10 research outputs found

    Using citizen science to expand the global map of landslides: Introducing the Cooperative Open Online Landslide Repository (COOLR).

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    Robust inventories are vital for improving assessment of and response to deadly and costly landslide hazards. However, collecting landslide events in inventories is difficult at the global scale due to inconsistencies in or the absence of landslide reporting. Citizen science is a valuable opportunity for addressing some of these challenges. The new Cooperative Open Online Landslide Repository (COOLR) supplements data in a NASA-developed Global Landslide Catalog (GLC) with citizen science reports to build a more robust, publicly available global inventory. This manuscript introduces the COOLR project and its methods, evaluates the initial citizen science results from the first 13 months, and discusses future improvements to increase the global engagement with the project. The COOLR project (https://landslides.nasa.gov) contains Landslide Reporter, the first global citizen science project for landslides, and Landslide Viewer, a portal to visualize data from COOLR and other satellite and model products. From March 2018 to April 2019, 49 citizen scientists contributed 162 new landslide events to COOLR. These events spanned 37 countries in five continents. The initial results demonstrated that both expert and novice participants are contributing via Landslide Reporter. Citizen scientists are filling in data gaps through news sources in 11 different languages, in-person observations, and new landslide events occurring hundreds and thousands of kilometers away from any existing GLC data. The data is of sufficient accuracy to use in NASA susceptibility and hazard models. COOLR continues to expand as an open platform of landslide inventories with new data from citizen scientists, NASA scientists, and other landslide groups. Future work on the COOLR project will seek to increase participation and functionality of the platform as well as move towards collective post-disaster mapping

    Radiologists staunchly support patient safety and autonomy, in opposition to the SCOTUS decision to overturn Roe v Wade

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    Initial invasive or conservative strategy for stable coronary disease

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    BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

    Health-status outcomes with invasive or conservative care in coronary disease

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    BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline
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