Multicentre validation of the Geneva Risk Score for hospitalised medical patients at risk of venous thromboembolism. Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE).

There is a need to validate risk assessment tools for hospitalised medical patients at risk of venous thromboembolism (VTE). We investigated whether a predefined cut-off of the Geneva Risk Score, as compared to the Padua Prediction Score, accurately distinguishes low-risk from high-risk patients regardless of the use of thromboprophylaxis. In the multicentre, prospective Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE) cohort study, 1,478 hospitalised medical patients were enrolled of whom 637 (43%) did not receive thromboprophylaxis. The primary endpoint was symptomatic VTE or VTE-related death at 90 days. The study is registered at ClinicalTrials.gov, number NCT01277536. According to the Geneva Risk Score, the cumulative rate of the primary endpoint was 3.2% (95% confidence interval [CI] 2.2-4.6%) in 962 high-risk vs 0.6% (95% CI 0.2-1.9%) in 516 low-risk patients (p=0.002); among patients without prophylaxis, this rate was 3.5% vs 0.8% (p=0.029), respectively. In comparison, the Padua Prediction Score yielded a cumulative rate of the primary endpoint of 3.5% (95% CI 2.3-5.3%) in 714 high-risk vs 1.1% (95% CI 0.6-2.3%) in 764 low-risk patients (p=0.002); among patients without prophylaxis, this rate was 3.2% vs 1.5% (p=0.130), respectively. Negative likelihood ratio was 0.28 (95% CI 0.10-0.83) for the Geneva Risk Score and 0.51 (95% CI 0.28-0.93) for the Padua Prediction Score. In conclusion, among hospitalised medical patients, the Geneva Risk Score predicted VTE and VTE-related mortality and compared favourably with the Padua Prediction Score, particularly for its accuracy to identify low-risk patients who do not require thromboprophylaxis.

The potential of stomata analysis in conifers to estimate presence of conifer trees: examples from the Alps

To estimate whether or not a plant taxon found in the fossil record was locally present may be difficult if only pollen is analyzed. Plant macrofossils, in contrast, provide a clear indication of a taxon's local presence, although in some lake sediments or peats, macrofossils may be rare or degraded. For conifers, the stomata found on pollen slides are derived from needles and thus provide a valuable proxy for local presence and they can be identified to genus level. From previously published studies, a transect across the Alps based on 13 sites is presented. For basal samples in sandy silt above the till with high pollen values of Pinus, for example, we may distinguish pine pollen from distant sources (samples with no stomata), from reworked pollen (samples with stomata present). The first apparent local presence of most conifer genera based on stomata often but not always occurs together with the phase of rapid pollen increase (rational limit). An exception is Larix, with its annual deposition of needles and heavy poorly dispersed pollen, for it often shows the first stomata earlier, at the empirical pollen limit. The decline and potential local extinction of a conifer can sometimes be shown in the stomata record. The decline may have been caused by climatic change, competition, or human impact. In situations where conifers form the timberline, the stomata record may indicate timberline fluctuations. In the discussion of immigration or migration of taxa we advocate the use of the cautious term ``apparent local presence'' to include some uncertainties. Absence of a taxon is impossible to prove.

Reproductive investment and seedling survival of the mast-fruiting rain forest tree, Microberlinia bisulcata A. chev

In the southern part of Korup National Park, Cameroon, the mast fruiting tree Microberlinia bisulcata occurs as a codominant in groves of ectomycorrhizal Caesalpiniaceae within a mosaic of otherwise species-rich lowland rain forest. To estimate the amount of carbon and nutrients invested in reproduction during a mast fruiting event, and the consequential seed and seedling survival, three related field studies were made in 1995. These provided a complete seed and seedling budget for the cohort. Seed production was estimated by counting woody pods on the forest floor. Trees produced on average 26,000 (range 0-92,000) seeds/tree, with a dry mass of 16.6 kg/tree. Seeds were contained in woody pods of mass 307 kg/tree. Dry mass production of pods and seeds was 1034 kg ha(-1), equivalent to over half (55%) of annual leaf litterfall for this species, and contained 13% of the nitrogen and 21% of the phosphorus in annual leaf litterfall. Seed and young-seedling mortality was investigated with open quadrats and cages to exclude vertebrate predators, at two distances from the parent tree. The proportion of seeds on the forest floor which disappeared in the first 6 wk after dispersal was 84%, of which 26.5% was due to likely vertebrate removal, 36% to rotting, and 21.5% to other causes. Vertebrate predation was greater close to the stem than 5 m beyond the crown (41 vs 12% of seeds disappearing) where the seed shadow was less dense. Previous studies have demonstrated an association between mast years at Korup and high dry-season radiation before flowering, and have shown lower leaf-litterfall phosphorus concentrations following mast fruiting. The emerging hypothesis is that mast fruiting is primarily imposed by energy limitation for fruit production, but phosphorus supply and vertebrate predation are regulating factors. Recording the survival of naturally-regenerating M. bisulcata seedlings (6-wk stage) showed that 21% of seedlings survived to 31 mo. A simple three-stage recruitment model was constructed. Mortality rates were initially high and peaked again in each of the next two dry seasons, with smaller peaks in the two intervening wet seasons, these latter coinciding with annual troughs in radiation. The very poor recruitment of M. bisulcata trees in Korup, demonstrated in previous investigations, appears not to be due to a limitation in seed or young-seedling supply, but rather by factors operating at the established-seedling stage.

Relative survival is an adequate estimate of cancer-specific survival: baseline mortality-adjusted 10-year survival of 771 rectal cancer patients.

BACKGROUND The objective of the present investigation is to assess the baseline mortality-adjusted 10-year survival of rectal cancer patients. METHODS Ten-year survival was analyzed in 771 consecutive American Joint Committee on Cancer (AJCC) stage I-IV rectal cancer patients undergoing open resection between 1991 and 2008 using risk-adjusted Cox proportional hazard regression models adjusting for population-based baseline mortality. RESULTS The median follow-up of patients alive was 8.8 years. The 10-year relative, overall, and cancer-specific survival were 66.5% [95% confidence interval (CI) 61.3-72.1], 48.7% (95% CI 44.9-52.8), and 66.4% (95% CI 62.5-70.5), respectively. In the entire patient sample (stage I-IV) 47.3% and in patients with stage I-III 33.6 % of all deaths were related to rectal cancer during the 10-year period. For patients with AJCC stage I rectal cancer, the 10-year overall survival was 96% and did not significantly differ from an average population after matching for gender, age, and calendar year (p = 0.151). For the more advanced tumor stages, however, survival was significantly impaired (p < 0.001). CONCLUSIONS Retrospective investigations of survival after rectal cancer resection should adjust for baseline mortality because a large fraction of deaths is not cancer related. Stage I rectal cancer patients, compared to patients with more advanced disease stages, have a relative survival close to 100% and can thus be considered cured. Using this relative-survival approach, the real public health burden caused by rectal cancer can reliably be analyzed and reported.

Predictors of thromboprophylaxis in hospitalised medical patients. Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE).

Both, underuse and overuse of thromboprophylaxis in hospitalised medical patients is common. We aimed to explore clinical factors associated with the use of pharmacological or mechanical thromboprophylaxis in acutely ill medical patients at high (Geneva Risk Score ≥ 3 points) vs low (Geneva Risk Score < 3 points) risk of venous thromboembolism. Overall, 1,478 hospitalised medical patients from eight large Swiss hospitals were enrolled in the prospective Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE) cohort study. The study is registered on ClinicalTrials.gov, number NCT01277536. Thromboprophylaxis increased stepwise with increasing Geneva Risk Score (p< 0.001). Among the 962 high-risk patients, 366 (38 %) received no thromboprophylaxis; cancer-associated thrombocytopenia (OR 4.78, 95 % CI 2.75-8.31, p< 0.001), active bleeding on admission (OR 2.88, 95 % CI 1.69-4.92, p< 0.001), and thrombocytopenia without cancer (OR 2.54, 95 % CI 1.31-4.95, p=0.006) were independently associated with the absence of prophylaxis. The use of thromboprophylaxis declined with increasing severity of thrombocytopenia (p=0.001). Among the 516 low-risk patients, 245 (48 %) received thromboprophylaxis; none of the investigated clinical factors predicted its use. In conclusion, in acutely ill medical patients, bleeding and thrombocytopenia were the most important factors for the absence of thromboprophylaxis among high-risk patients. The use of thromboprophylaxis among low-risk patients was inconsistent, without clearly identifiable predictors, and should be addressed in further research.

The effect of superiors' exogenous constraints on budget negotiations

In a world characterized by increasing pressure from financial and product markets, the question of how exogenous constraints affect internal coordination and control processes has become increasingly important. This experiment investigates how two exogenous constraints that superiors can face in budget negotiation settings, increased opportunity costs and financial pressure to meet unit targets, affect budget negotiations and subordinate effort. The results show that both constraints induce more cooperation, but in different ways. Financial pressure on the superior leads to more cooperative negotiation behavior by superiors and subordinates than increased opportunity costs. Specifically, subordinates do not take advantage of the superior's increased financial pressure to enforce lower budgets. After negotiation, both constraints strongly mitigate the negative effects of superior budget imposition on subordinate effort because exogenous constraints eliminate the effect of procedural fairness considerations on subordinate effort.

Electoral and Financial Bookkeeping: A Comparison of Pre-Electoral Pledges on Public Spending and the Outcome of Post-Electoral Budget Debates

In the wake of the financial crisis, budgetary discipline has taken centre stage in politics. More than ever a country's budget mirrors the true policy preferences of the legislative majority beyond all political discourse and cheap talk. The paper sheds light on mandate fulfilment in the field of public spending and fiscal policy in general. Based on previous work on pledge fulfilment in Switzerland the paper compares publicised pre-electoral statements of MPs on public spending and the development of the public finances with their post-electoral legislative behaviour during budget debates and votes. The findings of the paper confirm the results of the aforementioned earlier studies and point to the potential of budgetary statements for future mandate fulfilment research.

Transient sediment supply in a high-altitude Alpine environment evidenced through a 10Be budget of the Etages catchment (French Western Alps)

Although beryllium-10 (10Be) concentrations in stream sediments provide useful synoptic views of catchment-wide erosion rates, little is known on the relative contributions of different sediment supply mechanisms to the acquisition of their initial signature in the headwaters. Here we address this issue by conducting a 10Be-budget of detrital materials that characterize the morphogenetic domains representative of high-altitude environments of the European Alps. We focus on the Etages catchment, located in the Ecrins-Pelvoux massif (southeast France), and illustrate how in situ 10Be concentrations can be used for tracing the origin of the sand fraction from the bedload in the trunk stream. The landscape of the Etages catchment is characterized by a geomorphic transient state, high topographic gradients, and a large variety of modern geomorphic domains ranging from glacial environments to scarcely vegetated alluvial plains. Beryllium-10 concentrations measured in the Etages catchment vary from similar to 1 x 104 to 4.5 x 105 atoms per gram quartz, while displaying consistent 10Be signatures within each representative morphogenetic unit. We show that the basic requirements for inferring catchment-wide denudation from 10Be concentration measurements are not satisfied in this small, dynamic catchment. However, the distinct 10Be signature observed for the geomorphic domains can be used as a tracer. We suggest that a terrestrial cosmogenic nuclide (TCN) budget approach provides a valuable tool for the tracing of material origin in basins where the let nature do the averaging' principles may be violated.

SALSA: a tool to estimate the stray light contamination for low-Earth orbit observatories

Stray light contamination reduces considerably the precision of photometric of faint stars for low altitude spaceborne observatories. When measuring faint objects, the necessity of coping with stray light contamination arises in order to avoid systematic impacts on low signal-to-noise images. Stray light contamination can be represented by a flat offset in CCD data. Mitigation techniques begin by a comprehensive study during the design phase, followed by the use of target pointing optimisation and post-processing methods. We present a code that aims at simulating the stray-light contamination in low-Earth orbit coming from reflexion of solar light by the Earth. StrAy Light SimulAtor (SALSA) is a tool intended to be used at an early stage as a tool to evaluate the effective visible region in the sky and, therefore to optimise the observation sequence. SALSA can compute Earth stray light contamination for significant periods of time allowing missionwide parameters to be optimised (e.g. impose constraints on the point source transmission function (PST) and/or on the altitude of the satellite). It can also be used to study the behaviour of the stray light at different seasons or latitudes. Given the position of the satellite with respect to the Earth and the Sun, SALSA computes the stray light at the entrance of the telescope following a geometrical technique. After characterising the illuminated region of the Earth, the portion of illuminated Earth that affects the satellite is calculated. Then, the flux of reflected solar photons is evaluated at the entrance of the telescope. Using the PST of the instrument, the final stray light contamination at the detector is calculated. The analysis tools include time series analysis of the contamination, evaluation of the sky coverage and an objects visibility predictor. Effects of the South Atlantic Anomaly and of any shutdown periods of the instrument can be added. Several designs or mission concepts can be easily tested and compared. The code is not thought as a stand-alone mission designer. Its mandatory inputs are a time series describing the trajectory of the satellite and the characteristics of the instrument. This software suite has been applied to the design and analysis of CHEOPS (CHaracterizing ExOPlanet Satellite). This mission requires very high precision photometry to detect very shallow transits of exoplanets. Different altitudes and characteristics of the detector have been studied in order to find the best parameters, that reduce the effect of contamination. © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

A Genetic Algorithm to associate optical measurements and estimate orbits of geocentric objects

Cataloging geocentric objects can be put in the framework of Multiple Target Tracking (MTT). Current work tends to focus on the S = 2 MTT problem because of its favorable computational complexity of O(n²). The MTT problem becomes NP-hard for a dimension of S˃3. The challenge is to find an approximation to the solution within a reasonable computation time. To effciently approximate this solution a Genetic Algorithm is used. The algorithm is applied to a simulated test case. These results represent the first steps towards a method that can treat the S˃3 problem effciently and with minimal manual intervention.

Relative estimate of accuracy in orbit determination from a short tracklet

The Astronomical Institute of the University of Bern (AIUB) is conducting several search campaigns for orbital debris. The debris objects are discovered during systematic survey observations. In general only a short observation arc, or tracklet, is available for most of these objects. From this discovery tracklet a first orbit determination is computed in order to be able to find the object again in subsequent follow-up observations. The additional observations are used in the orbit improvement process to obtain accurate orbits to be included in a catalogue. In this paper, the accuracy of the initial orbit determination is analyzed. This depends on a number of factors: tracklet length, number of observations, type of orbit, astrometric error, and observation geometry. The latter is characterized by both the position of the object along its orbit and the location of the observing station. Different positions involve different distances from the target object and a different observing angle with respect to its orbital plane and trajectory. The present analysis aims at optimizing the geometry of the discovery observation is depending on the considered orbit.

Nonperturbative estimate of the heavy quark momentum diffusion coefficient

We estimate the momentum diffusion coefficient of a heavy quark within a pure SU(3) plasma at a temperature of about 1.5Tc. Large-scale Monte Carlo simulations on a series of lattices extending up to 1923×48 permit us to carry out a continuum extrapolation of the so-called color-electric imaginary-time correlator. The extrapolated correlator is analyzed with the help of theoretically motivated models for the corresponding spectral function. Evidence for a nonzero transport coefficient is found and, incorporating systematic uncertainties reflecting model assumptions, we obtain κ=(1.8–3.4)T3. This implies that the “drag coefficient,” characterizing the time scale at which heavy quarks adjust to hydrodynamic flow, is η−1D=(1.8–3.4)(Tc/T)2(M/1.5  GeV)  fm/c, where M is the heavy quark kinetic mass. The results apply to bottom and, with somewhat larger systematic uncertainties, to charm quarks.

A case-control study to estimate the effects of acute clinical infection with the Schmallenberg virus on milk yield, fertility and veterinary costs in Swiss dairy herds.

Schmallenberg virus (SBV) was first detected in Switzerland in July 2012 and many Swiss dairy farmers reported acute clinical signs in dairy cattle during the spread of the virus until December 2012. The objectives of the present study were to investigate the effects of an acute infection with SBV on milk yield, fertility and veterinary costs in dairy farms with clinical signs of SBV infection (case farms), and to compare those farms to a matched control group of dairy farms in which cattle did not show clinical signs of SBV infection. Herd size was significantly (p<0.001) larger in case farms (33 cows, n=77) than in control farms (25 cows, n=84). Within case herds, 14.8% (median) of the cows showed acute clinical signs. Managers from case farms indicated to have observed a higher abortion rate during the year with SBV (6.5%) than in the previous year (3.7%). Analysis of fertility parameters based on veterinary bills and data from the breeding associations showed no significant differences between case and control farms. The general veterinary costs per cow from July to December 2012 were significantly higher (p=0.02) in case (CHF 19.80; EUR 16.50) than in control farms (CHF 15.90; EUR 13.25). No differences in milk yield were found between groups, but there was a significant decrease in milk production in case farms in the second half year in 2012 compared to the same period in 2011 (p<0.001) and 2013 (p=0.009). The average daily milk yield per cow (both groups together) was +0.73kg higher (p=0.03) in the second half year 2011 and +0.52kg (p=0.12) in the second half year 2013 compared to the same half year 2012. Fifty-seven percent of the cows with acute clinical signs (n=461) were treated by a veterinarian. The average calculated loss after SBV infection for a standardized farm was CHF 1606 (EUR 1338), which can be considered as low at the national level, but the losses were subject to great fluctuations between farms, so that individual farms could have very high losses (>CHF 10,000, EUR 8333).