A programmable architecture for the provision of hybrid services

The success of new service provision platforms will largely depend on their ability to blend with existing technologies. The advent of Internet telephony, although impressive, is unlikely to make telephone customers suddenly turn in favor of computers. Rather, customers display increasing interest in services that span multiple networks (especially Internet Protocol-based networks and the telephone and cellular networks) and open new vistas. We refer to these services as hybrid services and propose an architecture for their provision. This architecture allows for programming the service platform elements (i.e., network nodes, gateways, control servers, and terminals) in order to include new service logics. We identify components that can be assembled to build these logics by considering a service as a composition of features such as address translation, security, call control, connectivity, charging and user interaction. Generic service components are derived from the modeling of these features. We assure that our proposal can be implemented even in existing systems in return for slight changes: These systems are required to generate an event when a special service is encountered. The treatment of this event is handled by an object at a Java Service Layer. Java has been chosen for its platform-neutrality feature and its embedded security mechanisms. Using our architecture, we design a hybrid closed user group service

Health-related quality of life in patients with inoperable malignant bowel obstruction: secondary outcome from a double-blind, parallel, placebo-controlled randomised trial of octreotide.

BACKGROUND:This analysis aims to evaluate health-related quality of life (HrQoL) (primary outcome for this analysis), nausea and vomiting, and pain in patients with inoperable malignant bowel obstruction (IMBO) due to cancer or its treatments randomised to standardised therapies plus octreotide or placebo over a maximum of 72 h in a double-blind clinical trial. METHODS:Adults with IMBO and vomiting recruited through 12 services spanning inpatient, consultative and community settings in Australia were randomised to subcutaneous octreotide infusion or saline. HrQoL was measured at baseline and treatment cessation (EORTC QLQ-C15-PAL). Mean within-group paired differences between baseline and post-treatment scores were analysed using Wilcoxon Signed Rank test and between group differences estimated using linear mixed models, adjusted for baseline score, sex, age, time, and study arm. RESULTS:One hundred six of the 112 randomised participants were included in the analysis (n = 52 octreotide, n = 54 placebo); 6 participants were excluded due to major protocol violations. Mean baseline HrQoL scores were low (octreotide 22.1, 95% CI 14.3, 29.9; placebo 31.5, 95% CI 22.3, 40.7). There was no statistically significant within-group improvement in the mean HrQoL scores in the octreotide (p = 0.21) or placebo groups (p = 0.78), although both groups reported reductions in mean nausea and vomiting (octreotide p < 0.01; placebo p = 0.02) and pain scores (octreotide p < 0.01; placebo p = 0.03). Although no statistically significant difference in changes in HrQoL scores between octreotide and placebo were seen, an adequately powered study is required to fully assess any differences in HrQoL scores. CONCLUSION:The HrQoL of patients with IMBO and vomiting is poor. Further research to formally evaluate the effects of standard therapies for IMBO is therefore warranted. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12608000211369 (date registered 18/04/2008)

The 2021 western North America heat wave among the most extreme events ever recorded globally

This is the final version. Available on open access from the American Association for the Advancement of Science via the DOI in this recordData and materials availability: ERA5 dataset is available from the Copernicus Climate Change Service (C3S) Climate Data Store. JRA55 dataset is available from the JRA project webpage. CanESM5 data are available from CMIP6 search interface, https://esgf-node.llnl.gov/search/cmip6/. GHCNd station data are available from NOAA Climate Data Online. The code used to generate the figures in this paper and the Supplementary Materials is available from https://zenodo.org/record/6325508 or https://github.com/BrisClim, and this can be used to rapidly assess the extremeness of heat waves relative to other events globally. All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials.In June 2021, western North America experienced a record-breaking heat wave outside the distribution of previously observed temperatures. While it is clear that the event was extreme, it is not obvious whether other areas in the world have also experienced events so far outside their natural variability. Using a novel assessment of heat extremes, we investigate how extreme this event was in the global context. Characterizing the relative intensity of an event as the number of standard deviations from the mean, the western North America heat wave is remarkable, coming in at over four standard deviations. Throughout the globe, where we have reliable data, only five other heat waves were found to be more extreme since 1960. We find that in both reanalyses and climate projections, the statistical distribution of extremes increases through time, in line with the distribution mean shift due to climate change. Regions that, by chance, have not had a recent extreme heat wave may be less prepared for potentially imminent events.Natural Environment Research Council (NERC

Risks associated with global warming of 1.5 to 4 °C above pre-industrial levels in human and natural systems in six countries

The Topical Collection “Accrual of Climate Change Risk in Six Vulnerable Countries” provides a harmonised assessment of risks to human and natural systems due to global warming of 1.5–4 °C in six countries (China, Brazil, Egypt, Ethiopia, Ghana, and India) using a consistent set of climate change and socioeconomic scenarios. It compares risks in 2100 if warming has reached 3 °C, broadly corresponding to current global greenhouse gas emission reduction policies, including countries’ National Determined Contributions, rather than the Paris Agreement goal of limiting warming to ‘well below’ 2 °C and ‘pursuing efforts’ to limit to 1.5 °C. Global population is assumed either constant at year 2000 levels or to increase to 9.2 billion by 2100. In either case, greater warming is projected to lead, in all six countries, to greater exposure of land and people to drought and fluvial flood hazard, greater declines in biodiversity, and greater reductions in the yield of maize and wheat. Limiting global warming to 1.5 °C, compared with ~ 3 °C, is projected to deliver large benefits for all six countries, including reduced economic damages due to fluvial flooding. The greatest projected benefits are the avoidance of a large increase in exposure of agricultural land to severe drought, which is 61%, 43%, 18%, and 21% lower in Ethiopia, China, Ghana, and India at 1.5 °C than at 3 °C, whilst avoided increases in human exposure to severe drought are 20–80% lower at 1.5 °C than 3 °C across the six countries. Climate refugia for plants are largely preserved at 1.5 °C warming in Ghana, China, and Ethiopia, but refugia shrink in areal extent by a factor of 2, 3, 3, 4, and 10 in Ghana, China, India, Ethiopia, and Brazil, respectively, if warming reaches 3 °C. Economic damages associated with sea-level rise are projected to increase in coastal nations, but more slowly if warming were limited to 1.5 °C. Actual benefits on the ground will also depend on national and local contexts and the extent of future investment in adaptation

Validation of an Estonian version of the Parkinson's Disease Questionnaire (PDQ-39)

<p>Abstract</p> <p>Introduction</p> <p>Diagnosis and management of Parkinson's disease (PD) rely heavily on evaluation of clinical symptoms and patients' subjective perception of their condition. The purpose of this study was to evaluate the validity, acceptability, and reliability of the Estonian version of the 39-question Parkinson 's disease Questionnaire (PDQ-39).</p> <p>Methods</p> <p>Study subjects were approached during their regular clinic follow-up visits. 104 patients consented to the study and 81 completed questionnaires were used for subsequent testing of psychometric characteristics, validity and reliability.</p> <p>Results</p> <p>The content validity was assessed through qualitative content analysis during the pilot study. The patients indicated that the questions were relevant to measure the quality of life of people with PD.</p> <p>The analysis of means showed that the ceiling and floor effects of domain results were within the limits of 15% of Summary Index and of all domains except Stigma, Social Support and Communication where the ceiling effect was 16% to 24% of the responses. Convergent validity was interpreted through correlation between disease severity and PDQ-39 domains. There was a statistically significant difference between the domain scores in patients with mild versus moderate PD in domains of Mobility, ADL, and Communication but not for Stigma, Social Support and Cognition. The reliability was good, Cronbach alpha for all domains and summary index was over 0.8 and item-test correlations between domains and summary index ranged from 0.56 to 0.83.</p> <p>Conclusion</p> <p>The psychometric characteristics of an Estonian version of the PDQ-39 were satisfactory. The results of this study were comparable to the results of previous validation studies in other cultural settings in UK, USA, Canada, Spain and Italy.</p> <p>The Estonian version of the PDQ-39 is an acceptable, valid and reliable instrument for quality of life measurement in PD patients.</p

Impact of Climate Change on Voltinism and Prospective Diapause Induction of a Global Pest Insect – Cydia pomonella (L.)

Global warming will lead to earlier beginnings and prolongation of growing seasons in temperate regions and will have pronounced effects on phenology and life-history adaptation in many species. These changes were not easy to simulate for actual phenologies because of the rudimentary temporal (season) and spatial (regional) resolution of climate model projections. We investigate the effect of climate change on the regional incidence of a pest insect with nearly worldwide distribution and very high potential for adaptation to season length and temperature – the Codling Moth, Cydia pomonella. Seasonal and regional climate change signals were downscaled to the hourly temporal scale of a pest phenology model and the spatial scale of pest habitats using a stochastic weather generator operating at daily scale in combination with a re-sampling approach for simulation of hourly weather data. Under future conditions of increased temperatures (2045–2074), the present risk of below 20% for a pronounced second generation (peak larval emergence) in Switzerland will increase to 70–100%. The risk of an additional third generation will increase from presently 0–2% to 100%. We identified a significant two-week shift to earlier dates in phenological stages, such as overwintering adult flight. The relative extent (magnitude) of first generation pupae and all later stages will significantly increase. The presence of first generation pupae and later stages will be prolonged. A significant decrease in the length of overlap of first and second generation larval emergence was identified. Such shifts in phenology may induce changes in life-history traits regulating the life cycle. An accordingly life-history adaptation in photoperiodic diapause induction to shorter day-length is expected and would thereby even more increase the risk of an additional generation. With respect to Codling Moth management, the shifts in phenology and voltinism projected here will require adaptations of plant protection strategies to maintain their sustainability

Ethnic Minority–Majority Unions in Estonia

Ethnic minority–majority unions—also referred to as mixed ethnic unions—are often seen as the ultimate evidence of the integration of ethnic minorities into their host societies. We investigated minority–majority unions in Estonia, where ethnic minorities account for one-third of the total population (Russians 26%, followed by Ukrainians, Byelorussians, Finns and other smaller groups). Using data from the 2000 Estonian census and regression models, we found that Slavic women are less likely to be in minority–majority unions than are members of other minority groups, with Russians being the least likely. Finns, who are culturally most similar to the Estonian majority population, are the most likely to form a union with an Estonian. For ethnic minority women, the likelihood of being in minority–majority unions is highest in rural areas and increases over generations, with third-generation immigrants being the most likely. Estonian women are most likely to have a minority partner when they or their parents were born abroad and when they live in urban areas. Our findings suggest that both the opportunity to meet potential partners and openness to other ethnic groups are important factors for understanding the dynamics of minority–majority unions