Bulletin of Computer Science and Electrical Engineering (BCSEE)
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Internal Climate Variability in the Present Climate and the Change in ENSO Amplitude in Future Climate Simulations
No full textIn this study, we define a metric for the intensity of internal climate variability (ICV) based on global surface temperature in the present climate and suggest that it can be used to understand the diversity of projected changes in ENSO amplitude in the future. We analyze both the 35-member Community Earth System Model Large Ensemble and the 30-members from Geophysical Fluid Dynamical Laboratory Large Ensemble from the present climate to future climate. While ENSO amplitude tends to decrease from the present climate to the end of 21st century in some ensemble member with a strong ICV during the present climate, it increases or stays the same in other ensemble members with a weak ICV. The result indicates that the intensity of ICV in the present climate in climate models may cause the difference of ENSO amplitude changes in a warmer world. Therefore, the intensity of ICV in the present climate should be cautiously examined in climate models to correctly project the ENSO amplitude changes in a changing climate
The Politics of Progressivity: Court-Ordered Reforms, Racial Difference, and School Finance Fairness
No full textThis article contributes to our understanding of American education politics by exploring when and why states redistribute K-12 education dollars to poorer schools. It does so by examining three explanations for intrastate changes in progressivity: court-ordered finance reforms, political trends, and demographic changes. Using state-level data from 1995 to 2016, we find mixed evidence that progressivity increased following a court-ordered school-finance overhaul. Rather, we show that changes in progressivity were most consistently tied to changes in student demography: As students became poorer, or more racially diverse, lawmakers created less progressive finance systems. The article concludes by discussing what these findings mean for advocates seeking to protect and advance gains in education-spending progressivity
Alternative parameterization approaches for modelling risk assessment in the presence of imbalance: An example using parotid malignancy
No full textIn collaborative statistics, logistic regression models are commonly used with binary outcomes and reference cell coding for categorical predictors. However, despite the usefulness of reference cell coding schemes under many investigative objectives, it is not always appropriate to address research questions of interest. Investigators often consider modifying research questions to align with inference possible using reference cell coding. Alternative coding schemes can offer a more appropriate approach for the investigation. We explored application of deviation from means coding in determining how results from a diagnostic tool provide additional information on a patient's risk of disease with respect to the overall (naive) risk at clinical presentation. We compared model parameterizations between using reference cell coding and deviation from means coding, by both unweighted and weighted approaches, for assessing risk of parotid malignancy, comparing patients with indeterminate FNAB results with the general (naive) risk among presenting patients. Unweighted deviation from means coding estimates a 1.2-fold increase in the odds of malignancy with an indeterminate FNAB result compared to the naive odds of malignancy at clinical presentation (OR: 1.21 [95% CI: 1.63-2.32], p = 0.5699). The weighted approach takes into account the imbalance in the presenting population and estimates an increased risk (OR: 2.54 [95% CI: 1.52-4.26], p = 0.0004), which is more accurately representing the naive risk at presentation and to answer the research question of interest. Using standard reference cell coding, an indeterminate result is associated with significantly higher odds than that of a negative result (OR: 5.20 [95% CI: 2.22-12.20], p = 0.0001), but this does not inform us as to the risk with respect to that inherent at clinical presentation and thus may not be useful for clinical decision making
Crossing birth and mortality data as a clue for prevalence of congenital diaphragmatic hernia in Sao Paulo State: A cross sectional study
No full textCongenital diaphragmatic hernia (CDH) is a severe embryological defect that causes pulmonary hypoplasia and hypertension. The prevalence and mortality rate of CDH varies around the world and little information is available about CDH in Latin America. Our aim was to estimate the general prevalence, mortality rate, prevalence of associated anomalies and features related to the outcomes of CDH in newborns from São Paulo state, Brazil.
Population-based cross-sectional study based on data gathered from the Live Births Information System (SINASC) and the Mortality Information System (SIM) of children born in São Paulo state between January 1st, 2006, and December 31st, 2017.
From 7,311,074 total survival discharges between 2006 and 2017, 1,155 were CDH-related, resulting in a prevalence rate of 1:6329 (95%CI = 1/6715 - 1/5984) and a mortality rate of 63·72% (95%CI = 60.95 - 66.50), 510 presented complex associated anomalies (44·15%). Maternal data showed higher prevalence among older mothers (older than 35 years old: 2·13 per 10,000) and, also, women with more years of schooling (higher than 12 years: 1·99 per 10,000). Presence of associated anomalies (95%CI = 5.69-11.10), 1-min Apgar (95%CI = 1.44-2.95), maternal schooling (95%CI = 1.06-2.43) and birth weight (95%CI = 1.04-2.26) were the most significant features associated with mortality.
There was 1 CDH case for every 6329 newborns in São Paulo and the mortality rate among those cases was 63·72% - a high rate compared to other countries.
This study didn't receive any specific grant from any funding agency in the public, commercial or not-for-profit sectors
Echocardiographic changes after arteriovenous fistula creation in hemodialysis patients
No full textBackground:
Pulmonary hypertension (PH) is common in end-stage renal disease (ESRD) patients and is associated with increased all-cause and cardiovascular mortality in this group. There is scarce data on the long-term effect of arteriovenous fistula (AVF) creation on pulmonary hypertension (PH) and the reflected changes in echocardiographic measurements.
Materials and methods:
This is a retrospective study of 54 patients who underwent AVF creation between 2009 and 2014 and with echocardiographic evaluations before and after surgery. We analyzed pairwise changes in right ventricular systolic pressure (RVSP), right atrial pressure (RAP) during systole, left ventricular mass (LVM), tricuspid regurgitation (TR), mitral E/E’ ratio, and ejection fraction (EF), as well as the factors that predicted change in RVSP after surgery.
Results:
The median time for the preoperative echocardiogram was 0.3 years (interquartile range (IQR) 0.2 – 0.7 years) prior to AVF creation, while the follow-up echo was done 1.3 (0.6 – 2.1) years after surgery. 67% of the patients had RVSP > 37 mmHg at baseline. There was a significant reduction in RVSP after AVF creation compared to baseline (median 33 (IQR 26 – 43) vs. 46 mmHg, p = 0.0015), with 59% of the patients experiencing a decrease and 19% remaining stable. There were also significant decreases in LVM (201 (143 – 256) vs. 215 (163 – 276), p = 0.045) and RAP systole (10 (10 – 15) vs. 3 (3 – 8); p < 0.001) after surgery. Higher preoperative weight (p = 0.038) and RVSP (p = 0.006), and use of loop diuretics (p = 0.015) were significantly associated with improvement in RVSP after AVF creation.
Conclusion:
Our results suggest that AVF creation is associated with a significant reduction or stable measurements of RVSP in the ESRD population, likely due to an improvement in volume status
Renal Cell Carcinoma with Supradiaphragmatic Tumor Thrombus: Avoiding Sternotomy and Cardiopulmonary Bypass
No full textRenal cell carcinoma (RCC) accounts for 2–3% of all malignant disease in adults and has a propensity to infiltrate the surrounding adjacent structures with a biologic predisposition for vascular invasion. This tropism for the venous system facilitates propagation into the renal vein and inferior vena cava (IVC) in up to 25% of patients with RCC. Surgical resection remains the mainstay treatment for RCC with venous tumor thrombus (TT) extension and the only hope for a potential cure. Higher thrombus levels correlate with more advanced stages of disease and thus poorer survival rates. Although CPB with circulatory arrest has been successfully performed during resection of these tumors, its use remains controversial due to the risk of coagulopathy, platelet dysfunction, and central nervous system complications. Complete intraabdominal surgical excision of level III thrombi can be achieved without sternotomy and CPB by utilizing hepatic mobilization maneuvers. The purpose of this review is to provide an update on the surgical management of these difficult cases of RCC with supradiaphragmatic tumor thrombi, including a description of transplant-based techniques that avoid sternotomy and cardiopulmonary bypass (CPB), minimizing intra- and post-operative complications
Dyadic digital health interventions: Their rationale and implementation
No full textWhile most psychosocial and behavioral digital health interventions have been designed to be consumed by an individual, intervening at the level of a dyad – two interdependent individuals – can more comprehensively address the needs of both individuals and their relationship. The clinical utility of the dyadic digital health intervention approach, as well as the practical implementation of this design, will be demonstrated via three examples: eSCCIP, FAMS, and OurRelationship
Predicting performance on the NFL-225 bench press test using bar velocity
No full textBACKGROUND: Bar velocity has been proved to accurately predict performance in several exercises.
OBJECTIVE: To estimate the total number of repetitions during the NFL-225 Bench Press Test (NFL-225) based on bar velocity in collegiate football players.
METHODS: Forty-six NCAA Division I football players performed as many bench press repetitions as possible with a standard load of 225 lbs. The variables used to estimate the total number of repetitions were: mean velocity of the fastest repetition achieved in the test (FR); mean velocity of the first repetition (V1); mean velocity of the first three repetitions (MV3); mean velocity of the first five repetitions (MV5); and mean velocity of the first 10 repetitions (MV10). Linear regression analyses were conducted to predict NFL-225 performance based on bar velocity.
RESULTS: The prediction of the total number of repetitions was similar between the five mean velocities (FR: R-2 = 0.64, SEE = 3.87, V1: R-2 = 0.65, SEE = 3.80, MV3: R2 = 0.70, SEE = 3.52, MV5: R-2 = 0.71, SEE = 3.48, and MV10: R-2 = 0.62, SEE = 3.37).
CONCLUSION: The mean velocities allowed the production of general regression equations for the estimation of the total number of repetitions in the NFL-225. V1 and MV3 presented as the best options due to their accuracy, time-efficiency, and reduced musculoskeletal stress
