The friction cost method: a comment.

PubMed

Johannesson, M; Karlsson, G

1997-04-01

The friction cost method has been proposed as an alternative to the human-capital approach of estimating indirect costs. We argue that the friction cost method is based on implausible assumptions not supported by neoclassical economic theory. Furthermore consistently applying the friction cost method would mean that the method should also be applied in the estimation of direct costs, which would mean that the costs of health care programmes are substantially decreased. It is concluded that the friction cost method does not seem to be a useful alternative to the human-capital approach in the estimation of indirect costs.

Integrated direct/indirect adaptive robust motion trajectory tracking control of pneumatic cylinders

NASA Astrophysics Data System (ADS)

Meng, Deyuan; Tao, Guoliang; Zhu, Xiaocong

2013-09-01

This paper studies the precision motion trajectory tracking control of a pneumatic cylinder driven by a proportional-directional control valve. An integrated direct/indirect adaptive robust controller is proposed. The controller employs a physical model based indirect-type parameter estimation to obtain reliable estimates of unknown model parameters, and utilises a robust control method with dynamic compensation type fast adaptation to attenuate the effects of parameter estimation errors, unmodelled dynamics and disturbances. Due to the use of projection mapping, the robust control law and the parameter adaption algorithm can be designed separately. Since the system model uncertainties are unmatched, the recursive backstepping technology is adopted to design the robust control law. Extensive comparative experimental results are presented to illustrate the effectiveness of the proposed controller and its performance robustness to parameter variations and sudden disturbances.

It's positive to be negative: Achilles tendon work loops during human locomotion.

PubMed

Zelik, Karl E; Franz, Jason R

2017-01-01

Ultrasound imaging is increasingly used with motion and force data to quantify tendon dynamics during human movement. Frequently, tendon dynamics are estimated indirectly from muscle fascicle kinematics (by subtracting muscle from muscle-tendon unit length), but there is mounting evidence that this Indirect approach yields implausible tendon work loops. Since tendons are passive viscoelastic structures, when they undergo a loading-unloading cycle they must exhibit a negative work loop (i.e., perform net negative work). However, prior studies using this Indirect approach report large positive work loops, often estimating that tendons return 2-5 J of elastic energy for every 1 J of energy stored. More direct ultrasound estimates of tendon kinematics have emerged that quantify tendon elongations by tracking either the muscle-tendon junction or localized tendon tissue. However, it is unclear if these yield more plausible estimates of tendon dynamics. Our objective was to compute tendon work loops and hysteresis losses using these two Direct tendon kinematics estimates during human walking. We found that Direct estimates generally resulted in negative work loops, with average tendon hysteresis losses of 2-11% at 1.25 m/s and 33-49% at 0.75 m/s (N = 8), alluding to 0.51-0.98 J of tendon energy returned for every 1 J stored. We interpret this finding to suggest that Direct approaches provide more plausible estimates than the Indirect approach, and may be preferable for understanding tendon energy storage and return. However, the Direct approaches did exhibit speed-dependent trends that are not consistent with isolated, in vitro tendon hysteresis losses of about 5-10%. These trends suggest that Direct estimates also contain some level of error, albeit much smaller than Indirect estimates. Overall, this study serves to highlight the complexity and difficulty of estimating tendon dynamics non-invasively, and the care that must be taken to interpret biological function from current ultrasound-based estimates.

Infant mortality in the Marshall Islands.

PubMed

Levy, S J; Booth, H

1988-12-01

Levy and Booth present previously unpublished infant mortality rates for the Marshall Islands. They use an indirect method to estimate infant mortality from the 1973 and 1980 censuses, then apply indirect and direct methods of estimation to data from the Marshall Islands Women's Health Survey of 1985. Comparing the results with estimates of infant mortality obtained from vital registration data enables them to estimate the extent of underregistration of infant deaths. The authors conclude that 1973 census appears to be the most valid information source. Direct estimates from the Women's Health Survey data suggest that infant mortality has increased since 1970-1974, whereas the indirect estimates indicate a decreasing trend in infant mortality rates, converging with the direct estimates in more recent years. In view of increased efforts to improve maternal and child health in the mid-1970s, the decreasing trend is plausible. It is impossible to estimate accurately infant mortality in the Marshall Islands during 1980-1984 from the available data. Estimates based on registration data for 1975-1979 are at least 40% too low. The authors speculate that the estimate of 33 deaths per 1000 live births obtained from registration data for 1984 is 40-50% too low. In round figures, a value of 60 deaths per 1000 may be taken as the final estimate for 1980-1984.

The Minicommunity Design to Assess Indirect Effects of Vaccination.

PubMed

Halloran, M Elizabeth

2012-08-01

We propose the minicommunity design to estimate indirect effects of vaccination. Establishing indirect effects of vaccination in unvaccinated subpopulations could have important implications for global vaccine policies. In the minicommunity design, the household or other small transmission unit serves as the cluster in which to estimate indirect effects of vaccination, similar to studies in larger communities to estimate indirect, total, and overall effects. Examples from the literature include studies in small transmission units to estimate indirect effects of pertussis, pneumococcal, influenza, and cholera vaccines. We characterize the minicommunity design by several methodologic considerations, including the assignment mechanism, ascertainment, the role of transmission outside the transmission unit, and the relation of the size of the transmission unit to number of people vaccinated. The minicommunity study for indirect effects is contrasted with studies to estimate vaccine effects on infectiousness and protective effects under conditions of household exposure within small transmission units. The minicommunity design can be easily implemented in individually randomized studies by enrolling and following-up members of households of the randomized individuals. The methodology for the minicommunity design for estimating indirect effects of vaccination deserves much future research.

Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

PubMed

Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

2011-08-16

To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study

PubMed Central

Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

2011-01-01

Objective To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Design Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Main outcome measure Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. Results The study included 112 independent trial networks (including 1552 trials with 478 775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Conclusions Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence. PMID:21846695

Comparison of haemoglobin estimates using direct & indirect cyanmethaemoglobin methods.

PubMed

Bansal, Priyanka Gupta; Toteja, Gurudayal Singh; Bhatia, Neena; Gupta, Sanjeev; Kaur, Manpreet; Adhikari, Tulsi; Garg, Ashok Kumar

2016-10-01

Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions. Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation. Haemoglobin levels were estimated for 888 adolescent girls aged 11-18 yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared. The mean haemoglobin levels for 888 whole blood samples estimated by direct and indirect cyanmethaemoglobin method were 116.1 ± 12.7 and 110.5 ± 12.5 g/l, respectively, with a mean difference of 5.67 g/l (95% confidence interval: 5.45 to 5.90, P<0.001); which is equivalent to 0.567 g%. The prevalence of anaemia was reported as 59.6 and 78.2 per cent by direct and indirect methods, respectively. Sensitivity and specificity of indirect cyanmethaemoglobin method were 99.2 and 56.4 per cent, respectively. Using regression analysis, prediction equation was developed for indirect haemoglobin values. The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods.

How accurately can the peak skin dose in fluoroscopy be determined using indirect dose metrics?

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org; Ensor, Joe E.; Pasciak, Alexander S.

Purpose: Skin dosimetry is important for fluoroscopically-guided interventions, as peak skin doses (PSD) that result in skin reactions can be reached during these procedures. There is no consensus as to whether or not indirect skin dosimetry is sufficiently accurate for fluoroscopically-guided interventions. However, measuring PSD with film is difficult and the decision to do so must be madea priori. The purpose of this study was to assess the accuracy of different types of indirect dose estimates and to determine if PSD can be calculated within ±50% using indirect dose metrics for embolization procedures. Methods: PSD were measured directly using radiochromicmore » film for 41 consecutive embolization procedures at two sites. Indirect dose metrics from the procedures were collected, including reference air kerma. Four different estimates of PSD were calculated from the indirect dose metrics and compared along with reference air kerma to the measured PSD for each case. The four indirect estimates included a standard calculation method, the use of detailed information from the radiation dose structured report, and two simplified calculation methods based on the standard method. Indirect dosimetry results were compared with direct measurements, including an analysis of uncertainty associated with film dosimetry. Factors affecting the accuracy of the different indirect estimates were examined. Results: When using the standard calculation method, calculated PSD were within ±35% for all 41 procedures studied. Calculated PSD were within ±50% for a simplified method using a single source-to-patient distance for all calculations. Reference air kerma was within ±50% for all but one procedure. Cases for which reference air kerma or calculated PSD exhibited large (±35%) differences from the measured PSD were analyzed, and two main causative factors were identified: unusually small or large source-to-patient distances and large contributions to reference air kerma from cone beam computed tomography or acquisition runs acquired at large primary gantry angles. When calculated uncertainty limits [−12.8%, 10%] were applied to directly measured PSD, most indirect PSD estimates remained within ±50% of the measured PSD. Conclusions: Using indirect dose metrics, PSD can be determined within ±35% for embolization procedures. Reference air kerma can be used without modification to set notification limits and substantial radiation dose levels, provided the displayed reference air kerma is accurate. These results can reasonably be extended to similar procedures, including vascular and interventional oncology. Considering these results, film dosimetry is likely an unnecessary effort for these types of procedures when indirect dose metrics are available.« less

Calculation versus measurement of total energy expenditure.

PubMed

van Lanschot, J J; Feenstra, B W; Vermeij, C G; Bruining, H A

1986-11-01

In acutely ill patients both hypo- and hyperalimentation must be avoided by adjusting caloric intake to total energy expenditure (TEE). We determined the discrepancy between basal energy expenditure (BEE) calculated from the basic Harris-Benedict formula and TEE measured by continuous indirect calorimetry in a heterogeneous group of mechanically ventilated surgical patients. We also compared the accuracy of TEE calculated from the corrected Harris-Benedict formula or estimated by intermittent indirect calorimetry to that of TEE measured by continuous indirect calorimetry. The poor correlation between calculated BEE and measured TEE was significantly (p less than .05) improved by a correction factor based on each patient's clinical condition. The mean absolute difference between calculated TEE and measured TEE was 8.9 +/- 9.6 (SD) %. Calculations were significantly (p less than .05) improved by estimating TEE from two 5-min recording periods, which suggests that continuous indirect calorimetry may not always be necessary to guide caloric replacement.

Estimating Power Outage Cost based on a Survey for Industrial Customers

NASA Astrophysics Data System (ADS)

Yoshida, Yoshikuni; Matsuhashi, Ryuji

A survey was conducted on power outage cost for industrial customers. 5139 factories, which are designated energy management factories in Japan, answered their power consumption and the loss of production value due to the power outage in an hour in summer weekday. The median of unit cost of power outage of whole sectors is estimated as 672 yen/kWh. The sector of services for amusement and hobbies and the sector of manufacture of information and communication electronics equipment relatively have higher unit cost of power outage. Direct damage cost from power outage in whole sectors reaches 77 billion yen. Then utilizing input-output analysis, we estimated indirect damage cost that is caused by the repercussion of production halt. Indirect damage cost in whole sectors reaches 91 billion yen. The sector of wholesale and retail trade has the largest direct damage cost. The sector of manufacture of transportation equipment has the largest indirect damage cost.

Lifetime indirect cost of childhood overweight and obesity: A decision analytic model.

PubMed

Sonntag, Diana; Ali, Shehzad; De Bock, Freia

2016-01-01

To estimate the indirect lifetime cost of childhood overweight and obesity for Germany. The lifetime cohort model consisted of two parts: (a) Model I used data from the German Interview and Examination Survey for Children on prevalence of BMI categories during childhood to evaluate BMI trajectories before the age of 18; and (b) Model II estimated lifetime excess indirect cost based on the history of childhood BMI. Indirect costs were defined as the opportunity cost of lost productivity due to mortality and morbidity and were identified through a systematic literature review. Our analysis showed that the majority of children with overweight and obesity remained in the same BMI category during their adult life, resulting in significant indirect lifetime costs. We estimated that overweight and obesity during childhood resulted in an excess lifetime cost per person of €4,209 (men) and €2,445 (women). For the current prevalent German population, the excess lifetime cost was €145 billion. Our study showed that childhood obesity results in significant economic burden on the society. Therefore, cost-effective strategies targeted at reducing the prevalence of obesity during the early years of life can significantly reduce both healthcare and nonhealthcare costs over the lifetime. © 2015 The Obesity Society.

The health-related social costs of alcohol in Belgium.

PubMed

Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

2017-12-16

Alcohol is associated with adverse health effects causing a considerable economic impact to society. A reliable estimate of this economic impact for Belgium is lacking. This is the aim of the study. A prevalence-based approach estimating the direct, indirect and intangible costs for the year 2012 was used. Attributional fractions for a series of health effects were derived from literature. The human capital approach was used to estimate indirect costs, while the concept of disability-adjusted life years was used to estimate intangible costs. Sensitivity and scenario analyses were conducted to assess the uncertainty around cost estimates and to evaluate the impact of alternative modelling assumptions. In 2012, total alcohol-attributable direct costs were estimated at €906.1 million, of which the majority were due to hospitalization (€743.7 million, 82%). The indirect costs amounted to €642.6 million, of which 62% was caused by premature mortality. Alcohol was responsible for 157,500 disability-adjusted life years representing €6.3 billion intangible costs. Despite a number of limitations intrinsic to this kind of research, the study can be considered as the most comprehensive analysis thus far of the health-related social costs of alcohol in Belgium.

Direct and indirect effects of body weight on adult wages.

PubMed

Han, Euna; Norton, Edward C; Powell, Lisa M

2011-12-01

Previous estimates of the association between body weight and wages in the literature have been conditional on education and occupation. In addition to the effect of current body weight status (body mass index (BMI) or obesity) on wages, this paper examines the indirect effect of body weight status in the late-teenage years on wages operating through education and occupation choice. Using the National Longitudinal Survey of Youth 1979 data, for women, we find that a one-unit increase in BMI is directly associated with 1.83% lower hourly wages whereas the indirect BMI wage penalty is not statistically significant. Neither a direct nor an indirect BMI wage penalty is found for men. However, results based on clinical weight classification reveal that the indirect wage penalty occurs to a larger extent at the upper tail of the BMI distribution for both men and women via the pathways of education and occupation outcomes. Late-teen obesity is indirectly associated with 3.5% lower hourly wages for both women and men. These results are important because they imply that the total effect of obesity on wages is significantly larger than has been estimated in previous cross-sectional studies. 2011 Elsevier B.V. All rights reserved.

Two-step estimation in ratio-of-mediator-probability weighted causal mediation analysis.

PubMed

Bein, Edward; Deutsch, Jonah; Hong, Guanglei; Porter, Kristin E; Qin, Xu; Yang, Cheng

2018-04-15

This study investigates appropriate estimation of estimator variability in the context of causal mediation analysis that employs propensity score-based weighting. Such an analysis decomposes the total effect of a treatment on the outcome into an indirect effect transmitted through a focal mediator and a direct effect bypassing the mediator. Ratio-of-mediator-probability weighting estimates these causal effects by adjusting for the confounding impact of a large number of pretreatment covariates through propensity score-based weighting. In step 1, a propensity score model is estimated. In step 2, the causal effects of interest are estimated using weights derived from the prior step's regression coefficient estimates. Statistical inferences obtained from this 2-step estimation procedure are potentially problematic if the estimated standard errors of the causal effect estimates do not reflect the sampling uncertainty in the estimation of the weights. This study extends to ratio-of-mediator-probability weighting analysis a solution to the 2-step estimation problem by stacking the score functions from both steps. We derive the asymptotic variance-covariance matrix for the indirect effect and direct effect 2-step estimators, provide simulation results, and illustrate with an application study. Our simulation results indicate that the sampling uncertainty in the estimated weights should not be ignored. The standard error estimation using the stacking procedure offers a viable alternative to bootstrap standard error estimation. We discuss broad implications of this approach for causal analysis involving propensity score-based weighting. Copyright © 2018 John Wiley & Sons, Ltd.

Abstract: Inference and Interval Estimation for Indirect Effects With Latent Variable Models.

PubMed

Falk, Carl F; Biesanz, Jeremy C

2011-11-30

Models specifying indirect effects (or mediation) and structural equation modeling are both popular in the social sciences. Yet relatively little research has compared methods that test for indirect effects among latent variables and provided precise estimates of the effectiveness of different methods. This simulation study provides an extensive comparison of methods for constructing confidence intervals and for making inferences about indirect effects with latent variables. We compared the percentile (PC) bootstrap, bias-corrected (BC) bootstrap, bias-corrected accelerated (BC a ) bootstrap, likelihood-based confidence intervals (Neale & Miller, 1997), partial posterior predictive (Biesanz, Falk, and Savalei, 2010), and joint significance tests based on Wald tests or likelihood ratio tests. All models included three reflective latent variables representing the independent, dependent, and mediating variables. The design included the following fully crossed conditions: (a) sample size: 100, 200, and 500; (b) number of indicators per latent variable: 3 versus 5; (c) reliability per set of indicators: .7 versus .9; (d) and 16 different path combinations for the indirect effect (α = 0, .14, .39, or .59; and β = 0, .14, .39, or .59). Simulations were performed using a WestGrid cluster of 1680 3.06GHz Intel Xeon processors running R and OpenMx. Results based on 1,000 replications per cell and 2,000 resamples per bootstrap method indicated that the BC and BC a bootstrap methods have inflated Type I error rates. Likelihood-based confidence intervals and the PC bootstrap emerged as methods that adequately control Type I error and have good coverage rates.

Energy-based adaptive focusing of waves: application to noninvasive aberration correction of ultrasonic wavefields

PubMed Central

Herbert, Eric; Pernot, Mathieu; Montaldo, Gabriel; Fink, Mathias; Tanter, Mickael

2009-01-01

An aberration correction method based on the maximization of the wave intensity at the focus of an emitting array is presented. The potential of this new adaptive focusing technique is investigated for ultrasonic focusing in biological tissues. The acoustic intensity is maximized non invasively through the direct measurement or indirect estimation of the beam energy at the focus for a series of spatially coded emissions. For ultrasonic waves, the acoustic energy at the desired focus can be indirectly estimated from the local displacements induced in tissues by the ultrasonic radiation force of the beam. Based on the measurement of these displacements, this method allows the precise estimation of the phase and amplitude aberrations and consequently the correction of aberrations along the beam travel path. The proof of concept is first performed experimentally using a large therapeutic array with strong electronic phase aberrations (up to 2π). Displacements induced by the ultrasonic radiation force at the desired focus are indirectly estimated using the time shift of backscattered echoes recorded on the array. The phase estimation is deduced accurately using a direct inversion algorithm which reduces the standard deviation of the phase distribution from σ = 1.89 before correction to σ = 0.53 following correction. The corrected beam focusing quality is verified using a needle hydrophone. The peak intensity obtained through the aberrator is found to be −7.69 dB below the reference intensity obtained without any aberration. Using the phase correction, a sharp focus is restored through the aberrator with a relative peak intensity of −0.89 dB. The technique is tested experimentally using a linear transmit/receive array through a real aberrating layer. The array is used to automatically correct its beam quality, as it both generates the radiation force with coded excitations and indirectly estimates the acoustic intensity at the focus with speckle tracking. This technique could have important implications in the field of High Intensity Focused Ultrasound even in complex configurations such as transcranial, transcostal or deep seated organs. PMID:19942526

Sport fishing: a comparison of three indirect methods for estimating benefits.

Treesearch

Darrell L. Hueth; Elizabeth J. Strong; Roger D. Fight

1988-01-01

Three market-based methods for estimating values of sport fishing were compared by using a common data base. The three approaches were the travel-cost method, the hedonic travel-cost method, and the household-production method. A theoretical comparison of the resulting values showed that the results were not fully comparable in several ways. The comparison of empirical...

Global Economic Impact of Dental Diseases.

PubMed

Listl, S; Galloway, J; Mossey, P A; Marcenes, W

2015-10-01

Reporting the economic burden of oral diseases is important to evaluate the societal relevance of preventing and addressing oral diseases. In addition to treatment costs, there are indirect costs to consider, mainly in terms of productivity losses due to absenteeism from work. The purpose of the present study was to estimate the direct and indirect costs of dental diseases worldwide to approximate the global economic impact. Estimation of direct treatment costs was based on a systematic approach. For estimation of indirect costs, an approach suggested by the World Health Organization's Commission on Macroeconomics and Health was employed, which factored in 2010 values of gross domestic product per capita as provided by the International Monetary Fund and oral burden of disease estimates from the 2010 Global Burden of Disease Study. Direct treatment costs due to dental diseases worldwide were estimated at US$298 billion yearly, corresponding to an average of 4.6% of global health expenditure. Indirect costs due to dental diseases worldwide amounted to US$144 billion yearly, corresponding to economic losses within the range of the 10 most frequent global causes of death. Within the limitations of currently available data sources and methodologies, these findings suggest that the global economic impact of dental diseases amounted to US$442 billion in 2010. Improvements in population oral health may imply substantial economic benefits not only in terms of reduced treatment costs but also because of fewer productivity losses in the labor market. © International & American Associations for Dental Research 2015.

M-X Environmental Technical Report. Economic Model.

DTIC Science & Technology

1980-12-22

TABLE PAGE C-4. Estimated off base school facility costs. 147 C-5. Estimated development costs to other public facilities. 148 C-6. Estimated utility... development costs. 149 C-7. Estimated non-residential building development . 151 E-1. Adjustments to baseline population projections to account for...the fringes of the rural deployment areas themselves. These metropolitan areas potentially would experience significant indirect employment growth as a

Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States

PubMed Central

2009-01-01

Background The aim of this study was to estimate both the direct and indirect annual costs of treating bacterial conjunctivitis (BC) in the United States. This was a cost of illness study performed from a U.S. healthcare payer perspective. Methods A comprehensive review of the medical literature was supplemented by data on the annual incidence of BC which was obtained from an analysis of the National Ambulatory Medical Care Survey (NAMCS) database for the year 2005. Cost estimates for medical visits and laboratory or diagnostic tests were derived from published Medicare CPT fee codes. The cost of prescription drugs was obtained from standard reference sources. Indirect costs were calculated as those due to lost productivity. Due to the acute nature of BC, no cost discounting was performed. All costs are expressed in 2007 U.S. dollars. Results The number of BC cases in the U.S. for 2005 was estimated at approximately 4 million yielding an estimated annual incidence rate of 135 per 10,000. Base-case analysis estimated the total direct and indirect cost of treating patients with BC in the United States at $ 589 million. One- way sensitivity analysis, assuming either a 20% variation in the annual incidence of BC or treatment costs, generated a cost range of $ 469 million to $ 705 million. Two-way sensitivity analysis, assuming a 20% variation in both the annual incidence of BC and treatment costs occurring simultaneously, resulted in an estimated cost range of $ 377 million to $ 857 million. Conclusion The economic burden posed by BC is significant. The findings may prove useful to decision makers regarding the allocation of healthcare resources necessary to address the economic burden of BC in the United States. PMID:19939250

Clinical attachment loss: estimation by direct and indirect methods.

PubMed

Barbosa, Viviane Leal; Angst, Patricia D Melchiors; Finger Stadler, Amanda; Oppermann, Rui V; Gomes, Sabrina Carvalho

2016-06-01

This observational study aimed to compare the estimation of clinical attachment loss (CAL) as measured by direct (CALD ) and indirect (CALI ) methods. Periodontitis patients (n = 75; mean age: 50.9 ± 8.02 years; 72.2% women; 50.6% smokers) received a periodontal examination (six sites/tooth) to determine the presence of visible plaque and calculus, the gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), CALD and gingival recession (GR). CALI values resulted from the sum of PPD and GR values. Statistical analysis considered only data from sites with visible GR (e.g. the gingival margin apical to the cemento-enamel junction; n = 4,757 sites) and determined the mean difference between CALI and CALD measurements. Based on the mean difference, univariate and multivariate analyses were also performed. Mean CALD and CALI values were 3.96 ± 2.07 mm and 4.47 ± 2.03 mm, respectively. The indirect method overestimated CAL compared with the direct method (mean difference: 0.51 ± 1.23 mm; P < 0.001). On uni- and multivariate analyses, absence of GBI and BOP, PPD and proximal site location had significant influences on the overestimation of CAL by the indirect method (all P ≤ 0.01). The indirect method increased the CAL value by 0.38 mm for each additional 1 mm in PPD. To decrease the number of probing errors in daily practice it is suggested that direct examination is more appropriate than the indirect method for estimating CAL. © 2016 FDI World Dental Federation.

Using direct calorimetry to test the accuracy of indirect calorimetry in an ectotherm.

PubMed

Walsberg, Glenn E; Hoffman, Ty C M

2006-01-01

We previously demonstrated that the relationship between respiratory gas exchange and metabolic heat production is unexpectedly variable and that conventional approaches to estimating energy expenditure by indirect calorimetry can incorporate large errors. Prior studies, however, comparing direct and indirect calorimetry of animals focused only on endothermic organisms. Given that endothermy and ectothermy represent a fundamental dichotomy of animal energetics, in this analysis we explore how these contrasting physiologies correlate with the relationship between heat production and respiratory gas exchange. Simultaneous indirect and direct calorimetry in an ectotherm, the ball python (Python regius Shaw), revealed that the relationships between gas exchange and heat production were within 1% of those expected when analyses using indirect calorimetry were based on the assumption that the fasting animal catabolized only protein. This accuracy of indirect calorimetry contrasts sharply with our previous conclusions for three species of birds and mammals.

Indirect and direct recharges in a tropical forested watershed: Mule Hole, India

NASA Astrophysics Data System (ADS)

Maréchal, Jean-Christophe; Varma, Murari R. R.; Riotte, Jean; Vouillamoz, Jean-Michel; Kumar, M. S. Mohan; Ruiz, Laurent; Sekhar, M.; Braun, Jean-Jacques

2009-01-01

SummaryIt is commonly accepted that forest plays role to modify the water cycle at the watershed scale. However, the impact of forest on aquifer recharge is still discussed: some studies indicate that infiltration is facilitated under forest while other studies suggest a decrease of recharge. This paper presents an estimate of recharge rates to groundwater in a humid forested watershed of India. Recharge estimates are based on the joint use of several methods: chloride mass balance, water table fluctuation, geophysics, groundwater chemistry and flow analysis. Two components of the recharge (direct and indirect) are estimated over 3 years of monitoring (2003-2006). The direct and localized recharges resulting from rainfall over the entire watershed surface area is estimated to 45 mm/yr while the indirect recharge occurring from the stream during flood events is estimated to 30 mm/yr for a 2 km-long stream. Calculated recharge rates, rainfall and runoff measurements are then combined in a water budget to estimate yearly evapotranspiration which ranges from 80% to 90% of the rainfall, i.e. 1050 mm/y as an average. This unexpected high value for a deciduous forest is nevertheless in agreement with the forest worldwide relationship between rainfall and evapotranspiration. The large evapotranspiration from the forest cover contributes to decrease the recharge rate which leads to a lowering of the water table. This is the reason why the stream is highly ephemeral.

Site quality relationships for shortleaf pine

Treesearch

David L. Graney

1986-01-01

Existing information about site quality relationships for shortleaf pine (Pinus echinata Mill.) in the southeastern United States is reviewed in this paper. Estimates of site quality, whether from direct tree measurements or indirect estimates based on soil and site features, are only local observations for many points on the landscape. To be of value to the land...

SEASONAL AND REGIONAL VARIATIONS OF PRIMARY AND SECONDARY ORGANIC AEROSOLS OVER THE CONTINENTAL UNITED STATES: OBSERVATION-BASED ESTIMATES AND MODEL EVALUATION

EPA Science Inventory

Due to the lack of an analytical technique for directly quantifying the atmospheric concentrations of primary (OC_pri) and secondary (OC_sec) organic carbon aerosols, different indirect methods have been developed to estimate their concentrations. In this stu...

Issues connected with indirect cost quantification: a focus on the transportation system

NASA Astrophysics Data System (ADS)

Křivánková, Zuzana; Bíl, Michal; Kubeček, Jan; Vodák, Rostislav

2017-04-01

Transportation and communication networks in general are vital parts of modern society. The economy relies heavily on transportation system performance. A number of people commutes to work regularly. Stockpiles in many companies are being reduced as the just-in-time production process is able to supply resources via the transportation network on time. Natural hazards have the potential to disturb transportation systems. Earthquakes, flooding or landsliding are examples of high-energetic processes which are capable of causing direct losses (i.e. physical damage to the infrastructure). We have focused on quantification of the indirect cost of natural hazards which are not easy to estimate. Indirect losses can also emerge as a result of meteorological hazards with low energy which only seldom cause direct losses, e.g. glaze, snowfall. Whereas evidence of repair work and general direct costs usually exist or can be estimated, indirect costs are much more difficult to identify particularly when they are not covered by insurance agencies. Delimitations of alternative routes (detours) are the most frequent responses to blocked road links. Indirect costs can then be related to increased fuel consumption and additional operating costs. Detours usually result in prolonged travel times. Indirect costs quantification has to therefore cover the value of the time. The costs from the delay are a nonlinear function of travel time, however. The existence of an alternative transportation pattern may also result in an increased number of traffic crashes. This topic has not been studied in depth but an increase in traffic crashes has been reported when people suddenly changed their traffic modes, e.g. when air traffic was not possible. The lost user benefit from those trips that were cancelled or suppressed is also difficult to quantify. Several approaches, based on post-event questioner surveys, have been applied to communities and companies affected by transportation accessibility cut-off. No widely accepted methodology is available, however. In this presentation we will discuss current approaches, and their limitations related to indirect cost estimation which can be applied to estimation of natural hazard impacts.

Assessing the indirect effects due to natural hazards on a mesoscale

NASA Astrophysics Data System (ADS)

Pfurtscheller, C.; Schwarze, R.

2009-04-01

Measuring indirect economic costs and other effects from natural hazards, especially floods in alpine and other mountainous regions, are a necessary part of a comprehensive economic assessment. Their omission seriously affects the relative economic benefits of structural or non structural measures of flood defence. Surpassing controversial, IO-model-based economic estimates, analysing indirect economic effects lead to the key question of identifying and evaluating the drivers of indirect economic effects and resilience to system effects in the regional economy, i.e. at the meso-level. This investigation takes place for the catastrophic floods in summer 2005 in the provinces of Tyrol and Vorarlberg, Austria, which caused an estimated € 670 Mio direct loss on private and public assets and severe interruptions in lifeline services. The paper starts out with differentiating the concept of indirect economic costs from direct costs, examing different temporal (short vs. long-term) and spatial (macro-, meso- vs. microeconomic) system boundaries. It surveys common theories of economic resilience and vulnerability at the regional economy level. Indirect effects at the regional economy level can be defined as interferences of the economic exchange of goods and services triggered by breakdowns of transport lines and critical production inputs. The extent and persistence of indirect effects of natural hazards is not only by parameters of the extreme event, such as duration and amplitude of the flood, but much more by resilience parameters of the regional economy such as size of enterprises, the network structure (linkages) of the regional economy, availability of insurance and relief funds, and the stock of inventory. These effects can only be dissected by means of expert judgement and event studies. This paper presents the results of a survey conducted among business practioneers, members of chamber of commerce, civil protection agencies to identify and scale the drivers of indirect costs triggered by floods on a local and regional scale. We develop a risk point scale and explain how it can be nested into IO-model-based economic tools such as the HAZUS indirect economic loss calculator

Indirect costs of absenteeism due to rheumatoid arthritis, psoriasis, multiple sclerosis, insulin-dependent diabetes mellitus, and ulcerative colitis in 2012: a study based on real-life data from the Social Insurance Institution in Poland.

PubMed

Malinowski, Krzysztof Piotr; Kawalec, Paweł Piotr; Moćko, Paweł

2016-01-01

The aim of this study is to assess the indirect costs of six major autoimmune diseases including seropositive rheumatoid arthritis, other types of rheumatoid arthritis, psoriasis, multiple sclerosis, Type 1 diabetes, and ulcerative colitis. Relevant data for 2012 on sick leave and short- and long-term work disabilities were obtained from the Social Insurance Institution in Poland. Indirect costs were estimated using the human capital approach based on gross domestic product per capita, gross value added per worker, and gross income per worker in Poland in 2012 and expressed in euro. We recorded data on the total number of 45,500 patients. The total indirect costs were EUR 146,862,569; 353,683,508; and 108,154,271, calculated using gross domestic product, gross value added, and gross income, respectively. Considering only data on absenteeism collected by the Social Insurance Institution in Poland, we can conclude that the selected autoimmune diseases are associated with great indirect costs.

Quantitative assessment of direct and indirect landslide risk along transportation lines in southern India

NASA Astrophysics Data System (ADS)

Jaiswal, P.; van Westen, C. J.; Jetten, V.

2010-06-01

A quantitative approach for landslide risk assessment along transportation lines is presented and applied to a road and a railway alignment in the Nilgiri hills in southern India. The method allows estimating direct risk affecting the alignments, vehicles and people, and indirect risk resulting from the disruption of economic activities. The data required for the risk estimation were obtained from historical records. A total of 901 landslides were catalogued initiating from cut slopes along the railway and road alignment. The landslides were grouped into three magnitude classes based on the landslide type, volume, scar depth, run-out distance, etc and their probability of occurrence was obtained using frequency-volume distribution. Hazard, for a given return period, expressed as the number of landslides of a given magnitude class per kilometre of cut slopes, was obtained using Gumbel distribution and probability of landslide magnitude. In total 18 specific hazard scenarios were generated using the three magnitude classes and six return periods (1, 3, 5, 15, 25, and 50 years). The assessment of the vulnerability of the road and railway line was based on damage records whereas the vulnerability of different types of vehicles and people was subjectively assessed based on limited historic incidents. Direct specific loss for the alignments (railway line and road), vehicles (train, bus, lorry, car and motorbike) was expressed in monetary value (US), and direct specific loss of life of commuters was expressed in annual probability of death. Indirect specific loss (US) derived from the traffic interruption was evaluated considering alternative driving routes, and includes losses resulting from additional fuel consumption, additional travel cost, loss of income to the local business, and loss of revenue to the railway department. The results indicate that the total loss, including both direct and indirect loss, from 1 to 50 years return period, varies from US 90 840 to US 779 500 and the average annual total loss was estimated as US 35 000. The annual probability of a person most at risk travelling in a bus, lorry, car, motorbike and train is less than 10-4/annum in all the time periods considered. The detailed estimation of direct and indirect risk will facilitate developing landslide risk mitigation and management strategies for transportation lines in the study area.

Direct and indirect costs for systemic lupus erythematosus in Sweden. A nationwide health economic study based on five defined cohorts.

PubMed

Jönsen, Andreas; Hjalte, Frida; Willim, Minna; Carlsson, Katarina Steen; Sjöwall, Christopher; Svenungsson, Elisabet; Leonard, Dag; Bengtsson, Christine; Rantapää-Dahlqvist, Solbritt; Pettersson, Susanne; Gunnarsson, Iva; Zickert, Agneta; Gustafsson, Johanna T; Rönnblom, Lars; Petersson, Ingemar F; Bengtsson, Anders A; Nived, Ola

2016-06-01

The main objectives of this study were to calculate total costs of illness and cost-driving disease features among patients with systemic lupus erythematosus (SLE) in Sweden. Five cohorts of well-defined SLE patients, located in different parts of the country were merged. Incident and prevalent cases from 2003 through 2010 were included. The American College of Rheumatology (ACR) classification criteria was used. From the local cohorts, data on demographics, disease activity (SLEDAI 2K), and organ damage (SDI) were collected. Costs for inpatient care, specialist outpatient care and drugs were retrieved from national registries at the National Board of Health and Welfare. Indirect costs were calculated based on sickness leave and disability pensions from the Swedish Social Insurance Agency. In total, 1029 SLE patients, 88% females, were included, and approximately 75% were below 65 years at the end of follow-up, and thus in working age. The mean number of annual specialist physician visits varied from six to seven; mean annual inpatient days were 3.1-3.6, and mean annual sick leave was 123-148 days, all per patient. The total annual cost was 208,555 SEK ($33,369 = 22,941€), of which direct cost was 63,672kr ($10,188 = 7004€) and the indirect cost was 144,883 SEK ($23,181 = 15,937€), all per patient. The costs for patients with short disease duration were higher. Higher disease activity as measured by a SLEDAI 2K score > 3 was associated with approximately 50% increase in both indirect and direct costs. Damage in the neuropsychiatric and musculoskeletal domains were also linked to higher direct and indirect costs, while organ damage in the renal and ocular systems increased direct costs. Based on this study and an estimate of slightly more than 6000 SLE patients in Sweden, the total annual cost for SLE in the country is estimated at $188 million (=129.5 million €). Both direct (30%) and indirect costs (70%) are substantial. Medication accounts for less than 10% of the total cost. The tax paid national systems for health care and social security in Sweden ensure equal access to health care, sick leave reimbursements, and disability pensions nationwide. Our extrapolated annual costs for SLE in Sweden are therefore the best supported estimations thus far, and they clearly underline the importance of improved management, especially to reduce the indirect costs. Copyright © 2016 Elsevier Inc. All rights reserved.

Regional economic activity and absenteeism: a new approach to estimating the indirect costs of employee productivity loss.

PubMed

Bankert, Brian; Coberley, Carter; Pope, James E; Wells, Aaron

2015-02-01

This paper presents a new approach to estimating the indirect costs of health-related absenteeism. Productivity losses related to employee absenteeism have negative business implications for employers and these losses effectively deprive the business of an expected level of employee labor. The approach herein quantifies absenteeism cost using an output per labor hour-based method and extends employer-level results to the region. This new approach was applied to the employed population of 3 health insurance carriers. The economic cost of absenteeism was estimated to be $6.8 million, $0.8 million, and $0.7 million on average for the 3 employers; regional losses were roughly twice the magnitude of employer-specific losses. The new approach suggests that costs related to absenteeism for high output per labor hour industries exceed similar estimates derived from application of the human capital approach. The materially higher costs under the new approach emphasize the importance of accurately estimating productivity losses.

[Direct and indirect costs associated with respiratory allergic diseases in Italy. A probabilistic cost of illness study].

PubMed

Marcellusi, Andrea; Viti, Raffaella; Incorvaia, Cristoforo; Mennini, Francesco Saverio

2015-10-01

The respiratory allergies, including allergic rhinitis and allergic asthma, represent a substantial medical and economic burden worldwide. Despite their dimension and huge economic-social burden, no data are available on the costs associated with the management of respiratory allergic diseases in Italy. The objective of this study was to estimate the average annual cost incurred by the National Health Service (NHS), as well as society, due to respiratory allergies and their main co-morbidities in Italy. A probabilistic prevalence-based cost of illness model was developed to estimate an aggregate measure of the economic burden associated with respiratory allergies and their main co-morbidities in terms of direct and indirect costs. A systematic literature review was performed in order to identify both the cost per case (expressed in present value) and the number of affected patients, by applying an incidence-based estimation method. Direct costs were estimated multiplying the hospitalization, drugs and management costs derived by the literature with the Italian epidemiological data. Indirect costs were calculated based on lost productivity according to the human capital approach. Furthermore, a one-way and probabilistic sensitivity analysis with 5,000 Monte Carlo simulations were performed, in order to test the robustness of the results and define the proper 95% Confidence Interval (CI). Overall, the total economic burden associated with respiratory allergies and their main co-morbidities was € 7.33 billion (95% CI: € 5.99-€ 8.82). A percentage of 27.5% was associated with indirect costs (€ 2.02; 95% CI: € 1.72-€ 2.34 billion) and 72.5% with direct costs (€ 5.32; 95% CI: € 4.04-€ 6.77 billion). In allergic asthma, allergic rhinitis, combined allergic rhinitis and asthma, turbinate hypertrophy and allergic conjunctivitis, the model estimate an average annual economic burden of € 1,35 (95% CI: € 1,14-€ 1,58) billion, € 1,72 (95% CI: € 1,14-€ 2,43) billion, € 1,62 billion (€ 0,91-€ 2,53) billion, € 0,12 (€ 0,07-€ 0,17) billion, € 0,46 (€ 0,16-€ 0,92) billion respectively. To our knowledge, this is the first study in which direct costs (incurred by NHS) and indirect ones (incurred by the society) were taken into account to estimate the overall burden associated with respiratory allergies and their main co-morbidities in our Country. In conclusion, this work may be considered an efficient tool for public decision-makers to correctly understand the economic aspects involved by the management and treatment of respiratory allergies-induced diseases in Italy.

Expensive Children in Poor Families: The Intersection of Childhood Disabilities and Welfare.

ERIC Educational Resources Information Center

Meyers, Marcia K.; Brady, Henry E.; Seto, Eva Y.

This book provides new estimates of the private costs and public effects of childhood disabilities among welfare recipients. Based on over 2,000 interviews conducted between 1992-96 with household heads in 3 California counties, the estimates cover direct expenditures by families and indirect costs from employment reductions. The study finds that…

Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

PubMed

Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

2012-01-01

The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Indirect Human Impacts Reverse Centuries of Carbon Sequestration and Salt Marsh Accretion

PubMed Central

Coverdale, Tyler C.; Brisson, Caitlin P.; Young, Eric W.; Yin, Stephanie F.; Donnelly, Jeffrey P.; Bertness, Mark D.

2014-01-01

Direct and indirect human impacts on coastal ecosystems have increased over the last several centuries, leading to unprecedented degradation of coastal habitats and loss of ecological services. Here we document a two-century temporal disparity between salt marsh accretion and subsequent loss to indirect human impacts. Field surveys, manipulative experiments and GIS analyses reveal that crab burrowing weakens the marsh peat base and facilitates further burrowing, leading to bank calving, disruption of marsh accretion, and a loss of over two centuries of sequestered carbon from the marsh edge in only three decades. Analogous temporal disparities exist in other systems and are a largely unrecognized obstacle in attaining sustainable ecosystem services in an increasingly human impacted world. In light of the growing threat of indirect impacts worldwide and despite uncertainties in the fate of lost carbon, we suggest that estimates of carbon emissions based only on direct human impacts may significantly underestimate total anthropogenic carbon emissions. PMID:24675669

A comparison of average wages with age-specific wages for assessing indirect productivity losses: analytic simplicity versus analytic precision.

PubMed

Connolly, Mark P; Tashjian, Cole; Kotsopoulos, Nikolaos; Bhatt, Aomesh; Postma, Maarten J

2017-07-01

Numerous approaches are used to estimate indirect productivity losses using various wage estimates applied to poor health in working aged adults. Considering the different wage estimation approaches observed in the published literature, we sought to assess variation in productivity loss estimates when using average wages compared with age-specific wages. Published estimates for average and age-specific wages for combined male/female wages were obtained from the UK Office of National Statistics. A polynomial interpolation was used to convert 5-year age-banded wage data into annual age-specific wages estimates. To compare indirect cost estimates, average wages and age-specific wages were used to project productivity losses at various stages of life based on the human capital approach. Discount rates of 0, 3, and 6 % were applied to projected age-specific and average wage losses. Using average wages was found to overestimate lifetime wages in conditions afflicting those aged 1-27 and 57-67, while underestimating lifetime wages in those aged 27-57. The difference was most significant for children where average wage overestimated wages by 15 % and for 40-year-olds where it underestimated wages by 14 %. Large differences in projecting productivity losses exist when using the average wage applied over a lifetime. Specifically, use of average wages overestimates productivity losses between 8 and 15 % for childhood illnesses. Furthermore, during prime working years, use of average wages will underestimate productivity losses by 14 %. We suggest that to achieve more precise estimates of productivity losses, age-specific wages should become the standard analytic approach.

Separating Direct and Indirect Turbofan Engine Combustion Noise While Estimating Post-Combustion (Post-Flame) Residence Time Using the Correlation Function

NASA Technical Reports Server (NTRS)

Miles, Jeffrey Hilton

2011-01-01

A previous investigation on the presence of direct and indirect combustion noise for a full-scale turbofan engine using a far-field microphone at 130 is extended by also examining signals obtained at two additional downstream directions using far-field microphones at 110 deg and 160 deg. A generalized cross-correlation function technique is used to study the change in propagation time to the far field of the combined direct and indirect combustion noise signal as a sequence of low-pass filters are applied. The filtering procedure used produces no phase distortion. As the low-pass filter frequency is decreased, the travel time increases because the relative amount of direct combustion noise is reduced. The indirect combustion noise signal travels more slowly because in the combustor entropy fluctuations move with the flow velocity, which is slow compared to the local speed of sound. The indirect combustion noise signal travels at acoustic velocities after reaching the turbine and being converted into an acoustic signal. The direct combustion noise is always propagating at acoustic velocities. The results show that the estimated indirect combustion noise time delay values (post-combustion residence times) measured at each angle are fairly consistent with one another for a relevant range of operating conditions and demonstrate source separation of a mixture of direct and indirect combustion noise. The results may lead to a better idea about the acoustics in the combustor and may help develop and validate improved reduced-order physics-based methods for predicting turbofan engine core noise.

Direct and Indirect Costs of Chronic and Episodic Migraine in the United States: A Web-Based Survey.

PubMed

Messali, Andrew; Sanderson, Joanna C; Blumenfeld, Andrew M; Goadsby, Peter J; Buse, Dawn C; Varon, Sepideh F; Stokes, Michael; Lipton, Richard B

2016-02-01

The objective of this study was to compare the societal direct and indirect costs of chronic and episodic migraine in the United States. Episodic and chronic migraine are distinguished by the frequency of headache-days. Chronic migraine has a greater overall impact on quality of life than does episodic migraine. Individuals with chronic migraine also use more healthcare resources (resulting in higher direct costs) and experience greater decreases in productivity (resulting in higher indirect costs) than those with episodic migraine as shown in the American Migraine Prevalence and Prevention (AMPP) Study. The International Burden of Migraine Study utilized a web-based questionnaire to elicit data on several topics related to the burden of migraine illness, including health resource utilization and productivity losses. Potential survey participants were identified by Synovate Healthcare (Chicago, IL, USA) from a pool of registered panelists from various countries. The panelists were screened online to determine eligibility and to identify individuals with migraine (episodic or chronic), based on reported symptoms. Participants from the United States were divided into episodic and chronic migraine groups, based on reported headache-day per month frequency. Direct and indirect costs were estimated by applying estimated unit costs to reported headache-related productivity losses and resource use. Costs were compared between participants with episodic and chronic migraine. Mean [standard deviation] total annual cost of headache among people with chronic migraine ($8243 [$10,646]) was over three times that of episodic migraine ($2649 [$4634], P < .001). Participants with chronic migraine had significantly greater direct medical costs ($4943 [$6382]) and indirect (lost productivity) costs ($3300 [$6907]) than did participants with episodic migraine (direct, $1705 [$3591]; indirect, $943 [$2084]) (P < .001 for each). Unlike previous findings, direct medical costs constituted the majority of total headache-related costs for both chronic migraine (60.0%, $4943 of $8243) and episodic migraine (64.3%, $1705 of $2649) participants. A large portion of direct medical costs are attributable to pharmaceutical utilization among both chronic migraine (80%, $3925 of 4943) and episodic migraine (70%, $1196 of $1705) participants. The results of this study build on previous results of the AMPP Study, demonstrating that headache-related direct, indirect, and total costs are significantly greater among individuals with chronic migraine than with episodic migraine in the United States. © 2016 American Headache Society.

Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach.

PubMed

Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Bakakos, Petros; Toumbis, Michalis; Loukides, Stelios; Vassilakopoulos, Theodoros

2017-01-01

Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal. Patients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs. Asthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.

Plumage condition in laying hens: genetic parameters for direct and indirect effects in two purebred layer lines.

PubMed

Brinker, Tessa; Bijma, Piter; Visscher, Jeroen; Rodenburg, T Bas; Ellen, Esther D

2014-05-29

Feather pecking is a major welfare issue in laying hen industry that leads to mortality. Due to a ban on conventional cages in the EU and on beak trimming in some countries of the EU, feather pecking will become an even bigger problem. Its severity depends both on the victim receiving pecking and on its group mates inflicting pecking (indirect effects), which together determine plumage condition of the victim. Plumage condition may depend, therefore, on both the direct genetic effect of an individual itself and on the indirect genetic effects of its group mates. Here, we present estimated genetic parameters for direct and indirect effects on plumage condition of different body regions in two purebred layer lines, and estimates of genetic correlations between body regions. Feather condition scores (FCS) were recorded at 40 weeks of age for neck, back, rump and belly and these four scores were added-up into a total FCS. A classical animal model and a direct-indirect effects model were used to estimate genetic parameters for FCS. In addition, a bivariate model with mortality (0/1) was used to account for mortality before recording FCS. Due to mortality during the first 23 weeks of laying, 5363 (for W1) and 5089 (for WB) FCS records were available. Total heritable variance for FCS ranged from 1.5% to 9.8% and from 9.8% to 53.6% when estimated respectively with the classical animal and the direct-indirect effects model. The direct-indirect effects model had a significantly higher likelihood. In both lines, 70% to 94% of the estimated total heritable variation in FCS was due to indirect effects. Using bivariate analysis of FCS and mortality did not affect estimates of genetic parameters. Genetic correlations were high between adjacent regions for FCS on neck, back, and rump but moderate to low for belly with other regions. Our results show that 70% to 94% of the heritable variation in FCS relates to indirect effects, indicating that methods of genetic selection that include indirect genetic effects offer perspectives to improve plumage condition in laying hens. This, in turn could reduce a major welfare problem.

Direct parametric reconstruction in dynamic PET myocardial perfusion imaging: in vivo studies.

PubMed

Petibon, Yoann; Rakvongthai, Yothin; El Fakhri, Georges; Ouyang, Jinsong

2017-05-07

Dynamic PET myocardial perfusion imaging (MPI) used in conjunction with tracer kinetic modeling enables the quantification of absolute myocardial blood flow (MBF). However, MBF maps computed using the traditional indirect method (i.e. post-reconstruction voxel-wise fitting of kinetic model to PET time-activity-curves-TACs) suffer from poor signal-to-noise ratio (SNR). Direct reconstruction of kinetic parameters from raw PET projection data has been shown to offer parametric images with higher SNR compared to the indirect method. The aim of this study was to extend and evaluate the performance of a direct parametric reconstruction method using in vivo dynamic PET MPI data for the purpose of quantifying MBF. Dynamic PET MPI studies were performed on two healthy pigs using a Siemens Biograph mMR scanner. List-mode PET data for each animal were acquired following a bolus injection of ~7-8 mCi of 18 F-flurpiridaz, a myocardial perfusion agent. Fully-3D dynamic PET sinograms were obtained by sorting the coincidence events into 16 temporal frames covering ~5 min after radiotracer administration. Additionally, eight independent noise realizations of both scans-each containing 1/8th of the total number of events-were generated from the original list-mode data. Dynamic sinograms were then used to compute parametric maps using the conventional indirect method and the proposed direct method. For both methods, a one-tissue compartment model accounting for spillover from the left and right ventricle blood-pools was used to describe the kinetics of 18 F-flurpiridaz. An image-derived arterial input function obtained from a TAC taken in the left ventricle cavity was used for tracer kinetic analysis. For the indirect method, frame-by-frame images were estimated using two fully-3D reconstruction techniques: the standard ordered subset expectation maximization (OSEM) reconstruction algorithm on one side, and the one-step late maximum a posteriori (OSL-MAP) algorithm on the other side, which incorporates a quadratic penalty function. The parametric images were then calculated using voxel-wise weighted least-square fitting of the reconstructed myocardial PET TACs. For the direct method, parametric images were estimated directly from the dynamic PET sinograms using a maximum a posteriori (MAP) parametric reconstruction algorithm which optimizes an objective function comprised of the Poisson log-likelihood term, the kinetic model and a quadratic penalty function. Maximization of the objective function with respect to each set of parameters was achieved using a preconditioned conjugate gradient algorithm with a specifically developed pre-conditioner. The performance of the direct method was evaluated by comparing voxel- and segment-wise estimates of [Formula: see text], the tracer transport rate (ml · min -1 · ml -1 ), to those obtained using the indirect method applied to both OSEM and OSL-MAP dynamic reconstructions. The proposed direct reconstruction method produced [Formula: see text] maps with visibly lower noise than the indirect method based on OSEM and OSL-MAP reconstructions. At normal count levels, the direct method was shown to outperform the indirect method based on OSL-MAP in the sense that at matched level of bias, reduced regional noise levels were obtained. At lower count levels, the direct method produced [Formula: see text] estimates with significantly lower standard deviation across noise realizations than the indirect method based on OSL-MAP at matched bias level. In all cases, the direct method yielded lower noise and standard deviation than the indirect method based on OSEM. Overall, the proposed direct reconstruction offered a better bias-variance tradeoff than the indirect method applied to either OSEM and OSL-MAP. Direct parametric reconstruction as applied to in vivo dynamic PET MPI data is therefore a promising method for producing MBF maps with lower variance.

Direct parametric reconstruction in dynamic PET myocardial perfusion imaging: in-vivo studies

PubMed Central

Petibon, Yoann; Rakvongthai, Yothin; Fakhri, Georges El; Ouyang, Jinsong

2017-01-01

Dynamic PET myocardial perfusion imaging (MPI) used in conjunction with tracer kinetic modeling enables the quantification of absolute myocardial blood flow (MBF). However, MBF maps computed using the traditional indirect method (i.e. post-reconstruction voxel-wise fitting of kinetic model to PET time-activity-curves -TACs) suffer from poor signal-to-noise ratio (SNR). Direct reconstruction of kinetic parameters from raw PET projection data has been shown to offer parametric images with higher SNR compared to the indirect method. The aim of this study was to extend and evaluate the performance of a direct parametric reconstruction method using in-vivo dynamic PET MPI data for the purpose of quantifying MBF. Dynamic PET MPI studies were performed on two healthy pigs using a Siemens Biograph mMR scanner. List-mode PET data for each animal were acquired following a bolus injection of ~7-8 mCi of 18F-flurpiridaz, a myocardial perfusion agent. Fully-3D dynamic PET sinograms were obtained by sorting the coincidence events into 16 temporal frames covering ~5 min after radiotracer administration. Additionally, eight independent noise realizations of both scans - each containing 1/8th of the total number of events - were generated from the original list-mode data. Dynamic sinograms were then used to compute parametric maps using the conventional indirect method and the proposed direct method. For both methods, a one-tissue compartment model accounting for spillover from the left and right ventricle blood-pools was used to describe the kinetics of 18F-flurpiridaz. An image-derived arterial input function obtained from a TAC taken in the left ventricle cavity was used for tracer kinetic analysis. For the indirect method, frame-by-frame images were estimated using two fully-3D reconstruction techniques: the standard Ordered Subset Expectation Maximization (OSEM) reconstruction algorithm on one side, and the One-Step Late Maximum a Posteriori (OSL-MAP) algorithm on the other side, which incorporates a quadratic penalty function. The parametric images were then calculated using voxel-wise weighted least-square fitting of the reconstructed myocardial PET TACs. For the direct method, parametric images were estimated directly from the dynamic PET sinograms using a maximum a posteriori (MAP) parametric reconstruction algorithm which optimizes an objective function comprised of the Poisson log-likelihood term, the kinetic model and a quadratic penalty function. Maximization of the objective function with respect to each set of parameters was achieved using a preconditioned conjugate gradient algorithm with a specifically developed pre-conditioner. The performance of the direct method was evaluated by comparing voxel- and segment-wise estimates of K1, the tracer transport rate (mL.min−1.mL−1), to those obtained using the indirect method applied to both OSEM and OSL-MAP dynamic reconstructions. The proposed direct reconstruction method produced K1 maps with visibly lower noise than the indirect method based on OSEM and OSL-MAP reconstructions. At normal count levels, the direct method was shown to outperform the indirect method based on OSL-MAP in the sense that at matched level of bias, reduced regional noise levels were obtained. At lower count levels, the direct method produced K1 estimates with significantly lower standard deviation across noise realizations than the indirect method based on OSL-MAP at matched bias level. In all cases, the direct method yielded lower noise and standard deviation than the indirect method based on OSEM. Overall, the proposed direct reconstruction offered a better bias-variance tradeoff than the indirect method applied to either OSEM and OSL-MAP. Direct parametric reconstruction as applied to in-vivo dynamic PET MPI data is therefore a promising method for producing MBF maps with lower variance. PMID:28379843

Direct parametric reconstruction in dynamic PET myocardial perfusion imaging: in vivo studies

NASA Astrophysics Data System (ADS)

Petibon, Yoann; Rakvongthai, Yothin; El Fakhri, Georges; Ouyang, Jinsong

2017-05-01

Dynamic PET myocardial perfusion imaging (MPI) used in conjunction with tracer kinetic modeling enables the quantification of absolute myocardial blood flow (MBF). However, MBF maps computed using the traditional indirect method (i.e. post-reconstruction voxel-wise fitting of kinetic model to PET time-activity-curves-TACs) suffer from poor signal-to-noise ratio (SNR). Direct reconstruction of kinetic parameters from raw PET projection data has been shown to offer parametric images with higher SNR compared to the indirect method. The aim of this study was to extend and evaluate the performance of a direct parametric reconstruction method using in vivo dynamic PET MPI data for the purpose of quantifying MBF. Dynamic PET MPI studies were performed on two healthy pigs using a Siemens Biograph mMR scanner. List-mode PET data for each animal were acquired following a bolus injection of ~7-8 mCi of 18F-flurpiridaz, a myocardial perfusion agent. Fully-3D dynamic PET sinograms were obtained by sorting the coincidence events into 16 temporal frames covering ~5 min after radiotracer administration. Additionally, eight independent noise realizations of both scans—each containing 1/8th of the total number of events—were generated from the original list-mode data. Dynamic sinograms were then used to compute parametric maps using the conventional indirect method and the proposed direct method. For both methods, a one-tissue compartment model accounting for spillover from the left and right ventricle blood-pools was used to describe the kinetics of 18F-flurpiridaz. An image-derived arterial input function obtained from a TAC taken in the left ventricle cavity was used for tracer kinetic analysis. For the indirect method, frame-by-frame images were estimated using two fully-3D reconstruction techniques: the standard ordered subset expectation maximization (OSEM) reconstruction algorithm on one side, and the one-step late maximum a posteriori (OSL-MAP) algorithm on the other side, which incorporates a quadratic penalty function. The parametric images were then calculated using voxel-wise weighted least-square fitting of the reconstructed myocardial PET TACs. For the direct method, parametric images were estimated directly from the dynamic PET sinograms using a maximum a posteriori (MAP) parametric reconstruction algorithm which optimizes an objective function comprised of the Poisson log-likelihood term, the kinetic model and a quadratic penalty function. Maximization of the objective function with respect to each set of parameters was achieved using a preconditioned conjugate gradient algorithm with a specifically developed pre-conditioner. The performance of the direct method was evaluated by comparing voxel- and segment-wise estimates of {{K}1} , the tracer transport rate (ml · min-1 · ml-1), to those obtained using the indirect method applied to both OSEM and OSL-MAP dynamic reconstructions. The proposed direct reconstruction method produced {{K}1} maps with visibly lower noise than the indirect method based on OSEM and OSL-MAP reconstructions. At normal count levels, the direct method was shown to outperform the indirect method based on OSL-MAP in the sense that at matched level of bias, reduced regional noise levels were obtained. At lower count levels, the direct method produced {{K}1} estimates with significantly lower standard deviation across noise realizations than the indirect method based on OSL-MAP at matched bias level. In all cases, the direct method yielded lower noise and standard deviation than the indirect method based on OSEM. Overall, the proposed direct reconstruction offered a better bias-variance tradeoff than the indirect method applied to either OSEM and OSL-MAP. Direct parametric reconstruction as applied to in vivo dynamic PET MPI data is therefore a promising method for producing MBF maps with lower variance.

A Simple Model of Global Aerosol Indirect Effects

NASA Technical Reports Server (NTRS)

Ghan, Steven J.; Smith, Steven J.; Wang, Minghuai; Zhang, Kai; Pringle, Kirsty; Carslaw, Kenneth; Pierce, Jeffrey; Bauer, Susanne; Adams, Peter

2013-01-01

Most estimates of the global mean indirect effect of anthropogenic aerosol on the Earth's energy balance are from simulations by global models of the aerosol lifecycle coupled with global models of clouds and the hydrologic cycle. Extremely simple models have been developed for integrated assessment models, but lack the flexibility to distinguish between primary and secondary sources of aerosol. Here a simple but more physically based model expresses the aerosol indirect effect (AIE) using analytic representations of cloud and aerosol distributions and processes. Although the simple model is able to produce estimates of AIEs that are comparable to those from some global aerosol models using the same global mean aerosol properties, the estimates by the simple model are sensitive to preindustrial cloud condensation nuclei concentration, preindustrial accumulation mode radius, width of the accumulation mode, size of primary particles, cloud thickness, primary and secondary anthropogenic emissions, the fraction of the secondary anthropogenic emissions that accumulates on the coarse mode, the fraction of the secondary mass that forms new particles, and the sensitivity of liquid water path to droplet number concentration. Estimates of present-day AIEs as low as 5 W/sq m and as high as 0.3 W/sq m are obtained for plausible sets of parameter values. Estimates are surprisingly linear in emissions. The estimates depend on parameter values in ways that are consistent with results from detailed global aerosol-climate simulation models, which adds to understanding of the dependence on AIE uncertainty on uncertainty in parameter values.

Quasi-adiabatic calorimeter for direct electrocaloric measurements

NASA Astrophysics Data System (ADS)

Sanlialp, Mehmet; Shvartsman, Vladimir V.; Faye, Romain; Karabasov, Maksim O.; Molin, Christian; Gebhardt, Sylvia; Defay, Emmanuel; Lupascu, Doru C.

2018-03-01

The electrocaloric effect (ECE) in ferroelectric materials is a promising candidate for small, effective, low cost, and environmentally friendly solid state cooling applications. Instead of the commonly used indirect estimates based on Maxwell's relations, direct measurements of the ECE are required to obtain reliable values. In this work, we report on a custom-made quasi-adiabatic calorimeter for direct ECE measurements. The ECE is measured for two promising lead-free materials: Ba(Zr0.12Ti0.88)O3 and Ba(Zr0.2Ti0.8)O3 bulk ceramics. Adiabatic temperature changes of ΔTEC = 0.5 K at 355 K and ΔTEC = 0.3 K at 314 K were achieved under the application of an electric field of 2 kV/mm for the Ba(Zr0.12Ti0.88)O3 and Ba(Zr0.2Ti0.8)O3 samples, respectively. The quasi-adiabatic ECE measurements reliably match other direct EC measurements using a differential scanning calorimeter or an infrared camera. The data are compared to indirect EC estimations based on Maxwell's relations and show that the indirect measurements typically underestimate the effect to a certain degree.

Contributions of atmospheric nitrogen deposition to U.S. estuaries: Summary and conclusions: Chapter 8

USGS Publications Warehouse

Stacey, Paul E.; Greening, Holly; Kremer, James N.; Peterson, David; Tomasko, David A.; Valigura, Richard A.; Alexander, Richard B.; Castro, Mark S.; Meyers, Tilden P.; Paerl, Hans W.; Stacey, Paul E.; Turner, R. Eugene

2001-01-01

A NOAA project was initiated in 1998, with support from the U.S. EPA, to develop state-of-the-art estimates of atmospheric N deposition to estuarine watersheds and water surfaces and its delivery to the estuaries. Work groups were formed to address N deposition rates, indirect (from the watershed) yields from atmospheric and other anthropogenic sources, and direct deposition on the estuarine waterbodies, and to evaluate the levels of uncertainty within the estimates. Watershed N yields were estimated using both a land-use based process approach and a national (SPARROW) model, compared to each other, and compared to estimates of N yield from the literature. The total N yields predicted by the national model were similar to values found in the literature and the land-use derived estimates were consistently higher. Atmospheric N yield estimates were within a similar range for the two approaches, but tended to be higher in the land-use based estimates and were not wellcorrelated. Median atmospheric N yields were around 15% of the total N yield for both groups, but ranged as high as 60% when both direct and indirect deposition were considered. Although not the dominant source of anthropogenic N, atmospheric N is, and will undoubtedly continue to be, an important factor in culturally eutrophied estuarine systems, warranting additional research and management attention.

A comparison of consumptive-use estimates derived from the simplified surface energy balance approach and indirect reporting methods

USGS Publications Warehouse

Maupin, Molly A.; Senay, Gabriel B.; Kenny, Joan F.; Savoca, Mark E.

2012-01-01

Recent advances in remote-sensing technology and Simplified Surface Energy Balance (SSEB) methods can provide accurate and repeatable estimates of evapotranspiration (ET) when used with satellite observations of irrigated lands. Estimates of ET are generally considered equivalent to consumptive use (CU) because they represent the part of applied irrigation water that is evaporated, transpired, or otherwise not available for immediate reuse. The U.S. Geological Survey compared ET estimates from SSEB methods to CU data collected for 1995 using indirect methods as part of the National Water Use Information Program (NWUIP). Ten-year (2000-2009) average ET estimates from SSEB methods were derived using Moderate Resolution Imaging Spectroradiometer (MODIS) 1-kilometer satellite land surface temperature and gridded weather datasets from the Global Data Assimilation System (GDAS). County-level CU estimates for 1995 were assembled and referenced to 1-kilometer grid cells to synchronize with the SSEB ET estimates. Both datasets were seasonally and spatially weighted to represent the irrigation season (June-September) and those lands that were identified in the county as irrigated. A strong relation (R2 greater than 0.7) was determined between NWUIP CU and SSEB ET data. Regionally, the relation is stronger in arid western states than in humid eastern states, and positive and negative biases are both present at state-level comparisons. SSEB ET estimates can play a major role in monitoring and updating county-based CU estimates by providing a quick and cost-effective method to detect major year-to-year changes at county levels, as well as providing a means to disaggregate county-based ET estimates to sub-county levels. More research is needed to identify the causes for differences in state-based relations.

The evaluation of cost-of-illness due to use of cost-of-illness-based chemicals.

PubMed

Hong, Jiyeon; Lee, Yongjin; Lee, Geonwoo; Lee, Hanseul; Yang, Jiyeon

2015-01-01

This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

Sequence-dependent DNA deformability studied using molecular dynamics simulations.

PubMed

Fujii, Satoshi; Kono, Hidetoshi; Takenaka, Shigeori; Go, Nobuhiro; Sarai, Akinori

2007-01-01

Proteins recognize specific DNA sequences not only through direct contact between amino acids and bases, but also indirectly based on the sequence-dependent conformation and deformability of the DNA (indirect readout). We used molecular dynamics simulations to analyze the sequence-dependent DNA conformations of all 136 possible tetrameric sequences sandwiched between CGCG sequences. The deformability of dimeric steps obtained by the simulations is consistent with that by the crystal structures. The simulation results further showed that the conformation and deformability of the tetramers can highly depend on the flanking base pairs. The conformations of xATx tetramers show the most rigidity and are not affected by the flanking base pairs and the xYRx show by contrast the greatest flexibility and change their conformations depending on the base pairs at both ends, suggesting tetramers with the same central dimer can show different deformabilities. These results suggest that analysis of dimeric steps alone may overlook some conformational features of DNA and provide insight into the mechanism of indirect readout during protein-DNA recognition. Moreover, the sequence dependence of DNA conformation and deformability may be used to estimate the contribution of indirect readout to the specificity of protein-DNA recognition as well as nucleosome positioning and large-scale behavior of nucleic acids.

Uncertainty in peat volume and soil carbon estimated using ground-penetrating radar and probing

Treesearch

Andrew D. Parsekian; Lee Slater; Dimitrios Ntarlagiannis; James Nolan; Stephen D. Sebestyen; Randall K. Kolka; Paul J. Hanson

2012-01-01

Estimating soil C stock in a peatland is highly dependent on accurate measurement of the peat volume. In this study, we evaluated the uncertainty in calculations of peat volume using high-resolution data to resolve the three-dimensional structure of a peat basin based on both direct (push probes) and indirect geophysical (ground-penetrating radar) measurements. We...

The Cost of Blindness in the Republic of Ireland 2010-2020.

PubMed

Green, D; Ducorroy, G; McElnea, E; Naughton, A; Skelly, A; O'Neill, C; Kenny, D; Keegan, D

2016-01-01

Aims. To estimate the prevalence of blindness in the Republic of Ireland and the associated financial and total economic cost between 2010 and 2020. Methods. Estimates for the prevalence of blindness in the Republic of Ireland were based on blindness registration data from the National Council for the Blind of Ireland. Estimates for the financial and total economic cost of blindness were based on the sum of direct and indirect healthcare and nonhealthcare costs. Results. We estimate that there were 12,995 blind individuals in Ireland in 2010 and in 2020 there will be 17,997. We estimate that the financial and total economic costs of blindness in the Republic of Ireland in 2010 were €276.6 million and €809 million, respectively, and will increase in 2020 to €367 million and €1.1 billion, respectively. Conclusions. Here, ninety-eight percent of the cost of blindness is borne by the Departments of Social Protection and Finance and not by the Department of Health as might initially be expected. Cost of illness studies should play a role in public policy making as they help to quantify the indirect or "hidden" costs of disability and so help to reveal the true cost of illness.

The Cost of Blindness in the Republic of Ireland 2010–2020

PubMed Central

Green, D.; Ducorroy, G.; McElnea, E.; Naughton, A.; Skelly, A.; O'Neill, C.; Kenny, D.; Keegan, D.

2016-01-01

Aims. To estimate the prevalence of blindness in the Republic of Ireland and the associated financial and total economic cost between 2010 and 2020. Methods. Estimates for the prevalence of blindness in the Republic of Ireland were based on blindness registration data from the National Council for the Blind of Ireland. Estimates for the financial and total economic cost of blindness were based on the sum of direct and indirect healthcare and nonhealthcare costs. Results. We estimate that there were 12,995 blind individuals in Ireland in 2010 and in 2020 there will be 17,997. We estimate that the financial and total economic costs of blindness in the Republic of Ireland in 2010 were €276.6 million and €809 million, respectively, and will increase in 2020 to €367 million and €1.1 billion, respectively. Conclusions. Here, ninety-eight percent of the cost of blindness is borne by the Departments of Social Protection and Finance and not by the Department of Health as might initially be expected. Cost of illness studies should play a role in public policy making as they help to quantify the indirect or “hidden” costs of disability and so help to reveal the true cost of illness. PMID:26981276

The total lifetime costs of smoking.

PubMed

Rasmussen, Susanne R; Prescott, Eva; Sørensen, Thorkild I A; Søgaard, Jes

2004-03-01

Net costs of smoking in a lifetime perspective and, hence, the economic interests in antismoking policies have been questioned. It has been proposed that the health-related costs of smoking are balanced by smaller expenditure due to shorter life expectancy. A dynamic (life cycle) method taking differences in life expectancy into account. Main outcome measures were direct and indirect lifetime health costs for ever-smokers and never-smokers, and cost ratios (ever-smokers to never-smokers). The estimations were based on annual disease rates of use of the healthcare services, smoking relative risks, smoking prevalences, and costs. Annual direct and indirect costs of ever-smokers were higher than for never-smokers in all age groups of both genders. The direct and indirect cost ratios were highest at age 45 for women, and at age 35 and 40 for men, respectively. Taking life expectancy differences into account, direct and indirect lifetime health costs for men aged 35, discounted by 5% per year were 66% and 83% higher in ever-smokers than in never-smokers. Corresponding results for women were 74% and 79%, respectively. The results are insensitive to a broad range of relative risk-estimates and discount rates including no discounting. Excess costs of ever-smokers disappear if the inclusion of smoking-related diseases is narrowed to that of previous studies. Smoking imposes costs to society even when taking life expectancy into consideration--both in direct and indirect costs.

Direct and indirect genetic and fine-scale location effects on breeding date in song sparrows.

PubMed

Germain, Ryan R; Wolak, Matthew E; Arcese, Peter; Losdat, Sylvain; Reid, Jane M

2016-11-01

Quantifying direct and indirect genetic effects of interacting females and males on variation in jointly expressed life-history traits is central to predicting microevolutionary dynamics. However, accurately estimating sex-specific additive genetic variances in such traits remains difficult in wild populations, especially if related individuals inhabit similar fine-scale environments. Breeding date is a key life-history trait that responds to environmental phenology and mediates individual and population responses to environmental change. However, no studies have estimated female (direct) and male (indirect) additive genetic and inbreeding effects on breeding date, and estimated the cross-sex genetic correlation, while simultaneously accounting for fine-scale environmental effects of breeding locations, impeding prediction of microevolutionary dynamics. We fitted animal models to 38 years of song sparrow (Melospiza melodia) phenology and pedigree data to estimate sex-specific additive genetic variances in breeding date, and the cross-sex genetic correlation, thereby estimating the total additive genetic variance while simultaneously estimating sex-specific inbreeding depression. We further fitted three forms of spatial animal model to explicitly estimate variance in breeding date attributable to breeding location, overlap among breeding locations and spatial autocorrelation. We thereby quantified fine-scale location variances in breeding date and quantified the degree to which estimating such variances affected the estimated additive genetic variances. The non-spatial animal model estimated nonzero female and male additive genetic variances in breeding date (sex-specific heritabilities: 0·07 and 0·02, respectively) and a strong, positive cross-sex genetic correlation (0·99), creating substantial total additive genetic variance (0·18). Breeding date varied with female, but not male inbreeding coefficient, revealing direct, but not indirect, inbreeding depression. All three spatial animal models estimated small location variance in breeding date, but because relatedness and breeding location were virtually uncorrelated, modelling location variance did not alter the estimated additive genetic variances. Our results show that sex-specific additive genetic effects on breeding date can be strongly positively correlated, which would affect any predicted rates of microevolutionary change in response to sexually antagonistic or congruent selection. Further, we show that inbreeding effects on breeding date can also be sex specific and that genetic effects can exceed phenotypic variation stemming from fine-scale location-based variation within a wild population. © 2016 The Authors. Journal of Animal Ecology © 2016 British Ecological Society.

Estimating the cost of epilepsy in Europe: a review with economic modeling.

PubMed

Pugliatti, Maura; Beghi, Ettore; Forsgren, Lars; Ekman, Mattias; Sobocki, Patrik

2007-12-01

Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated. Europe was defined as the 25 European Union member countries, Iceland, Norway, and Switzerland. Guidelines for epidemiological studies on epilepsy were used for a case definition. A bottom-up prevalence-based cost-of-illness approach, the societal perspective for including the cost items, and the human capital approach as valuation principle for indirect costs were used. The cost estimates were based on selected studies with common methodology and valuation principles. The estimated prevalence of epilepsy in Europe in 2004 was 4.3-7.8 per 1,000. The estimated total cost of the disease in Europe was euro15.5 billion in 2004, indirect cost being the single most dominant cost category (euro8.6 billion). Direct health care costs were euro2.8 billion, outpatient care comprising the largest part (euro1.3 billion). Direct nonmedical cost was euro4.2 billion. That of antiepileptic drugs was euro400 million. The total cost per case was euro2,000-11,500 and the estimated cost per European inhabitant was euro33. Epilepsy is a relevant socioeconomic burden at individual, family, health services, and societal level in Europe. The greater proportion of such burden is outside the formal health care sector, antiepileptic drugs representing a smaller proportion. Lack of economic data from several European countries and other methodological limitations make this report an initial estimate of the cost of epilepsy in Europe. Prospective incidence cost-of-illness studies from well-defined populations and common methodology are encouraged.

Factors associated with adverse clinical outcomes among obstetric trainees

PubMed Central

Aiken PhD, Catherine E.; Aiken, Abigail; Park, Hannah; Brockelsby, Jeremy C.; Prentice, Andrew

2016-01-01

Objective To determine whether UK obstetric trainees transitioning from directly to indirectly-supervised practice have a higher likelihood of adverse patient outcomes from operative deliveries compared to other indirectly supervised trainees and to examine whether performing more procedures under direct supervision is associated with fewer adverse outcomes in initial indirect practice. Methods We examined all deliveries (13,861) conducted by obstetricians at a single centre over 5 years (2008-2013). Mixed-effects logistic regression models were used to compare estimated blood loss, maternal trauma, umbilical arterial pH, delayed neonatal respiration, failed instrumental delivery, and critical incidents for trainees in their first indirectly-supervised year with trainees in all other years of indirect practice. Outcomes for trainees in their first indirectly-supervised 3 months were compared to their outcomes for the remainder of the year. Linear regression was used to examine the relationship between number of procedures performed under direct supervision and initial outcomes under indirect supervision. Results Trainees in their first indirectly-supervised year had a higher likelihood of >2 litres estimated blood loss at any delivery (OR 1.32;CI(1.01-1.64) p<0.05) and of failed instrumental delivery (OR 2.33;CI(1.37-3.29) p<0.05) compared with other indirectly-supervised trainees. Other measured outcomes showed no significant differences. Within the first three months of indirect supervision, the likelihood of operative vaginal deliveries with >1litre estimated blood loss (OR 2.54;CI(1.88-3.20) p<0.05) was higher compared to the remainder of the first year. Performing more deliveries under direct supervision prior to beginning indirectly-supervised training was associated with decreased risk of >1litre estimated blood loss (p<0.05). Conclusions Obstetric trainees in their first year of indirectly-supervised practice have a higher likelihood of immediate adverse delivery outcomes, which are primarily maternal rather than neonatal. Undertaking more directly supervised procedures prior to transitioning to indirectly-supervised practice may reduce adverse outcomes, suggesting that experience is a key consideration in obstetric training programme design. PMID:26077215

Genetic relationships between growth and carcass traits and profitability in Japanese Brown cattle.

PubMed

Kahi, A K; Oguni, T; Sumio, Y; Hirooka, H

2007-02-01

The objectives of this study were 1) to examine the genetic relationship between growth and carcass traits and carcass price (CaP) and profitability in Japanese Brown cattle, 2) to estimate economic values of carcass and growth traits as regression coefficients of price and profit traits on growth and carcass traits using a multiple regression model, and 3) to compare direct and indirect predictions of the genetic merit of profit obtained from multitrait analysis and selection index, respectively. Growth and carcass traits considered in this study were ADG during the feedlot period, CWT, LM area (LMA), rib thickness (RT), subcutaneous fat thickness (SFT), and marbling score (MS). Carcass price was evaluated as a price trait independent of its influence on profit. Profit traits were defined as 1) net income per year (PROF1), 2) net income per year/energy requirement (PROF2), and 3) net income per year minus feed costs (PROF3). Correlations between direct and indirect predictions were estimated based on EBV of sires and dams with progeny records. The heritability estimate for CaP was 0.41. The heritability estimates for profit traits were high and were 0.62, 0.66, and 0.60 for PROF1, PROF2, and PROF3, respectively. The genetic correlations between CaP and ADG, CWT, LMA, RT, SFT, and MS were 0.19, 0.14, 0.30, 0.38, -0.11, and 0.98, respectively. Among the profit traits, PROF1 had the greatest genetic correlations with growth and carcass traits. The correlations with ADG, CWT, LMA, RT, SFT, and MS were 0.30, 0.21, 0.24, 0.39, -0.01, and 0.69, respectively. These estimates indicate that use of profit traits as a selection criterion may promote desirable correlated responses in growth and carcass traits. The economic values for growth and carcass traits estimated relative to CaP and each profit trait differed because of the apparent differences in the description of these traits. The correlations between EBV for the same profit traits from direct and indirect predictions were high and ranged from 0.818 to 0.846 based on EBV of sires and from 0.786 to 0.798 based on EBV of dams. The strong correlations between direct and indirect predictions for profit indicate that there is no advantage to selecting directly for profit compared with an index with all of the component traits.

A method for estimating both the solubility parameters and molar volumes of liquids

NASA Technical Reports Server (NTRS)

Fedors, R. F.

1974-01-01

Development of an indirect method of estimating the solubility parameter of high molecular weight polymers. The proposed method of estimating the solubility parameter, like Small's method, is based on group additive constants, but is believed to be superior to Small's method for two reasons: (1) the contribution of a much larger number of functional groups have been evaluated, and (2) the method requires only a knowledge of structural formula of the compound.

Exposure Assessment Tools by Approaches - Indirect Estimation (Scenario Evaluation)

EPA Pesticide Factsheets

EPA ExpoBox is a toolbox for exposure assessors. Its purpose is to provide a compendium of exposure assessment and risk characterization tools that will present comprehensive step-by-step guidance and links to relevant exposure assessment data bases, mode

ARE LITERACY SKILLS ASSOCIATED WITH YOUNG ADULTS’ HEALTH IN AFRICA? EVIDENCE FROM MALAWI

PubMed Central

Smith-Greenaway, Emily

2014-01-01

This study investigates whether literacy skills are a distinct dimension of education that influences young adults’ health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults’ health—net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy’s prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy’s prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited. PMID:25164414

DNA double strand breaks induced by the indirect effect of radiation are more efficiently repaired by non-homologous end joining compared to homologous recombination repair.

PubMed

Bajinskis, Ainars; Natarajan, Adayapalam T; Erixon, Klaus; Harms-Ringdahl, Mats

2013-08-30

The aim of this study was to investigate the relative involvement of three major DNA repair pathways, i.e., non-homologous end joining (NHEJ), homologous recombination (HRR) and base excision (BER) in repair of DNA lesions of different complexity induced by low- or high-LET radiation with emphasis on the contribution of the indirect effect of radiation for these radiation qualities. A panel of DNA repair-deficient CHO cell lines was irradiated by (137)Cs γ-rays or radon progeny α-particles. Irradiation was also performed in the presence of 2M DMSO to reduce the indirect effect of radiation and the complexity of the DNA damage formed. Clonogenic survival and micronucleus assays were used to estimate efficiencies of the different repair pathways for DNA damages produced by direct and indirect effects. Removal of the indirect effect of low-LET radiation by DMSO increased clonogenic survival and decreased MN formation for all cell lines investigated. A direct contribution of the indirect effect of radiation to DNA base damage was suggested by the significant protection by DMSO seen for the BER deficient cell line. Lesions formed by the indirect effect are more readily repaired by the NHEJ pathway than by HRR after irradiation with γ-rays or α-particles as evaluated by cell survival and the yields of MN. The results obtained with BER- and NHEJ-deficient cells suggest that the indirect effect of radiation contributes significantly to the formation of repair substrates for these pathways. Copyright © 2013 Elsevier B.V. All rights reserved.

Large CO 2 effluxes at night and during synoptic weather events significantly contribute to CO 2 emissions from a reservoir

DOE PAGES

Liu, Heping; Zhang, Qianyu; Katul, Gabriel G.; ...

2016-05-24

CO 2 emissions from inland waters are commonly determined by indirect methods that are based on the product of a gas transfer coefficient and the concentration gradient at the air water interface (e.g., wind-based gas transfer models). The measurements of concentration gradient are typically collected during the day in fair weather throughout the course of a year. Direct measurements of eddy covariance CO 2 fluxes from a large inland water body (Ross Barnett reservoir, Mississippi, USA) show that CO 2 effluxes at night are approximately 70% greater than those during the day. At longer time scales, frequent synoptic weather eventsmore » associated with extratropical cyclones induce CO 2 flux pulses, resulting in further increase in annual CO 2 effluxes by 16%. Therefore, CO 2 emission rates from this reservoir, if these diel and synoptic processes are under-sampled, are likely to be underestimated by approximately 40%. Our results also indicate that the CO 2 emission rates from global inland waters reported in the literature, when based on indirect methods, are likely underestimated. Field samplings and indirect modeling frameworks that estimate CO 2 emissions should account for both daytime-nighttime efflux difference and enhanced emissions during synoptic weather events. Furthermore, the analysis here can guide carbon emission sampling to improve regional carbon estimates.« less

Large CO 2 effluxes at night and during synoptic weather events significantly contribute to CO 2 emissions from a reservoir

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

Liu, Heping; Zhang, Qianyu; Katul, Gabriel G.

CO 2 emissions from inland waters are commonly determined by indirect methods that are based on the product of a gas transfer coefficient and the concentration gradient at the air water interface (e.g., wind-based gas transfer models). The measurements of concentration gradient are typically collected during the day in fair weather throughout the course of a year. Direct measurements of eddy covariance CO 2 fluxes from a large inland water body (Ross Barnett reservoir, Mississippi, USA) show that CO 2 effluxes at night are approximately 70% greater than those during the day. At longer time scales, frequent synoptic weather eventsmore » associated with extratropical cyclones induce CO 2 flux pulses, resulting in further increase in annual CO 2 effluxes by 16%. Therefore, CO 2 emission rates from this reservoir, if these diel and synoptic processes are under-sampled, are likely to be underestimated by approximately 40%. Our results also indicate that the CO 2 emission rates from global inland waters reported in the literature, when based on indirect methods, are likely underestimated. Field samplings and indirect modeling frameworks that estimate CO 2 emissions should account for both daytime-nighttime efflux difference and enhanced emissions during synoptic weather events. Furthermore, the analysis here can guide carbon emission sampling to improve regional carbon estimates.« less

Estimating chronic hepatitis C prognosis using transient elastography-based liver stiffness: A systematic review and meta-analysis.

PubMed

Erman, A; Sathya, A; Nam, A; Bielecki, J M; Feld, J J; Thein, H-H; Wong, W W L; Grootendorst, P; Krahn, M D

2018-05-01

Chronic hepatitis C (CHC) is a leading cause of hepatic fibrosis and cirrhosis. The level of fibrosis is traditionally established by histology, and prognosis is estimated using fibrosis progression rates (FPRs; annual probability of progressing across histological stages). However, newer noninvasive alternatives are quickly replacing biopsy. One alternative, transient elastography (TE), quantifies fibrosis by measuring liver stiffness (LSM). Given these developments, the purpose of this study was (i) to estimate prognosis in treatment-naïve CHC patients using TE-based liver stiffness progression rates (LSPR) as an alternative to FPRs and (ii) to compare consistency between LSPRs and FPRs. A systematic literature search was performed using multiple databases (January 1990 to February 2016). LSPRs were calculated using either a direct method (given the difference in serial LSMs and time elapsed) or an indirect method given a single LSM and the estimated duration of infection and pooled using random-effects meta-analyses. For validation purposes, FPRs were also estimated. Heterogeneity was explored by random-effects meta-regression. Twenty-seven studies reporting on 39 groups of patients (N = 5874) were identified with 35 groups allowing for indirect and 8 for direct estimation of LSPR. The majority (~58%) of patients were HIV/HCV-coinfected. The estimated time-to-cirrhosis based on TE vs biopsy was 39 and 38 years, respectively. In univariate meta-regressions, male sex and HIV were positively and age at assessment, negatively associated with LSPRs. Noninvasive prognosis of HCV is consistent with FPRs in predicting time-to-cirrhosis, but more longitudinal studies of liver stiffness are needed to obtain refined estimates. © 2017 John Wiley & Sons Ltd.

Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

PubMed

Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

2018-06-01

In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey.

PubMed

Malhan, Simten; Pay, Salih; Ataman, Sebnem; Dalkilic, Ediz; Dinc, Ayhan; Erken, Eren; Ertenli, Ihsan; Ertugrul, Esin; Gogus, Feride; Hamuryudan, Vedat; Inanc, Murat; Karaarslan, Yasar; Karadag, Omer; Karakoc, Yuksel; Keskin, Goksal; Kisacik, Bunyamin; Kiraz, Sedat; Oksel, Fahrettin; Oksuz, Ergun; Pirildar, Timur; Sari, Ismail; Soy, Mehmet; Senturk, Taskin; Taylan, Ali

2012-01-01

To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using 'cost-of-illness' methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the 'human capital approach', based on the minimum wage. The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.

The economic burden of inadequate consumption of vegetables and fruit in Canada.

PubMed

Ekwaru, John Paul; Ohinmaa, Arto; Loehr, Sarah; Setayeshgar, Solmaz; Thanh, Nguyen Xuan; Veugelers, Paul J

2017-02-01

Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada. We accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015. About 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion. Further investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.

Direct and indirect costs of nonfatal road traffic injuries in Iran: A population-based study.

PubMed

Karimi, Hasti; Soleyman-Jahi, Saeed; Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Saadat, Soheil; Akbari Sari, Ali; Rahimi-Movaghar, Vafa

2017-05-19

The objective of this study was to assess the incidence rate as well as direct and indirect costs of nonfatal road traffic injuries (RTIs) in Iran in 2011. Data from the 2011 national household survey were used. In this survey, data on demographics, history, and costs of injury were obtained in 2 steps: first, direct face-to-face interview and second, telephone calls. We estimated the incidence rate of nonfatal RTIs in this year. The direct costs included medical care as well as nonmedical costs paid by the patient or insurance services. The indirect costs were estimated by considering the cost of absence from work or education. We also used logistic regression analyses to investigate risk factors of nonfatal RTIs. We found 76 nonfatal RTI cases (0.96%) out of 7,886 whole reference study cases. These 76 injured patients had a history of RTI in the preceding 3 months. The annual incidence of RTIs was estimated at 3.84%. The mean age of RTI cases was 28.5 ± 10.6 and 88.16% of them were male. Male gender was a major risk factor (odds ratio [OR] = 9.64, 95% confidence interval [CI], 4.79-19.41) and marriage was a protective factor (OR = 0.44, 95% CI, 0.28-0.70) for RTI. The medians of direct, indirect, and total costs were US$214, US$163, and US$387, respectively. The total cost of nonfatal RTIs in Iran was estimated at 1.29% of the gross domestic product (GDP) in 2011. In Iran, nonfatal RTIs imposed a total cost of almost US$7 billion to the country for one year. Extension and more serious implementation of preventive measurements seem necessary to decrease this notable burden of RTIs.

Evaluating the total costs of chemotherapy-induced toxicity: results from a pilot study with ovarian cancer patients.

PubMed

Calhoun, E A; Chang, C H; Welshman, E E; Fishman, D A; Lurain, J R; Bennett, C L

2001-01-01

While chemotherapy-related toxicities affect cancer patients' activities of daily living and result in large expenditures of medical care for treatment, few studies have assessed the out-of-pocket and indirect costs incurred by patients who experience toxicity. The objective of this study was to evaluate the feasibility of obtaining detailed and comprehensive cost information from patients who experienced neutropenia, thrombocytopenia, or neurotoxicity during treatment. Ovarian cancer patients who experienced chemotherapy-associated hematologic or neurologic toxicities were asked to record detailed information about hospitalization, laboratories, physician visits, phone calls, home visits, medication, medical devices, lost productivity, and caregivers. Resource estimates were converted into cost units, with direct medical cost estimates based on hospital cost-accounting data and indirect costs (i.e., productivity loss) on modified labor force, employment, and earnings data. Direct medical costs were highest for neutropenia (mean of $7,546/episode), intermediate for thrombocytopenia (mean of $3,268/episode), and lowest for neurotoxicity (mean of $688/episode). Indirect costs relating to patient and caregiver work loss and payments for caregiver support were substantial, accounting for $4,220, $3,834, and $4,282 for patients who developed neurotoxicity, neutropenia, and thrombocytopenia, respectively. The total costs of chemotherapy-related neurotoxicity, neutropenia, and thrombocytopenia were $4,908, $11,830, and $7,550. Our study has shown that, with the assistance of patients who are experiencing toxicity, estimation of the total costs of cancer-related toxicities is feasible. Indirect costs, while not included in prior estimates of the costs of toxicity studies, accounted for 34% to 86% of the total costs of cancer supportive care.

Female genital mutilation/cutting in Italy: an enhanced estimation for first generation migrant women based on 2016 survey data.

PubMed

Ortensi, Livia Elisa; Farina, Patrizia; Leye, Els

2018-01-12

Migration flows of women from Female Genital Mutilation/Cutting practicing countries have generated a need for data on women potentially affected by Female Genital Mutilation/Cutting. This paper presents enhanced estimates for foreign-born women and asylum seekers in Italy in 2016, with the aim of supporting resource planning and policy making, and advancing the methodological debate on estimation methods. The estimates build on the most recent methodological development in Female Genital Mutilation/Cutting direct and indirect estimation for Female Genital Mutilation/Cutting non-practicing countries. Direct estimation of prevalence was performed for 9 communities using the results of the survey FGM-Prev, held in Italy in 2016. Prevalence for communities not involved in the FGM-Prev survey was estimated using to the 'extrapolation-of-FGM/C countries prevalence data method' with corrections according to the selection hypothesis. It is estimated that 60 to 80 thousand foreign-born women aged 15 and over with Female Genital Mutilation/Cutting are present in Italy in 2016. We also estimated the presence of around 11 to 13 thousand cut women aged 15 and over among asylum seekers to Italy in 2014-2016. Due to the long established presence of female migrants from some practicing communities Female Genital Mutilation/Cutting is emerging as an issue also among women aged 60 and over from selected communities. Female Genital Mutilation/Cutting is an additional source of concern for slightly more than 60% of women seeking asylum. Reliable estimates on Female Genital Mutilation/Cutting at country level are important for evidence-based policy making and service planning. This study suggests that indirect estimations cannot fully replace direct estimations, even if corrections for migrant socioeconomic selection can be implemented to reduce the bias.

Kriging Direct and Indirect Estimates of Sulfate Deposition: A Comparison

Treesearch

Gregory A. Reams; Manuela M.P. Huso; Richard J. Vong; Joseph M. McCollum

1997-01-01

Due to logistical and cost constraints, acidic deposition is rarely measured at forest research or sampling locations. A crucial first step to assessing the effects of acid rain on forests is an accurate estimate of acidic deposition at forest sample sites. We examine two methods (direct and indirect) for estimating sulfate deposition at atmospherically unmonitored...

Notification: Preliminary Research: Review of Independent Government Cost Estimates and Indirect Costs for EPA’s Interagency Agreements

EPA Pesticide Factsheets

Project #OA-FY14-0130, February 11, 2014. The EPA OIG plans to begin preliminary research of the independent government cost estimates and indirect costs for the EPA's funds-in interagency agreements.

Electric Power Consumption Coefficients for U.S. Industries: Regional Estimation and Analysis

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

Boero, Riccardo

Economic activity relies on electric power provided by electrical generation, transmission, and distribution systems. This paper presents a method developed at Los Alamos National Laboratory to estimate electric power consumption by different industries in the United States. Results are validated through comparisons with existing literature and benchmarking data sources. We also discuss the limitations and applications of the presented method, such as estimating indirect electric power consumption and assessing the economic impact of power outages based on input-output economic models.

Enhanced understanding of the relationship between erection and satisfaction in ED treatment: application of a longitudinal mediation model.

PubMed

Bushmakin, A G; Cappelleri, J C; Symonds, T; Stecher, V J

2014-01-01

To apportion the direct effect and the indirect effect (through erections) that sildenafil (vs placebo) has on individual satisfaction and couple satisfaction over time, longitudinal mediation modeling was applied to outcomes on the Sexual Experience Questionnaire. The model included data from weeks 4 and 10 (double-blind phase) and week 16 (open-label phase) of a controlled study. Data from 167 patients with erectile dysfunction (ED) were available for analysis. Estimation of statistical significance was based on bootstrap simulations, which allowed inferences at and between time points. Percentages (and corresponding 95% confidence intervals) for direct and indirect effects of treatment were calculated using the model. For the individual satisfaction and couple satisfaction domains, direct treatment effects were negligible (not statistically significant) whereas indirect treatment effects via the erection domain represented >90% of the treatment effects (statistically significant). Week 4 vs week 10 percentages of direct and indirect effects were not statistically different, indicating that the mediation effects are longitudinally invariant. As there was no placebo arm in the open-label phase, mediation effects at week 16 were not estimable. In conclusion, erection has a crucial role as a mediator in restoring individual satisfaction and couple satisfaction in men with ED treated with sildenafil.

Indirect costs in chronic obstructive pulmonary disease: a review of the economic burden on employers and individuals in the United States.

PubMed

Patel, Jeetvan G; Nagar, Saurabh P; Dalal, Anand A

2014-01-01

To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US. Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987-2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%-18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27-63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3-19.4 days. Estimates of bed confinement range from 13-32 days per year. Estimated mean annual indirect costs were $893-$2,234/person (US dollars) with COPD ($1,521-$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%-61% of total costs, depending on the population studied. COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD.

WE-E-18A-03: How Accurately Can the Peak Skin Dose in Fluoroscopy Be Determined Using Indirect Dose Metrics?

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

Jones, A; Pasciak, A

Purpose: Skin dosimetry is important for fluoroscopically-guided interventions, as peak skin doses (PSD) that Result in skin reactions can be reached during these procedures. The purpose of this study was to assess the accuracy of different indirect dose estimates and to determine if PSD can be calculated within ±50% for embolization procedures. Methods: PSD were measured directly using radiochromic film for 41 consecutive embolization procedures. Indirect dose metrics from procedures were collected, including reference air kerma (RAK). Four different estimates of PSD were calculated and compared along with RAK to the measured PSD. The indirect estimates included a standard method,more » use of detailed information from the RDSR, and two simplified calculation methods. Indirect dosimetry was compared with direct measurements, including an analysis of uncertainty associated with film dosimetry. Factors affecting the accuracy of the indirect estimates were examined. Results: PSD calculated with the standard calculation method were within ±50% for all 41 procedures. This was also true for a simplified method using a single source-to-patient distance (SPD) for all calculations. RAK was within ±50% for all but one procedure. Cases for which RAK or calculated PSD exhibited large differences from the measured PSD were analyzed, and two causative factors were identified: ‘extreme’ SPD and large contributions to RAK from rotational angiography or runs acquired at large gantry angles. When calculated uncertainty limits [−12.8%, 10%] were applied to directly measured PSD, most indirect PSD estimates remained within ±50% of the measured PSD. Conclusions: Using indirect dose metrics, PSD can be determined within ±50% for embolization procedures, and usually to within ±35%. RAK can be used without modification to set notification limits and substantial radiation dose levels. These results can be extended to similar procedures, including vascular and interventional oncology. Film dosimetry is likely an unnecessary effort for these types of procedures.« less

Indirect costs in chronic obstructive pulmonary disease: A review of the economic burden on employers and individuals in the United States

PubMed Central

Patel, Jeetvan G; Nagar, Saurabh P; Dalal, Anand A

2014-01-01

Objective To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US. Methods Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Results Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987–2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%–18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27–63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3–19.4 days. Estimates of bed confinement range from 13–32 days per year. Estimated mean annual indirect costs were $893–$2,234/person (US dollars) with COPD ($1,521–$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%–61% of total costs, depending on the population studied. Conclusions COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD. PMID:24672234

Estimating two indirect logging costs caused by accelerated erosion.

Treesearch

Glen O. Klock

1976-01-01

In forest areas where high soil erosion potential exists, a comparative yarding cost estimate, including the indirect costs determined by methods proposed here, shows that the total cost of using "advanced" logging methods may be less than that of "traditional" systems.

Indirect Dietary Residential Exposure Assessment Model (IDREAM) Implementation

EPA Pesticide Factsheets

The Indirect Dietary Residential Exposure Assessment Model (IDREAM) estimates indirect ingestion exposure to disinfectants used in residential settings on hard surfaces where there may be inadvertent transfer to edible items prepared on those surfaces.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALCULATING INGESTION EXPOSURE ESTIMATING INGESTION EXPOSURE, THE INDIRECT METHOD OF EXPOSURE ESTIMATION (IIT-A-7.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken for calculating ingestion exposure using the indirect method of exposure estimation. This SOP uses This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University ...

Estimating the effect of burrowing shrimp on deep-sea sediment community oxygen consumption.

PubMed

Leduc, Daniel; Pilditch, Conrad A

2017-01-01

Sediment community oxygen consumption (SCOC) is a proxy for organic matter processing and thus provides a useful proxy of benthic ecosystem function. Oxygen uptake in deep-sea sediments is mainly driven by bacteria, and the direct contribution of benthic macro- and mega-infauna respiration is thought to be relatively modest. However, the main contribution of infaunal organisms to benthic respiration, particularly large burrowing organisms, is likely to be indirect and mainly driven by processes such as feeding and bioturbation that stimulate bacterial metabolism and promote the chemical oxidation of reduced solutes. Here, we estimate the direct and indirect contributions of burrowing shrimp ( Eucalastacus cf. torbeni ) to sediment community oxygen consumption based on incubations of sediment cores from 490 m depth on the continental slope of New Zealand. Results indicate that the presence of one shrimp in the sediment is responsible for an oxygen uptake rate of about 40 µmol d -1 , only 1% of which is estimated to be due to shrimp respiration. We estimate that the presence of ten burrowing shrimp m -2 of seabed would lead to an oxygen uptake comparable to current estimates of macro-infaunal community respiration on Chatham Rise based on allometric equations, and would increase total sediment community oxygen uptake by 14% compared to sediment without shrimp. Our findings suggest that oxygen consumption mediated by burrowing shrimp may be substantial in continental slope ecosystems.

Relay discovery and selection for large-scale P2P streaming

PubMed Central

Zhang, Chengwei; Wang, Angela Yunxian

2017-01-01

In peer-to-peer networks, application relays have been commonly used to provide various networking services. The service performance often improves significantly if a relay is selected appropriately based on its network location. In this paper, we studied the location-aware relay discovery and selection problem for large-scale P2P streaming networks. In these large-scale and dynamic overlays, it incurs significant communication and computation cost to discover a sufficiently large relay candidate set and further to select one relay with good performance. The network location can be measured directly or indirectly with the tradeoffs between timeliness, overhead and accuracy. Based on a measurement study and the associated error analysis, we demonstrate that indirect measurements, such as King and Internet Coordinate Systems (ICS), can only achieve a coarse estimation of peers’ network location and those methods based on pure indirect measurements cannot lead to a good relay selection. We also demonstrate that there exists significant error amplification of the commonly used “best-out-of-K” selection methodology using three RTT data sets publicly available. We propose a two-phase approach to achieve efficient relay discovery and accurate relay selection. Indirect measurements are used to narrow down a small number of high-quality relay candidates and the final relay selection is refined based on direct probing. This two-phase approach enjoys an efficient implementation using the Distributed-Hash-Table (DHT). When the DHT is constructed, the node keys carry the location information and they are generated scalably using indirect measurements, such as the ICS coordinates. The relay discovery is achieved efficiently utilizing the DHT-based search. We evaluated various aspects of this DHT-based approach, including the DHT indexing procedure, key generation under peer churn and message costs. PMID:28410384

Relay discovery and selection for large-scale P2P streaming.

PubMed

Zhang, Chengwei; Wang, Angela Yunxian; Hei, Xiaojun

2017-01-01

In peer-to-peer networks, application relays have been commonly used to provide various networking services. The service performance often improves significantly if a relay is selected appropriately based on its network location. In this paper, we studied the location-aware relay discovery and selection problem for large-scale P2P streaming networks. In these large-scale and dynamic overlays, it incurs significant communication and computation cost to discover a sufficiently large relay candidate set and further to select one relay with good performance. The network location can be measured directly or indirectly with the tradeoffs between timeliness, overhead and accuracy. Based on a measurement study and the associated error analysis, we demonstrate that indirect measurements, such as King and Internet Coordinate Systems (ICS), can only achieve a coarse estimation of peers' network location and those methods based on pure indirect measurements cannot lead to a good relay selection. We also demonstrate that there exists significant error amplification of the commonly used "best-out-of-K" selection methodology using three RTT data sets publicly available. We propose a two-phase approach to achieve efficient relay discovery and accurate relay selection. Indirect measurements are used to narrow down a small number of high-quality relay candidates and the final relay selection is refined based on direct probing. This two-phase approach enjoys an efficient implementation using the Distributed-Hash-Table (DHT). When the DHT is constructed, the node keys carry the location information and they are generated scalably using indirect measurements, such as the ICS coordinates. The relay discovery is achieved efficiently utilizing the DHT-based search. We evaluated various aspects of this DHT-based approach, including the DHT indexing procedure, key generation under peer churn and message costs.

The bioavailability of chemicals in soil for earthworms

USGS Publications Warehouse

Lanno, R.; Wells, J.; Conder, Jason M.; Bradham, K.; Basta, N.

2004-01-01

The bioavailability of chemicals to earthworms can be modified dramatically by soil physical/chemical characteristics, yet expressing exposure as total chemical concentrations does not address this problem. In order to understand the effects of modifying factors on bioavailability, one must measure and express chemical bioavailability to earthworms in a consistent, logical manner. This can be accomplished by direct biological measures of bioavailability (e.g., bioaccumulation, critical body residues), indirect biological measures of bioavailability (e.g., biomarkers, reproduction), or indirect chemical measures of bioavailability (e.g., chemical or solid-phase extracts of soil). If indirect chemical measures of bioavailability are to be used, they must be correlated with some biological response. Bioavailability can be incorporated into ecological risk assessment during risk analysis, primarily in the estimation of exposure. However, in order to be used in the site-specific ecological risk assessment of chemicals, effects concentrations must be developed from laboratory toxicity tests based on exposure estimates utilizing techniques that measure the bioavailable fraction of chemicals in soil, not total chemical concentrations. ?? 2003 Elsevier Inc. All rights reserved.

The effects of temporal perspective on college students' energy drink consumption.

PubMed

Kim, Jarim; Anagondahalli, Deepa

2017-09-01

Consideration of future consequences (CFC) describes the extent to which individuals consider potential future outcomes of their present behaviors. This personality trait has been found to predict repetitive health behaviors. Research is yet to explore the role of health beliefs, which may mediate the relationship between CFC and self-directed health behaviors. Thus, this study examined how CFC affects energy drink-related health beliefs and consumption behavior. A cross-sectional correlational online survey with 1,050 college students was conducted. Key measures include the CFC Scale, health belief measures, and current energy drink consumption pattern. CFC was associated with energy drink consumption as well as several health beliefs. CFC had indirect effects on energy drink consumption through health beliefs, including perceived severity of consuming energy drinks (indirect effect estimate = -.191, 95% confidence interval [CI] [-.271, -.122]), perceived benefits of avoiding energy drinks (indirect effect estimate = -.108, 95% CI [-.174, -.050]), and perceived barriers in abstaining from energy drinks (energy level-related barriers, indirect effect estimate = -.274, 95% CI [-.387, -.181]; and socialization-related barriers, indirect effect estimate = .152, 95% CI [.078, .249]). As the first study to examine CFC's indirect effects on a self-directed health behavior through health beliefs, this study extended CFC's applicability by examining its role in the context of college students' energy drink consumption. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

National and regional comparisons between Strahler order and stream size

EPA Science Inventory

Water body size is one of the most important factors affecting the structure and function of aquatic ecosystems. The categorical variable, Strahler stream order, is frequently used as an indirect estimate of stream size. Other indirect estimates of stream size, such as catchmen...

Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

PubMed Central

2013-01-01

Background National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. Methods We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. Results 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). Conclusions The indirect method may be questioned, because of variations in definition of smoking and lung cancer type in the epidemiological database, changes over time in diagnosis of lung cancer types, lack of national representativeness of some studies, and regional variation in smoking misclassification. However, the results seem consistent with the literature, and provide additional information on variability by time and region, including evidence of a rise in never smoker adenocarcinoma rates relative to squamous cell carcinoma rates. PMID:23570286

[Macroeconomic costs of eye diseases].

PubMed

Hirneiß, C; Kampik, A; Neubauer, A S

2014-05-01

Eye diseases that are relevant regarding their macroeconomic costs and their impact on society include cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors. The aim of this article is to provide a comprehensive overview of direct and indirect costs for major eye disease categories for Germany, based on existing literature and data sources. A semi-structured literature search was performed in the databases Medline and Embase and in the search machine Google for relevant original papers and reviews on costs of eye diseases with relevance for or transferability to Germany (last research date October 2013). In addition, manual searching was performed in important national databases and information sources, such as the Federal Office of Statistics and scientific societies. The direct costs for these diseases add up to approximately 2.6 billion Euros yearly for the Federal Republic of Germany, including out of the pocket payments from patients but excluding optical aids (e.g. glasses). In addition to those direct costs there are also indirect costs which are caused e.g. by loss of employment or productivity or by a reduction in health-related quality of life. These indirect costs can only be roughly estimated. Including the indirect costs for the eye diseases investigated, a total yearly macroeconomic cost ranging between 4 and 12 billion Euros is estimated for Germany. The costs for the eye diseases cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors have a macroeconomic relevant dimension. Based on the predicted demographic changes with an ageing society an increase of the prevalence and thus also an increase of costs for eye diseases is expected in the future.

Estimating the social cost of respiratory cancer cases attributable to occupational exposures in France.

PubMed

Serrier, Hassan; Sultan-Taieb, Hélène; Luce, Danièle; Bejean, Sophie

2014-07-01

The objective of this article was to estimate the social cost of respiratory cancer cases attributable to occupational risk factors in France in 2010. According to the attributable fraction method and based on available epidemiological data from the literature, we estimated the number of respiratory cancer cases due to each identified risk factor. We used the cost-of-illness method with a prevalence-based approach. We took into account the direct and indirect costs. We estimated the cost of production losses due to morbidity (absenteeism and presenteeism) and mortality costs (years of production losses) in the market and nonmarket spheres. The social cost of lung, larynx, sinonasal and mesothelioma cancer caused by exposure to asbestos, chromium, diesel engine exhaust, paint, crystalline silica, wood and leather dust in France in 2010 were estimated at between 917 and 2,181 million euros. Between 795 and 2,011 million euros (87-92%) of total costs were due to lung cancer alone. Asbestos was by far the risk factor representing the greatest cost to French society in 2010 at between 531 and 1,538 million euros (58-71%), ahead of diesel engine exhaust, representing an estimated social cost of between 233 and 336 million euros, and crystalline silica (119-229 million euros). Indirect costs represented about 66% of total costs. Our assessment shows the magnitude of the economic impact of occupational respiratory cancers. It allows comparisons between countries and provides valuable information for policy-makers responsible for defining public health priorities.

Epilepsy in Sweden: health care costs and loss of productivity--a register-based approach.

PubMed

Bolin, Kristian; Lundgren, Anders; Berggren, Fredrik; Källén, Kristina

2012-12-01

The objective was to estimate health care costs and productivity losses due to epilepsy in Sweden and to compare these estimates to previously published estimates. Register data on health care utilisation, pharmaceutical sales, permanent disability and mortality were used to calculate health care costs and costs that accrue due to productivity losses. By linkage of register information, we were able to distinguish pharmaceuticals prescribed against epilepsy from prescriptions that were prompted by other indications. The estimated total cost of epilepsy in Sweden in 2009 was 441 million, which corresponds to an annual per-patient cost of 8,275. Health care accounted for about 16% of the estimated total cost, and drug costs accounted for about 7% of the total cost. The estimated health care cost corresponded to about 0.2% of the total health care cost in Sweden in 2009. Indirect costs were estimated at 370 million, 84% of which was due to sickness absenteeism. Costs resulting from epilepsy-attributable premature deaths or permanent disability to work accounted for about 1% of the total indirect cost in Sweden in 2009. The per-patient cost of epilepsy is substantial. Thus, even though the prevalence of the illness is relatively small, the aggregated cost that epilepsy incurs on society is significant.

Latent degradation indicators estimation and prediction: A Monte Carlo approach

NASA Astrophysics Data System (ADS)

Zhou, Yifan; Sun, Yong; Mathew, Joseph; Wolff, Rodney; Ma, Lin

2011-01-01

Asset health inspections can produce two types of indicators: (1) direct indicators (e.g. the thickness of a brake pad, and the crack depth on a gear) which directly relate to a failure mechanism; and (2) indirect indicators (e.g. the indicators extracted from vibration signals and oil analysis data) which can only partially reveal a failure mechanism. While direct indicators enable more precise references to asset health condition, they are often more difficult to obtain than indirect indicators. The state space model provides an efficient approach to estimating direct indicators by using indirect indicators. However, existing state space models to estimate direct indicators largely depend on assumptions such as, discrete time, discrete state, linearity, and Gaussianity. The discrete time assumption requires fixed inspection intervals. The discrete state assumption entails discretising continuous degradation indicators, which often introduces additional errors. The linear and Gaussian assumptions are not consistent with nonlinear and irreversible degradation processes in most engineering assets. This paper proposes a state space model without these assumptions. Monte Carlo-based algorithms are developed to estimate the model parameters and the remaining useful life. These algorithms are evaluated for performance using numerical simulations through MATLAB. The result shows that both the parameters and the remaining useful life are estimated accurately. Finally, the new state space model is used to process vibration and crack depth data from an accelerated test of a gearbox. During this application, the new state space model shows a better fitness result than the state space model with linear and Gaussian assumption.

FY 2011 4th Quarter Metric: Estimate of Future Aerosol Direct and Indirect Effects

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

Koch, D

2011-09-21

The global and annual mean aerosol direct and indirect effects, relative to 1850 conditions, estimated from CESM simulations are 0.02 W m-2 and -0.39 W m-2, respectively, for emissions in year 2100 under the IPCC RCP8.5 scenario. The indirect effect is much smaller than that for 2000 emissions because of much smaller SO2 emissions in 2100; the direct effects are small due to compensation between warming by black carbon and cooling by sulfate.

The Impact of Using Different Methods to Assess Completeness of 24-Hour Urine Collection on Estimating Dietary Sodium.

PubMed

Wielgosz, Andreas; Robinson, Christopher; Mao, Yang; Jiang, Ying; Campbell, Norm R C; Muthuri, Stella; Morrison, Howard

2016-06-01

The standard for population-based surveillance of dietary sodium intake is 24-hour urine testing; however, this may be affected by incomplete urine collection. The impact of different indirect methods of assessing completeness of collection on estimated sodium ingestion has not been established. The authors enlisted 507 participants from an existing community study in 2009 to collect 24-hour urine samples. Several methods of assessing completeness of urine collection were tested. Mean sodium intake varied between 3648 mg/24 h and 7210 mg/24 h depending on the method used. Excluding urine samples collected for longer or shorter than 24 hours increased the estimated urine sodium excretion, even when corrections for the variation in timed collections were applied. Until an accurate method of indirectly assessing completeness of urine collection is identified, the gold standard of administering para-aminobenzoic acid is recommended. Efforts to ensure participants collect complete urine samples are also warranted. ©2015 Wiley Periodicals, Inc.

The Dynamics of Glomerular Ultrafiltration in the Rat

PubMed Central

Brenner, Barry M.; Troy, Julia L.; Daugharty, Terrance M.

1971-01-01

Using a unique strain of Wistar rats endowed with glomeruli situated directly on the renal cortical surface, we measured glomerular capillary pressures using servo-nulling micropipette transducer techniques. Pressures in 12 glomerular capillaries from 7 rats averaged 60 cm H2O, or approximately 50% of mean systemic arterial values. Wave form characteristics for these glomerular capillaries were found to be remarkably similar to those of the central aorta. From similarly direct estimates of hydrostatic pressures in proximal tubules, and colloid osmotic pressures in systemic and efferent arteriolar plasmas, the net driving force for ultrafiltration was calculated. The average value of 14 cm H2O is lower by some two-thirds than the majority of estimates reported previously based on indirect techniques. Single nephron GFR (glomerular filtration rate) was also measured in these rats, thereby permitting calculation of the glomerular capillary ultrafiltration coefficient. The average value of 0.044 nl sec−1 cm H2O−1 glomerulus−1 is at least fourfold greater than previous estimates derived from indirect observations. PMID:5097578

Methoprene and control of stored-product insects

USDA-ARS?s Scientific Manuscript database

Estimated direct and indirect losses of grains and grain-based products caused by stored-product insects range from about 10% in temperate regions to almost 50% in humid tropical areas. Pest management strategies in bulk grains include the use of fumigants such as phosphine and sulfuryl fluoride, an...

Influenza-related mortality trends in Japanese and American seniors: evidence for the indirect mortality benefits of vaccinating schoolchildren.

PubMed

Charu, Vivek; Viboud, Cécile; Simonsen, Lone; Sturm-Ramirez, Katharine; Shinjoh, Masayoshi; Chowell, Gerardo; Miller, Mark; Sugaya, Norio

2011-01-01

The historical Japanese influenza vaccination program targeted at schoolchildren provides a unique opportunity to evaluate the indirect benefits of vaccinating high-transmitter groups to mitigate disease burden among seniors. Here we characterize the indirect mortality benefits of vaccinating schoolchildren based on data from Japan and the US. We compared age-specific influenza-related excess mortality rates in Japanese seniors aged ≥65 years during the schoolchildren vaccination program (1978-1994) and after the program was discontinued (1995-2006). Indirect vaccine benefits were adjusted for demographic changes, socioeconomics and dominant influenza subtype; US mortality data were used as a control. We estimate that the schoolchildren vaccination program conferred a 36% adjusted mortality reduction among Japanese seniors (95%CI: 17-51%), corresponding to ∼1,000 senior deaths averted by vaccination annually (95%CI: 400-1,800). In contrast, influenza-related mortality did not change among US seniors, despite increasing vaccine coverage in this population. The Japanese schoolchildren vaccination program was associated with substantial indirect mortality benefits in seniors.

Indirect scaling methods for testing quantitative emotion theories.

PubMed

Junge, Martin; Reisenzein, Rainer

2013-01-01

Two studies investigated the utility of indirect scaling methods, based on graded pair comparisons, for the testing of quantitative emotion theories. In Study 1, we measured the intensity of relief and disappointment caused by lottery outcomes, and in Study 2, the intensity of disgust evoked by pictures, using both direct intensity ratings and graded pair comparisons. The stimuli were systematically constructed to reflect variables expected to influence the intensity of the emotions according to theoretical models of relief/disappointment and disgust, respectively. Two probabilistic scaling methods were used to estimate scale values from the pair comparison judgements: Additive functional measurement (AFM) and maximum likelihood difference scaling (MLDS). The emotion models were fitted to the direct and indirect intensity measurements using nonlinear regression (Study 1) and analysis of variance (Study 2). Both studies found substantially improved fits of the emotion models for the indirectly determined emotion intensities, with their advantage being evident particularly at the level of individual participants. The results suggest that indirect scaling methods yield more precise measurements of emotion intensity than rating scales and thereby provide stronger tests of emotion theories in general and quantitative emotion theories in particular.

Comparing Alternative Effect Decomposition Methods: The Role of Literacy in Mediating Educational Effects on Mortality.

PubMed

Nguyen, Thu T; Tchetgen Tchetgen, Eric J; Kawachi, Ichiro; Gilman, Stephen E; Walter, Stefan; Glymour, M Maria

2016-09-01

Inverse odds ratio weighting, a newly proposed tool to evaluate mediation in exposure-disease associations, may be valuable for a host of research questions, but little is known about its performance in real data. We compare this approach to a more conventional Baron and Kenny type of decomposition on an additive hazards scale to estimate total, direct, and indirect effects using the example of the role of literacy in mediating the effects of education on mortality. Health and Retirement Study participants born in the United States between 1900 and 1947 were interviewed biennially for up to 12 years (N = 17,054). Literacy was measured with a brief vocabulary assessment. Decomposition estimates were derived based on Aalen additive hazards models. A 1 standard deviation difference in educational attainment (3 years) was associated with 6.7 fewer deaths per 1000 person-years (β = -6.7, 95% confidence interval [CI]: -7.9, -5.4). Of this decrease, 1.3 fewer deaths (β = -1.3, 95% CI: -4.0, 1.2) were attributed to the literacy pathway (natural indirect), representing 19% of the total effect. Baron and Kenny estimates were consistent with inverse odds ratio weighting estimates but were less variable (natural indirect effect: -1.2 [95% CI: -1.7, -0.69], representing 18% of total effect). In a cohort of older Americans, literacy partially mediated the effect of education on mortality. See Video Abstract at http://links.lww.com/EDE/B78.

Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder.

PubMed

O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K

2015-01-01

The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.

The costs of hepatitis A infections in South Korea

PubMed Central

Kim, Kyohyun; Jeong, Baek-Geun; Ki, Moran; Park, Mira; Park, Jin Kyung; Choi, Bo Youl; Yoo, Weon-Seob

2014-01-01

OBJECTIVES: The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies. METHODS: We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008. RESULTS: There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group. CONCLUSIONS: This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate. PMID:25139060

An Index and Test of Linear Moderated Mediation.

PubMed

Hayes, Andrew F

2015-01-01

I describe a test of linear moderated mediation in path analysis based on an interval estimate of the parameter of a function linking the indirect effect to values of a moderator-a parameter that I call the index of moderated mediation. This test can be used for models that integrate moderation and mediation in which the relationship between the indirect effect and the moderator is estimated as linear, including many of the models described by Edwards and Lambert ( 2007 ) and Preacher, Rucker, and Hayes ( 2007 ) as well as extensions of these models to processes involving multiple mediators operating in parallel or in serial. Generalization of the method to latent variable models is straightforward. Three empirical examples describe the computation of the index and the test, and its implementation is illustrated using Mplus and the PROCESS macro for SPSS and SAS.

Estimating Driving Performance Based on EEG Spectrum Analysis

NASA Astrophysics Data System (ADS)

Lin, Chin-Teng; Wu, Ruei-Cheng; Jung, Tzyy-Ping; Liang, Sheng-Fu; Huang, Teng-Yi

2005-12-01

The growing number of traffic accidents in recent years has become a serious concern to society. Accidents caused by driver's drowsiness behind the steering wheel have a high fatality rate because of the marked decline in the driver's abilities of perception, recognition, and vehicle control abilities while sleepy. Preventing such accidents caused by drowsiness is highly desirable but requires techniques for continuously detecting, estimating, and predicting the level of alertness of drivers and delivering effective feedbacks to maintain their maximum performance. This paper proposes an EEG-based drowsiness estimation system that combines electroencephalogram (EEG) log subband power spectrum, correlation analysis, principal component analysis, and linear regression models to indirectly estimate driver's drowsiness level in a virtual-reality-based driving simulator. Our results demonstrated that it is feasible to accurately estimate quantitatively driving performance, expressed as deviation between the center of the vehicle and the center of the cruising lane, in a realistic driving simulator.

Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes.

PubMed

Mather, Richard C; Nho, Shane J; Federer, Andrew; Demiralp, Berna; Nguyen, Jennifer; Saavoss, Asha; Salata, Michael J; Philippon, Marc J; Bedi, Asheesh; Larson, Christopher M; Byrd, J W Thomas; Koenig, Lane

2018-04-01

The diagnosis and treatment of femoroacetabular impingement (FAI) have increased steadily within the past decade, and research indicates clinically significant improvements after treatment of FAI with hip arthroscopy. This study examined the societal and economic impact of hip arthroscopy by high-volume surgeons for patients with FAI syndrome aged <50 years with noncontroversial diagnosis and indications for surgery. Economic and decision analysis; Level of evidence, 2. The cost-effectiveness of hip arthroscopy versus nonoperative treatment was evaluated by calculating direct and indirect treatment costs. Direct cost was calculated with Current Procedural Terminology medical codes associated with FAI treatment. Indirect cost was measured with the patient-reported data of 102 patients who underwent arthroscopy and from the reimbursement records of 32,143 individuals between the ages of 16 and 79 years who had information in a private insurance claims data set contained within the PearlDiver Patient Records Database. The indirect economic benefits of hip arthroscopy were inferred through regression analysis to estimate the statistical relationship between functional status and productivity. A simulation-based approach was then used to estimate the change in productivity associated with the change in functional status observed in the treatment cohort between baseline and follow-up. To analyze cost-effectiveness, 1-, 2-, and 3-way sensitivity analyses were performed on all variables in the model, and Monte Carlo analysis evaluated the impact of uncertainty in the model assumptions. Analysis of indirect costs identified a statistically significant increase of mean aggregate productivity of $8968 after surgery. Cost-effectiveness analysis showed a mean cumulative total 10-year societal savings of $67,418 per patient from hip arthroscopy versus nonoperative treatment. Hip arthroscopy also conferred a gain of 2.03 quality-adjusted life years over this period. The mean cost for hip arthroscopy was estimated at $23,120 ± $10,279, and the mean cost of nonoperative treatment was estimated at $91,602 ± $14,675. In 99% of trials, hip arthroscopy was recognized as the preferred cost-effective strategy. FAI syndrome produces a substantial economic burden on society that may be reduced through the indirect cost savings and economic benefits from hip arthroscopy.

Use of direct versus indirect preparation data for assessing risk associated with airborne exposures at asbestos-contaminated sites.

PubMed

Goldade, Mary Patricia; O'Brien, Wendy Pott

2014-01-01

At asbestos-contaminated sites, exposure assessment requires measurement of airborne asbestos concentrations; however, the choice of preparation steps employed in the analysis has been debated vigorously among members of the asbestos exposure and risk assessment communities for many years. This study finds that the choice of preparation technique used in estimating airborne amphibole asbestos exposures for risk assessment is generally not a significant source of uncertainty. Conventionally, the indirect preparation method has been less preferred by some because it is purported to result in false elevations in airborne asbestos concentrations, when compared to direct analysis of air filters. However, airborne asbestos sampling in non-occupational settings is challenging because non-asbestos particles can interfere with the asbestos measurements, sometimes necessitating analysis via indirect preparation. To evaluate whether exposure concentrations derived from direct versus indirect preparation techniques differed significantly, paired measurements of airborne Libby-type amphibole, prepared using both techniques, were compared. For the evaluation, 31 paired direct and indirect preparations originating from the same air filters were analyzed for Libby-type amphibole using transmission electron microscopy. On average, the total Libby-type amphibole airborne exposure concentration was 3.3 times higher for indirect preparation analysis than for its paired direct preparation analysis (standard deviation = 4.1), a difference which is not statistically significant (p = 0.12, two-tailed, Wilcoxon signed rank test). The results suggest that the magnitude of the difference may be larger for shorter particles. Overall, neither preparation technique (direct or indirect) preferentially generates more precise and unbiased data for airborne Libby-type amphibole concentration estimates. The indirect preparation method is reasonable for estimating Libby-type amphibole exposure and may be necessary given the challenges of sampling in environmental settings. Relative to the larger context of uncertainties inherent in the risk assessment process, uncertainties associated with the use of airborne Libby-type amphibole exposure measurements derived from indirect preparation analysis are low. Use of exposure measurements generated by either direct or indirect preparation analyses is reasonable to estimate Libby-type Amphibole exposures in a risk assessment.

A Simple Estimation Method for Aggregate Government Outsourcing

ERIC Educational Resources Information Center

Minicucci, Stephen; Donahue, John D.

2004-01-01

The scholarly and popular debate on the delegation to the private sector of governmental tasks rests on an inadequate empirical foundation, as no systematic data are collected on direct versus indirect service delivery. We offer a simple method for approximating levels of service outsourcing, based on relatively straightforward combinations of and…

Aerosol Indirect Effects on Cirrus Clouds in Global Aerosol-Climate Models

NASA Astrophysics Data System (ADS)

Liu, X.; Zhang, K.; Wang, Y.; Neubauer, D.; Lohmann, U.; Ferrachat, S.; Zhou, C.; Penner, J.; Barahona, D.; Shi, X.

2015-12-01

Cirrus clouds play an important role in regulating the Earth's radiative budget and water vapor distribution in the upper troposphere. Aerosols can act as solution droplets or ice nuclei that promote ice nucleation in cirrus clouds. Anthropogenic emissions from fossil fuel and biomass burning activities have substantially perturbed and enhanced concentrations of aerosol particles in the atmosphere. Global aerosol-climate models (GCMs) have now been used to quantify the radiative forcing and effects of aerosols on cirrus clouds (IPCC AR5). However, the estimate uncertainty is very large due to the different representation of ice cloud formation and evolution processes in GCMs. In addition, large discrepancies have been found between model simulations in terms of the spatial distribution of ice-nucleating aerosols, relative humidity, and temperature fluctuations, which contribute to different estimates of the aerosol indirect effect through cirrus clouds. In this presentation, four GCMs with the start-of-the art representations of cloud microphysics and aerosol-cloud interactions are used to estimate the aerosol indirect effects on cirrus clouds and to identify the causes of the discrepancies. The estimated global and annual mean anthropogenic aerosol indirect effect through cirrus clouds ranges from 0.1 W m-2 to 0.3 W m-2 in terms of the top-of-the-atmosphere (TOA) net radiation flux, and 0.5-0.6 W m-2 for the TOA longwave flux. Despite the good agreement on global mean, large discrepancies are found at the regional scale. The physics behind the aerosol indirect effect is dramatically different. Our analysis suggests that burden of ice-nucleating aerosols in the upper troposphere, ice nucleation frequency, and relative role of ice formation processes (i.e., homogeneous versus heterogeneous nucleation) play key roles in determining the characteristics of the simulated aerosol indirect effects. In addition to the indirect effect estimate, we also use field campaign measurements and satellite retrievals to evaluate the simulated micro- and macro- physical properties of ice clouds in the four GCMs.

A comparison of direct and indirect methods for the estimation of health utilities from clinical outcomes.

PubMed

Hernández Alava, Mónica; Wailoo, Allan; Wolfe, Fred; Michaud, Kaleb

2014-10-01

Analysts frequently estimate health state utility values from other outcomes. Utility values like EQ-5D have characteristics that make standard statistical methods inappropriate. We have developed a bespoke, mixture model approach to directly estimate EQ-5D. An indirect method, "response mapping," first estimates the level on each of the 5 dimensions of the EQ-5D and then calculates the expected tariff score. These methods have never previously been compared. We use a large observational database from patients with rheumatoid arthritis (N = 100,398). Direct estimation of UK EQ-5D scores as a function of the Health Assessment Questionnaire (HAQ), pain, and age was performed with a limited dependent variable mixture model. Indirect modeling was undertaken with a set of generalized ordered probit models with expected tariff scores calculated mathematically. Linear regression was reported for comparison purposes. Impact on cost-effectiveness was demonstrated with an existing model. The linear model fits poorly, particularly at the extremes of the distribution. The bespoke mixture model and the indirect approaches improve fit over the entire range of EQ-5D. Mean average error is 10% and 5% lower compared with the linear model, respectively. Root mean squared error is 3% and 2% lower. The mixture model demonstrates superior performance to the indirect method across almost the entire range of pain and HAQ. These lead to differences in cost-effectiveness of up to 20%. There are limited data from patients in the most severe HAQ health states. Modeling of EQ-5D from clinical measures is best performed directly using the bespoke mixture model. This substantially outperforms the indirect method in this example. Linear models are inappropriate, suffer from systematic bias, and generate values outside the feasible range. © The Author(s) 2013.

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

PubMed

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Accuracy of Noninvasive Estimation Techniques for the State of the Cochlear Amplifier

NASA Astrophysics Data System (ADS)

Dalhoff, Ernst; Gummer, Anthony W.

2011-11-01

Estimation of the function of the cochlea in human is possible only by deduction from indirect measurements, which may be subjective or objective. Therefore, for basic research as well as diagnostic purposes, it is important to develop methods to deduce and analyse error sources of cochlear-state estimation techniques. Here, we present a model of technical and physiologic error sources contributing to the estimation accuracy of hearing threshold and the state of the cochlear amplifier and deduce from measurements of human that the estimated standard deviation can be considerably below 6 dB. Experimental evidence is drawn from two partly independent objective estimation techniques for the auditory signal chain based on measurements of otoacoustic emissions.

Theoretical Analysis of Penalized Maximum-Likelihood Patlak Parametric Image Reconstruction in Dynamic PET for Lesion Detection.

PubMed

Yang, Li; Wang, Guobao; Qi, Jinyi

2016-04-01

Detecting cancerous lesions is a major clinical application of emission tomography. In a previous work, we studied penalized maximum-likelihood (PML) image reconstruction for lesion detection in static PET. Here we extend our theoretical analysis of static PET reconstruction to dynamic PET. We study both the conventional indirect reconstruction and direct reconstruction for Patlak parametric image estimation. In indirect reconstruction, Patlak parametric images are generated by first reconstructing a sequence of dynamic PET images, and then performing Patlak analysis on the time activity curves (TACs) pixel-by-pixel. In direct reconstruction, Patlak parametric images are estimated directly from raw sinogram data by incorporating the Patlak model into the image reconstruction procedure. PML reconstruction is used in both the indirect and direct reconstruction methods. We use a channelized Hotelling observer (CHO) to assess lesion detectability in Patlak parametric images. Simplified expressions for evaluating the lesion detectability have been derived and applied to the selection of the regularization parameter value to maximize detection performance. The proposed method is validated using computer-based Monte Carlo simulations. Good agreements between the theoretical predictions and the Monte Carlo results are observed. Both theoretical predictions and Monte Carlo simulation results show the benefit of the indirect and direct methods under optimized regularization parameters in dynamic PET reconstruction for lesion detection, when compared with the conventional static PET reconstruction.

Burns, metabolism and nutritional requirements.

PubMed

Mendonça Machado, N; Gragnani, A; Masako Ferreira, L

2011-01-01

To review the nutritional evaluation in burned patient, considering the literature descriptions of nutritional evaluation and energy requirements of these patients. Thermal injury is the traumatic event with the highest metabolic response in critically ill patients. Various mathematical formulas have been developed to estimate nutritional requirements in burned patient. Indirect Calorimetry is the only method considered gold standard for measuring caloric expenditure. A survey of the literature and data was collected based on official data bases, LILACS, EMBASE and PubMed. The metabolic changes involved in hypermetabolism are designed to supply energy to support immune function, brain activity, wound healing, and preservation of body tissues. Body weight is considered the easiest indicator and perhaps the best to assess the nutritional status. The most common formulas utilized in these patients are the Curreri, Pennisi, Schofield, Ireton-Jones, Harris-Benedict and the ASPEN recommendations. For children is the Mayes and World Health Organization formula. The majority of mathematical formulas overestimate the nutritional needs. The regular use of Indirect Calorimetry supplies adequate nutritional support to the burn patient. The traditional nutritional evaluation considers anthropometry, biochemical markers and estimation of nutritional requirements. The weight provides a basis for decisions that are established in the clinical context. Classic parameters can be adapted to intensive care environment. The use of Indirect Calorimetry is crucial to ensure the safety of the nutritional support of burn patients and this should be widely encouraged.

Two-condition within-participant statistical mediation analysis: A path-analytic framework.

PubMed

Montoya, Amanda K; Hayes, Andrew F

2017-03-01

Researchers interested in testing mediation often use designs where participants are measured on a dependent variable Y and a mediator M in both of 2 different circumstances. The dominant approach to assessing mediation in such a design, proposed by Judd, Kenny, and McClelland (2001), relies on a series of hypothesis tests about components of the mediation model and is not based on an estimate of or formal inference about the indirect effect. In this article we recast Judd et al.'s approach in the path-analytic framework that is now commonly used in between-participant mediation analysis. By so doing, it is apparent how to estimate the indirect effect of a within-participant manipulation on some outcome through a mediator as the product of paths of influence. This path-analytic approach eliminates the need for discrete hypothesis tests about components of the model to support a claim of mediation, as Judd et al.'s method requires, because it relies only on an inference about the product of paths-the indirect effect. We generalize methods of inference for the indirect effect widely used in between-participant designs to this within-participant version of mediation analysis, including bootstrap confidence intervals and Monte Carlo confidence intervals. Using this path-analytic approach, we extend the method to models with multiple mediators operating in parallel and serially and discuss the comparison of indirect effects in these more complex models. We offer macros and code for SPSS, SAS, and Mplus that conduct these analyses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Harris-Benedict equation estimations of energy needs as compared to measured 24-h energy expenditure by indirect calorimetry in people with early to mid-stage Huntington's disease.

PubMed

Gaba, Ann; Zhang, Kuan; Moskowitz, Carol B; Boozer, Carol N; Marder, Karen

2008-10-01

Weight loss and energy metabolism are important clinical research areas in understanding the disease mechanisms in Huntington's disease. Having an accurate method to estimate expected total energy expenditure would likely facilitate the development of studies about these features of the disease. The Harris-Benedict equation is a formula commonly used to estimate basal energy expenditure of individuals, adjusted for height, weight, age and gender. This estimate is then multiplied by a physical activity factor to estimate total daily energy needs to maintain the given weight. Data from 24-h indirect calorimetry was utilized to derive an adjustment formula for the physical activity factor of the Harris-Benedict equation for 13 early to mid-stage Huntington's disease patients. The adjusted activity factor provided the most accurate estimate of energy needs. This adjusted formula can be used in clinical assessments of Huntington's disease patients, as well as in research studies when indirect calorimetry has not been performed.

[Methodologies for estimating the indirect costs of traffic accidents].

PubMed

Carozzi, Soledad; Elorza, María Eugenia; Moscoso, Nebel Silvana; Ripari, Nadia Vanina

2017-01-01

Traffic accidents generate multiple costs to society, including those associated with the loss of productivity. However, there is no consensus about the most appropriate methodology for estimating those costs. The aim of this study was to review methods for estimating indirect costs applied in crash cost studies. A thematic review of the literature was carried out between 1995 and 2012 in PubMed with the terms cost of illness, indirect cost, road traffic injuries, productivity loss. For the assessment of costs we used the the human capital method, on the basis of the wage-income lost during the time of treatment and recovery of patients and caregivers. In the case of premature death or total disability, the discount rate was applied to obtain the present value of lost future earnings. The computed years arose by subtracting to life expectancy at birth the average age of those affected who are not incorporated into the economically active life. The interest in minimizing the problem is reflected in the evolution of the implemented methodologies. We expect that this review is useful to estimate efficiently the real indirect costs of traffic accidents.

Evaluation of a serological test (indirect ELISA) for the diagnosis of sarcoptic mange in red foxes (Vulpes vulpes).

PubMed

Bornstein, Set; Frössling, Jenny; Näslund, Katarina; Zakrisson, Göran; Mörner, Torsten

2006-12-01

Sarcoptic mange occurs in many parts of the world and is common in populations of domestic and wild canids, including red foxes (Vulpes vulpes). In recent years, an indirect antibody enzyme-linked immunosorbent assay (ELISA), with higher sensitivity and specificity than traditional diagnostic methods, has been successfully applied in the diagnosis of sarcoptic mange in dogs. The same ELISA has also demonstrated specific antibodies to Sarcoptes scabiei in experimentally infected red foxes. The aim of this study was to evaluate the indirect ELISA when used to detect antibodies to S. scabiei in field sera from Swedish red foxes. One cohort of both infected and non-infected red foxes (cohort 1; n = 88), and one cohort of apparently non-infected foxes (cohort 2; n = 67) were examined for skin lesions and presence of S. scabiei by thorough visual examination at autopsy and skin scrapings. Samples of blood-tinted body liquid from the abdomen or thorax cavity were collected and analysed by the indirect ELISA. The relative sensitivity and specificity of the ELISA at different cut-offs (OD values) were estimated by comparing the test results to the infection status as determined by examination and skin scrapings. The highest combination of relative sensitivity and specificity, calculated based on cohort 1, was 95.4 and 100.0%, respectively. These estimates were constant for cut-offs 0.150-0.225, which included the cut-off based on the mean plus three standard deviations of test results from cohort 2 (0.165). It is concluded that this test can be useful in diagnosis and epidemiological studies of S. scabiei infection in red foxes.

Investigation on circular asymmetry of geographical distribution in cancer mortality of Hiroshima atomic bomb survivors based on risk maps: analysis of spatial survival data.

PubMed

Tonda, Tetsuji; Satoh, Kenichi; Otani, Keiko; Sato, Yuya; Maruyama, Hirofumi; Kawakami, Hideshi; Tashiro, Satoshi; Hoshi, Masaharu; Ohtaki, Megu

2012-05-01

While there is a considerable number of studies on the relationship between the risk of disease or death and direct exposure from the atomic bomb in Hiroshima, the risk for indirect exposure caused by residual radioactivity has not yet been fully evaluated. One of the reasons is that risk assessments have utilized estimated radiation doses, but that it is difficult to estimate indirect exposure. To evaluate risks for other causes, including indirect radiation exposure, as well as direct exposure, a statistical method is described here that evaluates risk with respect to individual location at the time of atomic bomb exposure instead of radiation dose. In addition, it is also considered to split the risks into separate risks due to direct exposure and other causes using radiation dose. The proposed method is applied to a cohort study of Hiroshima atomic bomb survivors. The resultant contour map suggests that the region west to the hypocenter has a higher risk compared to other areas. This in turn suggests that there exists an impact on risk that cannot be explained by direct exposure.

Input-output modeling for urban energy consumption in Beijing: dynamics and comparison.

PubMed

Zhang, Lixiao; Hu, Qiuhong; Zhang, Fan

2014-01-01

Input-output analysis has been proven to be a powerful instrument for estimating embodied (direct plus indirect) energy usage through economic sectors. Using 9 economic input-output tables of years 1987, 1990, 1992, 1995, 1997, 2000, 2002, 2005, and 2007, this paper analyzes energy flows for the entire city of Beijing and its 30 economic sectors, respectively. Results show that the embodied energy consumption of Beijing increased from 38.85 million tonnes of coal equivalent (Mtce) to 206.2 Mtce over the past twenty years of rapid urbanization; the share of indirect energy consumption in total energy consumption increased from 48% to 76%, suggesting the transition of Beijing from a production-based and manufacturing-dominated economy to a consumption-based and service-dominated economy. Real estate development has shown to be a major driving factor of the growth in indirect energy consumption. The boom and bust of construction activities have been strongly correlated with the increase and decrease of system-side indirect energy consumption. Traditional heavy industries remain the most energy-intensive sectors in the economy. However, the transportation and service sectors have contributed most to the rapid increase in overall energy consumption. The analyses in this paper demonstrate that a system-wide approach such as that based on input-output model can be a useful tool for robust energy policy making.

Input-Output Modeling for Urban Energy Consumption in Beijing: Dynamics and Comparison

PubMed Central

Zhang, Lixiao; Hu, Qiuhong; Zhang, Fan

2014-01-01

Input-output analysis has been proven to be a powerful instrument for estimating embodied (direct plus indirect) energy usage through economic sectors. Using 9 economic input-output tables of years 1987, 1990, 1992, 1995, 1997, 2000, 2002, 2005, and 2007, this paper analyzes energy flows for the entire city of Beijing and its 30 economic sectors, respectively. Results show that the embodied energy consumption of Beijing increased from 38.85 million tonnes of coal equivalent (Mtce) to 206.2 Mtce over the past twenty years of rapid urbanization; the share of indirect energy consumption in total energy consumption increased from 48% to 76%, suggesting the transition of Beijing from a production-based and manufacturing-dominated economy to a consumption-based and service-dominated economy. Real estate development has shown to be a major driving factor of the growth in indirect energy consumption. The boom and bust of construction activities have been strongly correlated with the increase and decrease of system-side indirect energy consumption. Traditional heavy industries remain the most energy-intensive sectors in the economy. However, the transportation and service sectors have contributed most to the rapid increase in overall energy consumption. The analyses in this paper demonstrate that a system-wide approach such as that based on input-output model can be a useful tool for robust energy policy making. PMID:24595199

Estimating forest canopy bulk density using six indirect methods

Treesearch

Robert E. Keane; Elizabeth D. Reinhardt; Joe Scott; Kathy Gray; James Reardon

2005-01-01

Canopy bulk density (CBD) is an important crown characteristic needed to predict crown fire spread, yet it is difficult to measure in the field. Presented here is a comprehensive research effort to evaluate six indirect sampling techniques for estimating CBD. As reference data, detailed crown fuel biomass measurements were taken on each tree within fixed-area plots...

Hand-held indirect calorimeter offers advantages compared with prediction equations, in a group of overweight women, to determine resting energy expenditures and estimated total energy expenditures during research screening.

PubMed

Spears, Karen E; Kim, Hyunsook; Behall, Kay M; Conway, Joan M

2009-05-01

To compare standardized prediction equations to a hand-held indirect calorimeter in estimating resting energy and total energy requirements in overweight women. Resting energy expenditure (REE) was measured by hand-held indirect calorimeter and calculated by prediction equations Harris-Benedict, Mifflin-St Jeor, World Health Organization/Food and Agriculture Organization/United Nations University (WHO), and Dietary Reference Intakes (DRI). Physical activity level, assessed by questionnaire, was used to estimate total energy expenditure (TEE). Subjects (n=39) were female nonsmokers older than 25 years of age with body mass index more than 25. Repeated measures analysis of variance, Bland-Altman plot, and fitted regression line of difference. A difference within +/-10% of two methods indicated agreement. Significant proportional bias was present between hand-held indirect calorimeter and prediction equations for REE and TEE (P<0.01); prediction equations overestimated at lower values and underestimated at higher values. Mean differences (+/-standard error) for REE and TEE between hand-held indirect calorimeter and Harris-Benedict were -5.98+/-46.7 kcal/day (P=0.90) and 21.40+/-75.7 kcal/day (P=0.78); between hand-held indirect calorimeter and Mifflin-St Jeor were 69.93+/-46.7 kcal/day (P=0.14) and 116.44+/-75.9 kcal/day (P=0.13); between hand-held indirect calorimeter and WHO were -22.03+/-48.4 kcal/day (P=0.65) and -15.8+/-77.9 kcal/day (P=0.84); and between hand-held indirect calorimeter and DRI were 39.65+/-47.4 kcal/day (P=0.41) and 56.36+/-85.5 kcal/day (P=0.51). Less than 50% of predictive equation values were within +/-10% of hand-held indirect calorimeter values, indicating poor agreement. A significant discrepancy between predicted and measured energy expenditure was observed. Further evaluation of hand-held indirect calorimeter research screening is needed.

Direct estimation of tracer-kinetic parameter maps from highly undersampled brain dynamic contrast enhanced MRI.

PubMed

Guo, Yi; Lingala, Sajan Goud; Zhu, Yinghua; Lebel, R Marc; Nayak, Krishna S

2017-10-01

The purpose of this work was to develop and evaluate a T 1 -weighted dynamic contrast enhanced (DCE) MRI methodology where tracer-kinetic (TK) parameter maps are directly estimated from undersampled (k,t)-space data. The proposed reconstruction involves solving a nonlinear least squares optimization problem that includes explicit use of a full forward model to convert parameter maps to (k,t)-space, utilizing the Patlak TK model. The proposed scheme is compared against an indirect method that creates intermediate images by parallel imaging and compressed sensing before to TK modeling. Thirteen fully sampled brain tumor DCE-MRI scans with 5-second temporal resolution are retrospectively undersampled at rates R = 20, 40, 60, 80, and 100 for each dynamic frame. TK maps are quantitatively compared based on root mean-squared-error (rMSE) and Bland-Altman analysis. The approach is also applied to four prospectively R = 30 undersampled whole-brain DCE-MRI data sets. In the retrospective study, the proposed method performed statistically better than indirect method at R ≥ 80 for all 13 cases. This approach provided restoration of TK parameter values with less errors in tumor regions of interest, an improvement compared to a state-of-the-art indirect method. Applied prospectively, the proposed method provided whole-brain, high-resolution TK maps with good image quality. Model-based direct estimation of TK maps from k,t-space DCE-MRI data is feasible and is compatible up to 100-fold undersampling. Magn Reson Med 78:1566-1578, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Estimation of position and velocity for a low dynamic vehicle in near space using nonresolved photometric and astrometric data.

PubMed

Jing, Nan; Li, Chuang; Chong, Yaqin

2017-01-20

An estimation method for indirectly observable parameters for a typical low dynamic vehicle (LDV) is presented. The estimation method utilizes apparent magnitude, azimuth angle, and elevation angle to estimate the position and velocity of a typical LDV, such as a high altitude balloon (HAB). In order to validate the accuracy of the estimated parameters gained from an unscented Kalman filter, two sets of experiments are carried out to obtain the nonresolved photometric and astrometric data. In the experiments, a HAB launch is planned; models of the HAB dynamics and kinematics and observation models are built to use as time update and measurement update functions, respectively. When the HAB is launched, a ground-based optoelectronic detector is used to capture the object images, which are processed using aperture photometry technology to obtain the time-varying apparent magnitude of the HAB. Two sets of actual and estimated parameters are given to clearly indicate the parameter differences. Two sets of errors between the actual and estimated parameters are also given to show how the estimated position and velocity differ with respect to the observation time. The similar distribution curve results from the two scenarios, which agree within 3σ, verify that nonresolved photometric and astrometric data can be used to estimate the indirectly observable state parameters (position and velocity) for a typical LDV. This technique can be applied to small and dim space objects in the future.

Monitoring the size and protagonists of the drug market: combining supply and demand data sources and estimates.

PubMed

Rossi, Carla

2013-06-01

The size of the illicit drug market is an important indicator to assess the impact on society of an important part of the illegal economy and to evaluate drug policy and law enforcement interventions. The extent of illicit drug use and of the drug market can essentially only be estimated by indirect methods based on indirect measures and on data from various sources, as administrative data sets and surveys. The combined use of several methodologies and data sets allows to reduce biases and inaccuracies of estimates obtained on the basis of each of them separately. This approach has been applied to Italian data. The estimation methods applied are capture-recapture methods with latent heterogeneity and multiplier methods. Several data sets have been used, both administrative and survey data sets. First, the retail dealer prevalence has been estimated on the basis of administrative data, then the user prevalence by multiplier methods. Using information about behaviour of dealers and consumers from survey data, the average amount of a substance used or sold and the average unit cost have been estimated and allow estimating the size of the drug market. The estimates have been obtained using a supply-side approach and a demand-side approach and have been compared. These results are in turn used for estimating the interception rate for the different substances in term of the value of the substance seized with respect to the total value of the substance to be sold at retail prices.

Evaluation of a reproductive index to estimate grasshopper sparrow and eastern meadowlark reproductive success

USGS Publications Warehouse

Althoff, Donald P.; Gipson, P.S.; Pontius, J.S.; Japuntich, R.D.

2009-01-01

We compared an index of reproductive success based on breeding behavior to actual nest fates of grasshopper sparrows (Ammodramus savannarum) and eastern meadowlarks (Sturnella magna) on 12 plots (4-ha). Concordance of results between the two methods was 58% for grasshopper sparrows and 42% for eastern meadowlarks on a plot-by-plot basis. The indirect method yielded higher estimates of reproductive activity than nest monitoring for the balance of the plots,. There was little evidence that brown-headed cowbird (Molothrus ater) parasitism influenced the estimates of reproductive success using the indirect method. We concluded that nests and about-to-fledge nestlings were missed during searches on some plots. It may be appropriate to use an indirect method to more efficiently survey territories and/or plots for species with hard-to-find nests or when monitoring large areas. Use of a reproductive index may be appropriate and more time-efficient than nest searching and monitoring for comparing management effects such as burning, grazing, haying, military training, and other localized disturbances that are likely to affect reproductive success of grasshopper sparrows and eastern meadowlarks. However, nest monitoring may be necessary for more precise estimates of productivity necessary for long-term monitoring. Nest monitoring results are also likely to allow for direct comparisons to results from other studies because the index method requires intimate knowledge of the species being evaluated - a factor that could lead to reduced precision because the experience level of technicians relying only on behavioral cues from study-to-study is likely to vary considerably.

Assessing Mediational Models: Testing and Interval Estimation for Indirect Effects

ERIC Educational Resources Information Center

Biesanz, Jeremy C.; Falk, Carl F.; Savalei, Victoria

2010-01-01

Theoretical models specifying indirect or mediated effects are common in the social sciences. An indirect effect exists when an independent variable's influence on the dependent variable is mediated through an intervening variable. Classic approaches to assessing such mediational hypotheses (Baron & Kenny, 1986; Sobel, 1982) have in recent years…

Estimating the indirect costs associated with the expected number of cancer cases in Mexico by 2020.

PubMed

Gutiérrez-Delgado, Cristina; Armas-Texta, Daniel; Reynoso-Noverón, Nancy; Meneses-García, Abelardo; Mohar-Betancourt, Alejandro

2016-04-01

To estimate the indirect costs generated by adults with cancer in Mexico from 2002-2020. Using information from national sources and the national cancer incidence from GLOBOCAN, we estimated income lost due to premature death (ILPD), short-term benefits (STBs), disability pensions (DPs), and opportunity costs for the carer (OCCs) generated by patients with cancer. Amounts were reported in Mexican pesos. We estimated 23 359 deaths and 216 679 new cases of cancer by 2020, which would be associated with a total indirect cost of 20.15 billion Mexican pesos. Men are expected to generate 54.9% of these costs. ILPD is expected to comprise the highest percentage of the cost (60%), followed by OCCs (22%), STBs (17%) and DPs (1%). From an economic perspective, the results emphasize the need to strengthen preventive interventions and early detection of cancer among adults to reduce its effect on the productivity of Mexico.

Certainty Equivalence M-MRAC for Systems with Unmatched Uncertainties

NASA Technical Reports Server (NTRS)

Stepanyan, Vahram; Krishnakumar, Kalmanje

2012-01-01

The paper presents a certainty equivalence state feedback indirect adaptive control design method for the systems of any relative degree with unmatched uncertainties. The approach is based on the parameter identification (estimation) model, which is completely separated from the control design and is capable of producing parameter estimates as fast as the computing power allows without generating high frequency oscillations. It is shown that the system's input and output tracking errors can be systematically decreased by the proper choice of the design parameters.

Validation of five minimally obstructive methods to estimate physical activity energy expenditure in young adults in semi-standardized settings.

PubMed

Schneller, Mikkel B; Pedersen, Mogens T; Gupta, Nidhi; Aadahl, Mette; Holtermann, Andreas

2015-03-13

We compared the accuracy of five objective methods, including two newly developed methods combining accelerometry and activity type recognition (Acti4), against indirect calorimetry, to estimate total energy expenditure (EE) of different activities in semi-standardized settings. Fourteen participants performed a standardized and semi-standardized protocol including seven daily life activity types, while having their EE measured by indirect calorimetry. Simultaneously, physical activity was quantified by an ActivPAL3, two ActiGraph GT3X+'s and an Actiheart. EE was estimated by the standard ActivPAL3 software (ActivPAL), ActiGraph GT3X+ (ActiGraph) and Actiheart (Actiheart), and by a combination of activity type recognition via Acti4 software and activity counts per minute (CPM) of either a hip- or thigh-worn ActiGraph GT3X+ (AGhip + Acti4 and AGthigh + Acti4). At group level, estimated physical activities EE by Actiheart (MSE = 2.05) and AGthigh + Acti4 (MSE = 0.25) were not significantly different from measured EE by indirect calorimetry, while significantly underestimated by ActiGraph, ActivPAL and AGhip + Acti4. AGthigh + Acti4 and Actiheart explained 77% and 45%, of the individual variations in measured physical activity EE by indirect calorimetry, respectively. This study concludes that combining accelerometer data from a thigh-worn ActiGraph GT3X+ with activity type recognition improved the accuracy of activity specific EE estimation against indirect calorimetry in semi-standardized settings compared to previously validated methods using CPM only.

Problems in estimating self-supplied industrial water use by indirect methods, the California example

USGS Publications Warehouse

Burt, R.J.

1983-01-01

Consumptive fresh-water use by industry in California is estimated at about 230 million gallons per day, or about one-half of one percent of agricultural withdrawals in the State , and only about 1 percent of agricultural consumptive use. Therefore, a significant State-wide realignment of the total water resources could not be made by industrial conservation measures. Nevertheless, considerable latitude for water conservation exists in industry -- fresh water consumed by self-supplied industry amounts to about 40 percent of its withdrawals in California, and only about 10 to 15 percent nationally (not including power-plant use). Furthermore, where firms withdraw and consume less water there is more for others nearby to use. The main question in attempting to estimate self-supplied industrial water use in California by indirect methods was whether accurate estimates of industrial water use could be made from data on surrogates such as production and employment. The answer is apparently not. A fundamental problem was that different data bases produced variable coefficients of water use for similar industries. Much of the potential for error appeared to lie in the water data bases rather than the production or employment data. The apparent reasons are that water-use data are based on responses to questionnaires, which are prone to errors in reporting, and because the data may be aggregated inappropriately for this kind of correlation. Industries within an apparently similar category commonly use different amounts of water, both because of differences in the product and because of differences in production processes even where the end-product is similar. (USGS)

Converting Parkinson-Specific Scores into Health State Utilities to Assess Cost-Utility Analysis.

PubMed

Chen, Gang; Garcia-Gordillo, Miguel A; Collado-Mateo, Daniel; Del Pozo-Cruz, Borja; Adsuar, José C; Cordero-Ferrera, José Manuel; Abellán-Perpiñán, José María; Sánchez-Martínez, Fernando Ignacio

2018-06-07

The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with three multi-attribute utility (MAU) instruments (EQ-5D-3L, EQ-5D-5L, and 15D) and to develop mapping algorithms that could be used to transform PDQ-8 scores into MAU scores. A cross-sectional study was conducted. A final sample of 228 evaluable patients was included in the analyses. Sociodemographic and clinical data were also collected. Two EQ-5D questionnaires were scored using Spanish tariffs. Two models and three statistical techniques were used to estimate each model in the direct mapping framework for all three MAU instruments, including the most widely used ordinary least squares (OLS), the robust MM-estimator, and the generalized linear model (GLM). For both EQ-5D-3L and EQ-5D-5L, indirect response mapping based on an ordered logit model was also conducted. Three goodness-of-fit tests were employed to compare the models: the mean absolute error (MAE), the root-mean-square error (RMSE), and the intra-class correlation coefficient (ICC) between the predicted and observed utilities. Health state utility scores ranged from 0.61 (EQ-5D-3L) to 0.74 (15D). The mean PDQ-8 score was 27.51. The correlation between overall PDQ-8 score and each MAU instrument ranged from - 0.729 (EQ-5D-5L) to - 0.752 (EQ-5D-3L). A mapping algorithm based on PDQ-8 items had better performance than using the overall score. For the two EQ-5D questionnaires, in general, the indirect mapping approach had comparable or even better performance than direct mapping based on MAE. Mapping algorithms developed in this study enable the estimation of utility values from the PDQ-8. The indirect mapping equations reported for two EQ-5D questionnaires will further facilitate the calculation of EQ-5D utility scores using other country-specific tariffs.

PIV-based estimation of unsteady loads on a flat plate at high angle of attack using momentum equation approaches

NASA Astrophysics Data System (ADS)

Guissart, A.; Bernal, L. P.; Dimitriadis, G.; Terrapon, V. E.

2017-05-01

This work presents, compares and discusses results obtained with two indirect methods for the calculation of aerodynamic forces and pitching moment from 2D Particle Image Velocimetry (PIV) measurements. Both methodologies are based on the formulations of the momentum balance: the integral Navier-Stokes equations and the "flux equation" proposed by Noca et al. (J Fluids Struct 13(5):551-578, 1999), which has been extended to the computation of moments. The indirect methods are applied to spatio-temporal data for different separated flows around a plate with a 16:1 chord-to-thickness ratio. Experimental data are obtained in a water channel for both a plate undergoing a large amplitude imposed pitching motion and a static plate at high angle of attack. In addition to PIV data, direct measurements of aerodynamic loads are carried out to assess the quality of the indirect calculations. It is found that indirect methods are able to compute the mean and the temporal evolution of the loads for two-dimensional flows with a reasonable accuracy. Nonetheless, both methodologies are noise sensitive, and the parameters impacting the computation should thus be chosen carefully. It is also shown that results can be improved through the use of dynamic mode decomposition (DMD) as a pre-processing step.

Continuous millennial decrease of the Earth's magnetic axial dipole

NASA Astrophysics Data System (ADS)

Poletti, Wilbor; Biggin, Andrew J.; Trindade, Ricardo I. F.; Hartmann, Gelvam A.; Terra-Nova, Filipe

2018-01-01

Since the establishment of direct estimations of the Earth's magnetic field intensity in the first half of the nineteenth century, a continuous decay of the axial dipole component has been observed and variously speculated to be linked to an imminent reversal of the geomagnetic field. Furthermore, indirect estimations from anthropologically made materials and volcanic derivatives suggest that this decrease began significantly earlier than direct measurements have been available. Here, we carefully reassess the available archaeointensity dataset for the last two millennia, and show a good correspondence between direct (observatory/satellite) and indirect (archaeomagnetic) estimates of the axial dipole moment creating, in effect, a proxy to expand our analysis back in time. Our results suggest a continuous linear decay as the most parsimonious long-term description of the axial dipole variation for the last millennium. We thus suggest that a break in the symmetry of axial dipole moment advective sources occurred approximately 1100 years earlier than previously described. In addition, based on the observed dipole secular variation timescale, we speculate that the weakening of the axial dipole may end soon.

Indirect Estimates of Jaw Muscle Tension in Children with Suspected Hypertonia, Children with Suspected Hypotonia, and Matched Controls

ERIC Educational Resources Information Center

Connaghan, Kathryn P.; Moore, Christopher A.

2013-01-01

Purpose: In this study, the authors compared indirect estimates of jaw-muscle tension in children with suspected muscle-tone abnormalities with age- and gender-matched controls. Method: Jaw movement and muscle activation were measured in children (ages 3 years, 11 months, to 10 years) with suspected muscle-tone abnormalities (Down syndrome or…

Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

PubMed

Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

2012-06-13

Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged <5 years with laboratory-confirmed, medically attended influenza during the 2003-2004 season. Children hospitalized or seen in emergency department (ED) or outpatient settings in surveillance counties with laboratory-confirmed influenza were identified and data were collected from medical records, accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

SPSS and SAS procedures for estimating indirect effects in simple mediation models.

PubMed

Preacher, Kristopher J; Hayes, Andrew F

2004-11-01

Researchers often conduct mediation analysis in order to indirectly assess the effect of a proposed cause on some outcome through a proposed mediator. The utility of mediation analysis stems from its ability to go beyond the merely descriptive to a more functional understanding of the relationships among variables. A necessary component of mediation is a statistically and practically significant indirect effect. Although mediation hypotheses are frequently explored in psychological research, formal significance tests of indirect effects are rarely conducted. After a brief overview of mediation, we argue the importance of directly testing the significance of indirect effects and provide SPSS and SAS macros that facilitate estimation of the indirect effect with a normal theory approach and a bootstrap approach to obtaining confidence intervals, as well as the traditional approach advocated by Baron and Kenny (1986). We hope that this discussion and the macros will enhance the frequency of formal mediation tests in the psychology literature. Electronic copies of these macros may be downloaded from the Psychonomic Society's Web archive at www.psychonomic.org/archive/.

Breast cancer management: quality-of-life and cost considerations.

PubMed

Radice, Davide; Redaelli, Alberto

2003-01-01

The purpose of this article was to provide a literature-based extensive overview of the quality-of-life and cost issues posed by the management of breast cancer. Incidence and mortality rates vary widely in different countries. Breast cancer accounts approximately for one-fifth of all deaths in women aged 40-50 years. The 1994-1998 incidence rate in the US population was on average 114.3 per 100 000 women. Treatment options include surgery, radiotherapy and drug therapy (cytotoxic and endocrine drugs). All treatment options affect patients' health-related quality of life (HR-QOL) in various ways. The use of cytotoxic agents has a particularly large HR-QOL impact. HR-QOL questionnaires are complex tools, not routinely used in breast cancer trials.Worldwide, around 10 million individuals develop cancer each year; this figure is expected to increase to 15 million in 2020. For all cancers, the total economic burden of this disease worldwide was projected by the authors to be in the range of $US 300-400 billion in 2001 (about $US 100-140 billion as direct costs and the remainder as indirect costs [morbidity and mortality]). According to the National Institute of Health (NIH), the total cost of cancer was estimated at $US 156.7 billion in 2001 in US ($US 56.4 billion as direct costs, $US 15.6 as indirect morbidity costs, and $US 84.7 billion as indirect mortality costs). Based on limited information, in the US, breast cancer can be projected to account for about one-fifth/one-fourth of the total cost of cancer. Breast cancer treatment costs are higher in the US than in other developed countries. Both direct and indirect costs are dependent on disease stage. The per-patient costs for initial care in 1992 were estimated at $US 10 813, for continuing care at $US 1084 and for terminal care at $US 17 886. Stage-specific costs provide information for cost-effectiveness analyses of cancer-control initiatives, such as screening programmes. Economic studies on breast cancer are heterogeneous, and the cost estimates made are not easily generalisable. The cost of treatment for breast cancer in developing countries is < or =5% of that in developed regions.

Societal burden of cluster headache in the United States: a descriptive economic analysis.

PubMed

Ford, Janet H; Nero, Damion; Kim, Gilwan; Chu, Bong Chul; Fowler, Robert; Ahl, Jonna; Martinez, James M

2018-01-01

To estimate direct and indirect costs in patients with a diagnosis of cluster headache in the US. Adult patients (18-64 years of age) enrolled in the Marketscan Commercial and Medicare Databases with ≥2 non-diagnostic outpatient (≥30 days apart between the two outpatient claims) or ≥1 inpatient diagnoses of cluster headache (ICD-9-CM code 339.00, 339.01, or 339.02) between January 1, 2009 and June 30, 2014, were included in the analyses. Patients had ≥6 months of continuous enrollment with medical and pharmacy coverage before and after the index date (first cluster headache diagnosis). Three outcomes were evaluated: (1) healthcare resource utilization, (2) direct healthcare costs, and (3) indirect costs associated with work days lost due to absenteeism and short-term disability. Direct costs included costs of all-cause and cluster headache-related outpatient, inpatient hospitalization, surgery, and pharmacy claims. Indirect costs were based on an average daily wage, which was estimated from the 2014 US Bureau of Labor Statistics and inflated to 2015 dollars. There were 9,328 patients with cluster headache claims included in the analysis. Cluster headache-related total direct costs (mean [standard deviation]) were $3,132 [$13,396] per patient per year (PPPY), accounting for 17.8% of the all-cause total direct cost. Cluster headache-related inpatient hospitalizations ($1,604) and pharmacy ($809) together ($2,413) contributed over 75% of the cluster headache-related direct healthcare cost. There were three sub-groups of patients with claims associated with indirect costs that included absenteeism, short-term disability, and absenteeism + short-term disability. Indirect costs PPPY were $4,928 [$4,860] for absenteeism, $803 [$2,621] for short-term disability, and $3,374 [$3,198] for absenteeism + disability. Patients with cluster headache have high healthcare costs that are associated with inpatient admissions and pharmacy fulfillments, and high indirect costs associated with absenteeism and short-term disability.

Economic Burden of Smoking in Iran: A Prevalence-Based Annual Cost Approach

PubMed Central

Rezaei, Satar; Matin, Behzad Karami; Hajizadeh, Mohammad; Bazyar, Mohammad; Sari, Ali Akbari

2017-01-01

Objectives: The burden of smoking on the health system and society is significant. The current study aimed to estimate the annual direct and indirect costs of smoking in Iran for the year 2014. Methods: A prevalence-based disease-specific approach was used to determine costs associated with the three most common smoking-related diseases: lung cancer (LC), chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD). Data on healthcare utilization were obtained from an original survey, hospital records and questionnaires. The number of deaths was extracted from the global burden diseases study (GBD). The human capital approach was applied to estimate the costs of morbidity and mortality due to smoking-related diseases, classified as direct (hospitalization, outpatients and non-medical costs) and indirect (mortality and morbidity). Results: The total economic cost of the three most common smoking-attributable diseases in Iran was US$1.46 billion in 2014, including US$1.05 billion (71.7%) in indirect and US$0.41 billion (28.3%) in direct costs. Direct costs of the three smoking-related diseases accounted for 1.6% of total healthcare expenditures and total costs were about 0.26% of Iran’s gross domestic product (GDP) in 2014. Conclusions: Our study indicated that smoking places a substantial economic burden on Iranian society. Therefore, sustained smoking cessation interventions and tobacco control policies are required to reduce the magnitude and extent of smoking-attributable costs in Iran. PMID:29072438

Method for evaluating multiple mediators: mediating effects of smoking and COPD on the association between the CHRNA5-A3 variant and lung cancer risk.

PubMed

Wang, Jian; Spitz, Margaret R; Amos, Christopher I; Wu, Xifeng; Wetter, David W; Cinciripini, Paul M; Shete, Sanjay

2012-01-01

A mediation model explores the direct and indirect effects between an independent variable and a dependent variable by including other variables (or mediators). Mediation analysis has recently been used to dissect the direct and indirect effects of genetic variants on complex diseases using case-control studies. However, bias could arise in the estimations of the genetic variant-mediator association because the presence or absence of the mediator in the study samples is not sampled following the principles of case-control study design. In this case, the mediation analysis using data from case-control studies might lead to biased estimates of coefficients and indirect effects. In this article, we investigated a multiple-mediation model involving a three-path mediating effect through two mediators using case-control study data. We propose an approach to correct bias in coefficients and provide accurate estimates of the specific indirect effects. Our approach can also be used when the original case-control study is frequency matched on one of the mediators. We employed bootstrapping to assess the significance of indirect effects. We conducted simulation studies to investigate the performance of the proposed approach, and showed that it provides more accurate estimates of the indirect effects as well as the percent mediated than standard regressions. We then applied this approach to study the mediating effects of both smoking and chronic obstructive pulmonary disease (COPD) on the association between the CHRNA5-A3 gene locus and lung cancer risk using data from a lung cancer case-control study. The results showed that the genetic variant influences lung cancer risk indirectly through all three different pathways. The percent of genetic association mediated was 18.3% through smoking alone, 30.2% through COPD alone, and 20.6% through the path including both smoking and COPD, and the total genetic variant-lung cancer association explained by the two mediators was 69.1%.

[Financial burden of hepatitis B-related diseases and factors influencing the costs in Shenzhen, China].

PubMed

Liang, Sen; Zhang, Shun-xiang; Ma, Qi-shan; Xiao, He-wei; Lü, Qiu-ying; Xie, Xu; Mei, Shu-jiang; Hu, Dong-sheng; Zhou, Bo-ping; Li, Bing; Chen, Jing-fang; Cui, Fu-qiang; Wang, Fu-zhen; Liang, Xiao-feng

2010-12-01

To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected from eligible hepatitis B-related patients. By pre-trained professional investigators, health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital. Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden. On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9%), 15 258.01 Yuan (18.7%), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis, compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0:1, increased from hepato-cellular carcinoma (0.7:1) to compensated cirrhosis (3.5:1), followed by acute hepatitis B (3.3:1), severe hepatitis B (2.8:1), decompensate cirrhosis (2.3:1) and chronic hepatitis B (2.2:1). Direct medical costs were more than direct nonmedical. Ratio between the sum total was 16:1. The proportions of total annual cost per patient with hepatitis B-related diseases accounted for annual patient income were 285.3%, and 75.4% for annual household income. Furthermore, proportions of direct costs accounted for annual patient income and annual household income were 108.1% and 28.6%. The total annual indirect cost per person was 8123.38 Yuan for patients of all hepatitis B-related diseases, while 7134.63 Yuan for caregivers. Corresponding work-loss days were 55.74 days for patients and 19.83 days for caregivers. Based on multiple linear stepwise regression analysis, age of patients was a common influencing factor to all kinds of costs. Other factors were as follows: complicated with other diseases, antiviral medication, monthly household income and self-medications. The economic burden of hepatitis B-related diseases was substantial for patients and their families. All costs tended to increase with the severity of disease. The direct costs were larger than the indirect costs. And the direct medical costs were more than the direct ones. Indirect costs based on patients were larger than the ones of caregivers.

Weather-based pest forecasting for efficient crop protection

Treesearch

Rabiu Olatinwo; Gerrit Hoogenboom

2014-01-01

Although insects, pathogens, mites, nematodes, weeds, vertebrates, and arthropods are different in many ways, they are regarded as pests. They are a major constraint to crop productivity and profitability around the world caused by direct and indirect damage to valuable crops. Insect pests, pathogens, and weeds account for an estimated 45% of pre- and post-harvest...

Estimating the value of volunteer-assisted community-based aging services: a case example.

PubMed

Scharlach, Andrew E

2015-01-01

This study demonstrates the use of a social return on investment (SROI) approach in estimating the financial and social value created by volunteer-assisted community-based aging services. An expanded value added statement (EVAS) analysis found that the total value of outputs produced by the Concierge Club of San Diego substantially exceeded the cost of the program, after considering likely secondary and tertiary benefits for a range of affected stakeholders-including elderly service recipients, family members, volunteers, and societal institutions. Additional research is needed regarding the direct and indirect costs and benefits of volunteer support services for vulnerable older adults and their families.

ARM-Led Improvements Aerosols in Climate and Climate Models

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

Ghan, Steven J.; Penner, Joyce E.

2016-07-25

The DOE ARM program has played a foundational role in efforts to quantify aerosol effects on climate, beginning with the early back-of-the-envelope estimates of direct radiative forcing by anthropogenic sulfate and biomass burning aerosol (Penner et al., 1994). In this chapter we review the role that ARM has played in subsequent detailed estimates based on physically-based representations of aerosols in climate models. The focus is on quantifying the direct and indirect effects of anthropogenic aerosol on the planetary energy balance. Only recently have other DOE programs applied the aerosol modeling capability to simulate the climate response to the radiative forcing.

Economic burden of seasonal influenza in the United States.

PubMed

Putri, Wayan C W S; Muscatello, David J; Stockwell, Melissa S; Newall, Anthony T

2018-05-22

Seasonal influenza is responsible for a large disease and economic burden. Despite the expanding recommendation of influenza vaccination, influenza has continued to be a major public health concern in the United States (U.S.). To evaluate influenza prevention strategies it is important that policy makers have current estimates of the economic burden of influenza. To provide an updated estimate of the average annual economic burden of seasonal influenza in the U.S. population in the presence of vaccination efforts. We evaluated estimates of age-specific influenza-attributable outcomes (ill-non medically attended, office-based outpatient visit, emergency department visits, hospitalizations and death) and associated productivity loss. Health outcome rates were applied to the 2015 U.S. population and multiplied by the relevant estimated unit costs for each outcome. We evaluated both direct healthcare costs and indirect costs (absenteeism from paid employment) reporting results from both a healthcare system and societal perspective. Results were presented in five age groups (<5 years, 5-17 years, 18-49 years, 50-64 years and ≥65 years of age). The estimated average annual total economic burden of influenza to the healthcare system and society was $11.2 billion ($6.3-$25.3 billion). Direct medical costs were estimated to be $3.2 billion ($1.5-$11.7 billion) and indirect costs $8.0 billion ($4.8-$13.6 billion). These total costs were based on the estimated average numbers of (1) ill-non medically attended patients (21.6 million), (2) office-based outpatient visits (3.7 million), (3) emergency department visit (0.65 million) (4) hospitalizations (247.0 thousand), (5) deaths (36.3 thousand) and (6) days of productivity lost (20.1 million). This study provides an updated estimate of the total economic burden of influenza in the U.S. Although we found a lower total cost than previously estimated, our results confirm that influenza is responsible for a substantial economic burden in the U.S. Copyright © 2018. Published by Elsevier Ltd.

Quantifying and Testing Indirect Effects in Simple Mediation Models when the Constituent Paths Are Nonlinear

ERIC Educational Resources Information Center

Hayes, Andrew F.; Preacher, Kristopher J.

2010-01-01

Most treatments of indirect effects and mediation in the statistical methods literature and the corresponding methods used by behavioral scientists have assumed linear relationships between variables in the causal system. Here we describe and extend a method first introduced by Stolzenberg (1980) for estimating indirect effects in models of…

Expanding Local Cancer Clinical Trial Options: Analysis of the Economic Impact of the Midwest Cancer Alliance in Kansas.

PubMed

Gafford, J Atlee; Gurley-Calvez, Tami; Krebill, Hope; Lai, Sue Min; Christiadi; Doolittle, Gary C

2017-09-01

Patients benefit from receiving cancer treatment closer to home when possible and at high-volume regional centers when specialized care is required. The purpose of this analysis was to estimate the economic impact of retaining more patients in-state for cancer clinical trials and care, which might offset some of the costs of establishing broader cancer trial and treatment networks. Kansas Cancer Registry data were used to estimate the number of patients retained in-state for cancer care following the expansion of local cancer clinical trial options through the Midwest Cancer Alliance based at the University of Kansas Medical Center. The 2014 economic impact of this enhanced local clinical trial network was estimated in four parts: Medical spending was estimated on the basis of National Cancer Institute cost-of-care estimates. Household travel cost savings were estimated as the difference between in-state and out-of-state travel costs. Trial-related grant income was calculated from administrative records. Indirect and induced economic benefits to the state were estimated using an economic impact model. The authors estimated that the enhanced local cancer clinical trial network resulted in approximately $6.9 million in additional economic activity in the state in 2014, or $362,000 per patient retained in-state. This estimate includes $3.6 million in direct spending and $3.3 million in indirect economic activity. The enhanced trial network also resulted in 45 additional jobs. Retaining patients in-state for cancer care and clinical trial participation allows patients to remain closer to home for care and enhances the state economy.

Indirect Estimation of Radioactivity in Containerized Cargo

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

Jarman, Kenneth D.; Scherrer, Chad; Smith, Eric L.

Detecting illicit nuclear and radiological material in containerized cargo challenges the state of the art in detection systems. Current systems are being evaluated and new systems envisioned to address the need for the high probability of detection and extremely low false alarm rates necessary to thwart potential threats and extremely low nuisance and false alarm rates while maintaining necessary to maintain the flow of commerce impacted by the enormous volume of commodities imported in shipping containers. Maintaining flow of commerce also means that primary inspection must be rapid, requiring relatively indirect measurements of cargo from outside the containers. With increasingmore » information content in such indirect measurements, it is natural to ask how the information might be combined to improved detection. Toward this end, we present an approach to estimating isotopic activity of naturally occurring radioactive material in cargo grouped by commodity type, combining container manifest data with radiography and gamma spectroscopy aligned to location along the container. The heart of this approach is our statistical model of gamma counts within peak regions of interest, which captures the effects of background suppression, counting noise, convolution of neighboring cargo contributions, and down-scattered photons to provide physically constrained estimates of counts due to decay of specific radioisotopes in cargo alone. Coupled to that model, we use a mechanistic model of self-attenuated radiation flux to estimate the isotopic activity within cargo, segmented by location within each container, that produces those counts. We demonstrate our approach by applying it to a set of measurements taken at the Port of Seattle in 2006. This approach to synthesizing disparate available data streams and extraction of cargo characteristics holds the potential to improve primary inspection using current detection capabilities and to enable simulation-based evaluation of new candidate detection systems.« less

Prevalence of Chronic Hypoparathyroidism in a Mediterranean Region as Estimated by the Analysis of Anonymous Healthcare Database.

PubMed

Cianferotti, Luisella; Parri, Simone; Gronchi, Giorgio; Marcucci, Gemma; Cipriani, Cristiana; Pepe, Jessica; Raglianti, Marco; Minisola, Salvatore; Brandi, Maria Luisa

2018-03-08

Epidemiological data on prevalence and incidence of chronic hypoparathyroidism are still scarce. This study aimed to establish prevalence of chronic hypoparathyroidism and incidence of surgical hypoparathyroidism using the analysis of electronic anonymous public health care database. Data referred to a 5-year period (2009-2013, Region of Tuscany, Italy, as a sample representative of the whole Mediterranean/European population, estimated mean population: 3,750,000 inhabitants) were retrieved by the analysis of pharmaceutical distribution dataset, containing data related to drugs reimbursed by public health system, hospital discharge and procedures codes, and ICD9 exemption codes for chronic diseases. The application of a specific algorithm was applied to indirectly identify people with chronic hypoparathyroidism as assuming chronic therapy with active vitamin D metabolites (AVDM). The number of people taking AVDM for a period equal to or longer than 6 months till the end of the study period, with ICD9 exemption code for hypoparathyroidism, and with a disease-related discharge code were identified. Within this restricted group, patients with chronic kidney disease and osteoporosis were excluded. The indirect estimate of chronic hypoparathyroidism in a European Mediterranean subpopulation by means of the analysis of chronic therapy with AVDM was 27/100,000 inhabitants (female:male ratio = 2.2:1), with a mean age of 63.5 ± 16.7 years. The risk of developing hypoparathyroidism after neck surgery was 1.5%. While the epidemiological approaches based on disease code and hospital discharge code greatly underestimates the prevalence of hypoparathyroidism, the indirect estimate of this disease through the analysis of prescriptions of AVDM in a European region is in line with the results of studies performed in other regions of the world.

Development of Real Time Implementation of 5/5 Rule based Fuzzy Logic Controller Shunt Active Power Filter for Power Quality Improvement

NASA Astrophysics Data System (ADS)

Puhan, Pratap Sekhar; Ray, Pravat Kumar; Panda, Gayadhar

2016-12-01

This paper presents the effectiveness of 5/5 Fuzzy rule implementation in Fuzzy Logic Controller conjunction with indirect control technique to enhance the power quality in single phase system, An indirect current controller in conjunction with Fuzzy Logic Controller is applied to the proposed shunt active power filter to estimate the peak reference current and capacitor voltage. Current Controller based pulse width modulation (CCPWM) is used to generate the switching signals of voltage source inverter. Various simulation results are presented to verify the good behaviour of the Shunt active Power Filter (SAPF) with proposed two levels Hysteresis Current Controller (HCC). For verification of Shunt Active Power Filter in real time, the proposed control algorithm has been implemented in laboratory developed setup in dSPACE platform.

Defining and estimating causal direct and indirect effects when setting the mediator to specific values is not feasible

PubMed Central

Lok, Judith J.

2016-01-01

Natural direct and indirect effects decompose the effect of a treatment into the part that is mediated by a covariate (the mediator) and the part that is not. Their definitions rely on the concept of outcomes under treatment with the mediator “set” to its value without treatment. Typically, the mechanism through which the mediator is set to this value is left unspecified, and in many applications it may be challenging to fix the mediator to particular values for each unit or patient. Moreover, how one sets the mediator may affect the distribution of the outcome. This article introduces “organic” direct and indirect effects, which can be defined and estimated without relying on setting the mediator to specific values. Organic direct and indirect effects can be applied for example to estimate how much of the effect of some treatments for HIV/AIDS on mother-to-child transmission of HIV infection is mediated by the effect of the treatment on the HIV viral load in the blood of the mother. PMID:27229743

A finite element analysis of the optimal bending angles in a running loop for mesial translation of a mandibular molar using indirect skeletal anchorage.

PubMed

Kim, M-J; Park, J H; Kojima, Y; Tai, K; Chae, J-M

2018-02-01

To estimate the optimal bending angles in the running loop for mesial translation of a mandibular second molar using indirect skeletal anchorage and to clarify the mechanics of tipping and rotating the molar. A three-dimensional finite element model was developed for predicting tooth movement, and a mechanical model based on the beam theory was constructed for clarifying the force systems. When using a running loop without bends, the molar tipped mesially 14.4° and lingually 0.6°, rotated counterclockwise 4.1°, and the incisors retracted 0.02 mm and intruded 0.05 mm. These angles were about the same as those estimated by the beam theory. When the amount of tip back and toe-in angles was 11.0°, mesial translation of the molar was achieved, and incisors retracted 0.10 mm and intruded 0.30 mm. Mesial translation of a mandibular second molar without any significant movement of anterior teeth was achieved during protraction by controlling the tip back and toe-in angles and enhancing anterior anchorage with the combined use of a running loop and indirect skeletal anchorage. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Energy expenditure estimation during daily military routine with body-fixed sensors.

PubMed

Wyss, Thomas; Mäder, Urs

2011-05-01

The purpose of this study was to develop and validate an algorithm for estimating energy expenditure during the daily military routine on the basis of data collected using body-fixed sensors. First, 8 volunteers completed isolated physical activities according to an established protocol, and the resulting data were used to develop activity-class-specific multiple linear regressions for physical activity energy expenditure on the basis of hip acceleration, heart rate, and body mass as independent variables. Second, the validity of these linear regressions was tested during the daily military routine using indirect calorimetry (n = 12). Volunteers' mean estimated energy expenditure did not significantly differ from the energy expenditure measured with indirect calorimetry (p = 0.898, 95% confidence interval = -1.97 to 1.75 kJ/min). We conclude that the developed activity-class-specific multiple linear regressions applied to the acceleration and heart rate data allow estimation of energy expenditure in 1-minute intervals during daily military routine, with accuracy equal to indirect calorimetry.

Consumptive use and resulting leach-field water budget of a mountain residence

USGS Publications Warehouse

Stannard, David; Paul, William T.; Laws, Roy; Poeter, Eileen P.

2010-01-01

Consumptive use of water in a dispersed rural community has important implications for maximum housing density and its effects on sustainability of groundwater withdrawals. Recent rapid growth in Colorado, USA has stressed groundwater supplies in some areas, thereby increasing scrutiny of approximate methods developed there more than 30 years ago to estimate consumptive use that are still used today. A foothills residence was studied during a 2-year period to estimate direct and indirect water losses. Direct losses are those from evaporation inside the home, plus any outdoor use. Indirect loss is evapotranspiration (ET) from the residential leach-field in excess of ET from the immediately surrounding terrain. Direct losses were 18.7% of water supply to the home, substantially larger than estimated historically in Colorado. A new approach was developed to estimate indirect loss, using chamber methods together with the Penman–Monteith model. Indirect loss was only 0.9% of water supply, but this value probably was anomalously low due to a recurring leach-field malfunction. Resulting drainage beneath the leach-field was 80.4% of water supply. Guidelines are given to apply the same methodology at other sites and combine results with a survey of leach-fields in an area to obtain more realistic average values of ET losses.

Alternative sensor system and MLP neural network for vehicle pedal activity estimation.

PubMed

Wefky, Ahmed M; Espinosa, Felipe; Jiménez, José A; Santiso, Enrique; Rodríguez, José M; Fernández, Alfredo J

2010-01-01

It is accepted that the activity of the vehicle pedals (i.e., throttle, brake, clutch) reflects the driver's behavior, which is at least partially related to the fuel consumption and vehicle pollutant emissions. This paper presents a solution to estimate the driver activity regardless of the type, model, and year of fabrication of the vehicle. The solution is based on an alternative sensor system (regime engine, vehicle speed, frontal inclination and linear acceleration) that reflects the activity of the pedals in an indirect way, to estimate that activity by means of a multilayer perceptron neural network with a single hidden layer.

Alternative Sensor System and MLP Neural Network for Vehicle Pedal Activity Estimation

PubMed Central

Wefky, Ahmed M.; Espinosa, Felipe; Jiménez, José A.; Santiso, Enrique; Rodríguez, José M.; Fernández, Alfredo J.

2010-01-01

It is accepted that the activity of the vehicle pedals (i.e., throttle, brake, clutch) reflects the driver’s behavior, which is at least partially related to the fuel consumption and vehicle pollutant emissions. This paper presents a solution to estimate the driver activity regardless of the type, model, and year of fabrication of the vehicle. The solution is based on an alternative sensor system (regime engine, vehicle speed, frontal inclination and linear acceleration) that reflects the activity of the pedals in an indirect way, to estimate that activity by means of a multilayer perceptron neural network with a single hidden layer. PMID:22319326

Tolerance to bovine clinical mastitis: Total, direct, and indirect milk losses.

PubMed

Detilleux, J

2018-04-01

The objectives of this paper were to estimate direct and indirect milk losses associated with mastitis. Indirect losses, linked to indirect tolerance, are mediated by the increase in milk somatic cell count (SCC) in response to bacterial infection. Direct losses, linked to weak direct tolerance, are not mediated by the increase in SCC. So far, studies have evaluated milk loss associated with clinical mastitis without considering both components, which may lead to biased estimates of their sum; that is, the total loss in milk. A total of 43,903 test-day records on milk and SCC from 3,716 cows and 5,858 lactations were analyzed with mediation mixed models and health trajectories to estimate the amount of direct, indirect, and total milk losses after adjustment for known and potentially unmeasured (sensitivity analyses) confounding factors. Estimates were formalized under the counterfactual causal theory of causation. In this study, milk losses were mostly mediated by an increase in SCC. They were highest in the first month of lactation, when SCC were highest. Milk losses were estimated at 0.5, 0.8, and 1.1 kg/d in first, second, and third and greater parity, respectively. Two phases described how changes in milk were associated with changes in SCC: on average, one occurred before and one after the day preceding the clinical diagnosis. In both phases, changes in milk were estimated at 1 mg/d per 10 3 cells/mL. After adjusting for known confounders, cow effect accounted for 20.7 and 64.2% of the variation in milk in the first and second phases, respectively. This suggests that deviations from the resilient path were highest during the second phase of inflammation and that selection for cows more tolerant to mastitis is feasible. As discussed herein, epigenetic regulation of macrophage polarization may contribute to the variation in milk observed in the second phase. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Simplification of a light-based model for estimating final internode length in greenhouse cucumber canopies.

PubMed

Kahlen, Katrin; Stützel, Hartmut

2011-10-01

Light quantity and quality affect internode lengths in cucumber (Cucumis sativus), whereby leaf area and the optical properties of the leaves mainly control light quality within a cucumber plant community. This modelling study aimed at providing a simple, non-destructive method to predict final internode lengths (FILs) using light quantity and leaf area data. Several simplifications of a light quantity and quality sensitive model for estimating FILs in cucumber have been tested. The direct simplifications substitute the term for the red : far-red (R : FR) ratios, by a term for (a) the leaf area index (LAI, m(2) m(-2)) or (b) partial LAI, the cumulative leaf area per m(2) ground, where leaf area per m(2) ground is accumulated from the top of each plant until a number, n, of leaves per plant is reached. The indirect simplifications estimate the input R : FR ratio based on partial leaf area and plant density. In all models, simulated FILs were in line with the measured FILs over various canopy architectures and light conditions, but the prediction quality varied. The indirect simplification based on leaf area of ten leaves revealed the best fit with measured data. Its prediction quality was even higher than of the original model. This study showed that for vertically trained cucumber plants, leaf area data can substitute local light quality data for estimating FIL data. In unstressed canopies, leaf area over the upper ten ranks seems to represent the feedback of the growing architecture on internode elongation with respect to light quality. This highlights the role of this domain of leaves as the primary source for the specific R : FR signal controlling the final length of an internode and could therefore guide future research on up-scaling local processes to the crop level.

SAMICS support study. Volume 1: Cost account catalog

NASA Technical Reports Server (NTRS)

1977-01-01

The Jet Propulsion Laboratory (JPL) is examining the feasibility of a new industry to produce photovoltaic solar energy collectors similar to those used on spacecraft. To do this, a standardized costing procedure was developed. The Solar Array Manufacturing Industry Costing Standards (SAMICS) support study supplies the following information: (1) SAMICS critique; (2) Standard data base--cost account structure, expense item costs, inflation rates, indirect requirements relationships, and standard financial parameter values; (3) Facilities capital cost estimating relationships; (4) Conceptual plant designs; (5) Construction lead times; (6) Production start-up times; (7) Manufacturing price estimates.

Indirect estimation of signal-dependent noise with nonadaptive heterogeneous samples.

PubMed

Azzari, Lucio; Foi, Alessandro

2014-08-01

We consider the estimation of signal-dependent noise from a single image. Unlike conventional algorithms that build a scatterplot of local mean-variance pairs from either small or adaptively selected homogeneous data samples, our proposed approach relies on arbitrarily large patches of heterogeneous data extracted at random from the image. We demonstrate the feasibility of our approach through an extensive theoretical analysis based on mixture of Gaussian distributions. A prototype algorithm is also developed in order to validate the approach on simulated data as well as on real camera raw images.

aerosol radiative effects and forcing: spatial and temporal distributions

NASA Astrophysics Data System (ADS)

Kinne, Stefan

2014-05-01

A monthly climatology for aerosol optical properties based on a synthesis from global modeling and observational data has been applied to illustrate spatial distributions and global averages of aerosol radiative impacts. With the help of a pre-industrial reference for aerosol optical properties from global modeling, also the aerosol direct forcing (ca -0.35W/m2 globally and annual averaged) and their spatial and seasonal distributions and contributions by individual aerosol components are estimated. Finally, CCN and IN concentrations associated with this climatology are applied to estimate aerosol indirect effects and forcing.

Automobile Industry Retail Price Equivalent and Indirect Cost ...

EPA Pesticide Factsheets

This report develops a modified multiplier, referred to as an indirect cost (IC) multiplier, which specifically evaluates the components of indirect costs that are likely to be affected by vehicle modifications associated with environmental regulation. A range of IC multipliers are developed that 1) account for differences in the technical complexity of required vehicle modifications and 2) adjust over time as new technologies become assimilated into the automotive production process. To develop an improved methodology for estimating indirect costs of new environmental regulations on automobile manufacturers.

Time-to-contact estimation of accelerated stimuli is based on first-order information.

PubMed

Benguigui, Nicolas; Ripoll, Hubert; Broderick, Michael P

2003-12-01

The goal of this study was to test whether 1st-order information, which does not account for acceleration, is used (a) to estimate the time to contact (TTC) of an accelerated stimulus after the occlusion of a final part of its trajectory and (b) to indirectly intercept an accelerated stimulus with a thrown projectile. Both tasks require the production of an action on the basis of predictive information acquired before the arrival of the stimulus at the target and allow the experimenter to make quantitative predictions about the participants' use (or nonuse) of 1st-order information. The results show that participants do not use information about acceleration and that they commit errors that rely quantitatively on 1st-order information even when acceleration is psychophysically detectable. In the indirect interceptive task, action is planned about 200 ms before the initiation of the movement, at which time the 1st-order TTC attains a critical value. ((c) 2003 APA, all rights reserved)

Implications of Middle School Behavior Problems for High School Graduation and Employment Outcomes of Young Adults: Estimation of a Recursive Model.

PubMed

Karakus, Mustafa C; Salkever, David S; Slade, Eric P; Ialongo, Nicholas; Stuart, Elizabeth

2012-01-01

The potentially serious adverse impacts of behavior problems during adolescence on employment outcomes in adulthood provide a key economic rationale for early intervention programs. However, the extent to which lower educational attainment accounts for the total impact of adolescent behavior problems on later employment remains unclear As an initial step in exploring this issue, we specify and estimate a recursive bivariate probit model that 1) relates middle school behavior problems to high school graduation and 2) models later employment in young adulthood as a function of these behavior problems and of high school graduation. Our model thus allows for both a direct effect of behavior problems on later employment as well as an indirect effect that operates via graduation from high school. Our empirical results, based on analysis of data from the NELS, suggest that the direct effects of externalizing behavior problems on later employment are not significant but that these problems have important indirect effects operating through high school graduation.

Estimation of tool wear during CNC milling using neural network-based sensor fusion

NASA Astrophysics Data System (ADS)

Ghosh, N.; Ravi, Y. B.; Patra, A.; Mukhopadhyay, S.; Paul, S.; Mohanty, A. R.; Chattopadhyay, A. B.

2007-01-01

Cutting tool wear degrades the product quality in manufacturing processes. Monitoring tool wear value online is therefore needed to prevent degradation in machining quality. Unfortunately there is no direct way of measuring the tool wear online. Therefore one has to adopt an indirect method wherein the tool wear is estimated from several sensors measuring related process variables. In this work, a neural network-based sensor fusion model has been developed for tool condition monitoring (TCM). Features extracted from a number of machining zone signals, namely cutting forces, spindle vibration, spindle current, and sound pressure level have been fused to estimate the average flank wear of the main cutting edge. Novel strategies such as, signal level segmentation for temporal registration, feature space filtering, outlier removal, and estimation space filtering have been proposed. The proposed approach has been validated by both laboratory and industrial implementations.

Economic Assessment of Waterborne Outbreak of Cryptosporidiosis

PubMed Central

Chyzheuskaya, Aksana; Cormican, Martin; Srivinas, Raghavendra; O’Donovan, Diarmuid; Prendergast, Martina; O’Donoghue, Cathal

2017-01-01

In 2007, a waterborne outbreak of Cryptosporidium hominis infection occurred in western Ireland, resulting in 242 laboratory-confirmed cases and an uncertain number of unconfirmed cases. A boil water notice was in place for 158 days that affected 120,432 persons residing in the area, businesses, visitors, and commuters. This outbreak represented the largest outbreak of cryptosporidiosis in Ireland. The purpose of this study was to evaluate the cost of this outbreak. We adopted a societal perspective in estimating costs associated with the outbreak. Economic cost estimated was based on totaling direct and indirect costs incurred by public and private agencies. The cost of the outbreak was estimated based on 2007 figures. We estimate that the cost of the outbreak was >€19 million (≈€120,000/day of the outbreak). The US dollar equivalent based on today’s exchange rates would be $22.44 million (≈$142,000/day of the outbreak). This study highlights the economic need for a safe drinking water supply. PMID:28930007

Population growth rates of reef sharks with and without fishing on the great barrier reef: robust estimation with multiple models.

PubMed

Hisano, Mizue; Connolly, Sean R; Robbins, William D

2011-01-01

Overfishing of sharks is a global concern, with increasing numbers of species threatened by overfishing. For many sharks, both catch rates and underwater visual surveys have been criticized as indices of abundance. In this context, estimation of population trends using individual demographic rates provides an important alternative means of assessing population status. However, such estimates involve uncertainties that must be appropriately characterized to credibly and effectively inform conservation efforts and management. Incorporating uncertainties into population assessment is especially important when key demographic rates are obtained via indirect methods, as is often the case for mortality rates of marine organisms subject to fishing. Here, focusing on two reef shark species on the Great Barrier Reef, Australia, we estimated natural and total mortality rates using several indirect methods, and determined the population growth rates resulting from each. We used bootstrapping to quantify the uncertainty associated with each estimate, and to evaluate the extent of agreement between estimates. Multiple models produced highly concordant natural and total mortality rates, and associated population growth rates, once the uncertainties associated with the individual estimates were taken into account. Consensus estimates of natural and total population growth across multiple models support the hypothesis that these species are declining rapidly due to fishing, in contrast to conclusions previously drawn from catch rate trends. Moreover, quantitative projections of abundance differences on fished versus unfished reefs, based on the population growth rate estimates, are comparable to those found in previous studies using underwater visual surveys. These findings appear to justify management actions to substantially reduce the fishing mortality of reef sharks. They also highlight the potential utility of rigorously characterizing uncertainty, and applying multiple assessment methods, to obtain robust estimates of population trends in species threatened by overfishing.

Population Growth Rates of Reef Sharks with and without Fishing on the Great Barrier Reef: Robust Estimation with Multiple Models

PubMed Central

Hisano, Mizue; Connolly, Sean R.; Robbins, William D.

2011-01-01

Overfishing of sharks is a global concern, with increasing numbers of species threatened by overfishing. For many sharks, both catch rates and underwater visual surveys have been criticized as indices of abundance. In this context, estimation of population trends using individual demographic rates provides an important alternative means of assessing population status. However, such estimates involve uncertainties that must be appropriately characterized to credibly and effectively inform conservation efforts and management. Incorporating uncertainties into population assessment is especially important when key demographic rates are obtained via indirect methods, as is often the case for mortality rates of marine organisms subject to fishing. Here, focusing on two reef shark species on the Great Barrier Reef, Australia, we estimated natural and total mortality rates using several indirect methods, and determined the population growth rates resulting from each. We used bootstrapping to quantify the uncertainty associated with each estimate, and to evaluate the extent of agreement between estimates. Multiple models produced highly concordant natural and total mortality rates, and associated population growth rates, once the uncertainties associated with the individual estimates were taken into account. Consensus estimates of natural and total population growth across multiple models support the hypothesis that these species are declining rapidly due to fishing, in contrast to conclusions previously drawn from catch rate trends. Moreover, quantitative projections of abundance differences on fished versus unfished reefs, based on the population growth rate estimates, are comparable to those found in previous studies using underwater visual surveys. These findings appear to justify management actions to substantially reduce the fishing mortality of reef sharks. They also highlight the potential utility of rigorously characterizing uncertainty, and applying multiple assessment methods, to obtain robust estimates of population trends in species threatened by overfishing. PMID:21966402

High-strain rate tensile characterization of graphite platelet reinforced vinyl ester based nanocomposites using split-Hopkinson pressure bar

NASA Astrophysics Data System (ADS)

Pramanik, Brahmananda

The dynamic response of exfoliated graphite nanoplatelet (xGnP) reinforced and carboxyl terminated butadiene nitrile (CTBN) toughened vinyl ester based nanocomposites are characterized under both dynamic tensile and compressive loading. Dynamic direct tensile tests are performed applying the reverse impact Split Hopkinson Pressure Bar (SHPB) technique. The specimen geometry for tensile test is parametrically optimized by Finite Element Analysis (FEA) using ANSYS Mechanical APDLRTM. Uniform stress distribution within the specimen gage length has been verified using high-speed digital photography. The on-specimen strain gage installation is substituted by a non-contact Laser Occlusion Expansion Gage (LOEG) technique for infinitesimal dynamic tensile strain measurements. Due to very low transmitted pulse signal, an alternative approach based on incident pulse is applied for obtaining the stress-time history. Indirect tensile tests are also performed combining the conventional SHPB technique with Brazilian disk test method for evaluating cylindrical disk specimens. The cylindrical disk specimen is held snugly in between two concave end fixtures attached to the incident and transmission bars. Indirect tensile stress is estimated from the SHPB pulses, and diametrical transverse tensile strain is measured using LOEG. Failure diagnosis using high-speed digital photography validates the viability of utilizing this indirect test method for characterizing the tensile properties of the candidate vinyl ester based nanocomposite system. Also, quasi-static indirect tensile response agrees with previous investigations conducted using the traditional dog-bone specimen in quasi-static direct tensile tests. Investigation of both quasi-static and dynamic indirect tensile test responses show the strain rate effect on the tensile strength and energy absorbing capacity of the candidate materials. Finally, the conventional compressive SHPB tests are performed. It is observed that both strength and energy absorbing capacity of these candidate material systems are distinctively less under dynamic tension than under compressive loading. Nano-reinforcement appears to marginally improve these properties for pure vinyl ester under dynamic tension, although it is found to be detrimental under dynamic compression.

Conceptual model and experimental framework to determine the contributions of direct and indirect photoreactions to the solar disinfection of MS2, phiX174, and adenovirus.

PubMed

Mattle, Michael J; Vione, Davide; Kohn, Tamar

2015-01-06

Sunlight inactivates waterborne viruses via direct (absorption of sunlight by the virus) and indirect processes (adsorption of sunlight by external chromophores, which subsequently generate reactive species). While the mechanisms underlying these processes are understood, their relative importance remains unclear. This study establishes an experimental framework to determine the kinetic parameters associated with a virus' susceptibility to solar disinfection and proposes a model to estimate disinfection rates and to apportion the contributions of different inactivation processes. Quantum yields of direct inactivation were determined for three viruses (MS2, phiX174, and adenovirus), and second-order rate constants associated with indirect inactivation by four reactive species ((1)O2, OH(•), CO3(•-), and triplet states) were established. PhiX174 exhibited the greatest quantum yield (1.4 × 10(-2)), indicating that it is more susceptible to direct inactivation than MS2 (2.9 × 10(-3)) or adenovirus (2.5 × 10(-4)). Second-order rate constants ranged from 1.7 × 10(7) to 7.0 × 10(9) M(-1) s(-1) and followed the sequence MS2 > adenovirus > phiX174. A predictive model based on these parameters accurately estimated solar disinfection of MS2 and phiX174 in a natural water sample and approximated that of adenovirus within a factor of 6. Inactivation mostly occurred by direct processes, though indirect inactivation by (1)O2 also contributed to the disinfection of MS2 and adenovirus.

The societal burden of blindness secondary to retinopathy of prematurity in Lima, Peru.

PubMed

Dave, Hreem B; Gordillo, Luz; Yang, Zhou; Zhang, Monica S; Hubbard, G Baker; Olsen, Timothy W

2012-10-01

To determine the cost-effectiveness of laser treatment for retinopathy of prematurity (ROP) in Lima, Peru. A cost-of-illness study (in US dollars) to determine the direct cost of treatment, the indirect lifetime cost of blindness, and the quality-adjusted life years. The direct cost of ROP-related treatment was determined by reviewing data retrospectively from a social security sector hospital. The indirect cost was determined using national economic data of Peru published by the Central Information Agency (CIA), including the per capita gross domestic product, the sex-adjusted income distribution, and years spent in the work force. Indirect costs per child that were avoided by treatment were calculated using the known natural history of ROP vs evidence-based treatment. For ROP-related neonatal blindness in Peru, we estimate the total indirect cost saving at $197,753 per child and the direct cost of laser treatment at $2496 per child. The societal lifetime cost saving per child is estimated at $195,257. The mean annual income per educated adult in Peru is $8000 and treating 1 child is equivalent to employing 24 educated Peruvians per year. The generational cost savings for society is approximately $516 million, or the equivalent of 64,500 educated Peruvian work years. The societal burden of blindness far exceeds the costs of treatment per child. Proper screening and treatment of ROP prevents blindness and leads to substantial cost savings for society. Public health policy in Peru and other middle-income countries should consider financial impact when allocating healthcare resources. Copyright © 2012 Elsevier Inc. All rights reserved.

Smoking and Mortality in Eastern Europe: Results From the PrivMort Retrospective Cohort Study of 177 376 Individuals.

PubMed

Stefler, Denes; Murphy, Michael; Irdam, Darja; Horvat, Pia; Jarvis, Martin; King, Lawrence; McKee, Martin; Bobak, Martin

2018-05-03

The estimated prevalence of smoking and proportion of deaths due to tobacco in Eastern European countries are among the highest in the world. Existing estimates of mortality attributable to smoking in the region are mostly indirect. The aim of this analysis was to calculate the proportion of tobacco-attributed deaths in three Eastern European countries using individual level cohort data. The PrivMort project established a cohort of relatives of participants in population sample surveys in Russia, Belarus and Hungary. Survey participants provided data on smoking habits and vital statistics of their close relatives between 1982 and 2013. Population attributable risk fractions (PARF) in men (n = 99528) and women (n = 77848) aged 40-79 years were calculated from the prevalence rates of smoking and hazard ratios of mortality for smokers versus non-smokers. Trends in PARF over four 8-year time periods (1982-1989, 1990-1997, 1998-2005, and 2006-2013) were examined. In men in the most recent period (2006-2013), the proportions of deaths attributable to tobacco were 23% in Russia, 22% in Belarus, and 22% in Hungary. The respective estimates in women were lower (2%, 2%, and 13%), possibly due to underestimation of smoking prevalence. PARF estimates have declined slightly since the early 1990s in men but increased in women. Consistently with existing indirect estimates, our results based on individual level cohort data suggest that over one fifth of all deaths in men aged 40-79 years are attributable to tobacco. While these proportions are lower in women, the increasing trend is a major concern. This is the first large scale, individual-level cohort study that estimated the mortality attributable to tobacco smoking directly in Eastern European population samples. The results confirm previous indirect estimates and show that more than 20% of all deaths in Eastern European men can be attributed to tobacco. The study also confirms the increasing trend in smoking-related deaths among women. These findings emphasize the importance of targeted policy interventions in Eastern European countries.

Direct and indirect comparison meta-analysis of levetiracetam versus phenytoin or valproate for convulsive status epilepticus.

PubMed

Brigo, Francesco; Bragazzi, Nicola; Nardone, Raffaele; Trinka, Eugen

2016-11-01

The aim of this study was to conduct a meta-analysis of published studies to directly compare intravenous (IV) levetiracetam (LEV) with IV phenytoin (PHT) or IV valproate (VPA) as second-line treatment of status epilepticus (SE), to indirectly compare intravenous IV LEV with IV VPA using common reference-based indirect comparison meta-analysis, and to verify whether results of indirect comparisons are consistent with results of head-to-head randomized controlled trials (RCTs) directly comparing IV LEV with IV VPA. Random-effects Mantel-Haenszel meta-analyses to obtain odds ratios (ORs) for efficacy and safety of LEV versus VPA and LEV or VPA versus PHT were used. Adjusted indirect comparisons between LEV and VPA were used. Two RCTs comparing LEV with PHT (144 episodes of SE) and 3 RCTs comparing VPA with PHT (227 episodes of SE) were included. Direct comparisons showed no difference in clinical seizure cessation, neither between VPA and PHT (OR: 1.07; 95% CI: 0.57 to 2.03) nor between LEV and PHT (OR: 1.18; 95% CI: 0.50 to 2.79). Indirect comparisons showed no difference between LEV and VPA for clinical seizure cessation (OR: 1.16; 95% CI: 0.45 to 2.97). Results of indirect comparisons are consistent with results of a recent RCT directly comparing LEV with VPA. The absence of a statistically significant difference in direct and indirect comparisons is due to the lack of sufficient statistical power to detect a difference. Conducting a RCT that has not enough people to detect a clinically important difference or to estimate an effect with sufficient precision can be regarded a waste of time and resources and may raise several ethical concerns, especially in RCT on SE. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparing methodologies for the allocation of overhead and capital costs to hospital services.

PubMed

Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona

2009-06-01

Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

Influence of indirect information on interpersonal trust despite direct information.

PubMed

Zarolia, Pareezad; Weisbuch, Max; McRae, Kateri

2017-01-01

Trust is integral to successful relationships. The development of trust stems from how one person treats others, and there are multiple ways to learn about someone's trust-relevant behavior. The present research captures the development of trust to examine if trust-relevant impressions and behavior are influenced by indirect behavioral information (i.e., descriptions of how a person treated another individual)-even in the presence of substantial direct behavioral information (i.e., self-relevant, first-hand experience with a person). Participants had repeated interpersonal exchanges with a partner who was trustworthy or untrustworthy with participants' money. The present studies vary the frequency with which (Studies 1 & 2), the order in which (Study 3) and the number of people for whom (Study 4) indirect information (i.e., brief vignettes describing trustworthy or untrustworthy behavior) were presented. As predicted, across 4 studies, we observed a robust effect of indirect-information despite the presence of substantial direct information. Even after dozens of interactions in which a partner betrayed (or not), a brief behavioral description of a partner influenced participants' willingness to actually trust the partner with money, memory-based estimates of partner-behavior, and impressions of the partner. These effects were observed even though participants were also sensitive to partners' actual trust behavior, and even when indirect behavioral descriptions were only presented a single time. Impressions were identified as a strong candidate mechanism for the effect of indirect-information on behavior. We discuss implications of the persistence of indirect information for impression formation, relationship development, and future studies of trust. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The economic impact of chronic prostatitis.

PubMed

Calhoun, Elizabeth A; McNaughton Collins, Mary; Pontari, Michel A; O'Leary, Michael; Leiby, Benjamin E; Landis, J Richard; Kusek, John W; Litwin, Mark S

2004-06-14

Little information exists on the economic impact of chronic prostatitis. The objective of this study was to determine the direct and indirect costs associated with chronic prostatitis. Outcomes were assessed using a questionnaire designed to capture health care resource utilization. Resource estimates were converted into unit costs with direct medical cost estimates based on hospital cost-accounting data and indirect costs based on modified labor force, employment, and earnings data from the US Census Bureau. The total direct costs for the 3 months prior to entry into the cohort, excluding hospitalization, were $126 915 for the 167 study participants for an average of $954 per person among the 133 consumers. Of the men, 26% reported work loss valued at an average of $551. The average total costs (direct and indirect) for the 3 months was $1099 per person for those 137 men who had resource consumption with an expected annual total cost per person of $4397. For those study participants with any incurred costs, tests for association revealed that the National Institutes of Health Chronic Prostatitis Symptom Index (P<.001) and each of the 3 subcategories of pain (P =.003), urinary function (P =.03), and quality-of-life (P =.002) were significantly associated with resource use, although the quality-of-life subscale score from the National Institutes of Health Chronic Prostatitis Symptom Index was the only predictor of resource consumption. Chronic prostatitis is associated with substantial costs and lower quality-of-life scores, which predicted resource consumption. The economic impact of chronic prostatitis warrants increased medical attention and resources to identify and test effective treatment strategies.

Indirect medical education and disproportionate share adjustments to Medicare inpatient payment rates.

PubMed

Nguyen, Nguyen Xuan; Sheingold, Steven H

2011-11-04

The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare's prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations. These adjustments were originally established based on the statistical relationships between IME and DSH and hospital costs. Due to a variety of policy considerations, the legislated levels of these adjustments may have deviated over time from these "empirically justified levels," or simply, "empirical levels." In this paper, we estimate the empirical levels of IME and DSH using 2006 hospital data and 2009 Medicare final payment rules. Our analyses suggest that the empirical level for IME would be much smaller than under current law-about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)--about one-quarter of the pre-ACA level. For IME, the estimates imply an increase in costs of 1.88% for each 10% increase in teaching intensity. For DSH, the estimates imply that costs would rise by 0.52% for each 10% increase in the low-income patient share for large urban hospitals. Public Domain.

Accelerated DNA Methylation Age: Associations with PTSD and Neural Integrity

PubMed Central

Wolf, Erika J.; Logue, Mark W.; Hayes, Jasmeet P.; Sadeh, Naomi; Schichman, Steven A.; Stone, Annjanette; Salat, David H.; Milberg, William; McGlinchey, Regina; Miller, Mark W.

2015-01-01

Background Accumulating evidence suggests that post traumatic stress disorder (PTSD) may accelerate cellular aging and lead to premature morbidity and neurocognitive decline. Methods This study evaluated associations between PTSD and DNA methylation (DNAm) age using recently developed algorithms of cellular age by Horvath (2013) and Hannum et al. (2013). These estimates reflect accelerated aging when they exceed chronological age. We also examined if accelerated cellular age manifested in degraded neural integrity, indexed via diffusion tensor imaging. Results Among 281 male and female veterans of the conflicts in Iraq and Afghanistan, DNAm age was strongly related to chronological age (rs ~.88). Lifetime PTSD severity was associated with Hannum DNAm age estimates residualized for chronological age (β = .13, p= .032). Advanced DNAm age was associated with reduced integrity in the genu of the corpus callosum (β = −.17, p= .009) and indirectly linked to poorer working memory performance via this region (indirect β = − .05, p= .029). Horvath DNAm age estimates were not associated with PTSD or neural integrity. Conclusions Results provide novel support for PTSD-related accelerated aging in DNAm and extend the evidence base of known DNAm age correlates to the domains of neural integrity and cognition. PMID:26447678

Comparison of direct and indirect methods for assessing leaf area index across a tropical rain forest landscape

Treesearch

Paulo C. Olivas; Steven F. Oberbauer; David B. Clark; Deborah A. Clark; Michael G. Ryan; Joseph J. O' Brien; Harlyn Ordonez

2013-01-01

Many functional properties of forests depend on the leaf area; however, measuring leaf area is not trivial in tall evergreen vegetation. As a result, leaf area is generally estimated indirectly by light absorption methods. These indirect methods are widely used, but have never been calibrated against direct measurements in tropical rain forests, either at point or...

Performance of Predictive Equations Specifically Developed to Estimate Resting Energy Expenditure in Ventilated Critically Ill Children.

PubMed

Jotterand Chaparro, Corinne; Taffé, Patrick; Moullet, Clémence; Laure Depeyre, Jocelyne; Longchamp, David; Perez, Marie-Hélène; Cotting, Jacques

2017-05-01

To determine, based on indirect calorimetry measurements, the biases of predictive equations specifically developed recently for estimating resting energy expenditure (REE) in ventilated critically ill children, or developed for healthy populations but used in critically ill children. A secondary analysis study was performed using our data on REE measured in a previous prospective study on protein and energy needs in pediatric intensive care unit. We included 75 ventilated critically ill children (median age, 21 months) in whom 407 indirect calorimetry measurements were performed. Fifteen predictive equations were used to estimate REE: the equations of White, Meyer, Mehta, Schofield, Henry, the World Health Organization, Fleisch, and Harris-Benedict and the tables of Talbot. Their differential and proportional biases (with 95% CIs) were computed and the bias plotted in graphs. The Bland-Altman method was also used. Most equations underestimated and overestimated REE between 200 and 1000 kcal/day. The equations of Mehta, Schofield, and Henry and the tables of Talbot had a bias ≤10%, but the 95% CI was large and contained values by far beyond ±10% for low REE values. Other specific equations for critically ill children had even wider biases. In ventilated critically ill children, none of the predictive equations tested met the performance criteria for the entire range of REE between 200 and 1000 kcal/day. Even the equations with the smallest bias may entail a risk of underfeeding or overfeeding, especially in the youngest children. Indirect calorimetry measurement must be preferred. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of direct and indirect methods of measuring airborne chrysotile fibre concentration.

PubMed

Eypert-Blaison, Celine; Veissiere, Sylvie; Rastoix, Olivier; Kauffer, Edmond

2010-01-01

Transmission electron microscopy observations most frequently form a basis for estimating asbestos fibre concentration in the environment and in buildings with asbestos-containing materials. Sampled fibres can be transferred to microscope grids by applying either a direct [ISO (1995) Draft International ISO/DIS 10312. Ambient air. Determination of asbestos fibres. Direct transfer transmission electron microscopy procedure. Geneva, Switzerland: International Standardization Organization] or an indirect [AFNOR (1996) Détermination de la concentration en fibres d'amiante par microscopie électronique à transmission-Méthode indirecte. Cedex, France: AFNOR, p. 42; ISO (1997) Draft International ISO/DIS 13794. Ambient air. Determination of asbestos fibres. Indirect-transfer transmission electron microscopy procedure. Geneva, Switzerland: International Standardization Organization] method. In the latter case, ISO Standard 13794 recommends filtering calcination residues either on a polycarbonate (PC) filter (PC indirect method) or on a cellulose ester (CE) membrane (CE indirect method). The PC indirect method requires that fibres deposited on a PC filter be covered by a carbon layer, whereas in the CE indirect method, the CE membrane has to be directly processed using a method described in ISO Standard 10312. The purpose of this study was to compare results obtained using, on the one hand, direct preparation methods and, on the other hand, PC indirect or CE indirect methods, for counting asbestos fibres deposited on filters as a result of liquid filtration or air sampling. In direct method-based preparation, we observed that an etching time of 6-14 min does not affect the measured densities, except for fibres <1 microm deposited by liquid filtration. Moreover, in all cases, the direct method gives higher densities than the PC indirect method because of possible fibre disappearance when using the carbon evaporator implemented in the PC indirect method. The CE membrane used for sample preparation in the CE indirect method is collapsed prior to passing it through the carbon evaporator, so the fibres are less likely to disappear at this stage. We then note that the resulting fibre densities for chrysotile-loaded filters prepared using the direct method are close to those obtained with filters prepared using the CE indirect method. Our study therefore shows that, under the implemented experimental conditions, the PC and CE indirect preparation methods described in ISO Standard 13794 are not equivalent.

Expanding Local Cancer Clinical Trial Options: Analysis of the Economic Impact of the Midwest Cancer Alliance in Kansas

PubMed Central

Gafford, J. Atlee; Krebill, Hope; Lai, Sue Min; Christiadi; Doolittle, Gary C.

2017-01-01

Purpose Patients benefit from receiving cancer treatment closer to home when possible and at high-volume regional centers when specialized care is required. The purpose of this analysis was to estimate the economic impact of retaining more patients in-state for cancer clinical trials and care, which might offset some of the costs of establishing broader cancer trial and treatment networks. Method Kansas Cancer Registry data were used to estimate the number of patients retained in-state for cancer care following the expansion of local cancer clinical trial options through the Midwest Cancer Alliance based at the University of Kansas Medical Center. The 2014 economic impact of this enhanced local clinical trial network was estimated in four parts: Medical spending was estimated on the basis of National Cancer Institute cost-of-care estimates. Household travel cost savings were estimated as the difference between in-state and out-of-state travel costs. Trial-related grant income was calculated from administrative records. Indirect and induced economic benefits to the state were estimated using an economic impact model. Results The authors estimated that the enhanced local cancer clinical trial network resulted in approximately $6.9 million in additional economic activity in the state in 2014, or $362,000 per patient retained in-state. This estimate includes $3.6 million in direct spending and $3.3 million in indirect economic activity. The enhanced trial network also resulted in 45 additional jobs. Conclusions Retaining patients in-state for cancer care and clinical trial participation allows patients to remain closer to home for care and enhances the state economy. PMID:28253204

Defining and estimating causal direct and indirect effects when setting the mediator to specific values is not feasible.

PubMed

Lok, Judith J

2016-09-30

Natural direct and indirect effects decompose the effect of a treatment into the part that is mediated by a covariate (the mediator) and the part that is not. Their definitions rely on the concept of outcomes under treatment with the mediator 'set' to its value without treatment. Typically, the mechanism through which the mediator is set to this value is left unspecified, and in many applications, it may be challenging to fix the mediator to particular values for each unit or patient. Moreover, how one sets the mediator may affect the distribution of the outcome. This article introduces 'organic' direct and indirect effects, which can be defined and estimated without relying on setting the mediator to specific values. Organic direct and indirect effects can be applied, for example, to estimate how much of the effect of some treatments for HIV/AIDS on mother-to-child transmission of HIV infection is mediated by the effect of the treatment on the HIV viral load in the blood of the mother. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Error Analysis of Indirect Broadband Monitoring of Multilayer Optical Coatings using Computer Simulations

NASA Astrophysics Data System (ADS)

Semenov, Z. V.; Labusov, V. A.

2017-11-01

Results of studying the errors of indirect monitoring by means of computer simulations are reported. The monitoring method is based on measuring spectra of reflection from additional monitoring substrates in a wide spectral range. Special software (Deposition Control Simulator) is developed, which allows one to estimate the influence of the monitoring system parameters (noise of the photodetector array, operating spectral range of the spectrometer and errors of its calibration in terms of wavelengths, drift of the radiation source intensity, and errors in the refractive index of deposited materials) on the random and systematic errors of deposited layer thickness measurements. The direct and inverse problems of multilayer coatings are solved using the OptiReOpt library. Curves of the random and systematic errors of measurements of the deposited layer thickness as functions of the layer thickness are presented for various values of the system parameters. Recommendations are given on using the indirect monitoring method for the purpose of reducing the layer thickness measurement error.

Effect decomposition in the presence of an exposure-induced mediator-outcome confounder

PubMed Central

VanderWeele, Tyler J.; Vansteelandt, Stijn; Robins, James M.

2014-01-01

Methods from causal mediation analysis have generalized the traditional approach to direct and indirect effects in the epidemiologic and social science literature by allowing for interaction and non-linearities. However, the methods from the causal inference literature have themselves been subject to a major limitation in that the so-called natural direct and indirect effects that are employed are not identified from data whenever there is a variable that is affected by the exposure, which also confounds the relationship between the mediator and the outcome. In this paper we describe three alternative approaches to effect decomposition that give quantities that can be interpreted as direct and indirect effects, and that can be identified from data even in the presence of an exposure-induced mediator-outcome confounder. We describe a simple weighting-based estimation method for each of these three approaches, illustrated with data from perinatal epidemiology. The methods described here can shed insight into pathways and questions of mediation even when an exposure-induced mediator-outcome confounder is present. PMID:24487213

Graph-based impact analysis as a framework for incorporating practitioner knowledge in dairy herd health management.

PubMed

Krieger, M; Schwabenbauer, E-M; Hoischen-Taubner, S; Emanuelson, U; Sundrum, A

2018-03-01

Production diseases in dairy cows are multifactorial, which means they emerge from complex interactions between many different farm variables. Variables with a large impact on production diseases can be identified for groups of farms using statistical models, but these methods cannot be used to identify highly influential variables in individual farms. This, however, is necessary for herd health planning, because farm conditions and associated health problems vary largely between farms. The aim of this study was to rank variables according to their anticipated effect on production diseases on the farm level by applying a graph-based impact analysis on 192 European organic dairy farms. Direct impacts between 13 pre-defined variables were estimated for each farm during a round-table discussion attended by practitioners, that is farmer, veterinarian and herd advisor. Indirect impacts were elaborated through graph analysis taking into account impact strengths. Across farms, factors supposedly exerting the most influence on production diseases were 'feeding', 'hygiene' and 'treatment' (direct impacts), as well as 'knowledge and skills' and 'herd health monitoring' (indirect impacts). Factors strongly influenced by production diseases were 'milk performance', 'financial resources' and 'labour capacity' (directly and indirectly). Ranking of variables on the farm level revealed considerable differences between farms in terms of their most influential and most influenced farm factors. Consequently, very different strategies may be required to reduce production diseases in these farms. The method is based on perceptions and estimations and thus prone to errors. From our point of view, however, this weakness is clearly outweighed by the ability to assess and to analyse farm-specific relationships and thus to complement general knowledge with contextual knowledge. Therefore, we conclude that graph-based impact analysis represents a promising decision support tool for herd health planning. The next steps include testing the method using more specific and problem-oriented variables as well as evaluating its effectiveness.

NEW APPROACHES TO ESTIMATING INDIRECT PHOTOLYSIS RATES IN AQUATIC ENVIRONMENTS

EPA Science Inventory

Indirect photoreactions in aquatic environments are driven by reactive species, most of which are oxygen centered. Humic substances play an important role in photosensitizing the production of these reactive species, which include singlet molecular oxygen, superoxide ions, hydrog...

Stochastic inversion of cross-borehole radar data from metalliferous vein detection

NASA Astrophysics Data System (ADS)

Zeng, Zhaofa; Huai, Nan; Li, Jing; Zhao, Xueyu; Liu, Cai; Hu, Yingsa; Zhang, Ling; Hu, Zuzhi; Yang, Hui

2017-12-01

In the exploration and evaluation of the metalliferous veins with a cross-borehole radar system, traditional linear inversion methods (least squares inversion, LSQR) only get indirect parameters (permittivity, resistivity, or velocity) to estimate the target structure. They cannot accurately reflect the geological parameters of the metalliferous veins’ media properties. In order to get the intrinsic geological parameters and internal distribution, in this paper, we build a metalliferous veins model based on the stochastic effective medium theory, and carry out stochastic inversion and parameter estimation based on the Monte Carlo sampling algorithm. Compared with conventional LSQR, the stochastic inversion can get higher resolution inversion permittivity and velocity of the target body. We can estimate more accurately the distribution characteristics of abnormality and target internal parameters. It provides a new research idea to evaluate the properties of complex target media.

A global portrait of the manganese industry-A socioeconomic perspective.

PubMed

Clarke, Carl; Upson, Sophie

2017-01-01

In 2013/14, Risk & Policy Analysts Ltd undertook the first global study on the socio-economic value of Manganese (Mn). Based on a top-down analysis of the key supply chains for Mn, it outlined the economic importance of Mn ore and alloys in terms of their direct and indirect economic value, as well as their effects on employment (jobs and wages). In 2013, global production of Mn ore was worth an estimated US$ 10.2-11.1 billion. Taking into account multiplier effects in the supply chain, the total economic value of Mn ore production globally in 2013 is estimated at US$ 21-23 billion. Direct employment related to Mn ore production is estimated at 44,000-78,000 people worldwide (with total wages estimated at US$ 2.7-4.6 billion per year), plus 33,000-59,000 jobs are created through indirect and induced employment effects. Meanwhile, the production of Mn alloy contributes around US$ 23 billion per year to the global economy (based on global production of around 19 million mt and 2013 market prices). In total, the value of Mn alloy production worldwide, taking into account downstream multiplier effects in the supply chain, is estimated at around US$ 146 billion per year. Direct employment related to Mn alloy production is estimated at 67,000-86,000 jobs worldwide (with total wages estimated at US$ 613-796 million per year), plus 217,000-278,000 jobs created through indirect & induced employment effects. In addition, numerous industries/sectors, products and/or applications are heavily dependent on Mn production and use. Mn is a critical raw material input and alloying element for the steel industry, for which there are no known alternatives. It can be argued that without Mn the entire steel industry (based on the current physico-chemical properties of steel) would not exist and, as a result, the value of the steel industry - an estimated US$ 964 billion to US$ 1446 billion in 2013 - is reliant on the continued supply and use of Mn. Besides its use in steel, Mn is also a critical element in the manufacture of dry cell and other batteries (notably, those used in electric vehicles) and the production of aluminium alloys (e.g. for beverage cans). Mn is also a micronutrient needed for plant growth and plays a vital role in agricultural production. It is also essential for maintaining the health and well-being of the human body and is used in food supplements and medicines. Furthermore, its use in developing applications (such as advanced steel products in automotive applications and batteries for electric vehicles) has the potential to provide socio-economic and environmental benefits in the future through enhancing vehicle safety and reducing fuel use/emissions. Copyright © 2016 Elsevier B.V. All rights reserved.

The direct and indirect costs of Dravet Syndrome.

PubMed

Whittington, Melanie D; Knupp, Kelly G; Vanderveen, Gina; Kim, Chong; Gammaitoni, Arnold; Campbell, Jonathan D

2018-03-01

The objective of this study was to estimate the annual direct and indirect costs associated with Dravet Syndrome (DS). A survey was electronically administered to the caregivers of patients with DS treated at Children's Hospital Colorado. Survey domains included healthcare utilization of the patient with DS and DS caregiver work productivity and activity impairment. Patient healthcare utilization was measured using modified questions from the National Health Interview Survey; caregiver work productivity and activity impairment were measured using modified questions from the Work Productivity and Activity Impairment questionnaire. Direct costs were calculated by multiplying the caregiver-reported healthcare utilization rates by the mean unit cost for each healthcare utilization category. Indirect costs included lost productivity, income loss, and lost leisure time. The indirect costs were a function of caregiver-reported hours spent caregiving and an hourly unit cost. The survey was emailed to 60 DS caregivers, of which 34 (57% response rate) responded. Direct costs on average were $27,276 (95% interval: $15,757, $41,904) per patient with DS. Hospitalizations ($11,565 a year) and in-home medical care visits ($9894 a year) were substantial cost drivers. Additionally, caregivers reported extensive time spent providing care to an individual with DS. This caregiver time resulted in average annual indirect costs of $81,582 (95% interval: $57,253, $110,151), resulting in an average total annual financial burden of $106,378 (95% interval: $78,894, $137,906). Dravet Syndrome results in substantial healthcare utilization, financial burden, and time commitment. Establishing evidence on the financial burden of DS is essential to understanding the overall impact of DS, identifying potential areas for support needs, and assessing the impact of novel treatments as they become available. Based on the study findings, in-home visits, hospitalizations, and lost productivity and leisure time of caregivers are key domains for DS economic evaluations. Future research should extend these estimates to include the potential additional healthcare utilization of the DS caregiver. Copyright © 2018 Elsevier Inc. All rights reserved.

Longitudinal analysis of direct and indirect effects on average daily gain in rabbits using a structured antedependence model.

PubMed

David, Ingrid; Sánchez, Juan-Pablo; Piles, Miriam

2018-05-10

Indirect genetic effects (IGE) are important components of various traits in several species. Although the intensity of social interactions between partners likely vary over time, very few genetic studies have investigated how IGE vary over time for traits under selection in livestock species. To overcome this issue, our aim was: (1) to analyze longitudinal records of average daily gain (ADG) in rabbits subjected to a 5-week period of feed restriction using a structured antedependence (SAD) model that includes IGE and (2) to evaluate, by simulation, the response to selection when IGE are present and genetic evaluation is based on a SAD model that includes IGE or not. The direct genetic variance for ADG (g/d) increased from week 1 to 3 [from 8.03 to 13.47 (g/d) 2 ] and then decreased [6.20 (g/d) 2 at week 5], while the indirect genetic variance decreased from week 1 to 4 [from 0.43 to 0.22 (g/d) 2 ]. The correlation between the direct genetic effects of different weeks was moderate to high (ranging from 0.46 to 0.86) and tended to decrease with time interval between measurements. The same trend was observed for IGE for weeks 2 to 5 (correlations ranging from 0.62 to 0.91). Estimates of the correlation between IGE of week 1 and IGE of the other weeks did not follow the same pattern and correlations were lower. Estimates of correlations between direct and indirect effects were negative at all times. After seven generations of simulated selection, the increase in ADG from selection on EBV from a SAD model that included IGE was higher (~ 30%) than when those effects were omitted. Indirect genetic effects are larger just after mixing animals at weaning than later in the fattening period, probably because of the establishment of social hierarchy that is generally observed at that time. Accounting for IGE in the selection criterion maximizes genetic progress.

The prediction of the residual life of electromechanical equipment based on the artificial neural network

NASA Astrophysics Data System (ADS)

Zhukovskiy, Yu L.; Korolev, N. A.; Babanova, I. S.; Boikov, A. V.

2017-10-01

This article is devoted to the prediction of the residual life based on an estimate of the technical state of the induction motor. The proposed system allows to increase the accuracy and completeness of diagnostics by using an artificial neural network (ANN), and also identify and predict faulty states of an electrical equipment in dynamics. The results of the proposed system for estimation the technical condition are probability technical state diagrams and a quantitative evaluation of the residual life, taking into account electrical, vibrational, indirect parameters and detected defects. Based on the evaluation of the technical condition and the prediction of the residual life, a decision is made to change the control of the operating and maintenance modes of the electric motors.

Effective number of breeding adults in Bufo bufo estimated from age-specific variation at minisatellite loci

USGS Publications Warehouse

Scribner, K.T.; Arntzen, J.W.; Burke, T.

1997-01-01

Estimates of the effective number of breeding adults were derived for three semi-isolated populations of the common toad Bufo bufo based on temporal (i.e. adult-progeny) variance in allele frequency for three highly polymorphic minisatellite loci. Estimates of spatial variance in allele frequency among populations and of age-specific measures of genetic variability are also described. Each population was characterized by a low effective adult breeding number (N(b)) based on a large age-specific variance in minisatellite allele frequency. Estimates of N(b) (range 21-46 for population means across three loci) were ??? 55-230-fold lower than estimates of total adult census size. The implications of low effective breeding numbers for long-term maintenance of genetic variability and population viability are discussed relative to the species' reproductive ecology, current land-use practices, and present and historical habitat modification and loss. The utility of indirect measures of population parameters such as N(b) and N(e) based on time-series data of minisatellite allele frequencies is discussed relative to similar measures estimated from commonly used genetic markers such as protein allozymes.

Economic Costs Attributable to Smoking in China: Update and an 8-year Comparison, 2000–2008

PubMed Central

Yang, Lian; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Rao, Keqin

2013-01-01

Objective To estimate the health-related economic costs attributable to smoking in China for persons aged 35 and older in 2003 and in 2008 and to compare these costs with the respective results from 2000. Methods A prevalence-based, disease-specific approach was used to estimate smoking-attributable direct and indirect economic costs. The primary data source was the 2003 and 2008 China National Health Services Survey, which contains individual participant’s smoking status, healthcare utilization, and expenditures. Results The total economic cost of smoking in China amounted to $17.1 billion in 2003 and $28.9 billion in 2008 (both measured in 2008 constant US dollars). Direct smoking-attributable healthcare costs in 2003 and 2008 were $4.2 billion and $6.2 billion, respectively. Indirect economic costs in 2003 and 2008 were $12.9 billion and $22.7 billion, respectively. Compared to 2000, the direct costs of smoking rose by 72% in 2003 and 154% in 2008, while the indirect costs of smoking rose by 170% in 2003 and 376% in 2008. Conclusion The economic burden of cigarette smoking has increased substantially in China during the past decade and is expected to continue to increase as the national economy and the price of healthcare services grow. Stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking. PMID:21339491

Estimating the probability of an extinction or major outbreak for an environmentally transmitted infectious disease.

PubMed

Lahodny, G E; Gautam, R; Ivanek, R

2015-01-01

Indirect transmission through the environment, pathogen shedding by infectious hosts, replication of free-living pathogens within the environment, and environmental decontamination are suspected to play important roles in the spread and control of environmentally transmitted infectious diseases. To account for these factors, the classic Susceptible-Infectious-Recovered-Susceptible epidemic model is modified to include a compartment representing the amount of free-living pathogen within the environment. The model accounts for host demography, direct and indirect transmission, replication of free-living pathogens in the environment, and removal of free-living pathogens by natural death or environmental decontamination. Based on the assumptions of the deterministic model, a continuous-time Markov chain model is developed. An estimate for the probability of disease extinction or a major outbreak is obtained by approximating the Markov chain with a multitype branching process. Numerical simulations illustrate important differences between the deterministic and stochastic counterparts, relevant for outbreak prevention, that depend on indirect transmission, pathogen shedding by infectious hosts, replication of free-living pathogens, and environmental decontamination. The probability of a major outbreak is computed for salmonellosis in a herd of dairy cattle as well as cholera in a human population. An explicit expression for the probability of disease extinction or a major outbreak in terms of the model parameters is obtained for systems with no direct transmission or replication of free-living pathogens.

Indirect monitoring shot-to-shot shock waves strength reproducibility during pump-probe experiments

NASA Astrophysics Data System (ADS)

Pikuz, T. A.; Faenov, A. Ya.; Ozaki, N.; Hartley, N. J.; Albertazzi, B.; Matsuoka, T.; Takahashi, K.; Habara, H.; Tange, Y.; Matsuyama, S.; Yamauchi, K.; Ochante, R.; Sueda, K.; Sakata, O.; Sekine, T.; Sato, T.; Umeda, Y.; Inubushi, Y.; Yabuuchi, T.; Togashi, T.; Katayama, T.; Yabashi, M.; Harmand, M.; Morard, G.; Koenig, M.; Zhakhovsky, V.; Inogamov, N.; Safronova, A. S.; Stafford, A.; Skobelev, I. Yu.; Pikuz, S. A.; Okuchi, T.; Seto, Y.; Tanaka, K. A.; Ishikawa, T.; Kodama, R.

2016-07-01

We present an indirect method of estimating the strength of a shock wave, allowing on line monitoring of its reproducibility in each laser shot. This method is based on a shot-to-shot measurement of the X-ray emission from the ablated plasma by a high resolution, spatially resolved focusing spectrometer. An optical pump laser with energy of 1.0 J and pulse duration of ˜660 ps was used to irradiate solid targets or foils with various thicknesses containing Oxygen, Aluminum, Iron, and Tantalum. The high sensitivity and resolving power of the X-ray spectrometer allowed spectra to be obtained on each laser shot and to control fluctuations of the spectral intensity emitted by different plasmas with an accuracy of ˜2%, implying an accuracy in the derived electron plasma temperature of 5%-10% in pump-probe high energy density science experiments. At nano- and sub-nanosecond duration of laser pulse with relatively low laser intensities and ratio Z/A ˜ 0.5, the electron temperature follows Te ˜ Ilas2/3. Thus, measurements of the electron plasma temperature allow indirect estimation of the laser flux on the target and control its shot-to-shot fluctuation. Knowing the laser flux intensity and its fluctuation gives us the possibility of monitoring shot-to-shot reproducibility of shock wave strength generation with high accuracy.

Human joint motion estimation for electromyography (EMG)-based dynamic motion control.

PubMed

Zhang, Qin; Hosoda, Ryo; Venture, Gentiane

2013-01-01

This study aims to investigate a joint motion estimation method from Electromyography (EMG) signals during dynamic movement. In most EMG-based humanoid or prosthetics control systems, EMG features were directly or indirectly used to trigger intended motions. However, both physiological and nonphysiological factors can influence EMG characteristics during dynamic movements, resulting in subject-specific, non-stationary and crosstalk problems. Particularly, when motion velocity and/or joint torque are not constrained, joint motion estimation from EMG signals are more challenging. In this paper, we propose a joint motion estimation method based on muscle activation recorded from a pair of agonist and antagonist muscles of the joint. A linear state-space model with multi input single output is proposed to map the muscle activity to joint motion. An adaptive estimation method is proposed to train the model. The estimation performance is evaluated in performing a single elbow flexion-extension movement in two subjects. All the results in two subjects at two load levels indicate the feasibility and suitability of the proposed method in joint motion estimation. The estimation root-mean-square error is within 8.3% ∼ 10.6%, which is lower than that being reported in several previous studies. Moreover, this method is able to overcome subject-specific problem and compensate non-stationary EMG properties.

Cost-benefit analysis of vaccination against Mycobacterium avium ssp. paratuberculosis in dairy cattle, given its cross-reactivity with tuberculosis tests.

PubMed

Groenendaal, Huybert; Zagmutt, Francisco J; Patton, Elisabeth A; Wells, Scott J

2015-09-01

Johne's disease (JD), or paratuberculosis, is a chronic enteric disease of ruminants, caused by infection with Mycobacterium avium ssp. paratuberculosis (MAP). Johne's disease causes considerable economic losses to the US dairy industry, estimated to be over $200 million annually. Available control strategies include management measures to improve calf hygiene, test-and-cull strategies, and vaccination. Although the first 2 strategies have shown to reduce the prevalence of MAP, they require dedicated and long-term efforts from dairy producers, with often relatively slow progress. As a result, uptake of both strategies has not been as wide as expected given the economic benefits especially of improved hygiene. Vaccination has also been found to reduce the prevalence and economic losses of JD, but most economic estimates have been based on simulation of hypothetical vaccines. In addition, if an animal is vaccinated, cross-reactivity between MAP antibodies and bovine tuberculosis (BTB) antigens may occur, decreasing the specificity of BTB tests. Therefore, MAP vaccination would cause additional indirect costs to the BTB surveillance and control program. The objective of the present study was to use data from a MAP vaccine trial together with an epidemiologic and economic model to estimate the direct on-farm benefits of MAP vaccination and to estimate the indirect costs of MAP vaccination due to the cross-reactivity with BTB tests. Direct economic benefits of MAP vaccination were estimated at $8.03 (90% predictive interval: -$25.97 to $41.36) per adult animal per year, all accruing to the dairy producers. This estimate is likely an underestimation of the true direct benefits of MAP vaccination. In addition, indirect economic costs due to cross-reactivity were $2.14 per adult animal per year, making MAP vaccination economically attractive. Only in regions or states with a high frequency of BTB testing (because of, for example, Mycobacterium bovis outbreaks in a wild deer population) and areas where typically small groups of animals are BTB tested would MAP vaccination not be economically attractive. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The logic of comparative life history studies for estimating key parameters, with a focus on natural mortality rate

USGS Publications Warehouse

Hoenig, John M; Then, Amy Y.-H.; Babcock, Elizabeth A.; Hall, Norman G.; Hewitt, David A.; Hesp, Sybrand A.

2016-01-01

There are a number of key parameters in population dynamics that are difficult to estimate, such as natural mortality rate, intrinsic rate of population growth, and stock-recruitment relationships. Often, these parameters of a stock are, or can be, estimated indirectly on the basis of comparative life history studies. That is, the relationship between a difficult to estimate parameter and life history correlates is examined over a wide variety of species in order to develop predictive equations. The form of these equations may be derived from life history theory or simply be suggested by exploratory data analysis. Similarly, population characteristics such as potential yield can be estimated by making use of a relationship between the population parameter and bio-chemico–physical characteristics of the ecosystem. Surprisingly, little work has been done to evaluate how well these indirect estimators work and, in fact, there is little guidance on how to conduct comparative life history studies and how to evaluate them. We consider five issues arising in such studies: (i) the parameters of interest may be ill-defined idealizations of the real world, (ii) true values of the parameters are not known for any species, (iii) selecting data based on the quality of the estimates can introduce a host of problems, (iv) the estimates that are available for comparison constitute a non-random sample of species from an ill-defined population of species of interest, and (v) the hierarchical nature of the data (e.g. stocks within species within genera within families, etc., with multiple observations at each level) warrants consideration. We discuss how these issues can be handled and how they shape the kinds of questions that can be asked of a database of life history studies.

Indirect Nitrous Oxide Emissions from Major Rivers in the World: Integration of a Process-based Model with Observational Data

NASA Astrophysics Data System (ADS)

Zhang, B.; Yao, Y.; Xu, R.; Yang, J.; WANG, Z.; Pan, S.; Tian, H.

2016-12-01

The atmospheric concentration of nitrous oxide (N2O), one of major greenhouse gases, has increased over 121% compared with the preindustrial level, and most of the increase arises from anthropogenic activities. Previous studies suggested that indirect emissions from global rivers remains a large source of uncertainty among all the N2O sources and restricted the assessment of N2O budget at both regional and global scales. Here, we have integrated a coupled biogeochemical model (DLEM) with observational data to quantify the magnitude and spatio-temporal variation of riverine N2O emission and attribute the environmental controls of indirect N2O emission from major rivers in the world. Our preliminary results indicate that the magnitude of indirect N2O emission from rivers is closely associated with the stream orders. To include N2O emissions from headwater streams is essential for reducing uncertainty in the estimation of indirect N2O emission. By implementing a set of factorial simulations, we have further quantified the relative contributions of climate, nitrogen deposition, nitrogen fertilizer use, and manure application to riverine N2O emission. Finally, this study has identified major knowledge gaps and uncertainties associated with model structure, parameters and input data that need to be improved in future research.

The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece.

PubMed

Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Tzanakis, Nikos; Toumbis, Michalis; Vassilakopoulos, Theodoros

2017-01-01

COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs). In addition, absenteeism and caregiver's costs were recorded in order to quantify indirect COPD costs. The total costs of managing COPD per patient per year were estimated at €4,730, with direct (medical and nonmedical) and indirect costs accounting for 62.5% and 37.5%, respectively. COPD exacerbations were responsible for 32% of total costs (€1,512). Key exacerbation-related cost drivers were hospitalization (€830) and intensive care unit (ICU) admission costs (€454), jointly accounting for 85% of total exacerbation costs. Annual maintenance phase costs were estimated at €835, with pharmaceutical treatment accounting for 77% (€639.9). Patient time costs were estimated at €146 per year. The average number of sick days per year was estimated at 16.9, resulting in productivity losses of €968. Caregiver's costs were estimated at €806 per year. The management of COPD in Greece is associated with intensive resource use and significant economic burden. Exacerbations and productivity losses are the key cost drivers. Cost containment policies should focus on prioritizing treatments that increase patient compliance as these can lead to reduction of exacerbations, longer maintenance phases, and thus lower costs.

Effect of Body Position on Energy Expenditure of Preterm Infants as Determined by Simultaneous Direct and Indirect Calorimetry.

PubMed

Bell, Edward F; Johnson, Karen J; Dove, Edwin L

2017-04-01

Background  Indirect calorimetry is the standard method for estimating energy expenditure in clinical research. Few studies have evaluated indirect calorimetry in infants by comparing it with simultaneous direct calorimetry. Our purpose was (1) to compare the energy expenditure of preterm infants determined by these two methods, direct calorimetry and indirect calorimetry; and (2) to examine the effect of body position, supine or prone, on energy expenditure. Study Design  We measured energy expenditure by simultaneous direct (heat loss by gradient-layer calorimeter corrected for heat storage) and indirect calorimetry (whole-body oxygen consumption and carbon dioxide production) in 15 growing preterm infants during two consecutive interfeeding intervals, once in the supine position and once in the prone position. Results  The mean energy expenditure for all measurements in both positions did not differ significantly by the method used: 2.82 (standard deviation [SD] 0.42) kcal/kg/h by direct calorimetry and 2.78 (SD 0.48) kcal/kg/h by indirect calorimetry. The energy expenditure was significantly lower, by 10%, in the prone than in the supine position, whether examined by direct calorimetry (2.67 vs. 2.97 kcal/kg/h, p  < 0.001) or indirect calorimetry (2.64 vs. 2.92 kcal/kg/h, p  = 0.017). Conclusion  Direct calorimetry and indirect calorimetry gave similar estimates of energy expenditure. Energy expenditure was 10% lower in the prone position than in the supine position. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Walking Distance Estimation Using Walking Canes with Inertial Sensors

PubMed Central

Suh, Young Soo

2018-01-01

A walking distance estimation algorithm for cane users is proposed using an inertial sensor unit attached to various positions on the cane. A standard inertial navigation algorithm using an indirect Kalman filter was applied to update the velocity and position of the cane during movement. For quadripod canes, a standard zero-velocity measurement-updating method is proposed. For standard canes, a velocity-updating method based on an inverted pendulum model is proposed. The proposed algorithms were verified by three walking experiments with two different types of canes and different positions of the sensor module. PMID:29342971

Mediation analysis to estimate direct and indirect milk losses due to clinical mastitis in dairy cattle.

PubMed

Detilleux, J; Kastelic, J P; Barkema, H W

2015-03-01

Milk losses associated with mastitis can be attributed to either effects of pathogens per se (i.e., direct losses) or effects of the immune response triggered by intramammary infection (indirect losses). The distinction is important in terms of mastitis prevention and treatment. Regardless, the number of pathogens is often unknown (particularly in field studies), making it difficult to estimate direct losses, whereas indirect losses can be approximated by measuring the association between increased somatic cell count (SCC) and milk production. An alternative is to perform a mediation analysis in which changes in milk yield are allocated into their direct and indirect components. We applied this method on data for clinical mastitis, milk and SCC test-day recordings, results of bacteriological cultures (Escherichia coli, Staphylococcus aureus, Streptococcus uberis, coagulase-negative staphylococci, Streptococcus dysgalactiae, and streptococci other than Strep. dysgalactiae and Strep. uberis), and cow characteristics. Following a diagnosis of clinical mastitis, the cow was treated and changes (increase or decrease) in milk production before and after a diagnosis were interpreted counterfactually. On a daily basis, indirect changes, mediated by SCC increase, were significantly different from zero for all bacterial species, with a milk yield decrease (ranging among species from 4 to 33g and mediated by an increase of 1000 SCC/mL/day) before and a daily milk increase (ranging among species from 2 to 12g and mediated by a decrease of 1000 SCC/mL/day) after detection. Direct changes, not mediated by SCC, were only different from zero for coagulase-negative staphylococci before diagnosis (72g per day). We concluded that mixed structural equation models were useful to estimate direct and indirect effects of the presence of clinical mastitis on milk yield. Copyright © 2015 Elsevier B.V. All rights reserved.

A comparison of direct and indirect analytical approaches to measuring total nicotine equivalents in urine.

PubMed

Taghavi, Taraneh; Novalen, Maria; Lerman, Caryn; George, Tony P; Tyndale, Rachel F

2018-05-31

Total nicotine equivalents (TNE), the sum of nicotine and metabolites in urine, is a valuable tool for evaluating nicotine exposure. Most methods for measuring TNE involve two-step enzymatic hydrolysis for indirect quantification of glucuronide metabolites. Here, we describe a rapid, low-cost direct liquid chromatography - tandem mass spectrometry (LCMS) assay. In 139 smokers' urine samples, Bland-Altman, correlation, and regression analyses were used to investigate differences in quantification of nicotine and metabolites, TNE, and nicotine metabolite ratio (NMR) between direct and indirect LCMS methods. DNA from a subset (n=97 smokers) was genotyped for UGT2B10*2 and UGT2B17*2 and the known impact of these variants was evaluated using urinary ratios determined by the direct versus indirect method. The direct method showed high accuracy (0-9% bias) and precision (3-14% coefficient of variation) with similar distribution of nicotine metabolites to literary estimates and good agreement between the direct and indirect methods for nicotine, cotinine, and 3-hydroxycotinine (ratios 0.99-1.07), but less agreement for their respective glucuronides (ratios 1.16-4.17). The direct method identified urinary 3HC+3HC-GLUC/COT as having the highest concordance with plasma NMR and provided substantially better estimations of the established genetic impact of glucuronidation variants compared to the indirect method. Direct quantification of nicotine and metabolites is less time-consuming and less costly, and provides accurate estimates of nicotine intake, metabolism rate and the impact of genetic variation in smokers. Lower cost and maintenance combined with high accuracy and reproducibility make the direct method ideal for smoking biomarker, NMR and pharmacogenomics studies. Copyright ©2018, American Association for Cancer Research.

Indirect estimates of natal dispersal distance from genetic data in a stream-dwelling fish (Mogurnda adspersa).

PubMed

Shipham, Ashlee; Schmidt, Daniel J; Hughes, Jane M

2013-01-01

Recent work has highlighted the need to account for hierarchical patterns of genetic structure when estimating evolutionary and ecological parameters of interest. This caution is particularly relevant to studies of riverine organisms, where hierarchical structure appears to be commonplace. Here, we indirectly estimate dispersal distance in a hierarchically structured freshwater fish, Mogurnda adspersa. Microsatellite and mitochondrial DNA (mtDNA) data were obtained for 443 individuals across 27 sites separated by an average of 1.3 km within creeks of southeastern Queensland, Australia. Significant genetic structure was found among sites (mtDNA Φ(ST) = 0.508; microsatellite F(ST) = 0.225, F'(ST) = 0.340). Various clustering methods produced congruent patterns of hierarchical structure reflecting stream architecture. Partial mantel tests identified contiguous sets of sample sites where isolation by distance (IBD) explained F(ST) variation without significant contribution of hierarchical structure. Analysis of mean natal dispersal distance (σ) within sets of IBD-linked sample sites suggested most dispersal occurs over less than 1 km, and the average effective density (D(e)) was estimated at 11.5 individuals km(-1); indicating sedentary behavior and small effective population size are responsible for the remarkable patterns of genetic structure observed. Our results demonstrate that Rousset's regression-based method is applicable to estimating the scale of dispersal in riverine organisms and that identifying contiguous populations that satisfy the assumptions of this model is achievable with genetic clustering methods and partial correlations.

Estimation of leaf area index and foliage clumping in deciduous forests using digital photography

NASA Astrophysics Data System (ADS)

Chianucci, Francesco; Cutini, Andrea

2013-04-01

Rapid, reliable and meaningful estimates of leaf area index (LAI) are essential to the characterization of forest ecosystems. In this contribution the accuracy of both fisheye and non-fisheye digital photography for the estimation of forest leaf area in deciduous stands was evaluated. We compared digital hemispherical photography (DHP), the most widely used technique that measures the gap fraction at multiple zenith angles, with methods that measure the gap fraction at a single zenith angle, namely 57.5 degree photography and cover photography (DCP). Comparison with other different gap fraction methods used to calculate LAI such as canopy transmittance measurements from AccuPAR ceptometer and LAI- 2000 Plant Canopy Analyzer (PCA) were also performed. LAI estimated from all these indirect methods were compared with direct measurements obtained by litter traps (LAILT). We applied these methods in 10 deciduous stands of Quercus cerris, Castanea sativa and Fagus sylvatica, the most common deciduous species in Italy, where LAILT ranged from 3.9 to 7.3. DHP and DCP provided good indirect estimates of LAILT, and outperformed the other indirect methods. The DCP method provided estimates of crown porosity, crown cover, foliage cover and the clumping index at the zenith, but required assumptions about the light extinction coefficient at the zenith (k), to accurately estimate LAI. Cover photography provided good indirect estimates of LAI assuming a spherical leaf angle distribution, even though k appeared to decrease as LAI increased, thus affecting the accuracy of LAI estimates in DCP. In contrast, the accuracy of LAI estimates in DHP appeared insensitive to LAILT values, but the method was sensitive to photographic exposure, gamma-correction and was more time-consuming than DCP. Foliage clumping was estimated from all the photographic methods by analyzing either gap size distribution (DCP) or gap fraction distribution (DHP). Foliage clumping was also calculated from PCA and compared with DHP. The studied stands were characterized by fairly homogeneous canopies with higher within-crown clumping than between-crowns clumping; only the segmented analysis of gap fraction for each ring of the fisheye images was found to provide useful clumping index in such homogeneous canopies. By contrast, the 1-azimuth segment method employed in PCA poorly detected clumping in dense canopies. We conclude both fisheye and non-fisheye photographic methods are suitable for dense deciduous forests. Cover photography holds great promise as a means to quickly obtain inexpensive estimates of LAI over large areas. However, in situations where no direct reference measurements of k are available, we recommend using both DHP and DCP, in order to cross-calibrate the two methods; DCP could then be used for more routinely indirect measurement and monitoring of LAI. Keywords: digital hemispherical photography, cover photography, litter trap, AccuPAR ceptometer, LAI-2000.

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

Mann, M.K.

Technoeconomic analyses have been conducted on two processes to produce hydrogen from biomass: indirectly-heated gasification of biomass followed by steam reforming of the syngas, and biomass pyrolysis followed by steam reforming of the pyrolysis oil. The analysis of the gasification-based process was highly detailed, including a process flowsheet, material and energy balances calculated with a process simulation program, equipment cost estimation, and the determination of the necessary selling price of hydrogen. The pyrolysis-based process analysis was of a less detailed nature, as all necessary experimental data have not been obtained; this analysis is a follow-up to the preliminary economic analysismore » presented at the 1994 Hydrogen Program Review. A coproduct option in which pyrolysis oil is used to produce hydrogen and a commercial adhesive was also studied for economic viability. Based on feedstock availability estimates, three plant sizes were studied: 907 T/day, 272 T/day, and 27 T/day. The necessary selling price of hydrogen produced by steam reforming syngas from the Battelle Columbus Laboratories indirectly heated biomass gasifier falls within current market values for the large and medium size plants within a wide range of feedstock costs. Results show that the small scale plant does not produce hydrogen at economically competitive prices, indicating that if gasification is used as the upstream process to produce hydrogen, local refueling stations similar to current gasoline stations, would probably not be feasible.« less

Indirect effects of radiation induce apoptosis and neuroinflammation in neuronal SH-SY5Y cells.

PubMed

Saeed, Yasmeen; Xie, Bingjie; Xu, Jin; Wang, Hailong; Hassan, Murtaza; Wang, Rui; Hong, Ma; Hong, Qing; Deng, Yulin

2014-12-01

Recent studies have evaluated the role of direct radiation exposure in neurodegenerative disorders; however, association among indirect effects of radiation and neurodegenerative diseases remains rarely discussed. The objective of this study was to estimate the relative risk of neurodegeneration due to direct and indirect effects of radiation. (60)Co gamma ray was used as source of direct radiation whereas irradiated cell conditioned medium (ICCM) was used to mimic the indirect effect of radiation. To determine the potency of ICCM to inhibit neuronal cells survival colony forming assay was performed. The role of ICCM to induce apoptosis in neuronal SH-SY5Y cells was estimated by TUNEL assay and Annexin V/PI assay. Level of oxidative stress and the concentration of inflammatory cytokines after exposing to direct radiation and ICCM were evaluated by ELISA method. Expression of key apoptotic protein following direct and indirect radiation exposure was investigated by western blot technique. Experimental data manifest that ICCM account loss of cell survival and increase apoptotic induction in neuronal SH-SY5Y cells that was dependent on time and dose. Moreover, ICCM stimulate significant release of inflammatory cytokines i.e., tumor necrosis factor TNF-alpha (P < 0.01), Interleukin-1 (IL-1, P < 0.001), and Interleukin-6 (IL-6, P < 0.001) in neuronal SH-SY5Y cells and elevate the level of oxidative stress (MDA, P < 0.01). Up-regulation of key apoptotic protein expression i.e., Bax, Bid, cytochrome C, caspase-8 and caspase-3 confirms the toxicity of ICCM to neuronal cells. This study provides the evidence that indirect effect of radiation can be as much damaging to neuronal cells as direct radiation exposure can be. Hence, more focused research on estimation risks of indirect effect of radiation to CNS at molecular level may help to reduce the uncertainty about cure and cause of several neurodegenerative disorders.

Longitudinal analyses of correlated response efficiencies of fillet traits in Nile tilapia.

PubMed

Turra, E M; Fernandes, A F A; de Alvarenga, E R; Teixeira, E A; Alves, G F O; Manduca, L G; Murphy, T W; Silva, M A

2018-03-01

Recent studies with Nile tilapia have shown divergent results regarding the possibility of selecting on morphometric measurements to promote indirect genetic gains in fillet yield (FY). The use of indirect selection for fillet traits is important as these traits are only measurable after harvesting. Random regression models are a powerful tool in association studies to identify the best time point to measure and select animals. Random regression models can also be applied in a multiple trait approach to analyze indirect response to selection, which would avoid the need to sacrifice candidate fish. Therefore, the aim of this study was to investigate the genetic relationships between several body measurements, weight and fillet traits throughout the growth period and to evaluate the possibility of indirect selection for fillet traits in Nile tilapia. Data were collected from 2042 fish and was divided into two subsets. The first subset was used to estimate genetic parameters, including the permanent environmental effect for BW and body measurements (8758 records for each body measurement, as each fish was individually weighed and measured a maximum of six times). The second subset (2042 records for each trait) was used to estimate genetic correlations and heritabilities, which enabled the calculation of correlated response efficiencies between body measurements and the fillet traits. Heritability estimates across ages ranged from 0.05 to 0.5 for height, 0.02 to 0.48 for corrected length (CL), 0.05 to 0.68 for width, 0.08 to 0.57 for fillet weight (FW) and 0.12 to 0.42 for FY. All genetic correlation estimates between body measurements and FW were positive and strong (0.64 to 0.98). The estimates of genetic correlation between body measurements and FY were positive (except for CL at some ages), but weak to moderate (-0.08 to 0.68). These estimates resulted in strong and favorable correlated response efficiencies for FW and positive, but moderate for FY. These results indicate the possibility of achieving indirect genetic gains for FW and by selecting for morphometric traits, but low efficiency for FY when compared with direct selection.

Associations between lifestyle and air pollution exposure: Potential for confounding in large administrative data cohorts.

PubMed

Strak, Maciej; Janssen, Nicole; Beelen, Rob; Schmitz, Oliver; Karssenberg, Derek; Houthuijs, Danny; van den Brink, Carolien; Dijst, Martin; Brunekreef, Bert; Hoek, Gerard

2017-07-01

Cohorts based on administrative data have size advantages over individual cohorts in investigating air pollution risks, but often lack in-depth information on individual risk factors related to lifestyle. If there is a correlation between lifestyle and air pollution, omitted lifestyle variables may result in biased air pollution risk estimates. Correlations between lifestyle and air pollution can be induced by socio-economic status affecting both lifestyle and air pollution exposure. Our overall aim was to assess potential confounding by missing lifestyle factors on air pollution mortality risk estimates. The first aim was to assess associations between long-term exposure to several air pollutants and lifestyle factors. The second aim was to assess whether these associations were sensitive to adjustment for individual and area-level socioeconomic status (SES), and whether they differed between subgroups of the population. Using the obtained air pollution-lifestyle associations and indirect adjustment methods, our third aim was to investigate the potential bias due to missing lifestyle information on air pollution mortality risk estimates in administrative cohorts. We used a recent Dutch national health survey of 387,195 adults to investigate the associations of PM 10 , PM 2.5 , PM 2.5-10 , PM 2.5 absorbance, OP DTT, OP ESR and NO 2 annual average concentrations at the residential address from land use regression models with individual smoking habits, alcohol consumption, physical activity and body mass index. We assessed the associations with and without adjustment for neighborhood and individual SES characteristics typically available in administrative data cohorts. We illustrated the effect of including lifestyle information on the air pollution mortality risk estimates in administrative cohort studies using a published indirect adjustment method. Current smoking and alcohol consumption were generally positively associated with air pollution. Physical activity and overweight were negatively associated with air pollution. The effect estimates were small (mostly <5% of the air pollutant standard deviations). Direction and magnitude of the associations depended on the pollutant, use of continuous vs. categorical scale of the lifestyle variable, and level of adjustment for individual and area-level SES. Associations further differed between subgroups (age, sex) in the population. Despite the small associations between air pollution and smoking intensity, indirect adjustment resulted in considerable changes of air pollution risk estimates for cardiovascular and especially lung cancer mortality. Individual lifestyle-related risk factors were weakly associated with long-term exposure to air pollution in the Netherlands. Indirect adjustment for missing lifestyle factors in administrative data cohort studies may substantially affect air pollution mortality risk estimates. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Burden of rheumatoid arthritis from a societal perspective: A prevalence-based study on cost of illness for patients with rheumatoid arthritis in China.

PubMed

Hu, Hao; Luan, Luan; Yang, Keqin; Li, Shu-Chuen

2017-02-17

To provide a comprehensive estimation of the economic burden of rheumatoid arthritis (RA) in China, especially for patients from less developed areas, and to explore the cost transferability between regions to assist healthcare decision-making. The study was conducted in south and north China from May 2013 to December 2013. The burden of RA was investigated by interviewing participants with a questionnaire battery containing socio-demographic, cost of illness (COI) and medical treatments. The COI questionnaire captured direct, indirect and intangible costs. Direct costs included hospitalizations, outpatient visits and medications. Indirect costs were estimated using the human capital approach, and intangible costs valued through the willingness-to-pay approach. All cost data were converted to 2013 US dollars by purchasing power parity, and then summarized descriptively and analyzed with mixed models. Questionnaires were administered to 133 RA patients. The average direct costs were $1917.21 ± $2559.06 per patient year, with medications at $1283.89 ± $1898.15 comprising more than 50% of the total. The average indirect costs were $492.88 ± $1739.74 per patient year, while intangible costs were $20396.30 ± $31145.10. There was no significant difference detected between regions. Recent hospitalization was tested as a significant predictor of the direct costs. Age and income were significantly associated with indirect and intangible costs. Besides the substantial burden in terms of direct medical costs and productivity lost, there were notable intangible costs, especially among older patients. This conclusion could be potentially expanded to other provinces in China or even other countries through the adjustments for transferability. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

The economic burden of self-reported and undiagnosed cardiovascular diseases and diabetes on Indonesian households.

PubMed

Finkelstein, Eric A; Chay, Junxing; Bajpai, Shailendra

2014-01-01

The goal of this study is: (1) to estimate the current direct out-of-pocket (OOP) and indirect non-communicable diseases (NCD) burden on Indonesian households and (2) to project NCD prevalence and burden in 2020 focusing specifically on hypertension, diabetes, heart problems and stroke. This study relies on econometric analyses based on four waves of the Indonesian Family Life Survey (IFLS). In aggregate, of the NCDs studied, heart problems exert the greatest economic burden on households, costing Int$1.56 billion in OOP and indirect burden in 2010. This was followed by hypertension (Int$1.36 billion), diabetes (Int$0.81 billion) and stroke (Int$0.29 billion). The OOP and indirect burden of these conditions is estimated to be Int$4.02 billion. Diabetes and stroke are expected to have the largest proportional increases in burden by 2020; 56.0% for diabetes and 56.9% for stroke to total Int$1.27 billion and Int$0.45 billion respectively. The burden of heart problems in 2020 is expected to increase by 34.4% to total Int$2.09 billion and hypertension burden will increase by 46.1% to Int$1.99 billion. In 2020, these conditions are expected to impose an economic burden of Int$5.80 billion. In conclusion, this study demonstrates the significant burden of 4 primary NCDs on Indonesian households. In addition to the indirect burden, hypertension, diabetes, heart problems and stroke account for 8% of the nation's OOP healthcare expenditure, and due to rising disease prevalence and an aging population, this figure is expected to increase to 12% by 2020 without a significant health intervention.

Indirect rotor position sensing in real time for brushless permanent magnet motor drives

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

Ertugrul, N.; Acarnley, P.P.

1998-07-01

This paper describes a modern solution to real-time rotor position estimation of brushless permanent magnet (PM) motor drives. The position estimation scheme, based on flux linkage and line-current estimation, is implemented in real time by using the abc reference frame, and it is tested dynamically. The position estimation model of the test motor, development of hardware, and basic operation of the digital signal processor (DSP) are discussed. The overall position estimation strategy is accomplished with a fast DSP (TMS320C30). The method is a shaft position sensorless method that is applicable to a wide range of excitation types in brushless PMmore » motors without any restriction on the motor model and the current excitation. Both rectangular and sinewave-excited brushless PM motor drives are examined, and the results are given to demonstrate the effectiveness of the method with dynamic loads in closed estimated position loop.« less

Network Mendelian randomization: using genetic variants as instrumental variables to investigate mediation in causal pathways

PubMed Central

Burgess, Stephen; Daniel, Rhian M; Butterworth, Adam S; Thompson, Simon G

2015-01-01

Background: Mendelian randomization uses genetic variants, assumed to be instrumental variables for a particular exposure, to estimate the causal effect of that exposure on an outcome. If the instrumental variable criteria are satisfied, the resulting estimator is consistent even in the presence of unmeasured confounding and reverse causation. Methods: We extend the Mendelian randomization paradigm to investigate more complex networks of relationships between variables, in particular where some of the effect of an exposure on the outcome may operate through an intermediate variable (a mediator). If instrumental variables for the exposure and mediator are available, direct and indirect effects of the exposure on the outcome can be estimated, for example using either a regression-based method or structural equation models. The direction of effect between the exposure and a possible mediator can also be assessed. Methods are illustrated in an applied example considering causal relationships between body mass index, C-reactive protein and uric acid. Results: These estimators are consistent in the presence of unmeasured confounding if, in addition to the instrumental variable assumptions, the effects of both the exposure on the mediator and the mediator on the outcome are homogeneous across individuals and linear without interactions. Nevertheless, a simulation study demonstrates that even considerable heterogeneity in these effects does not lead to bias in the estimates. Conclusions: These methods can be used to estimate direct and indirect causal effects in a mediation setting, and have potential for the investigation of more complex networks between multiple interrelated exposures and disease outcomes. PMID:25150977

Association of Aggression and Non-Suicidal Self Injury: A School-Based Sample of Adolescents

PubMed Central

Tang, Jie; Ma, Ying; Guo, Yong; Ahmed, Niman Isse; Yu, Yizhen; Wang, Jiaji

2013-01-01

Purpose Non-suicidal self-injury (NSSI) in adolescent has drawn increasing attention because it is associated with subsequent depression, drug abuse, anxiety disorders, and suicide. In the present study, we aimed to estimate the prevalence of non-suicidal self-injury (NSSI) in a school-based sample of Chinese adolescents and to explore the association between aggression and NSSI. Methods This study was part of a nationwide study on aggression among adolescents in urban areas of China. A sample of 2907 school students including 1436 boys and 1471 girls were randomly selected in Guangdong Province, with their age ranging from 10 to 18 years old. NSSI, aggression, emotional management and other factors were measured by self-administrated questionnaire. Multinomial logistic regression was used to estimate the association between aggression and NSSI, after adjustment for participants’ emotional management, and other potential confounding variables. Results The one year self-reported prevalence of NSSI was 33.6%. Of them, 21.7% engaged in ‘minor NSSI’, 11.9% in ‘moderate/severe NSSI’. 96.9% of self-injuries engaged in one to five different types of NSSI in the past year. Hostility, verbal and indirect aggression was significantly associated with self-reported NSSI after adjusting for other potential factors both in ‘minor NSSI’ and ‘moderate/severe NSSI’. Hostility, verbal and indirect aggression was significantly associated with greater risk of ‘minor NSSI’ and ‘moderate/severe NSSI’ in those who had poor emotional management ability. Conclusion These findings highlight a high prevalence of NSSI and indicate the importance of hostility, verbal and indirect aggression as potentially risk factor for NSSI among Chinese adolescents. PMID:24205132

Radiative Susceptibility of Cloudy Atmospheres to Droplet Number Perturbations: 2. Global analysis from MODIS

NASA Technical Reports Server (NTRS)

Oreopoulos, Lazaros; Platnick, Steven

2008-01-01

Global distributions of albedo susceptibility for areas covered by liquid clouds are presented for 4 months in 2005. The susceptibility estimates are based on expanded definitions presented in a companion paper and include relative cloud droplet number concentration (CDNC) changes, perturbations in cloud droplet asymmetry parameter and single-scattering albedo, atmospheric/surface effects, and incorporation of the full solar spectrum. The cloud properties (optical thickness and effective radius) used as input in the susceptibility calculations come from MODIS Terra and Aqua Collection 5 gridded data. Geographical distributions of susceptibility corresponding to absolute ( absolute cloud susceptibility ) and relative ( relative cloud susceptibility ) CDNC changes are markedly different indicating that the detailed nature of the cloud microphysical perturbation is important for determining the radiative forcing associated with the first indirect aerosol effect. However, both types of susceptibility exhibit common characteristics such as significant reductions when perturbations in single-scattering properties are omitted, significant increases when atmospheric absorption and surface albedo effects are ignored, and the tendency to decrease with latitude, to be higher over ocean than over land, and to be statistically similar between the morning and afternoon MODIS overpasses. The satellite-based susceptibility analysis helps elucidate the role of present-day cloud and land surface properties in indirect aerosol forcing responses. Our realistic yet moderate CDNC perturbations yield forcings on the order of 1-2 W/sq m for cloud optical property distributions and land surface spectral albedos observed by MODIS. Since susceptibilities can potentially be computed from model fields, these results have practical application in assessing the reasonableness of model-generated estimates of the aerosol indirect radiative forcing.

A Business Case for Electronic Commerce

DTIC Science & Technology

1990-09-01

Electronic Commerce . This report presents the results of that examination. Based upon an examination of 16 key documents, we estimate that DoD could realize direct and indirect cost savings of almost $1.2 billion over a 10-year period by replacing these manually processed documents with their electronic equivalents. To achieve those savings, DoD would need to make investments totaling approximately $80 million in new systems and procedures. (Author)

Modelling Geomechanical Heterogeneity of Rock Masses Using Direct and Indirect Geostatistical Conditional Simulation Methods

NASA Astrophysics Data System (ADS)

Eivazy, Hesameddin; Esmaieli, Kamran; Jean, Raynald

2017-12-01

An accurate characterization and modelling of rock mass geomechanical heterogeneity can lead to more efficient mine planning and design. Using deterministic approaches and random field methods for modelling rock mass heterogeneity is known to be limited in simulating the spatial variation and spatial pattern of the geomechanical properties. Although the applications of geostatistical techniques have demonstrated improvements in modelling the heterogeneity of geomechanical properties, geostatistical estimation methods such as Kriging result in estimates of geomechanical variables that are not fully representative of field observations. This paper reports on the development of 3D models for spatial variability of rock mass geomechanical properties using geostatistical conditional simulation method based on sequential Gaussian simulation. A methodology to simulate the heterogeneity of rock mass quality based on the rock mass rating is proposed and applied to a large open-pit mine in Canada. Using geomechanical core logging data collected from the mine site, a direct and an indirect approach were used to model the spatial variability of rock mass quality. The results of the two modelling approaches were validated against collected field data. The study aims to quantify the risks of pit slope failure and provides a measure of uncertainties in spatial variability of rock mass properties in different areas of the pit.

Racial residential segregation and preterm birth: built environment as a mediator.

PubMed

Anthopolos, Rebecca; Kaufman, Jay S; Messer, Lynne C; Miranda, Marie Lynn

2014-05-01

Racial residential segregation has been associated with preterm birth. Few studies have examined mediating pathways, in part because, with binary outcomes, indirect effects estimated from multiplicative models generally lack causal interpretation. We develop a method to estimate additive-scale natural direct and indirect effects from logistic regression. We then evaluate whether segregation operates through poor-quality built environment to affect preterm birth. To estimate natural direct and indirect effects, we derive risk differences from logistic regression coefficients. Birth records (2000-2008) for Durham, North Carolina, were linked to neighborhood-level measures of racial isolation and a composite construct of poor-quality built environment. We decomposed the total effect of racial isolation on preterm birth into direct and indirect effects. The adjusted total effect of an interquartile increase in racial isolation on preterm birth was an extra 27 preterm events per 1000 births (risk difference = 0.027 [95% confidence interval = 0.007 to 0.047]). With poor-quality built environment held at the level it would take under isolation at the 25th percentile, the direct effect of an interquartile increase in isolation was 0.022 (-0.001 to 0.042). Poor-quality built environment accounted for 35% (11% to 65%) of the total effect. Our methodology facilitates the estimation of additive-scale natural effects with binary outcomes. In this study, the total effect of racial segregation on preterm birth was partially mediated by poor-quality built environment.

On the characteristics of aerosol indirect effect based on dynamic regimes in global climate models

DOE PAGES

Zhang, Shipeng; Wang, Minghuai; Ghan, Steven J.; ...

2016-03-04

Aerosol–cloud interactions continue to constitute a major source of uncertainty for the estimate of climate radiative forcing. The variation of aerosol indirect effects (AIE) in climate models is investigated across different dynamical regimes, determined by monthly mean 500 hPa vertical pressure velocity ( ω 500), lower-tropospheric stability (LTS) and large-scale surface precipitation rate derived from several global climate models (GCMs), with a focus on liquid water path (LWP) response to cloud condensation nuclei (CCN) concentrations. The LWP sensitivity to aerosol perturbation within dynamic regimes is found to exhibit a large spread among these GCMs. It is in regimes of strongmore » large-scale ascent ( ω 500  <  −25 hPa day −1) and low clouds (stratocumulus and trade wind cumulus) where the models differ most. Shortwave aerosol indirect forcing is also found to differ significantly among different regimes. Shortwave aerosol indirect forcing in ascending regimes is close to that in subsidence regimes, which indicates that regimes with strong large-scale ascent are as important as stratocumulus regimes in studying AIE. It is further shown that shortwave aerosol indirect forcing over regions with high monthly large-scale surface precipitation rate (> 0.1 mm day −1) contributes the most to the total aerosol indirect forcing (from 64 to nearly 100 %). Results show that the uncertainty in AIE is even larger within specific dynamical regimes compared to the uncertainty in its global mean values, pointing to the need to reduce the uncertainty in AIE in different dynamical regimes.« less

Mediation misgivings: ambiguous clinical and public health interpretations of natural direct and indirect effects.

PubMed

Naimi, Ashley I; Kaufman, Jay S; MacLehose, Richard F

2014-10-01

Recent methodological innovation is giving rise to an increasing number of applied papers in medical and epidemiological journals in which natural direct and indirect effects are estimated. However, there is a longstanding debate on whether such effects are relevant targets of inference in population health. In light of the repeated calls for a more pragmatic and consequential epidemiology, we review three issues often raised in this debate: (i) the use of composite cross-world counterfactuals and the need for cross-world independence assumptions; (ii) interventional vs non-interventional identifiability; and (iii) the interpretational ambiguity of natural direct and indirect effect estimates. We use potential outcomes notation and directed acyclic graphs to explain 'cross-world' assumptions, illustrate implications of this assumption via regression models and discuss ensuing issues of interpretation. We argue that the debate on the relevance of natural direct and indirect effects rests on whether one takes as a target of inference the mathematical object per se, or the change in the world that the mathematical object represents. We further note that public health questions may be better served by estimating controlled direct effects. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makers.

PubMed

Barcelo, Alberto; Arredondo, Armando; Gordillo-Tobar, Amparo; Segovia, Johanna; Qiang, Anthony

2017-12-01

The financial implications of the increase in the prevalence of diabetes in middle-income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015. The study used a prevalence-based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015. Direct costs included health care expenditures such as medications (insulin and oral hypoglycemic agents), tests, consultations, hospitalizations, emergency visits and treating complications. Two different scenarios (S1 and S2) were used to analyze direct cost. S1 assumed conservative estimates while S2 assumed broader coverage of medication and services. Indirect costs included lost resources due to premature mortality, temporary and permanent disabilities. In 2015 over 41 million adults (20 years of age and more) were estimated to have Diabetes Mellitus in LAC. The total indirect cost attributed to Diabetes was US$ 57.1 billion, of which US$ 27.5 billion was due to premature mortality, US$16.2 billion to permanent disability, and US$ 13.3 billion to temporary disability. The total direct cost was estimated between US$ 45 and US$ 66 billion, of which the highest estimated cost was due to treatment of complications (US$ 1 616 to US$ 26 billion). Other estimates indicated the cost of insulin between US$ 6 and US$ 11 billion; oral medication US$ 4 to US$ 6 billion; consultations between US$ 5 and US$ 6 billion; hospitalization US$ 10 billion; emergency visits US$ 1 billion; test and laboratory exams between US$ 1 and US$ 3 million. The total cost of diabetes in 2015 in LAC was estimated to be between US$ 102 and US$ 123 billion. On average, the annual cost of treating one case of diabetes mellitus (DM) in LAC was estimated between US$ 1088 and US$ 1818. Per capita National Health Expenditures averaged US$ 1061 in LAC. Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision-making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC.

The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makers

PubMed Central

Barcelo, Alberto; Arredondo, Armando; Gordillo–Tobar, Amparo; Segovia, Johanna; Qiang, Anthony

2017-01-01

BACKGROUND The financial implications of the increase in the prevalence of diabetes in middle–income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015. METHODS The study used a prevalence–based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015. Direct costs included health care expenditures such as medications (insulin and oral hypoglycemic agents), tests, consultations, hospitalizations, emergency visits and treating complications. Two different scenarios (S1 and S2) were used to analyze direct cost. S1 assumed conservative estimates while S2 assumed broader coverage of medication and services. Indirect costs included lost resources due to premature mortality, temporary and permanent disabilities. RESULTS In 2015 over 41 million adults (20 years of age and more) were estimated to have Diabetes Mellitus in LAC. The total indirect cost attributed to Diabetes was US$ 57.1 billion, of which US$ 27.5 billion was due to premature mortality, US$16.2 billion to permanent disability, and US$ 13.3 billion to temporary disability. The total direct cost was estimated between US$ 45 and US$ 66 billion, of which the highest estimated cost was due to treatment of complications (US$ 1 616 to US$ 26 billion). Other estimates indicated the cost of insulin between US$ 6 and US$ 11 billion; oral medication US$ 4 to US$ 6 billion; consultations between US$ 5 and US$ 6 billion; hospitalization US$ 10 billion; emergency visits US$ 1 billion; test and laboratory exams between US$ 1 and US$ 3 million. The total cost of diabetes in 2015 in LAC was estimated to be between US$ 102 and US$ 123 billion. On average, the annual cost of treating one case of diabetes mellitus (DM) in LAC was estimated between US$ 1088 and US$ 1818. Per capita National Health Expenditures averaged US$ 1061 in LAC. CONCLUSIONS Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision–making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC. PMID:29163935

Efficient data assimilation algorithm for bathymetry application

NASA Astrophysics Data System (ADS)

Ghorbanidehno, H.; Lee, J. H.; Farthing, M.; Hesser, T.; Kitanidis, P. K.; Darve, E. F.

2017-12-01

Information on the evolving state of the nearshore zone bathymetry is crucial to shoreline management, recreational safety, and naval operations. The high cost and complex logistics of using ship-based surveys for bathymetry estimation have encouraged the use of remote sensing techniques. Data assimilation methods combine the remote sensing data and nearshore hydrodynamic models to estimate the unknown bathymetry and the corresponding uncertainties. In particular, several recent efforts have combined Kalman Filter-based techniques such as ensembled-based Kalman filters with indirect video-based observations to address the bathymetry inversion problem. However, these methods often suffer from ensemble collapse and uncertainty underestimation. Here, the Compressed State Kalman Filter (CSKF) method is used to estimate the bathymetry based on observed wave celerity. In order to demonstrate the accuracy and robustness of the CSKF method, we consider twin tests with synthetic observations of wave celerity, while the bathymetry profiles are chosen based on surveys taken by the U.S. Army Corps of Engineer Field Research Facility (FRF) in Duck, NC. The first test case is a bathymetry estimation problem for a spatially smooth and temporally constant bathymetry profile. The second test case is a bathymetry estimation problem for a temporally evolving bathymetry from a smooth to a non-smooth profile. For both problems, we compare the results of CSKF with those obtained by the local ensemble transform Kalman filter (LETKF), which is a popular ensemble-based Kalman filter method.

Estimation of Energy Expenditure Using a Patch-Type Sensor Module with an Incremental Radial Basis Function Neural Network

PubMed Central

Li, Meina; Kwak, Keun-Chang; Kim, Youn Tae

2016-01-01

Conventionally, indirect calorimetry has been used to estimate oxygen consumption in an effort to accurately measure human body energy expenditure. However, calorimetry requires the subject to wear a mask that is neither convenient nor comfortable. The purpose of our study is to develop a patch-type sensor module with an embedded incremental radial basis function neural network (RBFNN) for estimating the energy expenditure. The sensor module contains one ECG electrode and a three-axis accelerometer, and can perform real-time heart rate (HR) and movement index (MI) monitoring. The embedded incremental network includes linear regression (LR) and RBFNN based on context-based fuzzy c-means (CFCM) clustering. This incremental network is constructed by building a collection of information granules through CFCM clustering that is guided by the distribution of error of the linear part of the LR model. PMID:27669249

Implications of Middle School Behavior Problems for High School Graduation and Employment Outcomes of Young Adults: Estimation of a Recursive Model

PubMed Central

Karakus, Mustafa C.; Salkever, David S.; Slade, Eric P.; Ialongo, Nicholas; Stuart, Elizabeth

2013-01-01

The potentially serious adverse impacts of behavior problems during adolescence on employment outcomes in adulthood provide a key economic rationale for early intervention programs. However, the extent to which lower educational attainment accounts for the total impact of adolescent behavior problems on later employment remains unclear As an initial step in exploring this issue, we specify and estimate a recursive bivariate probit model that 1) relates middle school behavior problems to high school graduation and 2) models later employment in young adulthood as a function of these behavior problems and of high school graduation. Our model thus allows for both a direct effect of behavior problems on later employment as well as an indirect effect that operates via graduation from high school. Our empirical results, based on analysis of data from the NELS, suggest that the direct effects of externalizing behavior problems on later employment are not significant but that these problems have important indirect effects operating through high school graduation. PMID:23576834

Is CO2 emission a side effect of financial development? An empirical analysis for China.

PubMed

Hao, Yu; Zhang, Zong-Yong; Liao, Hua; Wei, Yi-Ming; Wang, Shuo

2016-10-01

Based on panel data for 29 Chinese provinces from 1995 to 2012, this paper explores the relationship between financial development and environmental quality in China. A comprehensive framework is utilized to estimate both the direct and indirect effects of financial development on CO 2 emissions in China using a carefully designed two-stage regression model. The first-difference and orthogonal-deviation Generalized Method of Moments (GMM) methods are used to control for potential endogeneity and introduce dynamics. To ensure the robustness of the estimations, two indicators measuring financial development-financial depth and financial efficiency-are used. The empirical results indicate that the direct effects of financial depth and financial efficiency on environmental quality are positive and negative, respectively. The indirect effects of both indicators are U shaped and dominate the shape of the total effects. These findings suggest that the influences of the financial development on environment depend on the level of economic development. At the early stage of economic growth, financial development is environmentally friendly. When the economy is highly developed, a higher level of financial development is harmful to the environmental quality.

A Real-Time Method for Estimating Viscous Forebody Drag Coefficients

NASA Technical Reports Server (NTRS)

Whitmore, Stephen A.; Hurtado, Marco; Rivera, Jose; Naughton, Jonathan W.

2000-01-01

This paper develops a real-time method based on the law of the wake for estimating forebody skin-friction coefficients. The incompressible law-of-the-wake equations are numerically integrated across the boundary layer depth to develop an engineering model that relates longitudinally averaged skin-friction coefficients to local boundary layer thickness. Solutions applicable to smooth surfaces with pressure gradients and rough surfaces with negligible pressure gradients are presented. Model accuracy is evaluated by comparing model predictions with previously measured flight data. This integral law procedure is beneficial in that skin-friction coefficients can be indirectly evaluated in real-time using a single boundary layer height measurement. In this concept a reference pitot probe is inserted into the flow, well above the anticipated maximum thickness of the local boundary layer. Another probe is servomechanism-driven and floats within the boundary layer. A controller regulates the position of the floating probe. The measured servomechanism position of this second probe provides an indirect measurement of both local and longitudinally averaged skin friction. Simulation results showing the performance of the control law for a noisy boundary layer are then presented.

A Comprehensive Estimation of the Economic Effects of Meteorological Services Based on the Input-Output Method

PubMed Central

Wu, Xianhua; Yang, Lingjuan; Guo, Ji; Lu, Huaguo; Chen, Yunfeng; Sun, Jian

2014-01-01

Concentrating on consuming coefficient, partition coefficient, and Leontief inverse matrix, relevant concepts and algorithms are developed for estimating the impact of meteorological services including the associated (indirect, complete) economic effect. Subsequently, quantitative estimations are particularly obtained for the meteorological services in Jiangxi province by utilizing the input-output method. It is found that the economic effects are noticeably rescued by the preventive strategies developed from both the meteorological information and internal relevance (interdependency) in the industrial economic system. Another finding is that the ratio range of input in the complete economic effect on meteorological services is about 1 : 108.27–1 : 183.06, remarkably different from a previous estimation based on the Delphi method (1 : 30–1 : 51). Particularly, economic effects of meteorological services are higher for nontraditional users of manufacturing, wholesale and retail trades, services sector, tourism and culture, and art and lower for traditional users of agriculture, forestry, livestock, fishery, and construction industries. PMID:24578666

A comprehensive estimation of the economic effects of meteorological services based on the input-output method.

PubMed

Wu, Xianhua; Wei, Guo; Yang, Lingjuan; Guo, Ji; Lu, Huaguo; Chen, Yunfeng; Sun, Jian

2014-01-01

Concentrating on consuming coefficient, partition coefficient, and Leontief inverse matrix, relevant concepts and algorithms are developed for estimating the impact of meteorological services including the associated (indirect, complete) economic effect. Subsequently, quantitative estimations are particularly obtained for the meteorological services in Jiangxi province by utilizing the input-output method. It is found that the economic effects are noticeably rescued by the preventive strategies developed from both the meteorological information and internal relevance (interdependency) in the industrial economic system. Another finding is that the ratio range of input in the complete economic effect on meteorological services is about 1 : 108.27-1 : 183.06, remarkably different from a previous estimation based on the Delphi method (1 : 30-1 : 51). Particularly, economic effects of meteorological services are higher for nontraditional users of manufacturing, wholesale and retail trades, services sector, tourism and culture, and art and lower for traditional users of agriculture, forestry, livestock, fishery, and construction industries.

Economic valuation of landslide damage in hilly regions: a case study from Flanders, Belgium.

PubMed

Vranken, Liesbet; Van Turnhout, Pieter; Van Den Eeckhaut, Miet; Vandekerckhove, Liesbeth; Poesen, Jean

2013-03-01

Several regions around the globe are at risk of incurring damage from landslides, but only few studies have concentrated on a quantitative estimate of the overall damage caused by landslides at a regional scale. This study therefore starts with a quantitative economic assessment of the direct and indirect damage caused by landslides in a 2,910 km study area located west of Brussels, a low-relief region susceptible to landslides. Based on focus interviews as well as on semi-structured interviews with homeowners, civil servants and the owners and providers of lifelines such as electricity and sewage, a quantitative damage assessment is provided. For private properties (houses, forest and pasture land) we estimate the real estate and production value losses for different damage scenarios, while for public infrastructure the costs of measures to repair and prevent landslide induced damage are estimated. In addition, the increase in amenity value of forests and grasslands due to the occurrence of landslides is also calculated. The study illustrates that a minority of land (only 2.3%) within the study area is used for dwellings, roads and railway lines, but that these land use types are responsible for the vast majority of the economic damage due to the occurrence of landslides. The annual cost of direct damage due to landsliding amounts to 688,148 €/year out of which 550,740 €/year for direct damage to houses, while the annual indirect damage augments to 3,020,049 €/year out of which 2,007,375 €/year for indirect damage to real estate. Next, the study illustrates that the increase of the amenity value of forests and grasslands outweighs the production value loss. As such the study does not only provide quantitative input data for the estimation of future risks, but also important information for government officials as it clearly informs about the costs associated with certain land use types in landslide areas. Copyright © 2013 Elsevier B.V. All rights reserved.

Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

PubMed

Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

2016-12-01

Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

Burden of disease associated with cervical cancer in malaysia and potential costs and consequences of HPV vaccination.

PubMed

Aljunid, S; Zafar, A; Saperi, S; Amrizal, M

2010-01-01

An estimated 70% of cervical cancers worldwide are attributable to persistent infection with human papillomaviruses (HPV) 16 and 18. Vaccination against HPV 16/18 has been shown to dramatically reduce the incidence of associated precancerous and cancerous lesions. The aims of the present analyses were, firstly, to estimate the clinical and economic burden of disease attributable to HPV in Malaysia and secondly, to estimate long-term outcomes associated with HPV vaccination using a prevalence-based modeling approach. In the first part of the analysis costs attributable to cervical cancer and precancerous lesions were estimated; epidemiologic data were sourced from the WHO GLOBOCAN database and Malaysian national data sources. In the second part, a prevalence-based model was used to estimate the potential annual number of cases of cervical cancer and precancerous lesions that could be prevented and subsequent HPV-related treatment costs averted with the bivalent (HPV 16/18) and the quadrivalent (HPV 16/18/6/11) vaccines, at the population level, at steady state. A vaccine efficacy of 98% was assumed against HPV types included in both vaccines. Effectiveness against other oncogenic HPV types was based on the latest results from each vaccine's respective clinical trials. In Malaysia there are an estimated 4,696 prevalent cases of cervical cancer annually and 1,372 prevalent cases of precancerous lesions, which are associated with a total direct cost of RM 39.2 million with a further RM 12.4 million in indirect costs owing to lost productivity. At steady state, vaccination with the bivalent vaccine was estimated to prevent 4,199 cervical cancer cases per year versus 3,804 cases for the quadrivalent vaccine. Vaccination with the quadrivalent vaccine was projected to prevent 1,721 cases of genital warts annually, whereas the annual number of cases remained unchanged with the bivalent vaccine. Furthermore, vaccination with the bivalent vaccine was estimated to avert RM 45.4 million in annual HPV-related treatment costs (direct+indirect) compared with RM 42.9 million for the quadrivalent vaccine. This analysis showed that vaccination against HPV 16/18 can reduce the clinical and economic burden of cervical cancer and precancerous lesions in Malaysia. The greatest potential economic benefit was observed using the bivalent vaccine in preference to the quadrivalent vaccine.

Improving PERSIANN-CCS rain estimation using probabilistic approach and multi-sensors information

NASA Astrophysics Data System (ADS)

Karbalaee, N.; Hsu, K. L.; Sorooshian, S.; Kirstetter, P.; Hong, Y.

2016-12-01

This presentation discusses the recent implemented approaches to improve the rainfall estimation from Precipitation Estimation from Remotely Sensed Information using Artificial Neural Network-Cloud Classification System (PERSIANN-CCS). PERSIANN-CCS is an infrared (IR) based algorithm being integrated in the IMERG (Integrated Multi-Satellite Retrievals for the Global Precipitation Mission GPM) to create a precipitation product in 0.1x0.1degree resolution over the chosen domain 50N to 50S every 30 minutes. Although PERSIANN-CCS has a high spatial and temporal resolution, it overestimates or underestimates due to some limitations.PERSIANN-CCS can estimate rainfall based on the extracted information from IR channels at three different temperature threshold levels (220, 235, and 253k). This algorithm relies only on infrared data to estimate rainfall indirectly from this channel which cause missing the rainfall from warm clouds and false estimation for no precipitating cold clouds. In this research the effectiveness of using other channels of GOES satellites such as visible and water vapors has been investigated. By using multi-sensors the precipitation can be estimated based on the extracted information from multiple channels. Also, instead of using the exponential function for estimating rainfall from cloud top temperature, the probabilistic method has been used. Using probability distributions of precipitation rates instead of deterministic values has improved the rainfall estimation for different type of clouds.

The Role of Light in the Emergence of Weeds: Using Camelina microcarpa as an Example.

PubMed

Royo-Esnal, Aritz; Gesch, Russell W; Forcella, Frank; Torra, Joel; Recasens, Jordi; Necajeva, Jevgenija

2015-01-01

When modelling the emergence of weeds, two main factors are considered that condition this process: temperature and soil moisture. Optimum temperature is necessary for metabolic processes that generate energy for growth, while turgor pressure is necessary for root and shoot elongation which eventually leads to seedling emergence from the soil. Most emergence models do not usually consider light as a residual factor, but it could have an important role as it can alter directly or indirectly the dormancy and germination of seeds. In this paper, inclusion of light as an additional factor to photoperiod and radiation in emergence models is explored and compared with the classical hydrothermal time (HTT) model using Camelina microcarpa as an example. HTT based on hourly estimates is also compared with that based on daily estimates. Results suggest that, although HTT based models are accurate enough for local applications, the precision of these models is improved when HTT is estimated hourly and solar radiation is included as a factor.

TU-D-209-04: How Useful Are Indirect Dose Metrics for Estimating Peak Skin Dose in Interventional Cardiology?

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

Jones, A; Pasciak, A

Purpose: The purpose of this study was to determine if a relationship between indirect dose metrics and PSD could be established for fluoroscopically-guided interventional cardiology procedures. Methods: PSD were measured directly using XR-RV3 radiochromic film for 94 consecutive fluoroscopically guided interventional cardiology procedures performed at two sites. Procedures were both diagnostic and therapeutic in nature. Radiation dose structured reports (RDSR) were collected for each procedure and used to calculate indirect estimates of PSD which were compared to the measured PSD. Reference air kerma (Ka,r) was also compared to the measured PSD. Pearson’s correlation coefficient was calculated for each metric andmore » metrics were compared to measured PSD using a two-tailed t-test. Data were log transformed prior to statistical analysis. Results: Both Ka,r and the calculated PSD were closely correlated with measured PSD at each sites (Ka,r: 0.92 and 0.86, indirect PSD: 0.91 and 0.88). At one site, neither Ka,r nor indirect PSD was significantly different from the measured PSD (p = 0.22 and p=0.054, respectively), while at the second site both Ka,r and indirect PSD were significantly higher than measured PSD (p<0.0001 and p<0.0001, respectively). In almost all cases, both Ka,r and indirect PSD overestimated the true PSD. Conclusions: The use of a range of gantry angles and table positions, along with variation in procedural imaging requirements, limits the utility of indirect dose metrics for predicting PSD for interventional cardiology procedures. A. Kyle Jones and Alexander S. Pasciak are owners of Fluoroscopic Safety, LLC.« less

Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil

PubMed Central

Novaes, Hillegonda Maria Dutilh; Itria, Alexander; Silva, Gulnar Azevedo e; Sartori, Ana Marli Christovam; Rama, Cristina Helena; de Soárez, Patrícia Coelho

2015-01-01

OBJECTIVE: To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil. METHODS: This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD. RESULTS: From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%. CONCLUSION: Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management. PMID:26017797

Indirect Genetic Effects and the Spread of Infectious Disease: Are We Capturing the Full Heritable Variation Underlying Disease Prevalence?

PubMed Central

Lipschutz-Powell, Debby; Woolliams, John A.; Bijma, Piter; Doeschl-Wilson, Andrea B.

2012-01-01

Reducing disease prevalence through selection for host resistance offers a desirable alternative to chemical treatment. Selection for host resistance has proven difficult, however, due to low heritability estimates. These low estimates may be caused by a failure to capture all the relevant genetic variance in disease resistance, as genetic analysis currently is not taylored to estimate genetic variation in infectivity. Host infectivity is the propensity of transmitting infection upon contact with a susceptible individual, and can be regarded as an indirect effect to disease status. It may be caused by a combination of physiological and behavioural traits. Though genetic variation in infectivity is difficult to measure directly, Indirect Genetic Effect (IGE) models, also referred to as associative effects or social interaction models, allow the estimation of this variance from more readily available binary disease data (infected/non-infected). We therefore generated binary disease data from simulated populations with known amounts of variation in susceptibility and infectivity to test the adequacy of traditional and IGE models. Our results show that a conventional model fails to capture the genetic variation in infectivity inherent in populations with simulated infectivity. An IGE model, on the other hand, does capture some of the variation in infectivity. Comparison with expected genetic variance suggests that there is scope for further methodological improvement, and that potential responses to selection may be greater than values presented here. Nonetheless, selection using an index of estimated direct and indirect breeding values was shown to have a greater genetic selection differential and reduced future disease risk than traditional selection for resistance only. These findings suggest that if genetic variation in infectivity substantially contributes to disease transmission, then breeding designs which explicitly incorporate IGEs might help reduce disease prevalence. PMID:22768088

Fusion of electromagnetic trackers to improve needle deflection estimation: simulation study.

PubMed

Sadjadi, Hossein; Hashtrudi-Zaad, Keyvan; Fichtinger, Gabor

2013-10-01

We present a needle deflection estimation method to anticipate needle bending during insertion into deformable tissue. Using limited additional sensory information, our approach reduces the estimation error caused by uncertainties inherent in the conventional needle deflection estimation methods. We use Kalman filters to combine a kinematic needle deflection model with the position measurements of the base and the tip of the needle taken by electromagnetic (EM) trackers. One EM tracker is installed on the needle base and estimates the needle tip position indirectly using the kinematic needle deflection model. Another EM tracker is installed on the needle tip and estimates the needle tip position through direct, but noisy measurements. Kalman filters are then employed to fuse these two estimates in real time and provide a reliable estimate of the needle tip position, with reduced variance in the estimation error. We implemented this method to compensate for needle deflection during simulated needle insertions and performed sensitivity analysis for various conditions. At an insertion depth of 150 mm, we observed needle tip estimation error reductions in the range of 28% (from 1.8 to 1.3 mm) to 74% (from 4.8 to 1.2 mm), which demonstrates the effectiveness of our method, offering a clinically practical solution.

Perception-based Impact upon Community Resilience in the Aftermath of Natural Disasters

NASA Astrophysics Data System (ADS)

Fernandez, S.; Li, H.

2008-05-01

In the event of natural disasters, recovery from the direct and indirect effects of the disaster phenomena are topics of most community emergency response plans. In addition to the direct and indirect impacts that represent changes in activity that can be tied directly to an event, additional perception-based impacts are possible. Usually these perception-based impacts are larger and more difficult to measure or mitigate than direct impacts. These impacts are based primarily on the affected population's changes in attitudes toward a particular neighborhood or region based on fear of a future event or future losses. These impacts can be motivated by fear of future storms or man-caused events, lingering toxic contamination that may or may not have been removed, and any other behavior by individuals that cannot be explained by actual events or calculated measures of risk or uncertainty. Perception-based impacts are often difficult to estimate directly. In many instaces, case studies of comparable events are used to attempt to develop judgemental estimates of possible future impacts on the area of question. For example, impacts from such events as Love Canal, the Three Mile Island nucear accident, the September 11 attacks, and the Goiana radioactive material spill are used to get a sense of the severity and duration of possible perception-based impacts of a particular event. Perception-based impacts can include additional losses in property value, losses in population (or reduced rates of population due to lower migration rates) that cannot be attributed to actual economic and demographic changes that can be tied to the event directly. Additional perception-based impacts can include long-term worker absenteeism by an asymptomatic public (i.e., the worried well), losses in tourism, losses in cargo at transportation hubs due to fears by shippers and recipients who choose alternative modes of transportation for shipping goods into the affected area. Another proxy for perception-based impacts from man-caused events can be additional security expenditures by government, the private sector, and individuals. This presentation will describe potential methodologies for estimating or anticipating these potential events for generic planning scenarios.

[Estimation with the capture-recapture method of the number of economic immigrants in Mallorca].

PubMed

Ramos Monserrat, M; March Cerdá, J C

2002-05-15

estimate the number of irregular economic immigrants in Mallorca. We used the capture-recapture method, an indirect method based on contrasts of data from two or more sources. Data were obtained from the Delegación de Gobierno (police and immigration authority), Comisiones Obreras (labor union), and institutions that provide health-related services to immigrants. Individuals were identified by birth date and country of origin. The total number of economic immigrants estimated with this method was 39 392. According to the Delegación de Gobierno data, the number of regular immigrants on the date of our inquiry was 9000. With the capture-recapture method, the number of irregular immigrants in Mallorca was therefore estimated at 30 000. The capture-recapture method can be useful to estimate the population of irregular immigrants in a given area at a given time, if sufficiently precise information on the identity of each individual can be obtained.

Effect of adalimumab on work productivity and indirect costs in moderate to severe Crohn’s disease: A meta-analysis

PubMed Central

Binion, David G; Louis, Edouard; Oldenburg, Bas; Mulani, Parvez; Bensimon, Arielle G; Yang, Mei; Chao, Jingdong

2011-01-01

OBJECTIVE: To assess the effect of adalimumab on work productivity and indirect costs in patients with Crohn’s disease (CD) using a meta-analysis of clinical trials. METHODS: Study-level results were pooled from all clinical trials of adalimumab for moderate to severe CD in which work productivity outcomes were evaluated. Work Productivity and Activity Impairment Questionnaire outcomes (absenteeism, presenteeism and total work productivity impairment [TWPI]) were extracted from adalimumab trials. Meta-analyses were used to estimate pooled averages and 95% CIs of one-year accumulated reductions in work productivity impairment with adalimumab. Pooled averages were multiplied by the 2008 United States national average annual salary ($44,101) to estimate per-patient indirect cost savings during the year following adalimumab initiation. RESULTS: The four included trials (ACCESS, CARE, CHOICE and EXTEND) represented a total of 1202 employed adalimumab-treated patients at baseline. Each study followed patients for a minimum of 20 weeks. Pooled estimates (95% CIs) of one-year accumulated work productivity improvements were as follows: −9% (−10% to −7%) for absenteeism; −22% (−26% to −18%) for presenteeism; and −25% (−30% to −20%) for TWPI. Reductions in absenteeism and TWPI translated into per-patient indirect cost savings (95% CI) of $3,856 ($3,183 to $4,529) and $10,964 ($8,833 to $13,096), respectively. CONCLUSION: Adalimumab provided clinically meaningful improvements in work productivity among patients with moderate to severe CD, which may translate into substantial indirect cost savings from an employer’s perspective. PMID:21912760

The Effect of Environmental Regulation on Employment in Resource-Based Areas of China-An Empirical Research Based on the Mediating Effect Model.

PubMed

Cao, Wenbin; Wang, Hui; Ying, Huihui

2017-12-19

While environmental pollution is becoming more and more serious, many countries are adopting policies to control pollution. At the same time, the environmental regulation will inevitably affect economic and social development, especially employment growth. The environmental regulation will not only affect the scale of employment directly, but it will also have indirect effects by stimulating upgrades in the industrial structure and in technological innovation. This paper examines the impact of environmental regulation on employment, using a mediating model based on the data from five typical resource-based provinces in China from 2000 to 2015. The estimation is performed based on the system GMM (Generalized Method of Moments) estimator. The results show that the implementation of environmental regulation in resource-based areas has both a direct effect and a mediating effect on employment. These findings provide policy implications for these resource-based areas to promote the coordinating development between the environment and employment.

The Effect of Environmental Regulation on Employment in Resource-Based Areas of China—An Empirical Research Based on the Mediating Effect Model

PubMed Central

Cao, Wenbin; Wang, Hui; Ying, Huihui

2017-01-01

While environmental pollution is becoming more and more serious, many countries are adopting policies to control pollution. At the same time, the environmental regulation will inevitably affect economic and social development, especially employment growth. The environmental regulation will not only affect the scale of employment directly, but it will also have indirect effects by stimulating upgrades in the industrial structure and in technological innovation. This paper examines the impact of environmental regulation on employment, using a mediating model based on the data from five typical resource-based provinces in China from 2000 to 2015. The estimation is performed based on the system GMM (Generalized Method of Moments) estimator. The results show that the implementation of environmental regulation in resource-based areas has both a direct effect and a mediating effect on employment. These findings provide policy implications for these resource-based areas to promote the coordinating development between the environment and employment. PMID:29257068

A computer-based matrix for rapid calculation of pulmonary hemodynamic parameters in congenital heart disease

PubMed Central

Lopes, Antonio Augusto; dos Anjos Miranda, Rogério; Gonçalves, Rilvani Cavalcante; Thomaz, Ana Maria

2009-01-01

BACKGROUND: In patients with congenital heart disease undergoing cardiac catheterization for hemodynamic purposes, parameter estimation by the indirect Fick method using a single predicted value of oxygen consumption has been a matter of criticism. OBJECTIVE: We developed a computer-based routine for rapid estimation of replicate hemodynamic parameters using multiple predicted values of oxygen consumption. MATERIALS AND METHODS: Using Microsoft® Excel facilities, we constructed a matrix containing 5 models (equations) for prediction of oxygen consumption, and all additional formulas needed to obtain replicate estimates of hemodynamic parameters. RESULTS: By entering data from 65 patients with ventricular septal defects, aged 1 month to 8 years, it was possible to obtain multiple predictions for oxygen consumption, with clear between-age groups (P <.001) and between-methods (P <.001) differences. Using these predictions in the individual patient, it was possible to obtain the upper and lower limits of a likely range for any given parameter, which made estimation more realistic. CONCLUSION: The organized matrix allows for rapid obtainment of replicate parameter estimates, without error due to exhaustive calculations. PMID:19641642

Estimating population sizes for elusive animals: the forest elephants of Kakum National Park, Ghana.

PubMed

Eggert, L S; Eggert, J A; Woodruff, D S

2003-06-01

African forest elephants are difficult to observe in the dense vegetation, and previous studies have relied upon indirect methods to estimate population sizes. Using multilocus genotyping of noninvasively collected samples, we performed a genetic survey of the forest elephant population at Kakum National Park, Ghana. We estimated population size, sex ratio and genetic variability from our data, then combined this information with field observations to divide the population into age groups. Our population size estimate was very close to that obtained using dung counts, the most commonly used indirect method of estimating the population sizes of forest elephant populations. As their habitat is fragmented by expanding human populations, management will be increasingly important to the persistence of forest elephant populations. The data that can be obtained from noninvasively collected samples will help managers plan for the conservation of this keystone species.

Assessment of indirect losses and costs of emergency for project planning of alpine hazard mitigation

NASA Astrophysics Data System (ADS)

Amenda, Lisa; Pfurtscheller, Clemens

2013-04-01

By virtue of augmented settling in hazardous areas and increased asset values, natural disasters such as floods, landslides and rockfalls cause high economic losses in Alpine lateral valleys. Especially in small municipalities, indirect losses, mainly stemming from a breakdown of transport networks, and costs of emergency can reach critical levels. A quantification of these losses is necessary to estimate the worthiness of mitigation measures, to determine the appropriate level of disaster assistance and to improve risk management strategies. There are comprehensive approaches available for assessing direct losses. However, indirect losses and costs of emergency are widely not assessed and the empirical basis for estimating these costs is weak. To address the resulting uncertainties of project appraisals, a standardized methodology has been developed dealing with issues of local economic effects and emergency efforts needed. In our approach, the cost-benefit-analysis for technical mitigation of the Austrian Torrent and Avalanche Control (TAC) will be optimized and extended using the 2005-debris flow as a design event, which struggled a small town in the upper Inn valley in southwest Tyrol (Austria). Thereby, 84 buildings were affected, 430 people were evacuated and due to this, the TAC implemented protection measures for 3.75 million Euros. Upgrading the method of the TAC and analyzing to what extent the cost-benefit-ratio is about to change, is one of the main objectives of this study. For estimating short-run indirect effects and costs of emergency on the local level, data was collected via questionnaires, field mapping, guided interviews, as well as intense literature research. According to this, up-to-date calculation methods were evolved and the cost-benefit-analysis of TAC was recalculated with these new-implemented results. The cost-benefit-ratio will be more precise and specific and hence, the decision, which mitigation alternative will be carried out. Based on this, the worthiness of the mitigation measures can be determined in more detail and the proper level of emergency assistance can be calculated more adequately. By dint of this study, a better data basis will be created evaluating technical and non-technical mitigation measures, which is useful for government agencies, insurance companies and research.

Satellite Remote Sensing of Aerosol Forcing

NASA Technical Reports Server (NTRS)

Remer, Lorraine; Kaufman, Yoram; Ramaprasad, Jaya; Procopio, Aline; Levin, Zev

1999-01-01

The role of aerosol forcing remains one of the largest uncertainties in estimating man's impact on the global climate system. One school of thought suggests that remote sensing by satellite sensors will provide the data necessary to narrow these uncertainties. While satellite measurements of direct aerosol forcing appear to be straightforward, satellite measurements of aerosol indirect forcing will be more complicated. Pioneering studies identified indirect aerosol forcing using AVHRR data in the biomass burning regions of Brazil. We have expanded this analysis with AVHRR to include an additional year of data and assimilated water vapor fields. The results show similar latitudinal dependence as reported by Kaufman and Fraser, but by using water vapor observations we conclude that latitude is not a proxy for water vapor and the strength of the indirect effect is not correlated to water vapor amounts. In addition to the AVHRR study we have identified indirect aerosol forcing in Brazil at much smaller spatial scales using the MODIS Airborne Simulator. The strength of the indirect effect appears to be related to cloud type and cloud dynamics. There is a suggestion that some of the cloud dynamics may be influenced by smoke destabilization of the atmospheric column. Finally, this study attempts to quantify remote sensing limitations due to the accuracy limits of the retrieval algorithms. We use a combination of numerical aerosol transport models, ground-based AERONET data and ISCCP cloud climatology to determine how much of the forcing occurs in regions too clean to determine from satellite retrievals.

Evaluation of Direct and Indirect Methods of Sub-Neoglottic Pressure Measurement in Tracheoesophageal Speakers: A Systematic Review and Meta-Analysis.

PubMed

Sheela, Shekaraiah; Aithal, Venkataraja U; Rajashekhar, Bellur; Lewis, Melissa Glenda

2016-01-01

Tracheoesophageal (TE) prosthetic voice is one of the voice restoration options for individuals who have undergone a total laryngectomy. Aerodynamic analysis of the TE voice provides insight into the physiological changes that occur at the level of the neoglottis with voice prosthesis in situ. The present study is a systematic review and meta-analysis of sub-neoglottic pressure (SNP) measurement in TE speakers by direct and indirect methods. The screening of abstracts and titles was carried out for inclusion of articles using 10 electronic databases spanning the period from 1979 to 2016. Ten articles which met the inclusion criteria were considered for meta-analysis with a pooled age range of 40-83 years. The pooled mean SNP obtained from the direct measurement method was 53.80 cm H2O with a 95% confidence interval of 21.14-86.46 cm H2O, while for the indirect measurement method, the mean SNP was 23.55 cm H2O with a 95% confidence interval of 19.23-27.87 cm H2O. Based on the literature review, the various procedures followed for direct and indirect measurements of SNP contributed to a range of differences in outcome measures. The meta-analysis revealed that the "interpolation method" for indirect estimation of SNP was the most acceptable and valid method in TE speakers. © 2017 S. Karger AG, Basel.

Causal mediation analysis with multiple causally non-ordered mediators.

PubMed

Taguri, Masataka; Featherstone, John; Cheng, Jing

2018-01-01

In many health studies, researchers are interested in estimating the treatment effects on the outcome around and through an intermediate variable. Such causal mediation analyses aim to understand the mechanisms that explain the treatment effect. Although multiple mediators are often involved in real studies, most of the literature considered mediation analyses with one mediator at a time. In this article, we consider mediation analyses when there are causally non-ordered multiple mediators. Even if the mediators do not affect each other, the sum of two indirect effects through the two mediators considered separately may diverge from the joint natural indirect effect when there are additive interactions between the effects of the two mediators on the outcome. Therefore, we derive an equation for the joint natural indirect effect based on the individual mediation effects and their interactive effect, which helps us understand how the mediation effect works through the two mediators and relative contributions of the mediators and their interaction. We also discuss an extension for three mediators. The proposed method is illustrated using data from a randomized trial on the prevention of dental caries.

Predicting the Impact of Vaccination on the Transmission Dynamics of Typhoid in South Asia: A Mathematical Modeling Study

PubMed Central

Pitzer, Virginia E.; Bowles, Cayley C.; Baker, Stephen; Kang, Gagandeep; Balaji, Veeraraghavan; Farrar, Jeremy J.; Grenfell, Bryan T.

2014-01-01

Background Modeling of the transmission dynamics of typhoid allows for an evaluation of the potential direct and indirect effects of vaccination; however, relevant typhoid models rooted in data have rarely been deployed. Methodology/Principal Findings We developed a parsimonious age-structured model describing the natural history and immunity to typhoid infection. The model was fit to data on culture-confirmed cases of typhoid fever presenting to Christian Medical College hospital in Vellore, India from 2000–2012. The model was then used to evaluate the potential impact of school-based vaccination strategies using live oral, Vi-polysaccharide, and Vi-conjugate vaccines. The model was able to reproduce the incidence and age distribution of typhoid cases in Vellore. The basic reproductive number (R 0) of typhoid was estimated to be 2.8 in this setting. Vaccination was predicted to confer substantial indirect protection leading to a decrease in the incidence of typhoid in the short term, but (intuitively) typhoid incidence was predicted to rebound 5–15 years following a one-time campaign. Conclusions/Significance We found that model predictions for the overall and indirect effects of vaccination depend strongly on the role of chronic carriers in transmission. Carrier transmissibility was tentatively estimated to be low, consistent with recent studies, but was identified as a pivotal area for future research. It is unlikely that typhoid can be eliminated from endemic settings through vaccination alone. PMID:24416466

Indirect monitoring shot-to-shot shock waves strength reproducibility during pump–probe experiments

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

Pikuz, T. A., E-mail: tatiana.pikuz@eie.eng.osaka-u.ac.jp; Photon Pioneers Center, Osaka University, Suita, Osaka 565-0871 Japan; Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412

We present an indirect method of estimating the strength of a shock wave, allowing on line monitoring of its reproducibility in each laser shot. This method is based on a shot-to-shot measurement of the X-ray emission from the ablated plasma by a high resolution, spatially resolved focusing spectrometer. An optical pump laser with energy of 1.0 J and pulse duration of ∼660 ps was used to irradiate solid targets or foils with various thicknesses containing Oxygen, Aluminum, Iron, and Tantalum. The high sensitivity and resolving power of the X-ray spectrometer allowed spectra to be obtained on each laser shot and tomore » control fluctuations of the spectral intensity emitted by different plasmas with an accuracy of ∼2%, implying an accuracy in the derived electron plasma temperature of 5%–10% in pump–probe high energy density science experiments. At nano- and sub-nanosecond duration of laser pulse with relatively low laser intensities and ratio Z/A ∼ 0.5, the electron temperature follows T{sub e} ∼ I{sub las}{sup 2/3}. Thus, measurements of the electron plasma temperature allow indirect estimation of the laser flux on the target and control its shot-to-shot fluctuation. Knowing the laser flux intensity and its fluctuation gives us the possibility of monitoring shot-to-shot reproducibility of shock wave strength generation with high accuracy.« less

TOTALL: high cost of allergic rhinitis-a national Swedish population-based questionnaire study.

PubMed

Cardell, Lars-Olaf; Olsson, Petter; Andersson, Morgan; Welin, Karl-Olof; Svensson, Johanna; Tennvall, Gunnel Ragnarson; Hellgren, Johan

2016-02-04

Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18-65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society.

The relationship of the lunar regolith less than 10 micrometer fraction and agglutinates. I - A model for agglutinate formation and some indirect supportive evidence

NASA Technical Reports Server (NTRS)

Papike, J. J.; Simon, S. B.; White, C.; Laul, J. C.

1982-01-01

The first part of a study of the 'less than 10 micrometer' soil fraction and agglutinates is concerned with the chemical systematics of the considered fraction of lunar soils, taking into account a model for agglutinate formation based on the fusion of the finest fraction (FFF). Attention is given to some evidence which supports the FFF model. The evidence is based on some indirect approaches to an estimation of the composition of the fused soil component. It is found that the 'less than 10 micrometer' soil fraction from all Apollo sites except Apollo 16 (which can be explained) is more feldspathic and enriched in incompatible elements (e.g., K and Th) than the bulk soil. It is concluded that these systematics result from simple comminution in which feldspar breaks down to finer sizes than pyroxene and olivine and the fine-grained incompatible-element-enriched mesostasis concentrates in the 'less than 10 micrometer' soil fraction.

[Development of an Excel spreadsheet for meta-analysis of indirect and mixed treatment comparisons].

PubMed

Tobías, Aurelio; Catalá-López, Ferrán; Roqué, Marta

2014-01-01

Meta-analyses in clinical research usually aimed to evaluate treatment efficacy and safety in direct comparison with a unique comparator. Indirect comparisons, using the Bucher's method, can summarize primary data when information from direct comparisons is limited or nonexistent. Mixed comparisons allow combining estimates from direct and indirect comparisons, increasing statistical power. There is a need for simple applications for meta-analysis of indirect and mixed comparisons. These can easily be conducted using a Microsoft Office Excel spreadsheet. We developed a spreadsheet for indirect and mixed effects comparisons of friendly use for clinical researchers interested in systematic reviews, but non-familiarized with the use of more advanced statistical packages. The use of the proposed Excel spreadsheet for indirect and mixed comparisons can be of great use in clinical epidemiology to extend the knowledge provided by traditional meta-analysis when evidence from direct comparisons is limited or nonexistent.

Space structures insulating material's thermophysical and radiation properties estimation

NASA Astrophysics Data System (ADS)

Nenarokomov, A. V.; Alifanov, O. M.; Titov, D. M.

2007-11-01

In many practical situations in aerospace technology it is impossible to measure directly such properties of analyzed materials (for example, composites) as thermal and radiation characteristics. The only way that can often be used to overcome these difficulties is indirect measurements. This type of measurement is usually formulated as the solution of inverse heat transfer problems. Such problems are ill-posed in mathematical sense and their main feature shows itself in the solution instabilities. That is why special regularizing methods are needed to solve them. The experimental methods of identification of the mathematical models of heat transfer based on solving the inverse problems are one of the modern effective solving manners. The objective of this paper is to estimate thermal and radiation properties of advanced materials using the approach based on inverse methods.

Modeling the cost-effectiveness of infant vaccination with pneumococcal conjugate vaccines in Germany.

PubMed

Kuhlmann, Alexander; von der Schulenburg, J-Matthias Graf

2017-04-01

In 2009, the European Medicines Agency granted approval for two higher-valent pneumococcal conjugate vaccines. This study aims to evaluate the cost-effectiveness of universal infant (<2 years old) vaccination with a 13-valent pneumococcal conjugate vaccine (PCV13) in comparison with a 10-valent pneumococcal conjugate vaccine (PCV10) for the prevention of pneumococcal disease in Germany. A population-based Markov model was developed to estimate the impact of PCV13 and PCV10 on invasive pneumococcal disease (IPD), non-invasive pneumonia (PNE), and acute otitis media (AOM) over a time horizon of 50 years. The model included the effects of the historical vaccination scheme in infants as well as indirect herd effects and replacement disease. We used German epidemiological data to calculate episodes of IPD, PNE, and AOM, as well as direct and indirect effects of the vaccination. Parameter uncertainty was tested in univariate and probabilistic sensitivity analyses. In the base-case analysis, the ICER of PCV13 versus PCV10 infant vaccination was EUR 9826 per quality-adjusted life-year (QALY) gained or EUR 5490 per life-year (LY) gained from the societal perspective and EUR 3368 per QALY gained or EUR 1882 per LY gained from the perspective of the German statutory health insurance. The results were particularly sensitive to the magnitude of indirect effects of both vaccines. Universal infant vaccination with PCV13 is likely to be a cost-effective intervention compared with PCV10 within the German health care system, if additional net indirect effects of PCV13 vaccination are significant.

The cost of vision loss in Canada. 1. Methodology.

PubMed

Gordon, Keith D; Cruess, Alan F; Bellan, Lorne; Mitchell, Scott; Pezzullo, M Lynne

2011-08-01

This paper outlines the methodology used to estimate the cost of vision loss in Canada. The results of this study will be presented in a second paper. The cost of vision loss (VL) in Canada was estimated using a prevalence-based approach. This was done by estimating the number of people with VL in a base period (2007) and the costs associated with treating them. The cost estimates included direct health system expenditures on eye conditions that cause VL, as well as other indirect financial costs such as productivity losses. Estimates were also made of the value of the loss of healthy life, measured in Disability Adjusted Life Years or DALY's. To estimate the number of cases of VL in the population, epidemiological data on prevalence rates were applied to population data. The number of cases of VL was stratified by gender, age, ethnicity, severity and cause. The following sources were used for estimating prevalence: Population-based eye studies; Canadian Surveys; Canadian journal articles and research studies; and International Population Based Eye Studies. Direct health costs were obtained primarily from Health Canada and Canadian Institute for Health Information (CIHI) sources, while costs associated with productivity losses were based on employment information compiled by Statistics Canada and on economic theory of productivity loss. Costs related to vision rehabilitation (VR) were obtained from Canadian VR organizations. This study shows that it is possible to estimate the costs for VL for a country in the absence of ongoing local epidemiological studies. Copyright © 2011 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Indirect selection of industrial tomato genotypes that are resistant to spider mites (Tetranychus urticae).

PubMed

Baier, J E; Resende, J T V; Faria, M V; Schwarz, K; Meert, L

2015-01-16

Acyl sugars present in the tomato Solanum lycopersicum 'LA-716' accession confer good levels of resistance to arthropod pests. The objective of the present study was to select F₂ plants from the interspecific cross Solanum pennellii 'LA-716' x Solanum lycopersicum 'Redenção' to assess resistance to spider mites (Tetranychus urticae) based on the leaf acyl sugar content and repellence tests. Four genotypes were selected with high leaflet acyl sugar content (RVTA-2010 pl#31, RVTA-2010 pl#75, RVTA-2010 pl#83, and RVTA-2010 pl#94), and an additional three genotypes with low acyl sugar content were also selected (RVTA-2010 pl#33, RVTA-2010 pl#39, and RVTA-2010 pl#73). The results from the in vivo tests used to confirm the selection of plants resistant to mites indicated that the genotypes with high acyl sugars content did not differ from the resistant parent LA-716. The negative correlation between acyl sugar content and the distance run by the mite along the leaflet surface confirmed the association between high and low allelochemical content and resistance. The medium degree of dominance (MDD) was estimated (MDD = -0.83), indicating that the high acyl sugar content was due to incomplete dominance of a recessive allele. A value of 81.85% was found for the broad sense heritability estimate, which suggests that most among-plant variation in the F2 generation is genetically based. Furthermore, 0.69 genes were estimated, which presumably confirms monogenic inheritance. Thus, indirect selection was an efficient method used to obtain industrial tomato plants that are resistant to spider mites.

Petroleum Refinery Jobs and Economic Development Impact (JEDI) Model User Reference Guide

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

Goldberg, Marshall

The Jobs and Economic Development Impact (JEDI) models, developed through the National Renewable Energy Laboratory (NREL), are user-friendly tools utilized to estimate the economic impacts at the local level of constructing and operating fuel and power generation projects for a range of conventional and renewable energy technologies. The JEDI Petroleum Refinery Model User Reference Guide was developed to assist users in employing and understanding the model. This guide provides information on the model's underlying methodology, as well as the parameters and references used to develop the cost data utilized in the model. This guide also provides basic instruction on modelmore » add-in features, operation of the model, and a discussion of how the results should be interpreted. Based on project-specific inputs from the user, the model estimates job creation, earning and output (total economic activity) for a given petroleum refinery. This includes the direct, indirect and induced economic impacts to the local economy associated with the refinery's construction and operation phases. Project cost and job data used in the model are derived from the most current cost estimations available. Local direct and indirect economic impacts are estimated using economic multipliers derived from IMPLAN software. By determining the regional economic impacts and job creation for a proposed refinery, the JEDI Petroleum Refinery model can be used to field questions about the added value refineries may bring to the local community.« less

An analysis of indirect genetic effects on adult body weight of the Pacific white shrimp Litopenaeus vannamei at low rearing density.

PubMed

Luan, Sheng; Luo, Kun; Chai, Zhan; Cao, Baoxiang; Meng, Xianhong; Lu, Xia; Liu, Ning; Xu, Shengyu; Kong, Jie

2015-12-14

Our aim was to estimate the genetic parameters for the direct genetic effect (DGE) and indirect genetic effects (IGE) on adult body weight in the Pacific white shrimp. IGE is the heritable effect of an individual on the trait values of its group mates. To examine IGE on body weight, 4725 shrimp from 105 tagged families were tested in multiple small test groups (MSTG). Each family was separated into three groups (15 shrimp per group) that were randomly assigned to 105 concrete tanks with shrimp from two other families. To estimate breeding values, one large test group (OLTG) in a 300 m(2) circular concrete tank was used for the communal rearing of 8398 individuals from 105 families. Body weight was measured after a growth-test period of more than 200 days. Variance components for body weight in the MSTG programs were estimated using an animal model excluding or including IGE whereas variance components in the OLTG programs were estimated using a conventional animal model that included only DGE. The correlation of DGE between MSTG and OLTG programs was estimated by a two-trait animal model that included or excluded IGE. Heritability estimates for body weight from the conventional animal model in MSTG and OLTG programs were 0.26 ± 0.13 and 0.40 ± 0.06, respectively. The log likelihood ratio test revealed significant IGE on body weight. Total heritable variance was the sum of direct genetic variance (43.5%), direct-indirect genetic covariance (2.1%), and indirect genetic variance (54.4%). It represented 73% of the phenotypic variance and was more than two-fold greater than that (32%) obtained by using a classical heritability model for body weight. Correlations of DGE on body weight between MSTG and OLTG programs were intermediate regardless of whether IGE were included or not in the model. Our results suggest that social interactions contributed to a large part of the heritable variation in body weight. Small and non-significant direct-indirect genetic correlations implied that neutral or slightly cooperative heritable interactions, rather than competition, were dominant in this population but this may be due to the low rearing density.

Alternative Statistical Frameworks for Student Growth Percentile Estimation

ERIC Educational Resources Information Center

Lockwood, J. R.; Castellano, Katherine E.

2015-01-01

This article suggests two alternative statistical approaches for estimating student growth percentiles (SGP). The first is to estimate percentile ranks of current test scores conditional on past test scores directly, by modeling the conditional cumulative distribution functions, rather than indirectly through quantile regressions. This would…

An Indirect System Identification Technique for Stable Estimation of Continuous-Time Parameters of the Vestibulo-Ocular Reflex (VOR)

NASA Technical Reports Server (NTRS)

Kukreja, Sunil L.; Wallin, Ragnar; Boyle, Richard D.

2013-01-01

The vestibulo-ocular reflex (VOR) is a well-known dual mode bifurcating system that consists of slow and fast modes associated with nystagmus and saccade, respectively. Estimation of continuous-time parameters of nystagmus and saccade models are known to be sensitive to estimation methodology, noise and sampling rate. The stable and accurate estimation of these parameters are critical for accurate disease modelling, clinical diagnosis, robotic control strategies, mission planning for space exploration and pilot safety, etc. This paper presents a novel indirect system identification method for the estimation of continuous-time parameters of VOR employing standardised least-squares with dual sampling rates in a sparse structure. This approach permits the stable and simultaneous estimation of both nystagmus and saccade data. The efficacy of this approach is demonstrated via simulation of a continuous-time model of VOR with typical parameters found in clinical studies and in the presence of output additive noise.

Healthcare resource use, direct and indirect costs of hypoglycemia in type 1 and type 2 diabetes, and nationwide projections. Results of the HYPOS-1 study.

PubMed

Giorda, C B; Rossi, M C; Ozzello, O; Gentile, S; Aglialoro, A; Chiambretti, A; Baccetti, F; Gentile, F M; Romeo, F; Lucisano, G; Nicolucci, A

2017-03-01

To obtain an accurate picture of the total costs of hypoglycemia, including the indirect costs and comparing the differences between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). HYPOS-1 was a multicenter, retrospective cohort study which analyzed the data of 2229 consecutive patients seen at 18 diabetes clinics. Data on healthcare resource use and indirect costs by diabetes type were collected via a questionnaire. The domains of inpatient admission and hospital stay, work days lost, and third-party assistance were also explored. Resource utilization was reported as estimated incidence rates (IRs) of hypoglycemic episodes per 100 person-years and estimated costs as IRs per person-years. For every 100 patients with T1DM, 9 emergency room (ER) visits and 6 emergency medical service calls for hypoglycemia were required per year; for every 100 patients with T2DM, 3 ER visits and 1 inpatient admission were required, with over 3 nights spent in hospital. Hypoglycemia led to 58 work days per 100 person-years lost by the patient or a family member in T1DM versus 19 in T2DM. The costs in T1DM totaled €90.99 per person-year and €62.04 in T2DM. Direct and indirect costs making up the total differed by type of diabetes (60% indirect costs in T1DM versus 43% in T2DM). The total cost associated with hypoglycemia in Italy is estimated to be €107 million per year. Indirect costs meaningfully contribute to the total costs associated with hypoglycemia. As compared with T1DM, T2DM requires fewer ER visits and incurs lower indirect costs but more frequent hospital use. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Estimating the probability of spontaneous abortion in the presence of induced abortion and vice versa.

PubMed Central

Hammerslough, C R

1992-01-01

An integrated approach to estimate the total number of pregnancies that begin in a population during one calendar year and the probability of spontaneous abortion is described. This includes an indirect estimate of the number of pregnancies that result in spontaneous abortions. The method simultaneously takes into account the proportion of induced abortions that are censored by spontaneous abortions and vice versa in order to estimate the true annual number of spontaneous and induced abortions for a population. It also estimates the proportion of pregnancies that women intended to allow to continue to a live birth. The proposed indirect approach derives adjustment factors to make indirect estimates by combining vital statistics information on gestational age at induced abortion (from the 12 States that report to the National Center for Health Statistics) with a life table of spontaneous abortion probabilities. The adjustment factors are applied to data on induced abortions from the Alan Guttmacher Institute Abortion Provider Survey and data on births from U.S. vital statistics. For the United States in 1980 the probability of a spontaneous abortion is 19 percent, given the presence of induced abortion. Once the effects of spontaneous abortion are discounted, women in 1980 intended to allow 73 percent of their pregnancies to proceed to a live birth. One medical benefit to a population practicing induced abortion is that induced abortions avert some spontaneous abortions, leading to a lower mean gestational duration at the time of spontaneous abortion. PMID:1594736

Socioeconomic impact of osteoarthritis in Hong Kong: utilization of health and social services, and direct and indirect costs.

PubMed

Woo, Jean; Lau, Edith; Lau, Chak Sing; Lee, Polly; Zhang, James; Kwok, Timothy; Chan, Cynthia; Chiu, P; Chan, Kai Ming; Chan, A; Lam, D

2003-08-15

To determine the direct and indirect cost of osteoarthritis (OA) according to disease severity, and to estimate the total cost of the disease in Hong Kong. This study is a retrospective, cross-sectional, nonrandom, cohort design, with subjects stratified according to disease severity based on functional limitation and the presence or absence of joint prosthesis. Subjects were recruited from primary care, geriatric medicine, rheumatology, and orthopedic clinics. There were 219 patients in the mild disease category, 290 patients in the severe category, and 65 patients with joint replacement. A questionnaire gathered information on demographic and socioeconomic characteristics, function limitation, use of health and social services, and effect on occupation and living arrangements over the previous 12 months. Costs were calculated as direct and indirect. Low education and socioeconomic class were associated with more severe disease. OA affected family or close relationships in 44%. The average cost incurred as a result of side effects of medication is similar to the average cost of medication itself. Excluding joint replacement, the direct costs ranged from Hong Kong (HK) dollar $11,690 to $40,180 per person per year and indirect costs, HK $3,300-$6,640. The direct costs are comparable to those reported in Western countries; however, the ratio of direct to indirect costs is much higher than 1, in contrast to the greater indirect versus direct costs reported in whites. The total cost expressed as a percentage of gross national product is also much lower in Hong Kong. The socioeconomic impact of OA in the Hong Kong population is comparable to Western countries, but the economic burden is largely placed on the government, with patients having relatively low out-of-pocket expenditures.

Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: a protocol for a prospective observational study.

PubMed

Chan, Jocelyn; Nguyen, Cattram D; Lai, Jana Y R; Dunne, Eileen M; Andrews, Ross; Blyth, Christopher C; Datta, Siddhartha; Fox, Kim; Ford, Rebecca; Hinds, Jason; La Vincente, Sophie; Lehmann, Deborah; Lim, Ruth; Mungun, Tuya; Newton, Paul N; Phetsouvanh, Rattanaphone; Pomat, Willam S; Xeuatvongsa, Anonh; von Mollendorf, Claire; Dance, David A B; Satzke, Catherine; Muholland, Kim; Russell, Fiona M

2018-05-18

Pneumococcal conjugate vaccines (PCVs) prevent disease through both direct protection of vaccinated individuals and indirect protection of unvaccinated individuals by reducing nasopharyngeal (NP) carriage and transmission of vaccine-type (VT) pneumococci. While the indirect effects of PCV vaccination are well described, the PCV coverage required to achieve the indirect effects is unknown. We will investigate the relationship between PCV coverage and VT carriage among undervaccinated children using hospital-based NP pneumococcal carriage surveillance at three sites in Asia and the Pacific. We are recruiting cases, defined as children aged 2-59 months admitted to participating hospitals with acute respiratory infection in Lao People's Democratic Republic, Mongolia and Papua New Guinea. Thirteen-valent PCV status is obtained from written records. NP swabs are collected according to standard methods, screened using lytA qPCR and serotyped by microarray. Village-level vaccination coverage, for the resident communities of the recruited cases, is determined using administrative data or community survey. Our analysis will investigate the relationship between VT carriage among undervaccinated cases (indirect effects) and vaccine coverage using generalised estimating equations. Ethical approval has been obtained from the relevant ethics committees at participating sites. The results are intended for publication in open-access peer-reviewed journals and will demonstrate methods suitable for low- and middle-income countries to monitor vaccine impact and inform vaccine policy makers about the PCV coverage required to achieve indirect protection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review.

PubMed

Frankenfield, David; Roth-Yousey, Lori; Compher, Charlene

2005-05-01

An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact outcome. Therefore, a systematic review of the literature was undertaken to document the accuracy of predictive equations preliminary to deciding on the imperative to measure metabolic rate. As part of a larger project to determine the role of indirect calorimetry in clinical practice, an evidence team identified published articles that examined the validity of various predictive equations for resting metabolic rate (RMR) in nonobese and obese people and also in individuals of various ethnic and age groups. Articles were accepted based on defined criteria and abstracted using evidence analysis tools developed by the American Dietetic Association. Because these equations are applied by dietetics practitioners to individuals, a key inclusion criterion was research reports of individual data. The evidence was systematically evaluated, and a conclusion statement and grade were developed. Four prediction equations were identified as the most commonly used in clinical practice (Harris-Benedict, Mifflin-St Jeor, Owen, and World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAO/UNU]). Of these equations, the Mifflin-St Jeor equation was the most reliable, predicting RMR within 10% of measured in more nonobese and obese individuals than any other equation, and it also had the narrowest error range. No validation work concentrating on individual errors was found for the WHO/FAO/UNU equation. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of that measured, but noteworthy errors and limitations exist when it is applied to individuals and possibly when it is generalized to certain age and ethnic groups. RMR estimation errors would be eliminated by valid measurement of RMR with indirect calorimetry, using an evidence-based protocol to minimize measurement error. The Expert Panel advises clinical judgment regarding when to accept estimated RMR using predictive equations in any given individual. Indirect calorimetry may be an important tool when, in the judgment of the clinician, the predictive methods fail an individual in a clinically relevant way. For members of groups that are greatly underrepresented by existing validation studies of predictive equations, a high level of suspicion regarding the accuracy of the equations is warranted.

Testing survey-based methods for rapid monitoring of child mortality, with implications for summary birth history data.

PubMed

Brady, Eoghan; Hill, Kenneth

2017-01-01

Under-five mortality estimates are increasingly used in low and middle income countries to target interventions and measure performance against global development goals. Two new methods to rapidly estimate under-5 mortality based on Summary Birth Histories (SBH) were described in a previous paper and tested with data available. This analysis tests the methods using data appropriate to each method from 5 countries that lack vital registration systems. SBH data are collected across many countries through censuses and surveys, and indirect methods often rely upon their quality to estimate mortality rates. The Birth History Imputation method imputes data from a recent Full Birth History (FBH) onto the birth, death and age distribution of the SBH to produce estimates based on the resulting distribution of child mortality. DHS FBHs and MICS SBHs are used for all five countries. In the implementation, 43 of 70 estimates are within 20% of validation estimates (61%). Mean Absolute Relative Error is 17.7.%. 1 of 7 countries produces acceptable estimates. The Cohort Change method considers the differences in births and deaths between repeated Summary Birth Histories at 1 or 2-year intervals to estimate the mortality rate in that period. SBHs are taken from Brazil's PNAD Surveys 2004-2011 and validated against IGME estimates. 2 of 10 estimates are within 10% of validation estimates. Mean absolute relative error is greater than 100%. Appropriate testing of these new methods demonstrates that they do not produce sufficiently good estimates based on the data available. We conclude this is due to the poor quality of most SBH data included in the study. This has wider implications for the next round of censuses and future household surveys across many low- and middle- income countries.

A direct estimate of evapotranspiration over the Amazon basin and implications for our understanding of carbon and water cycling

NASA Astrophysics Data System (ADS)

Swann, A. L. S.; Koven, C.; Lombardozzi, D.; Bonan, G. B.

2017-12-01

Evapotranspiration (ET) is a critical term in the surface energy budget as well as the water cycle. There are few direct measurements of ET, and thus the magnitude and variability is poorly constrained at large spatial scales. Estimates of the annual cycle of ET over the Amazon are critical because they influence predictions of the seasonal cycle of carbon fluxes, as well as atmospheric dynamics and circulation. We estimate ET for the Amazon basin using a water budget approach, by differencing rainfall, discharge, and time-varying storage from the Gravity Recovery and Climate Experiment. We find that the climatological annual cycle of ET over the Amazon basin upstream of Óbidos shows suppression of ET during the wet season, and higher ET during the dry season, consistent with flux tower based observations in seasonally dry forests. We also find a statistically significant decrease in ET over the time period 2002-2015 of -1.46 mm/yr. Our direct estimate of the seasonal cycle of ET is largely consistent with previous indirect estimates, including energy budget based approaches, an up-scaled station based estimate, and land surface model estimates, but suggests that suppression of ET during the wet season is underestimated by existing products. We further quantify possible contributors to the phasing of the seasonal cycle and downward time trend using land surface models.

IN-RESIDENCE, MULTIPLE ROUTE EXPOSURES TO CHLORPYRIFOS AND DIAZINON ESTIMATED BY INDIRECT METHOD MODELS

EPA Science Inventory

One of the objectives of the National Human Exposure Assessment Survey (NHEXAS) is to estimate exposures to several pollutants in multiple media and determine their distributions for the population of Arizona. This paper presents modeling methods used to estimate exposure dist...

An assessment of the tracer-based approach to quantifying groundwater contributions to streamflow

NASA Astrophysics Data System (ADS)

Jones, J. P.; Sudicky, E. A.; Brookfield, A. E.; Park, Y.-J.

2006-02-01

The use of conservative geochemical and isotopic tracers along with mass balance equations to determine the pre-event groundwater contributions to streamflow during a rainfall event is widely used for hydrograph separation; however, aspects related to the influence of surface and subsurface mixing processes on the estimates of the pre-event contribution remain poorly understood. Moreover, the lack of a precise definition of "pre-event" versus "event" contributions on the one hand and "old" versus "new" water components on the other hand has seemingly led to confusion within the hydrologic community about the role of Darcian-based groundwater flow during a storm event. In this work, a fully integrated surface and subsurface flow and solute transport model is used to analyze flow system dynamics during a storm event, concomitantly with advective-dispersive tracer transport, and to investigate the role of hydrodynamic mixing processes on the estimates of the pre-event component. A number of numerical experiments are presented, including an analysis of a controlled rainfall-runoff experiment, that compare the computed Darcian-based groundwater fluxes contributing to streamflow during a rainfall event with estimates of these contributions based on a tracer-based separation. It is shown that hydrodynamic mixing processes can dramatically influence estimates of the pre-event water contribution estimated by a tracer-based separation. Specifically, it is demonstrated that the actual amount of bulk flowing groundwater contributing to streamflow may be much smaller than the quantity indirectly estimated from a separation based on tracer mass balances, even if the mixing processes are weak.

Debiasing comparative optimism and increasing worry for health outcomes.

PubMed

Rose, Jason P

2012-11-01

Comparative optimism - feeling at less personal risk for negative outcomes than one's peers - has been linked to reduced prevention efforts. This study examined a novel debiasing technique aimed at simultaneously reducing both indirectly and directly measured comparative optimism. Before providing direct comparative estimates, participants provided absolute self and peer estimates in a joint format (same computer screen) or a separate format (different computer screens). Relative to the separate format condition, participants in the joint format condition showed (1) lower comparative optimism in absolute/indirect measures, (2) lower direct comparative optimism, and (3) heightened worry. Implications for risk perception screening are discussed.

Use of logistic regression for modelling risk factors: with application to non-melanoma skin cancer

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

Vitaliano, P.P.

Logistic regression was used to estimate the relative risk of basal and squamous skin cancer for such factors as cumulative lifetime solar exposure, age, complexion, and tannability. In previous reports, a subject's exposure was estimated indirectly, by latitude, or by the number of sun days in a subject's habitat. In contrast, these results are based on interview data gathered for each subject. A relatively new technique was used to estimate relative risk by controlling for confounding and testing for effect modification. A linear effect for the relative risk of cancer versus exposure was found. Tannability was shown to be amore » more important risk factor than complexion. This result is consistent with the work of Silverstone and Searle.« less

The direct and indirect cost of diabetes in Italy: a prevalence probabilistic approach.

PubMed

Marcellusi, A; Viti, R; Mecozzi, A; Mennini, F S

2016-03-01

Diabetes mellitus is a chronic degenerative disease associated with a high risk of chronic complications and comorbidities. However, very few data are available on the associated cost. The objective of this study is to identify the available information on the epidemiology of the disease and estimate the average annual cost incurred by the National Health Service and Society for the Treatment of Diabetes in Italy. A probabilistic prevalence cost of illness model was developed to calculate an aggregate measure of the economic burden associated with the disease, in terms of direct medical costs (drugs, hospitalizations, monitoring and adverse events) and indirect costs (absenteeism and early retirement). A systematic review of the literature was conducted to determine both the epidemiological and economic data. Furthermore, a one-way and probabilistic sensitivity analysis with 5,000 Monte Carlo simulations was performed to test the robustness of the results and define a 95% CI. The model estimated a prevalence of 2.6 million patients under drug therapies in Italy. The total economic burden of diabetic patients in Italy amounted to €20.3 billion/year (95% CI €18.61 to €22.29 billion), 54% of which are associated with indirect costs (95% CI €10.10 to €11.62 billion) and 46% with direct costs only (95% CI €8.11 to €11.06 billion). This is the first study conducted in Italy aimed at estimating the direct and indirect cost of diabetes with a probabilistic prevalence approach. As might be expected, the lack of information means that the real burden of diabetes is partly underestimated, especially with regard to indirect costs. However, this is a useful approach for policy makers to understand the economic implications of diabetes treatment in Italy.

The cost of headache disorders in Europe: the Eurolight project.

PubMed

Linde, M; Gustavsson, A; Stovner, L J; Steiner, T J; Barré, J; Katsarava, Z; Lainez, J M; Lampl, C; Lantéri-Minet, M; Rastenyte, D; Ruiz de la Torre, E; Tassorelli, C; Andrée, C

2012-05-01

Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe.   From November 2008 to August 2009, a cross-sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom-up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs.   Mean per-person annual costs were €1222 for migraine (95% CI 1055-1389; indirect costs 93%), €303 for tension-type headache (TTH, 95% CI 230-376; indirect costs 92%), €3561 for medication-overuse headache (MOH, 95% CI 2487-4635; indirect costs 92%), and €253 for other headaches (95% CI 99-407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually).   Headache disorders are prominent health-related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

The Estimated Annual Cost of Uterine Leiomyomata in the United States

PubMed Central

CARDOZO, Eden R.; CLARK, Andrew D.; BANKS, Nicole K.; HENNE, Melinda B.; STEGMANN, Barbara J.; SEGARS, James H.

2011-01-01

Objective To estimate the total annual societal cost of uterine fibroids in the United States, based on direct and indirect costs, including associated obstetric complications. Study Design A systematic review of the literature was conducted to estimate the number of women seeking treatment for symptomatic fibroids annually, the costs of medical and surgical treatment, work lost and obstetric complications attributable to fibroids. Total annual costs were converted to 2010 U.S. dollars. A sensitivity analysis was performed. Results The estimated annual direct costs (surgery, hospital admissions, outpatient visits, medications) were $4.1 to $9.4 billion. Estimated lost work costs ranged from $1.55 to $17.2 billion annually. Obstetric outcomes attributed to fibroids resulted in a cost of $238 million to $7.76 billion annually. Uterine fibroids were estimated to cost the US $5.9 to $34.4 billion annually. Conclusions Obstetric complications associated with fibroids contributed significantly to their economic burden. Lost work costs may account for the largest proportion of societal costs due to fibroids. PMID:22244472

Effects of worksite health interventions involving reduced work hours and physical exercise on sickness absence costs.

PubMed

von Thiele Schwarz, Ulrica; Hasson, Henna

2012-05-01

To investigate the effects of physical exercise during work hours (PE) and reduced work hours (RWH) on direct and indirect costs associated with sickness absence (SA). Sickness absence and related costs at six workplaces, matched and randomized to three conditions (PE, RWH, and referents), were retrieved from company records and/or estimated using salary conversion methods or value-added equations on the basis of interview data. Although SA days decreased in all conditions (PE, 11.4%; RWH, 4.9%; referents, 15.9%), costs were reduced in the PE (22.2%) and RWH (4.9%) conditions but not among referents (10.2% increase). Worksite health interventions may generate savings in SA costs. Costs may not be linear to changes in SA days. Combing the friction method with indirect cost estimates on the basis of value-added productivity may help illuminate both direct and indirect SA costs.

Development of a thermal gradient cloud condensation nucleus spectrometer

NASA Technical Reports Server (NTRS)

Leu, Ming-Taun; Friedl, R.

2004-01-01

Droplet clouds are one of the most important factors controlling the albedo and hence the temperature of out planet. Anthropogenic aerosols, such as black carbon (BC) organic carbon (OC) and sulfate, have a strong influence on cloud albedo. IPCC (2001) has estimated the global mean forcing from aerosols to be potentially as large as that of green house gases but opposite in sign. However, the uncertainties associated with the indirect aerosol forcing preclude a quantitative estimate. An additional impact on the indirect aerosol forcing, not quantified by IPCC, arises from recently identified chemical factors, for examples, interactions of atmospheric soluble gases, slightly soluble solutes, and organic substance with aerosols, which may influence the formation of cloud droplets. Recent studies suggest that inclusion of chemical effects on aerosol droplets. We plan to conduct several critical laboratory experiments that will reduce the uncertainty associated with indirect radiative forcing due to chemical modification of sulfate and BC aerosols by ambient gases.

Testing for biases in selection on avian reproductive traits and partitioning direct and indirect selection using quantitative genetic models.

PubMed

Reed, Thomas E; Gienapp, Phillip; Visser, Marcel E

2016-10-01

Key life history traits such as breeding time and clutch size are frequently both heritable and under directional selection, yet many studies fail to document microevolutionary responses. One general explanation is that selection estimates are biased by the omission of correlated traits that have causal effects on fitness, but few valid tests of this exist. Here, we show, using a quantitative genetic framework and six decades of life-history data on two free-living populations of great tits Parus major, that selection estimates for egg-laying date and clutch size are relatively unbiased. Predicted responses to selection based on the Robertson-Price Identity were similar to those based on the multivariate breeder's equation (MVBE), indicating that unmeasured covarying traits were not missing from the analysis. Changing patterns of phenotypic selection on these traits (for laying date, linked to climate change) therefore reflect changing selection on breeding values, and genetic constraints appear not to limit their independent evolution. Quantitative genetic analysis of correlational data from pedigreed populations can be a valuable complement to experimental approaches to help identify whether apparent associations between traits and fitness are biased by missing traits, and to parse the roles of direct versus indirect selection across a range of environments. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

Comparison of Nurse Staffing Measurements in Staffing-Outcomes Research.

PubMed

Park, Shin Hye; Blegen, Mary A; Spetz, Joanne; Chapman, Susan A; De Groot, Holly A

2015-01-01

Investigators have used a variety of operational definitions of nursing hours of care in measuring nurse staffing for health services research. However, little is known about which approach is best for nurse staffing measurement. To examine whether various nursing hours measures yield different model estimations when predicting patient outcomes and to determine the best method to measure nurse staffing based on the model estimations. We analyzed data from the University HealthSystem Consortium for 2005. The sample comprised 208 hospital-quarter observations from 54 hospitals, representing information on 971 adult-care units and about 1 million inpatient discharges. We compared regression models using different combinations of staffing measures based on productive/nonproductive and direct-care/indirect-care hours. Akaike Information Criterion and Bayesian Information Criterion were used in the assessment of staffing measure performance. The models that included the staffing measure calculated from productive hours by direct-care providers were best, in general. However, the Akaike Information Criterion and Bayesian Information Criterion differences between models were small, indicating that distinguishing nonproductive and indirect-care hours from productive direct-care hours does not substantially affect the approximation of the relationship between nurse staffing and patient outcomes. This study is the first to explicitly evaluate various measures of nurse staffing. Productive hours by direct-care providers are the strongest measure related to patient outcomes and thus should be preferred in research on nurse staffing and patient outcomes.

Simulation of the Indirect Radiative Forcing of Climate Due to Aerosols by the Two-Way Coupled WRF-CMAQ over the Eastern United States

EPA Science Inventory

In this study, the shortwave cloud forcing (SWCF) and longwave cloud forcing (LWCF) are estimated with the newly developed two-way coupled WRF-CMAQ over the eastern United States. Preliminary indirect aerosol forcing has been successfully implemented in WRF-CMAQ. The comparisons...

Does Education Affect Happiness? Evidence for Spain

ERIC Educational Resources Information Center

Cunado, Juncal; de Gracia, Fernando Perez

2012-01-01

In this paper we study the impact of education on happiness in Spain using individual-level data from the European Social Survey, by means of estimating Ordinal Logit Models. We find both direct and indirect effects of education on happiness. First, we find an indirect effect of education on happiness through income and labour status. That is, we…

Evidence for Limited Indirect Aerosol Forcing in Stratocumulus

NASA Technical Reports Server (NTRS)

Ackerman, Andrew S.; Toon, O. B.; Stevens, D. E.

2003-01-01

Increases in cloud cover and condensed water contribute more than half of the indirect aerosol effect in an ensemble of general circulation model (GCM) simulations estimating the global radiative forcing of anthropogenic aerosols. We use detailed simulations of marine stratocumulus clouds and airborne observations of ship tracks to show that increases in cloud cover and condensed water in reality are far less than represented by the GCM ensemble. Our results offer an explanation for recent simplified inverse climate calculations indicating that indirect aerosol effects are greatly exaggerated in GCMs.

Estimating human exposure to PFOS isomers and PFCA homologues: the relative importance of direct and indirect (precursor) exposure.

PubMed

Gebbink, Wouter A; Berger, Urs; Cousins, Ian T

2015-01-01

Contributions of direct and indirect (via precursors) pathways of human exposure to perfluorooctane sulfonic acid (PFOS) isomers and perfluoroalkyl carboxylic acids (PFCAs) are estimated using a Scenario-Based Risk Assessment (SceBRA) modelling approach. Monitoring data published since 2008 (including samples from 2007) are used. The estimated daily exposures (resulting from both direct and precursor intake) for the general adult population are highest for PFOS and perfluorooctanoic acid (PFOA), followed by perfluorohexanoic acid (PFHxA) and perfluorodecanoic acid (PFDA), while lower daily exposures are estimated for perfluorobutanoic acid (PFBA) and perfluorododecanoic acid (PFDoDA). The precursor contributions to the individual perfluoroalkyl acid (PFAA) daily exposures are estimated to be 11-33% for PFOS, 0.1-2.5% for PFBA, 3.7-34% for PFHxA, 13-64% for PFOA, 5.2-66% for PFDA, and 0.7-25% for PFDoDA (ranges represent estimated precursor contributions in a low- and high-exposure scenario). For PFOS, direct intake via diet is the major exposure pathway regardless of exposure scenario. For PFCAs, the dominant exposure pathway is dependent on perfluoroalkyl chain length and exposure scenario. Modelled PFOS and PFOA concentrations in human serum using the estimated intakes from an intermediate-exposure scenario are in agreement with measured concentrations in different populations. The isomer pattern of PFOS resulting from total intakes (direct and via precursors) is estimated to be enriched with linear PFOS (84%) relative to technical PFOS (70% linear). This finding appears to be contradictory to the observed enrichment of branched PFOS isomers in recent human serum monitoring studies and suggests that either external exposure is not fully understood (e.g. there are unknown precursors, missing or poorly quantified exposure pathways) and/or that there is an incomplete understanding of the isomer-specific human pharmacokinetic processes of PFOS, its precursors and intermediates. Copyright © 2014. Published by Elsevier Ltd.

Estimating direct and indirect costs of premenstrual syndrome.

PubMed

Borenstein, Jeff; Chiou, Chiun-Fang; Dean, Bonnie; Wong, John; Wade, Sally

2005-01-01

To quantify the economic impact of premenstrual syndrome (PMS) on the employer. Data were collected from 374 women aged 18-45 with regular menses. Direct costs were quantified using administrative claims of these patients and the Medicare Fee Schedule. Indirect costs were quantified by both self-reported days of work missed and lost productivity at work. Regression analyses were used to develop a model to project PMS-related direct and indirect costs. A total of 29.6% (n = 111) of the participants were diagnosed with PMS. A PMS diagnosis was associated with an average annual increase of $59 in direct costs (P < 0.026) and $4333 in indirect costs per patient (P < 0.0001) compared with patients without PMS. A PMS diagnosis correlated with a modest increase in direct medical costs and a large increase in indirect costs.

The costs of alcohol, illegal drugs, and tobacco in Canada, 2002.

PubMed

Rehm, Jürgen; Gnam, William; Popova, Svetlana; Baliunas, Dolly; Brochu, Serge; Fischer, Benedikt; Patra, Jayadeep; Sarnocinska-Hart, Anna; Taylor, Benjamin

2007-11-01

The aim of this study was to estimate costs attributable to substance use and misuse in Canada in 2002. Based on information about prevalence of exposure and risk relations for more than 80 disease categories, deaths, years of life lost, and hospitalizations attributable to substance use and misuse were estimated. In addition, substance-attributable fractions for criminal justice expenditures were derived. Indirect costs were estimated using a modified human capital approach. Costs of substance use and misuse totaled almost Can. $40 billion in 2002. The total cost per capita for substance use and misuse was about Can. $1,267: Can. $463 for alcohol, Can. $262 for illegal drugs, and Can. $541 for tobacco. Legal substances accounted for the vast majority of these costs (tobacco: almost 43% of total costs; alcohol: 37%). Indirect costs or productivity losses were the largest cost category (61%), followed by health care (22%) and law enforcement costs (14%). More than 40,000 people died in Canada in 2002 because of substance use and misuse: 37,209 deaths were attributable to tobacco, 4,258 were attributable to alcohol, and 1,695 were attributable to illegal drugs. A total of about 3.8 million hospital days were attributable to substance use and misuse, again mainly to tobacco. Substance use and misuse imposes a considerable economic toll on Canadian society and requires more preventive efforts.

A Total Economic Valuation of Wetland Ecosystem Services: An Evidence from Jagadishpur Ramsar Site, Nepal

PubMed Central

Basnyat, Bijendra; Khanal, Rajendra; Gauli, Kalyan

2016-01-01

Wetlands are the most productive ecosystem and provide wide arrays of wetland ecosystems (goods and services) to the local communities in particular and global communities in general. However, management of the wetland often does not remain priority and recognized as the unproductive waste land mainly due to poor realization of the economic value of the wetlands. Taking this into account, the study estimated the total economic value of the Jagadishpur Reservoir taking into account direct, indirect, and nonuse value. The study prioritized six major values of the reservoir which include wetland goods consumption, tourism, irrigation, carbon sequestration, biodiversity conservation, and conservation for future use (existence and option value). The study used market and nonmarket based valuation techniques to estimate total economic value of the reservoir. Household survey, focus group discussions, and interaction with the tourism entrepreneurs and district stakeholders were carried out to collect information. The study estimated the total annual economic value of the reservoir as NRs 94.5 million, where option/existence value remains main contributor followed by direct use value such as wetland goods and tourism and indirect use value, for example, carbon sequestration, biodiversity conservation, and irrigation. The study reveals that the local communities gave high importance to the future use value and are willing to make investment for conservation and restoration of reservoir given its conservation significance. PMID:27830175

A Total Economic Valuation of Wetland Ecosystem Services: An Evidence from Jagadishpur Ramsar Site, Nepal.

PubMed

Baral, Sony; Basnyat, Bijendra; Khanal, Rajendra; Gauli, Kalyan

Wetlands are the most productive ecosystem and provide wide arrays of wetland ecosystems (goods and services) to the local communities in particular and global communities in general. However, management of the wetland often does not remain priority and recognized as the unproductive waste land mainly due to poor realization of the economic value of the wetlands. Taking this into account, the study estimated the total economic value of the Jagadishpur Reservoir taking into account direct, indirect, and nonuse value. The study prioritized six major values of the reservoir which include wetland goods consumption, tourism, irrigation, carbon sequestration, biodiversity conservation, and conservation for future use (existence and option value). The study used market and nonmarket based valuation techniques to estimate total economic value of the reservoir. Household survey, focus group discussions, and interaction with the tourism entrepreneurs and district stakeholders were carried out to collect information. The study estimated the total annual economic value of the reservoir as NRs 94.5 million, where option/existence value remains main contributor followed by direct use value such as wetland goods and tourism and indirect use value, for example, carbon sequestration, biodiversity conservation, and irrigation. The study reveals that the local communities gave high importance to the future use value and are willing to make investment for conservation and restoration of reservoir given its conservation significance.

Estimating the Size and Impact of the Ecological Restoration Economy

PubMed Central

BenDor, Todd; Lester, T. William; Livengood, Avery; Davis, Adam; Yonavjak, Logan

2015-01-01

Domestic public debate continues over the economic impacts of environmental regulations that require environmental restoration. This debate has occurred in the absence of broad-scale empirical research on economic output and employment resulting from environmental restoration, restoration-related conservation, and mitigation actions — the activities that are part of what we term the “restoration economy.” In this article, we provide a high-level accounting of the size and scope of the restoration economy in terms of employment, value added, and overall economic output on a national scale. We conducted a national survey of businesses that participate in restoration work in order to estimate the total sales and number of jobs directly associated with the restoration economy, and to provide a profile of this nascent sector in terms of type of restoration work, industrial classification, workforce needs, and growth potential. We use survey results as inputs into a national input-output model (IMPLAN 3.1) in order to estimate the indirect and induced economic impacts of restoration activities. Based on this analysis we conclude that the domestic ecological restoration sector directly employs ~ 126,000 workers and generates ~ $9.5 billion in economic output (sales) annually. This activity supports an additional 95,000 jobs and $15 billion in economic output through indirect (business-to-business) linkages and increased household spending. PMID:26083034

Marine Dispersal Scales Are Congruent over Evolutionary and Ecological Time.

PubMed

Pinsky, Malin L; Saenz-Agudelo, Pablo; Salles, Océane C; Almany, Glenn R; Bode, Michael; Berumen, Michael L; Andréfouët, Serge; Thorrold, Simon R; Jones, Geoffrey P; Planes, Serge

2017-01-09

The degree to which offspring remain near their parents or disperse widely is critical for understanding population dynamics, evolution, and biogeography, and for designing conservation actions. In the ocean, most estimates suggesting short-distance dispersal are based on direct ecological observations of dispersing individuals, while indirect evolutionary estimates often suggest substantially greater homogeneity among populations. Reconciling these two approaches and their seemingly competing perspectives on dispersal has been a major challenge. Here we show for the first time that evolutionary and ecological measures of larval dispersal can closely agree by using both to estimate the distribution of dispersal distances. In orange clownfish (Amphiprion percula) populations in Kimbe Bay, Papua New Guinea, we found that evolutionary dispersal kernels were 17 km (95% confidence interval: 12-24 km) wide, while an exhaustive set of direct larval dispersal observations suggested kernel widths of 27 km (19-36 km) or 19 km (15-27 km) across two years. The similarity between these two approaches suggests that ecological and evolutionary dispersal kernels can be equivalent, and that the apparent disagreement between direct and indirect measurements can be overcome. Our results suggest that carefully applied evolutionary methods, which are often less expensive, can be broadly relevant for understanding ecological dispersal across the tree of life. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mathematical model of cycad cones' thermogenic temperature responses: inverse calorimetry to estimate metabolic heating rates.

PubMed

Roemer, R B; Booth, D; Bhavsar, A A; Walter, G H; Terry, L I

2012-12-21

A mathematical model based on conservation of energy has been developed and used to simulate the temperature responses of cones of the Australian cycads Macrozamia lucida and Macrozamia. macleayi during their daily thermogenic cycle. These cones generate diel midday thermogenic temperature increases as large as 12 °C above ambient during their approximately two week pollination period. The cone temperature response model is shown to accurately predict the cones' temperatures over multiple days as based on simulations of experimental results from 28 thermogenic events from 3 different cones, each simulated for either 9 or 10 sequential days. The verified model is then used as the foundation of a new, parameter estimation based technique (termed inverse calorimetry) that estimates the cones' daily metabolic heating rates from temperature measurements alone. The inverse calorimetry technique's predictions of the major features of the cones' thermogenic metabolism compare favorably with the estimates from conventional respirometry (indirect calorimetry). Because the new technique uses only temperature measurements, and does not require measurements of oxygen consumption, it provides a simple, inexpensive and portable complement to conventional respirometry for estimating metabolic heating rates. It thus provides an additional tool to facilitate field and laboratory investigations of the bio-physics of thermogenic plants. Copyright © 2012 Elsevier Ltd. All rights reserved.

A comparison of moment-based methods of estimation for the log Pearson type 3 distribution

NASA Astrophysics Data System (ADS)

Koutrouvelis, I. A.; Canavos, G. C.

2000-06-01

The log Pearson type 3 distribution is a very important model in statistical hydrology, especially for modeling annual flood series. In this paper we compare the various methods based on moments for estimating quantiles of this distribution. Besides the methods of direct and mixed moments which were found most successful in previous studies and the well-known indirect method of moments, we develop generalized direct moments and generalized mixed moments methods and a new method of adaptive mixed moments. The last method chooses the orders of two moments for the original observations by utilizing information contained in the sample itself. The results of Monte Carlo experiments demonstrated the superiority of this method in estimating flood events of high return periods when a large sample is available and in estimating flood events of low return periods regardless of the sample size. In addition, a comparison of simulation and asymptotic results shows that the adaptive method may be used for the construction of meaningful confidence intervals for design events based on the asymptotic theory even with small samples. The simulation results also point to the specific members of the class of generalized moments estimates which maintain small values for bias and/or mean square error.

Indirect estimation of emission factors for phosphate surface mining using air dispersion modeling.

PubMed

Tartakovsky, Dmitry; Stern, Eli; Broday, David M

2016-06-15

To date, phosphate surface mining suffers from lack of reliable emission factors. Due to complete absence of data to derive emissions factors, we developed a methodology for estimating them indirectly by studying a range of possible emission factors for surface phosphate mining operations and comparing AERMOD calculated concentrations to concentrations measured around the mine. We applied this approach for the Khneifiss phosphate mine, Syria, and the Al-Hassa and Al-Abyad phosphate mines, Jordan. The work accounts for numerous model unknowns and parameter uncertainties by applying prudent assumptions concerning the parameter values. Our results suggest that the net mining operations (bulldozing, grading and dragline) contribute rather little to ambient TSP concentrations in comparison to phosphate processing and transport. Based on our results, the common practice of deriving the emission rates for phosphate mining operations from the US EPA emission factors for surface coal mining or from the default emission factor of the EEA seems to be reasonable. Yet, since multiple factors affect dispersion from surface phosphate mines, a range of emission factors, rather than only a single value, was found to satisfy the model performance. Copyright © 2016 Elsevier B.V. All rights reserved.

Dimensional Model for Estimating Factors influencing Childhood Obesity: Path Analysis Based Modeling

PubMed Central

Kheirollahpour, Maryam; Shohaimi, Shamarina

2014-01-01

The main objective of this study is to identify and develop a comprehensive model which estimates and evaluates the overall relations among the factors that lead to weight gain in children by using structural equation modeling. The proposed models in this study explore the connection among the socioeconomic status of the family, parental feeding practice, and physical activity. Six structural models were tested to identify the direct and indirect relationship between the socioeconomic status and parental feeding practice general level of physical activity, and weight status of children. Finally, a comprehensive model was devised to show how these factors relate to each other as well as to the body mass index (BMI) of the children simultaneously. Concerning the methodology of the current study, confirmatory factor analysis (CFA) was applied to reveal the hidden (secondary) effect of socioeconomic factors on feeding practice and ultimately on the weight status of the children and also to determine the degree of model fit. The comprehensive structural model tested in this study suggested that there are significant direct and indirect relationships among variables of interest. Moreover, the results suggest that parental feeding practice and physical activity are mediators in the structural model. PMID:25097878

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

Bonneville, Alain H.; Kouzes, Richard T.

Imaging subsurface geological formations, oil and gas reservoirs, mineral deposits, cavities or magma chambers under active volcanoes has been for many years a major quest of geophysicists and geologists. Since these objects cannot be observed directly, different indirect geophysical methods have been developed. They are all based on variations of certain physical properties of the subsurface that can be detected from the ground surface or from boreholes. Electrical resistivity, seismic wave’s velocities and density are certainly the most used properties. If we look at density, indirect estimates of density distributions are performed currently by seismic reflection methods - since themore » velocity of seismic waves depend also on density - but they are expensive and discontinuous in time. Direct estimates of density are performed using gravimetric data looking at variations of the gravity field induced by the density variations at depth but this is not sufficiently accurate. A new imaging technique using cosmic-ray muon detectors has emerged during the last decade and muon tomography - or muography - promises to provide, for the first time, a complete and precise image of the density distribution in the subsurface. Further, this novel approach has the potential to become a direct, real-time, and low-cost method for monitoring fluid displacement in subsurface reservoirs.« less

Indirect viscosimetric method is less accurate than ektacytometry for the measurement of red blood cell deformability.

PubMed

Vent-Schmidt, Jens; Waltz, Xavier; Pichon, Aurélien; Hardy-Dessources, Marie-Dominique; Romana, Marc; Connes, Philippe

2015-01-01

The aim of this study was to test the accuracy of viscosimetric method to estimate the red blood cell (RBC) deformability properties. Thirty-three subjects were enrolled in this study: 6 healthy subjects (AA), 11 patients with sickle cell-hemoglobin C disease (SC) and 16 patients with sickle cell anemia (SS). Two methods were used to assess RBC deformability: 1) indirect viscosimetric method and 2) ektacytometry. The indirect viscosimetric method was based on the Dintenfass equation where blood viscosity, plasma viscosity and hematocrit are measured and used to calculate an index of RBC rigidity (Tk index). The RBC deformability/rigidity of the three groups was compared using the two methods. Tk index was not different between SS and SC patients and the two groups had higher values than AA group. When ektacytometry was used, RBC deformability was lower in SS and SC groups compared to the AA group and SS and SC patients were different. Although the two measures of RBC deformability were correlated, the association was not very high. Bland and Altman analysis demonstrated a 3.25 bias suggesting a slight difference between the two methods. In addition, the limit of agreement represented 28% (>15%) of the mean values of RBC deformability, showing no interchangeability between the two methods. In conclusion, measuring RBC deformability by indirect viscosimetry is less accurate than by ektacytometry, which is considered the gold standard.

Self-reported impulsivity, but not behavioral choice or response impulsivity, partially mediates the effect of stress on drinking behavior

PubMed Central

HAMILTON, KRISTEN R.; ANSELL, EMILY B.; REYNOLDS, BRADY; POTENZA, MARC N.; SINHA, RAJITA

2013-01-01

Stress and impulsivity contribute to alcohol use, and stress may also act via impulsivity to increase drinking behavior. Impulsivity represents a multi-faceted construct and self-report and behavioral assessments may effectively capture distinct clinically relevant factors. The present research investigated whether aspects of impulsivity mediate the effect of stress on alcohol use. A community-based sample of 192 men and women was assessed on measures of cumulative stress, alcohol use, self-reported impulsivity, and behavioral choice and response impulsivity. Data were analyzed using regression and bootstrapping techniques to estimate indirect effects of stress on drinking via impulsivity. Cumulative adversity exhibited both direct effects and indirect effects (via self-reported impulsivity) on drinking behavior. Additional models examining specific types of stress indicated direct and indirect effects of trauma and recent life events, and indirect effects of major life events and chronic stressors on drinking behavior. Overall, cumulative stress was associated with increased drinking behavior, and this effect was partially mediated by self-reported impulsivity. Self-reported impulsivity also mediated the effects of different types of stress on drinking behavior. These findings highlight the value of mediation models to examine the pathways through which different types of stress increase drinking behavior. Treatment and prevention strategies should focus on enhancing stress management and self-control. PMID:22376044

Self-reported impulsivity, but not behavioral choice or response impulsivity, partially mediates the effect of stress on drinking behavior.

PubMed

Hamilton, Kristen R; Ansell, Emily B; Reynolds, Brady; Potenza, Marc N; Sinha, Rajita

2013-01-01

Stress and impulsivity contribute to alcohol use, and stress may also act via impulsivity to increase drinking behavior. Impulsivity represents a multi-faceted construct and self-report and behavioral assessments may effectively capture distinct clinically relevant factors. The present research investigated whether aspects of impulsivity mediate the effect of stress on alcohol use. A community-based sample of 192 men and women was assessed on measures of cumulative stress, alcohol use, self-reported impulsivity, and behavioral choice and response impulsivity. Data were analyzed using regression and bootstrapping techniques to estimate indirect effects of stress on drinking via impulsivity. Cumulative adversity exhibited both direct effects and indirect effects (via self-reported impulsivity) on drinking behavior. Additional models examining specific types of stress indicated direct and indirect effects of trauma and recent life events, and indirect effects of major life events and chronic stressors on drinking behavior. Overall, cumulative stress was associated with increased drinking behavior, and this effect was partially mediated by self-reported impulsivity. Self-reported impulsivity also mediated the effects of different types of stress on drinking behavior. These findings highlight the value of mediation models to examine the pathways through which different types of stress increase drinking behavior. Treatment and prevention strategies should focus on enhancing stress management and self-control.

Multisite stochastic simulation of daily precipitation from copula modeling with a gamma marginal distribution

NASA Astrophysics Data System (ADS)

Lee, Taesam

2018-05-01

Multisite stochastic simulations of daily precipitation have been widely employed in hydrologic analyses for climate change assessment and agricultural model inputs. Recently, a copula model with a gamma marginal distribution has become one of the common approaches for simulating precipitation at multiple sites. Here, we tested the correlation structure of the copula modeling. The results indicate that there is a significant underestimation of the correlation in the simulated data compared to the observed data. Therefore, we proposed an indirect method for estimating the cross-correlations when simulating precipitation at multiple stations. We used the full relationship between the correlation of the observed data and the normally transformed data. Although this indirect method offers certain improvements in preserving the cross-correlations between sites in the original domain, the method was not reliable in application. Therefore, we further improved a simulation-based method (SBM) that was developed to model the multisite precipitation occurrence. The SBM preserved well the cross-correlations of the original domain. The SBM method provides around 0.2 better cross-correlation than the direct method and around 0.1 degree better than the indirect method. The three models were applied to the stations in the Nakdong River basin, and the SBM was the best alternative for reproducing the historical cross-correlation. The direct method significantly underestimates the correlations among the observed data, and the indirect method appeared to be unreliable.

The cost of clinical mastitis in the first 30 days of lactation: An economic modeling tool.

PubMed

Rollin, E; Dhuyvetter, K C; Overton, M W

2015-12-01

Clinical mastitis results in considerable economic losses for dairy producers and is most commonly diagnosed in early lactation. The objective of this research was to estimate the economic impact of clinical mastitis occurring during the first 30 days of lactation for a representative US dairy. A deterministic partial budget model was created to estimate direct and indirect costs per case of clinical mastitis occurring during the first 30 days of lactation. Model inputs were selected from the available literature, or when none were available, from herd data. The average case of clinical mastitis resulted in a total economic cost of $444, including $128 in direct costs and $316 in indirect costs. Direct costs included diagnostics ($10), therapeutics ($36), non-saleable milk ($25), veterinary service ($4), labor ($21), and death loss ($32). Indirect costs included future milk production loss ($125), premature culling and replacement loss ($182), and future reproductive loss ($9). Accurate decision making regarding mastitis control relies on understanding the economic impacts of clinical mastitis, especially the longer term indirect costs that represent 71% of the total cost per case of mastitis. Future milk production loss represents 28% of total cost, and future culling and replacement loss represents 41% of the total cost of a case of clinical mastitis. In contrast to older estimates, these values represent the current dairy economic climate, including milk price ($0.461/kg), feed price ($0.279/kg DM (dry matter)), and replacement costs ($2,094/head), along with the latest published estimates on the production and culling effects of clinical mastitis. This economic model is designed to be customized for specific dairy producers and their herd characteristics to better aid them in developing mastitis control strategies. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Direct health costs of environmental tobacco smoke exposure and indirect health benefits due to smoking ban introduction.

PubMed

Hauri, Dimitri D; Lieb, Christoph M; Rajkumar, Sarah; Kooijman, Cornelis; Sommer, Heini L; Röösli, Martin

2011-06-01

Introducing comprehensive smoke-free policies to public places is expected to reduce health costs. This includes prevented health damages by avoiding environmental tobacco smoke (ETS) exposure as well as indirect health benefits from reduced tobacco consumption. The aim of this study was to estimate direct health costs of ETS exposure in public places and indirect health benefits from reduced tobacco consumption. We calculated attributable hospital days and years of life lost (YLL), based on the observed passive smoking and disease rates in Switzerland. The exposure-response associations of all relevant health outcomes were derived by meta-analysis from prospective cohort studies in order to calculate the direct health costs. To assess the indirect health benefits, a meta-analysis of smoking ban studies on hospital admissions for acute myocardial infarction was conducted. ETS exposure in public places in Switzerland causes 32,000 preventable hospital days (95% CI: 10,000-61,000), 3000 YLL (95% CI: 1000-5000), corresponding to health costs of 330 Mio CHF. The number of hospital days for ischaemic heart disease attributable to passive smoking is much larger if derived from smoking ban studies (41,000) than from prospective cohort studies (3200), resulting in additional health costs of 89 Mio CHF, which are attributed to the indirect health benefits of a smoking ban introduction. The example of smoking ban studies on ischaemic heart disease hospitalization rates suggests that total health costs that can be prevented with smoking bans are considerably larger than the costs arising from the direct health impact of ETS exposure in public places.

Daily physical activity enhances resilient resources for symptom management in middle-aged women.

PubMed

Kishida, Moé; Elavsky, Steriani

2015-07-01

The aim of the present study was to evaluate the direct and indirect associations between physical activity and menopausal symptoms. Community-dwelling middle-aged women (N = 103; age range 40-60 years) completed daily Internet surveys at the end of the day and wore an accelerometer for the objective assessment of physical activity for 21-days. 1-1-1 multilevel mediation models were estimated to test whether resilient resources (i.e., positive affect and coping efficacy) mediated the association between physical activity and symptom burden at the between- and within-person level. Analyses demonstrated physical activity had an indirect effect (-0.16) on symptom burden through the enhancement of positive affect at the within-person level (p < .05; 95% confidence interval [CI] based on 20,000 Monte Carlo replications [-0.25, -0.08]). In models that tested coping efficacy as the mediator, it was found that the indirect effect of physical activity on symptom burden at the within-person level was -0.08 (p < .05; 95% CI based on 20,000 Monte Carlo replications [-0.14, -0.03]). These effects were nonsignificant at the between-person level, suggesting one route in which physical activity may help a woman to cope with her symptoms is through the enhancement of positive affect and coping efficacy on a day-to-day basis. (c) 2015 APA, all rights reserved.

Small area estimation (SAE) model: Case study of poverty in West Java Province

NASA Astrophysics Data System (ADS)

Suhartini, Titin; Sadik, Kusman; Indahwati

2016-02-01

This paper showed the comparative of direct estimation and indirect/Small Area Estimation (SAE) model. Model selection included resolve multicollinearity problem in auxiliary variable, such as choosing only variable non-multicollinearity and implemented principal component (PC). Concern parameters in this paper were the proportion of agricultural venture poor households and agricultural poor households area level in West Java Province. The approach for estimating these parameters could be performed based on direct estimation and SAE. The problem of direct estimation, three area even zero and could not be conducted by directly estimation, because small sample size. The proportion of agricultural venture poor households showed 19.22% and agricultural poor households showed 46.79%. The best model from agricultural venture poor households by choosing only variable non-multicollinearity and the best model from agricultural poor households by implemented PC. The best estimator showed SAE better then direct estimation both of the proportion of agricultural venture poor households and agricultural poor households area level in West Java Province. The solution overcame small sample size and obtained estimation for small area was implemented small area estimation method for evidence higher accuracy and better precision improved direct estimator.

The social cost of rheumatoid arthritis in Italy: the results of an estimation exercise.

PubMed

Turchetti, G; Bellelli, S; Mosca, M

2014-03-14

The objective of this study is to estimate the mean annual social cost per adult person and the total social cost of rheumatoid arthritis (RA) in Italy. A literature review was performed by searching primary economic studies on adults in order to collect cost data of RA in Italy in the last decade. The review results were merged with data of institutional sources for estimating - following the methodological steps of the cost of illness analysis - the social cost of RA in Italy. The mean annual social cost of RA was € 13,595 per adult patient in Italy. Affecting 259,795 persons, RA determines a social cost of € 3.5 billions in Italy. Non-medical direct cost and indirect cost represent the main cost items (48% and 31%) of the total social cost of RA in Italy. Based on these results, it appears evident that the assessment of the economic burden of RA solely based on direct medical costs evaluation gives a limited view of the phenomenon.

Costs of ulcerative colitis from a societal perspective in a regional health care area in Spain: A database study.

PubMed

Aldeguer, Xavier; Sicras-Mainar, Antoni

2016-01-01

To estimate the management of UC associated costs from the societal perspective in Spain. Observational, longitudinal study with retrospective data collection based on reviews of outpatient health records. Socio-demographic, clinical and sick leave information was gathered. Patients diagnosed of UC between 2002 and 2012, older than 18 years, followed-up by a minimum of 12 months post diagnosis, with at least two clinical and use of resources data recorded, were included. 285 UC patients [51.2% men; 44.5 (SD: 15.6) years old; 88.4% without family history of UC; 39.3% proctitis; 5.6 (2.5) years disease follow-up] participated. More than half (65.6%) were active workers, 75.9% were on sick leave for reasons different from UC [mean 0.66 (0.70) times per year] during (mean) 28.43 (34.45) days. Only 64 patients were on UC-related sick-leaves, lasting (mean) 26.17 (37.43) days. Absenteeism due to medical visits caused loss of 29.55 (21.38) working hours per year. Mean direct and indirect annual cost per UC patient were €1754.10 (95%CI: 1473.37-2034.83) and €399.32 (282.31-422.69), respectively. Absenteeism was estimated at €88.21(32.72-50.06) per patient per year, in which sick-leaves were the main component of indirect costs (88.2%). Age, UC family history, diarrhea at diagnosis, blood and blood-forming organs diseases and psychological disorders were the main predictors of indirect costs. UC is a costly disease for the society and the Spanish National Healthcare System. Indirect costs imply a major burden by affecting the most productive years of patients. Further research is needed considering all components of productivity loss, including presenteeism-associated costs. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Nonlinear models for estimating GSFC travel requirements

NASA Technical Reports Server (NTRS)

Buffalano, C.; Hagan, F. J.

1974-01-01

A methodology is presented for estimating travel requirements for a particular period of time. Travel models were generated using nonlinear regression analysis techniques on a data base of FY-72 and FY-73 information from 79 GSFC projects. Although the subject matter relates to GSFX activities, the type of analysis used and the manner of selecting the relevant variables would be of interest to other NASA centers, government agencies, private corporations and, in general, any organization with a significant travel budget. Models were developed for each of six types of activity: flight projects (in-house and out-of-house), experiments on non-GSFC projects, international projects, ART/SRT, data analysis, advanced studies, tracking and data, and indirects.

Validity of the Yo-Yo Intermittent Recovery Test Level 1 for direct measurement or indirect estimation of maximal oxygen uptake in female soccer players.

PubMed

Martínez-Lagunas, Vanessa; Hartmann, Ulrich

2014-09-01

To evaluate the validity of the Yo-Yo Intermittent Recovery Test Level 1 (YYIR1) for the direct assessment and the indirect estimation of maximal oxygen consumption (VO2max) in female soccer players compared with a maximal laboratory treadmill test (LTT). Eighteen female soccer players (21.5 ± 3.4 y, 165.6 ± 7.5 cm, 63.3 ± 7.4 kg; mean ± SD) completed an LTT and a YYIR1 in random order (1 wk apart). Their VO2max was directly measured via portable spirometry during both tests and indirectly estimated from a published non-gender-specific formula (YYIR1-F1). The measured VO2max values in LTT and YYIR1 were 55.0 ± 5.3 and 49.9 ± 4.9 mL · kg-1 · min-1, respectively, while the estimated VO2max values from YYIR1-F1 corresponded to 45.2 ± 3.4 mL · kg-1 · min-1. Large positive correlations between the VO2max values from YYIR1 and LTT (r = .83, P < .001, 90% confidence interval = .64-.92) and YYIR1-F1 and LTT (r = .67, P = .002, .37-.84) were found. However, the YYIR1 significantly underestimated players' VO2max by 9.4% compared with LTT (P < .001) with Bland-Altman 95% limits of agreement ranging from -20.0% to 1.4%. A significant underestimation from the YYIR1-F1 (P < .001) was also identified (17.8% with Bland-Altman 95% limits of agreement ranging from -31.8% to -3.8%). The YYIR1 and YYIR1-F1 are not accurate methods for the direct assessment or indirect estimation of VO2max in female soccer players. The YYIR1-F1 lacks gender specificity, which might have been the reason for its larger error.

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

PubMed Central

Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, ASM; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2014-01-01

Objective Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. Design From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. Results We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93–8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96–121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76–147) in direct costs and US$59 million (95% CI: 37–91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4–2.6) in direct costs and US$0.4 million (95% CI: 0.1–0.8) in indirect costs in 2010. Conclusions In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. PMID:24750586

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010.

PubMed

Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, A S M; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2014-07-01

Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010. In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Comparison of measured versus predicted energy requirements in critically ill cancer patients.

PubMed

Pirat, Arash; Tucker, Anne M; Taylor, Kim A; Jinnah, Rashida; Finch, Clarence G; Canada, Todd D; Nates, Joseph L

2009-04-01

Accurate determination of caloric requirements is essential to avoid feeding-associated complications in critically ill patients. In critically ill cancer patients we compared the measured and estimated resting energy expenditures. All patients admitted to the oncology intensive care unit between March 2004 and July 2005 were considered for inclusion. For those patients enrolled (n = 34) we measured resting energy expenditure via indirect calorimetry, and estimated resting energy expenditure in 2 ways: clinically estimated resting energy expenditure; and the Harris-Benedict basal energy expenditure equation. Clinically estimated resting energy expenditure was associated with underfeeding, appropriate feeding, and overfeeding in approximately 15%, 15%, and 71% of the patients, respectively. The Harris-Benedict basal energy expenditure was associated with underfeeding, appropriate feeding, and overfeeding in approximately 29%, 41%, and 29% of the patients, respectively. The mean measured resting energy expenditure (1,623 +/- 384 kcal/d) was similar to the mean Harris-Benedict basal energy expenditure without the addition of stress or activity factors (1,613 +/- 382 kcal/d, P = .87), and both were significantly lower than the mean clinically estimated resting energy expenditure (1,862 +/- 330 kcal/d, P < or = .003 for both). There was a significant correlation only between mean measured resting energy expenditure and mean Harris-Benedict basal energy expenditure (P < .001), but the correlation coefficient between those values was low (r = 0.587). Underfeeding and overfeeding were common in our critically ill cancer patients when resting energy expenditure was estimated rather than measured. Indirect calorimetry is the method of choice for determining caloric need in critically ill cancer patients, but if indirect calorimetry is not available or feasible, the Harris-Benedict equation without added stress and activity factors is more accurate than the clinically estimated resting energy expenditure.

Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling

PubMed Central

Oldmeadow, Christopher; Hure, Alexis; Luu, Judy; Loxton, Deborah

2017-01-01

Background Type 2 diabetes is associated with significant morbidity and mortality. Modifiable risk factors have been found to contribute up to 60% of type 2 diabetes risk. However, type 2 diabetes continues to rise despite implementation of interventions based on traditional risk factors. There is a clear need to identify additional risk factors for chronic disease prevention. The aim of this study was to examine the relationship between perceived stress and type 2 diabetes onset, and partition the estimates into direct and indirect effects. Methods and findings Women born in 1946–1951 (n = 12,844) completed surveys for the Australian Longitudinal Study on Women’s Health in 1998, 2001, 2004, 2007 and 2010. The total causal effect was estimated using logistic regression and marginal structural modelling. Controlled direct effects were estimated through conditioning in the regression model. A graded association was found between perceived stress and all mediators in the multivariate time lag analyses. A significant association was found between hypertension, as well as physical activity and body mass index, and diabetes, but not smoking or diet quality. Moderate/high stress levels were associated with a 2.3-fold increase in the odds of diabetes three years later, for the total estimated effect. Results were only slightly attenuated when the direct and indirect effects of perceived stress on diabetes were partitioned, with the mediators only explaining 10–20% of the excess variation in diabetes. Conclusions Perceived stress is a strong risk factor for type 2 diabetes. The majority of the effect estimate of stress on diabetes risk is not mediated by the traditional risk factors of hypertension, physical activity, smoking, diet quality, and body mass index. This gives a new pathway for diabetes prevention trials and clinical practice. PMID:28222165

Cost of stroke in Australia from a societal perspective: results from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Dewey, H M; Thrift, A G; Mihalopoulos, C; Carter, R; Macdonell, R A; McNeil, J J; Donnan, G A

2001-10-01

Accurate information about resource use and costs of stroke is necessary for informed health service planning. The purpose of this study was to determine the patterns of resource use among stroke patients and to estimate the total costs (direct service use and indirect production losses) of stroke (excluding SAH) in Australia for 1997. An incidence-based cost-of-illness model was developed, incorporating data obtained from the North East Melbourne Stroke Incidence Study (NEMESIS). The costs of stroke during the first year after stroke and the present value of total lifetime costs of stroke were estimated. The total first-year costs of all first-ever-in-a lifetime strokes (SAH excluded) that occurred in Australia during 1997 were estimated to be A$555 million (US$420 million), and the present value of lifetime costs was estimated to be A$1.3 billion (US$985 million). The average cost per case during the first 12 months and over a lifetime was A$18 956 (US$14 361) and A$44 428 (US$33 658), respectively. The most important categories of cost during the first year were acute hospitalization (A$154 million), inpatient rehabilitation (A$150 million), and nursing home care (A$63 million). The present value of lifetime indirect costs was estimated to be A$34 million. Similar to other studies, hospital and nursing home costs contributed most to the total cost of stroke (excluding SAH) in Australia. Inpatient rehabilitation accounts for approximately 27% of total first-year costs. Given the magnitude of these costs, investigation of the cost-effectiveness of rehabilitation services should become a priority in this community.

Direct and Indirect Effects of Teenage Body Weight on Adult Wages. NBER Working Paper No. 15027

ERIC Educational Resources Information Center

Han, Euna; Norton, Edward C.; Powell, Lisa M.

2009-01-01

Previous estimates on the association between body weight and wages in the literature have been contingent on education and occupation. This paper examines the direct effect of BMI on wages and the indirect effects operating through education and occupation choice, particularly for late-teen BMI and adult wages. Using the National Longitudinal…

A tesselation-based model for intensity estimation and laser plasma interactions calculations in three dimensions

NASA Astrophysics Data System (ADS)

Colaïtis, A.; Chapman, T.; Strozzi, D.; Divol, L.; Michel, P.

2018-03-01

A three-dimensional laser propagation model for computation of laser-plasma interactions is presented. It is focused on indirect drive geometries in inertial confinement fusion and formulated for use at large temporal and spatial scales. A modified tesselation-based estimator and a relaxation scheme are used to estimate the intensity distribution in plasma from geometrical optics rays. Comparisons with reference solutions show that this approach is well-suited to reproduce realistic 3D intensity field distributions of beams smoothed by phase plates. It is shown that the method requires a reduced number of rays compared to traditional rigid-scale intensity estimation. Using this field estimator, we have implemented laser refraction, inverse-bremsstrahlung absorption, and steady-state crossed-beam energy transfer with a linear kinetic model in the numerical code Vampire. Probe beam amplification and laser spot shapes are compared with experimental results and pf3d paraxial simulations. These results are promising for the efficient and accurate computation of laser intensity distributions in holhraums, which is of importance for determining the capsule implosion shape and risks of laser-plasma instabilities such as hot electron generation and backscatter in multi-beam configurations.

Indirect genetic estimates of breeding population size in the polyploid green sturgeon (Acipenser medirostris).

PubMed

Israel, J A; May, B

2010-03-01

The utility of genetic measures for kinship reconstruction in polysomic species is not well evaluated. We developed a framework to test hypotheses about estimating breeding population size indirectly from collections of outmigrating green sturgeon juveniles. We evaluated a polysomic dataset, in allelic frequency and phenotypic formats, from green sturgeon to describe the relationship among known progeny from experimental families. The distributions of relatedness values for kin classes were used for reconstructing green sturgeon pedigrees from juveniles of unknown relationship. We compared three rarefaction functions that described the relationship between the number of kin groups and number of samples in a pedigree to estimate the annual abundance of spawners contributing to the threatened green sturgeon Southern Distinct Population Segment in the upper Sacramento River. Results suggested the estimated abundance of breeding green sturgeon remained roughly constant in the upper Sacramento River over a 5-year period, ranging from 10 to 28 individuals depending on the year and rarefaction method. These results demonstrate an empirical understanding for the distribution of relatedness values among individuals is a benefit for assessing pedigree reconstruction methods and identifying misclassification rates. Monitoring of rare species using these indirect methods is feasible and can provide insight into breeding and ontogenetic behaviour. While this framework was developed for specific application to studying fish populations in a riverscape, the framework could be advanced to improve genetic estimation of breeding population size and to identify important breeding habitats of rare species when combined with finer-scaled sampling of offspring.

Direct effects dominate responses to climate perturbations in grassland plant communities.

PubMed

Chu, Chengjin; Kleinhesselink, Andrew R; Havstad, Kris M; McClaran, Mitchel P; Peters, Debra P; Vermeire, Lance T; Wei, Haiyan; Adler, Peter B

2016-06-08

Theory predicts that strong indirect effects of environmental change will impact communities when niche differences between competitors are small and variation in the direct effects experienced by competitors is large, but empirical tests are lacking. Here we estimate negative frequency dependence, a proxy for niche differences, and quantify the direct and indirect effects of climate change on each species. Consistent with theory, in four of five communities indirect effects are strongest for species showing weak negative frequency dependence. Indirect effects are also stronger in communities where there is greater variation in direct effects. Overall responses to climate perturbations are driven primarily by direct effects, suggesting that single species models may be adequate for forecasting the impacts of climate change in these communities.

Reducing the Carbon Footprint of Commercial Refrigeration Systems Using Life Cycle Climate Performance Analysis: From System Design to Refrigerant Options

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

Fricke, Brian A; Abdelaziz, Omar; Vineyard, Edward Allan

In this paper, Life Cycle Climate Performance (LCCP) analysis is used to estimate lifetime direct and indirect carbon dioxide equivalent gas emissions of various refrigerant options and commercial refrigeration system designs, including the multiplex DX system with various hydrofluorocarbon (HFC) refrigerants, the HFC/R744 cascade system incorporating a medium-temperature R744 secondary loop, and the transcritical R744 booster system. The results of the LCCP analysis are presented, including the direct and indirect carbon dioxide equivalent emissions for each refrigeration system and refrigerant option. Based on the results of the LCCP analysis, recommendations are given for the selection of low GWP replacement refrigerantsmore » for use in existing commercial refrigeration systems, as well as for the selection of commercial refrigeration system designs with low carbon dioxide equivalent emissions, suitable for new installations.« less

[Disability Pension and Productivity Loss in Schizophrenia - An Empirical Analysis of the Financial Burden in Germany].

PubMed

Kortmann, Lisa-Maria; Müller, Dirk; Simic, Dusan; Civello, Daniele; Stock, Stephanie

2017-03-01

Objective Quantification of the economic burden for society and the German Statutory Pension Insurance due to early retirement in schizophrenia. Methods Based on empirical data of the German Statutory Pension Insurance, productivity losses were calculated using the human capital approach. Results The total expenditures of the German Statutory Pension Insurance due to pension payments for schizophrenic insurants amounted to € 450 million. Total indirect costs due to morbidity and mortality were estimated at € 2,3 million. Average indirect costs per patient ranged between € 17 000 - 28 000, depending on rates for discounting and inflation. Conclusion Regarding substantial economic consequences, preventive measures and therapeutic procedures should aim to prevent reduction in earning capacity and to promote occupational reintegration of schizophrenic patients. © Georg Thieme Verlag KG Stuttgart · New York.

Measuring and testing for gender discrimination in physician pay: English family doctors.

PubMed

Gravelle, Hugh; Hole, Arne Risa; Santos, Rita

2011-07-01

In 2008 the income of female GPs was 70%, and their wages (income per hour) were 89%, of those of male GPs. We estimate Oaxaca decompositions using OLS models of wages and 2SLS models of income and propose a set of new direct tests for within workplace gender discrimination. The direct tests are based on a comparison of the differences in income of female and male GPs in practices with varying proportions of female GPs and with female or male senior partners. These tests provide only weak evidence for discrimination. We also propose a set of indirect tests for discrimination, including a comparison of a GP's actual income with the income they report as an acceptable reward for their job. The indirect tests provide no evidence for gender discrimination within practices. Copyright © 2011 Elsevier B.V. All rights reserved.

Lurking systematics in dust-based estimates of galaxy ISM masses

NASA Astrophysics Data System (ADS)

Janowiecki, Steven; Cortese, Luca; Catinella, Barbara; Goodwin, Adelle

2018-01-01

We use galaxies from the Herschel Reference Survey to evaluate commonly used indirect predictors of cold gas masses. With observations of cold neutral atomic and molecular gas, we calibrate predictive relationships using infrared dust emission and gas depletion time methods. We derive a set of self-consistent predictions of cold gas masses with ~20% scatter, and the greatest accuracy for total cold gas mass. However, significant systematic residuals are found in all calibrations which depend strongly on the molecular-to-atomic hydrogen mass ratio, and they can over/under-predict gas masses by >0.5 dex. Extending these types of indirect predictions to high-z galaxies (e.g., using ALMA observations of dust continuum to determine gas masses) requires implicit assumptions about the conditions in their interstellar medium. Any scaling relations derived using predicted gas masses may be more closely related to the calibrations used than to the actual galaxies observed.

The Societal and Economic Value of Rotator Cuff Repair

PubMed Central

Mather, Richard C.; Koenig, Lane; Acevedo, Daniel; Dall, Timothy M.; Gallo, Paul; Romeo, Anthony; Tongue, John; Williams, Gerald

2013-01-01

Background: Although rotator cuff disease is a common musculoskeletal problem in the United States, the impact of this condition on earnings, missed workdays, and disability payments is largely unknown. This study examines the value of surgical treatment for full-thickness rotator cuff tears from a societal perspective. Methods: A Markov decision model was constructed to estimate lifetime direct and indirect costs associated with surgical and continued nonoperative treatment for symptomatic full-thickness rotator cuff tears. All patients were assumed to have been unresponsive to one six-week trial of nonoperative treatment prior to entering the model. Model assumptions were obtained from the literature and data analysis. We obtained estimates of indirect costs using national survey data and patient-reported outcomes. Four indirect costs were modeled: probability of employment, household income, missed workdays, and disability payments. Direct cost estimates were based on average Medicare reimbursements with adjustments to an all-payer population. Effectiveness was expressed in quality-adjusted life years (QALYs). Results: The age-weighted mean total societal savings from rotator cuff repair compared with nonoperative treatment was $13,771 over a patient’s lifetime. Savings ranged from $77,662 for patients who are thirty to thirty-nine years old to a net cost to society of $11,997 for those who are seventy to seventy-nine years old. In addition, surgical treatment results in an average improvement of 0.62 QALY. Societal savings were highly sensitive to age, with savings being positive at the age of sixty-one years and younger. The estimated lifetime societal savings of the approximately 250,000 rotator cuff repairs performed in the U.S. each year was $3.44 billion. Conclusions: Rotator cuff repair for full-thickness tears produces net societal cost savings for patients under the age of sixty-one years and greater QALYs for all patients. Rotator cuff repair is cost-effective for all populations. The results of this study should not be interpreted as suggesting that all rotator cuff tears require surgery. Rather, the results show that rotator cuff repair has an important role in minimizing the societal burden of rotator cuff disease. PMID:24257656

Estimating Subglottal Pressure from Neck-Surface Acceleration during Normal Voice Production

ERIC Educational Resources Information Center

Fryd, Amanda S.; Van Stan, Jarrad H.; Hillman, Robert E.; Mehta, Daryush D.

2016-01-01

Purpose: The purpose of this study was to evaluate the potential for estimating subglottal air pressure using a neck-surface accelerometer and to compare the accuracy of predicting subglottal air pressure relative to predicting acoustic sound pressure level (SPL). Method: Indirect estimates of subglottal pressure (P[subscript sg]') were obtained…

Measuring direct and indirect costs of land retirement in an irrigated river basin: A budgeting regional multiplier approach

NASA Astrophysics Data System (ADS)

Hamilton, Joel; Whittlesey, Norman K.; Robison, M. Henry; Willis, David

2002-08-01

This analysis addresses three important conceptual problems in the measurement of direct and indirect costs and benefits: (1) the distribution of impacts between a regional economy and the encompassing state economy; (2) the distinction between indirect impacts and indirect costs (IC), focusing on the dynamic time path unemployed resources follow to find alternative employment; and (3) the distinction among the affected firms' microeconomic categories of fixed and variable costs as they are used to compute regional direct and indirect costs. It uses empirical procedures that reconcile the usual measures of economic impact provided by input/output models with the estimates of economic costs and benefits required for analysis of welfare changes. The paper illustrates the relationships and magnitudes involved in the context of water policy issues facing the Pecos River Basin of New Mexico.

Partial report and other sampling procedures overestimate the duration of iconic memory.

PubMed

Appelman, I B

1980-03-01

In three experiments, subjects estimated the duration of a brief visual image (iconic memory) either directly by adjusting onset of a click to offset of the visual image, or indirectly with a Sperling partial report (sampling) procedure. The results indicated that partial report and other sampling procedures may reflect other brief phenomena along with iconic memory. First, the partial report procedure yields a greater estimate of the duration of iconic memory than the more direct click method. Second, the partial report estimate of the duration of iconic memory is affected if the subject is required to simultaneously retain a list of distractor items (memory load), while the click method estimate of the duration of iconic memory is not affected by a memory load. Finally, another sampling procedure based on visual cuing yields different estimates of the duration of iconic memory depending on how many items are cued. It was concluded that partial report and other sampling procedures overestimate the duration of iconic memory.

Causal mediation analysis with a binary outcome and multiple continuous or ordinal mediators: Simulations and application to an alcohol intervention.

PubMed

Nguyen, Trang Quynh; Webb-Vargas, Yenny; Koning, Ina M; Stuart, Elizabeth A

We investigate a method to estimate the combined effect of multiple continuous/ordinal mediators on a binary outcome: 1) fit a structural equation model with probit link for the outcome and identity/probit link for continuous/ordinal mediators, 2) predict potential outcome probabilities, and 3) compute natural direct and indirect effects. Step 2 involves rescaling the latent continuous variable underlying the outcome to address residual mediator variance/covariance. We evaluate the estimation of risk-difference- and risk-ratio-based effects (RDs, RRs) using the ML, WLSMV and Bayes estimators in Mplus. Across most variations in path-coefficient and mediator-residual-correlation signs and strengths, and confounding situations investigated, the method performs well with all estimators, but favors ML/WLSMV for RDs with continuous mediators, and Bayes for RRs with ordinal mediators. Bayes outperforms WLSMV/ML regardless of mediator type when estimating RRs with small potential outcome probabilities and in two other special cases. An adolescent alcohol prevention study is used for illustration.

Flood impacts on a water distribution network

NASA Astrophysics Data System (ADS)

Arrighi, Chiara; Tarani, Fabio; Vicario, Enrico; Castelli, Fabio

2017-12-01

Floods cause damage to people, buildings and infrastructures. Water distribution systems are particularly exposed, since water treatment plants are often located next to the rivers. Failure of the system leads to both direct losses, for instance damage to equipment and pipework contamination, and indirect impact, since it may lead to service disruption and thus affect populations far from the event through the functional dependencies of the network. In this work, we present an analysis of direct and indirect damages on a drinking water supply system, considering the hazard of riverine flooding as well as the exposure and vulnerability of active system components. The method is based on interweaving, through a semi-automated GIS procedure, a flood model and an EPANET-based pipe network model with a pressure-driven demand approach, which is needed when modelling water distribution networks in highly off-design conditions. Impact measures are defined and estimated so as to quantify service outage and potential pipe contamination. The method is applied to the water supply system of the city of Florence, Italy, serving approximately 380 000 inhabitants. The evaluation of flood impact on the water distribution network is carried out for different events with assigned recurrence intervals. Vulnerable elements exposed to the flood are identified and analysed in order to estimate their residual functionality and to simulate failure scenarios. Results show that in the worst failure scenario (no residual functionality of the lifting station and a 500-year flood), 420 km of pipework would require disinfection with an estimated cost of EUR 21 million, which is about 0.5 % of the direct flood losses evaluated for buildings and contents. Moreover, if flood impacts on the water distribution network are considered, the population affected by the flood is up to 3 times the population directly flooded.

Cost Effectiveness of Influenza Vaccine Choices in Children Aged 2–8 Years in the U.S.

PubMed Central

Smith, Kenneth J.; Raviotta, Jonathan M.; DePasse, Jay V.; Brown, Shawn T.; Shim, Eunha; Nowalk, Mary Patricia; Zimmerman, Richard K.

2015-01-01

Introduction Prior evidence found live attenuated influenza vaccine (LAIV) more effective than inactivated influenza vaccine (IIV) in children aged 2–8 years, leading CDC in 2014 to prefer LAIV use in this group. However, since 2013, LAIV has not proven superior, leading CDC in 2015 to rescind their LAIV preference statement. Here, the cost effectiveness of preferred LAIV use compared with IIV in children aged 2–8 years is estimated. Methods A Markov model estimated vaccination strategy cost effectiveness in terms of cost per quality-adjusted life year gained. Base case assumptions were: equal vaccine uptake, IIV use when LAIV was not indicated (in 11.7% of the cohort), and no indirect vaccination effects. Sensitivity analyses included estimates of indirect effects from both equation- and agent-based models. Analyses were performed in 2014–2015. Results Using prior effectiveness data in children aged 2–8 years (LAIV=83%, IIV=64%), preferred LAIV use was less costly and more effective than IIV (dominant), with results sensitive only to LAIV and IIV effectiveness variation. Using 2014–2015 U.S. effectiveness data (LAIV=0%, IIV=15%), IIV was dominant. In two-way sensitivity analyses, LAIV use was cost saving over the entire range of IIV effectiveness (0%–81%) when absolute LAIV effectiveness was >7.1% higher than IIV, but never cost saving when absolute LAIV effectiveness was <3.5% higher than IIV. Conclusions Results support CDC’s decision to no longer prefer LAIV use and provide guidance on effectiveness differences between influenza vaccines that might lead to preferential LAIV recommendation for children aged 2–8 years. PMID:26868283

Estimating the costs of induced abortion in Uganda: A model-based analysis

PubMed Central

2011-01-01

Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical. PMID:22145859

Estimating the costs of induced abortion in Uganda: a model-based analysis.

PubMed

Babigumira, Joseph B; Stergachis, Andy; Veenstra, David L; Gardner, Jacqueline S; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P

2011-12-06

The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

Estimating the cost-effectiveness of 54 weeks of infliximab for rheumatoid arthritis.

PubMed

Wong, John B; Singh, Gurkirpal; Kavanaugh, Arthur

2002-10-01

To estimate the cost-effectiveness of infliximab plus methotrexate for active, refractory rheumatoid arthritis. We projected the 54-week results from a randomized controlled trial of infliximab into lifetime economic and clinical outcomes using a Markov computer simulation model. Direct and indirect costs, quality of life, and disability estimates were based on trial results; Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) database outcomes; and published data. Results were discounted using the standard 3% rate. Because most well-accepted medical therapies have cost-effectiveness ratios below $50,000 to $100,000 per quality-adjusted life-year (QALY) gained, results below this range were considered to be "cost-effective." At 3 mg/kg, each infliximab infusion would cost $1393. When compared with methotrexate alone, 54 weeks of infliximab plus methotrexate decreased the likelihood of having advanced disability from 23% to 11% at the end of 54 weeks, which projected to a lifetime marginal cost-effectiveness ratio of $30,500 per discounted QALY gained, considering only direct medical costs. When applying a societal perspective and including indirect or productivity costs, the marginal cost-effectiveness ratio for infliximab was $9100 per discounted QALY gained. The results remained relatively unchanged with variation of model estimates over a broad range of values. Infliximab plus methotrexate for 54 weeks for rheumatoid arthritis should be cost-effective with its clinical benefit providing good value for the drug cost, especially when including productivity losses. Although infliximab beyond 54 weeks will likely be cost-effective, the economic and clinical benefit remains uncertain and will depend on long-term results of clinical trials.

The economic burden of human papillomavirus-related precancers and cancers in Sweden

PubMed Central

Silfverschiöld, Maria; Greiff, Lennart; Asciutto, Christine; Wennerberg, Johan; Lydryp, Marie-Louise; Håkansson, Ulf; Sparén, Pär; Borgfeldt, Christer

2017-01-01

Background High-risk (HR) human papillomavirus (HPV) infection is an established cause of malignant disease. We used a societal perspective to estimate the cost of HR HPV-related cervical, vulvar, vaginal, anal, and penile precancer and cancer, and oropharyngeal cancer in Sweden in 2006, 1 year before HPV vaccination became available in the country. Materials and methods This prevalence-based cost-of-illness study used diagnosis-specific data from national registries to determine the number of HR HPV-related precancers and cancers. The HR HPV-attributable fractions of these diseases were derived from a literature review and applied to the total burden to estimate HR HPV-attributable costs. Direct costs were based on health care utilization and indirect costs on loss of productivity due to morbidity (i.e., sick leave and early retirement) and premature mortality. Results The total annual cost of all HR HPV-attributable precancers and cancers was €94 million (€10.3/inhabitant). Direct costs accounted for €31.3 million (€3.4/inhabitant) of the total annual cost, and inpatient care amounted to €20.7 million of direct costs. Indirect costs made up €62.6 million (€6.9/inhabitant) of the total annual cost, and premature mortality amounted to €36 million of indirect costs. Cervical precancer and cancer was most costly (total annual cost €58.4 million). Among cancers affecting both genders, anal precancer and cancer, and oropharyngeal cancer were the most costly (€11.2 million and €11.9 million, respectively). For oropharyngeal cancer, males had the highest health care utilization and represented 71% of the total annual cost. Penile precancer and cancer was least costly (€2.6 million). Conclusion The economic burden of HR HPV-related precancers and cancers is substantial. The disease-related management and treatment costs we report are relevant as a point of reference for future economic evaluations investigating the overall benefits of HPV vaccination in females and males in Sweden. PMID:28651012

Economic Burden of Hepatitis B Virus-Related Diseases: Evidence From Iran

PubMed Central

Keshavarz, Khosro; Kebriaeezadeh, Abbas; Alavian, Seyed Moayed; Akbari Sari, Ali; Abedin Dorkoosh, Farid; Keshvari, Maryam; Malekhosseini, Seyed Ali; Nikeghbalian, Saman; Nikfar, Shekoufeh

2015-01-01

Background: Hepatitis B infection is still the main cause of chronic liver disease in Iran, which is associated with significant economic and social costs. Objectives: This study aimed to estimate the financial burden caused by CHB infection and its complications in Iran. Patients and Methods: Prevalence-based and bottom-up approaches were used to collect the data. Data on direct medical costs were extracted from outpatient medical records in a referral gastroenterology and hepatology research center, inpatient medical records in several major hospitals in Tehran and Shiraz in 2013, and the self-reports of specialists. Data on direct non-medical and indirect costs were collected based on the patients’ self-reports through face-to-face interviews performed in the mentioned centers. To calculate the indirect costs, friction cost approach was used. To calculate the total cost-of-illness in Iran, the total cost per patient at each stage of the disease was estimated and multiplied by the total number of patients. Results: The total annual cost for the activate population of CHB patients and for those receiving treatment at various disease stages were respectively 450 million and 226 million dollars, with 64% and 70% of which allocated to direct costs respectively, and 36% and 30% to indirect costs respectively. The total direct costs alone for each group were respectively 1.17% and 0.6% of the total health expenditure. Furthermore, the cost spent on drugs encompasses the largest proportion of the direct medical cost for all stages of the disease. Conclusions: According to the perspectives of payers, patients, and community, CHB infection can be considered as one of the diseases with a substantial economic burden; the disease, specifically in extreme cases, can be too expensive and costly for patients. Therefore, patients should be protected against more severe stages of the disease through proper treatment and early diagnosis. PMID:25977694

Mediation analysis with time varying exposures and mediators

PubMed Central

VanderWeele, Tyler J.; Tchetgen Tchetgen, Eric J.

2016-01-01

Summary In this paper we consider causal mediation analysis when exposures and mediators vary over time. We give non-parametric identification results, discuss parametric implementation, and also provide a weighting approach to direct and indirect effects based on combining the results of two marginal structural models. We also discuss how our results give rise to a causal interpretation of the effect estimates produced from longitudinal structural equation models. When there are time-varying confounders affected by prior exposure and mediator, natural direct and indirect effects are not identified. However, we define a randomized interventional analogue of natural direct and indirect effects that are identified in this setting. The formula that identifies these effects we refer to as the “mediational g-formula.” When there is no mediation, the mediational g-formula reduces to Robins’ regular g-formula for longitudinal data. When there are no time-varying confounders affected by prior exposure and mediator values, then the mediational g-formula reduces to a longitudinal version of Pearl’s mediation formula. However, the mediational g-formula itself can accommodate both mediation and time-varying confounders and constitutes a general approach to mediation analysis with time-varying exposures and mediators. PMID:28824285

A Water-Withdrawal Input-Output Model of the Indian Economy.

PubMed

Bogra, Shelly; Bakshi, Bhavik R; Mathur, Ritu

2016-02-02

Managing freshwater allocation for a highly populated and growing economy like India can benefit from knowledge about the effect of economic activities. This study transforms the 2003-2004 economic input-output (IO) table of India into a water withdrawal input-output model to quantify direct and indirect flows. This unique model is based on a comprehensive database compiled from diverse public sources, and estimates direct and indirect water withdrawal of all economic sectors. It distinguishes between green (rainfall), blue (surface and ground), and scarce groundwater. Results indicate that the total direct water withdrawal is nearly 3052 billion cubic meter (BCM) and 96% of this is used in agriculture sectors with the contribution of direct green water being about 1145 BCM, excluding forestry. Apart from 727 BCM direct blue water withdrawal for agricultural, other significant users include "Electricity" with 64 BCM, "Water supply" with 44 BCM and other industrial sectors with nearly 14 BCM. "Construction", "miscellaneous food products"; "Hotels and restaurants"; "Paper, paper products, and newsprint" are other significant indirect withdrawers. The net virtual water import is found to be insignificant compared to direct water used in agriculture nationally, while scarce ground water associated with crops is largely contributed by northern states.

Mediation analysis with time varying exposures and mediators.

PubMed

VanderWeele, Tyler J; Tchetgen Tchetgen, Eric J

2017-06-01

In this paper we consider causal mediation analysis when exposures and mediators vary over time. We give non-parametric identification results, discuss parametric implementation, and also provide a weighting approach to direct and indirect effects based on combining the results of two marginal structural models. We also discuss how our results give rise to a causal interpretation of the effect estimates produced from longitudinal structural equation models. When there are time-varying confounders affected by prior exposure and mediator, natural direct and indirect effects are not identified. However, we define a randomized interventional analogue of natural direct and indirect effects that are identified in this setting. The formula that identifies these effects we refer to as the "mediational g-formula." When there is no mediation, the mediational g-formula reduces to Robins' regular g-formula for longitudinal data. When there are no time-varying confounders affected by prior exposure and mediator values, then the mediational g-formula reduces to a longitudinal version of Pearl's mediation formula. However, the mediational g-formula itself can accommodate both mediation and time-varying confounders and constitutes a general approach to mediation analysis with time-varying exposures and mediators.

Hotspot Identification for Shanghai Expressways Using the Quantitative Risk Assessment Method

PubMed Central

Chen, Can; Li, Tienan; Sun, Jian; Chen, Feng

2016-01-01

Hotspot identification (HSID) is the first and key step of the expressway safety management process. This study presents a new HSID method using the quantitative risk assessment (QRA) technique. Crashes that are likely to happen for a specific site are treated as the risk. The aggregation of the crash occurrence probability for all exposure vehicles is estimated based on the empirical Bayesian method. As for the consequences of crashes, crashes may not only cause direct losses (e.g., occupant injuries and property damages) but also result in indirect losses. The indirect losses are expressed by the extra delays calculated using the deterministic queuing diagram method. The direct losses and indirect losses are uniformly monetized to be considered as the consequences of this risk. The potential costs of crashes, as a criterion to rank high-risk sites, can be explicitly expressed as the sum of the crash probability for all passing vehicles and the corresponding consequences of crashes. A case study on the urban expressways of Shanghai is presented. The results show that the new QRA method for HSID enables the identification of a set of high-risk sites that truly reveal the potential crash costs to society. PMID:28036009

The economic burden of musculoskeletal disease in Korea: a cross sectional study.

PubMed

Oh, In-Hwan; Yoon, Seok-Jun; Seo, Hye-Young; Kim, Eun-Jung; Kim, Young Ae

2011-07-13

Musculoskeletal diseases are becoming increasingly important due to population aging. However, studies on the economic burden of musculoskeletal disease in Korea are scarce. Therefore, we conducted a population-based study to measure the economic burden of musculoskeletal disease in Korea using nationally representative data. This study used a variety of data sources such as national health insurance statistics, the Korea Health Panel study and cause of death reports generated by the Korea National Statistical Office to estimate the economic burden of musculoskeletal disease. The total cost of musculoskeletal disease was estimated as the sum of direct medical care costs, direct non-medical care costs, and indirect costs. Direct medical care costs are composed of the costs paid by the insurer and patients, over the counter drugs costs, and other costs such as medical equipment costs. Direct non-medical costs are composed of transportation and caregiver costs. Indirect costs are the sum of the costs associated with premature death and the costs due to productivity loss. Age, sex, and disease specific costs were estimated. Among the musculoskeletal diseases, the highest costs are associated with other dorsopathies, followed by disc disorder and arthrosis. The direct medical and direct non-medical costs of all musculoskeletal diseases were $4.18 billion and $338 million in 2008, respectively. Among the indirect costs, those due to productivity loss were $2.28 billion and costs due to premature death were $79 million. The proportions of the total costs incurred by male and female patients were 33.8% and 66.2%, respectively, and the cost due to the female adult aged 20-64 years old was highest. The total economic cost of musculoskeletal disease was $6.89 billion, which represents 0.7% of the Korean gross domestic product. The economic burden of musculoskeletal disease in Korea is substantial. As the Korean population continues to age, the economic burden of musculoskeletal disease will continue to increase. Policy measures aimed at controlling the cost of musculoskeletal disease are therefore required.

The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study.

PubMed

Bommer, Christian; Heesemann, Esther; Sagalova, Vera; Manne-Goehler, Jennifer; Atun, Rifat; Bärnighausen, Till; Vollmer, Sebastian

2017-06-01

Differences in methods and data used in past studies have limited comparisons of the cost of illness of diabetes across countries. We estimate the full global economic burden of diabetes in adults aged 20-79 years in 2015, using a unified framework across all countries. Our objective was to highlight patterns of diabetes-associated costs as well as to identify the need for further research in low-income regions. Epidemiological and economic data for 184 countries were used to estimate the global economic burden of diabetes, regardless of diabetes type. Direct costs were derived using a top-down approach based on WHO general health expenditure figures and prevalence data from the 2015 International Diabetes Federation Diabetes Atlas. Indirect costs were assessed using a human-capital approach, including diabetes-associated morbidity and premature mortality. We estimate the global cost of diabetes for 2015 was US$1·31 trillion (95% CI 1·28-1·36) or 1·8% (95% CI 1·8-1·9) of global gross domestic product (GDP). Notably, indirect costs accounted for 34·7% (95% CI 34·7-35·0) of the total burden, although substantial variations existed both in the share and the composition of indirect costs across countries. North America was the most affected region relative to GDP and also the largest contributor to global absolute costs. However, on average, the economic burden as percentage of GDP was larger in middle-income countries than in high-income countries. Our results suggest a substantial global economic burden of diabetes. Although limited data were available for low-income and middle-income countries, our findings suggest that large diabetes-associated costs are not only a problem in high-income settings but also affect poorer world regions. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

An economic comparison of hospital-based and community-based glaucoma clinics

PubMed Central

Sharma, A; Jofre-Bonet, M; Panca, M; Lawrenson, J G; Murdoch, I

2012-01-01

Introduction We have established one model for community care of glaucoma clinic patients. Community optometrists received training and accreditation in glaucoma care. Once qualified they alternated between running half day glaucoma clinics in their own High Street practices and assisting in a hospital-based glaucoma clinic session. This paper reports the cost of this model. Methods Micro-costing was undertaken for the hospital clinic. A consensus meeting was held to agree costs for community clinics involving all optometrists in the project along with representatives of the multiple chain optometry practices who had participated. Costs to patients both indirect and direct were calculated following structured interviews of 197 patients attending hospital clinics and 194 attending community clinics. Results The estimated cost per patient attendance to the hospital clinic was £63.91 and the estimated cost per attendance to the community clinic was £145.62. For patients the combined direct and indirect cost to attend the hospital clinic was £6.15 and the cost to attend the community clinic £5.91. Discussion The principal reason for the higher cost in the community clinic was higher overhead costs in the community. Re-referral to the hospital system only occurred for 9% of patients and was not a large contribution to the increased cost. Time requested to next appointment was similar for the two clinics. Sensitivity analysis shows a strong effect of increasing patients seen per clinic. It would, however, require 25 patients to be seen per clinician per day in the community in order to make the costs comparable. PMID:22562188

Estimation of macroscopic elastic characteristics for hierarchical anisotropic solids based on probabilistic approach

NASA Astrophysics Data System (ADS)

Smolina, Irina Yu.

2015-10-01

Mechanical properties of a cable are of great importance in design and strength calculation of flexible cables. The problem of determination of elastic properties and rigidity characteristics of a cable modeled by anisotropic helical elastic rod is considered. These characteristics are calculated indirectly by means of the parameters received from statistical processing of experimental data. These parameters are considered as random quantities. With taking into account probable nature of these parameters the formulas for estimation of the macroscopic elastic moduli of a cable are obtained. The calculating expressions for macroscopic flexural rigidity, shear rigidity and torsion rigidity using the macroscopic elastic characteristics obtained before are presented. Statistical estimations of the rigidity characteristics of some cable grades are adduced. A comparison with those characteristics received on the basis of deterministic approach is given.

Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

NASA Astrophysics Data System (ADS)

Ram Prabhakar, J.; Ragavan, K.

2013-07-01

This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

Increasing efficiency of CO2 uptake by combined land-ocean sink

NASA Astrophysics Data System (ADS)

van Marle, M.; van Wees, D.; Houghton, R. A.; Nassikas, A.; van der Werf, G.

2017-12-01

Carbon-climate feedbacks are one of the key uncertainties in predicting future climate change. Such a feedback could originate from carbon sinks losing their efficiency, for example due to saturation of the CO2 fertilization effect or ocean warming. An indirect approach to estimate how the combined land and ocean sink responds to climate change and growing fossil fuel emissions is based on assessing the trends in the airborne fraction of CO2 emissions from fossil fuel and land use change. One key limitation with this approach has been the large uncertainty in quantifying land use change emissions. We have re-assessed those emissions in a more data-driven approach by combining estimates coming from a bookkeeping model with visibility-based land use change emissions available for the Arc of Deforestation and Equatorial Asia, two key regions with large land use change emissions. The advantage of the visibility-based dataset is that the emissions are observation-based and this dataset provides more detailed information about interannual variability than previous estimates. Based on our estimates we provide evidence that land use and land cover change emissions have increased more rapidly than previously thought, implying that the airborne fraction has decreased since the start of CO2 measurements in 1959. This finding is surprising because it means that the combined land and ocean sink has become more efficient while the opposite is expected.

The socioeconomic impact of drug-related crimes in Chile.

PubMed

Fernández, Matías

2012-11-01

Illegal drug use and trafficking are closely connected to crime. This article estimates the socioeconomic impact of this connection in Chile. Goldstein's tripartite model was applied quantifying drug-crime connections and then using those estimates to measure the socioeconomic impact of drug-related crimes. This was estimated in terms of both the monetary cost of law enforcement, and lost productivity due to incarceration. This socioeconomic impact can be divided into: (a) the direct costs arising from infractions to Chile's Drug Law, and the indirect costs originated by crimes linked only partially to drug consumption and trafficking; (b) is measured in productivity losses, as well as in costs to the three branches of Chile's criminal justice system (police, judiciary, and prisons); and (c) is attributed to the three illicit drugs most prevalent in Chile: cannabis, cocaine hydrochloride (CH) and cocaine base paste (CBP). The socioeconomic impact of Chile's drug-crime relationship in 2006 is estimated to be USD 268 million. Out of this amount, 36% is spent on national Drug Law enforcement, and the remaining 64% comes from the connection of drug use and trafficking with non-Drug-Law-related crimes. The police bear the largest share of drug enforcement costs (32%), followed by penitentiaries (25%). Productivity losses due to incarceration for drug-related crimes represent 29% of the total impact. 53% of the costs are attributable to CBP, 29% to CH, and the remaining 18% to cannabis. The impact of CBP is greater when indirect costs are taken into account, although direct costs are primarily associated with CH. The majority of costs is attributed to the trafficking and consumption of CBP, a drug with a relatively low prevalence. Based on the results, this study suggests reviewing drug enforcement policies to differentiate them according to the social and individual harm caused by each drug. Copyright © 2012 Elsevier B.V. All rights reserved.

Prevalence-based, disease-specific estimate of the social cost of smoking in Singapore.

PubMed

Cher, Boon Piang; Chen, Cynthia; Yoong, Joanne

2017-04-07

To estimate the cost of smoking in Singapore in 2014 from the societal perspective. A prevalence-based, disease-specific approach was undertaken to estimate the smoking-attributable costs. These include direct and indirect costs of inpatient treatment, premature mortality, loss of productivity due to medical leaves and smoking breaks. In 2014, the social cost of smoking in Singapore was conservatively estimated to be at least US$479.8 million, ∼0.2% of the 2014 gross domestic product. Most of this cost was attributable to productivity losses (US$464.9 million) and largely concentrated in the male population (US$434.9 million). Direct healthcare costs amounted to US$14.9 million where ischaemic heart disease and lung cancer had the highest cost burden. The social cost of smoking is smaller in Singapore than in other Asian countries. However, there is still cause for concern. A recently observed increase in smoking prevalence, particularly among adolescent men, is likely to result in rising total cost. Most significantly, our results suggest that a large share of the overall cost burden lies outside the healthcare system or may not be highly salient to the relevant decision makers. This is partly because of the nature of such costs (indirect or intangible costs such as productivity losses are often not salient) or data limitations (a potentially significant fraction of direct healthcare expenditure may be in private primary care where costs are not systematically captured and reported). The case of Singapore thus illustrates that even in countries perceived as success stories, strong multisectoral anti-tobacco strategies and a supporting research agenda continue to be needed. 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/.

Societal costs of multiple sclerosis in Ireland.

PubMed

Carney, Peter; O'Boyle, Derek; Larkin, Aidan; McGuigan, Christopher; O'Rourke, Killian

2018-05-01

This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. A questionnaire was developed to capture the demographics, disease characteristics, healthcare use, informal care, employment, and wellbeing. Referencing international studies, standardized survey instruments were included (e.g. CSRI, MFIS-5, EQ-5D) or adapted (EDSS) for inclusion in an online survey platform. Recruitment was directed at people with MS via the MS Society mailing list and social media platforms, as well as in traditional media. The economic costing was primarily conducted using a 'bottom-up' methodology, and national estimates were achieved using 'prevalence-based' extrapolation. A total of 594 people completed the survey in full. The sample had geographic, disease, and demographic characteristics indicating good representativeness. At an individual level, average societal cost was estimated at €47,683; the average annual costs for those with mild, moderate, and severe MS were calculated as €34,942, €57,857, and €100,554, respectively. For a total Irish MS population of 9,000, the total societal costs of MS amounted to €429m. Direct costs accounted for just 30% of the total societal costs, indirect costs amounted to 50% of the total, and intangible or QoL costs represented 20%. The societal cost associated with a relapse in the sample is estimated as €2,438. The findings highlight that up to 70% of the total costs associated with MS are not routinely counted. These "hidden" costs are higher in Ireland than the rest of Europe, due in part to significantly lower levels of workforce participation, a higher likelihood of permanent workforce withdrawal, and higher levels of informal care needs. The relationship between disease progression and costs emphasize the societal importance of managing and slowing the progression of the illness.

Mediation Analysis with Multiple Mediators

PubMed Central

VanderWeele, T.J.; Vansteelandt, S.

2014-01-01

Recent advances in the causal inference literature on mediation have extended traditional approaches to direct and indirect effects to settings that allow for interactions and non-linearities. In this paper, these approaches from causal inference are further extended to settings in which multiple mediators may be of interest. Two analytic approaches, one based on regression and one based on weighting are proposed to estimate the effect mediated through multiple mediators and the effects through other pathways. The approaches proposed here accommodate exposure-mediator interactions and, to a certain extent, mediator-mediator interactions as well. The methods handle binary or continuous mediators and binary, continuous or count outcomes. When the mediators affect one another, the strategy of trying to assess direct and indirect effects one mediator at a time will in general fail; the approach given in this paper can still be used. A characterization is moreover given as to when the sum of the mediated effects for multiple mediators considered separately will be equal to the mediated effect of all of the mediators considered jointly. The approach proposed in this paper is robust to unmeasured common causes of two or more mediators. PMID:25580377

Mediation Analysis with Multiple Mediators.

PubMed

VanderWeele, T J; Vansteelandt, S

2014-01-01

Recent advances in the causal inference literature on mediation have extended traditional approaches to direct and indirect effects to settings that allow for interactions and non-linearities. In this paper, these approaches from causal inference are further extended to settings in which multiple mediators may be of interest. Two analytic approaches, one based on regression and one based on weighting are proposed to estimate the effect mediated through multiple mediators and the effects through other pathways. The approaches proposed here accommodate exposure-mediator interactions and, to a certain extent, mediator-mediator interactions as well. The methods handle binary or continuous mediators and binary, continuous or count outcomes. When the mediators affect one another, the strategy of trying to assess direct and indirect effects one mediator at a time will in general fail; the approach given in this paper can still be used. A characterization is moreover given as to when the sum of the mediated effects for multiple mediators considered separately will be equal to the mediated effect of all of the mediators considered jointly. The approach proposed in this paper is robust to unmeasured common causes of two or more mediators.

Experimental Study of Dry Granular Flow and Impact Behavior Against a Rigid Retaining Wall

NASA Astrophysics Data System (ADS)

Jiang, Yuan-Jun; Towhata, Ikuo

2013-07-01

Shallow slope failure in mountainous regions is a common and emergent hazard in terms of its damage to important traffic routes and local communities. The impact of dry granular flows consisting of rock fragments and other particles resulting from shallow slope failures on retaining structures has yet to be systematically researched and is not covered by current design codes. As a preliminary study of the impact caused by dry granular flows, a series of dry granular impact experiments were carried out for one model of a retaining wall. It was indirectly verified that the total normal force exerted on a retaining wall consists of a drag force ( F d), a gravitational and frictional force ( F gf), and a passive earth force ( F p), and that the calculation of F d can be based on the empirical formula defined in NF EN Eurocode 1990 ( Eurocode structuraux. Base de calcul des structures, AFNOR La plaine Saint Denis, 2003). It was also indirectly verified that, for flow with Froude number from 6 to 11, the drag coefficient ( C d) can be estimated using the previously proposed empirical parameters.

The economic costs of alcohol consumption in Thailand, 2006

PubMed Central

2010-01-01

Background There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. Methods This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity). Results The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP) or about 1.99% of the total Gross Domestic Product (GDP). Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP) depending on the methods and assumptions employed. Conclusions Alcohol imposes a substantial economic burden on Thai society, and according to these findings, the Thai government needs to pay significantly more attention to implementing more effective alcohol policies/interventions in order to reduce the negative consequences associated with alcohol. PMID:20534112

The economic costs of alcohol consumption in Thailand, 2006.

PubMed

Thavorncharoensap, Montarat; Teerawattananon, Yot; Yothasamut, Jomkwan; Lertpitakpong, Chanida; Thitiboonsuwan, Khannika; Neramitpitagkul, Prapag; Chaikledkaew, Usa

2010-06-09

There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity). The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP) or about 1.99% of the total Gross Domestic Product (GDP). Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP) depending on the methods and assumptions employed. Alcohol imposes a substantial economic burden on Thai society, and according to these findings, the Thai government needs to pay significantly more attention to implementing more effective alcohol policies/interventions in order to reduce the negative consequences associated with alcohol.

On Assessment and Estimation of Potential Losses due to Land Subsidence in Urban Areas of Indonesia

NASA Astrophysics Data System (ADS)

Abidin, Hasanuddin Z.; Andreas, Heri; Gumilar, Irwan; Sidiq, Teguh P.

2016-04-01

Land subsidence is natural-anthropogenic hazard affecting several large urban areas in Indonesia, i.e. Jakarta, Bandung and Semarang. Geodetic based results from various techniques (e.g. Leveling, GPS and InSAR) show that land subsidence rates in all three cities generally have spatial and temporal variations, and their magnitude is in average about 5-10 cm/year. The impacts of subsidence in those cities can be seen in the field in various forms such as cracking of permanent constructions and roads, tilting of houses and buildings, 'sinking' of houses and buildings, changes in river canal and drain flow systems, wider expansion of coastal and/or inland flooding areas, and increased inland sea water intrusion. These impacts can be categorized into infrastructure, environmental, economic, and social impacts. The potential losses due to land subsidence in urban areas are actually quite significant. Related infrastructural, social and environmental costs due to direct and indirect impacts of land subsidence are economically quite significant, and can not be underestimated in sustainable urban development. The planning, development and maintenance costs of building and infrastructures in the affected areas are usually much higher than the normal situation. The collateral impact of coastal subsidence in Jakarta and Semarang, in the form of coastal flooding during high tides is also quite damaging. This repeated coastal flooding in several areas along the coast will deteriorate the structure and function of building and infrastructures, badly influences the quality of the living environment and life (e.g. health and sanitation condition), and also disrupts economic and social activities in the affected areas. As in the case of Bandung, inland subsidence also has a quite significant impact on inland flooding phenomena, since it will theoretically lead to expanded coverage and deeper water depth of flooded (inundated) areas. Since the direct and indirect impacts of subsidence have also relation among each other, the accurate quantification of the potential losses caused by land subsidence in urban areas is not an easy task to accomplish. The direct losses can be easier to estimate than the indirect losses. For example, the direct losses due to land subsidence in Bandung was estimated to be at least 180 Million USD; but the indirect losses is still unknown.

Development of an indirect ELISA for detection of antibody to wobbly possum disease virus in archival sera of Australian brushtail possums (Trichosurus vulpecula) in New Zealand.

PubMed

Giles, J C; Johnson, W; Jones, G; Heuer, C; Dunowska, M

2018-07-01

To develop an indirect ELISA based on recombinant nucleocapsid (rN) protein of wobbly possum disease (WPD) virus for investigation of the presence of WPD virus in Australian brushtail possums (Trichosurus vulpecula) in New Zealand. Pre- and post-infection sera (n=15 and 16, respectively) obtained from a previous experimental challenge study were used for ELISA development. Sera were characterised as positive or negative for antibody to WPD virus based on western-blot using WPD virus rN protein as antigen. An additional 215 archival serum samples, collected between 2000-2016 from five different regions of New Zealand, were also tested using the ELISA. Bayesian modelling of corrected optical density at 450 nm (OD 450 ) results from the ELISA was used to obtain estimates of receiver operating characteristic (ROC) curves to establish cut-off values for the ELISA, and to estimate the prevalence of antibody to WPD virus. Western blot analysis showed 5/14 (36%) pre-infection sera and 11/11 (100%) post-infection sera from experimentally infected possums were positive for antibodies to WPD virus. Bayesian estimates of the ROC curves established cut-off values of OD 450 ≥0.41 for samples positive, and OD 450 <0.28 for samples negative for antibody to WPD virus, for sera diluted 1:100 for the ELISA. Based on the model, the estimated proportion of samples with antibodies to WPD virus was 0.30 (95% probability interval=0.196-0.418). Of the 230 archival serum samples tested using the ELISA, 48 (20.9%) were positive for antibody to WPD virus, 155 (67.4%) were negative and 27 (11.7%) equivocal, using the established cut-off values. The proportion of samples positive for WPD virus antibody differed between geographical regions (p<0.001). The results suggested that WPD virus or a related virus has circulated among possums in New Zealand with differences in the proportion of antibody-positive samples from different geographical regions. Antibodies to WPD virus did not seem to protect possums from disease following experimental infection, as one third of possums from the previous challenge study showed evidence of pre-existing antibody at the time of challenge. These results provide further support for existence of different pathotypes of WPD virus, but the exact determinants of protection against WPD and epidemiology of infection in various regions of New Zealand remain to be established. Availability of the indirect ELISA for detection of WPD virus antibody will facilitate prospective epidemiological investigation of WPD virus circulation in wild possum populations in New Zealand.

Direct and indirect predictions of enteric methane daily production, yield, and intensity per unit of milk and cheese, from fatty acids and milk Fourier-transform infrared spectra.

PubMed

Bittante, Giovanni; Cipolat-Gotet, Claudio

2018-05-23

Mitigating the dairy chain's contribution to climate change requires cheap, rapid methods of predicting enteric CH 4 emissions (EME) of dairy cows in the field. Such methods may also be useful for genetically improving cows to reduce EME. Our objective was to evaluate different procedures for predicting EME traits from infrared spectra of milk samples taken at routine milk recording of cows. As a reference method, we used EME traits estimated from published equations developed from a meta-analysis of data from respiration chambers through analysis of various fatty acids in milk fat by gas chromatography (FA GC ). We analyzed individual milk samples of 1,150 Brown Swiss cows from 85 farms operating different dairy systems (from very traditional to modern), and obtained the cheese yields of individual model cheeses from these samples. We also obtained Fourier-transform infrared absorbance spectra on 1,060 wavelengths (5,000 to 930 waves/cm) from the same samples. Five reference enteric CH 4 traits were calculated: CH 4 yield (CH 4 /DMI, g/kg) per unit of dry matter intake (DMI), and CH 4 intensity (CH 4 /CM, g/kg) per unit of corrected milk (CM) from the FA GC profiles; CH 4 intensity per unit of fresh cheese (CH 4 /CY CURD , g/kg) and cheese solids (CH 4 /CY SOLIDS , g/kg) from individual cheese yields (CY); and daily CH 4 production (dCH 4 , g/d). Direct infrared (IR) calibrations were obtained by BayesB modeling; the determination coefficients of cross-validation varied from 0.36 for dCH 4 to 0.57 for CH 4 /CM, and were similar to the coefficient of determination values of the equations based on FA GC used as the reference method (0.47 for CH 4 /DMI and 0.54 for CH 4 /CM). The models allowed us to select the most informative wavelengths for each EME trait and to infer the milk chemical features underlying the predictions. Aside from the 5 direct infrared prediction calibrations, we tested another 8 indirect prediction models. Using IR-predicted informative fatty acids (FA IR ) instead of FA GC , we were able to obtain indirect predictions with about the same precision (correlation with reference values) as direct IR predictions of CH 4 /DMI (0.78 vs. 0.76, respectively) and CH 4 /CM (0.82 vs. 0.83). The indirect EME predictions based on IR-predicted CY were less precise than the direct IR predictions of both CH 4 /CY CURD (0.67 vs. 0.81) and CH 4 /CY SOLIDS (0.62 vs. 0.78). Four indirect dCH 4 predictions were obtained by multiplying the measured or IR-predicted daily CM production by the direct or indirect CH 4 /CM. Combining recorded daily CM and predicted CH 4 /CM greatly increased precision over direct dCH 4 predictions (0.96-0.96 vs. 0.68). The estimates obtained from the majority of direct and indirect IR-based prediction models exhibited herd and individual cow variability and effects of the main sources of variation (dairy system, parity, days in milk) similar to the reference data. Some rapid, cheap, direct and indirect IR prediction models appear to be useful for monitoring EME in the field and possibly for genetic/genomic selection, but future studies directly measuring CH 4 with different breeds and dairy systems are needed to validate our findings. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Indirect potentiometric titration of ascorbic acid in pharmaceutical preparations using copper based mercury film electrode.

PubMed

Abdul Kamal Nazer, Meeran Mohideen; Hameed, Abdul Rahman Shahul; Riyazuddin, Patel

2004-01-01

A simple and rapid potentiometric method for the estimation of ascorbic acid in pharmaceutical dosage forms has been developed. The method is based on treating ascorbic acid with iodine and titration of the iodide produced equivalent to ascorbic acid with silver nitrate using Copper Based Mercury Film Electrode (CBMFE) as an indicator electrode. Interference study was carried to check possible interference of usual excipients and other vitamins. The precision and accuracy of the method was assessed by the application of lack-of-fit test and other statistical methods. The results of the proposed method and British Pharmacopoeia method were compared using F and t-statistical tests of significance.

Power-law statistics of neurophysiological processes analyzed using short signals

NASA Astrophysics Data System (ADS)

Pavlova, Olga N.; Runnova, Anastasiya E.; Pavlov, Alexey N.

2018-04-01

We discuss the problem of quantifying power-law statistics of complex processes from short signals. Based on the analysis of electroencephalograms (EEG) we compare three interrelated approaches which enable characterization of the power spectral density (PSD) and show that an application of the detrended fluctuation analysis (DFA) or the wavelet-transform modulus maxima (WTMM) method represents a useful way of indirect characterization of the PSD features from short data sets. We conclude that despite DFA- and WTMM-based measures can be obtained from the estimated PSD, these tools outperform the standard spectral analysis when characterization of the analyzed regime should be provided based on a very limited amount of data.

The indirect costs of cancer-related absenteeism in the workplace in Poland.

PubMed

Macioch, Tomasz; Hermanowski, Tomasz

2011-12-01

The aim of this study was to evaluate cancer-related absenteeism costs in Poland. Data on sickness absences and disability were retrieved from the Department of Statistics of the Social Insurance Institution. The cost of lost productivity owing to premature death was estimated from data retrieved from the Polish National Cancer Registry. Absenteeism costs were estimated on the basis of the measure of gross value added per employee. The costs of lost productivity owing to sick leave, disability, and premature death were estimated to be 1.572 billion EUR, 0.504 billion EUR, and 0.535 billion EUR, respectively, in 2009. The indirect costs of lost productivity owing to cancer-related sick leave, disability, and premature death have a substantial effect on the Polish economy. In 2009, they accounted for more than 0.8% of GDP.

ESTIMATION OF CHILDREN'S EXPOSURES VIA POORLY CHARACTERIZED PATHWAYS USING CTEPP DATA

EPA Science Inventory

This work involved providing better exposure estimates for poorly characterized pathways (dermal and indirect ingestion) for young children in the CTEPP study. The chemicals used in this analysis were chlorpyrifos and its degradation product 3,5,6-trichloro-2-pyridinol.

Sex workers in Vietnam: how many, how risky?

PubMed

Minh, Truong Tan; Nhan, Do Thi; West, Gary R; Durant, Tonji M; Jenkins, Richard A; Huong, Pham Thi; Valdiserri, Ronald O

2004-10-01

Because of concerns for HIV risks and need to plan effective programs, we assessed the number and risks of sex workers in Nha Trang City, Vietnam. Sex workers were contacted in streets, beaches, bars, and restaurants, and a capture-recapture method was used to estimate their number. An estimated 444 women worked on the streets and beach ("direct" sex workers) and 486 worked in bars and restaurants or other facilities ("indirect" sex workers). Direct and indirect sex workers engaged in sex work primarily to support their families. Direct sex workers were older and were more at risk for HIV risk than were indirect sex workers. Direct sex workers had more clients, were less likely to report always using condoms (67% vs. 81%), more likely to report a prior sexually transmitted infection (19% vs. 16%), and more likely to have clients who inject drugs (16% vs. 13%). This assessment has implications for planning programs to reduce sex work and its risks in Vietnam and potentially other countries.

Validity of wearable activity monitors for tracking steps and estimating energy expenditure during a graded maximal treadmill test.

PubMed

Kendall, Bradley; Bellovary, Bryanne; Gothe, Neha P

2018-06-04

The purpose of this study was to assess the accuracy of energy expenditure (EE) estimation and step tracking abilities of six activity monitors (AMs) in relation to indirect calorimetry and hand counted steps and assess the accuracy of the AMs between high and low fit individuals in order to assess the impact of exercise intensity. Fifty participants wore the Basis watch, Fitbit Flex, Polar FT7, Jawbone, Omron pedometer, and Actigraph during a maximal graded treadmill test. Correlations, intra-class correlations, and t-tests determined accuracy and agreement between AMs and criterions. The results indicate that the Omron, Fitbit, and Actigraph were accurate for measuring steps while the Basis and Jawbone significantly underestimated steps. All AMs were significantly correlated with indirect calorimetry, however, no devices showed agreement (p < .05). When comparing low and high fit groups, correlations between AMs and indirect calorimetry improved for the low fit group, suggesting AMs may be better at measuring EE at lower intensity exercise.

Using indirect comparisons to compare interventions within a Cochrane review: a tool for comparative effectiveness research.

PubMed

Agapova, Maria; Devine, Emily B; Nguyen, Hiep; Wolf, Fredric M; Inoue, Lurdes Y T

2014-07-01

Assessing relative performance among competing interventions is an important part of comparative effectiveness research. Bayesian indirect comparisons add information to existing Cochrane reviews, such as which intervention is likely to perform best. However, heterogeneity variance priors may influence results and, potentially, clinical guidance. We highlight the features of Bayesian indirect comparisons using a case study of a Cochrane review update in asthma care. The probability that one self-management educational intervention outperforms others is estimated. Simulation studies investigate the effect of heterogeneity variance prior distributions. Results suggest a 55% probability that individual education is best, followed by combination (39%) and group (6%). The intervention with few trials was sensitive to prior distributions. Bayesian indirect comparisons updates of Cochrane reviews are valuable comparative effectiveness research tools.

Uncertainty estimation of water levels for the Mitch flood event in Tegucigalpa

NASA Astrophysics Data System (ADS)

Fuentes Andino, D. C.; Halldin, S.; Lundin, L.; Xu, C.

2012-12-01

Hurricane Mitch in 1998 left a devastating flood in Tegucigalpa, the capital city of Honduras. Simulation of elevated water surfaces provides a good way to understand the hydraulic mechanism of large flood events. In this study the one-dimensional HEC-RAS model for steady flow conditions together with the two-dimensional Lisflood-fp model were used to estimate the water level for the Mitch event in the river reaches at Tegucigalpa. Parameters uncertainty of the model was investigated using the generalized likelihood uncertainty estimation (GLUE) framework. Because of the extremely large magnitude of the Mitch flood, no hydrometric measurements were taken during the event. However, post-event indirect measurements of discharge and observed water levels were obtained in previous works by JICA and USGS. To overcome the problem of lacking direct hydrometric measurement data, uncertainty in the discharge was estimated. Both models could well define the value for channel roughness, though more dispersion resulted from the floodplain value. Analysis of the data interaction showed that there was a tradeoff between discharge at the outlet and floodplain roughness for the 1D model. The estimated discharge range at the outlet of the study area encompassed the value indirectly estimated by JICA, however the indirect method used by the USGS overestimated the value. If behavioral parameter sets can well reproduce water surface levels for past events such as Mitch, more reliable predictions for future events can be expected. The results acquired in this research will provide guidelines to deal with the problem of modeling past floods when no direct data was measured during the event, and to predict future large events taking uncertainty into account. The obtained range of the uncertain flood extension will be an outcome useful for decision makers.

The Cost of Ménière's Disease: A Novel Multisource Approach.

PubMed

Tyrrell, Jessica; Whinney, David J; Taylor, Timothy

2016-01-01

To estimate the annual cost of Ménière's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. The authors utilized a multidata approach to provide the first estimate of the cost of Ménière's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Ménière's Society (2014) were used to estimate the cost of Ménière's. Cases were self-reported in the UK Biobank and UK Ménière's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses (χ tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Ménière's was estimated to cost between £541.30 million and £608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to £3,341 to £3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over £400 million per annum. For the first time, the authors were able to estimate the economic burden of Ménière's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Ménière's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis.

Expectation, information processing, and subjective duration.

PubMed

Simchy-Gross, Rhimmon; Margulis, Elizabeth Hellmuth

2018-01-01

In research on psychological time, it is important to examine the subjective duration of entire stimulus sequences, such as those produced by music (Teki, Frontiers in Neuroscience, 10, 2016). Yet research on the temporal oddball illusion (according to which oddball stimuli seem longer than standard stimuli of the same duration) has examined only the subjective duration of single events contained within sequences, not the subjective duration of sequences themselves. Does the finding that oddballs seem longer than standards translate to entire sequences, such that entire sequences that contain oddballs seem longer than those that do not? Is this potential translation influenced by the mode of information processing-whether people are engaged in direct or indirect temporal processing? Two experiments aimed to answer both questions using different manipulations of information processing. In both experiments, musical sequences either did or did not contain oddballs (auditory sliding tones). To manipulate information processing, we varied the task (Experiment 1), the sequence event structure (Experiments 1 and 2), and the sequence familiarity (Experiment 2) independently within subjects. Overall, in both experiments, the sequences that contained oddballs seemed shorter than those that did not when people were engaged in direct temporal processing, but longer when people were engaged in indirect temporal processing. These findings support the dual-process contingency model of time estimation (Zakay, Attention, Perception & Psychophysics, 54, 656-664, 1993). Theoretical implications for attention-based and memory-based models of time estimation, the pacemaker accumulator and coding efficiency hypotheses of time perception, and dynamic attending theory are discussed.

Evaluating the predictive performance of empirical estimators of natural mortality rate using information on over 200 fish species

USGS Publications Warehouse

Then, Amy Y.; Hoenig, John M; Hall, Norman G.; Hewitt, David A.

2015-01-01

Many methods have been developed in the last 70 years to predict the natural mortality rate, M, of a stock based on empirical evidence from comparative life history studies. These indirect or empirical methods are used in most stock assessments to (i) obtain estimates of M in the absence of direct information, (ii) check on the reasonableness of a direct estimate of M, (iii) examine the range of plausible M estimates for the stock under consideration, and (iv) define prior distributions for Bayesian analyses. The two most cited empirical methods have appeared in the literature over 2500 times to date. Despite the importance of these methods, there is no consensus in the literature on how well these methods work in terms of prediction error or how their performance may be ranked. We evaluate estimators based on various combinations of maximum age (tmax), growth parameters, and water temperature by seeing how well they reproduce >200 independent, direct estimates of M. We use tenfold cross-validation to estimate the prediction error of the estimators and to rank their performance. With updated and carefully reviewed data, we conclude that a tmax-based estimator performs the best among all estimators evaluated. The tmax-based estimators in turn perform better than the Alverson–Carney method based on tmax and the von Bertalanffy K coefficient, Pauly’s method based on growth parameters and water temperature and methods based just on K. It is possible to combine two independent methods by computing a weighted mean but the improvement over the tmax-based methods is slight. Based on cross-validation prediction error, model residual patterns, model parsimony, and biological considerations, we recommend the use of a tmax-based estimator (M=4.899tmax−0.916">M=4.899t−0.916maxM=4.899tmax−0.916, prediction error = 0.32) when possible and a growth-based method (M=4.118K0.73L∞−0.33">M=4.118K0.73L−0.33∞M=4.118K0.73L∞−0.33 , prediction error = 0.6, length in cm) otherwise.

Literature review of organic matter transport from marshes

NASA Technical Reports Server (NTRS)

Dow, D. D.

1982-01-01

A conceptual model for estimating a transport coefficient for the movement of nonliving organic matter from wetlands to the adjacent embayments was developed in a manner that makes it compatible with the Earth Resources Laboratory's Productive Capacity Model. The model, which envisages detritus movement from wetland pixels to the nearest land-water boundary followed by movement within the water column from tidal creeks to the adjacent embayment, can be transposed to deal with only the interaction between tidal water and the marsh or to estimate the transport from embayments to the adjacent coastal waters. The outwelling hypothesis postulated wetlands as supporting coastal fisheries either by exporting nutrients, such as inorganic nitrogen, which stimulated the plankton-based grazing food chain in the water column, or through the export of dissolved and particulate organic carbon which provided a benthic, detritus-based food web which provides the food source for the grazing food chain in a more indirect fashion.

Seasonally Transported Aerosol Layers Over Southeast Atlantic are Closer to Underlying Clouds than Previously Reported

NASA Technical Reports Server (NTRS)

Rajapakshe, Chamara; Zhang, Zhibo; Yorks, John E.; Yu, Hongbin; Tan, Qian; Meyer, Kerry; Platnick, Steven; Winker, David M.

2017-01-01

From June to October, low-level clouds in the southeast (SE) Atlantic often underlie seasonal aerosol layers transported from African continent. Previously, the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) 532 nm lidar observations have been used to estimate the relative vertical location of the above-cloud aerosols (ACA) to the underlying clouds. Here we show new observations from NASA's Cloud-Aerosol Transport System (CATS) lidar. Two seasons of CATS 1064 nm observations reveal that the bottom of the ACA layer is much lower than previously estimated based on CALIPSO 532 nm observations. For about 60% of CATS nighttime ACA scenes, the aerosol layer base is within 360 m distance to the top of the underlying cloud. Our results are important for future studies of the microphysical indirect and semidirect effects of ACA in the SE Atlantic region.

Efficacy and tolerability of brivaracetam compared to lacosamide, eslicarbazepine acetate, and perampanel as adjunctive treatments in uncontrolled focal epilepsy: Results of an indirect comparison meta-analysis of RCTs.

PubMed

Brigo, Francesco; Bragazzi, Nicola Luigi; Nardone, Raffaele; Trinka, Eugen

2016-11-01

Brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and perampanel (PER) have been recently marketed as adjunctive treatments for focal onset seizures. To date, no randomized controlled trial (RCT) has directly compared BRV with ESL, LCM, or PER. To compare BRV with the other add-on AEDs in patients with uncontrolled focal epilepsy, estimating their efficacy and tolerability through an adjusted, common-reference based indirect comparison meta-analysis. We systematically searched RCTs in which add-on treatment with ESL or LCM in patients with focal onset seizures have been compared with placebo. Efficacy and tolerability outcomes were considered. Random-effects Mantel-Haenszel meta-analyses were performed to obtain odds ratios (ORs) for the efficacy of BRV, LCM, ESL, or PER versus placebo. Adjusted indirect comparisons were then made between BRV and the other three AEDs using the obtained results, comparing the minimum and the highest effective recommended daily dose of each drug. Seventeen RCTs, with a total of 4971 patients were included. After adjusting for dose-effects, indirect comparisons showed no difference between BRV and LCM, ESL, or PER for responder rate and seizure freedom. Lower adverse events were observed with high dose BRV compared to high dose ESL or PER, but no difference was found in withdrawing because of adverse events. Indirect comparisons do not demonstrate a significant difference in efficacy between add-on BRV and LCM, ESL, or PER in focal epilepsy, and might suggest a better tolerability of BRV than ESL, and possibly also PER, at the highest effective recommended dose. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

An introduction to the indirect exposure assessment approach: modeling human exposure using microenvironmental measurements and the recent National Human Activity Pattern Survey.

PubMed Central

Klepeis, N E

1999-01-01

Indirect exposure approaches offer a feasible and accurate method for estimating population exposures to indoor pollutants, including environmental tobacco smoke (ETS). In an effort to make the indirect exposure assessment approach more accessible to people in the health and risk assessment fields, this paper provides examples using real data from (italic>a(/italic>) a week-long personal carbon monoxide monitoring survey conducted by the author; and (italic>b(/italic>) the 1992 to 1994 National Human Activity Pattern Survey (NHAPS) for the United States. The indirect approach uses measurements of exposures in specific microenvironments (e.g., homes, bars, offices), validated microenvironmental models (based on the mass balance equation), and human activity pattern data obtained from questionnaires to predict frequency distributions of exposure for entire populations. This approach requires fewer resources than the direct approach to exposure assessment, for which the distribution of monitors to a representative sample of a given population is necessary. In the indirect exposure assessment approach, average microenvironmental concentrations are multiplied by the total time spent in each microenvironment to give total integrated exposure. By assuming that the concentrations encountered in each of 10 location categories are the same for different members of the U.S. population (i.e., the NHAPS respondents), the hypothetical contribution that ETS makes to the average 24-hr respirable suspended particle exposure for Americans working their main job is calculated in this paper to be 18 microg/m3. This article is an illustrative review and does not contain an actual exposure assessment or model validation. Images Figure 3 Figure 4 PMID:10350522

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models

PubMed Central

2013-01-01

Background Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as “practically impossible”, and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Methods Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Results Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Conclusions Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons. PMID:24168424

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models.

PubMed

Nicholl, Jon; Jacques, Richard M; Campbell, Michael J

2013-10-29

Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as "practically impossible", and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons.

Evaluation of approaches for estimating the accuracy of genomic prediction in plant breeding

PubMed Central

2013-01-01

Background In genomic prediction, an important measure of accuracy is the correlation between the predicted and the true breeding values. Direct computation of this quantity for real datasets is not possible, because the true breeding value is unknown. Instead, the correlation between the predicted breeding values and the observed phenotypic values, called predictive ability, is often computed. In order to indirectly estimate predictive accuracy, this latter correlation is usually divided by an estimate of the square root of heritability. In this study we use simulation to evaluate estimates of predictive accuracy for seven methods, four (1 to 4) of which use an estimate of heritability to divide predictive ability computed by cross-validation. Between them the seven methods cover balanced and unbalanced datasets as well as correlated and uncorrelated genotypes. We propose one new indirect method (4) and two direct methods (5 and 6) for estimating predictive accuracy and compare their performances and those of four other existing approaches (three indirect (1 to 3) and one direct (7)) with simulated true predictive accuracy as the benchmark and with each other. Results The size of the estimated genetic variance and hence heritability exerted the strongest influence on the variation in the estimated predictive accuracy. Increasing the number of genotypes considerably increases the time required to compute predictive accuracy by all the seven methods, most notably for the five methods that require cross-validation (Methods 1, 2, 3, 4 and 6). A new method that we propose (Method 5) and an existing method (Method 7) used in animal breeding programs were the fastest and gave the least biased, most precise and stable estimates of predictive accuracy. Of the methods that use cross-validation Methods 4 and 6 were often the best. Conclusions The estimated genetic variance and the number of genotypes had the greatest influence on predictive accuracy. Methods 5 and 7 were the fastest and produced the least biased, the most precise, robust and stable estimates of predictive accuracy. These properties argue for routinely using Methods 5 and 7 to assess predictive accuracy in genomic selection studies. PMID:24314298

Evaluation of approaches for estimating the accuracy of genomic prediction in plant breeding.

PubMed

Ould Estaghvirou, Sidi Boubacar; Ogutu, Joseph O; Schulz-Streeck, Torben; Knaak, Carsten; Ouzunova, Milena; Gordillo, Andres; Piepho, Hans-Peter

2013-12-06

In genomic prediction, an important measure of accuracy is the correlation between the predicted and the true breeding values. Direct computation of this quantity for real datasets is not possible, because the true breeding value is unknown. Instead, the correlation between the predicted breeding values and the observed phenotypic values, called predictive ability, is often computed. In order to indirectly estimate predictive accuracy, this latter correlation is usually divided by an estimate of the square root of heritability. In this study we use simulation to evaluate estimates of predictive accuracy for seven methods, four (1 to 4) of which use an estimate of heritability to divide predictive ability computed by cross-validation. Between them the seven methods cover balanced and unbalanced datasets as well as correlated and uncorrelated genotypes. We propose one new indirect method (4) and two direct methods (5 and 6) for estimating predictive accuracy and compare their performances and those of four other existing approaches (three indirect (1 to 3) and one direct (7)) with simulated true predictive accuracy as the benchmark and with each other. The size of the estimated genetic variance and hence heritability exerted the strongest influence on the variation in the estimated predictive accuracy. Increasing the number of genotypes considerably increases the time required to compute predictive accuracy by all the seven methods, most notably for the five methods that require cross-validation (Methods 1, 2, 3, 4 and 6). A new method that we propose (Method 5) and an existing method (Method 7) used in animal breeding programs were the fastest and gave the least biased, most precise and stable estimates of predictive accuracy. Of the methods that use cross-validation Methods 4 and 6 were often the best. The estimated genetic variance and the number of genotypes had the greatest influence on predictive accuracy. Methods 5 and 7 were the fastest and produced the least biased, the most precise, robust and stable estimates of predictive accuracy. These properties argue for routinely using Methods 5 and 7 to assess predictive accuracy in genomic selection studies.

Photovoltaic-Model-Based Solar Irradiance Estimators: Performance Comparison and Application to Maximum Power Forecasting

NASA Astrophysics Data System (ADS)

Scolari, Enrica; Sossan, Fabrizio; Paolone, Mario

2018-01-01

Due to the increasing proportion of distributed photovoltaic (PV) production in the generation mix, the knowledge of the PV generation capacity has become a key factor. In this work, we propose to compute the PV plant maximum power starting from the indirectly-estimated irradiance. Three estimators are compared in terms of i) ability to compute the PV plant maximum power, ii) bandwidth and iii) robustness against measurements noise. The approaches rely on measurements of the DC voltage, current, and cell temperature and on a model of the PV array. We show that the considered methods can accurately reconstruct the PV maximum generation even during curtailment periods, i.e. when the measured PV power is not representative of the maximum potential of the PV array. Performance evaluation is carried out by using a dedicated experimental setup on a 14.3 kWp rooftop PV installation. Results also proved that the analyzed methods can outperform pyranometer-based estimations, with a less complex sensing system. We show how the obtained PV maximum power values can be applied to train time series-based solar maximum power forecasting techniques. This is beneficial when the measured power values, commonly used as training, are not representative of the maximum PV potential.

Global-, Regional-, and Country-Level Economic Impacts of Dental Diseases in 2015.

PubMed

Righolt, A J; Jevdjevic, M; Marcenes, W; Listl, S

2018-05-01

Up-to-date information about the economic impact of dental diseases is essential for health care decision makers when seeking to make rational use of available resources. The purpose of this study was to provide up-to-date estimates for dental expenditures (direct costs) and productivity losses (indirect costs) due to dental diseases on the global, regional, and country level. Direct costs of dental diseases were estimated using a previously established systematic approach; indirect costs were estimated using an approach developed by the World Health Organization Commission on Macroeconomics and Health and factoring in 2015 values for gross domestic product and disability-adjusted life years from the Global Burden of Disease Study. The estimated direct costs of dental diseases amounted to $356.80 billion and indirect costs were estimated at $187.61 billion, totaling worldwide costs due to dental diseases of $544.41 billion in 2015. After adjustment for purchasing power parity, the highest levels of per capita dental expenditures were found for High-Income North America, Australasia, Western Europe, High-Income Asia Pacific, and East Asia; the highest levels of per capita productivity losses were found for Western Europe, Australasia, High-Income North America, High-Income Asia Pacific, and Central Europe. Severe tooth loss was found to imply 67% of global productivity losses due to dental diseases, followed by severe periodontitis (21%) and untreated caries (12%). From an economic perspective, improvements in population oral health may be highly beneficial and could contribute to further increases in people's well-being given available resources.

Parametric mediational g-formula approach to mediation analysis with time-varying exposures, mediators, and confounders

PubMed Central

Lin, Sheng-Hsuan; Young, Jessica; Logan, Roger; Tchetgen Tchetgen, Eric J.; VanderWeele, Tyler J.

2016-01-01

The assessment of direct and indirect effects with time-varying mediators and confounders is a common but challenging problem, and standard mediation analysis approaches are generally not applicable in this context. The mediational g-formula was recently proposed to address this problem, paired with a semi-parametric estimation approach to evaluate longitudinal mediation effects empirically. In this paper, we develop a parametric estimation approach to the mediational g-formula, including a feasible algorithm implemented in a freely available SAS macro. In the Framingham Heart Study data, we apply this method to estimate the interventional analogues of natural direct and indirect effects of smoking behaviors sustained over a 10-year period on blood pressure when considering weight change as a time-varying mediator. Compared with not smoking, smoking 20 cigarettes per day for 10 years was estimated to increase blood pressure by 1.2 (95 % CI: −0.7, 2.7) mm-Hg. The direct effect was estimated to increase blood pressure by 1.5 (95 % CI: −0.3, 2.9) mm-Hg, and the indirect effect was −0.3 (95% CI: −0.5, −0.1) mm-Hg, which is negative because smoking which is associated with lower weight is associated in turn with lower blood pressure. These results provide evidence that weight change in fact partially conceals the detrimental effects of cigarette smoking on blood pressure. Our work represents, to our knowledge, the first application of the parametric mediational g-formula in an epidemiologic cohort study. PMID:27984420

Economic consequences of legal and illegal drugs: The case of social costs in Belgium.

PubMed

Lievens, Delfine; Vander Laenen, Freya; Verhaeghe, Nick; Putman, Koen; Pauwels, Lieven; Hardyns, Wim; Annemans, Lieven

2017-06-01

Legal and illegal drugs impose a considerable burden to the individual and to society. The misuse of addictive substances results in healthcare and law enforcement costs, loss of productivity and reduced quality of life. A social cost study was conducted to estimate the substance-attributable costs of alcohol, tobacco, illegal drugs and psychoactive medication to Belgian society in 2012. The cost-of-illness framework with prevalence-based and human capital approach was applied. Three cost components were considered: direct, indirect and intangible costs related to substance misuse. The direct and indirect cost of addictive substances was estimated at 4.6 billion euros in Belgium (419 euros per capita or 1.19% of the GDP) and more than 515,000 healthy years are lost due to substance misuse. The Belgian social cost study reaffirms that alcohol and tobacco impose the highest cost to society compared to illegal drugs. Health problems are the main driver of the social cost of legal drugs. Law enforcement expenditure exceed the healthcare costs but only in the case of illegal drugs. Estimating social costs of addictive substances is complex because it is difficult to determine to what extent the societal harm is caused by substances. It can be argued that social cost studies take only a 'snapshot' of the monetary consequences of substance misuse. Nevertheless, the current study offers the most comprehensive analysis thus far of the social costs of substance misuse in Belgium. Copyright © 2017 Elsevier B.V. All rights reserved.

Cinnamon gulch revisited: Another look at separating natural and mining-impacted contributions to instream metal load

USGS Publications Warehouse

Runkel, Robert L.; Verplanck, Philip; Kimball, Briant; Walton-Day, Katie

2018-01-01

Baseline, premining data for streams draining abandoned mine lands is virtually non existent, and indirect methods for estimating premining conditions are needed to establish realistic, cost effective cleanup goals. One such indirect method is the proximal analog approach, in which premining conditions are estimated using data from nearby mineralized areas that are unaffected by mining. In this paper, we combine the proximal analog approach with a quantitative mass balance framework using data from a spatially-detailed synoptic sampling campaign. The combined approach is applied to Cinnamon Gulch, a headwater stream with numerous draining adits. Synoptic sampling results indicate that three of the top five metal sources are affected by mining activities, and stream segments draining these sources account for a large percentage of overall metal loading within the study reach. These initial calculations overestimate the effects of mining, as the affected stream segments were likely acidic and metal rich prior to mining. Premining loads and concentrations were therefore determined through a replacement approach in which the chemistry of each mining-affected stream segment is revised based on proximal analog concentrations. The revised loading profiles indicate that 15–17% of the Al, Cd, Cu, Mn, Ni, and Zn loads are attributable to mining, whereas the mining contribution for Pb is 40%. Premining concentrations of Al, Cd, Cu, Mn, and Zn are estimated to be in excess of aquatic life standards over the length of the study reach.

Mediation analysis to estimate direct and indirect milk losses associated with bacterial load in bovine subclinical mammary infections.

PubMed

Detilleux, J; Theron, L; Duprez, J-N; Reding, E; Moula, N; Detilleux, M; Bertozzi, C; Hanzen, C; Mainil, J

2016-08-01

Milk losses associated with mastitis can be attributed to either effects of pathogens per se (i.e. direct losses) or to effects of the immune response triggered by the presence of mammary pathogens (i.e. indirect losses). Test-day milk somatic cell counts (SCC) and number of bacterial colony forming units (CFU) found in milk samples are putative measures of the level of immune response and of the bacterial load, respectively. Mediation models, in which one independent variable affects a second variable which, in turn, affects a third one, are conceivable models to estimate direct and indirect losses. Here, we evaluated the feasibility of a mediation model in which test-day SCC and milk were regressed toward bacterial CFU measured at three selected sampling dates, 1 week apart. We applied this method on cows free of clinical signs and with records on up to 3 test-days before and after the date of the first bacteriological samples. Most bacteriological cultures were negative (52.38%), others contained either staphylococci (23.08%), streptococci (9.16%), mixed bacteria (8.79%) or were contaminated (6.59%). Only losses mediated by an increase in SCC were significantly different from null. In cows with three consecutive bacteriological positive results, we estimated a decreased milk yield of 0.28 kg per day for each unit increase in log2-transformed CFU that elicited one unit increase in log2-transformed SCC. In cows with one or two bacteriological positive results, indirect milk loss was not significantly different from null although test-day milk decreased by 0.74 kg per day for each unit increase of log2-transformed SCC. These results highlight the importance of milk losses that are mediated by an increase in SCC during mammary infection and the feasibility of decomposing total milk loss into its direct and indirect components.

A review of life expectancy and infant mortality estimations for Australian Aboriginal people

PubMed Central

2014-01-01

Background Significant variation exists in published Aboriginal mortality and life expectancy (LE) estimates due to differing and evolving methodologies required to correct for inadequate recording of Aboriginality in death data, under-counting of Aboriginal people in population censuses, and unexplained growth in the Aboriginal population attributed to changes in the propensity of individuals to identify as Aboriginal at population censuses. The objective of this paper is to analyse variation in reported Australian Aboriginal mortality in terms of LE and infant mortality rates (IMR), compared with all Australians. Methods Published data for Aboriginal LE and IMR were obtained and analysed for data quality and method of estimation. Trends in reported LE and IMR estimates were assessed and compared with those in the entire Australian population. Results LE estimates derived from different methodologies vary by as much as 7.2 years for the same comparison period. Indirect methods for estimating Aboriginal LE have produced LE estimates sensitive to small changes in underlying assumptions, some of which are subject to circular reasoning. Most indirect methods appear to under-estimate Aboriginal LE. Estimated LE gaps between Aboriginal people and the overall Australian population have varied between 11 and 20 years. Latest mortality estimates, based on linking census and death data, are likely to over-estimate Aboriginal LE. Temporal LE changes by each methodology indicate that Aboriginal LE has improved at rates similar to the Australian population overall. Consequently the gap in LE between Aboriginal people and the total Australian population appears to be unchanged since the early 1980s, and at the end of the first decade of the 21st century remains at least 11–12 years. In contrast, focussing on the 1990–2010 period Aboriginal IMR declined steeply over 2001–08, from more than 12 to around 8 deaths per 1,000 live births, the same level as Australia overall in 1993–95. The IMR gap between Aboriginal people and the total Australian population, while still unacceptable, has declined considerably, from over 8 before 2000 to around 4 per 1,000 live births by 2008. Conclusions Regardless of estimation method used, mortality and LE gaps between Aboriginal and non-Aboriginal people are substantial, but remain difficult to estimate accurately. PMID:24383435

A new method for indirectly estimating infiltration of paddy fields in situ

NASA Astrophysics Data System (ADS)

Xu, Yunqiang; Su, Baolin; Wang, Hongqi; He, Jingyi

2018-06-01

Infiltration is one of the major procedures in water balance research and pollution load estimation in paddy fields. In this study, a new method for indirectly estimating infiltration of paddy fields in situ was proposed and implemented in Taihu Lake basin. Since when there were no rainfall, irrigation and artificial drainage, the water depth variation process of a paddy field is only influenced by evapotranspiration and infiltration (E + F). Firstly, (E + F) was estimated by deciding the steady decreasing rate of water depth; then the evapotranspiration (ET) of the paddy field was calculated by using the crop coefficient method with the recommended FAO-56 Penman-Monteith equation; finally, the infiltration of the paddy field was obtained by subtracting ET from (E + F). Results show that the mean infiltration of the studied paddy field during rice jointing-booting period was 7.41 mm day-1, and the mean vertical infiltration and lateral seepage of the paddy field were 5.46 and 1.95 mm day-1 respectively.

Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?

PubMed

Carroll, Suzanne J; Niyonsenga, Theo; Coffee, Neil T; Taylor, Anne W; Daniel, Mark

2017-08-23

Associations between local-area residential features and glycosylated hemoglobin (HbA 1c ) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA 1c . HbA 1c was assessed three times for adults in a 10-year population-based biomedical cohort ( n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA 1c , accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA 1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA 1c trajectories. Walkability was directly and indirectly protective of worsening HbA 1c . Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.

Does Physical Activity Mediate the Associations between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?

PubMed Central

Daniel, Mark

2017-01-01

Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m2) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity. PMID:28832552

Health-Related Quality of Life Impairment and Indirect Cost of Crohn's Disease: A Self-Report Study in Poland.

PubMed

Holko, Przemysław; Kawalec, Paweł; Mossakowska, Małgorzata; Pilc, Andrzej

2016-01-01

Evidence on indirect cost of Crohn's disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity). A self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients' characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient's version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients' productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients' productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders. The responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (p<0.001) and lower indirect costs by 71% (p = 0.003) for absenteeism, 41% (p = 0.030) for presenteeism, 76% (p<0.001) for productivity loss at unpaid work, and 75% (p<0.001) for informal care. Our study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland.

Aerosol effect on cloud droplet size as monitored from surface-based remote sensing over East China Sea region

NASA Astrophysics Data System (ADS)

Pandithurai, G.; Takamura, T.; Yamaguchi, J.; Miyagi, K.; Takano, T.; Ishizaka, Y.; Dipu, S.; Shimizu, A.

2009-07-01

The effect of increased aerosol concentrations on the low-level, non-precipitating, ice-free stratus clouds is examined using a suite of surface-based remote sensing systems. Cloud droplet effective radius and liquid water path are retrieved using cloud radar and microwave radiometer. Collocated measurements of aerosol scattering coefficient, size distribution and cloud condensation nuclei (CCN) concentrations were used to examine the response of cloud droplet size and optical thickness to increased CCN proxies. During the episodic events of increase in aerosol accumulation-mode volume distribution, the decrease in droplet size and increase in cloud optical thickness is observed. The indirect effect estimates are made for both droplet effective radius and cloud optical thickness for different liquid water path ranges and they range 0.02-0.18 and 0.005-0.154, respectively. Data are also categorized into thin and thick clouds based on cloud geometric thickness (Δz) and estimates show IE values are relatively higher for thicker clouds.

Fuel-Burning Technology Alternatives for the Army.

DTIC Science & Technology

1985-01-01

control 0.85 2,287,000 Flue gas desulfurization 0.68 3,410,000 Total 12,478,000 *Capital cost estimate...34......... . . Particulate and sulfur dioxide control are needed. A baghouse and flue gas desulfurization (FD) scrubber system must be installed. Each item’s cost in...direct cost) Contingency (20% of 1,253,000 direct and indirect costs) Subtotal 7,518,000 Particulate control 1,342,000 Flue gas desulfurization

Estimation of Indirect Effects in the Presence of Unmeasured Confounding for the Mediator-Outcome Relationship in a Multilevel 2-1-1 Mediation Model

ERIC Educational Resources Information Center

Talloen, Wouter; Moerkerke, Beatrijs; Loeys, Tom; De Naeghel, Jessie; Van Keer, Hilde; Vansteelandt, Stijn

2016-01-01

To assess the direct and indirect effect of an intervention, multilevel 2-1-1 studies with intervention randomized at the upper (class) level and mediator and outcome measured at the lower (student) level are frequently used in educational research. In such studies, the mediation process may flow through the student-level mediator (the within…

The economic burden of musculoskeletal disorders on the Italian social security pension system estimated by a Monte Carlo simulation.

PubMed

Russo, S; Mariani, T T; Migliorini, R; Marcellusi, A; Mennini, F S

2015-09-16

The aim of the study is to estimate the pension costs incurred for patients with musculoskeletal disorders (MDs) and specifically with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in Italy between 2009 and 2012. We analyzed the database of the Italian National Social Security Institute (Istituto Nazionale Previdenza Sociale i.e. INPS) to estimate the total costs of three types of social security benefits granted to patients with MDs, RA and AS: disability benefits (for people with reduced working ability), disability pensions (for people who cannot qualify as workers) and incapacity pensions (for people without working ability). We developed a probabilistic model with a Monte Carlo simulation to estimate the total costs for each type of benefit associated with MDs, RA and AS. We also estimated the productivity loss resulting from RA in 2013. From 2009 to 2012 about 393 thousand treatments were paid for a total of approximately €2.7 billion. The annual number of treatments was on average 98 thousand and cost in total €674 million per year. In particular, the total pension burden was about €99 million for RA and €26 million for AS. The productivity loss for AR in 2013 was equal to €707,425,191 due to 9,174,221 working days lost. Our study is the fi rst to estimate the burden of social security pensions for MDs based on data of both approved claims and benefits paid by the national security system. From 2009 to 2012, in Italy, the highest indirect costs were associated with disability pensions (54% of the total indirect cost), followed by disability benefits (44.1% of cost) and incapacity pensions (1.8% of cost). In conclusion, MDs are chronic and highly debilitating diseases with a strong female predominance and very significant economic and social costs that are set to increase due to the aging of the population.

Heritability of female extra-pair paternity rate in song sparrows (Melospiza melodia)

PubMed Central

Reid, Jane M.; Arcese, Peter; Sardell, Rebecca J.; Keller, Lukas F.

2011-01-01

The forces driving the evolution of extra-pair reproduction in socially monogamous animals remain widely debated and unresolved. One key hypothesis is that female extra-pair reproduction evolves through indirect genetic benefits, reflecting increased additive genetic value of extra-pair offspring. Such evolution requires that a female's propensity to produce offspring that are sired by an extra-pair male is heritable. However, additive genetic variance and heritability in female extra-pair paternity (EPP) rate have not been quantified, precluding accurate estimation of the force of indirect selection. Sixteen years of comprehensive paternity and pedigree data from socially monogamous but genetically polygynandrous song sparrows (Melospiza melodia) showed significant additive genetic variance and heritability in the proportion of a female's offspring that was sired by an extra-pair male, constituting major components of the genetic architecture required for extra-pair reproduction to evolve through indirect additive genetic benefits. However, estimated heritabilities were moderately small (0.12 and 0.18 on the observed and underlying latent scales, respectively). The force of selection on extra-pair reproduction through indirect additive genetic benefits may consequently be relatively weak. However, the additive genetic variance and non-zero heritability observed in female EPP rate allow for multiple further genetic mechanisms to drive and constrain mating system evolution. PMID:20980302

Costs and global impacts of black carbon abatement strategies

NASA Astrophysics Data System (ADS)

Rypdal, Kristin; Rive, Nathan; Berntsen, Terje K.; Klimont, Zbigniew; Mideksa, Torben K.; Myhre, Gunnar; Skeie, Ragnhild B.

2009-09-01

Abatement of particulate matter has traditionally been driven by health concerns rather than its role in global warming. Here we assess future abatement strategies in terms of how much they reduce the climate impact of black carbon (BC) and organic carbon (OC) from contained combustion. We develop global scenarios which take into account regional differences in climate impact, costs of abatement and ability to pay, as well as both the direct and indirect (snow-albedo) climate impact of BC and OC. To represent the climate impact, we estimate consistent region-specific values of direct and indirect global warming potential (GWP) and global temperature potential (GTP). The indirect GWP has been estimated using a physical approach and includes the effect of change in albedo from BC deposited on snow. The indirect GWP is highest in the Middle East followed by Russia, Europe and North America, while the total GWP is highest in the Middle East, Africa and South Asia. We conclude that prioritizing emission reductions in Asia represents the most cost-efficient global abatement strategy for BC because Asia is (1) responsible for a large share of total emissions, (2) has lower abatement costs compared to Europe and North America and (3) has large health cobenefits from reduced PM10 emissions.

Costs of dementia in the Czech Republic.

PubMed

Holmerová, Iva; Hort, Jakub; Rusina, Robert; Wimo, Anders; Šteffl, Michal

2017-11-01

The aim of this study was to estimate the cost of dementia in the Czech Republic. One hundred and nineteen patient-caregiver dyads participated in our multicenter observational cost-of-illness study. The modified Resource Utilization in Dementia Questionnaire was used as the main tool to collect data from patients and caregivers. Medical specialists provided additional data from medical records. The average costs of dementia were calculated and patients were then divided by the level of cognitive impairment. A generalized linear model was used to determine if differences were present for selected cost variables. The mean (standard deviation) for direct cost per a patient in a month was estimated to be €243.0 (138.0), €1727.1 (1075.6) for the indirect cost, and €1970.0 (1090.3) for the total cost of dementia in the Czech Republic. All of the costs increased as dementia severity increased. Both the indirect and total costs significantly (p < 0.05) increased if patients were living with their primary caregiver, and if the severity of cognitive impairment was increased. The indirect cost, which was represented mainly by informal care, comprised the main part of the total cost of care for patients with dementia in the Czech Republic. Both total and indirect care costs increased significantly the cognition declined.

Estimating economic losses from earthquakes using an empirical approach

USGS Publications Warehouse

Jaiswal, Kishor; Wald, David J.

2013-01-01

We extended the U.S. Geological Survey's Prompt Assessment of Global Earthquakes for Response (PAGER) empirical fatality estimation methodology proposed by Jaiswal et al. (2009) to rapidly estimate economic losses after significant earthquakes worldwide. The requisite model inputs are shaking intensity estimates made by the ShakeMap system, the spatial distribution of population available from the LandScan database, modern and historic country or sub-country population and Gross Domestic Product (GDP) data, and economic loss data from Munich Re's historical earthquakes catalog. We developed a strategy to approximately scale GDP-based economic exposure for historical and recent earthquakes in order to estimate economic losses. The process consists of using a country-specific multiplicative factor to accommodate the disparity between economic exposure and the annual per capita GDP, and it has proven successful in hindcast-ing past losses. Although loss, population, shaking estimates, and economic data used in the calibration process are uncertain, approximate ranges of losses can be estimated for the primary purpose of gauging the overall scope of the disaster and coordinating response. The proposed methodology is both indirect and approximate and is thus best suited as a rapid loss estimation model for applications like the PAGER system.

Comparison of Sample Size by Bootstrap and by Formulas Based on Normal Distribution Assumption.

PubMed

Wang, Zuozhen

2018-01-01

Bootstrapping technique is distribution-independent, which provides an indirect way to estimate the sample size for a clinical trial based on a relatively smaller sample. In this paper, sample size estimation to compare two parallel-design arms for continuous data by bootstrap procedure are presented for various test types (inequality, non-inferiority, superiority, and equivalence), respectively. Meanwhile, sample size calculation by mathematical formulas (normal distribution assumption) for the identical data are also carried out. Consequently, power difference between the two calculation methods is acceptably small for all the test types. It shows that the bootstrap procedure is a credible technique for sample size estimation. After that, we compared the powers determined using the two methods based on data that violate the normal distribution assumption. To accommodate the feature of the data, the nonparametric statistical method of Wilcoxon test was applied to compare the two groups in the data during the process of bootstrap power estimation. As a result, the power estimated by normal distribution-based formula is far larger than that by bootstrap for each specific sample size per group. Hence, for this type of data, it is preferable that the bootstrap method be applied for sample size calculation at the beginning, and that the same statistical method as used in the subsequent statistical analysis is employed for each bootstrap sample during the course of bootstrap sample size estimation, provided there is historical true data available that can be well representative of the population to which the proposed trial is planning to extrapolate.

A comparison between indirect and objective wear-time assessment of removable orthodontic appliances.

PubMed

Schott, Timm C; Meyer-Gutknecht, Hannes; Mayer, Nicolai; Weber, Joachim; Weimer, Katja

2017-04-01

Patients do not always adhere to the wear times prescribed for removable orthodontic appliances. We evaluated the validity and usability of indirect wear-time assessment methods by comparing wear-time estimates with microelectronically measured wear times in patients with removable orthodontic appliances. Wear times of 33 expansion plates, 34 functional appliances, and 42 retention plates of patients aged 6-20 years (12.3±2.9 years, 50.5% female) were indirectly determined by practitioners using a questionnaire assessing five parameters on a 5-point Likert scale: appliance handling, appliance appearance, bite shift, tooth movement, and appliance fit. The perceived difficulty in assessing each parameter was rated. Actual wear times were evaluated with microelectronic sensors in the appliances. Regression analyses revealed that practitioners' decisions about wear times varied depending on the type of appliance and criteria used, with only one standard criterion best predicting estimated wear time for each appliance. Different standard criteria were better predictors of measured wear time: 22.3% of wear-time variability was explained by expansion plate appearance, 31.2% by functional appliance handling, and 18.8% by retainer fitting. However, practitioners rated the difficulty of assessment in most cases as 'easy'. The study was not double blinded for technical reasons, and practitioners may have considered the evaluation criteria more carefully than in normal daily practice. Practitioners' decisions about wear times based on standard criteria strongly vary depending on the type of appliance and criteria used. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

Influence of Neighborhood-level Factors on Social Support in Early-stage Breast Cancer Patients and Controls

PubMed Central

Thompson, Tess; Rodebaugh, Thomas L.; Pérez, Maria; Struthers, Jim; Sefko, Julianne A.; Lian, Min; Schootman, Mario; Jeffe, Donna B.

2016-01-01

Rationale Low social support has been linked to negative health outcomes in breast cancer patients. Objective We examined associations between perceived social support, neighborhood socioeconomic deprivation, and neighborhood-level social support in early-stage breast cancer patients and controls. Methods This two-year longitudinal study in the United States included information collected from telephone interviews and clinical records of 541 early-stage patients and 542 controls recruited from 2003 to 2007. Social support was assessed using the Medical Outcomes Study Social Support Survey (MOS-SS). Residential addresses were geocoded and used to develop measures including neighborhood social support (based on MOS-SS scores from nearby controls) and neighborhood socioeconomic deprivation (a composite index of census tract characteristics). Latent trajectory models were used to determine effects of neighborhood conditions on the stable (intercept) and changing (slope) aspects of social support. Results In a model with only neighborhood variables, greater socioeconomic deprivation was associated with patients’ lower stable social support (standardized estimate = −0.12, p = .027); neighborhood-level social support was associated with social support change (standardized estimate = 0.17, p = .046). After adding individual-level covariates, there were no direct neighborhood effects on social support. In patients, neighborhood socioeconomic deprivation was associated with support indirectly through marriage, insurance status, negative affect, and general health. In controls, neighborhood socioeconomic deprivation was associated with support indirectly through marriage (p < .05). Conclusion Indirect effects of neighborhood socioeconomic deprivation on social support differed in patients and controls. Psychosocial and neighborhood interventions may help patients with low social support, particularly patients without partnered relationships in deprived areas. PMID:27017091

Influence of neighborhood-level factors on social support in early-stage breast cancer patients and controls.

PubMed

Thompson, Tess; Rodebaugh, Thomas L; Pérez, Maria; Struthers, James; Sefko, Julianne A; Lian, Min; Schootman, Mario; Jeffe, Donna B

2016-05-01

Low social support has been linked to negative health outcomes in breast cancer patients. We examined associations between perceived social support, neighborhood socioeconomic deprivation, and neighborhood-level social support in early-stage breast cancer patients and controls. This two-year longitudinal study in the United States included information collected from telephone interviews and clinical records of 541 early-stage patients and 542 controls recruited from 2003 to 2007. Social support was assessed using the Medical Outcomes Study Social Support Survey (MOS-SS). Residential addresses were geocoded and used to develop measures including neighborhood social support (based on MOS-SS scores from nearby controls) and neighborhood socioeconomic deprivation (a composite index of census tract characteristics). Latent trajectory models were used to determine effects of neighborhood conditions on the stable (intercept) and changing (slope) aspects of social support. In a model with only neighborhood variables, greater socioeconomic deprivation was associated with patients' lower stable social support (standardized estimate = -0.12, p = 0.027); neighborhood-level social support was associated with social support change (standardized estimate = 0.17, p = 0.046). After adding individual-level covariates, there were no direct neighborhood effects on social support. In patients, neighborhood socioeconomic deprivation was associated with support indirectly through marriage, insurance status, negative affect, and general health. In controls, neighborhood socioeconomic deprivation was associated with support indirectly through marriage (p < 0.05). Indirect effects of neighborhood socioeconomic deprivation on social support differed in patients and controls. Psychosocial and neighborhood interventions may help patients with low social support, particularly patients without partnered relationships in deprived areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

Force Limiting Vibration Tests Evaluated from both Ground Acoustic Tests and FEM Simulations of a Flight Like Vehicle System Assembly

NASA Technical Reports Server (NTRS)

Smith, Andrew; LaVerde, Bruce; Waldon, James; Hunt, Ron

2014-01-01

Marshall Space Flight Center has conducted a series of ground acoustic tests with the dual goals of informing analytical judgment, and validating analytical methods when estimating vibroacoustic responses of launch vehicle subsystems. The process of repeatedly correlating finite element-simulated responses with test-measured responses has assisted in the development of best practices for modeling and post-processing. In recent work, force transducers were integrated to measure interface forces at the base of avionics box equipment. Other force data was indirectly measured using strain gauges. The combination of these direct and indirect force measurements has been used to support and illustrate the advantages of implementing the Force Limiting approach for equipment qualification tests. The comparison of force response from integrated system level tests to measurements at the same locations during component level vibration tests provides an excellent illustration. A second comparison of the measured response cases from the system level acoustic tests to finite element simulations has also produced some principles for assessing the suitability of Finite Element Models (FEMs) for making vibroacoustics estimates. The results indicate that when FEM models are employed to guide force limiting choices, they should include sufficient detail to represent the apparent mass of the system in the frequency range of interest.

[Biotechnology's macroeconomic impact].

PubMed

Dones Tacero, Milagros; Pérez García, Julián; San Román, Antonio Pulido

2008-12-01

This paper tries to yield an economic valuation of biotechnological activities in terms of aggregated production and employment. This valuation goes beyond direct estimation and includes the indirect effects derived from sectorial linkages between biotechnological activities and the rest of economic system. To deal with the proposed target several sources of data have been used, including official data from National Statistical Office (INE) such us national accounts, input-output tables, and innovation surveys, as well as, firms' level balance sheets and income statements and also specific information about research projects compiled by Genoma Spain Foundation. Methodological approach is based on the estimation of a new input-output table which includes the biotechnological activities as a specific branch. This table offers both the direct impact of these activities and the main parameters to obtain the induced effects over the rest of the economic system. According to the most updated available figures, biotechnological activities would have directly generated almost 1,600 millions of euros in 2005, and they would be employed more than 9,000 workers. But if we take into account the full linkages with the rest of the system, the macroeconomic impact of Biotechnological activities would reach around 5,000 millions euros in production terms (0.6% of total GDP) and would be responsible, directly or indirectly, of more than 44,000 employments.

Dating base flow in streams using dissolved gases and diurnal temperature changes

USGS Publications Warehouse

Sanford, Ward E.; Casile, Gerolamo C.; Haase, Karl B.

2015-01-01

A method is presented for using dissolved CFCs or SF6 to estimate the apparent age of stream base flow by indirectly estimating the mean concentration of the tracer in the inflowing groundwater. The mean value is estimated simultaneously with the mean residence times of the gas and water in the stream by sampling the stream for one or both age tracers, along with dissolved nitrogen and argon at a single location over a period of approximately 12–14 h. The data are fitted to an equation representing the temporal in-stream gas exchange as it responds to the diurnal temperature fluctuation. The efficacy of the method is demonstrated by collecting and analyzing samples at six different stream locations across parts of northern Virginia, USA. The studied streams drain watersheds with areas of between 2 and 122 km2 during periods when the diurnal stream temperature ranged between 2 and 5°C. The method has the advantage of estimating the mean groundwater residence time of discharge from the watershed to the stream without the need for the collection of groundwater infiltrating to streambeds or local groundwater sampled from shallow observation wells near the stream.

Estimating selection through male fitness: three complementary methods illuminate the nature and causes of selection on flowering time

PubMed Central

Austen, Emily J.; Weis, Arthur E.

2016-01-01

Our understanding of selection through male fitness is limited by the resource demands and indirect nature of the best available genetic techniques. Applying complementary, independent approaches to this problem can help clarify evolution through male function. We applied three methods to estimate selection on flowering time through male fitness in experimental populations of the annual plant Brassica rapa: (i) an analysis of mating opportunity based on flower production schedules, (ii) genetic paternity analysis, and (iii) a novel approach based on principles of experimental evolution. Selection differentials estimated by the first method disagreed with those estimated by the other two, indicating that mating opportunity was not the principal driver of selection on flowering time. The genetic and experimental evolution methods exhibited striking agreement overall, but a slight discrepancy between the two suggested that negative environmental covariance between age at flowering and male fitness may have contributed to phenotypic selection. Together, the three methods enriched our understanding of selection on flowering time, from mating opportunity to phenotypic selection to evolutionary response. The novel experimental evolution method may provide a means of examining selection through male fitness when genetic paternity analysis is not possible. PMID:26911957

Flexible Approaches to Computing Mediated Effects in Generalized Linear Models: Generalized Estimating Equations and Bootstrapping

ERIC Educational Resources Information Center

Schluchter, Mark D.

2008-01-01

In behavioral research, interest is often in examining the degree to which the effect of an independent variable X on an outcome Y is mediated by an intermediary or mediator variable M. This article illustrates how generalized estimating equations (GEE) modeling can be used to estimate the indirect or mediated effect, defined as the amount by…

Indirect boundary force measurements in beam-like structures using a derivative estimator

NASA Astrophysics Data System (ADS)

Chesne, Simon

2014-12-01

This paper proposes a new method for the identification of boundary forces (shear force or bending moment) in a beam, based on displacement measurements. The problem is considered in terms of the determination of the boundary spatial derivatives of transverse displacements. By assuming the displacement fields to be approximated by Taylor expansions in a domain close to the boundaries, the spatial derivatives can be estimated using specific point-wise derivative estimators. This approach makes it possible to extract the derivatives using a weighted spatial integration of the displacement field. Following the theoretical description, numerical simulations made with exact and noisy data are used to determine the relationship between the size of the integration domain and the wavelength of the vibrations. The simulations also highlight the self-regularization of the technique. Experimental measurements demonstrate the feasibility and accuracy of the proposed method.

Estimation of mercury emission from different sources to atmosphere in Chongqing, China.

PubMed

Wang, Dingyong; He, Lei; Wei, Shiqiang; Feng, Xinbin

2006-08-01

This investigation presents a first assessment of the contribution to the regional mercury budget from anthropogenic and natural sources in Chongqing, an important industrial region in southwest China. The emissions of mercury to atmosphere from anthropogenic sources in the region were estimated through indirect approaches, i.e. using commonly acceptable emission factors method, which based on annual process throughputs or consumption for these sources. The natural mercury emissions were estimated from selected natural sources by the dynamic flux chamber technique. The results indicated that the anthropogenic mercury emissions totaled approximately 8.85 tons (t), more than 50% of this total originated in coal combustion and 23.7% of this total emission in the industrial process (include cement production, metal smelting and chemical industry). The natural emissions represented approximately 17% of total emissions (1.78 t yr(-1)). The total mercury emission to atmosphere in Chongqing in 2001 was 10.63 t.

Economic costs of depression in China.

PubMed

Hu, Teh-wei; He, Yanling; Zhang, Mingyuan; Chen, Ningshan

2007-02-01

A recent survey in China indicated the 12-month prevalence rate of depressive disorders was 2.5% in Beijing and 1.7% in Shanghai. These disorders may result in disability, premature death, and severe suffering of those affected and their families. This study estimates the economic consequences of depressive disorders in China. Depressive disorders can have both direct and indirect costs. To obtain direct costs, the research team interviewed 505 patients with depressive disorders and their caregivers in eight clinics/hospitals in five cities in China. Depression-related suicide rates were obtained from published literature. The human capital approach was used to estimate indirect costs. Epidemiological data were taken from available literature. The total estimated cost of depression in China is 51,370 million Renminbi (RMB) (or US $6,264 million) at 2002 prices. Direct costs were 8,090 million RMB (or US$ 986 million), about 16% of the total cost of depression. Indirect costs were 43,280 million RMB (or US$ 5,278 million), about 84% of the total cost of depression. Depression is a very costly disorder in China. The application of an effective treatment--reducing the length of depressive episodes (or preventing episodes) and reducing suicide rates--will lead to a significant reduction in the total burden resulting from depressive disorders. Government policymakers should seriously consider further investments in mental health services.

SAM 2.1—A computer program for plotting and formatting surveying data for estimating peak discharges by the slope-area method

USGS Publications Warehouse

Hortness, J.E.

2004-01-01

The U.S. Geological Survey (USGS) measures discharge in streams using several methods. However, measurement of peak discharges is often impossible or impractical due to difficult access, inherent danger of making measurements during flood events, and timing often associated with flood events. Thus, many peak discharge values often are calculated after the fact by use of indirect methods. The most common indirect method for estimating peak dis- charges in streams is the slope-area method. This, like other indirect methods, requires measuring the flood profile through detailed surveys. Processing the survey data for efficient entry into computer streamflow models can be time demanding; SAM 2.1 is a program designed to expedite that process. The SAM 2.1 computer program is designed to be run in the field on a portable computer. The program processes digital surveying data obtained from an electronic surveying instrument during slope- area measurements. After all measurements have been completed, the program generates files to be input into the SAC (Slope-Area Computation program; Fulford, 1994) or HEC-RAS (Hydrologic Engineering Center-River Analysis System; Brunner, 2001) computer streamflow models so that an estimate of the peak discharge can be calculated.

Estimating soil solution nitrate concentration from dielectric spectra using PLS analysis

USDA-ARS?s Scientific Manuscript database

Fast and reliable methods for in situ monitoring of soil nitrate-nitrogen concentration are vital for reducing nitrate-nitrogen losses to ground and surface waters from agricultural systems. While several studies have been done to indirectly estimate nitrate-nitrogen concentration from time domain s...

Dynamic equilibrium of reconstituting hematopoietic stem cell populations.

PubMed

O'Quigley, John

2010-12-01

Clonal dominance in hematopoietic stem cell populations is an important question of interest but not one we can directly answer. Any estimates are based on indirect measurement. For marked populations, we can equate empirical and theoretical moments for binomial sampling, in particular we can use the well-known formula for the sampling variation of a binomial proportion. The empirical variance itself cannot always be reliably estimated and some caution is needed. We describe the difficulties here and identify ready solutions which only require appropriate use of variance-stabilizing transformations. From these we obtain estimators for the steady state, or dynamic equilibrium, of the number of hematopoietic stem cells involved in repopulating the marrow. The calculations themselves are not too involved. We give the distribution theory for the estimator as well as simple approximations for practical application. As an illustration, we rework on data recently gathered to address the question as to whether or not reconstitution of marrow grafts in the clinical setting might be considered to be oligoclonal.

Cost comparisons of raising a child from birth to 17 years among samples of abused, delinquent, violent, and homicidal youth using victimization and justice system estimates.

PubMed

Zagar, Agata Karolina; Zagar, Robert John; Bartikowski, Boris; Busch, Kenneth G

2009-02-01

Data from youth studied by Zagar and colleagues were randomly sampled to create groups of controls and abused, delinquent, violent, and homicidal youth (n=30 in each). Estimated costs of raising a nondelinquent youth from birth to 17 yr. were compared with the average costs incurred by other youth in each group. Estimates of living expenses, direct and indirect costs of victimization, and criminal justice system expenditures were summed. Groups differed significantly on total expenses, victimization costs, and criminal justice expenditures. Mean total costs for a homicidal youth were estimated at $3,935,433, while those for a control youth were $150,754. Abused, delinquent, and violent youth had average total expenses roughly double the total mean costs of controls. Prevention of dropout, alcoholism, addiction, career delinquency, or homicide justifies interception and empirical treatment on a cost-benefit basis, but also based on the severe personal costs to the victims and to the youth themselves.

Estimating The Effect of Biofuel on Land Cover Change Using Multi-Year Modis Land Cover Data

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

Singh, Nagendra; Bhaduri, Budhendra L

2010-01-01

There has been a growing debate on the effects of the increase in demands of biofuels on land use land cover (LULC) change with apprehension in some quarters that the growing demand for bioenergy as a clean fuel will result in widespread direct and indirect LULC change. However estimating both direct and indirect LULC change is challenging and will require development of accurate high frequency, high resolution (temporal and spatial) land use land cover data as well as new LULC models which can be used to locate, quantify and predict these changes. To assess whether the demand for biofuel hasmore » caused significant LULC we used MODIS land cover data (MCD12Q1) from 2001 to 2008 along with cropland data layer (CDL) to estimate cropland and grassland changes in United States for the years 2002-2008 as well as its correlation with biofuel growth.« less

Using Indirect Turbulence Measurements for Real-Time Parameter Estimation in Turbulent Air

NASA Technical Reports Server (NTRS)

Martos, Borja; Morelli, Eugene A.

2012-01-01

The use of indirect turbulence measurements for real-time estimation of parameters in a linear longitudinal dynamics model in atmospheric turbulence was studied. It is shown that measuring the atmospheric turbulence makes it possible to treat the turbulence as a measured explanatory variable in the parameter estimation problem. Commercial off-the-shelf sensors were researched and evaluated, then compared to air data booms. Sources of colored noise in the explanatory variables resulting from typical turbulence measurement techniques were identified and studied. A major source of colored noise in the explanatory variables was identified as frequency dependent upwash and time delay. The resulting upwash and time delay corrections were analyzed and compared to previous time shift dynamic modeling research. Simulation data as well as flight test data in atmospheric turbulence were used to verify the time delay behavior. Recommendations are given for follow on flight research and instrumentation.

Evaluation of selection index: application to the choice of an indirect multitrait selection index for soybean breeding.

PubMed

Bouchez, A; Goffinet, B

1990-02-01

Selection indices can be used to predict one trait from information available on several traits in order to improve the prediction accuracy. Plant or animal breeders are interested in selecting only the best individuals, and need to compare the efficiency of different trait combinations in order to choose the index ensuring the best prediction quality for individual values. As the usual tools for index evaluation do not remain unbiased in all cases, we propose a robust way of evaluation by means of an estimator of the mean-square error of prediction (EMSEP). This estimator remains valid even when parameters are not known, as usually assumed, but are estimated. EMSEP is applied to the choice of an indirect multitrait selection index at the F5 generation of a classical breeding scheme for soybeans. Best predictions for precocity are obtained by means of indices using only part of the available information.

Comparison of ionospheric plasma drifts obtained by different techniques

NASA Astrophysics Data System (ADS)

Kouba, Daniel; Arikan, Feza; Arikan, Orhan; Toker, Cenk; Mosna, Zbysek; Gok, Gokhan; Rejfek, Lubos; Ari, Gizem

2016-07-01

Ionospheric observatory in Pruhonice (Czech Republic, 50N, 14.9E) provides regular ionospheric sounding using Digisonde DPS-4D. The paper is focused on F-region vertical drift data. Vertical component of the drift velocity vector can be estimated by several methods. Digisonde DPS-4D allows sounding in drift mode with direct output represented by drift velocity vector. The Digisonde located in Pruhonice provides direct drift measurement routinely once per 15 minutes. However, also other different techniques can be found in the literature, for example the indirect estimation based on the temporal evolution of measured ionospheric characteristics is often used for calculation of the vertical drift component. The vertical velocity is thus estimated according to the change of characteristics scaled from the classical quarter-hour ionograms. In present paper direct drift measurement is compared with technique based on measuring of the virtual height at fixed frequency from the F-layer trace on ionogram, technique based on variation of h`F and hmF. This comparison shows possibility of using different methods for calculating vertical drift velocity and their relationship to the direct measurement used by Digisonde. This study is supported by the Joint TUBITAK 114E092 and AS CR 14/001 projects.

The direct and indirect cost burden of clinically significant and symptomatic uterine fibroids.

PubMed

Lee, David W; Ozminkowski, Ronald J; Carls, Ginger Smith; Wang, Shaohung; Gibson, Teresa B; Stewart, Elizabeth A

2007-05-01

To estimate direct medical costs and indirect (productivity related) for women age 25 to 54 who had clinically significant and symptomatic uterine fibroids (UF). We compared direct medical expenditures among 30,659 women who had clinically significant and symptomatic UF to expenditures among an equal number of matched controls who did not. We also compared indirect costs for a sub-sample of 910 employed women in each group. Regression analyses controlled for demographic and casemix factors. Mean 12-month direct medical costs for women with UF were $11,720 versus $3257 for controls, and mean 12-month indirect costs for women with UF were $11,752 versus $8083 for controls. Differences were statistically significant (P<0.0001). UF is a costly disorder and merits thought as interventions are considered to improve women's health and productivity.

Spatially resolved and time-resolved imaging of transport of indirect excitons in high magnetic fields

NASA Astrophysics Data System (ADS)

Dorow, C. J.; Hasling, M. W.; Calman, E. V.; Butov, L. V.; Wilkes, J.; Campman, K. L.; Gossard, A. C.

2017-06-01

We present the direct measurements of magnetoexciton transport. Excitons give the opportunity to realize the high magnetic-field regime for composite bosons with magnetic fields of a few tesla. Long lifetimes of indirect excitons allow the study of kinetics of magnetoexciton transport with time-resolved optical imaging of exciton photoluminescence. We performed spatially, spectrally, and time-resolved optical imaging of transport of indirect excitons in high magnetic fields. We observed that an increasing magnetic field slows down magnetoexciton transport. The time-resolved measurements of the magnetoexciton transport distance allowed for an experimental estimation of the magnetoexciton diffusion coefficient. An enhancement of the exciton photoluminescence energy at the laser excitation spot was found to anticorrelate with the exciton transport distance. A theoretical model of indirect magnetoexciton transport is presented and is in agreement with the experimental data.

Association between direct measurement of active serum calcium and risk of type 2 diabetes mellitus: A prospective study.

PubMed

Zaccardi, F; Webb, D R; Carter, P; Pitocco, D; Khunti, K; Davies, M J; Kurl, S; Laukkanen, J A

2015-06-01

Previous prospective studies showing a positive association between serum calcium and incidence of type 2 diabetes mellitus (T2DM) have relied on total calcium or an indirect estimate of active, ionized calcium (iCa). We aimed to assess this relationship using a direct measurement of iCa. iCa and cardiometabolic risk factors were measured in a population-based sample of 2350 men without a known history of T2DM at baseline. Associations between iCa levels and incident cases of T2DM (self-reported, ascertained with a glucose tolerance test, or determined by record linkage to national registers) were estimated using Cox regression analyses adjusted for potential confounders. At baseline, mean (standard deviation) age was 53 (5) years and mean iCa 1.18 (0.05) mmol/L. During a median follow-up of 23.1 years, 140 new cases of T2DM were recorded. In a multivariable analysis adjusted for age, body mass index, systolic blood pressure, serum HDL-cholesterol, and family history of T2DM, there was no association comparing second (hazard ratio 0.84; 95% confidence interval 0.59-1.18), third (0.77; 0.52-1.14), or fourth (0.98; 0.69-1.39) vs first quartile of iCa (p for trend 0.538); further adjustment for C-reactive protein, physical activity level, and triglycerides did not change the estimates (p for trend 0.389). In this study, we did not find evidence of an association between direct measurement of active calcium and risk of T2DM. Further studies are needed to confirm our findings and define the relationship between factors influencing indirect calcium estimation and incident T2DM. Copyright © 2015 Elsevier B.V. All rights reserved.

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

PubMed Central

Javanbakht, Mehdi; Mashayekhi, Atefeh; Baradaran, Hamid R.; Haghdoost, AliAkbar; Afshin, Ashkan

2015-01-01

Background The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030. Methods A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model. Results We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030. Conclusions The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority. PMID:26200913

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis.

PubMed

Javanbakht, Mehdi; Mashayekhi, Atefeh; Baradaran, Hamid R; Haghdoost, AliAkbar; Afshin, Ashkan

2015-01-01

The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030. A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model. We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030. The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.

Contributions of Uncertainty in Droplet Nucleation to the Indirect Effect in Global Models

NASA Astrophysics Data System (ADS)

Rothenberg, D. A.; Wang, C.; Avramov, A.

2016-12-01

Anthropogenic aerosol perturbations to clouds and climate (the indirect effect, or AIE) contribute significant uncertainty towards understanding contemporary climate change. Despite refinements over the past two decades, modern global aerosol-climate models widely disagree on the magnitude of AIE, and wholly disagree with satellite estimates. Part of the spread in estimates of AIE arises from a lack of constraints on what exactly comprised the pre-industrial atmospheric aerosol burden, but another component is attributable to inter-model differences in simulating the chain of aerosol-cloud-precipitation processes which ultimately produce the indirect effect. Thus, one way to help constrain AIE is to thoroughly investigate the differences in aerosol-cloud processes and interactions occurring in these models. We have configured one model, the CESM/MARC, with a suite of parameterizations affecting droplet activation. Each configuration produces similar climatologies with respect to precipitation and cloud macrophysics, but shows different sensitivies to aerosol perturbation - up to 1 W/m^2 differences in AIE. Regional differences in simulated aerosol-cloud interactions, especially in marine regions with little anthropogenic pollution, contribute to the spread in these AIE estimates. The baseline pre-industrial droplet number concentration in marine regions dominated by natural aerosol strongly predicts the magnitude of each model's AIE, suggesting that targeted observations of cloud microphysical properties across different cloud regimes and their sensitivity to aerosol influences could help provide firm constraints and targets for models. Additionally, we have performed supplemental fully-coupled (atmosphere/ocean) simulations with each model configuration, allowing the model to relax to equilibrium following a change in aerosol emissions. These simulations allow us to assess the slower-timescale responses to aerosol perturbations. The spread in fast model responses (which produce the noted changes in indirect effect or forcing) gives rise to large differences in the equilibrium climate state of each configuration. We show that these changes in equilibrium climate state have implications for AIE estimates from model configurations tuned to the present-day climate.

Community-based clinic volunteering: an evaluation of the direct and indirect effects on the experience of health science college students.

PubMed

Bird, Yelena; Islam, Adiba; Moraros, John

2016-01-18

The present study was conducted in a multi service-learning, student managed and operated, community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e., 'management', 'support received', 'duration of involvement', and 'average time spent per month') and mediators (i.e., 'training received', 'motivation', and 'commitment') influence distal outcomes (i.e., 'performance', 'satisfaction', and 'overall experience') within a volunteer organization. Participants were recruited through the use of an email list server. An online survey was used containing multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05. In this study, there are several direct effects worthy of note. First, the proximal factor of 'management' plays an important role in influencing the mediators of 'motivation' (standardized beta = 0.55) and 'training received' (0.65) by the student volunteers but has a relatively small impact on their 'commitment' (0.39) to the organization. Second, the mediator of 'motivation' proved to have the strongest impact on the distal outcome of volunteer 'performance' and 'satisfaction' levels (0.41 and 0.58 respectively), whereas 'commitment' (0.44) was the key in determining their 'overall experience' with the organization. These results in turn, help contextualize the indirect effects observed in our study. Namely, the proximal factor of 'management' played a distinctive role in influencing the distal outcomes of volunteer 'performance' (0.32) and 'overall experience' (0.66), whereas the organizational 'support received' by the volunteers was key to their 'satisfaction' (0.21). The findings of the present study shed light into the direct and indirect effects of how proximal factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers) in their efforts to improve student volunteer satisfaction and performance outcomes.

Economic burden attributable to functional bowel disorders in Iran: a cross-sectional population-based study.

PubMed

Moghimi-Dehkordi, Bijan; Vahedi, Mohsen; Pourhoseingholi, Mohammad Amin; Khoshkrood Mansoori, Babak; Safaee, Azadeh; Habibi, Manijeh; Pourhoseingholi, Asma; Zali, Mohammad Reza

2011-10-01

While few population-based studies on the economic burden of functional bowel disorders (FBD) have been published from developing countries like Iran, this study aimed to estimate their direct and indirect costs for five groups of patients: irritable bowel syndrome (IBS), functional constipation (FC), unspecified-FBD (U-FBD), functional abdominal bloating (FAB) and functional diarrhea (FD). Up to 18,180 adults randomly sampled from Tehran, Iran (2006-2007) were interviewed using two questionnaires based on the Rome III criteria to detect FBD patients and to estimate their medical expenses (such as visiting the doctor, drugs, hospitalization and laboratory tests) and productivity loss in the previous 6 months. All costs were converted to dollar purchasing power parity (PPP$) to facilitate cross-country comparisons. The mean total 6-month costs were approximately: 160, 147, 103, 96 and 42 PPP$ for IBS, FC, U-FBD, FAB and FD, respectively. The highest proportion of drug consumption was found in IBS patients. The highest mean duration of absence from work was seen in IBS patients (2.26 days). Overall, doctor visit costs accounted for approximately 1/3 of the total costs for FBD, followed by hospitalization. A higher indirect cost of illness was found in IBS (54 PPP$), whereas it was zero in FD. The economic burden of FBD seems to be moderately high in Iran and it imposes a relatively heavy financial burden on the Iranian national health system because of its high prevalence and its impact on quality of life, productivity and waste of resources. © 2011 The Authors. Journal of Digestive Diseases © 2011 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries.

PubMed

Foo, Jason; Landis, Sarah H; Maskell, Joe; Oh, Yeon-Mok; van der Molen, Thys; Han, MeiLan K; Mannino, David M; Ichinose, Masakazu; Punekar, Yogesh

2016-01-01

The Continuing to Confront COPD International Patient Survey estimated the prevalence and burden of COPD across 12 countries. Using data from this survey we evaluated the economic impact of COPD. This cross-sectional, population-based survey questioned 4,343 subjects aged 40 years and older, fulfilling a case definition of COPD based on self-reported physician diagnosis or symptomatology. Direct cost measures were based on exacerbations of COPD (treated and those requiring emergency department visits and/or hospitalisation), contacts with healthcare professionals, and COPD medications. Indirect costs were calculated from work loss values using the Work Productivity and Activity Impairment scale. Combined direct and indirect costs estimated the total societal costs per patient. The annual direct costs of COPD ranged from $504 (South Korea) to $9,981 (USA), with inpatient hospitalisations (5 countries) and home oxygen therapy (3 countries) being the key drivers of direct costs. The proportion of patients completely prevented from working due to their COPD ranged from 6% (Italy) to 52% (USA and UK) with 8 countries reporting this to be ≥20%. Total societal costs per patient varied widely from $1,721 (Russia) to $30,826 (USA) but a consistent pattern across countries showed greater costs among those with increased burden of COPD (symptoms, health status and more severe disease) and a greater number of comorbidities. The economic burden of COPD is considerable across countries, and requires targeted resources to optimise COPD management encompassing the control of symptoms, prevention of exacerbations and effective treatment of comorbidities. Strategies to allow COPD patients to remain in work are important for addressing the substantial wider societal costs.

Indirect nitrous oxide emissions from streams within the US Corn Belt scale with stream order

PubMed Central

Turner, Peter A.; Griffis, Timothy J.; Lee, Xuhui; Baker, John M.; Venterea, Rodney T.; Wood, Jeffrey D.

2015-01-01

N2O is an important greenhouse gas and the primary stratospheric ozone depleting substance. Its deleterious effects on the environment have prompted appeals to regulate emissions from agriculture, which represents the primary anthropogenic source in the global N2O budget. Successful implementation of mitigation strategies requires robust bottom-up inventories that are based on emission factors (EFs), simulation models, or a combination of the two. Top-down emission estimates, based on tall-tower and aircraft observations, indicate that bottom-up inventories severely underestimate regional and continental scale N2O emissions, implying that EFs may be biased low. Here, we measured N2O emissions from streams within the US Corn Belt using a chamber-based approach and analyzed the data as a function of Strahler stream order (S). N2O fluxes from headwater streams often exceeded 29 nmol N2O-N m−2⋅s−1 and decreased exponentially as a function of S. This relation was used to scale up riverine emissions and to assess the differences between bottom-up and top-down emission inventories at the local to regional scale. We found that the Intergovernmental Panel on Climate Change (IPCC) indirect EF for rivers (EF5r) is underestimated up to ninefold in southern Minnesota, which translates to a total tier 1 agricultural underestimation of N2O emissions by 40%. We show that accounting for zero-order streams as potential N2O hotspots can more than double the agricultural budget. Applying the same analysis to the US Corn Belt demonstrates that the IPCC EF5r underestimation explains the large differences observed between top-down and bottom-up emission estimates. PMID:26216994

Data-based estimates of the ocean carbon sink variability - results of the Surface Ocean pCO2 Mapping intercomparison (SOCOM)

NASA Astrophysics Data System (ADS)

Rödenbeck, Christian; Bakker, Dorothee; Gruber, Nicolas; Iida, Yosuke; Jacobson, Andy; Jones, Steve; Landschützer, Peter; Metzl, Nicolas; Nakaoka, Shin-ichiro; Olsen, Are; Park, Geun-Ha; Peylin, Philippe; Rodgers, Keith; Sasse, Tristan; Schuster, Ute; Shutler, James; Valsala, Vinu; Wanninkhof, Rik; Zeng, Jiye

2016-04-01

Using measurements of the surface-ocean COtwo partial pressure (pCOtwo) from the SOCAT and LDEO data bases and 14 different pCOtwo mapping methods recently collated by the Surface Ocean pCOtwo Mapping intercomparison (SOCOM) initiative, variations in regional and global sea-air COtwo fluxes are investigated. Though the available mapping methods use widely different approaches, we find relatively consistent estimates of regional pCOtwo seasonality, in line with previous estimates. In terms of interannual variability (IAV), all mapping methods estimate the largest variations to occur in the Eastern equatorial Pacific. Despite considerable spread in the detailed variations, mapping methods that fit the data more closely also tend to agree more closely with each other in regional averages. Encouragingly, this includes mapping methods belonging to complementary types - taking variability either directly from the pCOtwo data or indirectly from driver data via regression. From a weighted ensemble average, we find an IAV amplitude of the global sea-air COtwo flux of IAVampl (standard deviation over AnalysisPeriod), which is larger than simulated by biogeochemical process models. On a decadal perspective, the global ocean COtwo uptake is estimated to have gradually increased since about 2000, with little decadal change prior to that. The weighted mean net global ocean COtwo sink estimated by the SOCOM ensemble is -1.75 UPgCyr (AnalysisPeriod), consistent within uncertainties with estimates from ocean-interior carbon data or atmospheric oxygen trends. Using data-based sea-air COtwo fluxes in atmospheric COtwo inversions also helps to better constrain land-atmosphere COtwo fluxes.

Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation.

PubMed

Menzin, Joseph; Marton, Jeno P; Menzin, Jordan A; Willke, Richard J; Woodward, Rebecca M; Federico, Victoria

2012-06-25

Researchers and policy makers have determined that accounting for productivity costs, or "indirect costs," may be as important as including direct medical expenditures when evaluating the societal value of health interventions. These costs are also important when estimating the global burden of disease. The estimation of indirect costs is commonly done on a country-specific basis. However, there are few studies that evaluate indirect costs across countries using a consistent methodology. Using the human capital approach, we developed a model that estimates productivity costs as the present value of lifetime earnings (PVLE) lost due to premature mortality. Applying this methodology, the model estimates productivity costs for 29 selected countries, both developed and emerging. We also provide an illustration of how the inclusion of productivity costs contributes to an analysis of the societal burden of smoking. A sensitivity analysis is undertaken to assess productivity costs on the basis of the friction cost approach. PVLE estimates were higher for certain subpopulations, such as men, younger people, and people in developed countries. In the case study, productivity cost estimates from our model showed that productivity loss was a substantial share of the total cost burden of premature mortality due to smoking, accounting for over 75 % of total lifetime costs in the United States and 67 % of total lifetime costs in Brazil. Productivity costs were much lower using the friction cost approach among those of working age. Our PVLE model is a novel tool allowing researchers to incorporate the value of lost productivity due to premature mortality into economic analyses of treatments for diseases or health interventions. We provide PVLE estimates for a number of emerging and developed countries. Including productivity costs in a health economics study allows for a more comprehensive analysis, and, as demonstrated by our illustration, can have important effects on the results and conclusions.

Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation

PubMed Central

2012-01-01

Background Researchers and policy makers have determined that accounting for productivity costs, or “indirect costs,” may be as important as including direct medical expenditures when evaluating the societal value of health interventions. These costs are also important when estimating the global burden of disease. The estimation of indirect costs is commonly done on a country-specific basis. However, there are few studies that evaluate indirect costs across countries using a consistent methodology. Methods Using the human capital approach, we developed a model that estimates productivity costs as the present value of lifetime earnings (PVLE) lost due to premature mortality. Applying this methodology, the model estimates productivity costs for 29 selected countries, both developed and emerging. We also provide an illustration of how the inclusion of productivity costs contributes to an analysis of the societal burden of smoking. A sensitivity analysis is undertaken to assess productivity costs on the basis of the friction cost approach. Results PVLE estimates were higher for certain subpopulations, such as men, younger people, and people in developed countries. In the case study, productivity cost estimates from our model showed that productivity loss was a substantial share of the total cost burden of premature mortality due to smoking, accounting for over 75 % of total lifetime costs in the United States and 67 % of total lifetime costs in Brazil. Productivity costs were much lower using the friction cost approach among those of working age. Conclusions Our PVLE model is a novel tool allowing researchers to incorporate the value of lost productivity due to premature mortality into economic analyses of treatments for diseases or health interventions. We provide PVLE estimates for a number of emerging and developed countries. Including productivity costs in a health economics study allows for a more comprehensive analysis, and, as demonstrated by our illustration, can have important effects on the results and conclusions. PMID:22731620

Estimating surface visibility at Hong Kong from ground-based LIDAR, sun photometer and operational MODIS products.

PubMed

Shahzad, Muhammad I; Nichol, Janet E; Wang, Jun; Campbell, James R; Chan, Pak W

2013-09-01

Hong Kong's surface visibility has decreased in recent years due to air pollution from rapid social and economic development in the region. In addition to deteriorating health standards, reduced visibility disrupts routine civil and public operations, most notably transportation and aviation. Regional estimates of visibility solved operationally using available ground and satellite-based estimates of aerosol optical properties and vertical distribution may prove more effective than standard reliance on a few existing surface visibility monitoring stations. Previous studies have demonstrated that such satellite measurements correlate well with near-surface optical properties, despite these sensors do not consider range-resolved information and indirect parameterizations necessary to solve relevant parameters. By expanding such analysis to include vertically resolved aerosol profile information from an autonomous ground-based lidar instrument, this work develops six models for automated assessment of surface visibility. Regional visibility is estimated using co-incident ground-based lidar, sun photometer visibility meter and MODerate-resolution maging Spectroradiometer (MODIS) aerosol optical depth data sets. Using a 355 nm extinction coefficient profile solved from the lidar MODIS AOD (aerosol optical depth) is scaled down to the surface to generate a regional composite depiction of surface visibility. These results demonstrate the potential for applying passive satellite depictions of broad-scale aerosol optical properties together with a ground-based surface lidar and zenith-viewing sun photometer for improving quantitative assessments of visibility in a city such as Hong Kong.

A Primary Classroom Inquiry: Estimating the Height of a Tree

ERIC Educational Resources Information Center

Brown, Natalie; Watson, Jane; Wright, Suzie; Skalicky, Jane

2011-01-01

Measurement is one of the key areas of study in mathematics and features prominently in the "Australian Curriculum: Mathematics" (ACARA, 2010). In this set of investigations requiring students to estimate indirectly the height of a tree they are encouraged to use the "power of mathematical reasoning" and "apply their…

OH radicals from the indirect actions of X-rays induce cell lethality and mediate the majority of the oxygen enhancement effect.

PubMed

Hirayama, Ryoichi; Ito, Atsushi; Noguchi, Miho; Matsumoto, Yoshitaka; Uzawa, Akiko; Kobashi, Gen; Okayasu, Ryuichi; Furusawa, Yoshiya

2013-11-01

We examined OH radical-mediated indirect actions from X irradiation on cell killing in wild-type Chinese hamster ovary cell lines (CHO and AA8) under oxic and hypoxic conditions, and compared the contribution of direct and indirect actions under both conditions. The contribution of indirect action on cell killing can be estimated from the maximum degree of protection by dimethylsulfoxide, which suppresses indirect action by quenching OH radicals without affecting the direct action of X rays on cell killing. The contributions of indirect action on cell killing of CHO cells were 76% and 50% under oxic and hypoxic conditions, respectively, and those for AA8 cells were 85% and 47%, respectively. Therefore, the indirect action on cell killing was enhanced by oxygen during X irradiation in both cell lines tested. Oxygen enhancement ratios (OERs) at the 10% survival level (D10 or LD90) for CHO and AA8 cells were 2.68 ± 0.15 and 2.76 ± 0.08, respectively. OERs were evaluated separately for indirect and direct actions, which gave the values of 3.75 and 2.01 for CHO, and 4.11 and 1.32 for AA8 cells, respectively. Thus the generally accepted OER value of ∼3 is best understood as the average of the OER values for both indirect and direct actions. These results imply that both indirect and direct actions on cell killing require oxygen for the majority of lethal DNA damage, however, oxygen plays a larger role in indirect than for direct effects. Conversely, the lethal damage induced by the direct action of X rays are less affected by oxygen concentration.

Energy Expenditure in Playground Games in Primary School Children Measured by Accelerometer and Heart Rate Monitors.

PubMed

García-Prieto, Jorge Cañete; Martinez-Vizcaino, Vicente; García-Hermoso, Antonio; Sánchez-López, Mairena; Arias-Palencia, Natalia; Fonseca, Juan Fernando Ortega; Mora-Rodriguez, Ricardo

2017-10-01

The aim of this study was to examine the energy expenditure (EE) measured using indirect calorimetry (IC) during playground games and to assess the validity of heart rate (HR) and accelerometry counts as indirect indicators of EE in children´s physical activity games. 32 primary school children (9.9 ± 0.6 years old, 19.8 ± 4.9 kg · m -2 BMI and 37.6 ± 7.2 ml · kg -1 · min -1 VO 2max ). Indirect calorimetry (IC), accelerometry and HR data were simultaneously collected for each child during a 90 min session of 30 playground games. Thirty-eight sessions were recorded in 32 different children. Each game was recorded at least in three occasions in other three children. The intersubject coefficient of variation within a game was 27% for IC, 37% for accelerometry and 13% for HR. The overall mean EE in the games was 4.2 ± 1.4 kcals · min -1 per game, totaling to 375 ± 122 kcals/per 90 min/session. The correlation coefficient between indirect calorimetry and accelerometer counts was 0.48 (p = .026) for endurance games and 0.21 (p = .574) for strength games. The correlation coefficient between indirect calorimetry and HR was 0.71 (p = .032) for endurance games and 0.48 (p = .026) for strength games. Our data indicate that both accelerometer and HR monitors are useful devices for estimating EE during endurance games, but only HR monitors estimates are accurate for endurance games.

Impact of increasing adherence to disease-modifying therapies on healthcare resource utilization and direct medical and indirect work loss costs for patients with multiple sclerosis.

PubMed

Yermakov, Sander; Davis, Matthew; Calnan, Michaela; Fay, Monica; Cox-Buckley, Brieana; Sarda, Sujata; Duh, Mei Sheng; Iyer, Ravi

2015-01-01

To estimate the effect of adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) on healthcare resource utilization (HRU) and costs, and model the impact of a 10 percentage point increase in adherence on these outcomes. Employed patients, 18-64 years old, with ≥2 MS diagnoses and ≥1 DMT claim during January 1, 2002 to September 30, 2012 were identified from a large commercially-insured US claims database. Adherence was measured as proportion of days covered (PDC) during follow-up. Multivariate regression analyses were conducted to estimate the effect of adherence on HRU related to urgent care (i.e., inpatient or emergency room visit), days of work loss, direct medical cost, and indirect work loss costs. Model coefficients were used to evaluate the impact of a 10 percentage point increase in adherence on the outcomes. A total of 1510 patients were included (mean age = 43.4 years, 64% female). Patients with higher adherence had lower HRU, fewer days of work loss, and lower direct and indirect costs. A 10 percentage point increase in adherence significantly decreased the likelihood of an inpatient or emergency room visit by 9-19%, days of work loss by 3-8%, and direct and indirect costs by 3-5%, depending on the follow-up period (all p < 0.01). Increasing DMT adherence was found to significantly decrease urgent-care HRU, days of work loss, and direct and indirect costs among patients with MS.

Gender Variations in the Effects of Number of Organizational Memberships, Number of Social Networking Sites, and Grade-Point Average on Global Social Responsibility in Filipino University Students

PubMed Central

Lee, Romeo B.; Baring, Rito V.; Sta. Maria, Madelene A.

2016-01-01

The study seeks to estimate gender variations in the direct effects of (a) number of organizational memberships, (b) number of social networking sites (SNS), and (c) grade-point average (GPA) on global social responsibility (GSR); and in the indirect effects of (a) and of (b) through (c) on GSR. Cross-sectional survey data were drawn from questionnaire interviews involving 3,173 Filipino university students. Based on a path model, the three factors were tested to determine their inter-relationships and their relationships with GSR. The direct and total effects of the exogenous factors on the dependent variable are statistically significantly robust. The indirect effects of organizational memberships on GSR through GPA are also statistically significant, but the indirect effects of SNS on GSR through GPA are marginal. Men and women significantly differ only in terms of the total effects of their organizational memberships on GSR. The lack of broad gender variations in the effects of SNS, organizational memberships and GPA on GSR may be linked to the relatively homogenous characteristics and experiences of the university students interviewed. There is a need for more path models to better understand the predictors of GSR in local students. PMID:27247700

Gender Variations in the Effects of Number of Organizational Memberships, Number of Social Networking Sites, and Grade-Point Average on Global Social Responsibility in Filipino University Students.

PubMed

Lee, Romeo B; Baring, Rito V; Sta Maria, Madelene A

2016-02-01

The study seeks to estimate gender variations in the direct effects of (a) number of organizational memberships, (b) number of social networking sites (SNS), and (c) grade-point average (GPA) on global social responsibility (GSR); and in the indirect effects of (a) and of (b) through (c) on GSR. Cross-sectional survey data were drawn from questionnaire interviews involving 3,173 Filipino university students. Based on a path model, the three factors were tested to determine their inter-relationships and their relationships with GSR. The direct and total effects of the exogenous factors on the dependent variable are statistically significantly robust. The indirect effects of organizational memberships on GSR through GPA are also statistically significant, but the indirect effects of SNS on GSR through GPA are marginal. Men and women significantly differ only in terms of the total effects of their organizational memberships on GSR. The lack of broad gender variations in the effects of SNS, organizational memberships and GPA on GSR may be linked to the relatively homogenous characteristics and experiences of the university students interviewed. There is a need for more path models to better understand the predictors of GSR in local students.

Network meta-analysis: a technique to gather evidence from direct and indirect comparisons

PubMed Central

2017-01-01

Systematic reviews and pairwise meta-analyses of randomized controlled trials, at the intersection of clinical medicine, epidemiology and statistics, are positioned at the top of evidence-based practice hierarchy. These are important tools to base drugs approval, clinical protocols and guidelines formulation and for decision-making. However, this traditional technique only partially yield information that clinicians, patients and policy-makers need to make informed decisions, since it usually compares only two interventions at the time. In the market, regardless the clinical condition under evaluation, usually many interventions are available and few of them have been studied in head-to-head studies. This scenario precludes conclusions to be drawn from comparisons of all interventions profile (e.g. efficacy and safety). The recent development and introduction of a new technique – usually referred as network meta-analysis, indirect meta-analysis, multiple or mixed treatment comparisons – has allowed the estimation of metrics for all possible comparisons in the same model, simultaneously gathering direct and indirect evidence. Over the last years this statistical tool has matured as technique with models available for all types of raw data, producing different pooled effect measures, using both Frequentist and Bayesian frameworks, with different software packages. However, the conduction, report and interpretation of network meta-analysis still poses multiple challenges that should be carefully considered, especially because this technique inherits all assumptions from pairwise meta-analysis but with increased complexity. Thus, we aim to provide a basic explanation of network meta-analysis conduction, highlighting its risks and benefits for evidence-based practice, including information on statistical methods evolution, assumptions and steps for performing the analysis. PMID:28503228

Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010

PubMed Central

Bhuiyan, Mejbah Uddin; Luby, Stephen P; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm–Ramirez, Katharine; Gurley, Emily S.; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, ASM; Rahman, Mahmudur; Ortega–Sanchez, Ismael R.; Azziz–Baumgartner, Eduardo

2017-01-01

Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged <5 years with laboratory–confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case–patients’ homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non–medical costs (costs for food, lodging and transportation); indirect costs (caregivers’ productivity loss), and coping strategies used by families to pay for treatment. We used WHO–Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost–per–episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43–101), indirect cost was US$ 19 (IQR = 11–29) and total cost was US$ 94 (IQR = 67–127). The median out–of–pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV–associated hospitalization in children aged <5 years in Bangladesh was US$ 10 million (IQR: US$ 7–16 million), the median indirect cost was US$ 3.0 million (IQR: 2–5 million) in 2010. Conclusion RSV–associated hospitalization among children aged <5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship. PMID:28702175

Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010.

PubMed

Bhuiyan, Mejbah Uddin; Luby, Stephen P; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm-Ramirez, Katharine; Gurley, Emily S; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, Asm; Rahman, Mahmudur; Ortega-Sanchez, Ismael R; Azziz-Baumgartner, Eduardo

2017-06-01

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. From May through October 2010, children aged <5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged <5 years in Bangladesh was US$ 10 million (IQR: US$ 7-16 million), the median indirect cost was US$ 3.0 million (IQR: 2-5 million) in 2010. RSV-associated hospitalization among children aged <5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.

Causal mediation analysis with a binary outcome and multiple continuous or ordinal mediators: Simulations and application to an alcohol intervention

PubMed Central

Nguyen, Trang Quynh; Webb-Vargas, Yenny; Koning, Ina M.; Stuart, Elizabeth A.

2016-01-01

We investigate a method to estimate the combined effect of multiple continuous/ordinal mediators on a binary outcome: 1) fit a structural equation model with probit link for the outcome and identity/probit link for continuous/ordinal mediators, 2) predict potential outcome probabilities, and 3) compute natural direct and indirect effects. Step 2 involves rescaling the latent continuous variable underlying the outcome to address residual mediator variance/covariance. We evaluate the estimation of risk-difference- and risk-ratio-based effects (RDs, RRs) using the ML, WLSMV and Bayes estimators in Mplus. Across most variations in path-coefficient and mediator-residual-correlation signs and strengths, and confounding situations investigated, the method performs well with all estimators, but favors ML/WLSMV for RDs with continuous mediators, and Bayes for RRs with ordinal mediators. Bayes outperforms WLSMV/ML regardless of mediator type when estimating RRs with small potential outcome probabilities and in two other special cases. An adolescent alcohol prevention study is used for illustration. PMID:27158217

Economic evaluation of universal infant vaccination with 7vPCV in Hong Kong.

PubMed

Lee, Kenneth K C; Rinaldi, Fiona; Chan, Mia K U; Chan, Shirley T H; So, Thomas M T; Hon, Ellis K L; Lee, Vivian W Y

2009-01-01

The purpose of this study was to evaluate the clinical and economic benefits of routine infant vaccination with seven-valent pneumococcal conjugate vaccine (7vPCV) in Hong Kong. A decision-analytic model was populated with local age-specific incidence data to simulate the expected health outcomes resulting from 7vPCV vaccination of a birth cohort of 57,100 children compared with an unvaccinated cohort over a 10-year horizon. Primary analyses were conducted from a payer perspective, using local inpatient and outpatient costs associated with the treatment of pneumococcal disease. Vaccine efficacy rates were consistent with results from pivotal clinical trials. The reduction in adult invasive pneumococcal disease (IPD) and associated cost avoidance due to the indirect effect of vaccination were estimated in line with published overseas rates. Universal 7vPCV vaccination was estimated to prevent 524 cases of IPD and more than 2580 cases of otitis media in the birth cohort over a 10-year period, leading to a reduction of HK$28.7 million (US$3.7 million) in direct medical costs. Additional cost savings from the indirect prevention of 919 adult cases of IPD during this time period also resulted. Overall, 7vPCV vaccination was estimated to have an incremental cost per life-year gained of HK$50,456 (US$6460) from a payer perspective or HK$46,308 (US$5929) when both direct and indirect costs were included. With reference to the World Health Organization's threshold for cost-effectiveness, results from this study indicate that routine infant vaccination with 7vPCV is a cost-effective intervention because of the added cost savings resulting from the indirect effect of vaccination on adult disease.

Measuring zebrafish turning rate.

PubMed

Mwaffo, Violet; Butail, Sachit; di Bernardo, Mario; Porfiri, Maurizio

2015-06-01

Zebrafish is becoming a popular animal model in preclinical research, and zebrafish turning rate has been proposed for the analysis of activity in several domains. The turning rate is often estimated from the trajectory of the fish centroid that is output by commercial or custom-made target tracking software run on overhead videos of fish swimming. However, the accuracy of such indirect methods with respect to the turning rate associated with changes in heading during zebrafish locomotion is largely untested. Here, we compare two indirect methods for the turning rate estimation using the centroid velocity or position data, with full shape tracking for three different video sampling rates. We use tracking data from the overhead video recorded at 60, 30, and 15 frames per second of zebrafish swimming in a shallow water tank. Statistical comparisons of absolute turning rate across methods and sampling rates indicate that, while indirect methods are indistinguishable from full shape tracking, the video sampling rate significantly influences the turning rate measurement. The results of this study can aid in the selection of the video capture frame rate, an experimental design parameter in zebrafish behavioral experiments where activity is an important measure.

[Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

PubMed

Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

2016-06-01

To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

Microcomputer software to facilitate costing in pathology laboratories.

PubMed Central

Stilwell, J A; Woodford, F P

1987-01-01

A software program is described which will enable laboratory managers to calculate, for their laboratory over a 12 month period, the cost of each test or investigation and of components of that cost. These comprise the costs of direct labour, consumables, equipment maintenance and depreciation; allocated costs of intermediate operations--for example, specimen procurement, reception, and data processing; and apportioned indirect costs such as senior staff time as well as external overheads such as telephone charges, rent, and rates. Total annual expenditure on each type of test is also calculated. The principles on which the program is based are discussed. Considered in particular, are the problems of apportioning indirect costs (which are considerable in clinical laboratory work) over different test costs, and the merits of different ways of estimating the amount or fraction of staff members' time spent on each kind of test. The computer program is Crown copyright but is available under licence from one of us (JAS). PMID:3654982

Role of Self-Directed Learning in Communication Competence and Self-Efficacy.

PubMed

Song, Youngshin; Yun, Soon Young; Kim, Sun-Ae; Ahn, Eun-Kyong; Jung, Mi Sook

2015-10-01

Although effective self-directed learning (SDL) has been shown to improve clinical performance, little is known about its role between communication competence and communication self-efficacy in nursing students. This study aimed to identify whether SDL mediates the relationship between communication competence and communication self-efficacy. A cross-sectional survey was conducted with a sample of 213 nursing students taking a basic fundamentals of nursing course. A path diagram, using structural equation modeling, was used to estimate the direct and indirect effects of communication competence on communication self-efficacy, controlling for SDL as a mediator. A structural equation model confirmed direct and indirect effects of communication competence on communication self-efficacy when SDL was controlled as a mediator. An appropriate fit to the data was identified in this mediation model of SDL. For enhancing self-efficacy regarding communication skill, the specified SDL program based on the level of communication competence will yield more effective results. Copyright 2015, SLACK Incorporated.

Least Squares Solution of Small Sample Multiple-Master PSInSAR System

NASA Astrophysics Data System (ADS)

Zhang, Lei; Ding, Xiao Li; Lu, Zhong

2010-03-01

In this paper we propose a least squares based approach for multi-temporal SAR interferometry that allows to estimate the deformation rate with no need of phase unwrapping. The approach utilizes a series of multi-master wrapped differential interferograms with short baselines and only focuses on the arcs constructed by two nearby points at which there are no phase ambiguities. During the estimation an outlier detector is used to identify and remove the arcs with phase ambiguities, and pseudoinverse of priori variance component matrix is taken as the weight of correlated observations in the model. The parameters at points can be obtained by an indirect adjustment model with constraints when several reference points are available. The proposed approach is verified by a set of simulated data.

Direct and indirect economic costs among private-sector employees with osteoarthritis.

PubMed

Berger, Ariel; Hartrick, Craig; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

2011-11-01

To estimate direct and indirect economic costs among private-sector employees with osteoarthritis (OA). Using a large US employer benefits database, we identified all employees with evidence of OA during calendar year 2007, and compared their costs of health care and work loss to age-and-sex-matched employees without evidence of OA in that year. Private-sector employees with OA (n = 2399) averaged 62.9 days of absenteeism versus 36.7 days among matched comparators (n = 2399) (P < 0.01). Mean total direct costs among these persons were $17,751 and $5057, respectively (P < 0.01); 34% of health care costs among persons with OA arose from medical encounters with listed diagnoses of OA. Mean total indirect costs were two-fold higher among persons with OA ($5002 versus $2120 for those without OA; P < 0.01). Private-sector employees with OA have higher direct and indirect costs than those without this condition.

Market Assessment of Forward-Looking Turbulence Sensing Systems

NASA Technical Reports Server (NTRS)

Kauffmann, Paul

2003-01-01

This viewgraph presentation provides a cost benefit analysis of three next-generation forward-looking turbulence sensing systems: X band turbulence radar system for convective turbulence, LIDAR based turbulence systems to sense clear air turbulence and a combined hybrid system. Parameters for the cost benefit analysis were established using a business model which considered injury rates, cost of injuries, indirect costs, market penetration rate estimates and product success characteristics. Topics covered include: study approach, business case equations, data acquisition, benchmark analysis. Data interpretation from the cost benefit analysis is presented. The researchers conclude that the market potential for these products is based primarily on injury cost reduction and that X band radar systems have the greatest chance for commercial success.

Estimation of Asian Dust Aerosol Effect on Cloud Radiation Forcing Using Fu-Liou Radiative Model and CERES Measurements

NASA Technical Reports Server (NTRS)

Su, Jing; Huang, Jianping; Fu, Qiang; Minnis, Patrick; Ge, Jinming; Bi, Jianrong

2008-01-01

The impact of Asian dust on cloud radiative forcing during 2003-2006 is studied by using the Earth's Radiant Energy Budget Scanner (CERES) data and the Fu-Liou radiative transfer model. Analysis of satellite data shows that the dust aerosol significantly reduced the cloud cooling effect at TOA. In dust contaminated cloudy regions, the 4-year mean values of the instantaneous shortwave, longwave and net cloud radiative forcing are -138.9, 69.1, and -69.7 Wm(sup -2), which are 57.0, 74.2, and 46.3%, respectively, of the corresponding values in more pristine cloudy regions. The satellite-retrieved cloud properties are significantly different in the dusty regions and can influence the radiative forcing indirectly. The contributions to the cloud radiation forcing by the dust direct, indirect and semi-direct effects are estimated using combined satellite observations and Fu-Liou model simulation. The 4-year mean value of combination of indirect and semi-direct shortwave radiative forcing (SWRF) is 82.2 Wm(sup -2), which is 78.4% of the total dust effect. The direct effect is only 22.7 Wm(sup -2), which is 21.6% of the total effect. Because both first and second indirect effects enhance cloud cooling, the aerosol-induced cloud warming is mainly the result of the semi-direct effect of dust.

[Economic rehabilitation management among patients with chronic low back pain].

PubMed

Seitz, R; Schweikert, B; Jacobi, E; Tschirdewahn, B; Leidl, R

2001-12-01

Back pain causes high costs to society. In Germany, these amount to an estimated total of 5 billion euro of direct costs per year and 13 billion euro of indirect costs, the latter being caused by incapacity to work. The purpose of this study is to develop a concept for economic rehabilitation management. This concept is based on the managed care approach and aims at improving efficiency of care. The concept development consists of a theoretical and an empirical part. The method of the theoretical part is based on a systematic literature review on managed care (not included in this article), health systems research and the analysis of economic incentives. For the empirical investigation, long term effects and costs were calculated. For the evaluation of effects, we psychometrically tested and used the EuroQol (EQ-5D) as a measure of health-related quality of life (HRQL). The calculation of costs (both direct and indirect) is based on routine data of payers, a cost diary and the internal cost accounting systems of rehabilitation clinics. We statistically analysed the cost distribution and identified predictors of the management targets (e.g., costs of care) by means of regression analyses. The market-driven managed care approach is based on three tools: (1) a primary care system with case management and gatekeeping, (2) direct influence on providers by utilisation review and setting guidelines, and (3) indirect influence by setting supply-side economic incentives via the remuneration mode. The third managed care tool is most important when managing the rehabilitation of working age patients with chronic low back pain from an economic point of view. This concept consists of three components: (1) a case-based budget for direct costs; this is a prospective remuneration mode for an integrated primary care network including a rehabilitation facility, (2) retrospective bonus payments which are related to savings of indirect costs, and (3) retrospective bonus payments which are related to the effectiveness of rehabilitation, i.e. gains in HRQL. Common features of the three management components are a long-term perspective (e.g., from admission to a rehabilitation clinic until six months after discharge) and risk-adjustment of the three management targets (i.e., direct and indirect costs and gains in HRQL) in order to avoid selection and to limit the financial risk for providers. The EuroQol instrument shows acceptable psychometric properties in the rehabilitation setting for back pain patients. This instrument may yield two kinds of preference-based index values, one reflecting the preferences of the general population and one those of the patient. The Pearson correlation of these two approaches is fair, but there is a systematic difference. Empirical investigation shows that the distribution of both direct and indirect costs is skewed to the right. Statistically relevant predictors of the management targets are incapacity to work and HRQL at admission. Economic rehabilitation management might help to save money and to improve health outcomes, thus increasing the efficiency of care. The results of our empirical studies show the feasibility of tools for the economic management of rehabilitation. Risk adjustment of the management components is of paramount importance.

Modeling the cost of influenza: the impact of missing costs of unreported complications and sick leave

PubMed Central

2010-01-01

Background Estimating the economic impact of influenza is complicated because the disease may have non-specific symptoms, and many patients with influenza are registered with other diagnoses. Furthermore, in some countries like Norway, employees can be on paid sick leave for a specified number of days without a doctor's certificate ("self-reported sick leave") and these sick leaves are not registered. Both problems result in gaps in the existing literature: costs associated with influenza-related illness and self-reported sick leave are rarely included. The aim of this study was to improve estimates of total influenza-related health-care costs and productivity losses by estimating these missing costs. Methods Using Norwegian data, the weekly numbers of influenza-attributable hospital admissions and certified sick leaves registered with other diagnoses were estimated from influenza-like illness surveillance data using quasi-Poisson regression. The number of self-reported sick leaves was estimated using a Monte-Carlo simulation model of illness recovery curves based on the number of certified sick leaves. A probabilistic sensitivity analysis was conducted on the economic outcomes. Results During the 1998/99 through 2005/06 influenza seasons, the models estimated an annual average of 2700 excess influenza-associated hospitalizations in Norway, of which 16% were registered as influenza, 51% as pneumonia and 33% were registered with other diagnoses. The direct cost of seasonal influenza totaled US$22 million annually, including costs of pharmaceuticals and outpatient services. The annual average number of working days lost was predicted at 793 000, resulting in an estimated productivity loss of US$231 million. Self-reported sick leave accounted for approximately one-third of the total indirect cost. During a pandemic, the total cost could rise to over US$800 million. Conclusions Influenza places a considerable burden on patients and society with indirect costs greatly exceeding direct costs. The cost of influenza-attributable complications and the cost of self-reported sick leave represent a considerable part of the economic burden of influenza. PMID:21106057

The economic burden of physical inactivity: a systematic review and critical appraisal.

PubMed

Ding, Ding; Kolbe-Alexander, Tracy; Nguyen, Binh; Katzmarzyk, Peter T; Pratt, Michael; Lawson, Kenny D

2017-10-01

To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Total, direct, and indirect effects of paan on oral cancer.

PubMed

Merchant, Anwar T; Pitiphat, Waranuch

2015-03-01

Paan (betel leaf and betel nut quid) used with or without tobacco has been positively associated with oral cancer. Oral submucous fibrosis (OSMF), a precancerous condition caused by paan, lies on the causal pathway between paan use and oral cancer. The purpose of this analysis was to estimate the effect of paan consumption on oral cancer risk when it is mediated by OSMF. We used mediation methods proposed by VanderWeele, which are based on causal inference principles, to characterize the total, direct, and indirect effects of paan, consumed with and without tobacco, on oral cancer mediated by OSMF. We reanalyzed case-control data collected from three hospitals in Karachi, Pakistan, between July 1996 and March 1998. For paan without tobacco, the total effect on oral cancer was OR 7.39, 95 % CI 1.01, 38.11, the natural indirect effect (due to OSMF among paan users) was OR 2.48, 95 % CI 0.99, 10.44, and the natural direct effect (due to paan with OSMF absent) was OR 3.32, 95 % CI 0.68, 10.07. For paan with tobacco, the total direct effect was OR 15.68, 95 % CI 3.00, 54.90, the natural indirect effect was OR 2.18, 95 % CI 0.82, 5.52, and the natural direct effect was OR 7.27, 95 % CI 2.15, 20.43. Paan, whether or not it contained tobacco, raised oral cancer risk irrespective of OSMF. Oral cancer risk was higher among those who used paan with tobacco.

Direct Animal Calorimetry, the Underused Gold Standard for Quantifying the Fire of Life*

PubMed Central

Kaiyala, Karl J.; Ramsay, Douglas S.

2012-01-01

Direct animal calorimetry, the gold standard method for quantifying animal heat production (HP), has been largely supplanted by respirometric indirect calorimetry owing to the relative ease and ready commercial availability of the latter technique. Direct calorimetry, however, can accurately quantify HP and thus metabolic rate (MR) in both metabolically normal and abnormal states, whereas respirometric indirect calorimetry relies on important assumptions that apparently have never been tested in animals with genetic or pharmacologically-induced alterations that dysregulate metabolic fuel partitioning and storage so as to promote obesity and/or diabetes. Contemporary obesity and diabetes research relies heavily on metabolically abnormal animals. Recent data implicating individual and group variation in the gut microbiome in obesity and diabetes raise important questions about transforming aerobic gas exchange into HP because 99% of gut bacteria are anaerobic and they outnumber eukaryotic cells in the body by ~10-fold. Recent credible work in non-standard laboratory animals documents substantial errors in respirometry-based estimates of HP. Accordingly, it seems obvious that new research employing simultaneous direct and indirect calorimetry (total calorimetry) will be essential to validate respirometric MR phenotyping in existing and future pharmacological and genetic models of obesity and diabetes. We also detail the use of total calorimetry with simultaneous core temperature assessment as a model for studying homeostatic control in a variety of experimental situations, including acute and chronic drug administration. Finally, we offer some tips on performing direct calorimetry, both singly and in combination with indirect calorimetry and core temperature assessment. PMID:20427023

Motion estimation using point cluster method and Kalman filter.

PubMed

Senesh, M; Wolf, A

2009-05-01

The most frequently used method in a three dimensional human gait analysis involves placing markers on the skin of the analyzed segment. This introduces a significant artifact, which strongly influences the bone position and orientation and joint kinematic estimates. In this study, we tested and evaluated the effect of adding a Kalman filter procedure to the previously reported point cluster technique (PCT) in the estimation of a rigid body motion. We demonstrated the procedures by motion analysis of a compound planar pendulum from indirect opto-electronic measurements of markers attached to an elastic appendage that is restrained to slide along the rigid body long axis. The elastic frequency is close to the pendulum frequency, as in the biomechanical problem, where the soft tissue frequency content is similar to the actual movement of the bones. Comparison of the real pendulum angle to that obtained by several estimation procedures--PCT, Kalman filter followed by PCT, and low pass filter followed by PCT--enables evaluation of the accuracy of the procedures. When comparing the maximal amplitude, no effect was noted by adding the Kalman filter; however, a closer look at the signal revealed that the estimated angle based only on the PCT method was very noisy with fluctuation, while the estimated angle based on the Kalman filter followed by the PCT was a smooth signal. It was also noted that the instantaneous frequencies obtained from the estimated angle based on the PCT method is more dispersed than those obtained from the estimated angle based on Kalman filter followed by the PCT method. Addition of a Kalman filter to the PCT method in the estimation procedure of rigid body motion results in a smoother signal that better represents the real motion, with less signal distortion than when using a digital low pass filter. Furthermore, it can be concluded that adding a Kalman filter to the PCT procedure substantially reduces the dispersion of the maximal and minimal instantaneous frequencies.

Economic Burden of Rheumatoid Arthritis in Italy: Possible Consequences on Anti-Citrullinated Protein Antibody-Positive Patients.

PubMed

Mennini, Francesco Saverio; Marcellusi, Andrea; Gitto, Lara; Iannone, Florenzo

2017-04-01

Rheumatoid arthritis (RA) is an autoimmune disease with a substantial medical and economic burden. In Italy, it affects approximately 280,000 people, therefore representing the musculoskeletal disease with the highest economic impact in terms of costs for the National Health Service and the social security system. The aim of this study was to estimate the annual economic burden of RA in Italy and determine the potential cost reduction considering the most effective biologic treatment for early rapidly progressing RA (ERPRA) patients. The model developed considers both direct costs that are mainly due to the pharmacological treatments, and indirect costs, which also include the productivity lost because of the disease. A systematic literature review provided the epidemiological and economic data used to inform the model. A one-way probabilistic sensitivity analysis based on 5000 Monte Carlo simulations was performed. Furthermore, specific scenario analyses were developed for those patients presenting an ERPRA, with the aim of evaluating the effectiveness of different biologic treatments for this subgroup of patients and estimating potential cost reduction. The total economic burden associated with RA was estimated to be €2.0 billion per year (95% confidence interval [CI] €1.8-2.3 billion). Forty-five percent of the expenditure was due to indirect costs (95% CI €0.8-1.0 billion); 45% depended on direct medical costs (95% CI €0.7-1.1 billion), and the residual 10% was determined by direct non-medical costs (95% CI €0.16-0.25 billion). In particular, the costs estimated for ERPRA patients totalled €76,171,181, of which approximately €18 million was associated with patients with a high level of anti-citrullinated protein antibodies (ACPA). The results of the analysis outline how it is possible to obtain a cost reduction for ERPRA patients of between €1 and €3 million by varying the number of patients with a high level of immunoglobulin G treated with the most effective biologic drug. In fact, the latter may determine higher efficacy outcomes, especially for poor prognostic ERPRA patients, ensuing higher levels of productivity. This study presents a pioneering approach to estimate the direct and indirect costs of RA. The model developed is a useful tool for policy makers as it allows to understand the economic implications of RA treatment in Italy, identify the most effective allocation of resources, and select the most appropriate treatment for ERPRA patients.

Greenhouse Gases

MedlinePlus

... Information Administration (EIA) does not estimate emissions of water vapor. Research by NASA suggests a stronger impact from the indirect human effects on water vapor concentrations. Ozone is technically a greenhouse gas ...

Characterizing source-sink dynamics with genetic parentage assignments

Treesearch

M. Zachariah Peery; Steven R. Beissinger; Roger F. House; Martine Berube; Laurie A. Hall; Anna Sellas; Per J. Palsboll

2008-01-01

Source-sink dynamics have been suggested to characterize the population structure of many species, but the prevalence of source-sink systems in nature is uncertain because of inherent challenges in estimating migration rates among populations. Migration rates are often difficult to estimate directly with demographic methods, and indirect genetic methods are subject to...

Evaluating officially reported polycyclic aromatic hydrocarbon emissions in the Athabasca oil sands region with a multimedia fate model.

PubMed

Parajulee, Abha; Wania, Frank

2014-03-04

Emissions of organic substances with potential toxicity to humans and the environment are a major concern surrounding the rapid industrial development in the Athabasca oil sands region (AOSR). Although concentrations of polycyclic aromatic hydrocarbons (PAHs) in some environmental samples have been reported, a comprehensive picture of organic contaminant sources, pathways, and sinks within the AOSR has yet to be elucidated. We sought to use a dynamic multimedia environmental fate model to reconcile the emissions and residue levels reported for three representative PAHs in the AOSR. Data describing emissions to air compiled from two official sources result in simulated concentrations in air, soil, water, and foliage that tend to fall close to or below the minimum measured concentrations of phenanthrene, pyrene, and benzo(a)pyrene in the environment. Accounting for evaporative emissions (e.g., from tailings pond disposal) provides a more realistic representation of PAH distribution in the AOSR. Such indirect emissions to air were found to be a greater contributor of PAHs to the AOSR atmosphere relative to reported direct emissions to air. The indirect pathway transporting uncontrolled releases of PAHs to aquatic systems via the atmosphere may be as significant a contributor of PAHs to aquatic systems as other supply pathways. Emission density estimates for the three PAHs that account for tailings pond disposal are much closer to estimated global averages than estimates based on the available emissions datasets, which fall close to the global minima. Our results highlight the need for improved accounting of PAH emissions from oil sands operations, especially in light of continued expansion of these operations.

Contrast-Enhanced Ultrasound Angiogenesis Imaging by Mutual Information Analysis for Prostate Cancer Localization.

PubMed

Schalk, Stefan G; Demi, Libertario; Bouhouch, Nabil; Kuenen, Maarten P J; Postema, Arnoud W; de la Rosette, Jean J M C H; Wijkstra, Hessel; Tjalkens, Tjalling J; Mischi, Massimo

2017-03-01

The role of angiogenesis in cancer growth has stimulated research aimed at noninvasive cancer detection by blood perfusion imaging. Recently, contrast ultrasound dispersion imaging was proposed as an alternative method for angiogenesis imaging. After the intravenous injection of an ultrasound-contrast-agent bolus, dispersion can be indirectly estimated from the local similarity between neighboring time-intensity curves (TICs) measured by ultrasound imaging. Up until now, only linear similarity measures have been investigated. Motivated by the promising results of this approach in prostate cancer (PCa), we developed a novel dispersion estimation method based on mutual information, thus including nonlinear similarity, to further improve its ability to localize PCa. First, a simulation study was performed to establish the theoretical link between dispersion and mutual information. Next, the method's ability to localize PCa was validated in vivo in 23 patients (58 datasets) referred for radical prostatectomy by comparison with histology. A monotonic relationship between dispersion and mutual information was demonstrated. The in vivo study resulted in a receiver operating characteristic (ROC) curve area equal to 0.77, which was superior (p = 0.21-0.24) to that obtained by linear similarity measures (0.74-0.75) and (p <; 0.05) to that by conventional perfusion parameters (≤0.70). Mutual information between neighboring time-intensity curves can be used to indirectly estimate contrast dispersion and can lead to more accurate PCa localization. An improved PCa localization method can possibly lead to better grading and staging of tumors, and support focal-treatment guidance. Moreover, future employment of the method in other types of angiogenic cancer can be considered.

First surface-based estimation of the aerosol indirect effect over a site in southeastern China

NASA Astrophysics Data System (ADS)

Liu, Jianjun; Li, Zhanqing

2018-02-01

The deployment of the U.S. Atmospheric Radiation Measurement mobile facility in Shouxian from May to December 2008 amassed the most comprehensive set of measurements of atmospheric, surface, aerosol, and cloud variables in China. This deployment provided a unique opportunity to investigate the aerosol-cloud interactions, which are most challenging and, to date, have not been examined to any great degree in China. The relationship between cloud droplet effective radius (CER) and aerosol index (AI) is very weak in summer because the cloud droplet growth is least affected by the competition for water vapor. Mean cloud liquid water path (LWP) and cloud optical depth (COD) significantly increase with increasing AI in fall. The sensitivities of CER and LWP to aerosol loading increases are not significantly different under different air mass conditions. There is a significant correlation between the changes in hourly mean AI and the changes in hourly mean CER, LWP, and COD. The aerosol first indirect effect (FIE) is estimated in terms of relative changes in both CER (FIECER) and COD (FIECOD) with changes in AI for different seasons and air masses. FIECOD and FIECER are similar in magnitude and close to the typical FIE value of ˜ 0.23, and do not change much between summer and fall or between the two different air mass conditions. Similar analyses were done using spaceborne Moderate Resolution Imaging Spectroradiometer data. The satellite-derived FIE is contrary to the FIE estimated from surface retrievals and may have large uncertainties due to some inherent limitations.

Predictors of negotiated NIH indirect rates at US institutions.

PubMed

Johnston, S Claiborne; Desmond-Hellmann, Susan; Hauser, Stewart; Vermillion, Eric; Mia, Nilo

2015-01-01

The United States (US) Department of Health and Human Services and the Office of Naval Research negotiate institutional rates for payments of overhead costs associated with administration and space usage, commonly known as indirect rates. Such payments account for a large proportion of spending by the National Institutes of Health (NIH). Little has been published about differences in rates and their predictors. Negotiated indirect rates for on-campus research grants were requested from the Council on Governmental Relations for the 100 institutions with greatest NIH funding in 2010. NIH funding, cost of living (ACCRA Index for 2008), public vs. private status, negotiating governmental organization (Department of Health and Human Services or Office of Naval Research), US Census Region, and year were assessed as predictors of institutional indirect rates using generalized estimating equations with all variables included in the model. Overall, 72 institutions participated, with 207 reported indirect rates for the years 2006, 2008, and 2010. Indirect rates ranged from 36.3% to 78%, with an average of 54.5%. Mean rates increased from 53.6% in 2006 to 55.4% in 2010 (p<0.001). In multivariable models, private institutions had 6.2% (95% CI 3.7%-8.7%; p<0.001) higher indirect rates than public institutions. Rates in the Northeast were highest (Midwest 4.0% lower; West 4.9% lower; South 5.2% lower). Greater NIH funding (p = 0.025) and cost of living (p = 0.034) also predicted indirect rates while negotiating governmental organization did not (p = 0.414). Negotiated indirect rates for governmental research grants to academic centers vary widely. Although the association between indirect rates and cost of living may be justified, the cause of variation in rates by region, public-private status, and NIH funding levels is unclear.

Paule‐Mandel estimators for network meta‐analysis with random inconsistency effects

PubMed Central

Veroniki, Areti Angeliki; Law, Martin; Tricco, Andrea C.; Baker, Rose

2017-01-01

Network meta‐analysis is used to simultaneously compare multiple treatments in a single analysis. However, network meta‐analyses may exhibit inconsistency, where direct and different forms of indirect evidence are not in agreement with each other, even after allowing for between‐study heterogeneity. Models for network meta‐analysis with random inconsistency effects have the dual aim of allowing for inconsistencies and estimating average treatment effects across the whole network. To date, two classical estimation methods for fitting this type of model have been developed: a method of moments that extends DerSimonian and Laird's univariate method and maximum likelihood estimation. However, the Paule and Mandel estimator is another recommended classical estimation method for univariate meta‐analysis. In this paper, we extend the Paule and Mandel method so that it can be used to fit models for network meta‐analysis with random inconsistency effects. We apply all three estimation methods to a variety of examples that have been used previously and we also examine a challenging new dataset that is highly heterogenous. We perform a simulation study based on this new example. We find that the proposed Paule and Mandel method performs satisfactorily and generally better than the previously proposed method of moments because it provides more accurate inferences. Furthermore, the Paule and Mandel method possesses some advantages over likelihood‐based methods because it is both semiparametric and requires no convergence diagnostics. Although restricted maximum likelihood estimation remains the gold standard, the proposed methodology is a fully viable alternative to this and other estimation methods. PMID:28585257

Methodological evaluation of indirect calorimetry data in lean and obese rats.

PubMed

Rafecas, I; Esteve, M; Fernández-López, J A; Remesar, X; Alemany, M

1993-11-01

1. The applicability of current indirect calorimetry formulae to the study of energy and substrate balances on obese rats has been evaluated. The energy consumption of series of 60-day rats of Wistar, lean and obese Zucker stock were studied by means of direct and indirect calorimetry, and by establishing their energy balance through measurement of food intake and retention. Calorimetric studies encompassed a 24 h period, with gas and heat output measurements every 2 or 5 min, respectively, for direct and indirect calorimetry. 2. The analysis of fat composition (diet, whole rat, and synthesized and oxidized fat) showed only small variations that had only a limited effect on the overall energy equation parameters. 3. A gap in the nitrogen balance, which represents a urinary N excretion lower than the actual protein oxidized, resulted in significant deviations in the estimation of carbohydrate and lipid oxidized when using the equations currently available for indirect calorimetry. 4. Analysis of the amino acid composition of diet and rat protein as well as of the portion actually oxidized, and correcting for the nitrogen gap allowed the establishment of a set of equations that gave better coincidence of the calculated data with the measured substrate balance. 5. The measured heat output of all rats was lower than the estimated values calculated by means of either indirect calorimetry of direct energy balance measurement; the difference corresponded to the energy lost in water evaporation, and was in the range of one-fifth of total energy produced in the three rat stocks. 6. Wistar rats showed a biphasic circadian rhythm of substrate utilization, with alternate lipid synthesis/degradation that reversed that of carbohydrate, concordant with nocturnal feeding habits. Zucker rats did not show this rhythm; obese rats synthesized large amounts of fat during most of the light period, consuming fat at the end of the dark period, which suggests more diurnal feeding habits. Lean Zucker rats showed a similar, but less marked pattern. 7. The results obtained indicate that lean and obese rats can be studied using the same indirect calorimetry formulae provided that there is an adequate measure of protein oxidation and the composition of diet does not differ.

The economic burden of chronic non-communicable diseases in rural Malawi: an observational study.

PubMed

Wang, Qun; Brenner, Stephan; Kalmus, Olivier; Banda, Hastings Thomas; De Allegri, Manuela

2016-09-01

Evidence from population-based studies on the economic burden imposed by chronic non-communicable diseases (CNCDs) is still sparse in Sub-Saharan Africa. Our study aimed to fill this existing gap in knowledge by estimating both the household direct, indirect, and total costs incurred due to CNCDs and the economic burden households bear as a result of these costs in Malawi. The study used data from the first round of a longitudinal household health survey conducted in 2012 in three rural districts in Malawi. A cost-of-illness method was applied to estimate the economic burden of CNCDs. Indicators of catastrophic spending and impoverishment were used to estimate the economic burden imposed by CNCDs on households. A total 475 out of 5643 interviewed individuals reported suffering from CNCDs. Mean total costs of all reported CNCDs were 1,040.82 MWK, of which 56.8 % was contributed by direct costs. Individuals affected by chronic cardiovascular conditions and chronic neuropsychiatric conditions bore the highest levels of direct, indirect, and total costs. Using a threshold of 10 % of household non-food expenditure, 21.3 % of all households with at least one household member reporting a CNCD and seeking care for such a condition incurred catastrophic spending due to CNCDs. The poorest households were more likely to incur catastrophic spending due to CNCDs. An additional 1.7 % of households reporting a CNCD fell under the international poverty line once considering direct costs due to CNCDs. Our study showed that the economic burden of CNCDs is high, causes catastrophic spending, and aggravates poverty in rural Malawi, a country where in principle basic care for CNCDs should be offered free of charge at point of use through the provision of an Essential Health Package (EHP). Our findings further indicated that particularly high direct, indirect, and total costs were linked to specific diagnoses, although costs were high even for conditions targeted by the EHP. Our findings point at clear gaps in coverage in the current Malawian health system and call for further investments to ensure adequate affordable care for people suffering from CNCDs.

Socioeconomic inequality in health in the British household panel: Tests of the social causation, health selection and the indirect selection hypothesis using dynamic fixed effects panel models.

PubMed

Foverskov, Else; Holm, Anders

2016-02-01

Despite social inequality in health being well documented, it is still debated which causal mechanism best explains the negative association between socioeconomic position (SEP) and health. This paper is concerned with testing the explanatory power of three widely proposed causal explanations for social inequality in health in adulthood: the social causation hypothesis (SEP determines health), the health selection hypothesis (health determines SEP) and the indirect selection hypothesis (no causal relationship). We employ dynamic data of respondents aged 30 to 60 from the last nine waves of the British Household Panel Survey. Household income and location on the Cambridge Scale is included as measures of different dimensions of SEP and health is measured as a latent factor score. The causal hypotheses are tested using a time-based Granger approach by estimating dynamic fixed effects panel regression models following the method suggested by Anderson and Hsiao. We propose using this method to estimate the associations over time since it allows one to control for all unobserved time-invariant factors and hence lower the chances of biased estimates due to unobserved heterogeneity. The results showed no proof of the social causation hypothesis over a one to five year period and limited support for the health selection hypothesis was seen only for men in relation to HH income. These findings were robust in multiple sensitivity analysis. We conclude that the indirect selection hypothesis may be the most important in explaining social inequality in health in adulthood, indicating that the well-known cross-sectional correlations between health and SEP in adulthood seem not to be driven by a causal relationship, but instead by dynamics and influences in place before the respondents turn 30 years old that affect both their health and SEP onwards. The conclusion is limited in that we do not consider the effect of specific diseases and causal relationships in adulthood may be present over a longer timespan than 5 years. Copyright © 2015 Elsevier Ltd. All rights reserved.

The economic burden of musculoskeletal disease in Korea: A cross sectional study

PubMed Central

2011-01-01

Background Musculoskeletal diseases are becoming increasingly important due to population aging. However, studies on the economic burden of musculoskeletal disease in Korea are scarce. Therefore, we conducted a population-based study to measure the economic burden of musculoskeletal disease in Korea using nationally representative data. Methods This study used a variety of data sources such as national health insurance statistics, the Korea Health Panel study and cause of death reports generated by the Korea National Statistical Office to estimate the economic burden of musculoskeletal disease. The total cost of musculoskeletal disease was estimated as the sum of direct medical care costs, direct non-medical care costs, and indirect costs. Direct medical care costs are composed of the costs paid by the insurer and patients, over the counter drugs costs, and other costs such as medical equipment costs. Direct non-medical costs are composed of transportation and caregiver costs. Indirect costs are the sum of the costs associated with premature death and the costs due to productivity loss. Age, sex, and disease specific costs were estimated. Results Among the musculoskeletal diseases, the highest costs are associated with other dorsopathies, followed by disc disorder and arthrosis. The direct medical and direct non-medical costs of all musculoskeletal diseases were $4.18 billion and $338 million in 2008, respectively. Among the indirect costs, those due to productivity loss were $2.28 billion and costs due to premature death were $79 million. The proportions of the total costs incurred by male and female patients were 33.8% and 66.2%, respectively, and the cost due to the female adult aged 20-64 years old was highest. The total economic cost of musculoskeletal disease was $6.89 billion, which represents 0.7% of the Korean gross domestic product. Conclusions The economic burden of musculoskeletal disease in Korea is substantial. As the Korean population continues to age, the economic burden of musculoskeletal disease will continue to increase. Policy measures aimed at controlling the cost of musculoskeletal disease are therefore required. PMID:21749727

Human exposure to per- and polyfluoroalkyl substances (PFASs) via house dust in Korea: Implication to exposure pathway.

PubMed

Tian, Zhexi; Kim, Seung-Kyu; Shoeib, Mahiba; Oh, Jeong-Eun; Park, Jong-Eun

2016-05-15

A wide range of per- and polyfluoroalkyl substances (PFASs), including fluorotelomer alcohols (FTOHs), perfluorooctane sulfonamidoethanols (FOSEs), perfluoroalkyl carboxylic acids (PFCAs), and perfluoroalkane sulfonic acids (PFSAs), were measured in fifteen house dust and two nonresidential indoor dust of Korea. Total concentrations of PFASs in house dust ranged from 29.9 to 97.6 ng g(-1), with a dominance of perfluorooctane sulfonic acid (PFOS), followed by 8:2 FTOH, N-Ethyl perfluorooctane sulfonamidoethanol (EtFOSE), perfluoroctanoic acid (PFOA). In a typical exposure scenario, the estimated daily intakes (EDIs) of total PFASs via house dust ingestion were 2.83 ng d(-1) for toddlers and 1.13 ng d(-1) for adults, which were within the range of the mean EDIs reported from several countries. For PFOA and PFOS exposure via house dust ingestion, indirect exposure (via precursors) was a minor contributor, accounting for 5% and 12%, respectively. An aggregated exposure (hereafter, overall-EDIs) of PFOA and PFOS occurring via all pathways, estimated using data compiled from the literature, were 53.6 and 14.8 ng d(-1) for toddlers, and 20.5 and 40.6 ng d(-1) for adults, respectively, in a typical scenario. These overall-EDIs corresponded to 82% (PFOA) and 92% (PFOS) of a pharmacokinetic model-based EDIs estimated from adults' serum data. Direct dietary exposure was a major contributor (>89% of overall-EDI) to PFOS in both toddlers and adults, and PFOA in toddlers. As for PFOA exposure of adults, however direct exposure via tap water drinking (37%) and indirect exposure via inhalation (22%) were as important as direct dietary exposure (41%). House dust-ingested exposure (direct+indirect) was responsible for 5% (PFOS in toddlers) and <1% (PFOS in adults, and PFOA in both toddlers and adults) of the overall-EDIs. In conclusion, house-dust ingestion was a minor contributor in this study, but should not be ignored for toddlers' PFOS exposure due to its significance in the worst-case scenario. Copyright © 2016 Elsevier B.V. All rights reserved.

Using parentage analysis to estimate rates of straying and homing in Chinook salmon (Oncorhynchus tshawytscha).

PubMed

Ford, Michael J; Murdoch, Andrew; Hughes, Michael

2015-03-01

We used parentage analysis based on microsatellite genotypes to measure rates of homing and straying of Chinook salmon (Oncorhynchus tshawytscha) among five major spawning tributaries within the Wenatchee River, Washington. On the basis of analysis of 2248 natural-origin and 11594 hatchery-origin fish, we estimated that the rate of homing to natal tributaries by natural-origin fish ranged from 0% to 99% depending on the tributary. Hatchery-origin fish released in one of the five tributaries homed to that tributary at a far lower rate than the natural-origin fish (71% compared to 96%). For hatchery-released fish, stray rates based on parentage analysis were consistent with rates estimated using physical tag recoveries. Stray rates among major spawning tributaries were generally higher than stray rates of tagged fish to areas outside of the Wenatchee River watershed. Within the Wenatchee watershed, rates of straying by natural-origin fish were significantly affected by spawning tributary and by parental origin: progeny of naturally spawning hatchery-produced fish strayed at significantly higher rates than progeny whose parents were themselves of natural origin. Notably, none of the 170 offspring that were products of mating by two natural-origin fish strayed from their natal tributary. Indirect estimates of gene flow based on FST statistics were correlated with but higher than the estimates from the parentage data. Tributary-specific estimates of effective population size were also correlated with the number of spawners in each tributary. Published [2015]. This article is a U.S. Government work and is in the public domain in the USA.

Imaging tropical peatlands in Indonesia using ground-penetrating radar (GPR) and electrical resistivity imaging (ERI): implications for carbon stock estimates and peat soil characterization

Treesearch

X. Comas; N. Terry; M. Warren; R. Kolka; A. Kristiyono; N. Sudiana; D. Nurjaman; T. Darusman

2015-01-01

Current estimates of carbon (C) storage in peatland systems worldwide indicate that tropical peatlands comprise about 15% of the global peat carbon pool. Such estimates are uncertain due to data gaps regarding organic peat soil thickness, volume and C content. We combined a set of indirect geophysical methods (ground-penetrating radar, GPR, and electrical resistivity...

Economic burden of acute pesticide poisoning in South Korea.

PubMed

Choi, Yeongchull; Kim, Younhee; Ko, Yousun; Cha, Eun S; Kim, Jaeyoung; Lee, Won J

2012-12-01

To investigate the magnitude and characteristics of the economic burden resulting from acute pesticide poisoning (APP) in South Korea. The total costs of APP from a societal perspective were estimated by summing the direct medical and non-medical costs together with the indirect costs. Direct medical costs for patients assigned a disease code of pesticide poisoning were extracted from the Korean National Health Insurance Reimbursement Data. Direct non-medical costs were estimated using the average transportation and caregiving costs from the Korea Health Panel Survey. Indirect costs, incurred by pre-mature deaths and work loss, were obtained using 2009 Life Tables for Korea and other relevant literature. In 2009, a total of 11,453 patients were treated for APP and 1311 died, corresponding to an incidence of 23.1 per 100,000 population and a mortality rate of 2.6 per 100,000 population in South Korea. The total costs of APP were estimated at approximately US$ 150 million, 0.3% of the costs of total diseases. Costs due to pre-mature mortality accounted for 90.6% of the total costs, whereas the contribution of direct medical costs was relatively small. Costs from APP demonstrate a unique characteristic of a large proportion of the indirect costs originating from pre-mature mortality. This finding suggests policy implications for restrictions on lethal pesticides and safe storage to reduce fatality and cost due to APP. © 2012 Blackwell Publishing Ltd.

Comparison of serum levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin with indirect estimates of Agent Orange exposure among Vietnam veterans. Final report

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

Not Available

1989-09-01

The report tests the validity of several indirect methods for estimating the exposure of ground troops to Agent Orange in Vietnam during 1966-69. The study identified a sample of U.S. Army Vietnam veterans of that era and asked them to have blood drawn so that the level of 2,3,7,8-tetrachlorodibenzo-p- dioxin (TCDD) in serum could be measured. These veterans were selected from among those who served in 65 combat battalions in III Corps, a heavily sprayed part of Vietnam around Saigon. The men selected had all served only one tour in Vietnam and had been discharged with a pay grade ofmore » E1-E5, after having spent, on the average, over 300 days in Vietnam. The sample was chosen after the veterans had been stratified on likelihood of exposure (time and space proximity to recorded sprays) according to military records. For comparison, a sample of non-Vietnam U.S. Army veterans of the same era was also examined. The results show no meaningful association between TCDD levels and indirect estimate of Agent Orange exposure in Vietnam, with or without adjustment for other characteristics of the veterans, including age, race, body mass index, and self-reported civilian occupational and home herbicide exposure.« less

The annual global economic burden of heart failure.

PubMed

Cook, Christopher; Cole, Graham; Asaria, Perviz; Jabbour, Richard; Francis, Darrel P

2014-02-15

Heart failure (HF) imposes both direct costs to healthcare systems and indirect costs to society through morbidity, unpaid care costs, premature mortality and lost productivity. The global economic burden of HF is not known. We estimated the overall cost of heart failure in 2012, in both direct and indirect terms, across the globe. Existing country-specific heart failure costs analyses were expressed as a proportion of gross domestic product and total healthcare spend. Using World Bank data, these proportional values were used to interpolate the economic cost of HF for countries of the world where no published data exists. Countries were categorized according to their level of economic development to investigate global patterns of spending. 197 countries were included in the analysis, covering 98.7% of the world's population. The overall economic cost of HF in 2012 was estimated at $108 billion per annum. Direct costs accounted for ~60% ($65 billion) and indirect costs accounted for ~40% ($43 billion) of the overall spend. Heart failure spending varied widely between high-income and middle and low-income countries. High-income countries spend a greater proportion on direct costs: a pattern reversed for middle and low-income countries. Heart failure imposes a huge economic burden, estimated at $108 billion per annum. With an aging, rapidly expanding and industrializing global population this value will continue to rise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

An indirect estimation of the population size of students with high-risk behaviors in select universities of medical sciences: A network scale-up study.

PubMed

Sajjadi, Homeira; Jorjoran Shushtari, Zahra; Shati, Mohsen; Salimi, Yahya; Dejman, Masoomeh; Vameghi, Meroe; Karimi, Salahedin; Mahmoodi, Zohreh

2018-01-01

Network scale-up is one of the most important indirect methods of estimating the size of clandestine populations and people with high-risk behaviors. The present study is an indirect estimation of the population size of students with high-risk behaviors in select universities of medical sciences. A total of 801 students from two University of Medical Sciences at Tehran and Alborz University of Medical Sciences were selected through convenience sampling. Six subgroups of high-risk behaviors were examined in the study, including Tramadol use, cannabis use, opium use, alcohol consumption, extramarital heterosexual intercourse, and heterosexual intercourse in return for money. To estimate the social network size in the study population, each participant was asked to name their close student friends from the two select universities. Data were collected using a checklist designed for this purpose. The participants' mean number of close friends from the selected medical universities was C = 8.14 (CI: 7.54-8.75). Within these social networks, friends with extramarital heterosexual intercourse (5.53%) and friends who consumed alcohol (4.92%) had the highest frequency, and friends who used opium (0.33%) had the lowest frequency. The variables of age, gender, marital status, type of residence and academic degree were significantly related to the likelihood of having close friends with certain high-risk behaviors (P<0.001). According to the results obtained, alcohol consumption and extramarital heterosexual intercourse are very common among students. Special HIV prevention programs are therefore necessary for this age group.

How important are direct fitness benefits of sexual selection?

NASA Astrophysics Data System (ADS)

Møller, A. P.; Jennions, M. D.

2001-10-01

Females may choose mates based on the expression of secondary sexual characters that signal direct, material fitness benefits or indirect, genetic fitness benefits. Genetic benefits are acquired in the generation subsequent to that in which mate choice is performed, and the maintenance of genetic variation in viability has been considered a theoretical problem. Consequently, the magnitude of indirect benefits has traditionally been considered to be small. Direct fitness benefits can be maintained without consideration of mechanisms sustaining genetic variability, and they have thus been equated with the default benefits acquired by choosy females. There is, however, still debate as to whether or not males should honestly advertise direct benefits such as their willingness to invest in parental care. We use meta-analysis to estimate the magnitude of direct fitness benefits in terms of fertility, fecundity and two measures of paternal care (feeding rate in birds, hatching rate in male guarding ectotherms) based on an extensive literature survey. The mean coefficients of determination weighted by sample size were 6.3%, 2.3%, 1.3% and 23.6%, respectively. This compares to a mean weighted coefficient of determination of 1.5% for genetic viability benefits in studies of sexual selection. Thus, for several fitness components, direct benefits are only slightly more important than indirect ones arising from female choice. Hatching rate in male guarding ectotherms was by far the most important direct fitness component, explaining almost a quarter of the variance. Our analysis also shows that male sexual advertisements do not always reliably signal direct fitness benefits.

Optimal filtering and Bayesian detection for friction-based diagnostics in machines.

PubMed

Ray, L R; Townsend, J R; Ramasubramanian, A

2001-01-01

Non-model-based diagnostic methods typically rely on measured signals that must be empirically related to process behavior or incipient faults. The difficulty in interpreting a signal that is indirectly related to the fundamental process behavior is significant. This paper presents an integrated non-model and model-based approach to detecting when process behavior varies from a proposed model. The method, which is based on nonlinear filtering combined with maximum likelihood hypothesis testing, is applicable to dynamic systems whose constitutive model is well known, and whose process inputs are poorly known. Here, the method is applied to friction estimation and diagnosis during motion control in a rotating machine. A nonlinear observer estimates friction torque in a machine from shaft angular position measurements and the known input voltage to the motor. The resulting friction torque estimate can be analyzed directly for statistical abnormalities, or it can be directly compared to friction torque outputs of an applicable friction process model in order to diagnose faults or model variations. Nonlinear estimation of friction torque provides a variable on which to apply diagnostic methods that is directly related to model variations or faults. The method is evaluated experimentally by its ability to detect normal load variations in a closed-loop controlled motor driven inertia with bearing friction and an artificially-induced external line contact. Results show an ability to detect statistically significant changes in friction characteristics induced by normal load variations over a wide range of underlying friction behaviors.

Indirect estimation of the Convective Lognormal Transfer function model parameters for describing solute transport in unsaturated and undisturbed soil.

PubMed

Mohammadi, Mohammad Hossein; Vanclooster, Marnik

2012-05-01

Solute transport in partially saturated soils is largely affected by fluid velocity distribution and pore size distribution within the solute transport domain. Hence, it is possible to describe the solute transport process in terms of the pore size distribution of the soil, and indirectly in terms of the soil hydraulic properties. In this paper, we present a conceptual approach that allows predicting the parameters of the Convective Lognormal Transfer model from knowledge of soil moisture and the Soil Moisture Characteristic (SMC), parameterized by means of the closed-form model of Kosugi (1996). It is assumed that in partially saturated conditions, the air filled pore volume act as an inert solid phase, allowing the use of the Arya et al. (1999) pragmatic approach to estimate solute travel time statistics from the saturation degree and SMC parameters. The approach is evaluated using a set of partially saturated transport experiments as presented by Mohammadi and Vanclooster (2011). Experimental results showed that the mean solute travel time, μ(t), increases proportionally with the depth (travel distance) and decreases with flow rate. The variance of solute travel time σ²(t) first decreases with flow rate up to 0.4-0.6 Ks and subsequently increases. For all tested BTCs predicted solute transport with μ(t) estimated from the conceptual model performed much better as compared to predictions with μ(t) and σ²(t) estimated from calibration of solute transport at shallow soil depths. The use of μ(t) estimated from the conceptual model therefore increases the robustness of the CLT model in predicting solute transport in heterogeneous soils at larger depths. In view of the fact that reasonable indirect estimates of the SMC can be made from basic soil properties using pedotransfer functions, the presented approach may be useful for predicting solute transport at field or watershed scales. Copyright © 2012 Elsevier B.V. All rights reserved.

Occupational injury and illness in the United States. Estimates of costs, morbidity, and mortality.

PubMed

Leigh, J P; Markowitz, S B; Fahs, M; Shin, C; Landrigan, P J

1997-07-28

To estimate the annual incidence, the mortality and the direct and indirect costs associated with occupational injuries and illnesses in the United States in 1992. Aggregation and analysis of national and large regional data sets collected by the Bureau of Labor Statistics, the National Council on Compensation Insurance, the National Center for Health Statistics, the Health Care Financing Administration, and other governmental bureaus and private firms. To assess incidence of and mortality from occupational injuries and illnesses, we reviewed data from national surveys and applied an attributable risk proportion method. To assess costs, we used the human capital method that decomposes costs into direct categories such as medical and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from the literature while others were generated within this study. Total costs were calculated by multiplying average costs by the number of injuries and illnesses in each diagnostic category. Approximately 6500 job-related deaths from injury, 13.2 million nonfatal injuries, 60,300 deaths from disease, and 862,200 illnesses are estimated to occur annually in the civilian American workforce. The total direct ($65 billion) plus indirect ($106 billion) costs were estimated to be $171 billion. Injuries cost $145 billion and illnesses $26 billion. These estimates are likely to be low, because they ignore costs associated with pain and suffering as well as those of within-home care provided by family members, and because the numbers of occupational injuries and illnesses are likely to be undercounted. The costs of occupational injuries and illnesses are high, in sharp contrast to the limited public attention and societal resources devoted to their prevention and amelioration. Occupational injuries and illnesses are an insufficiently appreciated contributor to the total burden of health care costs in the United States.

Indirect estimation of the Convective Lognormal Transfer function model parameters for describing solute transport in unsaturated and undisturbed soil

NASA Astrophysics Data System (ADS)

Mohammadi, Mohammad Hossein; Vanclooster, Marnik

2012-05-01

Solute transport in partially saturated soils is largely affected by fluid velocity distribution and pore size distribution within the solute transport domain. Hence, it is possible to describe the solute transport process in terms of the pore size distribution of the soil, and indirectly in terms of the soil hydraulic properties. In this paper, we present a conceptual approach that allows predicting the parameters of the Convective Lognormal Transfer model from knowledge of soil moisture and the Soil Moisture Characteristic (SMC), parameterized by means of the closed-form model of Kosugi (1996). It is assumed that in partially saturated conditions, the air filled pore volume act as an inert solid phase, allowing the use of the Arya et al. (1999) pragmatic approach to estimate solute travel time statistics from the saturation degree and SMC parameters. The approach is evaluated using a set of partially saturated transport experiments as presented by Mohammadi and Vanclooster (2011). Experimental results showed that the mean solute travel time, μt, increases proportionally with the depth (travel distance) and decreases with flow rate. The variance of solute travel time σ2t first decreases with flow rate up to 0.4-0.6 Ks and subsequently increases. For all tested BTCs predicted solute transport with μt estimated from the conceptual model performed much better as compared to predictions with μt and σ2t estimated from calibration of solute transport at shallow soil depths. The use of μt estimated from the conceptual model therefore increases the robustness of the CLT model in predicting solute transport in heterogeneous soils at larger depths. In view of the fact that reasonable indirect estimates of the SMC can be made from basic soil properties using pedotransfer functions, the presented approach may be useful for predicting solute transport at field or watershed scales.

Infant and under-five mortality in Afghanistan: current estimates and limitations

PubMed Central

Becker, Stan; Hansen, Peter M; Kumar, Dhirendra; Kumar, Binay; Niayesh, Haseebullah; Peters, David H; Burnham, Gilbert

2010-01-01

Abstract Objective To examine historical estimates of infant and under-five mortality in Afghanistan, provide estimates for rural areas from current population-based data, and discuss the methodological challenges that undermine data quality and hinder retrospective estimations of mortality. Methods Indirect methods of estimation were used to calculate infant and under-five mortality from a household survey conducted in 2006. Sex-specific differences in underreporting of births and deaths were examined and sensitivity analyses were conducted to assess the effect of underreporting on infant and under-five mortality. Findings For 2004, rural unadjusted infant and under-five mortality rates were estimated to be 129 and 191 deaths per 1000 live births, respectively, with some evidence indicating underreporting of female deaths. If adjustment for underreporting is made (i.e. by assuming 50% of the unreported girls are dead), mortality estimates go up to 140 and 209, respectively. Conclusion Commonly used estimates of infant and under-five mortality in Afghanistan are outdated; they do not reflect changes that have occurred in the past 15 years or recent intensive investments in health services development, such as the implementation of the Basic Package of Health Services. The sociocultural aspects of mortality and their effect on the reporting of births and deaths in Afghanistan need to be investigated further. PMID:20680122

Cost analysis of direct versus indirect and individual versus group modes of manual-based speech-and-language therapy for primary school-age children with primary language impairment.

PubMed

Dickson, Kirstin; Marshall, Marjorie; Boyle, James; McCartney, Elspeth; O'Hare, Anne; Forbes, John

2009-01-01

The study is the first within trial cost analysis of direct versus indirect and individual versus group modes of speech-and-language therapy for children with primary language impairment. To compare the short-run resource consequences of the four interventions alongside the effects achieved measured by standardized scores on a test of expressive and receptive language. The study design was a cost analysis integrated within a randomized controlled trial using a 2x2 factorial design (direct/indirect versus individual/group therapy) together with a control group that received usual levels of community-based speech-and-language therapy. Research interventions were delivered in school settings in Scotland, UK. Children aged between 6 and 11 years, attending a mainstream school, with standard scores on the Clinical Evaluation of Language Fundamentals (CELF-III(UK)) of less than -1.25 standard deviation (SD) (receptive and/or expressive) and non-verbal IQ on the Wechsler Abbreviated Scale of Intelligence (WASI) above 75, and no reported hearing loss, no moderate/severe articulation/phonology/dysfluency problems or otherwise requiring individual work with a speech-and-language therapist. The intervention involved speech-and-language therapists and speech-and-language therapy assistants working with individual children or small groups of children. A therapy manual was constructed to assist the choice of procedures and activities for intervention. The cost analysis focused on the salary and travel costs associated with each mode of intervention. The cumulative distribution of total costs arising from the time of randomization to post-intervention assessment was estimated. Arithmetic mean costs were compared and reported with their 95% confidence intervals. The results of the intention-to-treat analysis revealed that there were no significant post-intervention differences between direct and indirect modes of therapy, or between individual and group modes on any of the primary language outcome measures. The cost analysis identified indirect therapy, particularly indirect group therapy, as the least costly of the intervention modes with direct individual therapy as the most costly option. The programme cost of providing therapy in practice over 30 weeks for children could represent between 30% and 75% of the total gross revenue spend in primary school per pupil, depending on the choice of assistant led group therapy or therapist-led individual therapy. This study suggests that speech-and-language therapy assistants can act as effective surrogates for speech-and-language therapists in delivering cost-effective services to children with primary language impairment. The resource gains from adopting a group-based approach may ensure that effective therapy is provided to more children in a more efficient way.

New Approaches in Reusable Booster System Life Cycle Cost Modeling

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2013-01-01

This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model and use genetic algorithms to explore results. A strong business case occurs when viable paths are identified for an affordable up-front investment, and these paths can credibly achieve affordable, responsive operations, characterized by smaller direct touch labor efforts at the wing level from flight to flight. The results supporting this approach, its potential, and its conclusions are presented here.

New Approaches in Reuseable Booster System Life Cycle Cost Modeling

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2013-01-01

This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model and use genetic algorithms to explore results. A strong business case occurs when viable paths are identified for an affordable up-front investment, and these paths can credibly achieve affordable, responsive operations, characterized by smaller direct touch labor efforts at the wing level from flight to flight. The results supporting this approach, its potential, and its conclusions are presented here.