Comparative flood damage model assessment: towards a European approach

There is a wide variety of flood damage models in use internationally, differing substantially in their approaches and economic estimates. Since these models are being used more and more as a basis for investment and planning decisions on an increasingly large scale, there is a need to reduce the uncertainties involved and develop a harmonised European approach, in particular with respect to the EU Flood Risks Directive. In this paper we present a qualitative and quantitative assessment of seven flood damage models, using two case studies of past flood events in Germany and the United Kingdom. The qualitative analysis shows that modelling approaches vary strongly, and that current methodologies for estimating infrastructural damage are not as well developed as methodologies for the estimation of damage to buildings. The quantitative results show that the model outcomes are very sensitive to uncertainty in both vulnerability (i.e. depth–damage functions) and exposure (i.e. asset values), whereby the first has a larger effect than the latter. We conclude that care needs to be taken when using aggregated land use data for flood risk assessment, and that it is essential to adjust asset values to the regional economic situation and property characteristics. We call for the development of a flexible but consistent European framework that applies best practice from existing models while providing room for including necessary regional adjustments

Baffin Island Expedition, 1950: A Preliminary Report

Brief resume by the leader, of the personnel, itinerary, camps, transportation and program of an expedition sponsored by Arctic Institute of North America, Royal Canadian Air Force, Geological Survey of Canada, Swiss Foundation for Alpine Research and the Canadian Geographical Society, to the east coast of Baffin Island at Clyde settlement, May-Aug. 1950; with short "initial reports on progress" of the scientific studies..

Maternal Cortisol Concentrations During Pregnancy and Sex-Specific Associations With Neonatal Amygdala Connectivity and Emerging Internalizing Behaviors

Background: Maternal cortisol during pregnancy has the potential to influence rapidly developing fetal brain systems that are commonly altered in neurodevelopmental and psychiatric disorders. Research examining maternal cortisol concentrations across pregnancy and offspring neurodevelopment proximal to birth is needed to advance understanding in this area and lead to insight into the etiology of these disorders. Methods: Participants were 70 adult women recruited during early pregnancy and their infants born after 34 weeks gestation. Maternal cortisol concentrations were assessed serially over 4 days in early, mid, and late gestation. Resting state functional connectivity magnetic resonance imaging of the neonatal amygdala was examined. Mothers reported on children's internalizing behavior problems at 24 months of age. Results: Maternal cortisol concentrations during pregnancy were significantly associated with neonatal amygdala connectivity in a sex-specific manner. Elevated maternal cortisol was associated with stronger amygdala connectivity to brain regions involved in sensory processing and integration, as well as the default mode network in girls, and with weaker connectivity to these brain regions in boys. Elevated maternal cortisol was associated with higher internalizing symptoms in girls only, and this association was mediated by stronger neonatal amygdala connectivity. Conclusions: Normative variation in maternal cortisol during pregnancy is associated with the coordinated functioning of the amygdala soon after birth in a sex-specific manner. The identified pathway from maternal cortisol to higher internalizing symptoms in girls via alterations in neonatal amygdala connectivity may be relevant for the etiology of sex differences in internalizing psychiatric disorders, which are more prevalent in women

Hyperfine Magnetic Field Measurements in Ferromagnetic Chalcogenide Spinels and Heusler Alloys by TDPAC Technique

Supported by the National Science Foundation and Indiana Universit

The Nursing Home Pneumonia Risk Index: A Simple, Valid MDS-Based Method of Identifying 6-Month Risk for Pneumonia and Mortality

Background Pneumonia is the leading infectious cause of hospitalization and death for nursing home (NH) residents; however, diagnosis is often delayed because classic signs of infection are not present. We sought to identify NH residents at high risk for pneumonia, to identify persons to target for more intensive surveillance and preventive measures. Methods Based on a literature review, we identified key risk factors for pneumonia and compiled them for use as prediction tool, limiting risk factors to those available on the Minimum Data Set (MDS). Next, we tested the tool's ability to predict 6-month pneumonia incidence and mortality rates in a sample of 674 residents from 7 NHs, evaluating it both as a continuous and a dichotomous variable, and applying both logistic regression and survival analysis to calculate estimates. Results NH Pneumonia Risk Index scores ranged from −1 to 6, with a mean of 2.1, a median of 2, and a mode of 2. For the outcome of pneumonia, a 1-point increase in the index was associated with a risk odds ratio of 1.26 (P =.038) or a hazard ratio of 1.24 (P =.037); using it as a dichotomous variable (≤2 vs ≥3), the corresponding figures were a risk odds ratio of 1.78 (P =.045) and a hazard ratio of 1.82 (P =.025). For the outcome of mortality, a 1-point increase in the NH Pneumonia Risk Index was associated with a risk odds ratio of 1.58 (P =.002) and a hazard ratio of 1.45 (P =.013); using the index as a dichotomous variable, the corresponding figures were a risk odds ratio of 3.71 (P <.001) and a hazard ratio of 3.29 (P =.001). Conclusions The NH Pneumonia Risk Index can be used by NH staff to identify residents for whom to apply especially intensive preventive measures and surveillance. Because of its strong association with mortality, the index may also be valuable in care planning and discussion of advance directives

Star Masses and Star-Planet Distances for Earth-like Habitability

This paper presents statistical estimates for the location and duration of habitable zones (HZs) around stars of different mass. The approach is based upon the assumption that Earth's location, and the Sun's mass, should not be highly atypical of inhabited planets. The results support climate-model-based estimates for the location of the Sun's HZ except models giving a present-day outer-edge beyond 1.64 AU. The statistical approach also demonstrates that there is a habitability issue for stars smaller than 0.65 solar masses since, otherwise, Earth would be an extremely atypical inhabited world. It is difficult to remove this anomaly using the assumption that poor habitability of planets orbiting low-mass stars results from unfavorable radiation regimes either before, or after, their stars enter the main sequence. However, the anomaly is well explained if poor habitability results from tidal locking of planets in the HZs of small stars. The expected host-star mass for planets with intelligent life then has a 95% confidence range of 0.78 M(⊙) < M < 1.04 M(⊙), and the range for planets with at least simple life is 0.57 M(⊙) < M < 1.64 M(⊙). Key Words: Habitability—Habitable zone—Anthropic—Red dwarfs—Initial mass function. Astrobiology 17, 61–77

Urine culture testing in community nursing homes: Gateway to antibiotic overprescribing

OBJECTIVE To describe current practice around urine testing and identify factors leading to overtreatment of asymptomatic bacteriuria in community nursing homes (NHs) DESIGN Observational study of a stratified random sample of NH patients who had urine cultures ordered in NHs within a 1-month study period SETTING 31 NHs in North Carolina PARTICIPANTS 254 NH residents who had a urine culture ordered within the 1-month study period METHODS We conducted an NH record audit of clinical and laboratory information during the 2 days before and 7 days after a urine culture was ordered. We compared these results with the urine antibiogram from the 31 NHs. RESULTS Empirical treatment was started in 30% of cases. When cultures were reported, previously untreated cases received antibiotics 89% of the time for colony counts of ≥100,000 CFU/mL and in 35% of cases with colony counts of 10,000-99,000 CFU/mL. Due to the high rate of prescribing when culture results returned, 74% of these patients ultimately received a full course of antibiotics. Treated and untreated patients did not significantly differ in temperature, frequency of urinary signs and symptoms, or presence of Loeb criteria for antibiotic initiation. Factors most commonly associated with urine culture ordering were acute mental status changes (32%); change in the urine color, odor, or sediment (17%); and dysuria (15%). CONCLUSIONS Urine cultures play a significant role in antibiotic overprescribing. Antibiotic stewardship efforts in NHs should include reduction in culture ordering for factors not associated with infection-related morbidity as well as more scrutiny of patient condition when results become available

Current Prescribing Practices for Skin and Soft Tissue Infections in Nursing Homes

Objectives Antibiotic stewardship has been called for across all sites of health care, including nursing homes (NHs). Skin and soft tissue infections (SSTIs) are the third most common indication for antibiotics in the NH, and so should be a focus of stewardship. This study audited medical records to identify signs and symptoms of SSTIs treated with antibiotics in relation to the McGeer criteria for surveillance, the Loeb minimum criteria for antibiotic initiation, and prescribing recommendations of the Infectious Disease Society of America. Design Cross-sectional study. Setting Thirty-one NHs in Southeastern United States. Measurements Chart data from a random sample of 161 antibiotic prescriptions for SSTIs were abstracted. To meet the McGeer criteria, pus was present at a suspected SSTI site, or at least four of the following findings were documented as present at the site: new or worsening warmth, redness, swelling, tenderness, serous drainage, or a constitutional finding. The Loeb minimum criteria for initiating antibiotics included findings of new or increasing purulent drainage at a suspected SSTI site or at least two of the following findings: fever or new or worsening redness, tenderness, warmth, or swelling at the suspected site. Audits also collected the name, route, and duration of the associated antibiotic. Analyses calculated the types of diagnoses and evaluated associations between published criteria and prescribing. Results Cellulitis, skin/soft tissue injury with infection, and abscess were diagnosed in 37% (N = 59), 18% (N = 29), and 16% (N = 26) of cases, respectively; 27% (N = 43) had less specific diagnoses. The McGeer criteria were met in 25% (N = 40), and the Loeb minimum criteria were met in 48% (N = 77) of cases. Doxycycline was the most frequently prescribed antibiotic. The mean treatment length was 9.6 days (standard deviation, 5.6), and the median length of treatment was 8.5 days (range, 3-45). Conclusion SSTIs are not routinely diagnosed or treated according to recommended standards of care, and prescriptions for systemic antibiotics appear to be frequently initiated without regard to recommended definitions of infection or therapies for the associated diagnoses. These findings indicate that SSTIs present various opportunities to improve antibiotic stewardship