Prediction of outcomes in acute exacerbation of COPD with DECAF score and BAP 65 score in a rural population

Background: Prognostic research in exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospitalization has been limited and there appears to be little common ground between predictors of mortality in stable disease and during AECOPD. Furthermore, none of the prognostic tools developed in stable disease have been tested on hospitalised patients, and most require clinical measurements not routinely available at hospital admission. This study intends to test dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) and biological assessment profile (BAP) 65 Scores on Indian patients in a tertiary care set up and validate the same to be used as a routine and effective score in predicting the outcome in AECOPD.  Methods: Hospital based prospective observational study was carried out in 100 patients with AECOPD who was present to general medicine. DECAF and BAP-65 Scores were calculated. Data was analyzed using SPSS 22 version software.Results: In our study both DECAF score and BAP‑65 score performed equally well for prediction of need for Mechanical Ventilation. The AUROC for need for Mechanical Ventilation was 0.77 (95% CI=0.67–0.84) for DECAF score and 0.77 (95% CI=0.67–0.85) for BAP‑65 score. The AUROC for prediction of mortality for DECAF score was 0.83 (95% confidence interval [CI]=0.74–0.89) and for BAP‑65 score was 0.79 (95% CI=0.69–0.86).Conclusions: DECAF and BAP-65 are good and also equal in predicting mortality as well as need for mechanical ventilation. Both scores can be easily applicable in AECOPD patients, so that death during hospitalization for AECOPD and need for mechanical ventilation can be minimized.

Custom Integrated Circuits

Contains reports on nine research projects.Analog Devices, Inc.International Business Machines, Inc.Joint Services Electronics Program (Contract DAALO03-86-K-0002)U.S. Air Force - Office of Scientific Research (Grant AFOSR 86-0164)Rockwell International CorporationOKI SemiconductorU.S. Navy - Office of Naval Research (Contract N00014-81-K-0742)Charles Stark Draper LaboratoryDARPA/U.S. Navy - Office of Naval Research (Contract N00014-80-C-0622)DARPA/U.S. Navy - Office of Naval Research (Contract N00014-87-K-0825)National Science Foundation (Grant ECS-83-10941)AT&T Bell Laboratorie

Digital Signal Processing

Contains table of contents for Part III, table of contents for Section 1, an introduction and reports on seventeen research projects.National Science Foundation FellowshipNational Science Foundation (Grant ECS 84-07285)National Science Foundation (Grant MIP 87-14969)U.S. Navy - Office of Naval Research (Contract N00014-81-K-0742)Scholarship from the Federative Republic of BrazilU.S. Air Force - Electronic Systems Division (Contract F19628-85-K-0028)AT&T Bell Laboratories Doctoral Support ProgramCanada, Bell Northern Research ScholarshipCanada, Fonds pour la Formation de Chercheurs et I'Aide a la Recherche Postgraduate FellowshipSanders Associates, Inc.OKI Semiconductor, Inc.Tel Aviv University, Department of Electronic SystemsU.S. Navy - Office of Naval Research (Contract N00014-85-K-0272)Natural Sciences and Engineering Research Council of Canada, Science and Engineering Scholarshi

Custom Integrated Circuits

Contains reports on six research projects.U.S. Air Force - Office of Scientific Research (Grant AFOSR-86-0164)U.S. Navy - Office of Naval Research (Contract N00014-80-C-0622)National Science Foundation (Grant ECS-83-10941

Signal Processing Research Program

Contains table of contents for Part III, table of contents for Section 1, an introduction and reports on fourteen research projects.Charles S. Draper Laboratory Contract DL-H-404158U.S. Navy - Office of Naval Research Grant N00014-89-J-1489National Science Foundation Grant MIP 87-14969Battelle LaboratoriesTel-Aviv University, Department of Electronic SystemsU.S. Army Research Office Contract DAAL03-86-D-0001The Federative Republic of Brazil ScholarshipSanders Associates, Inc.Bell Northern Research, Ltd.Amoco Foundation FellowshipGeneral Electric FellowshipNational Science Foundation FellowshipU.S. Air Force - Office of Scientific Research FellowshipU.S. Navy - Office of Naval Research Grant N00014-85-K-0272Natural Science and Engineering Research Council of Canada - Science and Technology Scholarshi

Digital Signal Processing Research Program

Contains table of contents for Part III, table of contents for Section 1, an introduction and reports on seventeen research projects.U.S. Navy - Office of Naval Research Contract N00014-90-J-1544Charles S. Draper Laboratory Contract DL-H-404158Rockwell Corporation Doctoral FellowshipU.S. Navy - Office of Naval Research Grant N00014-89-J-1489U.S. Navy - Office of Naval Research Grant N00014-90-J-1109The Federative Republic of Brazil ScholarshipLockheed Sanders, Inc.National Science Foundation Grant MIP 87-14969AT&T Bell Laboratories Doctoral ProgramBell Northern Research Ltd.Defense Advanced Research Projects Agency Contract N00014-87-K-0825IBM CorporationSloan FoundationU.S. Air Force - Office of Scientific Research FellowshipU.S. Air Force - Office of Scientific Research Grant AFOSR-91-0034National Science Foundation Graduate FellowshipCanada, Natural Science and Engineering Research Council ScholarshipU.S. Air Force - Office of Scientific Research Grant AFOSR-91-0034Texas Instruments, Inc

Cognitive Information Processing

Contains goals, background, research activities on one research project and reports on three research projects.Center for Advanced Television StudiesAmerican Broadcasting CompanyAmpex CorporationColumbia Broadcasting SystemsHarris CorporationHome Box OfficePublic Broadcasting ServiceNational Broadcasting CompanyRCA CorporationTektronix3M CompanyProvidence Gravure Co. (Grant)International Business Machines, Inc

Custom Integrated Circuits

Contains reports on twelve research projects.Analog Devices, Inc.International Business Machines, Inc.Joint Services Electronics Program (Contract DAAL03-86-K-0002)Joint Services Electronics Program (Contract DAAL03-89-C-0001)U.S. Air Force - Office of Scientific Research (Grant AFOSR 86-0164)Rockwell International CorporationOKI Semiconductor, Inc.U.S. Navy - Office of Naval Research (Contract N00014-81-K-0742)Charles Stark Draper LaboratoryNational Science Foundation (Grant MIP 84-07285)National Science Foundation (Grant MIP 87-14969)Battelle LaboratoriesNational Science Foundation (Grant MIP 88-14612)DuPont CorporationDefense Advanced Research Projects Agency/U.S. Navy - Office of Naval Research (Contract N00014-87-K-0825)American Telephone and TelegraphDigital Equipment CorporationNational Science Foundation (Grant MIP-88-58764

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019