On the Lessons Learned from the Operations of the ERBE Nonscanner Instrument in Space and the Production of the Nonscanner TOA Radiation Budget Dataset

Monitoring the flow of radiative energy at top-of-atmosphere (TOA) is essential for understanding the Earths climate and how it is changing with time. The determination of TOA global net radiation budget using broadband nonscanner instruments has received renewed interest recently due to advances in both instrument technology and the availability of small satellite platforms. The use of such instruments for monitoring Earths radiation budget was attempted in the past from satellite missions such as the Nimbus 7 and the Earth Radiation Budget Experiment (ERBE). This paper discusses the important lessons learned from the operation of the ERBE nonscanner instrument and the production of the ERBE nonscanner TOA radiation budget data set that have direct relevance to current nonscanner instrument efforts

Dome Degradation Characterization of Wide-Field-of-View Nonscanner Aboard ERBE and Its Reprocessing

Earth Radiation Budget Experiment (ERBE) wide-field-of-view (WFOV) nonscanners aboard ERBS and NOAA- 9/NOAA-10 provided broadband shortwave and longwave irradiances from 1985 to 1999. The previous analysis showed dome degradation in the shortwave nonscanner instruments. The correction was performed with a constant spectral (gray assumption) degradation. We suspect that the gray assumption affected daytime longwave irradiance and led to a day-minus-night longwave flux differences (little change in night time longwave) increase over time. Based on knowledge from the CERES process, we will reprocess entire ERBE nonscanner radiation dataset by characterizing shortwave dome transmissivity with spectral dependent degradation using the solar data observed by these instruments. Once spectral dependent degradation is derived, imager derived cloud fraction and the cloud phase as well as surface type over the FOV of nonscanner instruments will be used to model unfiltering coefficients. This poster primarily explains the reprocessing techniques and includes initial comparison of several months of data processed with existing and our recent methods

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

NEON Imaging Spectrometer (NIS) Calibration Updates

The NIS (NEON Imaging Spectrometer) is an airborne pushbroom hyperspectral instrument developed by NASA Jet Propulsion Laboratory (JPL) for the National Ecological Observation Network (NEON) and is included in all three of NEON’s Airborne Observation Platform (AOP) payloads. NEON, funded by the National Science Foundation (NSF), is a continental-scale observatory designed to collect long-term data to better understand and forecast impacts of climate change, land use change and invasive species (Kampe et al. 2010). NEON has recently completed the construction phase and is in the initial operational phase, which represents annual activities that will be repeated for the remaining 30-year lifetime of the project (Goulden et al. 2019). The AOP begun data collection in 2013, although only a small subset of NEON sites was collected. By 2018 and 2019, AOP was collecting data in 16 domains annually, representing the typical data collection scenario during the operational phase of the NEON project. NEON provides 28 data products from AOP, which are publicly available and can be freely accessed from NEON data portal: https://data.neonscience.org/home. In addition to the NIS, AOP payloads include a discrete and full-waveform lidar and a high resolution RGB camera. The NIS design is based on AVIRIS (Airborne Visible/Infrared Imaging Spectrometer) NextGen Imaging Spectrometer and measures radiant energy both in VNIR (Visible-Near Infrared) and SWIR (Shortwave Infrared) spectral region (380-2510 nm) with ~5 nm sampling and 1 mRad instantaneous field of view (IFOV) (Kuester et al. 2010). This 1 mRad IFOV leads to a ground resolution of 1m at a typical flight altitude of ~1000m. In order to ensure the accuracy of the measurements, the NIS requires stable and consistent annual calibrations (Leisso et al. 2014). Assessment of NIS calibration datasets revealed anomalies that should be characterized and corrected to improve the accuracy of NIS datasets. This presentation will briefly discuss the current status of NEON project and provides detailed description of NIS calibration improvements including: 1) characterizing NIS stray light anomalies, 2) techniques implemented to correct such anomalies, and 3) NIS stability analysis. Goulden T., B. Hass, J. Musinsky, and A. K. Shrestha, 2019, Status of NEON\u27s Airborne Observation Platform , AGU Fall Meeting, 9-13 December, 2019, San Francisco, CA, USA, Kampe T. U., B. R. Johnson, M. Kuester, and M. Keller, 2010, NEON: the first continental-scale ecological observatory with airborne remote sensing of vegetation canopy biochemistry and structure , Journal of Applied Remote Sensing 4(1), 043510 (1 March 2010). https://doi.org/10.1117/1.3361375 Kuester M. A., J.T. McCorkel, Johnson, B.R., and Kampe T.U., 2010, Radiometric Calibration Concept of Imaging Spectrometers for a long-term Ecological Remote Sensing Project Leisso N., Kampe T., Karpowicz B., 2014, Calibration of the National Ecological Observatory Network\u27s airborne imaging spectrometers , 2014 IEEE Geoscience and Remote Sensing Symposium, Quebec City, QC, 2014, pp. 2625-2628. doi: 10.1109/IGARSS.2014.694701

Morphometric analysis of the foramen magnum in sex estimation: An additional 3DCT study from Nepal on a larger sample

Abstract Background Estimation of sex of the skeletal remains plays a vital part in the identification of an individual. This study is focused on the morphometric measurements of the foramen magnum region and examining the accuracy of sexual dimorphism in the Nepalese population. Methods Measurements were obtained from 3D computed tomography (CT) scan of 261 Nepalese adult cranial bases with known age and sex. Length and breadth of the foramen magnum, length and breadth of right and left occipital condyles and maximum and minimum intercondylar distance were measured on the base of the skull CT images. Results The mean values for all parameters were higher in males than females except for the maximum intercondylar distance. Sex prediction done with discriminant function analysis could classify the skull with an overall accuracy of 70.5%–71%. Conclusions It can be concluded from the results that the morphometric study of the foramen magnum is less reliable for sex estimation in the Nepalese population

Gender equality and social inclusion in community-led multiple use water services in Nepal

The Constitution of Nepal 2015 enshrines everyone’s right of access to clean water for drinking and the right to food. The common operationalization of the right to water for drinking is providing access to infrastructure that brings water for drinking and other basic domestic uses near and at homesteads. Challenges to achieving this goal in rural areas include: low functionality of water systems; expansion of informal self supply for multiple uses; widespread de facto productive uses of water systems designed for domestic uses; growing competition for finite water resources; and male elite capture in polycentric decision-making. This paper traces how the Nepali government and nongovernmental organizations in the water, sanitation and hygiene (WASH), irrigation and other sectors have joined forces since the early 2000s to address these challenges by innovating community-led multiple use water services (MUS). The present literature review of these processes complemented by field research supported by the Water for Women Fund focuses on women in vulnerable households. Overcoming sectoral silos, these organizations support what is often seen as the sole responsibility of the WASH sector: targeting infrastructure development to bring sufficient water near and at homesteads of those left behind. Women’s priorities for using this water are respected and supported, which often includes productive uses, also at basic volumes. In line with decentralized federalism, inclusive community-led MUS planning processes build on vulnerable households’ self supply, commonly for multiple uses, and follow their priorities for local incremental infrastructure improvements. Further, community-led MUS builds on community-based arrangements for ‘sharing in’ and ‘sharing out’ the finite water resources in and under communities’ social territories. This realizes the constitutional right to food in line with the Nepal Water Resources Act, 1992, which prioritizes core minimum volumes of water for everyone’s domestic uses and many households’ irrigation. Evidence shows how the alleviation of domestic chores, women’s stronger control over food production for nutrition and income, and more sustainable infrastructure mutually reinforce each other in virtuous circles out of gendered poverty. However, the main challenge remains the inclusion of women and vulnerable households in participatory processes