A logistic regression model for microalbuminuria prediction in overweight male population

Background: Obesity promotes progression to microalbuminuria and increases the risk of chronic kidney disease. Current protocols of screening microalbuminuria are not recommended for the overweight or obese.

Design and Methods: A cross-sectional study was conducted. The relationship between metabolic risk factors and microalbuminuria was investigated. A regression model based on metabolic risk factors was developed and evaluated for predicting microalbuminuria in the overweight or obese.

Results: The prevalence of MA reached up to 17.6% in Chinese overweight men. Obesity, hypertension, hyperglycemia and hyperuricemia were the important risk factors for microalbuminuria in the overweight. The area under ROC curves of the regression model based on the risk factors was 0.82 in predicting microalbuminuria, meanwhile, a decision threshold of 0.2 was found for predicting microalbuminuria with a sensitivity of 67.4% and specificity of 79.0%, and a global predictive value of 75.7%. A decision threshold of 0.1 was chosen for screening microalbuminuria with a sensitivity of 90.0% and specificity of 56.5%, and a global predictive value of 61.7%.

Conclusions: The prediction model was an effective tool for screening microalbuminuria by using routine data among overweight populations

On the Role of Surface Friction in Tropical Intraseasonal Oscillation

The Madden-Julian oscillation (MJO), or the tropical intraseasonal oscillation, has attracted much attention, ever since its discovery in the early seventies for reasons of both scientific understanding and practical forecasts. Among the theoretical interpretations of the MJO, the wave-CISK (conditional instability of the second kind) mechanism is the most popular. The basic idea of the wave-CISK interpretation is that the cooperation between the low-level convergence associated with the eastward moving Kelvin wave and the cumulus convection generates an eastward moving Kelvin-wave-like mode. Later it was recognized that the MJO has an important Rossby-wave-like component. However linear analysis and numerical simulations based on it (even when conditional heating is used) have revealed two problems with the wave-CISK interpretation; i.e., excessive speed and the most preferred scale being zero or grid scale. Chao (1995) presented a discussion of these problems and attributed these problems to the particular type of expression for the cumulus heating used in the linear analyses and numerical studies (i.e., the convective heating is proportional to low-level convergence and a fixed vertical heating profile). It should be pointed out that in the relatively successful simulation of MJO with general circulation models the problem of grid scale being the most preferred scale does not appear and die problem of excessive speed is not as severe as in the linear analysis

The impacts of increased heat stress events on wheat yield under climate change in China

China is the largest wheat producing country in the world. Wheat is one of the two major staple cereals consumed in the country and about 60% of Chinese population eats the grain daily. To safeguard the production of this important crop, about 85% of wheat areas in the country are under irrigation or high rainfall conditions. However, wheat production in the future will be challenged by the increasing occurrence and magnitude of adverse and extreme weather events. In this paper, we present an analysis that combines outputs from a wide range of General Circulation Models (GCMs) with observational data to produce more detailed projections of local climate suitable for assessing the impact of increasing heat stress events on wheat yield. We run the assessment at 36 representative sites in China using the crop growth model CSM-CropSim Wheat of DSSAT 4.5. The simulations based on historical data show that this model is suitable for quantifying yield damages caused by heat stress. In comparison with the observations of baseline 1996-2005, our simulations for the future indicate that by 2100, the projected increases in heat stress would lead to an ensemble-mean yield reduction of –7.1% (with a probability of 80%) and –17.5% (with a probability of 96%) for winter wheat and spring wheat, respectively, under the irrigated condition. Although such losses can be fully compensated by CO2 fertilization effect as parameterized in DSSAT 4.5, a great caution is needed in interpreting this fertilization effect because existing crop dynamic models are unable to incorporate the effect of CO2 acclimation (the growth enhancing effect decreases over time) and other offsetting forces

Intraseasonal Oscillations over South America: A Study with a Regional Climate Model

The National Center for Atmospheric Research (NCAR) regional climate model version 2 (RegCM2) is used to investigate the observed characteristics of intraseasonal oscillations over South America. Our study is mainly concentrated on an intraseaonal mode, which is observed to account for a large portion of the intraseasonal variation, to have a standing feature and to be independent of the MJO. The NCEPDOE AMIP-II reanalysis is utilized to provide initial and lateral boundary conditions for the RegCM2 based upon the OOZ, 062, 122 and 182 data.Our results indicate that the intraseasonal oscillation still exists with time- averaged lateral boundary condition, which prevents the MJO and other outside disturbances from entering the model's domain, suggesting a locally forced oscillation responsible for ths intraseasonal mode independent of the MJO. Further experiments show that the annual and daily variabilities and a radiative-convective interaction are not essential to the locally forced intraseasonal oscillation. The intraseasonal oscillations over Amazon in our model essentially result from interactions among atmospheric continental- scale circulation, surface radiation, surface sensible and latent heat fluxes, and cumulus convection. The wavelet analyses of various surface energy fluxes and surface energy budget also verify that the primary cause of intraseasonal oscillation is the interaction of land surface processes with the atmosphere

Approximate Co-Location of Precipitation and Low-Level Westerlies in Tropical Monthly Means

In summer monsoon regions the monthly mean precipitation regions coincide approximately well with regions of westerlies at low-levels. An included chart shows a 15-year (1979-1993) mean August 850 hPa zonal wind from NCEP/NCAR reanalysis dataset and Xie-Arkin precipitation. It shows a region of westerlies covering most of Northern Indian Ocean and extending to northwestern Pacific. This region coincides well with the region with precipitation greater than 6 mm/day. Obviously the coincidence is not exact; the region of larges; zonal wind in the Arabian Sea is in a region of relatively low precipitation and is far from the region of maximum precipitation in Bay of Bengal. Also, in a zonally averaged sense between 40E and 140E, the latitude of maximum precipitation is slightly higher than that of the maximum zonal wind. Low-level westerlies are also found in regions west of Central America and in western Africa north of the equator. These regions are also closely associated with precipitation centers. Across equator from these westerlies regions there are regions of strong easterlies. Also, on their poleward side the westerly regions are flanked by weaker easterly regions. In February, similar observation can be found in the Australian monsoon area and in South America monsoon region; again the regions of westerlies coincide well with regions of maximum precipitation. As in the northern hemisphere, the maximum precipitation is found to the cast of the maximum zonal wind. The two maxima lie almost at the same latitude with that of the westerlies slightly closer to the equator. In the non-monsoon seasons the low- level westerlies can also be found in the tropical precipitation regions, the longitudinal range of the westerlies is undiminished and the speed of the westerlies is not much weaker than that found in February. The interpretation of these observational facts is the goal of this investigation. The approach taken is numerical simulation with the Goddard Earth Observation Systems atmospheric general circulation model, and its aqua-planet version, combined with theoretical arguments

Quasi-Equilibria of the Rotunno-Emanuel Tropical Cyclone Model

Long-term integrations using the Rotunno-Emanuel (RE) model demonstrate that given sufficient elapsed time the weak initial vortex specified by R E can also lead to tropical cyclogenesis, albeit at a slower growth rate. Thus the RE notion of the finite-amplitude nature of tropical cyclogenesis is valid only if the period of examination is limited to the first eight days. These results also show that, if initial vortex as specified by RE is used, prior to cyclogenesis the model state does not resemble the observed pre-genesis disturbances in the sense that there is no precipitation in the center of the disturbance. Another experiment using the same model but with the initial vortex replaced by a disturbance with a different structure shows that a state resembling the observed pre-genesis disturbances can be simulated and this state can lead to spontaneous cyclogenesis, a rapid transition between two quasi-equilibria. This spontaneous cyclogenesis is associated with the generation of a new convective region at large radius and its subsequent contraction, which reminds one of the observed eye-wall replacement, but the distinction from the latter is obvious

Single and Double ITCZ in Aqua-Planet Models with Globally Uniform Sea Surface Temperature and Solar Insolation: An Interpretation

It has been known for more than a decade that an aqua-planet model with globally uniform sea surface temperature and solar insolation angle can generate ITCZ (intertropical convergence zone). Previous studies have shown that the ITCZ under such model settings can be changed between a single ITCZ over the equator and a double ITCZ straddling the equator through one of several measures. These measures include switching to a different cumulus parameterization scheme, changes within the cumulus parameterization scheme, and changes in other aspects of the model design such as horizontal resolution. In this paper an interpretation for these findings is offered. The latitudinal location of the ITCZ is the latitude where the balance of two types of attraction on the ITCZ, both due to earth's rotation, exists. The first type is equator-ward and is directly related to the earth's rotation and thus not sensitive to model design changes. The second type is poleward and is related to the convective circulation and thus is sensitive to model design changes. Due to the shape of the attractors, the balance of the two types of attractions is reached either at the equator or more than 10 degrees away from the equator. The former case results in a single ITCZ over the equator and the latter case a double ITCZ straddling the equator

RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B.

OBJECTIVE: To develop a simple predictive model for significant fibrosis and cirrhosis in chronic hepatitis B (CHB) using the routine hematological parameters of a complete blood count. METHODS: A total of 458 eligible CHB patients who had undergone a liver biopsy were randomly divided into two cohorts: an estimation group (n = 310) and a validation group (n = 148). Liver histology was assessed according to the Metavir scoring scheme. All common demographics, hematological parameters, HBeAg status, HBV DNA, and liver biochemistry were analyzed. RESULTS: Based on routinely available clinical parameters (age, sex, HBeAg status, HBV DNA, common hematological parameters of a complete blood cell count), a model for predicting significant fibrosis (Metavir score ≥2) in the estimation group was derived using platelets and red cell distribution width (RDW), and another model for predicting cirrhosis (Metavir score = 4) was derived using platelets, RDW and hemoglobin. A novel index, the RDW to platelet ratio (RPR), was developed to amplify the opposing effects of liver fibrosis on the RDW and platelets. The AUCs of the RPR for predicting significant fibrosis and cirrhosis were 0.825 and 0.884, respectively, which is superior to the AAR, FIB-4 and APRI in the estimation group. Compared with the two derived models, the RPR has a comparable predictive power for significant fibrosis and cirrhosis. Using optimized cutoffs (0.10 and 0.16), the RPR accurately predicted 63.1% of cases with significant fibrosis and 73.7% of cases with cirrhosis and accurately excluded 85.5% of the cases with mild fibrosis and 93.0% of the cases with no cirrhosis. CONCLUSION: The RPR, a routinely available, inexpensive and easily calculated index, can predict significant fibrosis and cirrhosis in CHB patients with relatively high accuracy. The application of this index may reduce the need for liver biopsy in CHB patients