' social acceptance. We interviewed 250 high school students and identified six categories: popular, jocks, brains, burnouts, nonconformists, or average/other. Adolescents also reported on their health-risk behaviors (including use of cigarettes, alcohol, marijuana and other drugs; risky sexual behaviors; and other risk-taking behaviors), the health-risk behaviors of their friends, the peer crowd affiliation of their closest friends, and their perceived social acceptance. Burnouts and nonconformists had the highest levels of health-risk behaviors across the areas assessed, the greatest proportions of close friends who engaged in similar behaviors, and relatively low social acceptance from peers. Brains and their friends engaged in extremely low levels of health-risk behaviors. Jocks and populars also showed evidence of selected areas of health risk; these teens also were more socially accepted than others. In general, adolescents' closest friends were highly nested within the same peer crowds. The findings further our understanding of adolescent behaviors that put them at risk for serious adult onset conditions associated with high rates of morbidity and mortality. We discuss the implications of the findings for developing health promotion efforts for adolescents.

Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure: Findings from the Maracaibo Aging Study.

PubMed

Melgarejo, Jesús D; Lee, Joseph H; Petitto, Michele; Yépez, Juan B; Murati, Felipe A; Jin, Zhezhen; Chávez, Carlos A; Pirela, Rosa V; Calmón, Gustavo E; Lee, Winston; Johnson, Matthew P; Mena, Luis J; Al-Aswad, Lama A; Terwilliger, Joseph D; Allikmets, Rando; Maestre, Gladys E; De Moraes, C Gustavo

2018-06-01

To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics. Observational cross-sectional study. A subset (n = 93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants, who were at least 40 years of age, had measurements for optical tomography coherence, visual field (VF) tests, 24-hour BP, office BP, and intraocular pressure <22 mmHg. Univariate and multivariate logistic regression analyses under the generalized estimating equations (GEE) framework were used to examine the relationships between glaucomatous damage and BP parameters, with particular attention to decreases in nocturnal BP. Glaucomatous optic neuropathy (GON) based on the presence of optic nerve damage and VF defects. The mean age was 61.9 years, and 87.1% were women. Of 185 eyes evaluated, 19 (26.5%) had signs of GON. Individuals with GON had significantly lower 24-hour and nighttime diastolic BP levels than those without. However, results of the multivariate GEE models indicated that the glaucomatous damage was not related to the average systolic or diastolic BP levels measured over 24 hours, daytime, or nighttime. In contrast, extreme decreases in nighttime systolic and diastolic BP (>20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio, 19.78 and 5.55, respectively). In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme decreases in nocturnal BP in individuals at high risk of glaucoma are warranted. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Identification of extremely premature infants at high risk of rehospitalization.

PubMed

Ambalavanan, Namasivayam; Carlo, Waldemar A; McDonald, Scott A; Yao, Qing; Das, Abhik; Higgins, Rosemary D

2011-11-01

Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

Identification of Extremely Premature Infants at High Risk of Rehospitalization

PubMed Central

Carlo, Waldemar A.; McDonald, Scott A.; Yao, Qing; Das, Abhik; Higgins, Rosemary D.

2011-01-01

OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002–2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%–42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge. PMID:22007016

Comparing Running Specific and Traditional Prostheses During Running: Assessing Performance and Risk

DTIC Science & Technology

2016-09-01

extremity amputation (ILEA) running is limited with respect to biomechanical performance and injury risks. ILEA are able to run with both running...TERMS Kinetics, biomechanics , amputation, prosthesis, transtibial 16. SECURITY CLASSIFICATION OF: U 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES...with lower extremity amputation (ILEA) running is limited with respect to biomechanical performance and injury risks. ILEA are able to run with both

Is climate change modifying precipitation extremes?

NASA Astrophysics Data System (ADS)

Montanari, Alberto; Papalexiou, Simon Michael

2016-04-01

The title of the present contribution is a relevant question that is frequently posed to scientists, technicians and managers of local authorities. Although several research efforts were recently dedicated to rainfall observation, analysis and modelling, the above question remains essentially unanswered. The question comes from the awareness that the frequency of floods and the related socio-economic impacts are increasing in many countries, and climate change is deemed to be the main trigger. Indeed, identifying the real reasons for the observed increase of flood risk is necessary in order to plan effective mitigation and adaptation strategies. While mitigation of climate change is an extremely important issue at the global level, at small spatial scales several other triggers may interact with it, therefore requiring different mitigation strategies. Similarly, the responsibilities of administrators are radically different at local and global scales. This talk aims to provide insights and information to address the question expressed by its title. High resolution and long term rainfall data will be presented, as well as an analysis of the frequency of their extremes and its progress in time. The results will provide pragmatic indications for the sake of better planning flood risk mitigation policies.

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

NASA Astrophysics Data System (ADS)

Eelsalu, Maris; Soomere, Tarmo

2016-04-01

The risks and damages associated with coastal flooding that are naturally associated with an increase in the magnitude of extreme storm surges are one of the largest concerns of countries with extensive low-lying nearshore areas. The relevant risks are even more contrast for semi-enclosed water bodies such as the Baltic Sea where subtidal (weekly-scale) variations in the water volume of the sea substantially contribute to the water level and lead to large spreading of projections of future extreme water levels. We explore the options for using large ensembles of projections to more reliably evaluate return periods of extreme water levels. Single projections of the ensemble are constructed by means of fitting several sets of block maxima with various extreme value distributions. The ensemble is based on two simulated data sets produced in the Swedish Meteorological and Hydrological Institute. A hindcast by the Rossby Centre Ocean model is sampled with a resolution of 6 h and a similar hindcast by the circulation model NEMO with a resolution of 1 h. As the annual maxima of water levels in the Baltic Sea are not always uncorrelated, we employ maxima for calendar years and for stormy seasons. As the shape parameter of the Generalised Extreme Value distribution changes its sign and substantially varies in magnitude along the eastern coast of the Baltic Sea, the use of a single distribution for the entire coast is inappropriate. The ensemble involves projections based on the Generalised Extreme Value, Gumbel and Weibull distributions. The parameters of these distributions are evaluated using three different ways: maximum likelihood method and method of moments based on both biased and unbiased estimates. The total number of projections in the ensemble is 40. As some of the resulting estimates contain limited additional information, the members of pairs of projections that are highly correlated are assigned weights 0.6. A comparison of the ensemble-based projection of extreme water levels and their return periods with similar estimates derived from local observations reveals an interesting pattern of match and mismatch. The match is almost perfect in measurement sites where local effects (e.g., wave-induced set-up or local surge in very shallow areas that are not resolved by circulation models) do not contribute to the observed values of water level. There is, however, substantial mismatch between projected and observed extreme values for most of the Estonian coast. The mismatch is largest for sections that are open to high waves and for several bays that are deeply cut into mainland but open for predominant strong wind directions. Detailed quantification of this mismatch eventually makes it possible to develop substantially improved estimates of extreme water levels in sections where local effects considerably contribute into the total water level.

When are CT angiograms indicated for patients with lower extremity fractures? A review of 275 extremities.

PubMed

Monazzam, Shafagh; Goodell, Parker B; Salcedo, Edgardo S; Nelson, Sandahl H; Wolinsky, Philip R

2017-01-01

Computed tomography angiogram (CTA) is frequently utilized to detect vascular injuries even without examination findings indicating a vascular injury. We had the following hypotheses: (1) a CTA for lower extremity fractures with no clinical signs of a vascular injury is not indicated, and (2) fracture location and pattern would correlate with the risk of a vascular injury. A retrospective review was conducted on patients who had an acute lower extremity fracture(s) and a CTA. Their charts were reviewed for multiple factors including the presence or absence of hard or soft signs of a vascular injury, soft tissue status, and fracture location/pattern. Every CTA radiology report was reviewed and any vascular intervention or amputation resulting from a vascular injury was recorded. Statistical analysis was performed. Of the 275 CTAs of fractured extremities reviewed, 80 (29%) had a positive CTA finding and 16 (6%) required treatment. A total of 109 (40%) of the extremities had no hard or soft signs; all had normal CTAs. Having at least one hard or soft sign was a significant risk factor for having a positive CTA. An open fracture, isolated proximal third fibula fracture, distal and shaft tibia fractures, and the presence of multiple fractures in one extremity were also associated with an increased risk for having a positive CTA. We found no evidence to support the routine use of CTAs to evaluate lower extremity fractures unless at least one hard or soft sign is present. The presence of an open fracture, distal tibia or tibial shaft fractures, multiple fractures in one extremity, and/or an isolated proximal third fibula fracture increases the risk of having a finding consistent with a vascular injury on a CTA. Only 6% of the cases required treatment, and all of them had diminished or absent distal pulses on presentation. Diagnostic test, level III.

Global changes of extreme coastal wave energy fluxes triggered by intensified teleconnection patterns

NASA Astrophysics Data System (ADS)

Mentaschi, Lorenzo; Vousdoukas, Michalis I.; Voukouvalas, Evangelos; Dosio, Alessandro; Feyen, Luc

2017-03-01

In this study we conducted a comprehensive modeling analysis to identify global trends in extreme wave energy flux (WEF) along coastlines in the 21st century under a high emission pathway (Representative Concentration Pathways 8.5). For the end of the century, results show a significant increase up to 30% in 100 year return level WEF for the majority of the coastal areas of the southern temperate zone, while in the Northern Hemisphere large coastal areas are characterized by a significant negative trend. We show that the most significant long-term trends of extreme WEF can be explained by intensification of teleconnection patterns such as the Antarctic Oscillation, El Niño-Southern Oscillation, and North Atlantic Oscillation. The projected changes will have broad implications for ocean engineering applications and disaster risk management. Especially low-lying coastal countries in the Southern Hemisphere will be particularly vulnerable due to the combined effects of projected relative sea level rise and more extreme wave activities.

Process-dependent risk of delayed health effects for welders.

PubMed Central

Stern, R M

1981-01-01

In most industrialized countries large numbers of workers are exposed to welding fumes. Although the general pattern of welders' health may not significantly differ from that of workers in other dusty industrial occupations which demonstrate elevated incidence of respiratory tract diseases with long latency periods, the extremely wide range of substances at potentially high concentrations produced by various welding technologies may give rise to undetected process-specific high-risk working conditions: ("hot spots"). The origin, prevalence and range of magnitude of such hot spots, especially for cancer of the respiratory tract, is discussed, with emphasis placed on the assessment of risk resulting from exposure to Cr(VI) and Ni accompanying the use of various technologies for the welding of stainless and high alloy steels. The wide variation of health effects found within the industry, however, indicates the need for a standard protocol for future epidemiological studies, as well as for the development of suitable methodologies for experimental risk assessment. PMID:7333241

[Home care for the high-risk newborn infant].

PubMed

Puddu, M

2010-06-01

With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

Evaluation of the Psychoneurotic Tendencies Risk Using the Woodworth Mathews Personality Inventory in Non-Institutionalized Persons

PubMed Central

PÎRLOG, M.C.; RADA, CORNELIA; PREJBEANU, ILEANA; CARA, MONICA LAURA

2014-01-01

INTRODUCTION: Multiple factors of vulnerability may lead to development of abnormal social behaviour and to important psychiatric diseases. The psychopathological characteristics present at individual level can lead to a pattern of population groups that are subject to developing mental illness risks. MATERIAL AND METHODS: Multidisciplinary study (2009-2011) to assessing the current situation of mental health and identifying population risk groups for developing psychiatric disorders in a non-institutionalised population. We used the Woodworth Mathews Inventory (76 items) to a randomly selected sample of 1,200 men and women, residents in urban and rural areas. RESULTS: The extreme scores for emotiveness had a frequency more than triple for women, and we found a similar situation for obsessive-neurasthenic and depressive tendencies. People aging over 35 years had a double score (limit and poignancy) for depression than younger people, meanwhile correlation between age under 35 years and instability and antisocial tendencies is highly statistically significant (p<0.001), the frequency of extreme scores being almost double than in the older people. CONCLUSIONS: Female gender has a vulnerability for develop depressive and emotional disorders and age over 35 is also significant correlated with depressive tendencies. Younger people (under 35 years) are predisposed for pathological antisocial behaviour, fact revealed by the high scores for instability and antisocial tendencies. It is necessary to develop a program focused on the two risk categories to prevent the possible occurrence of psychiatric disorders. PMID:25729602

The Relationship Between Functional Movement, Balance Deficits, and Previous Injury History in Deploying Marine Warfighters.

PubMed

de la Motte, Sarah J; Lisman, Peter; Sabatino, Marc; Beutler, Anthony I; OʼConnor, Francis G; Deuster, Patricia A

2016-06-01

Screening for primary musculoskeletal injury (MSK-I) is costly and time-consuming. Both the Functional Movement Screen (FMS) and the Y-Balance Test (YBT) have been shown to predict future MSK-I. With a goal of optimizing the efficiency of primary MSK-I screening, we studied associations between performance on the FMS and YBT and whether history of MSK-I influenced FMS and YBT scores. In total, 365 deploying Marines performed the FMS and YBT as prescribed. Composite and individual scores were each categorized as high risk or low risk using published injury thresholds: High-risk FMS included composite scores ≤14 and right-to-left (R/L) asymmetry for Shoulder Mobility, In-Line Lunge, Straight Leg Raise, Hurdle Step, or Rotary Stability. High-risk YBT consisted of anterior, posteromedial, and/or posterolateral R/L differences >4 cm and/or composite differences ≥12 cm. Pearson's χ tests evaluated associations between: (a) all FMS and YBT risk groups and (b) previous MSK-I and all FMS and YBT risk groups. Marines with high-risk FMS were twice as likely to have high-risk YBT posteromedial scores (χ = 10.2, p = 0.001; odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.3-3.2). History of any MSK-I was not associated with high-risk FMS or high-risk YBT. However, previous lower extremity MSK-I was associated with In-Line Lunge asymmetries (χ = 9.8, p = 0.002, OR = 2.2, 95% CI = 1.3-3.6). Overall, we found limited overlap in FMS and YBT risk. Because both methods seem to assess different risk factors for injury, we recommend FMS and YBT continue to be used together in combination with a thorough injury history until their predictive capacities are further established.

Late-onset septicemia in a Norwegian national cohort of extremely premature infants receiving very early full human milk feeding.

PubMed

Rønnestad, Arild; Abrahamsen, Tore G; Medbø, Sverre; Reigstad, Hallvard; Lossius, Kristin; Kaaresen, Per I; Egeland, Thore; Engelund, Inger E; Irgens, Lorentz M; Markestad, Trond

2005-03-01

To investigate the occurrence of and risk factors for late-onset septicemia (LOS) in a national cohort of extremely premature infants who received very early full human milk feeding. A prospective study of all infants born in Norway in 1999 and 2000 with gestational age of <28 weeks or birth weight of <1000 g was performed. Extensive clinical information, including data on feeding practices and episodes of septicemia, was collected on predefined forms. LOS was defined as growth of bacteria or fungi in blood cultures in conjunction with clinical symptoms consistent with systemic infection occurring after day 6 of life. Cox regression models, including models allowing for time-dependent covariates, were applied in the analysis of LOS. Of 464 eligible infants, 462 (99.6%) were enrolled and 405 (87.7%) survived until day 7. LOS was diagnosed for 80 (19.7%). The predominant pathogens were coagulase-negative staphylococci, followed by Candida spp. Case fatality rates associated with septicemia were 10% in general and 43% for Candida spp septicemia. Necrotizing enterocolitis or bowel perforation was diagnosed for 19 infants (4%). Enteral feeding with human milk was initiated within the third day for 98% of patients, and 92% were receiving full enteral feeding (FEF) with human milk within the third week. Both high Clinical Risk Index for Babies scores and an umbilical venous catheter in situ at 7 days of age significantly predicted LOS. However, the overall most influential risk factor for LOS was the number of days without establishment of FEF with human milk, with an adjusted relative risk of 3.7 (2.0-6.9) for LOS if FEF was not established within the second week of life. The incidence and case fatality rate of septicemia for this cohort of extremely preterm infants were lower than values in comparable studies. The main difference, compared with other studies, was the feeding practice, and the data suggest that very early FEF with human milk significantly reduces the risk of LOS among extremely premature infants.

The spatial distribution of threats to plant species with extremely small populations

NASA Astrophysics Data System (ADS)

Wang, Chunjing; Zhang, Jing; Wan, Jizhong; Qu, Hong; Mu, Xianyun; Zhang, Zhixiang

2017-03-01

Many biological conservationists take actions to conserve plant species with extremely small populations (PSESP) in China; however, there have been few studies on the spatial distribution of threats to PSESP. Hence, we selected distribution data of PSESP and made a map of the spatial distribution of threats to PSESP in China. First, we used the weight assignment method to evaluate the threat risk to PSESP at both country and county scales. Second, we used a geographic information system to map the spatial distribution of threats to PSESP, and explored the threat factors based on linear regression analysis. Finally, we suggested some effective conservation options. We found that the PSESP with high values of protection, such as the plants with high scientific research values and ornamental plants, were threatened by over-exploitation and utilization, habitat fragmentation, and a small sized wild population in broad-leaved forests and bush fallows. We also identified some risk hotspots for PSESP in China. Regions with low elevation should be given priority for ex- and in-situ conservation. Moreover, climate change should be considered for conservation of PSESP. To avoid intensive over-exploitation or utilization and habitat fragmentation, in-situ conservation should be practiced in regions with high temperatures and low temperature seasonality, particularly in the high risk hotspots for PSESP that we proposed. Ex-situ conservation should be applied in these same regions, and over-exploitation and utilization of natural resources should be prevented. It is our goal to apply the concept of PSESP to the global scale in the future.

Race, Income Inequality, and Impervious Surfaces in Relation to Flooding Associated with Hurricane Harvey

NASA Astrophysics Data System (ADS)

de Sherbinin, A. M.; Mills, J.; Borkovska, O.

2017-12-01

Differential vulnerability is a concept that suggests that certain demographic groups - the poor, less educated, or minorities - are likely to be more impacted by climate extremes such as floods owing to their higher sensitivity and lower adaptive capacity. Differential exposure represents the concept that these same groups may be more highly exposed to flood events by virtue of their residing in less desirable, low-lying neighborhoods with higher percentages of impervious surface cover. This paper tests the hypothesis that poor communities of color were differentially exposed to flood risks in the aftermath of Hurricane Harvey, which struck Houston, Texas in August 2017. We explore the spatial relationship among census tracts with high percentages of low income communities of color, those with high percentages of impervious surface, and those most impacted by floods. We incorporat datasets disseminated by the NASA Socioeconomic Data and Application Center (SEDAC) - the Global Man-made Impervious Surface (GMIS) data set and the U.S. Census Grids 2010 - together with the American Community Survey (ACS) 2011-2015 and flood extent and depth data from FEMA. Preliminary analysis suggests that predominantly non-white neighborhoods have higher percentages of impervious surface cover, but that impervious surface cover is negatively correlated with flood risk. This paper will situate these findings in the context of a larger body of research exploring differential exposure to flood risks during Hurricanes Katrina and Sandy, as well as differential exposure to extreme heat in urban environments in Houston and beyond.

Spatial variability of excess mortality during prolonged dust events in a high-density city: a time-stratified spatial regression approach.

PubMed

Wong, Man Sing; Ho, Hung Chak; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Chan, Ta-Chien

2017-07-24

Dust events have long been recognized to be associated with a higher mortality risk. However, no study has investigated how prolonged dust events affect the spatial variability of mortality across districts in a downwind city. In this study, we applied a spatial regression approach to estimate the district-level mortality during two extreme dust events in Hong Kong. We compared spatial and non-spatial models to evaluate the ability of each regression to estimate mortality. We also compared prolonged dust events with non-dust events to determine the influences of community factors on mortality across the city. The density of a built environment (estimated by the sky view factor) had positive association with excess mortality in each district, while socioeconomic deprivation contributed by lower income and lower education induced higher mortality impact in each territory planning unit during a prolonged dust event. Based on the model comparison, spatial error modelling with the 1st order of queen contiguity consistently outperformed other models. The high-risk areas with higher increase in mortality were located in an urban high-density environment with higher socioeconomic deprivation. Our model design shows the ability to predict spatial variability of mortality risk during an extreme weather event that is not able to be estimated based on traditional time-series analysis or ecological studies. Our spatial protocol can be used for public health surveillance, sustainable planning and disaster preparation when relevant data are available.

Integrity management of offshore structures and its implication on computation of structural action effects and resistance

NASA Astrophysics Data System (ADS)

Moan, T.

2017-12-01

An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

PubMed

Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

2007-09-01

We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

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

PubMed

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

2014-12-01

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

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

NASA Astrophysics Data System (ADS)

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 regulators to promote transparency as to risk exposure and mitigation efforts. For the examples of mining companies provided, we note that the actual exposure is substantially higher than would be expected in the absence of space and time correlation of risk as is usually tacitly assumed. We also find evidence for the increasing exposure to climate-induced risk, and for decadal variability in exposure. The relative vulnerability of different portfolios to multiple extreme events in a given year is also demonstrated.

A study of the impacts of climate change scenarios on the plant hardiness zones of Albania

USDA-ARS?s Scientific Manuscript database

Maps of plant hardiness zones are useful tools for determining the extreme limits for the survival of plants. Exploration of projected climate change effects on hardiness zones can help identify areas most affected by climate change. Such studies are important in areas with high risks related to cli...

[Temporal and spatial variations of extreme climatic events in Songnen Grassland, Northeast China during 1960-2014].

PubMed

Ma, Qi Yun; Zhang, Ji Quan; Lai, Quan; Zhang, Feng; Dong, Zhen Hua; A, Lu Si

2017-06-18

Fourteen extreme climatic indices related with main regional meteorological disasters and vegetation growth were calculated based on daily data from 13 meteorological stations during 1960-2014 in Songnen Grassland, Northeast China. Then, the variation trend and the spatial and temporal patterns of climatic extreme events were analyzed by using regression analysis, break trend analy-sis, Mann-Kendall test, Sen's slope estimator and moving t-test method. The results indicated that summer days (SU25), warm days (TX90P), warm nights (TN90P) and warm spell duration (WSDI) representing extremely high temperatures showed significant increasing trends (P<0.05). Meanwhile, frost days (FD0), cold days (TX10P), cold nights (TN10P) and cold spell duration indicator (CSDI) representing extremely low temperatures showed obviously decreasing trends. The magnitudes of changes in cold indices (FD0, TX10P, TN10P and CSDI) were clearly greater than those of warm indices (SU25, TX90P, TN90P and WSDI), and that changes in night indices were larger than those of day indices. Regional climate warming trend was obvious from 1970 to 2009, and the most occurrences of the abrupt changes in these indices were identified in this period. The extreme precipitation indices did not show obvious trend, in general, SDII and CDD experienced a slightly decreasing trend while RX5D, R95P, PRCPTOT and CWD witnessed a mildly increasing trend. It may be concluded that regional climate changed towards warming and slightly wetting in Songnen Grassland. The most sensitive region for extreme temperature was distributed in the south and north region. Additionally, the extreme temperature indices showed clearly spatial difference between the south and the north. As for the spatial variations of extreme precipitation indices, the climate could be characterized by becoming wetter in northern region, and getting drier in southern region, especially in southwestern region with a high drought risk.

Soccer-Specific Warm-Up and Lower Extremity Injury Rates in Collegiate Male Soccer Players

PubMed Central

Grooms, Dustin R.; Palmer, Thomas; Onate, James A.; Myer, Gregory D.; Grindstaff, Terry

2013-01-01

Context: A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. Objective: To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. Design: Cohort study. Setting: One American collegiate soccer team followed for 2 seasons. Patients or Other Participants: Forty-one male collegiate athletes aged 18–25 years. Intervention(s): The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Main Outcome Measure(s): Lower extremity injury risk and time lost to lower extremity injury. Results: The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). Conclusions: This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes. PMID:23848519

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Development of an instrument for assessing workstyle in checkout cashier work (BAsIK).

PubMed

Kjellberg, Katarina; Palm, Peter; Josephson, Malin

2012-01-01

Checkout cashier work consists of handling a large number of items during a work shift, which implies repetitive movements of the shoulders, arms and hands/wrists, and a high work rate. The work is associated with a high prevalence of disorders in the neck and upper extremity. The concept of workstyle explains how ergonomic and psychosocial factors interact in the development of work-related upper extremity disorders. The aim of the project was to develop an instrument for the occupational health services to be used in the efforts to prevent upper extremity disorders in checkout cashier work. The instrument is based on the workstyle concept and is intended to be used as a tool to identify high-risk workstyle and needs for interventions, such as training and education. The instrument, BAsIK, consists of four parts; a questionnaire about workstyle, an observation protocol for work technique, a checklist about the design of the checkout and a questionnaire about work organization. The instrument was developed by selecting workstyle items developed for office work and adapting them to checkout cashier work, discussions with researchers and ergonomists, focus-group interviews with cashiers, observations of video recordings of cashiers, and studies of existing guidelines and checklists.

Early energy and protein intakes and associations with growth, BPD, and ROP in extremely preterm infants.

PubMed

Klevebro, Susanna; Westin, Vera; Stoltz Sjöström, Elisabeth; Norman, Mikael; Domellöf, Magnus; Edstedt Bonamy, Anna-Karin; Hallberg, Boubou

2018-05-29

Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in a high-risk population. This population-based cohort study includes infants born before 27 0/7 weeks of gestational age without severe malformations and surviving ≥10 days. Intake of energy and protein on postnatal days 4-6 and association with weight standard deviation score (WSDS) from birth to day 7, as well as intakes of energy and protein on postnatal days 4-6 and 7 to 27, respectively, and association with composite outcome of death and BPD and separate outcomes of BPD and ROP were examined, and adjusted for potential confounders. The cohort comprised 296 infants with a median gestational age of 25 3/7 weeks. Expressed as daily intakes, every additional 10 kcal/kg/d of energy during days 4-6 was associated with 0.08 higher WSDS on day 7 (95% CI 0.06-0.11; p < 0.001). Between days 7 and 27, every 10 kcal/kg/d increase in energy intake was associated with a reduced risk of BPD of 9% (95% CI 1-16; p = 0.029) and any grade of ROP with a reduced risk of 6% (95% CI 2-9; p = 0.005) in multivariable models. This association was statistically significant in infants with ≤10 days of mechanical ventilation. In infants with >10 days of mechanical ventilation, a combined higher intake of energy and protein was associated with a reduced risk of BPD. Early provision of energy and protein may reduce postnatal weight loss and risk of morbidity in extremely preterm infants. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Effects of Climate Change on Extreme Streamflow Risks in the Olympic National Park

NASA Astrophysics Data System (ADS)

Tohver, I. M.; Lee, S.; Hamlet, A.

2011-12-01

Conventionally, natural resource management practices are designed within the framework that past conditions serve as a baseline for future conditions. However, the warmer future climate projected for the Pacific Northwest will alter the region's flood and low flow risks, posing considerable challenges to resource managers in the Olympic National Forest (ONF) and Olympic National Park (ONP). Shifts in extreme streamflow will influence two key management objectives in the ONF and ONP: the protection of wildlife and the maintenance of road infrastructure. The ONF is charged with managing habitat for species listed under the Endangered Species Act (ESA), and with maintaining the network of forest roads and culverts. Climate-induced increases in flood severity will introduce additional challenges in road and culvert design. Furthermore, the aging road infrastructure and more extreme summer low flows will compromise aquatic habitats, intrinsic to the health of threatened and endangered fish species listed under the ESA. Current practice uses estimates of Q100 (or the peak flow with an estimated 100 year return frequency) as the standard metric for stream crossing design. Simple regression models relating annual precipitation and basin area to Q100 are used in the design process. Low flow estimates are based on historical streamflow data to calculate the 7-day consecutive lowest flow with a 10-year return interval, or 7Q10. Under the projections a changing climate, these methods for estimating extreme flows are ill equipped to capture the complex and spatially varying effects of seasonal changes in temperature, precipitation, and snowpack on extreme flow risk. As an alternative approach, this study applies a physically-based hydrologic model to estimate historical and future flood risk at 1/16th degree (latitude/longitude) resolution (about 32 km2). We downscaled climate data derived from 10 global climate models to use as input for the Variable Infiltration Capacity (VIC) model, a macro-scale hydrologic model, which simulates various hydrologic variables at a daily time step. Using the VIC estimates for baseflow and run-off, we calculated Q100 and 7Q10 for the historical period and under two emission scenarios, A1B and B1, at three future time intervals: the 2020s, the 2040s and the 2080s. We also calculated Q100 and 7Q10 at the spatial scale of the 12-digit hydrologic unit codes (HUCs) as delineated by the United States Geologic Survey. The results demonstrate the sensitivity of snowpack at mid-elevation basins to a warmer climate, resulting in more severe winter flooding and lower streamflows in the summertime. These ensemble estimates of extreme streamflows will serve as a tool for management practices by providing high-resolution maps of changing risk over the ONF and ONP.

AgroClimate: Simulating and Monitoring the Risk of Extreme Weather Events from a Crop Phenology Perspective

NASA Astrophysics Data System (ADS)

Fraisse, C.; Pequeno, D.; Staub, C. G.; Perry, C.

2016-12-01

Climate variability, particularly the occurrence of extreme weather conditions such as dry spells and heat stress during sensitive crop developmental phases can substantially increase the prospect of reduced crop yields. Yield losses or crop failure risk due to stressful weather conditions vary mainly due to stress severity and exposure time and duration. The magnitude of stress effects is also crop specific, differing in terms of thresholds and adaptation to environmental conditions. To help producers in the Southeast USA mitigate and monitor the risk of crop losses due to extreme weather events we developed a web-based tool that evaluates the risk of extreme weather events during the season taking into account the crop development stages. Producers can enter their plans for the upcoming season in a given field (e.g. crop, variety, planting date, acreage etc.), select or not a specific El Nino Southern Oscillation (ENSO) phase, and will be presented with the probabilities (ranging from 0 -100%) of extreme weather events occurring during sensitive phases of the growing season for the selected conditions. The DSSAT models CERES-Maize, CROPGRO-Soybean, CROPGRO-Cotton, and N-Wheat phenology models have been translated from FORTRAN to a standalone versions in R language. These models have been tested in collaboration with Extension faculty and producers during the 2016 season and their usefulness for risk mitigation and monitoring evaluated. A companion AgroClimate app was also developed to help producers track and monitor phenology development during the cropping season.

A large set of potential past, present and future hydro-meteorological time series for the UK

NASA Astrophysics Data System (ADS)

Guillod, Benoit P.; Jones, Richard G.; Dadson, Simon J.; Coxon, Gemma; Bussi, Gianbattista; Freer, James; Kay, Alison L.; Massey, Neil R.; Sparrow, Sarah N.; Wallom, David C. H.; Allen, Myles R.; Hall, Jim W.

2018-01-01

Hydro-meteorological extremes such as drought and heavy precipitation can have large impacts on society and the economy. With potentially increasing risks associated with such events due to climate change, properly assessing the associated impacts and uncertainties is critical for adequate adaptation. However, the application of risk-based approaches often requires large sets of extreme events, which are not commonly available. Here, we present such a large set of hydro-meteorological time series for recent past and future conditions for the United Kingdom based on weather@home 2, a modelling framework consisting of a global climate model (GCM) driven by observed or projected sea surface temperature (SST) and sea ice which is downscaled to 25 km over the European domain by a regional climate model (RCM). Sets of 100 time series are generated for each of (i) a historical baseline (1900-2006), (ii) five near-future scenarios (2020-2049) and (iii) five far-future scenarios (2070-2099). The five scenarios in each future time slice all follow the Representative Concentration Pathway 8.5 (RCP8.5) and sample the range of sea surface temperature and sea ice changes from CMIP5 (Coupled Model Intercomparison Project Phase 5) models. Validation of the historical baseline highlights good performance for temperature and potential evaporation, but substantial seasonal biases in mean precipitation, which are corrected using a linear approach. For extremes in low precipitation over a long accumulation period ( > 3 months) and shorter-duration high precipitation (1-30 days), the time series generally represents past statistics well. Future projections show small precipitation increases in winter but large decreases in summer on average, leading to an overall drying, consistently with the most recent UK Climate Projections (UKCP09) but larger in magnitude than the latter. Both drought and high-precipitation events are projected to increase in frequency and intensity in most regions, highlighting the need for appropriate adaptation measures. Overall, the presented dataset is a useful tool for assessing the risk associated with drought and more generally with hydro-meteorological extremes in the UK.

Risk Factors for Thirty-Day Readmissions After Lower Extremity Amputation in Patients With Vascular Disease.

PubMed

Vogel, Todd R; Smith, Jamie B; Kruse, Robin L

2018-05-29

Understanding risk factors associated with readmission after lower extremity amputation may indicate targets for reducing readmission. This study evaluated factors associated with all-cause 30-day readmission after lower extremity amputation procedures. Retrospective cohort study. Inpatient. A total of 2480 patients who had lower extremity amputations between 2008 and 2014 were selected from national electronic medical record database, Cerner Health Facts. Univariate analysis of demographics, diagnoses, postoperative medications, and laboratory results were examined. Multivariate logistic regression models were used to identify characteristics independently associated with readmission overall and by amputation location-above the knee (AKA) or below the knee (BKA). Readmission within 30 days of discharge. More than one half of patients (1403, 57%) underwent BKA and 1077 (43%) underwent AKA. Readmission within 30 days was 22% (24.1% BKA versus 19.4% AKA, P = .005). In multivariable logistic regression, factors associated with 30-day readmission after any amputation included BKA (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.15-1.74, P = .001), hypertension (OR 1.70, 95% CI 1.33-2.16), surgical-site infections (OR 1.44, 95% CI 1.02-2.04), heart failure (OR 1.39, 95% CI 1.10-1.75), discharge to a skilled nursing facility (OR 1.88, 95% CI 1.41-2.51), and emergency/urgent procedures (OR 1.32, 95% CI 1.04-1.67). At readmission, 13.3% of patients with a BKA required an AKA revision, and 21.3% had a diagnosis of surgical-site infection. Risk factors for readmission after any amputation included cardiac comorbidities, associated postoperative medications, and discharge to a skilled nursing facility. The finding that acute arterial embolism or thrombosis and a BKA during the index admission was highly associated with readmission, combined with the high rates of 30-day conversion to an AKA when readmitted, suggests these patients more often develop stump complications or may be undertreated during the initial hospitalization. III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Trauma transitional care coordination: A mature system at work.

PubMed

Hall, Erin C; Tyrrell, Rebecca L; Doyle, Karen E; Scalea, Thomas M; Stein, Deborah M

2018-05-01

We have previously demonstrated effectiveness of a Trauma Transitional Care Coordination (TTCC) Program in reducing 30-day readmission rates for trauma patients most at risk. With program maturation, we achieved improved readmission rates for specific patient populations. TTCC is a nursing driven program that supports patients at high risk for 30-day readmission. The TTCC interventions include calls to patients within 72 hours of discharge, complete medication reconciliation, coordination of medical appointments, and individualized problem solving. Account IDs were used to link TTCC patients with the Health Services Cost Review Commission database to collect data on statewide unplanned 30-day readmissions. Four hundred seventy-five patients were enrolled in the TTCC program from January 2014 to September 2016. Only 10.5% (n = 50) of TTCC enrollees were privately insured, 54.5% had Medicaid (n = 259), and 13.5% had Medicare (n = 64). Seventy-three percent had Health Services Cost Review Commission severity of injury ratings of 3 or 4 (maximum severity of injury = 4). The most common All Patient Refined Diagnosis Related Groups for participants were: lower-extremity procedures (n = 67, 14%); extensive abdominal/thoracic procedures (n = 40, 8.4%); musculoskeletal procedures (n = 37, 7.8%); complicated tracheostomy and upper extremity procedures (n = 29 each, 6.1%); infectious disease complications (n = 14, 2.9%); major chest/respiratory trauma, major small and large bowel procedures and vascular procedures (n = 13 each, 2.7%). The TTCC participants with lower-extremity injury, complicated tracheostomy, and bowel procedures had 6-point reduction (10% vs. 16%, p = 0.05), 11-point reduction (13% vs. 24%, p = 0.05), and 16-point reduction (11% vs. 27%, p = 0.05) in 30-day readmission rates, respectively, compared to those without TTCC. Targeted outpatient support for high-risk patients can decrease 30-day readmission rates. As our TTCC program matured, we reduced 30-day readmission in patients with lower-extremity injury, complicated tracheostomy and bowel procedures. This represents over one million-dollar savings for the hospital per year through quality-based reimbursement. Therapeutic/care management, level III.

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

PubMed

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

2008-04-01

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

Assessing the port to port risk of vessel movements vectoring non-indigenous marine species within and across domestic Australian borders.

PubMed

Campbell, Marnie L; Hewitt, Chad L

2011-07-01

Biofouling of vessels is implicated as a high risk transfer mechanism of non-indigenous marine species (NIMS). Biofouling on international vessels is managed through stringent border control policies, however, domestic biofouling transfers are managed under different policies and legislative arrangements as they cross internal borders. As comprehensive guidelines are developed and increased compliance of international vessels with 'clean hull' expectations increase, vessel movements from port to port will become the focus of biosecurity management. A semi-quantitative port to port biofouling risk assessment is presented that evaluates the presence of known NIMS in the source port and determines the likelihood of transfer based on the NIMS association with biofouling and environmental match between source and receiving ports. This risk assessment method was used to assess the risk profile of a single dredge vessel during three anticipated voyages within Australia, resulting in negligible to low risk outcomes. This finding is contrasted with expectations in the literature, specifically those that suggest slow moving vessels pose a high to extreme risk of transferring NIMS species.

Extreme Cognitions in Bipolar Spectrum Disorders: Associations with Personality Disorder Characteristics and Risk for Episode Recurrence

PubMed Central

Stange, Jonathan P.; Adams, Ashleigh Molz; O'Garro-Moore, Jared K.; Weiss, Rachel B.; Ong, Mian-Li; Walshaw, Patricia D.; Abramson, Lyn Y.; Alloy, Lauren B.

2014-01-01

Bipolar spectrum disorders (BSDs) are often characterized by cognitive inflexibility and affective extremities, including “extreme” or polarized thoughts and beliefs, which have been shown to predict a more severe course of illness. However, little research has evaluated factors that may be associated with extreme cognitions, such as personality disorders, which are often characterized by extreme, inflexible beliefs and also are associated with poor illness course in BSDs. The present study evaluated associations between BSDs, personality disorder characteristics, and extreme cognitions (polarized responses made on measures of attributional style and dysfunctional attitudes), as well as links between extreme cognitions and the occurrence of mood episodes, among euthymic young adults with BSDs (n = 83) and demographically-matched healthy controls (n = 89) followed prospectively for three years. The relationship between personality disorder characteristics and negative and positive extreme cognitions was stronger among BSD participants than among healthy controls, even after statistically accounting for general cognitive styles. Furthermore, extreme negative cognitions predicted the prospective onset of major depressive and hypomanic episodes. These results suggest that extreme cognitive styles are most common in individuals with BSDs and personality disorder characteristics, and they provide further evidence that extreme negative cognitions may confer risk for mood dysregulation. PMID:25645172

A hydro-meteorological model chain to assess the influence of natural variability and impacts of climate change on extreme events and propose optimal water management

NASA Astrophysics Data System (ADS)

von Trentini, F.; Willkofer, F.; Wood, R. R.; Schmid, F. J.; Ludwig, R.

2017-12-01

The ClimEx project (Climate change and hydrological extreme events - risks and perspectives for water management in Bavaria and Québec) focuses on the effects of climate change on hydro-meteorological extreme events and their implications for water management in Bavaria and Québec. Therefore, a hydro-meteorological model chain is applied. It employs high performance computing capacity of the Leibniz Supercomputing Centre facility SuperMUC to dynamically downscale 50 members of the Global Circulation Model CanESM2 over European and Eastern North American domains using the Canadian Regional Climate Model (RCM) CRCM5. Over Europe, the unique single model ensemble is conjointly analyzed with the latest information provided through the CORDEX-initiative, to better assess the influence of natural climate variability and climatic change in the dynamics of extreme events. Furthermore, these 50 members of a single RCM will enhance extreme value statistics (extreme return periods) by exploiting the available 1500 model years for the reference period from 1981 to 2010. Hence, the RCM output is applied to drive the process based, fully distributed, and deterministic hydrological model WaSiM in high temporal (3h) and spatial (500m) resolution. WaSiM and the large ensemble are further used to derive a variety of hydro-meteorological patterns leading to severe flood events. A tool for virtual perfect prediction shall provide a combination of optimal lead time and management strategy to mitigate certain flood events following these patterns.

International note: association between perceived resilience and health risk behaviours in homeless youth.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna

2015-02-01

Homeless youth are regarded as an extremely high risk group, susceptible to suicidal ideation substance abuse, and high rates of mental illness. While there exists a substantial body of knowledge regarding resilience of homeless youth, few studies has examined the relationship between perceived resilience and health risk behaviours. The present study describes the findings from a quantitative examination of street-related demographics, resilience, suicidal ideation, substance abuse, sexual risk behaviours and violent related behaviours among 227 homeless youth. The findings revealed that perceived resilience was negatively related to suicidal ideation, substance abuse and violence. Suicidal ideation was positively related to both substance abuse and violence, whilst violence and substance abuse were positively correlated. Multiple regressions showed that perceived resilience served as a protective factor for suicidal ideation and having multiple sexual lifetime partners, suggesting that youth with lower level of perceived resilience were more likely to engage in various health risks behaviours. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Bioclimatic conditions of the winter months in Western Kazakhstan and their dynamics in relation to climate change

NASA Astrophysics Data System (ADS)

Nyssanbayeva, Aiman S.; Cherednichenko, Alexandr V.; Cherednichenko, Vladimir S.; Abayev, Nurlan N.; Madibekov, Azamat S.

2018-03-01

The territory of West Kazakhstan is an intensively developing region. The main oil and gas fields are concentrated there. In addition, this region is well-known as a region of nomad cattle breeding. Both of industry and agriculture demand a lot of employees, working in the open air in wintertime. Severe winter conditions, primary very low temperatures, and strong winds characterize the region. In this work, we calculated and analyzed the spatial and temporal distributions of effective temperatures in the region and their dynamics due to the global warming in the last decades. To calculate the equivalent temperature (WCET) was used the method of OFCM 2003. Nowadays, it is known as a common method for similar studies. It was shown that in the observed region, WCET is significantly lower than the ambient temperature. Repeatability of WCET, corresponding to «increasing risk», «high risk» is high in the main part of the region. Global warming in the region results in returning extremely high temperatures of the air, decreasing repeatability of the average gradation of WCET approximately on 4%, but there is no any visible changing repeatability of extreme WCET. Obtained results can be used for planning any construction work in the open air and agriculture branches.

Bioclimatic conditions of the winter months in Western Kazakhstan and their dynamics in relation to climate change.

PubMed

Nyssanbayeva, Aiman S; Cherednichenko, Alexandr V; Cherednichenko, Vladimir S; Abayev, Nurlan N; Madibekov, Azamat S

2018-03-05

The territory of West Kazakhstan is an intensively developing region. The main oil and gas fields are concentrated there. In addition, this region is well-known as a region of nomad cattle breeding. Both of industry and agriculture demand a lot of employees, working in the open air in wintertime. Severe winter conditions, primary very low temperatures, and strong winds characterize the region. In this work, we calculated and analyzed the spatial and temporal distributions of effective temperatures in the region and their dynamics due to the global warming in the last decades. To calculate the equivalent temperature (WCET) was used the method of OFCM 2003. Nowadays, it is known as a common method for similar studies. It was shown that in the observed region, WCET is significantly lower than the ambient temperature. Repeatability of WCET, corresponding to «increasing risk», «high risk» is high in the main part of the region. Global warming in the region results in returning extremely high temperatures of the air, decreasing repeatability of the average gradation of WCET approximately on 4%, but there is no any visible changing repeatability of extreme WCET. Obtained results can be used for planning any construction work in the open air and agriculture branches.

Simulating US Agriculture in a Modern Dust Bowl Drought

NASA Technical Reports Server (NTRS)

Glotter, Michael; Elliott, Joshua

2016-01-01

Drought-induced agricultural loss is one of the most costly impacts of extreme weather, and without mitigation, climate change is likely to increase the severity and frequency of future droughts. The Dust Bowl of the 1930s was the driest and hottest for agriculture in modern US history. Improvements in farming practices have increased productivity, but yields today are still tightly linked to climate variation and the impacts of a 1930s-type drought on current and future agricultural systems remain unclear. Simulations of biophysical process and empirical models suggest that Dust-Bowl-type droughts today would have unprecedented consequences, with yield losses approx.50% larger than the severe drought of 2012. Damages at these extremes are highly sensitive to temperature, worsening by approx.25% with each degree centigrade of warming. We find that high temperatures can be more damaging than rainfall deficit, and, without adaptation, warmer mid-century temperatures with even average precipitation could lead to maize losses equivalent to the Dust Bowl drought. Warmer temperatures alongside consecutive droughts could make up to 85% of rain-fed maize at risk of changes that may persist for decades. Understanding the interactions of weather extremes and a changing agricultural system is therefore critical to effectively respond to, and minimize, the impacts of the next extreme drought event.

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

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Simulating US agriculture in a modern Dust Bowl drought.

PubMed

Glotter, Michael; Elliott, Joshua

2016-12-12

Drought-induced agricultural loss is one of the most costly impacts of extreme weather 1-3 , and without mitigation, climate change is likely to increase the severity and frequency of future droughts 4,5 . The Dust Bowl of the 1930s was the driest and hottest for agriculture in modern US history. Improvements in farming practices have increased productivity, but yields today are still tightly linked to climate variation 6 and the impacts of a 1930s-type drought on current and future agricultural systems remain unclear. Simulations of biophysical process and empirical models suggest that Dust-Bowl-type droughts today would have unprecedented consequences, with yield losses ∼50% larger than the severe drought of 2012. Damages at these extremes are highly sensitive to temperature, worsening by ∼25% with each degree centigrade of warming. We find that high temperatures can be more damaging than rainfall deficit, and, without adaptation, warmer mid-century temperatures with even average precipitation could lead to maize losses equivalent to the Dust Bowl drought. Warmer temperatures alongside consecutive droughts could make up to 85% of rain-fed maize at risk of changes that may persist for decades. Understanding the interactions of weather extremes and a changing agricultural system is therefore critical to effectively respond to, and minimize, the impacts of the next extreme drought event.

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

PubMed

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

2015-11-15

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-02-13

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

Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995.

PubMed

Silverstein, B; Welp, E; Nelson, N; Kalat, J

1998-12-01

This study examined the claim incidence rate, cost, and industry distribution of work-related upper extremity disorders in Washington. Washington State Fund workers' compensation claims from 1987 to 1995 were abstracted and categorized into general and specific disorders of gradual or sudden onset. Accepted claims included 100,449 for hand/wrist disorders (incidence rate: 98.2/10,000 full-time equivalents; carpal tunnel syndrome rate: 27.3), 30,468 for elbow disorders (incidence rate: 29.7; epicondylitis rate: 11.7), and 55,315 for shoulder disorders (incidence rate: 54.0; rotator cuff syndrome rate: 19.9). Average direct workers' compensation claims costs (medical treatment and indemnity) were $15,790 (median: $6774) for rotator cuff syndrome, $12,794 for carpal tunnel syndrome (median: $4190), and $6593 for epicondylitis (median: $534). Construction and food processing were among the industries with the highest rate ratios for all disorders (> 4.0). Upper extremity disorders represent a large and costly problem in Washington State industry. Industries characterized by manual handling and repetitive work have high rate ratios. The contingent workforce appears to be at high risk.

Nanomedicine for safe healing of bone trauma: Opportunities and challenges

PubMed Central

Behzadi, Shahed; Luther, Gaurav A.; Harris, Mitchel B.; Farokhzad, Omid C.; Mahmoudi, Morteza

2017-01-01

Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing. During the last decade, nanomedicine has demonstrated substantial potential in addressing the two major issues intrinsic to orthopedic traumas (i.e., high infection risk and low bony reconstruction) through combatting bacterial infection and accelerating/increasing the effectiveness of the bone-healing process. This review presents an overview and discusses recent challenges and opportunities to address major orthopedic trauma through nanomedical approaches. PMID:28918266

Core stability: implications for dance injuries.

PubMed

Rickman, Ashley M; Ambegaonkar, Jatin P; Cortes, Nelson

2012-09-01

Dancers experience a high incidence of injury due to the extreme physical demands of dancing. The majority of dance injuries are chronic in nature and occur in the lower extremities and low back. Researchers have indicated decreased core stability (CS) as a risk factor for these injuries. Although decreased CS is suggested to negatively affect lower extremity joint motion and lumbar control during activity, this relationship has not been extensively discussed in previous dance literature. Understanding the relationship between CS and injury risk is important to help reduce dance injury incidence and improve performance. The purposes of this review were to discuss: 1. the core and components of CS, 2. the relationship between CS and injury, 3. CS assessment techniques, and 4. future dance CS research areas. CS is the integration of passive (non-contractile), active (contractile), and neural structures to minimize the effects of external forces and maintain stability. CS is maintained by a combination of muscle power, strength, endurance, and sensory-motor control of the lumbopelvic-hip complex. CS assessments include measuring muscle strength and power using maximal voluntary isometric and isokinetic contractions and measuring endurance using the Biering-Sorensen, plank, and lateral plank tests. Measuring sensory-motor control requires specialized equipment (e.g., balance platforms). Overall, limited research has comprehensively examined all components of CS together and their relationships to injury. Rather, previous researchers have separately examined core power, strength, endurance, or sensory-motor control. Future researchers should explore the multifactorial role of CS in reducing injury risk and enhancing performance in dancers.

Management of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.

PubMed

Sola, Chrystelle; Choquet, Olivier; Prodhomme, Olivier; Capdevila, Xavier; Dadure, Christophe

2014-05-01

Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures. © 2013 John Wiley & Sons Ltd.

A regressive storm model for extreme space weather

NASA Astrophysics Data System (ADS)

Terkildsen, Michael; Steward, Graham; Neudegg, Dave; Marshall, Richard

2012-07-01

Extreme space weather events, while rare, pose significant risk to society in the form of impacts on critical infrastructure such as power grids, and the disruption of high end technological systems such as satellites and precision navigation and timing systems. There has been an increased focus on modelling the effects of extreme space weather, as well as improving the ability of space weather forecast centres to identify, with sufficient lead time, solar activity with the potential to produce extreme events. This paper describes the development of a data-based model for predicting the occurrence of extreme space weather events from solar observation. The motivation for this work was to develop a tool to assist space weather forecasters in early identification of solar activity conditions with the potential to produce extreme space weather, and with sufficient lead time to notify relevant customer groups. Data-based modelling techniques were used to construct the model, and an extensive archive of solar observation data used to train, optimise and test the model. The optimisation of the base model aimed to eliminate false negatives (missed events) at the expense of a tolerable increase in false positives, under the assumption of an iterative improvement in forecast accuracy during progression of the solar disturbance, as subsequent data becomes available.

Response of snow-dependent hydrologic extremes to continued global warming

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diffenbaugh, Noah; Scherer, Martin; Ashfaq, Moetasim

2012-01-01

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

Meteorological risks as drivers of innovation for agroecosystem management

NASA Astrophysics Data System (ADS)

Gobin, Anne; Van de Vyver, Hans; Zamani, Sepideh; Curnel, Yannick; Planchon, Viviane; Verspecht, Ann; Van Huylenbroeck, Guido

2015-04-01

Devastating weather-related events recorded in recent years have captured the interest of the general public in Belgium. The MERINOVA project research hypothesis is that meteorological risks act as drivers of environmental innovation in agro-ecosystem management which is being tested using a "chain of risk" approach. The major objectives are to (1) assess the probability of extreme meteorological events by means of probability density functions; (2) analyse the extreme events impact of on agro-ecosystems using process-based bio-physical modelling methods; (3) identify the most vulnerable agro-ecosystems using fuzzy multi-criteria and spatial analysis; (4) uncover innovative risk management and adaptation options using actor-network theory and economic modelling; and, (5) communicate to research, policy and practitioner communities using web-based techniques. Generalized Extreme Value (GEV) theory was used to model annual rainfall maxima based on location-, scale- and shape-parameters that determine the centre of the distribution, the deviation of the location-parameter and the upper tail decay, respectively. Likewise the distributions of consecutive rainy days, rainfall deficits and extreme 24-hour rainfall were modelled. Spatial interpolation of GEV-derived return levels resulted in maps of extreme precipitation, precipitation deficits and wet periods. The degree of temporal overlap between extreme weather conditions and sensitive periods in the agro-ecosystem was determined using a bio-physically based modelling framework that couples phenological models, a soil water balance, crop growth and environmental models. 20-year return values were derived for frost, heat stress, drought, waterlogging and field access during different sensitive stages for different arable crops. Extreme yield values were detected from detrended long term arable yields and relationships were found with soil moisture conditions, heat stress or other meteorological variables during the season. A methodology for identifying agro-ecosystem vulnerability was developed using spatially explicit information and was tested for arable crop production in Belgium. The different components of vulnerability for a region include spatial information on meteorology, soil available water content, soil erosion, the degree of waterlogging, crop share and the diversity of potato varieties. The level of vulnerability and resilience of an agro-ecosystem is also determined by risk management. The types of agricultural risk and their relative importance differ across sectors and farm types. Risk types are further distinguished according to production, market, institutional, financial and liability risks. Strategies are often combined in the risk management strategy of a farmer and include reduction and prevention, mitigation, coping and impact reduction. Based on an extensive literature review, a portfolio of potential strategies was identified at farm, market and policy level. Research hypotheses were tested using an on-line questionnaire on knowledge of agricultural risk, measuring the general risk aversion of the farmer and risk management strategies. The "chain of risk" approach adopted as a research methodology allows for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risks related to extreme weather events in Belgium are mainly caused by heat, frost, excess rainfall, drought and storms, and their impact is predominantly felt by arable, horticultural and extensive dairy farmers. Quantification of the risk is evaluated in terms of probability of occurrence, magnitude, frequency and extent of impact on several agro-ecosystems services. The spatial extent of vulnerability is developed by integrating different layers of geo-information, while risk management is analysed using questionnaires and economic modelling methods. Future work will concentrate on the further development and testing of the currently developed modelling methodologies. https://merinova.vito.be The research is funded by the Belgian Science Policy Organisation (Belspo) under contract nr SD/RI/03A.

Spatially explicit assessment of heat health risk by using multi-sensor remote sensing images and socioeconomic data in Yangtze River Delta, China.

PubMed

Chen, Qian; Ding, Mingjun; Yang, Xuchao; Hu, Kejia; Qi, Jiaguo

2018-05-25

The increase in the frequency and intensity of extreme heat events, which are potentially associated with climate change in the near future, highlights the importance of heat health risk assessment, a significant reference for heat-related death reduction and intervention. However, a spatiotemporal mismatch exists between gridded heat hazard and human exposure in risk assessment, which hinders the identification of high-risk areas at finer scales. A human settlement index integrated by nighttime light images, enhanced vegetation index, and digital elevation model data was utilized to assess the human exposure at high spatial resolution. Heat hazard and vulnerability index were generated by land surface temperature and demographic and socioeconomic census data, respectively. Spatially explicit assessment of heat health risk and its driving factors was conducted in the Yangtze River Delta (YRD), east China at 250 m pixel level. High-risk areas were mainly distributed in the urbanized areas of YRD, which were mostly driven by high human exposure and heat hazard index. In some less-urbanized cities and suburban and rural areas of mega-cities, the heat health risks are in second priority. The risks in some less-developed areas were high despite the low human exposure index because of high heat hazard and vulnerability index. This study illustrated a methodology for identifying high-risk areas by combining freely available multi-source data. Highly urbanized areas were considered hotspots of high heat health risks, which were largely driven by the increasing urban heat island effects and population density in urban areas. Repercussions of overheating were weakened due to the low social vulnerability in some central areas benefitting from the low proportion of sensitive population or the high level of socioeconomic development. By contrast, high social vulnerability intensifies heat health risks in some less-urbanized cities and suburban areas of mega-cities.

Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

PubMed Central

Guo, Fuyou; Shashikiran, Tagilapalli; Chen, Xi; Yang, Lei; Liu, Xianzhi; Song, Laijun

2015-01-01

Background: Deep venous thrombosis (DVT) contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05). The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical patients. Multiple factors were identified as predictive of DVT in neurosurgical patients, including the presence of a tumor, an age greater than 50 years, hypertension, and immobility. PMID:26752303

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

ERIC Educational Resources Information Center

Bemiller, Jim; Hardin, Robin

2010-01-01

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

The impacts of climate change on the risk of natural disasters.

PubMed

van Aalst, Maarten K

2006-03-01

Human emissions of greenhouse gases are already changing our climate. This paper provides an overview of the relation between climate change and weather extremes, and examines three specific cases where recent acute events have stimulated debate on the potential role of climate change: the European heatwave of 2003; the risk of inland flooding, such as recently in Central Europe and Great Britain; and the harsh Atlantic hurricane seasons of 2004 and 2005. Furthermore, it briefly assesses the relation between climate change and El Niño, and the potential of abrupt climate change. Several trends in weather extremes are sufficiently clear to inform risk reduction efforts. In many instances, however, the potential increases in extreme events due to climate change come on top of alarming rises in vulnerability. Hence, the additional risks due to climate change should not be analysed or treated in isolation, but instead integrated into broader efforts to reduce the risk of natural disasters.

Correlations Between Extreme Atmospheric Hazards and Global Teleconnections: Implications for Multihazard Resilience

NASA Astrophysics Data System (ADS)

Steptoe, H.; Jones, S. E. O.; Fox, H.

2018-03-01

Occurrences of concurrent extreme atmospheric hazards represent a significant area of uncertainty for organizations involved in disaster mitigation and risk management. Understanding risks posed by natural disasters and their relationship with global climate drivers is crucial in preparing for extreme events. In this review we quantify the strength of the physical mechanisms linking hazards and atmosphere-ocean processes. We demonstrate how research from the science community may be used to support disaster risk reduction and global sustainable development efforts. We examine peer-reviewed literature connecting 16 regions affected by extreme atmospheric hazards and eight key global drivers of weather and climate. We summarize current understanding of multihazard disaster risk in each of these regions and identify aspects of the global climate system that require further investigation to strengthen our resilience in these areas. We show that some drivers can increase the risk of concurrent hazards across different regions. Organizations that support disaster risk reduction, or underwrite exposure, in multiple regions may have a heightened risk of facing multihazard losses. We find that 15 regional hazards share connections via the El Niño-Southern Oscillation, with the Indian Ocean Dipole, North Atlantic Oscillation, and the Southern Annular Mode being secondary sources of significant regional interconnectivity. From a hazard perspective, rainfall over China shares the most connections with global drivers and has links to both Northern and Southern Hemisphere modes of variability. We use these connections to assess the global likelihood of concurrent hazard occurrence in support of multihazard resilience and disaster risk reduction goals.

Practices and attitudes towards radiation risk disclosure for computed tomography: survey of emergency medicine residency program directors.

PubMed

Marin, Jennifer R; Thomas, Karen E; Mills, Angela M; Broder, Joshua S; Boutis, Kathy

2017-10-01

The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks. Two hundred and seventy-four (50.6%) of 542 eligible physicians responded. There were 82.1% (95% CI 76.8%, 86.6%) who reported almost always or most of the time discussing potential risks for patients ≤18 years; proportions for adults 19-40, 41-65, and >65 years were 50.6% (95% CI 44.4, 56.7%), 20.7% (95% CI 16.0, 26.0%), and 5.2% (95% CI 2.9, 8.5%), respectively (test for trend, p < 0.001). The proportion reporting being "extremely" or "very" comfortable discussing risks was 57.1% (95% CI 51.1, 63.2%). Patient/family CT request that the physician felt was not indicated was of "very high" or "high" importance for driving risk discussions in 86.4% of respondents. For 75.5%, patient/family query about radiation risks was of "high" or "very high" importance. Among 57.4% of respondents, the patient being elderly and/or having a reduced life expectancy was of "high" or "very high" importance in the decision not to discuss risk. Emergency physicians involved in residency leadership report frequently disclosing potential malignancy risks from CT at frequencies inversely proportional to patient age. About half are comfortable with discussions, and many discussions are driven by patient requests. Opportunities exist to optimize and standardize emergency department CT radiation risk disclosure practices.

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

PubMed

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

2017-09-01

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

Arc and resistance welding and tumours of the endocrine glands: a Swedish case-control study with focus on extremely low frequency magnetic fields.

PubMed

Håkansson, N; Stenlund, C; Gustavsson, P; Johansen, C; Floderus, B

2005-05-01

Mechanisms for potential effects of extremely low frequency (ELF) magnetic fields on carcinogenesis have not been identified. A potential pathway could be an interaction with the endocrine system. To analyse occupational exposure to ELF magnetic fields from welding, and tumours of the endocrine glands. This case-control study was based on a cohort with an increased prevalence of high exposed individuals. A total of 174 incident cases of tumours of the endocrine glands, 1985-94, were identified and data were obtained from 140 (80%) of these cases; 1692 controls frequency matched on sex and age were selected, and information on 1306 (77%) individuals was obtained. A short questionnaire was sent to a work administrator at the workplaces of the cases and controls. The exposure assessment was based on questions about job tasks, exposure to different types of welding, and exposure to solvents. There was an overall increased risk for all tumours of the endocrine glands for individuals who had been welding sometime during the follow up. The increased risk was attributable to arc welding; for resistance welding there was no clear evidence of an association. We found an increased risk for the adrenal glands in relation to arc welding, and for the parathyroid glands in relation to both arc welding and resistance welding. An imprecise increase in risk was also noted for tumours of the pituitary gland for arc welding. No confounding effect was found for solvent exposure, and there was no sign of biological interaction. The increased risks of endocrine gland tumours related to welding might be explained by exposure to high levels of ELF magnetic fields.

Arc and resistance welding and tumours of the endocrine glands: a Swedish case-control study with focus on extremely low frequency magnetic fields

PubMed Central

Hakansson, N; Stenlund, C; Gustavsson, P; Johansen, C; Floderus, B

2005-01-01

Background: Mechanisms for potential effects of extremely low frequency (ELF) magnetic fields on carcinogenesis have not been identified. A potential pathway could be an interaction with the endocrine system. Aims: To analyse occupational exposure to ELF magnetic fields from welding, and tumours of the endocrine glands. Methods: This case-control study was based on a cohort with an increased prevalence of high exposed individuals. A total of 174 incident cases of tumours of the endocrine glands, 1985–94, were identified and data were obtained from 140 (80%) of these cases; 1692 controls frequency matched on sex and age were selected, and information on 1306 (77%) individuals was obtained. A short questionnaire was sent to a work administrator at the workplaces of the cases and controls. The exposure assessment was based on questions about job tasks, exposure to different types of welding, and exposure to solvents. Results: There was an overall increased risk for all tumours of the endocrine glands for individuals who had been welding sometime during the follow up. The increased risk was attributable to arc welding; for resistance welding there was no clear evidence of an association. We found an increased risk for the adrenal glands in relation to arc welding, and for the parathyroid glands in relation to both arc welding and resistance welding. An imprecise increase in risk was also noted for tumours of the pituitary gland for arc welding. No confounding effect was found for solvent exposure, and there was no sign of biological interaction. Conclusion: The increased risks of endocrine gland tumours related to welding might be explained by exposure to high levels of ELF magnetic fields. PMID:15837851

Quantifying Changes in Future Intensity-Duration-Frequency Curves Using Multimodel Ensemble Simulations

NASA Astrophysics Data System (ADS)

Ragno, Elisa; AghaKouchak, Amir; Love, Charlotte A.; Cheng, Linyin; Vahedifard, Farshid; Lima, Carlos H. R.

2018-03-01

During the last century, we have observed a warming climate with more intense precipitation extremes in some regions, likely due to increases in the atmosphere's water holding capacity. Traditionally, infrastructure design and rainfall-triggered landslide models rely on the notion of stationarity, which assumes that the statistics of extremes do not change significantly over time. However, in a warming climate, infrastructures and natural slopes will likely face more severe climatic conditions, with potential human and socioeconomical consequences. Here we outline a framework for quantifying climate change impacts based on the magnitude and frequency of extreme rainfall events using bias corrected historical and multimodel projected precipitation extremes. The approach evaluates changes in rainfall Intensity-Duration-Frequency (IDF) curves and their uncertainty bounds using a nonstationary model based on Bayesian inference. We show that highly populated areas across the United States may experience extreme precipitation events up to 20% more intense and twice as frequent, relative to historical records, despite the expectation of unchanged annual mean precipitation. Since IDF curves are widely used for infrastructure design and risk assessment, the proposed framework offers an avenue for assessing resilience of infrastructure and landslide hazard in a warming climate.

A Framework to Understand Extreme Space Weather Event Probability.

PubMed

Jonas, Seth; Fronczyk, Kassandra; Pratt, Lucas M

2018-03-12

An extreme space weather event has the potential to disrupt or damage infrastructure systems and technologies that many societies rely on for economic and social well-being. Space weather events occur regularly, but extreme events are less frequent, with a small number of historical examples over the last 160 years. During the past decade, published works have (1) examined the physical characteristics of the extreme historical events and (2) discussed the probability or return rate of select extreme geomagnetic disturbances, including the 1859 Carrington event. Here we present initial findings on a unified framework approach to visualize space weather event probability, using a Bayesian model average, in the context of historical extreme events. We present disturbance storm time (Dst) probability (a proxy for geomagnetic disturbance intensity) across multiple return periods and discuss parameters of interest to policymakers and planners in the context of past extreme space weather events. We discuss the current state of these analyses, their utility to policymakers and planners, the current limitations when compared to other hazards, and several gaps that need to be filled to enhance space weather risk assessments. © 2018 Society for Risk Analysis.

DOE Office of Scientific and Technical Information (OSTI.GOV)

La, Trang H.; Wolden, Suzanne L.; Rodeberg, David A.

Purpose: To evaluate the incidence and prognostic factors for regional failure, with attention to the in-transit pathways of spread, in children with nonmetastatic rhabdomyosarcoma of the extremity. Methods and Materials: The Intergroup rhabdomyosarcoma studies III, IV-Pilot, and IV enrolled 226 children with rhabdomyosarcoma of the extremity. Failure at the in-transit (epitrochlear/brachial and popliteal) and proximal (axillary/infraclavicular and inguinal/femoral) lymph nodes was evaluated. The median follow-up for the surviving patients was 10.4 years. Results: Of the 226 children, 55 (24%) had clinical or pathologic evidence of either in-transit and/or proximal lymph node involvement at diagnosis. The actuarial 5-year risk of regionalmore » failure was 12%. The prognostic factors for poor regional control were female gender and lymph node involvement at diagnosis. In the 116 patients with a distal extremity primary tumor, 5% had in-transit lymph node involvement at diagnosis. The estimated 5-year incidences of in-transit and proximal nodal failure was 12% and 8%, respectively. The in-transit failure rate was 0% for patients who underwent radiotherapy and/or underwent lymph node sampling of the in-transit nodal site but was 15% for those who did not (p = .07). However, the 5-year event-free survival rate did not differ between these two groups (64% vs. 55%, respectively, p = .47). Conclusion: The high incidence of regional involvement necessitates aggressive identification and treatment of regional lymph nodes in patients with rhabdomyosarcoma of the extremity. In patients with distal extremity tumors, in-transit failures were as common as failures in more proximal regional sites. Patients who underwent complete lymph node staging with appropriate radiotherapy to the in-transit nodal site, if indicated, were at a slightly lower risk of in-transit failure.« less

Developmental Outcomes of Extremely Preterm Infants Born to Adolescent Mothers

PubMed Central

Bann, Carla; Higgins, Rosemary; Vohr, Betty

2015-01-01

BACKGROUND AND OBJECTIVES: Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers <20 compared with adult mothers ≥20 years and to identify socioeconomic risk factors that affect outcomes. METHODS: Retrospective cohort analysis of 211 infants >27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18- to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) ≥75th percentile. RESULTS: Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived ≥3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/P ≥75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores <85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P ≥75th percentile (relative risk 1.50, 95% confidence interval 1.08–2.07). Living ≥3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite <70 and neurodevelopmental impairment. CONCLUSIONS: ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers. PMID:25963007

The use of copula functions for predictive analysis of correlations between extreme storm tides

NASA Astrophysics Data System (ADS)

Domino, Krzysztof; Błachowicz, Tomasz; Ciupak, Maurycy

2014-11-01

In this paper we present a method used in quantitative description of weakly predictable hydrological, extreme events at inland sea. Investigations for correlations between variations of individual measuring points, employing combined statistical methods, were carried out. As a main tool for this analysis we used a two-dimensional copula function sensitive for correlated extreme effects. Additionally, a new proposed methodology, based on Detrended Fluctuations Analysis (DFA) and Anomalous Diffusion (AD), was used for the prediction of negative and positive auto-correlations and associated optimum choice of copula functions. As a practical example we analysed maximum storm tides data recorded at five spatially separated places at the Baltic Sea. For the analysis we used Gumbel, Clayton, and Frank copula functions and introduced the reversed Clayton copula. The application of our research model is associated with modelling the risk of high storm tides and possible storm flooding.

Extreme warming challenges sentinel status of kelp forests as indicators of climate change.

PubMed

Reed, Daniel; Washburn, Libe; Rassweiler, Andrew; Miller, Robert; Bell, Tom; Harrer, Shannon

2016-12-13

The desire to use sentinel species as early warning indicators of impending climate change effects on entire ecosystems is attractive, but we need to verify that such approaches have sound biological foundations. A recent large-scale warming event in the North Pacific Ocean of unprecedented magnitude and duration allowed us to evaluate the sentinel status of giant kelp, a coastal foundation species that thrives in cold, nutrient-rich waters and is considered sensitive to warming. Here, we show that giant kelp and the majority of species that associate with it did not presage ecosystem effects of extreme warming off southern California despite giant kelp's expected vulnerability. Our results challenge the general perception that kelp-dominated systems are highly vulnerable to extreme warming events and expose the more general risk of relying on supposed sentinel species that are assumed to be very sensitive to climate change.

Antenatal magnesium sulfate is beneficial or harmful in very preterm and extremely preterm neonates: a new insight.

PubMed

Garg, Bhawan Deep

2018-01-17

To evaluate whether antenatal MgSO 4 is beneficial or harmful in very preterm and extremely preterm neonates. We retrieved published literature through searches of PubMed or Medline, CINAHL, and the Cochrane Library. Results were restricted to systematic reviews, meta-analysis, randomized controlled trials (RCTs), and relevant observational studies. Evidence revealed that antenatal MgSO 4 has neuroprotective role in preterm neonates and it decreased the risk of cerebral palsy and gross motor dysfunction. Evidences regarding association of antenatal MgSO 4 with feed intolerance, NEC and SIP were from cohort studies and controversial. We should continue use antenatal MgSO 4 to all eligible patients according to protocol till the more robust evidence will suggest association with gastrointestinal complications. In the meantime, we should have a high index of suspicion of gastrointestinal complications in extremely preterms particularly <26 weeks of gestation.

Extreme warming challenges sentinel status of kelp forests as indicators of climate change

NASA Astrophysics Data System (ADS)

Reed, Daniel; Washburn, Libe; Rassweiler, Andrew; Miller, Robert; Bell, Tom; Harrer, Shannon

2016-12-01

The desire to use sentinel species as early warning indicators of impending climate change effects on entire ecosystems is attractive, but we need to verify that such approaches have sound biological foundations. A recent large-scale warming event in the North Pacific Ocean of unprecedented magnitude and duration allowed us to evaluate the sentinel status of giant kelp, a coastal foundation species that thrives in cold, nutrient-rich waters and is considered sensitive to warming. Here, we show that giant kelp and the majority of species that associate with it did not presage ecosystem effects of extreme warming off southern California despite giant kelp's expected vulnerability. Our results challenge the general perception that kelp-dominated systems are highly vulnerable to extreme warming events and expose the more general risk of relying on supposed sentinel species that are assumed to be very sensitive to climate change.

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

PubMed Central

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

2015-01-01

Objective Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and high plantar pressure. Patients and methods Patients diagnosed with type 1 (n=27) or type 2 (n=47) diabetes (mean age 60.0±15.0 years) were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan®. An exploratory analysis of the association of risk factors with PP was performed. Results Neuropathy was present in 28 (38%), and 39 (53%) had callosities in the heel region. Low forefoot arch was present in 57 (77%). Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2±0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI) was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. Conclusions This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU). Hallux valgus and hallux rigidus appeared to increase the PP under the medial forefoot and a high BMI appeared to increase the PP under the lateral forefoot. There is a need to construct a simple, valid, and reliable assessment routine to detect potential risk factors for the onset of DFU. PMID:26087865

Body Dissatisfaction and Eating-Related Problems on the College Campus: Usefulness of the Eating Disorder Inventory with a Nonclinical Population.

ERIC Educational Resources Information Center

Klemchuk, Helen P.; And Others

1990-01-01

Administered Eating Disorder Inventory (EDI) to 1,506 female undergraduates. Found very high rates of body dissatisfaction. EDI factor analysis yielded six-factor structure accounting for 41 percent of variance. Two risk groups were identified on basis of extreme EDI factor scores: body-dissatisfied group and binge-purge group with poor…

Botswana and Swaziland: report links violations of women's rights to HIV.

PubMed

Krauss, Kate

2007-12-01

In May 2007, Physicians for Human Rights (PHR) released a report investigating the links between discriminatory views against women in Botswana and Swaziland and sexual risk-taking and, in turn, extremely high HIV prevalence in those countries. The report also examines the role of women's lack of political and economic power in those countries, and the connection to HIV infection.

A single tri-epitopic antibody virtually recapitulates the potency of a combination of three monoclonal antibodies in neutralization of Botulinum Neurotoxin Serotype A

USDA-ARS?s Scientific Manuscript database

Botulinum neurotoxins (BoNTs) are one of the six highest-risk threat agents for bioterrorism, due to their extreme potency and lethality, ease of production, and need for prolonged intensive care of intoxicated patients. The current standard of treatment, equine antitoxin, has a high incidence of al...

An Inner-City School Mentor: A Narrative Inquiry of the Life Experiences of "Daddy"

ERIC Educational Resources Information Center

Li, Xin; Lal, Dhyan

2006-01-01

A two-year ethnographic observation of an inner-city high school in Los Angeles, USA, indicated that the principal, who was extremely dedicated to at-risk students and possessed a unique style of mentoring, played a major role in students academic achievement. We--the principal and the researcher who observed the school--inquired about the…

Detectors in Extreme Conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blaj, G.; Carini, G.; Carron, S.

2015-08-06

Free Electron Lasers opened a new window on imaging the motion of atoms and molecules. At SLAC, FEL experiments are performed at LCLS using 120Hz pulses with 10 12 - 10 13 photons in 10 femtoseconds (billions of times brighter than the most powerful synchrotrons). This extreme detection environment raises unique challenges, from obvious to surprising. Radiation damage is a constant threat due to accidental exposure to insufficiently attenuated beam, focused beam and formation of ice crystals reflecting the beam onto the detector. Often high power optical lasers are also used (e.g., 25TW), increasing the risk of damage or impedingmore » data acquisition through electromagnetic pulses (EMP). The sample can contaminate the detector surface or even produce shrapnel damage. Some experiments require ultra high vacuum (UHV) with strict design, surface contamination and cooling requirements - also for detectors. The setup is often changed between or during experiments with short turnaround times, risking mechanical and ESD damage, requiring work planning, training of operators and sometimes continuous participation of the LCLS Detector Group in the experiments. The detectors used most often at LCLS are CSPAD cameras for hard x-rays and pnCCDs for soft x-rays.« less

Climate Changes and Human Health: A Review of the Effect of Environmental Stressors on Cardiovascular Diseases Across Epidemiology and Biological Mechanisms.

PubMed

Giorgini, Paolo; Di Giosia, Paolo; Petrarca, Marco; Lattanzio, Francesco; Stamerra, Cosimo Andrea; Ferri, Claudio

2017-01-01

Climate change is rapidly affecting all the regions of our planet. The most relevant example is global warming, which impacts on the earth's ecosystems, threatening human health. Other effects include extreme variations in temperature and increases in air pollution. These events may negatively impact mortality and morbidity for cardiovascular diseases. In this review, we discuss the main effects of climate changes on cardiovascular diseases, reporting the epidemiological evidences and the biological mechanisms linking climate change consequences to hypertension, diabetes, ischemic heart diseases, heart failure and stroke. Up to now, findings suggest that humans acclimate under different weather conditions, even though extreme temperatures and higher levels of air pollution can influence health-related outcomes. In these cases, climate change adversely affects cardiovascular system and the high-risk subjects for cardiovascular diseases are those more exposed. Finally, we examine climate change implications on publich health and suggest adaptation strategies to monitor the high-risk population, and reduce the amount of hospital admissions associated to these events. Such interventions may minimize the costs of public health and reduce the mortality for cardiovascular diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Are maturation, growth and lower extremity alignment associated with overuse injury in elite adolescent ballet dancers?

PubMed

Bowerman, Erin; Whatman, Chris; Harris, Nigel; Bradshaw, Elizabeth; Karin, Janet

2014-11-01

To identify growth, maturation and biomechanical risk factors for overuse injury in elite adolescent ballet dancers. Maturation (Tanner scale), growth (foot length change) and age at onset of menarche were recorded in elite adolescent ballet dancers. A modified knee valgus angle and lateral tilt of the pelvis were measured using 2D video during two dance movements (fondu, temps levé) to quantify lower extremity alignment. Overuse dance injuries were recorded by a physiotherapist. The injury rate ratio (RR) associated with each variable was estimated using over-dispersed Poisson regression modelling. Changes in right foot length (RR = 1.41, CI = 0.93-2.13), right knee angles during the fondu (RR = 0.68, CI = 0.45-1.03) and temps levé (RR = 0.72, CI = 0.53-0.98), and pelvic angles during the temps levé on the left (RR = 0.52, CI = 0.30-0.90) and fondu on the right (RR = 1.28, CI = 0.91-1.80) were associated with substantial changes in injury risk. Rate of growth in elite adolescent ballet dancers is likely associated with an increase in risk of lower extremity overuse injury and better right lower extremity alignment is likely associated with a reduction in risk of right lower extremity overuse injury. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Refined Prediction Model for Core and Lower Extremity Sprains and Strains Among Collegiate Football Players.

PubMed

Wilkerson, Gary B; Colston, Marisa A

2015-06-01

Researchers have identified high exposure to game conditions, low back dysfunction, and poor endurance of the core musculature as strong predictors for the occurrence of sprains and strains among collegiate football players. To refine a previously developed injury-prediction model through analysis of 3 consecutive seasons of data. Cohort study. National Collegiate Athletic Association Division I Football Championship Subdivision football program. For 3 consecutive years, all 152 team members (age = 19.7 ± 1.5 years, height = 1.84 ± 0.08 m, mass = 101.08 ± 19.28 kg) presented for a mandatory physical examination on the day before initiation of preseason practice sessions. Associations between preseason measurements and the subsequent occurrence of a core or lower extremity sprain or strain were established for 256 player-seasons of data. We used receiver operating characteristic analysis to identify optimal cut points for dichotomous categorizations of cases as high risk or low risk. Both logistic regression and Cox regression analyses were used to identify a multivariable injury-prediction model with optimal discriminatory power. Exceptionally good discrimination between injured and uninjured cases was found for a 3-factor prediction model that included equal to or greater than 1 game as a starter, Oswestry Disability Index score equal to or greater than 4, and poor wall-sit-hold performance. The existence of at least 2 of the 3 risk factors demonstrated 56% sensitivity, 80% specificity, an odds ratio of 5.28 (90% confidence interval = 3.31, 8.44), and a hazard ratio of 2.97 (90% confidence interval = 2.14, 4.12). High exposure to game conditions was the dominant injury risk factor for collegiate football players, but a surprisingly mild degree of low back dysfunction and poor core-muscle endurance appeared to be important modifiable risk factors that should be identified and addressed before participation.

A Refined Prediction Model for Core and Lower Extremity Sprains and Strains Among Collegiate Football Players

PubMed Central

Wilkerson, Gary B.; Colston, Marisa A.

2015-01-01

Context Researchers have identified high exposure to game conditions, low back dysfunction, and poor endurance of the core musculature as strong predictors for the occurrence of sprains and strains among collegiate football players. Objective To refine a previously developed injury-prediction model through analysis of 3 consecutive seasons of data. Design Cohort study. Setting National Collegiate Athletic Association Division I Football Championship Subdivision football program. Patients or Other Participants For 3 consecutive years, all 152 team members (age = 19.7 ± 1.5 years, height = 1.84 ± 0.08 m, mass = 101.08 ± 19.28 kg) presented for a mandatory physical examination on the day before initiation of preseason practice sessions. Main Outcome Measure(s) Associations between preseason measurements and the subsequent occurrence of a core or lower extremity sprain or strain were established for 256 player-seasons of data. We used receiver operating characteristic analysis to identify optimal cut points for dichotomous categorizations of cases as high risk or low risk. Both logistic regression and Cox regression analyses were used to identify a multivariable injury-prediction model with optimal discriminatory power. Results Exceptionally good discrimination between injured and uninjured cases was found for a 3-factor prediction model that included equal to or greater than 1 game as a starter, Oswestry Disability Index score equal to or greater than 4, and poor wall-sit–hold performance. The existence of at least 2 of the 3 risk factors demonstrated 56% sensitivity, 80% specificity, an odds ratio of 5.28 (90% confidence interval = 3.31, 8.44), and a hazard ratio of 2.97 (90% confidence interval = 2.14, 4.12). Conclusions High exposure to game conditions was the dominant injury risk factor for collegiate football players, but a surprisingly mild degree of low back dysfunction and poor core-muscle endurance appeared to be important modifiable risk factors that should be identified and addressed before participation. PMID:25844856

Injuries and medical issues in softball.

PubMed

Briskin, Susannah M

2012-01-01

Softball is enjoyed by millions of female and male athletes of all ages and competitive levels. Windmill pitchers are at risk for developing overuse injuries in the throwing arm. Improper mechanics and lack of pitch counts may increase the risk for developing a pitching-related injury. Softball-related overuse injuries include proximal biceps tendinitis, upper extremity stress fractures, and ulnar neuritis. Acute injuries commonly occur in the lower extremity and include both fractures and ligamentous injuries. Sliding injuries account for a significant number of these lower extremity injuries. The addition of breakaway bases and mandatory use of protective headgear by defensive players may decrease acute injuries commonly seen in softball. Off-season programs should stress proper throwing and sliding mechanics, core conditioning, and a lower extremity neuromuscular education program.

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

PubMed

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

2009-07-01

To assess academic attainment and special educational needs (SEN) in extremely preterm children in middle childhood. Of 307 extremely preterm (< or =25 weeks) survivors born in the UK and Ireland in 1995, 219 (71%) were re-assessed at 11 years of age and compared to 153 classmates born at term, using standardised tests of cognitive ability and academic attainment and teacher reports of school performance and SEN. Multiple imputation was used to correct for selective dropout. Extremely preterm children had significantly lower scores than classmates for cognitive ability (-20 points; 95% CI -23 to -17), reading (-18 points; -22 to -15) and mathematics (-27 points; -31 to -23). Twenty nine (13%) extremely preterm children attended special school. In mainstream schools, 105 (57%) extremely preterm children had SEN (OR 10; 6 to 18) and 103 (55%) required SEN resource provision (OR 10; 6 to 18). Teachers rated 50% of extremely preterm children as having below average attainment compared with 5% of classmates (OR 18; 8 to 41). Extremely preterm children who entered compulsory education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR 2; 1.0 to 3.6). Extremely preterm survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources to access the national curriculum. The prevalence and impact of SEN are likely to increase as these children approach the transition to secondary school.

Long-Term Marine Traffic Monitoring for Environmental Safety in the Aegean Sea

NASA Astrophysics Data System (ADS)

Giannakopoulos, T.; Gyftakis, S.; Charou, E.; Perantonis, S.; Nivolianitou, Z.; Koromila, I.; Makrygiorgos, A.

2015-04-01

The Aegean Sea is characterized by an extremely high marine safety risk, mainly due to the significant increase of the traffic of tankers from and to the Black Sea that pass through narrow straits formed by the 1600 Greek islands. Reducing the risk of a ship accident is therefore vital to all socio-economic and environmental sectors. This paper presents an online long-term marine traffic monitoring work-flow that focuses on extracting aggregated vessel risks using spatiotemporal analysis of multilayer information: vessel trajectories, vessel data, meteorological data, bathymetric / hydrographic data as well as information regarding environmentally important areas (e.g. protected high-risk areas, etc.). A web interface that enables user-friendly spatiotemporal queries is implemented at the frontend, while a series of data mining functionalities extracts aggregated statistics regarding: (a) marine risks and accident probabilities for particular areas (b) trajectories clustering information (c) general marine statistics (cargo types, etc.) and (d) correlation between spatial environmental importance and marine traffic risk. Towards this end, a set of data clustering and probabilistic graphical modelling techniques has been adopted.

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

PubMed

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

2014-01-21

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

Maternal residential proximity to sources of extremely low frequency electromagnetic fields and adverse birth outcomes in a UK cohort.

PubMed

de Vocht, Frank; Hannam, Kimberly; Baker, Philip; Agius, Raymond

2014-04-01

Studies have suggested that exposure to extremely low frequency electromagnetic fields (ELF-EMF) may be associated with increased risk of adverse birth outcomes. This study tested the hypothesis that close proximity to residential ELF-EMF sources is associated with a reduction in birth weight and increased the risk of low birthweight (LBW), small for gestational age (SGA) and spontaneous preterm birth (SPTB). Closest residential proximity to high voltage cables, overhead power lines, substations or towers during pregnancy was calculated for 140356 singleton live births between 2004 and 2008 in Northwest England. Associations between proximity and risk for LBW, SGA and SPTB were calculated, as well as associations with birth weight directly. Associations were adjusted for maternal age, ethnicity, parity and for part of the population additionally for maternal smoking during pregnancy. Reduced average birth weight of 212 g (95% confidence interval (CI): -395 to -29 g) was found for close proximity to a source, and was largest for female births (-251 g (95% CI: -487 to -15 g)). No statistically significant increased risks for any clinical birth outcomes with residential proximity of 50 m or less were observed. Living close (50 m or less) to a residential ELF-EMF source during pregnancy is associated with suboptimal growth in utero, with stronger effects in female than in males. However, only a few pregnant women live this close to high voltage cables, overhead power lines, substations or towers, likely limiting its public health impact. © 2014 Wiley Periodicals, Inc.

[Hypercholesterolemia: a therapeutic approach].

PubMed

Moráis López, A; Lama More, R A; Dalmau Serra, J

2009-05-01

High blood cholesterol levels represent an important cardiovascular risk factor. Hypercholesterolemia is defined as levels of total cholesterol and low-density lipoprotein cholesterol above 95th percentile for age and gender. For the paediatric population, selective screening is recommended in children older than 2 years who are overweight, with a family history of early cardiovascular disease or whose parents have high cholesterol levels. Initial therapeutic approach includes diet therapy, appropriate physical activity and healthy lifestyle changes. Drug treatment should be considered in children from the age of 10 who, after having followed appropriate diet recommendations, still have very high LDL-cholesterol levels or moderately high levels with concomitant risk factors. In case of extremely high LDL-cholesterol levels, drug treatment should be taken into consideration at earlier ages (8 years old). Modest response is usually observed with bile acid-binding resins. Statins can be considered first-choice drugs, once evidence on their efficacy and safety has been shown.

Lower extremity mechanics during landing after a volleyball block as a risk factor for anterior cruciate ligament injury.

PubMed

Zahradnik, David; Jandacka, Daniel; Uchytil, Jaroslav; Farana, Roman; Hamill, Joseph

2015-02-01

To compare lower extremity mechanics and energy absorption during two types of landing after a successful or unsuccessful block in volleyball and assess the risks of anterior cruciate ligament (ACL) injury. Cohort study. Fourteen elite male volleyball players (aged 24.5 ± 4.6 years; height 1.94 ± 0.06 m; mass 86.6 ± 7.6 kg). Subjects were required to land on force platforms using stick landing or step-back landing (with the right lower extremity stepping back away from the net) techniques after performing a standing block jump movement. Vertical ground reaction force (body weight); knee flexion (degrees); knee moments (Nm/kg); and hip, knee and ankle energy absorption (J/kg). The right lower extremity showed a greater first peak of vertical ground reaction force, a greater valgus moment, lower energy absorption by the knee, and higher energy absorption by the hip and ankle joints during step-back landing. The lower extremity may be exposed to a greater risk of ACL injury when stepping back from the net during the initial impact phase after a step-back landing. Copyright © 2014 Elsevier Ltd. All rights reserved.

High Resolution Simulation of a Colorado Rockies Extreme Snow and Rain Event in both a Current and Future Climate

NASA Astrophysics Data System (ADS)

Rasmussen, Roy; Ikeda, Kyoko; Liu, Changhai; Gutmann, Ethan; Gochis, David

2016-04-01

Modeling of extreme weather events often require very finely resolved treatment of atmospheric circulation structures in order to produce and localize the large moisture fluxes that result in extreme precipitation. This is particularly true for cool season orographic precipitation processes where the representation of the landform can significantly impact vertical velocity profiles and cloud moisture entrainment rates. This study presents results for high resolution regional climate modeling study of the Colorado Headwaters region using an updated version of the Weather Research and Forecasting (WRF) model run at 4 km horizontal resolution and a hydrological extension package called WRF-Hydro. Previous work has shown that the WRF modeling system can produce credible depictions of winter orographic precipitation over the Colorado Rockies if run at horizontal resolutions < 6 km. Here we present results from a detailed study of an extreme springtime snowfall event that occurred along the Colorado Front Range in March 2003. Results from the impact of warming on total precipitation, snow-rain partitioning and surface hydrological fluxes (evapotranspiration and runoff) will be discussed in the context of how potential changes in temperature impact the amount of precipitation, the phase of precipitation (rain vs. snow) and the timing and amplitude of streamflow responses. The results show using the Pseudo Global Warming technique that intense precipitation rates significantly increased during the event and a significant fraction of the snowfall converts to rain which significantly amplifies the runoff response from one where runoff is produced gradually to one in which runoff is rapidly translated into streamflow values that approach significant flooding risks. Results from a new, CONUS scale high resolution climate simulation of extreme events in a current and future climate will be presented as time permits.

Risk Factors for Neck and Upper Extremity Disorders among Computers Users and the Effect of Interventions: An Overview of Systematic Reviews

PubMed Central

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

2011-01-01

Background To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. Methodology/Principal Findings PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Conclusions/Significance Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented. PMID:21589875

Heightened extended amygdala metabolism following threat characterizes the early phenotypic risk to develop anxiety-related psychopathology

PubMed Central

Shackman, Alexander J.; Fox, Andrew S.; Oler, Jonathan A.; Shelton, Steven E.; Oakes, Terrence R.; Davidson, Richard J.; Kalin, Ned H.

2016-01-01

Children with an anxious temperament (AT) are prone to heightened shyness and behavioral inhibition (BI). When chronic and extreme, this anxious, inhibited phenotype is an important early-life risk factor for the development of anxiety disorders, depression, and co-morbid substance abuse. Individuals with extreme AT often show persistent distress in the absence of immediate threat and this contextually inappropriate anxiety predicts future symptom development. Despite its clear clinical relevance, the neural circuitry governing the maladaptive persistence of anxiety remains unknown. Here, we used a well-established nonhuman primate model of childhood temperament and high-resolution 18fluorodeoxyglucose positron emission tomography (FDG-PET) imaging to understand the neural systems governing persistent anxiety and clarify their relevance to early-life phenotypic risk. We focused on BI, a core component of anxious temperament, because it affords the moment-by-moment temporal resolution needed to assess contextually appropriate and inappropriate anxiety. From a pool of 109 peri-adolescent rhesus monkeys, we formed groups characterized by high or low levels of BI, as indexed by freezing in response to an unfamiliar human intruder’s profile. The High-BI group showed consistently elevated signs of anxiety and wariness across more than 2 years of assessments. At the time of brain imaging, 1.5 years after initial phenotyping, the High-BI group showed persistently elevated freezing during a 30-min ‘recovery’ period following an encounter with the intruder — more than an order of magnitude greater than the Low-BI group — and this was associated with increased metabolism in the bed nucleus of the stria terminalis, a key component of the central extended amygdala. These observations provide a neurobiological framework for understanding the early phenotypic risk to develop anxiety-related psychopathology, for accelerating the development of improved interventions, and for understanding the origins of childhood temperament. PMID:27573879

Extreme metabolic alkalosis in intensive care.

PubMed

Tripathy, Swagata

2009-10-01

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

Improving Communication About Potentially Catastrophic Risks of Climate Change

NASA Astrophysics Data System (ADS)

Ward, R. E. T.; Stern, N. H.

2014-12-01

Scientific assessments of future climate change tend to focus on central estimates and may understate or ignore the significance of low probability outcomes that may have extremely severe consequences. This relative neglect of tail risks is partly a result of traditions in prediction and forecasting, and conservatism about phenomena for which few data and information exist. The misinterpretation of such scientific assessments can have adverse results. Even though the central estimates of high emissions scenarios present obvious dangers, the tails of lower emissions scenarios still contain very serious risks which may be overlooked by policy-makers. Economic analyses may omit the possibility of catastrophic impacts, leading to substantial under-estimates of damage caused by climate change. So how do we avoid these shortcomings and achieve more effective communication about the risks of climate change? The scientific assessments of climate change differ in significant ways from the formal risk assessment methods successfully employed in other fields. We outline a 'good practice' approach to the identification, assessment and communication of potentially catastrophic risks based on examples from sectors such as civil engineering, national security and insurance. We illustrate how this 'good practice' approach could be applied to provide a better presentation of some catastrophic tail risks that are outlined in the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. The risks we consider include the possibility of 'extreme' rises in temperature and sea level lying outside the central projections described in the report, and the plausibility of significant releases of methane from the thawing of permafrost. Using these illustrations, we examine how scientific researchers can improve their communication about climate change to assist decision-making, and how policy-makers and politicians might respond differently to alternative presentations of information about the tail risks.

Investigation of mammographic breast density as a risk factor for ovarian cancer.

PubMed

Wernli, Karen J; O'Meara, Ellen S; Kerlikowske, Karla; Miglioretti, Diana L; Muller, Carolyn Y; Onega, Tracy; Sprague, Brian L; Henderson, Louise M; Buist, Diana S M

2014-01-01

Endogenous hormones and growth factors that increase mammographic breast density could increase ovarian cancer risk. We examined whether high breast density is associated with ovarian cancer risk. We conducted a cohort study of 724,603 women aged 40 to 79 years with 2,506,732 mammograms participating in the Breast Cancer Surveillance Consortium from 1995 to 2009. Incident epithelial ovarian cancer was diagnosed in 1373 women. We used partly conditional Cox regression to estimate the association between breast density and 5-year risk of incident epithelial ovarian cancer overall and stratified by 10-year age group. All statistical tests were two-sided. Compared with women with scattered fibroglandular densities, women with heterogeneously dense and extremely dense breast tissue had 20% and 18% increased 5-year risk of incident epithelial ovarian cancer (hazard ratio [HR] = 1.20, 95% confidence interval [CI] = 1.06 to 1.36; HR = 1.18, 95% CI = 0.93 to 1.50, respectively; P(trend) = .01). Among women aged 50 to 59 years, we observed a trend in elevated risk associated with increased breast density (P(trend) = .02); women with heterogeneously and extremely dense breast tissue had 30% (HR = 1.30; 95% CI = 1.03 to 1.64) and 65% (HR = 1.65; 95% CI = 1.12 to 2.44) increased risk, respectively, compared with women with scattered fibroglandular densities. The pattern was similar but not statistically significant at age 40 to 49 years. There were no consistent patterns of breast density and ovarian cancer risk at age 60 to 79 years. Dense breast tissue was associated with a modest increase in 5-year ovarian cancer risk in women aged 50 to 59 years but was not associated with ovarian cancer at ages 40 to 49 or 60 to 79 years.

Deadly heat waves projected in the densely populated agricultural regions of South Asia

PubMed Central

Im, Eun-Soon; Pal, Jeremy S.; Eltahir, Elfatih A. B.

2017-01-01

The risk associated with any climate change impact reflects intensity of natural hazard and level of human vulnerability. Previous work has shown that a wet-bulb temperature of 35°C can be considered an upper limit on human survivability. On the basis of an ensemble of high-resolution climate change simulations, we project that extremes of wet-bulb temperature in South Asia are likely to approach and, in a few locations, exceed this critical threshold by the late 21st century under the business-as-usual scenario of future greenhouse gas emissions. The most intense hazard from extreme future heat waves is concentrated around densely populated agricultural regions of the Ganges and Indus river basins. Climate change, without mitigation, presents a serious and unique risk in South Asia, a region inhabited by about one-fifth of the global human population, due to an unprecedented combination of severe natural hazard and acute vulnerability. PMID:28782036

Epidemiological role of birds in the transmission and maintenance of zoonoses.

PubMed

Contreras, A; Gómez-Martín, A; Paterna, A; Tatay-Dualde, J; Prats-Van Der Ham, M; Corrales, J C; De La Fe, C; Sánchez, A

2016-12-01

The risk of zoonoses spreading from birds to humans is lower, quantitatively speaking, than the risk of transmission between other host groups, because the two taxonomic groups share fewer pathogens. Nevertheless, birds have a number of epidemiological characteristics that make them extremely important hosts in the transmission and maintenance of zoonoses, including their susceptibility to pathogens that are extremely hazardous to humans (such as highly pathogenic avian influenza virus, West Nile virus and Chlamydia psittaci) and their ability to travel long distances, especially in the case of migratory birds. The fact that the human diet includes poultry products (meat, eggs and their by-products) also means that most human cases of foodborne zoonoses are infections of avian origin. Lastly, close contact between humans and pet birds or urban birds leads to interactions of public health concern. This article sets out to describe the main factors that determine the role of birds in the epidemiology of zoonotic infections. © OIE (World Organisation for Animal Health), 2016.

Correlates of firesetting in a community sample of young adolescents.

PubMed

Martin, Graham; Bergen, Helen A; Richardson, Angela S; Roeger, Leigh; Allison, Stephen

2004-03-01

To investigate relationships between firesetting, antisocial behaviour, individual, family and parenting factors in a large community sample of adolescents. A cross-sectional study of students (n = 2596) aged 13 years on average, from 27 schools in South Australia with a questionnaire on firesetting, antisocial behaviour (adapted 21-item Self Report Delinquency Scale), risk-taking, drug use, suicidality, physical and sexual abuse, depressive symptomatology, hopelessness, anxiety, locus of control, self-esteem, family functioning (McMaster Family Assessment Device) and parenting style (Influential Relationships Questionnaire). Data analysis included chi2, anova and logistic regression. Large significant differences are found between firesetters and non-firesetters on all measures. Among adolescents with serious levels of antisocial behaviour (7+ acts included in diagnostic guidelines for DSM-IV conduct disorder), firesetters differ from non-firesetters in reporting more extreme antisocial behaviour (10+ acts), extreme drug use, suicidal behaviour, and perceived failure at school. Gender differences are apparent. A study limitation is the single item assessment of firesetting. Self-report firesetting is strongly associated with extreme antisocial behaviour in young community adolescents, in support of existing evidence from incarcerated delinquent and psychiatric populations. Early detection of community firesetters demands further assessment and intervention. Clinicians should consider its coexistence with serious drug use and high risk-taking (especially in girls), and suicidality, sexual and physical abuse (in boys).

Contamination risk and drinking water protection for a large-scale managed aquifer recharge site in a semi-arid karst region, Jordan

NASA Astrophysics Data System (ADS)

Xanke, Julian; Liesch, Tanja; Goeppert, Nadine; Klinger, Jochen; Gassen, Niklas; Goldscheider, Nico

2017-09-01

Karst aquifers in semi-arid regions are particularly threatened by surface contamination, especially during winter seasons when extremely variable rainfall of high intensities prevails. An additional challenge is posed when managed recharge of storm water is applied, since karst aquifers display a high spatial variability of hydraulic properties. In these cases, adapted protection concepts are required to address the interaction of surface water and groundwater. In this study a combined protection approach for the surface catchment of the managed aquifer recharge site at the Wala reservoir in Jordan and the downstream Hidan wellfield, which are both subject to frequent bacteriological contamination, is developed. The variability of groundwater quality was evaluated by correlating contamination events to rainfall, and to recharge from the reservoir. Both trigger increased wadi flow downstream of the reservoir by surface runoff generation and groundwater seepage, respectively. A tracer test verified the major pathway of the surface flow into the underground by infiltrating from pools along Wadi Wala. An intrinsic karst vulnerability and risk map was adapted to the regional characteristics and developed to account for the catchment separation by the Wala Dam and the interaction of surface water and groundwater. Implementation of the proposed protection zones for the wellfield and the reservoir is highly recommended, since the results suggest an extreme contamination risk resulting from livestock farming, arable agriculture and human occupation along the wadi. The applied methods can be transferred to other managed aquifer recharge sites in similar karstic environments of semi-arid regions.

Soil heavy metal pollution and risk assessment associated with the Zn-Pb mining region in Yunnan, Southwest China.

PubMed

Cheng, Xianfeng; Danek, Tomas; Drozdova, Jarmila; Huang, Qianrui; Qi, Wufu; Zou, Liling; Yang, Shuran; Zhao, Xinliang; Xiang, Yungang

2018-03-07

The environmental assessment and identification of sources of heavy metals in Zn-Pb ore deposits are important steps for the effective prevention of subsequent contamination and for the development of corrective measures. The concentrations of eight heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) in soils from 40 sampling points around the Jinding Zn-Pb mine in Yunnan, China, were analyzed. An environmental quality assessment of the obtained data was performed using five different contamination and pollution indexes. Statistical analyses were performed to identify the relations among the heavy metals and the pH in soils and possible sources of pollution. The concentrations of As, Cd, Pb, and Zn were extremely high, and 23, 95, 25, and 35% of the samples, respectively, exceeded the heavy metal limits set in the Chinese Environmental Quality Standard for Soils (GB15618-1995, grade III). According to the contamination and pollution indexes, environmental risks in the area are high or extremely high. The highest risk is represented by Cd contamination, the median concentration of which exceeds the GB15618-1995 limit. Based on the combination of statistical analyses and geostatistical mapping, we identified three groups of heavy metals that originate from different sources. The main sources of As, Cd, Pb, Zn, and Cu are mining activities, airborne particulates from smelters, and the weathering of tailings. The main sources of Hg are dust fallout and gaseous emissions from smelters and tailing dams. Cr and Ni originate from lithogenic sources.

Safety of catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis: A systematic review and meta-analysis.

PubMed

Wang, Li; Zhang, Chuanlin; Mu, Shaoyu; Yeh, Chao Hsing; Chen, Liqun; Zhang, Zeju; Wang, Xueqin

2017-09-01

Despite established guidelines, catheter-directed thrombolysis (CDT) for the management of acute lower extremity deep vein thrombosis (DVT) should not be overstated because the risks of CDT are uncertain. We performed a meta-analysis to comprehensively and quantitatively evaluate the safety of CDT for patients with acute lower extremity DVT. Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE, and Scopus, were searched up to January 2017. The inclusion criteria were applied to select patients with acute lower extremity DVT treated by CDT or compared CDT with anticoagulation. In case series studies, the pooled estimates of safety outcomes for complications, pulmonary embolism (PE), and mortality were calculated across studies. In studies comparing CDT with anticoagulation, summary odds ratios (ORs) were calculated. Of the 1696 citations identified, 24 studies (6 comparing CDT with anticoagulation and 18 case series) including 9157 patients met the eligibility criteria. In the case series studies, the pooled risks of major, minor, and total complications were 0.03 (95% confidence interval [CI]: 0.02-0.04), 0.07 (95% CI: 0.05-0.08), and 0.09 (95% CI: 0.08-0.11), respectively; other pooled risk results were 0.00 for PE (95% CI: 0.00-0.01) and 0.07 for mortality (95% CI: 0.03-0.11). Our meta-analysis of 6 studies comparing the risk of complications and PE related to CDT with those related to anticoagulation showed that CDT was associated with an increased risk of complications (OR = 4.36; 95% CI: 2.94-6.47) and PE (OR = 1.57; 95% CI: 1.37-1.79). Acute lower extremity DVT patients receiving CDT are associated with a low risk of complications. However, compared with anticoagulation, CDT is associated with a higher risk of complications and PE. Rare mortality related to thrombolytic therapy was reported. More evidence should be accumulated to prove the safety of CDT.

Multimodality management of soft tissue tumors in the extremity

PubMed Central

Crago, Aimee M.; Lee, Ann Y.

2016-01-01

Most extremity soft tissue sarcomas present as a painless mass. Workup should generally involve cross-sectional imaging with MRI, as well as a core biopsy for pathologic diagnosis. Limb-sparing surgery is the standard of care, and may be supplemented with radiation for histologic subtypes at higher risk for local recurrence and chemotherapy for those at higher risk for distant metastases. This article reviews the work-up and surgical approach to extremity soft tissue sarcomas, as well as the role for radiation and chemotherapy, with particular attention given to the distinguishing characteristics of some of the most common subtypes. PMID:27542637

Impacts of climate change on heat-related mortality risk across the Middle East and North Africa (MENA)

NASA Astrophysics Data System (ADS)

Moradkhani, H.; Ahmadalipour, A.

2017-12-01

It has been reported that even if the global mean temperature increase is limited to 2°C, warming over land will be far beyond that in many regions. Global climate change will increase the frequency and intensity of heatwaves and extreme high temperatures, which will in turn have severe impacts on human life. In this study, the mortality risk caused by excessive heat stress is investigated. Daily maximum air temperature and relative humidity are acquired from 17 CMIP5 Regional Climate Models (RCMs) developed by CORDEX at 0.44 degree spatial resolution. Then, the daily wet-bulb temperature is calculated and a recently developed health risk model is implemented to quantify the mortality risk. The study is applied over the latitudes 6.6°S-42°N and longitudes 20°W-60°E covering parts of 70 countries and accommodating over 600 million inhabitants. The analysis is performed for the historical period of 1951-2005 as well as two future scenarios of RCP4.5 (moderate) and RCP8.5 (business as usual) during 2006-2100. Results indicate about 5 to 30 times higher mortality risk in distant future compared to the historical period. The most aggravation of mortality risk over land is found at the southwestern regions of MENA, due to substantial increase in frequency and intensity of extreme temperatures. Mortality risk is found to be much higher over open waters and coastal regions due to abundant humidity, especially in the coastal regions of the Red sea and Persian Gulf.

KSC-08pd1920

NASA Image and Video Library

2008-07-10

CAPE CANAVERAL, Fla. – In the Tile Shop at NASA's Kennedy Space Center, shelves are stacked with Boeing Rigid Insulation-18, or BRI-18, tiles. BRI-18 is the strongest material used for thermal insulation on the orbiters and, when coated to produce toughened unipiece fibrous insulation, provides a tile with extremely high-impact resistance. It is replacing tiles on areas of the vehicle where impact risk is high. These areas include the landing gear doors, the wing leading edge and the external tank doors. Photo credit: NASA/Jim Grossmann

KSC-08pd1919

NASA Image and Video Library

2008-07-10

CAPE CANAVERAL, Fla. – In the Tile Shop at NASA's Kennedy Space Center, shelves are stacked with Boeing Rigid Insulation-18, or BRI-18, tiles. BRI-18 is the strongest material used for thermal insulation on the orbiters and, when coated to produce toughened unipiece fibrous insulation, provides a tile with extremely high-impact resistance. It is replacing tiles on areas of the vehicle where impact risk is high. These areas include the landing gear doors, the wing leading edge and the external tank doors. Photo credit: NASA/Jim Grossmann

The risk factors and clinical outcomes of upper extremity deep vein thrombosis.

PubMed

Lee, Jung-Ah; Zierler, Brenda K; Zierler, R Eugene

2012-02-01

The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year period. Medical records of 373 consecutive patients who underwent upper extremity venous duplex ultrasound (VDU) examination were retrospectively reviewed. A quarter of the patients screened by VDU (94 of 373) had acute UEDVT; 63% presented with arm swelling or arm pain; 48% had cancer; and 93% had indwelling CVCs. Cancer patients with CVCs were more likely to develop UEDVT (48%). Of the 94 UEDVTs, 16% had concurrent lower extremity DVT. The incidence of objectively confirmed pulmonary embolism (PE) was 9% (8 of 94 patients), and the 1-month mortality rate was 6.4%. The majority of patients (80%) with UEDVT received anticoagulation therapy and 20% were not treated. The most common risk factors for UEDVT were indwelling CVCs and a diagnosis of cancer. The incidence rate of PE and mortality rate from UEDVT were not insignificant at 9% and 6%, respectively. There were no institutional screening protocols for patients at risk of UEDVT associated with CVCs. Future research should focus on risk assessment and management protocols for patients at risk of UEDVT. In addition, a comparison of clinical outcomes associated with the type, size, and duration of catheter placement should be conducted in patients at risk of or diagnosed with UEDVT.

Weather based risks and insurances for crop production in Belgium

NASA Astrophysics Data System (ADS)

Gobin, Anne

2014-05-01

Extreme weather events such as late frosts, droughts, heat waves and rain storms can have devastating effects on cropping systems. Damages due to extreme events are strongly dependent on crop type, crop stage, soil type and soil conditions. The perspective of rising risk-exposure is exacerbated further by limited aid received for agricultural damage, an overall reduction of direct income support to farmers and projected intensification of weather extremes with climate change. According to both the agriculture and finance sectors, a risk assessment of extreme weather events and their impact on cropping systems is needed. The impact of extreme weather events particularly during the sensitive periods of the farming calendar requires a modelling approach to capture the mixture of non-linear interactions between the crop, its environment and the occurrence of the meteorological event. The risk of soil moisture deficit increases towards harvesting, such that drought stress occurs in spring and summer. Conversely, waterlogging occurs mostly during early spring and autumn. Risks of temperature stress appear during winter and spring for chilling and during summer for heat. Since crop development is driven by thermal time and photoperiod, the regional crop model REGCROP (Gobin, 2010) enabled to examine the likely frequency, magnitude and impacts of frost, drought, heat stress and waterlogging in relation to the cropping season and crop sensitive stages. The risk profiles were subsequently confronted with yields, yield losses and insurance claims for different crops. Physically based crop models such as REGCROP assist in understanding the links between different factors causing crop damage as demonstrated for cropping systems in Belgium. Extreme weather events have already precipitated contraction of insurance coverage in some markets (e.g. hail insurance), and the process can be expected to continue if the losses or damages from such events increase in the future. Climate change will stress this further and impacts on crop growth are expected to be twofold, owing to the sensitive stages occurring earlier during the growing season and to the changes in return period of extreme weather events. Though average yields have risen continuously due to technological advances, there is no evidence that relative tolerance to adverse weather events has improved. The research is funded by the Belgian Science Policy Organisation (Belspo) under contract nr SD/RI/03A.

Esophageal cancer in high-risk areas of China: research progress and challenges.

PubMed

Lin, Yingsong; Totsuka, Yukari; Shan, Baoen; Wang, Chaochen; Wei, Wenqiang; Qiao, Youlin; Kikuchi, Shogo; Inoue, Manami; Tanaka, Hideo; He, Yutong

2017-03-01

The extremely high incidence of esophageal cancer in certain rural areas of China has prompted significant intellectual curiosity and research efforts both in China and abroad. We summarize the research progress over the past several decades in high-risk areas (Linxian, Cixian, Shexian, and Yanting) based on literature research and our field trip (2012-2013). Considerable progress in clarifying the environmental risk factors and pathogenesis of esophageal cancer in high-risk areas has been achieved over the past several decades. Epidemiologic evidence suggests that carcinogen exposure and nutritional deficiency, rather than smoking and drinking, may be the major risk factors for esophageal cancer in the Taihang Mountains region, where the incidence of esophageal cancer is among the highest in the world. Two genome-wide association studies have identified variants in PLCE1 at 10q23 that are significantly associated with esophageal cancer risk. Recent whole-exome studies have revealed a comprehensive mutation pattern, in which the C>T transition is the predominant mutation type. Despite extensive research, the main causative factors that contribute to esophageal cancer in high-risk areas have not yet been elucidated. Challenges in this research area include determining the causative role of nitrosamine, identifying other potential carcinogens, and conducting fruitful international collaborative studies based on a multidisciplinary approach. Increased international collaboration will contribute to a better understanding of the etiology of esophageal cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

Outcomes for Extremely Premature Infants

PubMed Central

Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

2015-01-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (< 1000 grams) remain at high risk for death and disability with 30–50% mortality and, in survivors, at least 20–50% risk of morbidity. The introduction of CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, since therapy and supportive care continue to change, the outcomes of ELBW infants are ever evolving. Efforts to minimize injury, preserve growth, and identify interventions focused on antioxidant and anti-inflammatory pathways are now being evaluated. Thus, treating and preventing long-term deficits must be developed in the context of a “moving target.” PMID:25988638

Dynamic balance performance and noncontact lower extremity injury in college football players: an initial study.

PubMed

Butler, Robert J; Lehr, Michael E; Fink, Michael L; Kiesel, Kyle B; Plisky, Phillip J

2013-09-01

Field expedient screening tools that can identify individuals at an elevated risk for injury are needed to minimize time loss in American football players. Previous research has suggested that poor dynamic balance may be associated with an elevated risk for injury in athletes; however, this has yet to be examined in college football players. To determine if dynamic balance deficits are associated with an elevated risk of injury in collegiate football players. It was hypothesized that football players with lower performance and increased asymmetry in dynamic balance would be at an elevated risk for sustaining a noncontact lower extremity injury. Prospective cohort study. Fifty-nine collegiate American football players volunteered for this study. Demographic information, injury history, and dynamic balance testing performance were collected, and noncontact lower extremity injuries were recorded over the course of the season. Receiver operator characteristic curves were calculated based on performance on the Star Excursion Balance Test (SEBT), including composite score and asymmetry, to determine the population-specific risk cut-off point. Relative risk was then calculated based on these variables, as well as previous injury. A cut-off point of 89.6% composite score on the SEBT optimized the sensitivity (100%) and specificity (71.7%). A college football player who scored below 89.6% was 3.5 times more likely to get injured. Poor performance on the SEBT may be related to an increased risk for sustaining a noncontact lower extremity injury over the course of a competitive American football season. College football players should be screened preseason using the SEBT to identify those at an elevated risk for injury based upon dynamic balance performance to implement injury mitigation strategies to this specific subgroup of athletes.

A Systematic Review and Meta-Analysis of Perforator-Pedicled Propeller Flaps in Lower Extremity Defects: Identification of Risk Factors for Complications.

PubMed

Bekara, Farid; Herlin, Christian; Mojallal, Ali; Sinna, Raphael; Ayestaray, Benoit; Letois, Flavie; Chavoin, Jean Pierre; Garrido, Ignacio; Grolleau, Jean Louis; Chaput, Benoit

2016-01-01

Currently, increased interest in the perforator-pedicled propeller flap should not obscure the fact that it is, in reality, a complex procedure requiring experience and monitoring similar to free flaps. Through a meta-analysis, the authors aimed to identify the risk factors of perforator-pedicled propeller flap failure in lower extremity defects. The MEDLINE, PubMed Central, Embase, and Cochrane databases were searched from 1991 to May of 2014 for articles describing perforator-pedicled propeller flaps in the lower extremity. The study selection met the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Fixed-effects models were used. Forty articles complied with the inclusion criteria, representing 428 perforator-pedicled propeller flaps. The most common cause was posttraumatic (55.2 percent). Most of the defects were at the distal third of the lower leg (45.6 percent). The arc of rotation was 180 degrees for 34.3 percent. Complications were found in 25.2 percent, including partial necrosis (10.2 percent) and complete necrosis (3.5 percent). Complete flap survival was found in 84.3 percent. The authors identified three significant risk factors: age older than 60 years (relative risk, 1.61; p = 0.03), diabetes (relative risk, 2.00; p = 0.02), and arteriopathy (relative risk, 3.12; p = 0.01). No significant results were found regarding smoking status other than a tendency (p = 0.06), acute cause (p = 0.59), posttraumatic cause (p = 0.97), distal third of the lower leg (p = 0.66), fascia inclusion (p = 0.70), and pedicle rotation greater than 120 degrees (p = 0.41). Age older than 60 years, diabetes, and arteriopathy are significant risk factors of perforator-pedicled propeller flap complications in the lower extremity. Risk, IV.

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes.

PubMed

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

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

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes

PubMed Central

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

2016-01-01

Background: Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. Hypothesis: The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. Results: There were significant associations between concussion and lateral ankle sprain (P = 0.012), knee injury (P = 0.002), and lower extremity muscle strain (P = 0.031). There were also significant associations between reported concussions and knee injury (P = 0.003), unreported concussions and knee injury (P = 0.002), and unrecognized concussions and lateral ankle sprain (P = 0.001) and lower extremity muscle strains (P = 0.006), with odds ratios ranging from 1.6 to 2.9. Conclusion: There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinical Relevance: Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols. PMID:27587598

Assessment of Costs for a Global Climate Fund Against Public Sector Disaster Risks

NASA Astrophysics Data System (ADS)

Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith

2013-04-01

National governments are key actors in managing climate variability and change, yet, many countries, faced with exhausted tax bases, high levels of indebtedness and limited donor assistance, have been unable to raise sufficient and timely capital to replace or repair damaged assets and restore livelihoods following major disasters exacerbating the impacts of disaster shocks on poverty and development. For weather extremes, which form a subset of the adaptation challenge and are supposed to increase in intensity and frequency with a changing climate, we conduct an assessment of the costs of managing and financing today's public sector risks on a global scale for more than 180 countries. A countries financial vulnerability is defined as a function of its financial resilience and its exposure to disaster risk. While disaster risk is estimated in terms of asset loss distributions based on catastrophe modeling approaches, financial resilience is operationalized as the public sector's ability to pay for relief to the affected population and support the reconstruction of affected assets and infrastructure for a given event. We consider governments financially vulnerable to disasters if they cannot access sufficient funding after a disaster to cover their liabilities. We operationalize this concept by the term resource gap, which we define the net loss associated with a disaster event after exhausting all possible ex-post and ex ante financing sources. Extending this approach for all possible disaster events, the risk that a resource gap will occur over a given time-span can be calculated for each country individually and dependent on the risk level different risk instruments may have to be applied. Furthermore, our estimates may inform decisions pertaining to a "climate insurance fund" absorbing "high level" country risks exceeding the ability of any given country to pay in the case of an extreme event. Our estimates relate to today's climate, yet we suggest that estimates of current climate variability and related risks, although also associated with substantial uncertainty, can be interpreted as a baseline for very uncertain future projections.

Threats from Climate Change to Terrestrial Vertebrate Hotspots in Europe

PubMed Central

Maiorano, Luigi; Amori, Giovanni; Capula, Massimo; Falcucci, Alessandra; Masi, Monica; Montemaggiori, Alessandro; Pottier, Julien; Psomas, Achilleas; Rondinini, Carlo; Russo, Danilo; Zimmermann, Niklaus E.

2013-01-01

We identified hotspots of terrestrial vertebrate species diversity in Europe and adjacent islands. Moreover, we assessed the extent to which by the end of the 21st century such hotspots will be exposed to average monthly temperature and precipitation patterns which can be regarded as extreme if compared to the climate experienced during 1950-2000. In particular, we considered the entire European sub-continent plus Turkey and a total of 1149 species of terrestrial vertebrates. For each species, we developed species-specific expert-based distribution models (validated against field data) which we used to calculate species richness maps for mammals, breeding birds, amphibians, and reptiles. Considering four global circulation model outputs and three emission scenarios, we generated an index of risk of exposure to extreme climates, and we used a bivariate local Moran’s I to identify the areas with a significant association between hotspots of diversity and high risk of exposure to extreme climates. Our results outline that the Mediterranean basin represents both an important hotspot for biodiversity and especially for threatened species for all taxa. In particular, the Iberian and Italian peninsulas host particularly high species richness as measured over all groups, while the eastern Mediterranean basin is particularly rich in amphibians and reptiles; the islands (both Macaronesian and Mediterranean) host the highest richness of threatened species for all taxa occurs. Our results suggest that the main hotspots of biodiversity for terrestrial vertebrates may be extensively influenced by the climate change projected to occur over the coming decades, especially in the Mediterranean bioregion, posing serious concerns for biodiversity conservation. PMID:24066162

Threats from climate change to terrestrial vertebrate hotspots in Europe.

PubMed

Maiorano, Luigi; Amori, Giovanni; Capula, Massimo; Falcucci, Alessandra; Masi, Monica; Montemaggiori, Alessandro; Pottier, Julien; Psomas, Achilleas; Rondinini, Carlo; Russo, Danilo; Zimmermann, Niklaus E; Boitani, Luigi; Guisan, Antoine

2013-01-01

We identified hotspots of terrestrial vertebrate species diversity in Europe and adjacent islands. Moreover, we assessed the extent to which by the end of the 21(st) century such hotspots will be exposed to average monthly temperature and precipitation patterns which can be regarded as extreme if compared to the climate experienced during 1950-2000. In particular, we considered the entire European sub-continent plus Turkey and a total of 1149 species of terrestrial vertebrates. For each species, we developed species-specific expert-based distribution models (validated against field data) which we used to calculate species richness maps for mammals, breeding birds, amphibians, and reptiles. Considering four global circulation model outputs and three emission scenarios, we generated an index of risk of exposure to extreme climates, and we used a bivariate local Moran's I to identify the areas with a significant association between hotspots of diversity and high risk of exposure to extreme climates. Our results outline that the Mediterranean basin represents both an important hotspot for biodiversity and especially for threatened species for all taxa. In particular, the Iberian and Italian peninsulas host particularly high species richness as measured over all groups, while the eastern Mediterranean basin is particularly rich in amphibians and reptiles; the islands (both Macaronesian and Mediterranean) host the highest richness of threatened species for all taxa occurs. Our results suggest that the main hotspots of biodiversity for terrestrial vertebrates may be extensively influenced by the climate change projected to occur over the coming decades, especially in the Mediterranean bioregion, posing serious concerns for biodiversity conservation.

Morbidity and mortality after emergency lower extremity embolectomy.

PubMed

Casillas-Berumen, Sergio; Sadri, Lili; Farber, Alik; Eslami, Mohammad H; Kalish, Jeffrey A; Rybin, Denis; Doros, Gheorghe; Siracuse, Jeffrey J

2017-03-01

Emergency lower extremity embolectomy is a common vascular surgical procedure that has poorly defined outcomes. Our goal was to define the perioperative morbidity for emergency embolectomy and develop a risk prediction model for perioperative mortality. The American College of Surgeons National Surgical Quality Improvement database was queried to identify patients undergoing emergency unilateral and lower extremity embolectomy. Patients with previous critical limb ischemia, bilateral embolectomy, nonemergency indication, and those undergoing concurrent bypass were excluded. Patient characteristics and postoperative morbidity and mortality were analyzed. Multivariate analysis for predictors of mortality was performed, and from this, a risk prediction model was developed to identify preoperative predictors of mortality. There were 1749 patients (47.9% male) who met the inclusion criteria. The average age was 68.2 ± 14.8 years. Iliofemoral-popliteal embolectomy was performed in 1231 patients (70.4%), popliteal-tibioperoneal embolectomy in 303 (17.3%), and at both levels in 215 (12.3%). Fasciotomies were performed concurrently with embolectomy in 308 patients (17.6%). The 30-day postoperative mortality was 13.9%. Postoperative complications included myocardial infarction or cardiac arrest (4.7%), pulmonary complications (16.0%), and wound complications (8.2%). The rate of return to the operating room ≤30 days was 25.7%. Hospital length of stay was 9.8 ± 11.5 days, and the 30-day readmission rate was 16.3%. A perioperative mortality risk prediction model based on factors identified in multivariate analysis included age >70 years, male gender, functional dependence, history of chronic obstructive pulmonary disease, congestive heart failure, recent myocardial infarction/angina, chronic renal insufficiency, and steroid use. The model showed good discrimination (C = 0.769; 95% confidence interval, 0733-0.806) and calibrated well. Emergency lower extremity embolectomy has high morbidity, mortality, and resource utilization. These data provide a benchmark for this complex patient population and may assist in risk stratifying patients, allowing for improved informed consent and goals of care at the time of presentation. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis.

PubMed

Weber, Christian D; Horst, Klemens; Nguyen, Anthony R; Lefering, Rolf; Pape, Hans-Christoph; Hildebrand, Frank

2018-04-19

The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York). A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries. Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior. Descriptive Epidemiologic Study, Level II.

Dietary Flavonoid Intake Is Inversely Associated with Cardiovascular Disease Risk as Assessed by Body Mass Index and Waist Circumference among Adults in the United States.

PubMed

Sebastian, Rhonda S; Wilkinson Enns, Cecilia; Goldman, Joseph D; Moshfegh, Alanna J

2017-08-02

Although flavonoids may confer anti-inflammatory and anti-oxidant benefits, no research has examined if flavonoid intake is related to cardiovascular disease (CVD) risk defined by anthropometric measures in the USA population. This study sought to determine whether flavonoid intake is associated with combined body mass index (BMI) and waist circumference (WC) measures indicative of high, very high, or extremely high ("high+") risk for CVD, using one day of 24-h recall data from adult (≥20 years) participants in What We Eat in America, National Health and Nutrition Examination Survey 2007-2010. Individuals were divided into categories of intake of total flavonoids and each flavonoid class, and adjusted estimates of the percentages at high+ CVD risk (based on BMI and WC, as per National Heart, Lung, and Blood Institute guidelines) were calculated. Inverse linear trends were found in percentages of adults at high+ CVD risk by intake of total flavonoids, anthocyanidins, flavan-3-ols, and flavanones ( p < 0.01). For individuals in the highest (versus the lowest) intake category of anthocyanidins, flavan-3-ols, and flavanones, relative risk and confidence intervals (RR and CI, respectively) were 0.86 (99% CI: 0.79, 0.93), 0.88 (99% CI: 0.79, 0.98), and 0.89 (99% CI: 0.80, 0.98), respectively. Research is needed to determine whether the inverse relationships found in this study are applicable to CVD endpoints at the population level.

Black Swan Tropical Cyclones

NASA Astrophysics Data System (ADS)

Emanuel, K.; Lin, N.

2012-12-01

Virtually all assessments of tropical cyclone risk are based on historical records, which are limited to a few hundred years at most. Yet stronger TCs may occur in the future and at places that have not been affected historically. Such events lie outside the realm of historically based expectations and may have extreme impacts. Their occurrences are also often made explainable after the fact (e.g., Hurricane Katrina). We nickname such potential future TCs, characterized by rarity, extreme impact, and retrospective predictability, "black swans" (Nassim Nicholas Taleb, 2007). As, by definition, black swan TCs have yet to happen, statistical methods that solely rely on historical track data cannot predict their occurrence. Global climate models lack the capability to predict intense storms, even with a resolution as high as 14 km (Emanuel et al. 2010). Also, most dynamic downscaling methods (e.g., Bender et al. 2010) are still limited in horizontal resolution and are too expensive to implement to generate enough events to include rare ones. In this study, we apply a simpler statistical/deterministic hurricane model (Emanuel et al. 2006) to simulate large numbers of synthetic storms under a given (observed or projected) climate condition. The method has been shown to generate realistic extremes in various basins (Emanuel et al. 2008 and 2010). We also apply a hydrodynamic model (ADCIRC; Luettich et al. 1992) to simulate the storm surges generated by these storms. We then search for black swan TCs, in terms of the joint wind and surge damage potential, in the generated large databases. Heavy rainfall is another important TC hazard and will be considered in a future study. We focus on three areas: Tampa Bay in the U.S., the Persian Gulf, and Darwin in Australia. Tampa Bay is highly vulnerable to storm surge as it is surrounded by shallow water and low-lying lands, much of which may be inundated by a storm tide of 6 m. High surges are generated by storms with a broad spectrum of characteristics in our synthetic database, although no large surge has been recorded historically as only one moderate storm passed by the area. Tampa black swans are identified as those that move northward parallel to the west Florida coast with high intensities and resonant with the Florida-shelf edge waves to generate extreme surges up to 10 m in Tampa Bay. The Arabian Sea area has sea surface temperatures warm enough to support the development of severe TCs, but TC development has been limited by low humidity and high wind shear, and only one recorded TC (super cyclonic storm Gonu in 2007) moved close to the Persian Gulf, making landfall in Oman and Iran. Our analysis shows that black swan TCs can originate within the Persian Gulf and make landfall with high intensities in populous places; extreme surges over 9 m for Abu Dubai and Doha and over 7 m for Dubai are possible. Darwin experienced immense devastation from Cyclone Tracy of 1974, but the damage was mainly due to the strong winds (the surge was only about 1.6 m). Our analysis includes extremely intense black swan TCs that make landfall just south of Darwin, generating surges above 10 m; these results may prompt the city to reconsider its TC risk. We are currently analyzing the join probability of the extreme wind and surge of these black swan TCs to more clearly assess their full damage potentials.

Towards a full representation of tropical cyclones in a global reanalysis of extreme sea levels

NASA Astrophysics Data System (ADS)

Muis, S.; Verlaan, M.; Lin, N.; Winsemius, H.; Vatvani, D.; Ward, P.; Aerts, J.

2016-12-01

Tropical cyclones (TCs), including hurricanes and typhoons, are characterised by high wind speeds and low pressure, and cause dangerous storm surges in coastal areas. Recent disasters like the flooding of New Orleans in 2005 due to Hurricane Katrina and of New York in 2012 due to Hurricane Sandy exemplify the significant TC risk in the United States. In this contribution, we present a new framework to model TC storm surges and probabilities at the Atlantic basin- and, ultimately, global scales. This works builds on the work of Muis et al. (2016), which presented the first dynamically-derived reanalysis dataset of storm surges that covers the entire world's coastline (GTSR dataset). Surge levels for the period 1979-2014 were simulated by forcing the Global Surge and Tide Model (GTSM) with wind speed and atmospheric pressure from the ERA-Interim reanalysis. There is generally a good agreement between simulated and observed sea level extremes in extra-tropical regions; however for areas prone to TCs there is a severe underestimation of extremes. For example, the maximum surge levels during Hurricane Katrina in New Orleans exceeded 8 m, whilst the GTSM surge levels in that area do not exceed 2-3 m. Hence, due to the coarse grid resolution, the strong intensities of TCs are not fully captured in ERA-Interim. Furthermore, the length of ERA-Interim data set, like other reanalysis datasets, is too short to estimate the probabilities of extreme TC events in a reliable way. For accurate risk assessments it is essential to improve the representation of TCs in these global reanalysis of extreme sea levels. First, we need a higher resolution of meteorological forcing, which can be modelled with input from the observed best track data. Second, we need to statistically extend the observed record to many thousands of years. We will present the first results of these steps for the east coast of the United States. We will validate the GTSM model forced with best track data using recent extreme events like Katrina and Sandy. We will investigate how the statistics of the extreme sea level will change due to improved representation of TCs.

Extreme Water Levels in Bangladesh: Past Trends, Future Projections and their Impact on Mortality

NASA Astrophysics Data System (ADS)

Thiele-Eich, I.; Burkart, K.; Hopson, T. M.; Simmer, C.

2014-12-01

Climate change is expected to have an impact on meteorological and therefore hydrological extremes, thereby possibly altering the vulnerability of exposed populations. Our study focuses on Bangladesh, which is particularly vulnerable to changes in extremes due to both the large population at risk, as well as geographical characteristics such as the low-rising slope of the country through which the outflow of the combined catchments of the Ganges, Brahmaputra and Meghna rivers (GBM, ~1.75 million km2) is channeled.Time series of daily discharge and water level data for the past 100 years were analyzed with respect to trends in frequency, magnitude and duration, focusing on rare but particularly high-risk events using extreme-value theory. Mortality data is available for a five-year period (2003-2007), with a distributed lag non-linear model used to examine possible connections between extreme water levels and mortality. Then, using output from the Community Climate System Model CCSM4, projections were made regarding future flooding due to changes in precipitation intensity and frequency, while also accounting for the backwater effect of sea-level rise. For this, the upper catchment precipitation as well as monthly mean thermosteric sea-level rise at the river mouth outflow were taken from the four CCSM4 1° 20th Century ensemble members as well as from six CCSM4 1° ensemble members for the RCP scenarios RCP 2.6, 4.5, 6.0 and 8.5.Results show that while e.g. the mean water level did not significantly rise during the past 100 years, a change in extreme water levels can be detected. In addition, annual minimum water levels have decreased, which is of particular importance as there is a significant connection to an increase in mortality for low water levels. While mortality does not seem to increase significantly due to extreme floods, our results indicate that return levels projected for the future shift progressively, with the effect being strongest for RCP 8.5. Further measures to strengthen the resilience of the exposed population are therefore required to ensure that climate change effects do not overwhelm the population's coping capacities.

Communicating Climate Change in the Agricultural Sector: Insights from Surveys and Interviews with Agricultural Advisors in the Midwestern United States

NASA Astrophysics Data System (ADS)

Prokopy, L. S.; Carlton, S.; Dunn, M.

2014-12-01

Understanding U.S. agricultural stakeholder views about the existence of climate change and what influences these views is central to developing communication in support of adaptation and mitigation. It has been postulated in the literature that extreme weather events can shape people's climate change beliefs and adaptation attitudes. In this presentation, we use data from pre- and post-extreme event surveys and interviews to examine the effects of the 2012 Midwestern US drought on agricultural advisors' climate change beliefs, adaptation attitudes, and risk perceptions. We found that neither climate change beliefs nor attitudes toward adaptation changed significantly as a result of the drought. Risk perceptions did change, however, with advisors becoming more concerned about risks from drought and pests and less concerned about risks related to flooding and ponding. Qualitative interviews revealed that while advisors readily accept the occurrence of extreme weather as a risk, the irregularity and unpredictability of extreme events for specific localities limits day-to-day consideration in respect to prescribed management advice. Instead, advisors' attention is directed towards planning for short-term changes encompassing weather, pests, and the market, as well as planning for long-term trends related to water availability. These findings provide important insights for communicating climate change in this critical sector while illustrating the importance of social science research in planning and executing communication campaigns.

Projected Risk of Flooding Disaster over China in 21st Century Based on CMIP5 Models

NASA Astrophysics Data System (ADS)

Li, Rouke; Xu, Ying

2016-04-01

Based on the simulations from CMIP5 models, using climate indices which have high correlation with historical disaster data, and in combination with terrain elevation data and the socio-economic data, to project the flooding disaster risk, the vulnerability of flooding hazard affected body and the risk of flooding hazard respectively during the near term(2015-2039), medium term(2045-2069) and long term(2075-2099) under RCP8.5. According to the IPCC AR5 WGII, we used risk evaluation model of disaster: R=E*H*V. R on behalf of disaster risk index. H, E and V express risk, exposure and vulnerability respectively. The results show that the extreme flooding disaster risk will gradually increase during different terms in the future, and regions with high risk level of flooding hazard are might mainly located in southeastern and eastern China. Under the RCP8.5 greenhouse gas emissions scenario, the high risk of flooding disaster in future might mainly appear in eastern part of Sichuan, most of North China, and major of East China. Compared with the baseline period,21st century forward, although the occurrence of floods area changes little, the regional strong risk will increase during the end of the 21st century. Due to the coarse resolution of climate models and the methodology for determining weight coefficients, large uncertainty still exists in the projection of the flooding disaster risk.

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

NASA Astrophysics Data System (ADS)

Liss, Alexander

Extreme weather events, such as heat waves and cold spells, cause substantial excess mortality and morbidity in the vulnerable elderly population, and cost billions of dollars. The accurate and reliable assessment of adverse effects of extreme weather events on human health is crucial for environmental scientists, economists, and public health officials to ensure proper protection of vulnerable populations and efficient allocation of scarce resources. However, the methodology for the analysis of large national databases is yet to be developed. The overarching objective of this dissertation is to examine the effect of extreme weather on the elderly population of the Conterminous US (ConUS) with respect to seasonality in temperature in different climatic regions by utilizing heterogeneous high frequency and spatio-temporal resolution data. To achieve these goals the author: 1) incorporated dissimilar stochastic high frequency big data streams and distinct data types into the integrated data base for use in analytical and decision support frameworks; 2) created an automated climate regionalization system based on remote sensing and machine learning to define climate regions for the Conterminous US; 3) systematically surveyed the current state of the art and identified existing gaps in the scientific knowledge; 4) assessed the dose-response relationship of exposure to temperature extremes on human health in relatively homogeneous climate regions using different statistical models, such as parametric and non-parametric, contemporaneous and asynchronous, applied to the same data; 5) assessed seasonal peak timing and synchronization delay of the exposure and the disease within the framework of contemporaneous high frequency harmonic time series analysis and modification of the effect by the regional climate; 6) modeled using hyperbolic functional form non-linear properties of the effect of exposure to extreme temperature on human health. The proposed climate regionalization method algorithmically forms eight climatically homogeneous regions for Conterminous US from satellite Remote Sensing inputs. The relative risk of hospitalizations due to extreme ambient temperature varied across climatic regions. Difference in regional hospitalization rates suggests presence of an adaptation effect to a prevailing climate. In various climatic regions the hospitalizations peaked earlier than the peak of exposure. This suggests disproportionally high impact of extreme weather events, such as cold spells or heat waves when they occur early in the season. These findings provide an insight into the use of high frequency disjoint data sets for the assessment of the magnitude, timing, synchronization and non-linear properties of adverse health consequences due to exposure to extreme weather events to the elderly in defined climatic regions. These findings assist in the creation of decision support frameworks targeting preventions and adaptation strategies such as improving infrastructure, providing energy assistance, education and early warning notifications for the vulnerable population. This dissertation offers a number of methodological innovations for the assessment of the high frequency spatio-temporal and non-linear impacts of extreme weather events on human health. These innovations help to ensure an improved protection of the elderly population, aid policy makers in the development of efficient disaster prevention strategies, and facilitate more efficient allocation of scarce resources.

Expertise on Cognitive Workloads and Performance During Navigation and Target Detection

DTIC Science & Technology

2012-03-01

requiring little or no attention 1. Little confusion, risk, frustration, or anxiety exists and can be easily accomodated 2. Occasionally have spare...to confusion, frustration, or anxiety noticeably adds to workload. Significant compensation is required to maintain adequate performance. 3... anxiety . High to extreme determination and self- control required 59 Field Description elapsedTime (sec) Continuous measurement of time from the

FES-Rowing versus Zoledronic Acid to Improve Bone Health in SCI

DTIC Science & Technology

2015-10-01

although the risk is high in this population of osteoporosis -related bone fracture. This study aims to learn if the severe osteoporosis in lower... Osteoporosis , FES-rowing, zoledronic acid, exercise, bone health 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...9 Introduction Serious spinal cord injury (SCI) causes osteoporosis in the lower extremities, significantly increasing

Integrating expert opinion with modelling for quantitative multi-hazard risk assessment in the Eastern Italian Alps

NASA Astrophysics Data System (ADS)

Chen, Lixia; van Westen, Cees J.; Hussin, Haydar; Ciurean, Roxana L.; Turkington, Thea; Chavarro-Rincon, Diana; Shrestha, Dhruba P.

2016-11-01

Extreme rainfall events are the main triggering causes for hydro-meteorological hazards in mountainous areas, where development is often constrained by the limited space suitable for construction. In these areas, hazard and risk assessments are fundamental for risk mitigation, especially for preventive planning, risk communication and emergency preparedness. Multi-hazard risk assessment in mountainous areas at local and regional scales remain a major challenge because of lack of data related to past events and causal factors, and the interactions between different types of hazards. The lack of data leads to a high level of uncertainty in the application of quantitative methods for hazard and risk assessment. Therefore, a systematic approach is required to combine these quantitative methods with expert-based assumptions and decisions. In this study, a quantitative multi-hazard risk assessment was carried out in the Fella River valley, prone to debris flows and flood in the north-eastern Italian Alps. The main steps include data collection and development of inventory maps, definition of hazard scenarios, hazard assessment in terms of temporal and spatial probability calculation and intensity modelling, elements-at-risk mapping, estimation of asset values and the number of people, physical vulnerability assessment, the generation of risk curves and annual risk calculation. To compare the risk for each type of hazard, risk curves were generated for debris flows, river floods and flash floods. Uncertainties were expressed as minimum, average and maximum values of temporal and spatial probability, replacement costs of assets, population numbers, and physical vulnerability. These result in minimum, average and maximum risk curves. To validate this approach, a back analysis was conducted using the extreme hydro-meteorological event that occurred in August 2003 in the Fella River valley. The results show a good performance when compared to the historical damage reports.

Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke.

PubMed

Goljar, Nika; Globokar, Daniel; Puzić, Nataša; Kopitar, Natalija; Vrabič, Maja; Ivanovski, Matic; Vidmar, Gaj

2016-09-01

To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients. A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010-2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006-2014 period to evaluate effectiveness of fall-risk reduction measures. The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55-101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014. The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention. Implications for Rehabilitation Recognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards. Assessing the fall risk is a team tasks and combines information from various sources. Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient.

The association between consecutive days' heat wave and cardiovascular disease mortality in Beijing, China.

PubMed

Yin, Qian; Wang, Jinfeng

2017-02-23

Although many studies have examined the effects of heat waves on the excess mortality risk (ER) posed by cardiovascular disease (CVD), scant attention has been paid to the effects of various combinations of differing heat wave temperatures and durations. We investigated such effects in Beijing, a city of over 20 million residents. A generalized additive model (GAM) was used to analyze the ER of consecutive days' exposure to extreme high temperatures. A key finding was that when extremely high temperatures occur continuously, at varying temperature thresholds and durations, the adverse effects on CVD mortality vary significantly. The longer the heat wave lasts, the greater the mortality risk is. When the daily maximum temperature exceeded 35 °C from the fourth day onward, the ER attributed to consecutive days' high temperature exposure saw an increase to about 10% (p < 0.05), and at the fifth day, the ER even reached 51%. For the thresholds of 32 °C, 33 °C, and 34 °C, from the fifth day onward, the ER also rose sharply (16, 29, and 31%, respectively; p < 0.05). In addition, extreme high temperatures appeared to contribute to a higher proportion of CVD deaths among elderly persons, females and outdoor workers. When the daily maximum temperature was higher than 33 °C from the tenth consecutive day onward, the ER of CVD death among these groups was 94, 104 and 149%, respectively (p < 0.05), which is considerably higher than the ER for the overall population (87%; p < 0.05). The results of this study may assist governments in setting standards for heat waves, creating more accurate heat alerts, and taking measures to prevent or reduce temperature-related deaths, especially against the backdrop of global warming.

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

PubMed

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

2014-11-01

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

Gender Affirmation: A Framework for Conceptualizing Risk Behavior among Transgender Women of Color.

PubMed

Sevelius, Jae M

2013-06-01

Experiences of stigma, discrimination, and violence as well as extreme health disparities and high rates of sexual risk behavior and substance use have been well-documented among transgender women of color. Using an intersectional approach and integrating prominent theories from stigma, eating disorders, and HIV-related research, this article offers a new framework for conceptualizing risk behavior among transgender women of color, specifically sexual risk behavior and risky body modification practices. This framework is centered on the concept of 'gender affirmation,' the process by which individuals are affirmed in their gender identity through social interactions. Qualitative data from 22 interviews with transgender women of color from the San Francisco Bay Area in the United States are analyzed and discussed in the context of the gender affirmation framework.

Optimizing the flow of care for prevention and treatment of deep vein thrombosis and pulmonary embolism.

PubMed

Ecklund, M M

1995-11-01

Critically ill patients have multiple risk factors for deep vein thrombosis and pulmonary embolism. The majority of patients with pulmonary embolism have a lower extremity deep vein thrombosis as a source of origin. Pulmonary embolism causes a high mortality rate in the hemodynamically compromised individual. Awareness of risk factors relative to the development of deep vein thrombosis and pulmonary embolism is important for the critical care nurse. Understanding the pathophysiology can help guide prophylaxis and treatment plans. The therapies, from invasive to mechanical, all carry risks and benefits, and are weighed for each patient. The advanced practice nurse, whether in the direct or indirect role, has an opportunity to impact the care of the high risk patient. Options range from teaching the nurse who is new to critical care, to teaching patients and families. Development of multidisciplinary protocols and clinical pathways are ways to impact the standard of care. Improved delivery of care methods can optimize the care rendered in an ever changing field of critical care.

Use of Cryoablation and Osteoplasty Reinforced with Kirschner Wires in the Treatment of Femoral Metastasis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abdel-Aal, Ahmed Kamel, E-mail: akamel@uabmc.edu; Underwood, Edgar S.; Saddekni, Souheil

2012-10-15

Purpose: We report the case of a 43-year-old man with metastatic breast carcinoma to the proximal right femur resulting in severe painful pathological fracture. The patient experienced severe pain despite large doses of analgesia, resulting in impaired functionality and quality of life. The patient had significant comorbidities, making him a high surgical risk. Materials and Methods: The patient was treated with cryoablation and osteoplasty, followed by a novel technique consisting of osteoplasty reinforced with bone marrow Kirschner wires (K-wires) which will be described in details in this report. Results: The patient reported significant pain relief after the procedure, and gainedmore » right lower extremity functionality, as compared to total immobility before the procedure. Conclusion: Our technique offers an alternative feasible treatment for patients at high surgical risk with pathological fractures in weight-bearing bones, in which osteoplasty alone has a high risk of cement leakage, inadequate fracture reduction, and early refracture. To our knowledge, our technique has not been previously described.« less

Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

PubMed

Shaw, W S; Feuerstein, M; Lincoln, A E; Miller, V I; Wood, P M

2001-08-01

A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: a prospective study.

PubMed

Brink, Yolandi; Crous, Lynette Christine; Louw, Quinette Abigail; Grimmer-Somers, Karen; Schreve, Kristiaan

2009-12-01

Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle (<34.75 degrees or >43.95 degrees; OR 2.8; 95% CI: 1.1-7.3) and a combination of extreme cervical and thoracic angles (<63.1 degrees or >71.1 degrees; OR 2.2; 95% CI: 1.1-5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9; 95% CI: 1.0-24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.

Chemical Speciation and Quantitative Evaluation of Heavy Metal Pollution Hazards in Two Army Shooting Range Backstop Soils.

PubMed

Islam, Mohammad Nazrul; Nguyen, Xuan Phuc; Jung, Ho-Young; Park, Jeong-Hun

2016-02-01

The chemical speciation and ecological risk assessment of heavy metals in two shooting range backstop soils in Korea were studied. Both soils were highly contaminated with Cd, Cu, Pb, and Sb. The chemical speciation of heavy metals reflected the present status of contamination, which could help in promoting management practices. We-rye soil had a higher proportion of exchangeable and carbonate bound metals and water-extractable Cd and Sb than the Cho-do soil. Bioavailable Pb represented 42 % of the total Pb content in both soils. A significant amount of Sb was found in the two most bioavailable fractions, amounting to ~32 % in the soil samples, in good agreement with the batch leaching test using water. Based on the values of ecological risk indices, both soils showed extremely high potential risk and may represent serious environmental problems.

Operation of Power Grids with High Penetration of Wind Power

NASA Astrophysics Data System (ADS)

Al-Awami, Ali Taleb

The integration of wind power into the power grid poses many challenges due to its highly uncertain nature. This dissertation involves two main components related to the operation of power grids with high penetration of wind energy: wind-thermal stochastic dispatch and wind-thermal coordinated bidding in short-term electricity markets. In the first part, a stochastic dispatch (SD) algorithm is proposed that takes into account the stochastic nature of the wind power output. The uncertainty associated with wind power output given the forecast is characterized using conditional probability density functions (CPDF). Several functions are examined to characterize wind uncertainty including Beta, Weibull, Extreme Value, Generalized Extreme Value, and Mixed Gaussian distributions. The unique characteristics of the Mixed Gaussian distribution are then utilized to facilitate the speed of convergence of the SD algorithm. A case study is carried out to evaluate the effectiveness of the proposed algorithm. Then, the SD algorithm is extended to simultaneously optimize the system operating costs and emissions. A modified multi-objective particle swarm optimization algorithm is suggested to identify the Pareto-optimal solutions defined by the two conflicting objectives. A sensitivity analysis is carried out to study the effect of changing load level and imbalance cost factors on the Pareto front. In the second part of this dissertation, coordinated trading of wind and thermal energy is proposed to mitigate risks due to those uncertainties. The problem of wind-thermal coordinated trading is formulated as a mixed-integer stochastic linear program. The objective is to obtain the optimal tradeoff bidding strategy that maximizes the total expected profits while controlling trading risks. For risk control, a weighted term of the conditional value at risk (CVaR) is included in the objective function. The CVaR aims to maximize the expected profits of the least profitable scenarios, thus improving trading risk control. A case study comparing coordinated with uncoordinated bidding strategies depending on the trader's risk attitude is included. Simulation results show that coordinated bidding can improve the expected profits while significantly improving the CVaR.

Increase of Elderly Population in the Rainstorm Hazard Areas of China.

PubMed

Liang, Pujun; Xu, Wei; Ma, Yunjia; Zhao, Xiujuan; Qin, Lianjie

2017-08-26

In light of global warming, increased extreme precipitation events have enlarged the population exposed to floods to some extent. Extreme precipitation risk assessments are of great significance in China and allow for the response to climate change and mitigation of risks to the population. China is one of the countries most influenced by climate change and has unique national population conditions. The influence of extreme precipitation depends on the degree of exposure and vulnerability of the population. Accurate assessments of the population exposed to rising rainstorm trends are crucial to mapping extreme precipitation risks. Studying the population exposed to rainstorm hazard areas (RSHA) at the microscale is extremely urgent, due to the local characteristics of extreme precipitation events and regional diversity of the population. The spatial distribution of population density was mapped based on the national population census data from China in 1990, 2000 and 2010. RSHA were also identified using precipitation data from 1975-2015 in China, and the rainstorm tendency values were mapped using GIS in this paper. The spatial characteristics of the rainstorm tendencies were then analyzed. Finally, changes in the population in the RSHA are discussed. The results show that the extreme precipitation trends are increasing in southeastern China. From 1990 to 2010, the population in RSHA increased by 110 million, at a rate of 14.6%. The elderly in the region increased by 38 million at a rate of 86.4%. Studying the size of the population exposed to rainstorm hazards at the county scale can provide scientific evidence for developing disaster prevention and mitigation strategies from the bottom up.

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

DTIC Science & Technology

2016-04-01

SERDP NOAA USACE Ocean MANAGING THE UNCERTAINTY OF FUTURE SEA LEVEL CHANGE AND EXTREME WATER LEVELS FOR DEPARTMENT OF DEFENSE COASTAL SITES...WORLDWIDE APRIL 2016 REGIONAL SEA LEVEL SCENARIOS FOR COASTAL RISK MANAGEMENT: COVER PHOTOS, FROM LEFT TO RIGHT: - Overwash of the island of Roi-Namur on...J.A., S. Gill, J. Obeysekera, W. Sweet, K. Knuuti, and J. Marburger. 2016. Regional Sea Level Scenarios for Coastal Risk Management: Managing the

Kinematic and neuromuscular relationships between lower extremity clinical movement assessments.

PubMed

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

2018-06-01

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

Do adolescents who are night owls have a higher risk of dental caries? - a case-control study.

PubMed

Lundgren, A-M; Öhrn, K; Jönsson, B

2016-08-01

The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits. A group of 196 adolescents (15 and 16 years old) were divided into two equal groups based on caries risk (case = high risk; and control = low risk). Before their dental examinations, they were asked to complete a questionnaire. The questionnaire included questions on circadian rhythm, dietary and oral self-care habits, and demographic variables. The participants were divided into three circadian types: evening types who are alert in the evening and tired in the morning; morning types who are the opposite; and neutral types who are neither particularly alert in the evening nor extremely tired in the morning. The most common sleep-cycle group type was neutral (50%). After this came evening types (37%) and finally morning types (13%). Morning and neutral types reported more frequently than evening types that they had breakfast every morning and brushed their teeth twice a day. More evening types were categorized as at high risk of caries. Circadian rhythm, breakfast habits and toothbrushing frequency were associated with a high risk of caries. The predicted probability of being at high risk of caries was almost four times higher for evening types than for morning types (OR 3.8; 95% CI 1.3-10.9). Adolescents who belonged to the evening circadian rhythm group brushed their teeth more seldom, ate breakfast less regularly and had a higher risk of caries than morning types. A patient's circadian rhythm should be considered when planning oral health education for adolescents with a high risk of caries. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using sea surface temperatures to improve performance of single dynamical downscaling model in flood simulation under climate change

NASA Astrophysics Data System (ADS)

Chao, Y.; Cheng, C. T.; Hsiao, Y. H.; Hsu, C. T.; Yeh, K. C.; Liu, P. L.

2017-12-01

There are 5.3 typhoons hit Taiwan per year on average in last decade. Typhoon Morakot in 2009, the most severe typhoon, causes huge damage in Taiwan, including 677 casualties and roughly NT 110 billion (3.3 billion USD) in economic loss. Some researches documented that typhoon frequency will decrease but increase in intensity in western North Pacific region. It is usually preferred to use high resolution dynamical model to get better projection of extreme events; because coarse resolution models cannot simulate intense extreme events. Under that consideration, dynamical downscaling climate data was chosen to describe typhoon satisfactorily, this research used the simulation data from AGCM of Meteorological Research Institute (MRI-AGCM). Considering dynamical downscaling methods consume massive computing power, and typhoon number is very limited in a single model simulation, using dynamical downscaling data could cause uncertainty in disaster risk assessment. In order to improve the problem, this research used four sea surfaces temperatures (SSTs) to increase the climate change scenarios under RCP 8.5. In this way, MRI-AGCMs project 191 extreme typhoons in Taiwan (when typhoon center touches 300 km sea area of Taiwan) in late 21th century. SOBEK, a two dimensions flood simulation model, was used to assess the flood risk under four SSTs climate change scenarios in Tainan, Taiwan. The results show the uncertainty of future flood risk assessment is significantly decreased in Tainan, Taiwan in late 21th century. Four SSTs could efficiently improve the problems of limited typhoon numbers in single model simulation.

Redefining climate regions in the United States of America using satellite remote sensing and machine learning for public health applications.

PubMed

Liss, Alexander; Koch, Magaly; Naumova, Elena N

2014-12-01

Existing climate classification has not been designed for an efficient handling of public health scenarios. This work aims to design an objective spatial climate regionalization method for assessing health risks in response to extreme weather. Specific climate regions for the conterminous United States of America (USA) were defined using satellite remote sensing (RS) data and compared with the conventional Köppen-Geiger (KG) divisions. Using the nationwide database of hospitalisations among the elderly (≥65 year olds), we examined the utility of a RS-based climate regionalization to assess public health risk due to extreme weather, by comparing the rate of hospitalisations in response to thermal extremes across climatic regions. Satellite image composites from 2002-2012 were aggregated, masked and compiled into a multi-dimensional dataset. The conterminous USA was classified into 8 distinct regions using a stepwise regionalization approach to limit noise and collinearity (LKN), which exhibited a high degree of consistency with the KG regions and a well-defined regional delineation by annual and seasonal temperature and precipitation values. The most populous was a temperate wet region (10.9 million), while the highest rate of hospitalisations due to exposure to heat and cold (9.6 and 17.7 cases per 100,000 persons at risk, respectively) was observed in the relatively warm and humid south-eastern region. RS-based regionalization demonstrates strong potential for assessing the adverse effects of severe weather on human health and for decision support. Its utility in forecasting and mitigating these effects has to be further explored.

Weather based risks and insurances for agricultural production

NASA Astrophysics Data System (ADS)

Gobin, Anne

2015-04-01

Extreme weather events such as frost, drought, heat waves and rain storms can have devastating effects on cropping systems. According to both the agriculture and finance sectors, a risk assessment of extreme weather events and their impact on cropping systems is needed. The principle of return periods or frequencies of natural hazards is adopted in many countries as the basis of eligibility for the compensation of associated losses. For adequate risk management and eligibility, hazard maps for events with a 20-year return period are often used. Damages due to extreme events are strongly dependent on crop type, crop stage, soil type and soil conditions. The impact of extreme weather events particularly during the sensitive periods of the farming calendar therefore requires a modelling approach to capture the mixture of non-linear interactions between the crop, its environment and the occurrence of the meteorological event in the farming calendar. Physically based crop models such as REGCROP (Gobin, 2010) assist in understanding the links between different factors causing crop damage. Subsequent examination of the frequency, magnitude and impacts of frost, drought, heat stress and soil moisture stress in relation to the cropping season and crop sensitive stages allows for risk profiles to be confronted with yields, yield losses and insurance claims. The methodology is demonstrated for arable food crops, bio-energy crops and fruit. The perspective of rising risk-exposure is exacerbated further by limited aid received for agricultural damage, an overall reduction of direct income support to farmers and projected intensification of weather extremes with climate change. Though average yields have risen continuously due to technological advances, there is no evidence that relative tolerance to adverse weather events has improved. The research is funded by the Belgian Science Policy Organisation (Belspo) under contract nr SD/RI/03A.

Restraint use and lower extremity fractures in frontal motor vehicle collisions.

PubMed

Estrada, Lance S; Alonso, Jorge E; McGwin, Gerald; Metzger, Jesse; Rue, Loring W

2004-08-01

Seat belts and air bags have been shown to significantly reduce morbidity and mortality following MVCs. Research suggests that restraint use does not protect against lower extremity fracture; however, no population-based studies of this association exist. The purpose of this study is to compare the effectiveness of combined seat belt and airbag restraint systems with airbag alone, seat belt alone, and no restraints with respect to incidence and location of lower extremity fractures. A retrospective analysis of front seat occupants involved in police-reported, tow-away frontal MVCs was conducted using data from the 1995 through 2000 National Automotive Sampling System (NASS). Incidence and relative risk (RR) of fracture to specific bony regions were measured according to seat belt use and airbag deployment. Compared with unrestrained occupants, occupants restrained with airbag only had significantly higher risk for all types of lower extremity fractures whereas those occupants restrained with either seat belt only or seat belt and airbag had lower risk of fracture. The greatest difference was seen with tibia/fibula fractures in airbag only (RR, 2.14) but this trend continued to be significant with femur and pelvic fractures (RR, 1.13 and 1.23, respectively). While airbags may reduce the risk of death when used alone or in combination with seat belts, the results of this study demonstrate that air bags increase the risk of lower extremity fractures when used as the sole method of passenger protection. Also, they may do so differentially according to skeletal region. This data strongly support the consideration of developing accessory knee bolster airbags to prevent the "submarining" or sliding under the airbag that may be responsible for this finding.

The impact of sustained hot weather on risk of acute work-related injury in Melbourne, Australia.

PubMed

McInnes, Judith Anne; MacFarlane, Ewan M; Sim, Malcolm R; Smith, Peter

2018-02-01

It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached.

The impact of sustained hot weather on risk of acute work-related injury in Melbourne, Australia

NASA Astrophysics Data System (ADS)

McInnes, Judith Anne; MacFarlane, Ewan M.; Sim, Malcolm R.; Smith, Peter

2018-02-01

It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached.

Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery.

PubMed

Popma, Jeffrey J; Adams, David H; Reardon, Michael J; Yakubov, Steven J; Kleiman, Neal S; Heimansohn, David; Hermiller, James; Hughes, G Chad; Harrison, J Kevin; Coselli, Joseph; Diez, Jose; Kafi, Ali; Schreiber, Theodore; Gleason, Thomas G; Conte, John; Buchbinder, Maurice; Deeb, G Michael; Carabello, Blasé; Serruys, Patrick W; Chenoweth, Sharla; Oh, Jae K

2014-05-20

This study sought to evaluate the safety and efficacy of the CoreValve transcatheter heart valve (THV) for the treatment of severe aortic stenosis in patients at extreme risk for surgery. Untreated severe aortic stenosis is a progressive disease with a poor prognosis. Transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis is a potentially effective therapy. We performed a prospective, multicenter, nonrandomized investigation evaluating the safety and efficacy of self-expanding TAVR in patients with symptomatic severe aortic stenosis with prohibitive risks for surgery. The primary endpoint was a composite of all-cause mortality or major stroke at 12 months, which was compared with a pre-specified objective performance goal (OPG). A total of 41 sites in the United States recruited 506 patients, of whom 489 underwent attempted treatment with the CoreValve THV. The rate of all-cause mortality or major stroke at 12 months was 26.0% (upper 2-sided 95% confidence bound: 29.9%) versus 43.0% with the OPG (p < 0.0001). Individual 30-day and 12-month events included all-cause mortality (8.4% and 24.3%, respectively) and major stroke (2.3% and 4.3%, respectively). Procedural events at 30 days included life-threatening/disabling bleeding (12.7%), major vascular complications (8.2%), and need for permanent pacemaker placement (21.6%). The frequency of moderate or severe paravalvular aortic regurgitation was lower 12 months after self-expanding TAVR (4.2%) than at discharge (10.7%; p = 0.004 for paired analysis). TAVR with a self-expanding bioprosthesis was safe and effective in patients with symptomatic severe aortic stenosis at prohibitive risk for surgical valve replacement. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Evaluating of the spatial heterogeneity of soil loss tolerance and its effects on erosion risk in the carbonate areas of southern China

NASA Astrophysics Data System (ADS)

Li, Yue; Bai, Xiao Yong; Jie Wang, Shi; Qin, Luo Yi; Chao Tian, Yi; Jie Luo, Guang

2017-05-01

Soil loss tolerance (T value) is one of the criteria in determining the necessity of erosion control measures and ecological restoration strategy. However, the validity of this criterion in subtropical karst regions is strongly disputed. In this study, T value is calculated based on soil formation rate by using a digital distribution map of carbonate rock assemblage types. Results indicated a spatial heterogeneity and diversity in soil loss tolerance. Instead of only one criterion, a minimum of three criteria should be considered when investigating the carbonate areas of southern China because the one region, one T value concept may not be applicable to this region. T value is proportionate to the amount of argillaceous material, which determines the surface soil thickness of the formations in homogenous carbonate rock areas. Homogenous carbonate rock, carbonate rock intercalated with clastic rock areas and carbonate/clastic rock alternation areas have T values of 20, 50 and 100 t/(km2 a), and they are extremely, severely and moderately sensitive to soil erosion. Karst rocky desertification (KRD) is defined as extreme soil erosion and reflects the risks of erosion. Thus, the relationship between T value and erosion risk is determined using KRD as a parameter. The existence of KRD land is unrelated to the T value, although this parameter indicates erosion sensitivity. Erosion risk is strongly dependent on the relationship between real soil loss (RL) and T value rather than on either erosion intensity or the T value itself. If RL > > T, then the erosion risk is high despite of a low RL. Conversely, if T > > RL, then the soil is safe although RL is high. Overall, these findings may clarify the heterogeneity of T value and its effect on erosion risk in a karst environment.

The impact of soil moisture extremes and their spatiotemporal variability on Zambian maize yields

NASA Astrophysics Data System (ADS)

Zhao, Y.; Estes, L. D.; Vergopolan, N.

2017-12-01

Food security in sub-Saharan Africa is highly sensitive to climate variability. While it is well understood that extreme heat has substantial negative impacts on crop yield, the impacts of precipitation extremes, particularly over large spatial extents, are harder to quantify. There are three primary reasons for this difficulty, which are (1) lack of high quality, high resolution precipitation data, (2) rainfall data provide incomplete information on plant water availability, the variable that most directly affects crop performance, and (3) the type of rainfall extreme that most affects crop yields varies throughout the crop development stage. With respect to the first reason, the spatial and temporal variation of precipitation is much greater than that of temperature, yet the spatial resolution of rainfall data is typically even coarser than it is for temperature, particularly within Africa. Even if there were high-resolution rainfall data, the amount of water available to crops also depends on other physical factors that affect evapotranspiration, which are strongly influenced by heterogeneity in the land surface related to topography, soil properties, and land cover. In this context, soil moisture provides a better measure of crop water availability than rainfall. Furthermore, soil moisture has significantly different influences on crop yield depending on the crop's growth stage. The goal of this study is to understand how the spatiotemporal scales of soil moisture extremes interact with crops, more specifically, the timing and the spatial scales of extreme events like droughts and flooding. In this study, we simulate daily-1km soil moisture using HydroBlocks - a physically based land surface model - and compare it with precipitation and remote sensing derived maize yields between 2000 and 2016 in Zambia. We use a novel combination of the SCYM (scalable satellite-based yield mapper) method with DSSAT crop model, which is a mechanistic model responsive to water stress. Understanding the relationships between soil moisture spatiotemporal variability and yields can help to improve agricultural drought risk assessment and seasonal crop yield forecasting as well as early season warning of potential famines.

Patterns of gun deaths across US counties 1999-2013.

PubMed

Kalesan, Bindu; Galea, Sandro

2017-05-01

We examined the socio-demographic distribution of gun deaths across 3143 counties in 50 United States' states to understand the spatial patterns and correlates of high and low gun deaths. We used aggregate counts of gun deaths and population in all counties from 1999 to 2013 from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER). We characterized four levels of gun violence, as distinct levels of gun death rates of relatively safe, unsafe, violent, and extremely violent counties, based on quartiles of 15-year county-specific gun death rates per 100,000 and used negative binomial regression models allowing clustering by state to calculate incidence rate ratios and 95% confidence intervals (95% CIs). Most states had at least one violent or extremely violent county. Extremely violent gun counties were mostly rural, poor, predominantly minority, had high unemployment rate and homicide rate. Overall, homicide rate was significantly associated with gun deaths (incidence rate ratios = 1.08, 95% CI = 1.06-1.09). In relatively safe counties, this risk was 1.09 (95% CI = 1.05-1.13) and in extremely violent gun counties was 1.03 (95% CI = 1.03-1.04). There are broad differences in gun death rates across the United States representing different levels of gun death rates in each state with distinct socio-demographic profiles. Copyright © 2017 Elsevier Inc. All rights reserved.

A role of high impact weather events in waterborne disease outbreaks in Canada, 1975 - 2001.

PubMed

Thomas, Kate M; Charron, Dominique F; Waltner-Toews, David; Schuster, Corinne; Maarouf, Abdel R; Holt, John D

2006-06-01

Recent outbreaks of Escherichia coli O157:H7, Campylobacter, and Cryptosporidium have heightened awareness of risks associated with contaminated water supply. The objectives of this research were to describe the incidence and distribution of waterborne disease outbreaks in Canada in relation to preceding weather conditions and to test the association between high impact weather events and waterborne disease outbreaks. We examined extreme rainfall and spring snowmelt in association with 92 Canadian waterborne disease outbreaks between 1975 and 2001, using case-crossover methodology. Explanatory variables including accumulated rainfall, air temperature, and peak stream flow were used to determine the relationship between high impact weather events and the occurrence of waterborne disease outbreaks. Total maximum degree-days above 0 degrees C and accumulated rainfall percentile were associated with outbreak risk. For each degree-day above 0 degrees C the relative odds of an outbreak increased by a factor of 1.007 (95% confidence interval [CI] = 1.002 - 1.012). Accumulated rainfall percentile was dichotomized at the 93rd percentile. For rainfall events greater than the 93rd percentile the relative odds of an outbreak increased by a factor of 2.283 (95% [CI] = 1.216 - 4.285). These results suggest that warmer temperatures and extreme rainfall are contributing factors to waterborne disease outbreaks in Canada. This could have implications for water management and public health initiatives.

High maternal mortality in Jigawa State, Northern Nigeria estimated using the sisterhood method.

PubMed

Sharma, Vandana; Brown, Willa; Kainuwa, Muhammad Abdullahi; Leight, Jessica; Nyqvist, Martina Bjorkman

2017-06-02

Maternal mortality is extremely high in Nigeria. Accurate estimation of maternal mortality is challenging in low-income settings such as Nigeria where vital registration is incomplete. The objective of this study was to estimate the lifetime risk (LTR) of maternal death and the maternal mortality ratio (MMR) in Jigawa State, Northern Nigeria using the Sisterhood Method. Interviews with 7,069 women aged 15-49 in 96 randomly selected clusters of communities in 24 Local Government Areas (LGAs) across Jigawa state were conducted. A retrospective cohort of their sisters of reproductive age was constructed to calculate the lifetime risk of maternal mortality. Using most recent estimates of total fertility for the state, the MMR was estimated. The 7,069 respondents reported 10,957 sisters who reached reproductive age. Of the 1,026 deaths in these sisters, 300 (29.2%) occurred during pregnancy, childbirth or within 42 days after delivery. This corresponds to a LTR of 6.6% and an estimated MMR for the study areas of 1,012 maternal deaths per 100,000 live births (95% CI: 898-1,126) with a time reference of 2001. Jigawa State has an extremely high maternal mortality ratio underscoring the urgent need for health systems improvement and interventions to accelerate reductions in MMR. The trial is registered at clinicaltrials.gov ( NCT01487707 ). Initially registered on December 6, 2011.