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  • Molecular Diversity Preservation International  (290)
  • American Geophysical Union (AGU)
  • 1
    Publication Date: 2018-12-07
    Description: More appropriate and measured use of antibiotics may be achieved using point-of-care (POC) C-reactive protein (CRP) testing, but there is limited evidence of cost-effectiveness in routine practice. A decision analytic model was developed to estimate the cost-effectiveness of testing, compared with standard care, in adults presenting in primary care with symptoms of acute respiratory tract infection (ARTI). Analyses considered (1) pragmatic use of testing, reflective of routine clinical practice, and (2) testing according to clinical guidelines. Threshold and scenario analysis were performed to identify cost-effective scenarios. In patients with symptoms of ARTI and based on routine practice, the incremental cost-effectiveness ratios of CRP testing were £19,705 per quality-adjusted-life-year (QALY) gained and £16.07 per antibiotic prescription avoided. Following clinical guideline, CRP testing in patients with lower respiratory tract infections (LRTIs) cost £4390 per QALY gained and £9.31 per antibiotic prescription avoided. At a threshold of £20,000 per QALY, the probabilities of POC CRP testing being cost-effective were 0.49 (ARTI) and 0.84 (LRTI). POC CRP testing as implemented in routine practice is appreciably less cost-effective than when adhering to clinical guidelines. The implications for antibiotic resistance and Clostridium difficile infection warrant further investigation.
    Electronic ISSN: 2079-6382
    Topics: Chemistry and Pharmacology , Medicine
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  • 2
    Publication Date: 2018-03-06
    Electronic ISSN: 2072-4292
    Topics: Architecture, Civil Engineering, Surveying , Geography
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  • 3
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    American Geophysical Union (AGU)
    In:  EPIC3Geophysical Research Letters, American Geophysical Union (AGU), 49(20), pp. e2022gl099529-e2022gl099529, ISSN: 0094-8276
    Publication Date: 2024-03-14
    Description: The climate signal imprinted in the snow isotopic composition allows to infer past climate variability from ice core stable water isotope records. The concurrent evolution of vapor and surface snow isotopic composition between precipitation events indicates that post-depositional atmosphere-snow humidity exchange influences the snow and hence the ice core isotope signal. To date, however, this is not accounted for in paeleoclimate reconstructions from isotope records. Here we show that vapor-snow exchange explains 36% of the summertime day-to-day δ18O variability of the surface snow between precipitation events, and 53% of the δD variability. Through observations from the Greenland Ice Sheet and accompanying modeling we demonstrate that vapor-snow exchange introduces a warm bias on the summertime snow isotope value relevant for ice core records. In case of long-term variability in atmosphere-snow exchange the relevance for the ice core signal is also variable and thus paleoclimate reconstructions from isotope records should be revisited.
    Repository Name: EPIC Alfred Wegener Institut
    Type: Article , peerRev
    Format: application/pdf
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  • 4
    Publication Date: 2014-08-21
    Description: This paper outlines the contributions of social science to the study of interactions between urbanization patterns and processes and the carbon cycle, and identifies gaps in knowledge and priority areas for future social scientific research contributions. While previously studied as a uni-dimensional process, we conceptualize urbanization as a multi-dimensional, social and biophysical process driven by continuous changes across space and time in various sub-systems including biophysical, built environment and socio-institutional (e.g. economic, political, demographic, behavioral and sociological). We review research trends and findings focused on the socio-institutional subsystem of the urbanization process, and particularly the dynamics, relationships and predictions relevant to energy use and greenhouse gas emissions. Our findings suggest that a multi-dimensional perspective of urbanization facilitates a wider spectrum of research relevant to carbon cycle dynamics, even within the socio-institutional sub-system. However, there is little consensus around the details and mechanisms underlying the relationship between urban socio-institutional subsystems and the carbon cycle. We argue that progress in understanding the relationship between urbanization and the carbon cycle may be achieved if social scientists work collaboratively with each other as well as with scientists from other disciplines. From this review we identify research priorities where collaborative social scientific efforts are necessary in conjunction with other disciplinary approaches to generate a more complete understanding of urbanization as a process and its relationship to the carbon cycle.
    Electronic ISSN: 2328-4277
    Topics: Geosciences
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  • 5
    Publication Date: 2014-08-30
    Description: Independent lines of research on urbanization, urban areas and carbon have advanced our understanding of some of the processes through which energy and land uses affect carbon. This synthesis integrates some of these diverse viewpoints as a first step towards a co-produced, integrated framework for understanding urbanization, urban areas and their relationships to carbon. It suggests the need for approaches that complement and combine the plethora of existing insights into interdisciplinary explorations of how different urbanization processes, and socio-ecological and technological components of urban areas affect the spatial and temporal patterns of carbon emissions, differentially over time and within and across cities. It also calls for a more holistic approach to examining the carbon implications of urbanization and urban areas, based not only on demographics or income, but also on such other interconnected features of urban development pathways as urban form, economic function, economic growth policies and other governance arrangements. It points to a wide array of uncertainties around the urbanization processes, their interactions with urban socio-institutional and built-environment systems, how these impact the exchange of carbon flows within and outside urban areas. We must also understand in turn how carbon feedbacks, including carbon impacts and potential impacts of climate change, can affect urbanization processes. Finally, the paper explores options, barriers and limits to transitioning cities to low-carbon trajectories, and suggests the development of an end-to-end, co-produced and integrated scientific understanding that can more effectively inform the navigation of transitional journeys and the avoidance of obstacles along the way.
    Electronic ISSN: 2328-4277
    Topics: Geosciences
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  • 6
    Publication Date: 2020-04-21
    Description: Neighborhood-level socioeconomic variables, such as the proportion of minority and low-income residents, have been associated with a greater density of tobacco retail outlets (TROs), though less is known about the degree to which these neighborhood indicators are related to vape shop outlet (VSO) density. Many studies of TROs and neighborhood characteristics include only a small set of variables and also fail to take into account the correlation among these variables. Using a carefully curated database of all TROs and VSOs in Virginia (2016–2018), we developed a Bayesian model to estimate a neighborhood disadvantage index and examine its association with rates of outlets across census tracts while also accounting for correlations among variables. Models included 12 census tract variables from the American Community Survey. Results showed that increasing neighborhood disadvantage was associated with a 63% and 64% increase in TRO and VSO risk, respectively. Important variables associated with TRO rates included % renter occupied housing, inverse median gross rent, inverse median monthly housing costs, inverse median monthly housing costs, and % vacant housing units. Important variables associated with VSO rates were % renter occupied housing and % Hispanic population. There were several spatial clusters of significantly elevated risk for TROs and VSOs in western and eastern Virginia.
    Print ISSN: 1661-7827
    Electronic ISSN: 1660-4601
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Medicine
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  • 7
    Publication Date: 2020-05-26
    Description: The predictive receiver operating characteristic (PROC) curve is a diagrammatic format with application in the statistical evaluation of probabilistic disease forecasts. The PROC curve differs from the more well-known receiver operating characteristic (ROC) curve in that it provides a basis for evaluation using metrics defined conditionally on the outcome of the forecast rather than metrics defined conditionally on the actual disease status. Starting from the binormal ROC curve formulation, an overview of some previously published binormal PROC curves is presented in order to place the PROC curve in the context of other methods used in statistical evaluation of probabilistic disease forecasts based on the analysis of predictive values; in particular, the index of separation (PSEP) and the leaf plot. An information theoretic perspective on evaluation is also outlined. Five straightforward recommendations are made with a view to aiding understanding and interpretation of the sometimes-complex patterns generated by PROC curve analysis. The PROC curve and related analyses augment the perspective provided by traditional ROC curve analysis. Here, the binormal ROC model provides the exemplar for investigation of the PROC curve, but potential application extends to analysis based on other distributional models as well as to empirical analysis.
    Electronic ISSN: 1099-4300
    Topics: Chemistry and Pharmacology , Physics
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  • 8
    Publication Date: 2020-05-25
    Description: Coastal wetlands are a critical component of the coastal landscape that are increasingly threatened by sea level rise and other human disturbance. Periodically mapping wetland distribution is crucial to coastal ecosystem management. Ensemble algorithms (EL), such as random forest (RF) and gradient boosting machine (GBM) algorithms, are now commonly applied in the field of remote sensing. However, the performance and potential of other EL methods, such as extreme gradient boosting (XGBoost) and bagged trees, are rarely compared and tested for coastal wetland mapping. In this study, we applied the three most widely used EL techniques (i.e., bagging, boosting and stacking) to map wetland distribution in a highly modified coastal catchment, the Manning River Estuary, Australia. Our results demonstrated the advantages of using ensemble classifiers to accurately map wetland types in a coastal landscape. Enhanced bagging decision trees, i.e., classifiers with additional methods to increasing ensemble diversity such as RF and weighted subspace random forest, had comparably high predictive power. For the stacking method evaluated in this study, our results are inconclusive, and further comprehensive quantitative study is encouraged. Our findings also suggested that the ensemble methods were less effective at discriminating minority classes in comparison with more common classes. Finally, the variable importance results indicated that hydro-geomorphic factors, such as tidal depth and distance to water edge, were among the most influential variables across the top classifiers. However, vegetation indices derived from longer time series of remote sensing data that arrest the full features of land phenology are likely to improve wetland type separation in coastal areas.
    Electronic ISSN: 2072-4292
    Topics: Architecture, Civil Engineering, Surveying , Geography
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  • 9
    Publication Date: 2020-05-02
    Description: Introduction: Alzheimer’s disease (AD) is a progressive and irreversible neurological disease. The genetics and molecular mechanisms underpinning differential cognitive decline in AD are not well understood; the genetics of AD risk have been studied far more assiduously. Materials and Methods: Two phase III clinical trials measuring cognitive decline over 48 weeks using Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog, n = 2060) and Clinical Dementia Rating-Sum of Boxes (CDR-SB, n = 1996) were retrospectively genotyped. A Genome-Wide Association Study (GWAS) was performed to identify and replicate genetic variants associated with cognitive decline. The relationship between polygenic risk score (PRS) and cognitive decline was tested to investigate the predictive power of aggregating many variants of individually small effect. Results: No loci met candidate gene or genome-wide significance. PRS explained a very small percentage of variance in rates of cognitive decline (ADAS-cog: 0.54%). Conclusions: These results suggest that incorporating genetic information in the prediction of cognitive decline in AD currently appears to have limited utility in clinical trials, consistent with small effect sizes estimated elsewhere. If AD progression is more heritable soon after disease onset, genetics may have more clinical utility.
    Electronic ISSN: 2073-4425
    Topics: Biology
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  • 10
    Publication Date: 2020-05-28
    Description: With the advancing trend towards lighter and faster rail transport, there is an increasing interest in integrating composite and advanced multifunctional materials in order to infuse smart sensing and monitoring, energy harvesting and wireless capabilities within the otherwise purely mechanical rail structures and the infrastructure. This paper presents a holistic multiphysics numerical study, across both mechanical and electrical domains, that describes an innovative technique of harvesting energy from a piezoelectric micro fiber composites (MFC) built-in composite rail chassis structure. Representative environmental vibration data measured from a rail cabin have been critically leveraged here to help predict the actual vibratory and power output behaviour under service. Time domain mean stress distribution data from the Finite Element simulation were used to predict the raw AC voltage output of the MFCs. Conditioned power output was then calculated using circuit simulation of several state-of-the-art power conditioning circuits. A peak instantaneous rectified power of 181.9 mW was obtained when eight-stage Synchronised Switch Harvesting Capacitors (SSHC) from eight embedded MFCs were located. The results showed that the harvested energy could be sufficient to sustain a self-powered structural health monitoring system with wireless communication capabilities. This study serves as a theoretical foundation of scavenging for vibrational power from the ambient state in a rail environment as well as to pointing to design principles to develop regenerative and power neutral smart vehicles.
    Electronic ISSN: 1996-1073
    Topics: Energy, Environment Protection, Nuclear Power Engineering
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