Simulation-based flood fragility and vulnerability analysis for expanding cities

Accurately quantifying flood-induced impacts on buildings and other infrastructure systems is essential for risk-sensitive planning and decision-making in expanding urban regions. Flood-induced impacts are directly related to the physical components of assets damaged due to contact with water. Such components include building contents (e.g., appliances, furniture) and other non-structural components whose damage/unavailability can severely impact the buildingsﾒ functionality. Conventional fragility analysis approaches for flooding do not account for the physical damage to the individual components, mostly relying on empirical methods based on historical data. However, recent studies proposed simulation-based, assembly-based fragility models that account for the damage to the building components. Such fragility models require developing detailed inventories of vulnerable components of households and identifying building archetypes to be considered in a building portfolio for the region of interest. Content inventories and building portfolios have so far been obtained for specific socio-economic contexts such as the United States of America. However, building types and their content can significantly differ between countries, making the available fragility models and computational frameworks unsuitable for flood vulnerability analysis in rapidly expanding cities characterised by extensive informal settlements, such as low- and middle-income countries. This paper details how to adapt the available methodologies for flood vulnerability assessment to the context of formal and informal settlements of expanding cities in the global south. It also details the development of content inventories for households in these cities using field surveys. The proposed survey is deployed in various areas vulnerable to floods in Kathmandu, Nepal. Based on the survey results, each component within the household is associated with a corresponding flood capacity (resistance) distribution (in terms of water height and flood duration). These distributions are then employed in a simulation-based probabilistic framework to obtain fragility relationship and consequence models. The relevant differences between the results obtained in this study and those from previous studies are then investigated for a case-study building type. In addition, the influence of socio-economic factors (e.g., household income) and past flood experience (possibly resulting in various flood-risk mitigation strategies at a household level) on the resulting flood impacts is also included in the model

Don’t turn your back on the symptoms of psychosis : a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK

Background: Reducing the duration of untreated psychosis (DUP) is an aspiration of international guidelines for first episode psychosis; however, public health initiatives have met with mixed results. Systematic reviews suggest that greater focus on the sources of delay within care pathways, (which will vary between healthcare settings) is needed to achieve sustainable reductions in DUP (BJP 198: 256-263; 2011). Methods/Design: A quasi-experimental trial, comparing a targeted intervention area with a ‘detection as usual’ area in the same city. A proof-of–principle trial, no a priori assumptions are made regarding effect size; key outcome will be an estimate of the potential effect size for a definitive trial. DUP and number of new cases will be collected over an 18-month period in target and control areas and compared; historical data on DUP collected in both areas over the previous three years, will serve as a benchmark. The intervention will focus on reducing two significant DUP component delays within the overall care pathway: delays within the mental health service and help-seeking delay. Discussion: This pragmatic trial will be the first to target known delays within the care pathway for those with a first episode of psychosis. If successful, this will provide a generalizable methodology that can be implemented in a variety of healthcare contexts with differing sources of delay. Trial registration: http://www.controlled-trials.com/ISRCTN45058713 Keywords: Public mental health campaign, First-episode psychosis, Early detection, Duration of untreated psychosis, Youth mental healt

Síndrome del opérculo torácico. Diagnóstico inesperado en una paciente con parestesias de miembro superior izquierdo

The thoracic outlet syndrome refers to the set of signs and symptoms that arise from compression of the neurovascular bundle by structures located above the first rib and behind the clavicle. Clinical manifestations depend on the affected structure (neurogenic, arterial or venous). The complementary study chosen will depend on the affected structure. Treatment is only performed in symptomatic patients. Therapeutic includes from physical therapy, interscalene injection of anesthetic agents, steroids or botulinum toxin type A (neurogenic), directed thrombolysis (vascular) catheter, and/or decompressive surgery.El síndrome del opérculo torácico hace referencia al conjunto de signos y síntomas que surgen de la compresión del paquete neurovascular, por estructuras situadas por encima de la primera costilla y por detrás de la clavícula. Las manifestaciones clínicas dependen de la estructura afectada (neurogénicas, arteriales o venosas). El estudio complementario elegido dependerá de la estructura afectada y de los síntomas. Respecto al tratamiento, solo se recomienda en pacientes sintomáticos. Los tratamientos incluyen desde terapia física, inyección interescalénica de agentes anestésicos, esteroides, toxina botulínica tipo A (neurogénico), trombólisis dirigida por catéter (vascular) y/o cirugía descompresiva

The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi

We describe hypoxemic pneumonia prevalence in outpatient and inpatient settings, in-hospital mortality, and clinical guideline performance for identifying hypoxemia in young infants in Malawi. In this retrospective analysis of a prospective cohort study, we investigate infants younger than 2 months participating in pneumonia surveillance at seven hospitals and 18 outpatient health centers in Malawi between 2011 and 2014. Logistic regression, multiple imputations with chained equations, and pattern mixture modeling were used to determine the association between peripheral oxyhemoglobin saturation (SpO2) levels and hospital mortality. We describe referral recommendations based on clinical characteristics and SpO2 distributions. Among 1,879 analyzed cases, SpO2 < 90% was more prevalent among outpatient health center cases than that among hospitalized cases (22.6% versus 13.5%, 95% CI: 17.6–28.4% and 12.0–15.3%, respectively). A larger proportion of hospitalized infants had signs of respiratory distress than infants at health centers (67.7% versus 56.6%, P < 0.001) and the signs were higher in male versus female infants (56.7% versus 40.6%, P < 0.001). An SpO2 of 90–92% and < 90% was associated with similarly increased odds of in-hospital mortality (adjusted odds ratio [aOR]: 4.3 and 4.4, 95% CI: 1.7–11.1 and 1.8–10.5, respectively). Unrecorded, or unobtainable, SpO2 was highly associated with mortality (n = 127, aOR: 18.1; 95% CI: 7.6–42.8). Four of 22 (18%) infants at health centers who did not meet clinical referral criteria had an SpO2 ≤ 92%. Clinicians should consider hospital referral in young infants with SpO2 ≤ 92%. Infants with unobtainable SpO2 readings should be considered a high-risk group, and hospital referral of these cases may be appropriate

British Election Longitudinal News Study 2015–2019: Print news coverage with validated topics and candidate sentiment

The British Election Longitudinal News Study 2015–2019 (BELNS) covers campaign coverage relating to three general elections: 2015, 2017, 2019. The print newspaper component in this release tracks topic and general election candidate coverage across 46 national and local sources, including actor-level sentiment. For a full description, see Documentation.Corrected file version uploaded on 17-05-2021.The British Election Longitudinal News Study 2015–2019 (BELNS) covers campaign coverage relating to three general elections: 2015, 2017, 2019. The print newspaper component in this release tracks topic and general election candidate coverage across 46 national and local sources, including actor-level sentiment.Economic and Social Research Council (ESRC)Economic and Social Research Council (ESRC)Economic and Social Research Council (ESRC

Magnetic resonance brain images algorithm to identify demyelinating and ischemic diseases

[EN] Brain demyelination lesions occur due to damage of the myelin layer of nerve fibers, this deterioration is the cause of pathologies such as multiple sclerosis, leukodystrophy, encephalomyelitis. Brain ischemia is the interruption of the blood supply to the brain, and the flow of oxygen and nutrients needed to maintain the correct functioning of brain cells. This project presents the results of an algorithm processing images with the the main objective of identify and differentiate between demyelination and ischemic brain diseases through the automatic detection, classification and identification of their features found in the magnetic resonance images. The sequences of images used were T1, T2, and FLAIR and with a dataset of 300 patients with and without these or other pathologies, respectively. The algorithm in this stage uses Discrete Wavelet Transform (DWT), principal component analysis (PCA) and a kernel support vector machine (SVM). The algorithm developed indicates a 75% of accuracy, for that reason, with an effective validation could be applied for the fast diagnosis and contribute to an effective treatment of these brain diseases especially in the rural places.Castillo-Malla, DP.; Samaniego, R.; Jimenez, Y.; Cuenca, L.; Vivanco, O.; Rodríguez-Álvarez, M. (2018). Magnetic resonance brain images algorithm to identify demyelinating and ischemic diseases. Proceedings of SPIE. 10752:1-6. https://doi.org/10.1117/12.2322048S161075

Polyfluoroalkyl Compounds in Texas Children from Birth through 12 Years of Age

Background: For > 50 years, polyfluoroalkyl compounds (PFCs) have been used worldwide, mainly as surfactants and emulsifiers, and human exposure to some PFCs is widespread

Factors associated with neonatal deaths in Chitwan district of Nepal

Background: Neonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal. Methods: A case–control study was conducted during April–July 2012. The study used a mixed-method approach, in which records of neonatal deaths were obtained from the District Public Health Office and a comparison group, survivors, was obtained from the same community. A total of 198 mothers (of 99 neonatal deaths and 99 survivor neonates) were included in the survey. Focus group discussions, in-depth interviews and case studies were also conducted. Maternal characteristics were analyzed using descriptive statistics, Mc Nemar’s Chi square test and multivariable backward conditional logistic regression analysis. Qualitative data were analyzed by narrative analysis method.Results: More than four-fifth of mothers (86 %) had antenatal check-up (ANC) and the proportion of four or more ANC was 64 %. Similarly, the percentage of mothers having institutional delivery was 62 %, and postnatal check-up was received by 65 % of mothers. In multivariable analysis, low birth weight [adjusted odds ratio: 8.49, 95 % CI (3.21–22.47)], applying nothing on cord [adjusted odds ratio: 5.72, 95 % CI (1.01-32.30)], not wrapping of newborn [adjusted odds ratio: 9.54, 95 % CI (2.03–44.73)], and no schooling of mother [adjusted odds ratio: 2.09, 95 % CI (1.07–4.11)] were significantly associated with an increased likelihood of neonatal mortality after adjusting for other confounding variables. Qualitative findings suggested that bathing newborns after 24 h and wrapping in clean clothes were common newborn care practices. The mothers only attended postnatal care services if health problems appeared either in the mother or in the child. Conclusion:L Results of this study suggest that the current community based newborn survival intervention should provide an even greater focus to essential newborn care practices, low birth weight newborns, and female education

Two new rapid SNP-typing methods for classifying Mycobacterium tuberculosis complex into the main phylogenetic lineages

There is increasing evidence that strain variation in Mycobacterium tuberculosis complex (MTBC) might influence the outcome of tuberculosis infection and disease. To assess genotype-phenotype associations, phylogenetically robust molecular markers and appropriate genotyping tools are required. Most current genotyping methods for MTBC are based on mobile or repetitive DNA elements. Because these elements are prone to convergent evolution, the corresponding genotyping techniques are suboptimal for phylogenetic studies and strain classification. By contrast, single nucleotide polymorphisms (SNP) are ideal markers for classifying MTBC into phylogenetic lineages, as they exhibit very low degrees of homoplasy. In this study, we developed two complementary SNP-based genotyping methods to classify strains into the six main human-associated lineages of MTBC, the 'Beijing' sublineage, and the clade comprising Mycobacterium bovis and Mycobacterium caprae. Phylogenetically informative SNPs were obtained from 22 MTBC whole-genome sequences. The first assay, referred to as MOL-PCR, is a ligation-dependent PCR with signal detection by fluorescent microspheres and a Luminex flow cytometer, which simultaneously interrogates eight SNPs. The second assay is based on six individual TaqMan real-time PCR assays for singleplex SNP-typing. We compared MOL-PCR and TaqMan results in two panels of clinical MTBC isolates. Both methods agreed fully when assigning 36 well-characterized strains into the main phylogenetic lineages. The sensitivity in allele-calling was 98.6% and 98.8% for MOL-PCR and TaqMan, respectively. Typing of an additional panel of 78 unknown clinical isolates revealed 99.2% and 100% sensitivity in allele-calling, respectively, and 100% agreement in lineage assignment between both methods. While MOL-PCR and TaqMan are both highly sensitive and specific, MOL-PCR is ideal for classification of isolates with no previous information, whereas TaqMan is faster for confirmation. Furthermore, both methods are rapid, flexible and comparably inexpensive