Hyperphosphatemia Is an Independent Risk Factor for Mortality in Critically Ill Patients: Results from a Cross-Sectional Study.

BACKGROUND Phosphate imbalances or disorders have a high risk of morbidity and mortality in patients with chronic kidney disease. It is unknown if this finding extends to mortality in patients presenting at an emergency room with or without normal kidney function. METHODS AND PATIENTS This cross sectional analysis included all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland. A multivariable cox regression model was applied to assess the association between phosphate levels and in-hospital mortality up to 28 days. RESULTS 22,239 subjects were screened for the study. Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died. In univariate analysis, phosphate levels were associated with mortality, age, diuretic therapy and kidney function (all p<0.001). In a multivariate Cox regression model, hyperphosphatemia (OR 3.29, p<0.001) was a strong independent risk factor for mortality. Hypophosphatemia was not associated with mortality (p>0.05). CONCLUSION Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

Silt grain-size analysis of ODP holes from the western equatorial Atlantic

Grain-size records of the terrigenous and calcareous silt fraction, preservation of planktic foraminifera, and benthic foraminiferal stable-isotope data (delta13C, delta18O values of C. wuellerstorfi) at ODP Site 927 on the Ceará Rise (5°27.7'N, 44°28.8'W), are used to reconstruct variations in the history of bottom current strength, ventilation, and carbonate corrosiveness of deep waters during the time interval from 0.8 to 0.3 Ma. Glacial periods are characterized by generally smaller mean sizes of the terrigenous sortable silt fraction (mean(SS)), lower delta13C values, and poorer preservation of planktic foraminifera compared to interglacials. This indicates lower bottom current speeds, larger nutrient contents and more corrosive deep water. By contrast, larger mean(SS) sizes, higher delta13C values, and well preserved planktic foraminifera indicate strong circulation and a well ventilated deep-water mass during interglacials. The observed changes are most likely related to the weakening and strengthening of circulation of Lower North Atlantic Deep Water (LNADW). Cross-spectral analysis between the mean(SS) and benthic delta18O records reveals that minima in mean(SS) occur about 7.6 k.y. after the maximum in ice volume. This indicates a considerable lag time between ice-shield induced changes in LNADW production and subsequent changes in the velocity of LNADW flow in the western equatorial Atlantic. Striking changes in bottom current speed occur regularly during glacial to interglacial transitions. Extremely fine mean(SS) minima point to an almost complete shutdown of bottom current vigor in response to a cessation of LNADW production caused by an enhanced melt water release during the initial phases of deglaciation. However, each of the fine minima extremes is followed by a rapid shift to very high mean(SS) values that indicate strong bottom currents, and hence, vigorous LNADW flow during the early interglacials. After the onset of glacial Stage 12, generally poorer carbonate preservation and higher variability is registered. This coincides with a global decrease in carbonate preservation during the mid-Brunhes (mid-Brunhes dissolution event). Detailed grain-size analysis of the calcareous fine fraction (<63 µm) revealed a considerable reduction of particles in the fraction from 7 to 63 µm during periods of enhanced dissolution. This indicates a preferential dissolution of larger planktic foraminiferal fragments which leads to an enrichment of coccoliths in the calcareous fine fraction.

Subjective QoE Analysis of HTTP Adaptive Streaming Applications

Actualmente la optimization de la calidad de experiencia (Quality of Experience- QoE) de HTTP Adaptive Streaming (HAS) de video recibe una atención creciente. Este incremento de interés proviene fundamentalmente de las carencias de las soluciones actuales HAS, que, al no ser QoE-driven, no incluyen la percepción de la calidad de los usuarios finales como una parte integral de la lógica de adaptación. Por lo tanto, la obtención de información de referencia fiable en QoE en HAS presenta retos importantes, ya que las metodologías de evaluación subjetiva de la calidad de vídeo propuestas en las normas actuales no son adecuadas para tratar con la variación temporal de la calidad que es consustancial de HAS. Esta tesis investiga la influencia de la adaptación dinámica en la calidad de la transmisión de vídeo considerando métodos de evaluación subjetiva. Tras un estudio exhaustivo del estado del arte en la evaluación subjetiva de QoE en HAS, se han resaltado los retos asociados y las líneas de investigación abiertas. Como resultado, se han seleccionado dos líneas principales de investigación: el análisis del impacto en la QoE de los parámetros de las técnicas de adaptación y la investigación de las metodologías de prueba subjetiva adecuada para evaluación de QoE en HAS. Se han llevado a cabo un conjunto de experimentos de laboratorio para investigar las cuestiones planteadas mediante la utilización de diferentes metodologáas para pruebas subjetivas. El análisis estadístico muestra que no son robustas todas las suposiciones y reivindicaciones de las referencias analizadas, en particular en lo que respecta al impacto en la QoE de la frecuencia de las variaciones de calidad, de las adaptaciones suaves o abruptas y de las oscilaciones de calidad. Por otra parte, nuestros resultados confirman la influencia de otros parámetros, como la longitud de los segmentos de vídeo y la amplitud de las oscilaciones de calidad. Los resultados también muestran que tomar en consideración las características objetivas de los contenidos puede ser beneficioso para la mejora de la QoE en HAS. Además, todos los resultados han sido validados mediante extensos análisis experimentales que han incluido estudio tanto en otros laboratorios como en crowdsourcing Por último, sobre los aspectos metodológicos de las pruebas subjetivas de QoE, se ha realizado la comparación entre los resultados experimentales obtenidos a partir de un método estandarizado basado en estímulos cortos (ACR) y un método semi continuo (desarrollado para la evaluación de secuencias prolongadas de vídeo). A pesar de algunas diferencias, el resultado de los análisis estadísticos no muestra ningún efecto significativo de la metodología de prueba. Asimismo, aunque se percibe la influencia de la presencia de audio en la evaluación de degradaciones del vídeo, no se han encontrado efectos estadísticamente significativos de dicha presencia. A partir de la ausencia de influencia del método de prueba y de la presencia de audio, se ha realizado un análisis adicional sobre el impacto de realizar comparaciones estadísticas múltiples en niveles estadísticos de importancia que aumentan la probabilidad de los errores de tipo-I (falsos positivos). Nuestros resultados muestran que, para obtener un efectos sólido en el análisis estadístico de los resultados subjetivos, es necesario aumentar el número de sujetos de las pruebas claramente por encima de los tamaños de muestras propuestos por las normas y recomendaciones actuales. ABSTRACT Optimizing the Quality of Experience (QoE) of HTTP adaptive video streaming (HAS) is receiving increasing attention nowadays. The growth of interest is mainly caused by the fact that current HAS solutions are not QoE-driven, i.e. end-user quality perception is not integral part of the adaptation logic. However, obtaining the necessary reliable ground truths on HAS QoE faces substantial challenges, since the subjective video quality assessment methodologies as proposed by current standards are not well-suited for dealing with the time-varying quality properties that are characteristic for HAS. This thesis investigates the influence of dynamic quality adaptation on the QoE of streaming video by means of subjective evaluation approaches. Based on a comprehensive survey of related work on subjective HAS QoE assessment, the related challenges and open research questions are highlighted and discussed. As a result, two main research directions are selected for further investigation: analysis of the QoE impact of different technical adaptation parameters, and investigation of testing methodologies suitable for HAS QoE evaluation. In order to investigate related research issues and questions, a set of laboratory experiments have been conducted using different subjective testing methodologies. Our statistical analysis demonstrates that not all assumptions and claims reported in the literature are robust, particularly as regards the QoE impact of switching frequency, smooth vs. abrupt switching, and quality oscillation. On the other hand, our results confirm the influence of some other parameters such as chunk length and switching amplitude on perceived quality. We also show that taking the objective characteristics of the content into account can be beneficial to improve the adaptation viewing experience. In addition, all aforementioned findings are validated by means of an extensive cross-experimental analysis that involves external laboratory and crowdsourcing studies. Finally, to address the methodological aspects of subjective QoE testing, a comparison between the experimental results obtained from a (short stimuli-based) ACR standardized method and a semi-continuous method (developed for assessment of long video sequences) has been performed. In spite of observation of some differences, the result of statistical analysis does not show any significant effect of testing methodology. Similarly, although the influence of audio presence on evaluation of video-related degradations is perceived, no statistically significant effect of audio presence could be found. Motivating by this finding (no effect of testing method and audio presence), a subsequent analysis has been performed investigating the impact of performing multiple statistical comparisons on statistical levels of significance which increase the likelihood of Type-I errors (false positives). Our results show that in order to obtain a strong effect from the statistical analysis of the subjective results, it is necessary to increase the number of test subjects well beyond the sample sizes proposed by current quality assessment standards and recommendations.

USING GPS DATA TO EXPLORE DEMOGRAPHIC PREDICTORS OF LIFE-SPACE: A POOLED ANALYSIS

Thesis (Master's)--University of Washington, 2016-06

Assessing the performance of a nucleus estate and smallholder scheme for oil palm production in West Sumatra: a stochastic frontier analysis

In this paper, we study the performance of smallholders in a nucleus estate and smallholder (NES) scheme in oil palm production schemein West Sumatra by measuring their technical efficiency using a stochastic frontier production function. Our results indicate a mean technical efficiency of 66%, which is below what we would have expected given the uniformity of the climate, soils and plantation construction among the sample farmers. The use of progressive farmers as a means of disseminating extension advice does not appear to have been successful, and more rigorous farmer selection procedures need to be put in place for similar schemes and for general agricultural extension in future. No clear relationship was established between technical efficiency and the use of female labour, suggesting there is no need to target extension services specifically at female labourers in the household. Finally, education was found to have an unexpectedly negative impact on technical efficiency, indicating that farmers with primary education may be more important than those with secondary and tertiary education as targets of development schemes and extension programs entailing non-formal education. (C) 2003 Elsevier Ltd. All rights reserved.

Relationships of Efficiency to Reproductive Disorders in Danish Milk Production: A Stochastic Frontier Analysis

Relationships of various reproductive disorders and milk production performance of Danish dairy farms were investigated. A stochastic frontier production function was estimated using data collected in 1998 from 514 Danish dairy farms. Measures of farm-level milk production efficiency relative to this production frontier were obtained, and relationships between milk production efficiency and the incidence risk of reproductive disorders were examined. There were moderate positive relationships between milk production efficiency and retained placenta, induction of estrus, uterine infections, ovarian cysts, and induction of birth. Inclusion of reproductive management variables showed that these moderate relationships disappeared, but directions of coefficients for almost all those variables remained the same. Dystocia showed a weak negative correlation with milk production efficiency. Farms that were mainly managed by young farmers had the highest average efficiency scores. The estimated milk losses due to inefficiency averaged 1142, 488, and 256 kg of energy-corrected milk per cow, respectively, for low-, medium-, and high-efficiency herds. It is concluded that the availability of younger cows, which enabled farmers to replace cows with reproductive disorders, contributed to high cow productivity in efficient farms. Thus, a high replacement rate more than compensates for the possible negative effect of reproductive disorders. The use of frontier production and efficiency/ inefficiency functions to analyze herd data may enable dairy advisors to identify inefficient herds and to simulate the effect of alternative management procedures on the individual herd's efficiency.

Efficiency analysis of Islamic banks:a case of Gulf Cooperation Council (GCC)

Although considerable effort has been invested in the measurement of banking efficiency using Data Envelopment Analysis, hardly any empirical research has focused on comparison of banks in Gulf States Countries This paper employs data on Gulf States banking sector for the period 2000-2002 to develop efficiency scores and rankings for both Islamic and conventional banks. We then investigate the productivity change using Malmquist Index and decompose the productivity into technical change and efficiency change. Further, hypothesis testing and statistical precision in the context of nonparametric efficiency and productivity measurement have been used. Specially, cross-country analysis of efficiency and comparisons of efficiencies between Islamic banks and conventional banks have been investigated using Mann-Whitney test.

A qualitative analysis of the congruency of Jungian psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development role of instructor/facilitator

The purpose of this ethnographic study was to describe and explain the congruency of psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development (HRD) role of instructor/facilitator. This investigation was conducted with 23 HRD professionals who worked in the Miami, Florida area as instructors/facilitators with adult learners in job-related contexts.^ The study was conducted using qualitative strategies of data collection and analysis. The research participants were selected through a purposive sampling strategy. Data collection strategies included: (a) administration and scoring of the MBTI, Form G, (b) open-ended and semi-structured interviews, (c) participant observations of the research subjects at their respective work sites and while conducting training sessions, (d) field notes, and (e) contact summary sheets to record field research encounters. Data analysis was conducted with the use of a computer program for qualitative analysis called FolioViews 3.1 for Windows. This included: (a) coding of transcribed interviews and field notes, (b) theme analysis, (c) memoing, and (d) cross-case analysis.^ The three major themes that emerged in relation to the congruency of psychological preferences and the role of instructor/facilitator were: (1) designing and preparing instruction/facilitation, (2) conducting training and managing group process, and (3) interpersonal relations and perspectives among instructors/facilitators.^ The first two themes were analyzed through the combination of the four Jungian personality functions. These combinations are: sensing-thinking (ST), sensing-feeling (SF), intuition-thinking (NT), and intuition-feeling (NF). The third theme was analyzed through the combination of the attitudes or energy focus and the judgment function. These combinations are: extraversion-thinking (ET), extraversion-feeling (EF), introversion-thinking (IT), and introversion-feeling (IF).^ A last area uncovered by this ethnographic study was the influence exerted by a training and development culture on the instructor/facilitator role. This professional culture is described and explained in terms of the shared values and expectations reported by the study respondents. ^

What makes online grocers work? A case study analysis of factors contributing to online grocery store profitability

This research examined the factors contributing to the performance of online grocers prior to, and following, the 2000 dot.com collapse. The primary goals were to assess the relationship between a company’s business model(s) and its performance in the online grocery channel and to determine if there were other company and/or market related factors that could account for company performance. ^ To assess the primary goals, a case based theory building process was utilized. A three-way cross-case analysis comprising Peapod, GroceryWorks, and Tesco examined the common profit components, the structural category (e.g., pure-play, partnership, and hybrid) profit components, and the idiosyncratic profit components related to each specific company. ^ Based on the analysis, it was determined that online grocery store business models could be represented at three distinct, but hierarchically, related levels. The first level was termed the core model and represented the basic profit structure that all online grocers needed in order to conduct operations. The next model level was termed the structural model and represented the profit structure associated with the specific business model configuration (i.e., pure-play, partnership, hybrid). The last model level was termed the augmented model and represented the company’s business model when idiosyncratic profit components were included. In relation to the five company related factors, scalability, rate of expansion, and the automation level were potential candidates for helping to explain online grocer performance. In addition, all the market structure related factors were deemed possible candidates for helping to explain online grocer performance. ^ The study concluded by positing an alternative hypothesis concerning the performance of online grocers. Prior to this study, the prevailing wisdom was that the business models were the primary cause of online grocer performance. However, based on the core model analysis, it was hypothesized that the customer relationship activities (i.e., advertising, promotions, and loyalty program tie-ins) were the real drivers of online grocer performance. ^

Predicting success or failure of tax -base revenue sharing attempts: A comparative analysis

To promote regional or mutual improvement, numerous interjurisdictional efforts to share tax bases have been attempted. Most of these efforts fail to be consummated. Motivations to share revenues include: narrowing fiscal disparities, enhancing regional cooperation and economic development, rationalizing land-use, and minimizing revenue losses caused by competition to attract and keep businesses. Various researchers have developed theories to aid understanding of why interjurisdictional cooperation efforts succeed or fail. Walter Rosenbaum and Gladys Kammerer studied two contemporaneous Florida local-government consolidation attempts. Boyd Messinger subsequently tested their Theory of Successful Consolidation on nine consolidation attempts. Paul Peterson's dual theories on Modern Federalism posit that all governmental levels attempt to further economic development and that politicians act in ways that either further their futures or cement job security. Actions related to the latter theory often interfere with the former. Samuel Nunn and Mark Rosentraub sought to learn how interjurisdictional cooperation evolves. Through multiple case studies they developed a model framing interjurisdictional cooperation in four dimensions. ^ This dissertation investigates the ability of the above theories to help predict success or failure of regional tax-base revenue sharing attempts. A research plan was formed that used five sequenced steps to gather data, analyze it, and conclude if hypotheses concerning the application of these theories were valid. The primary analytical tools were: multiple case studies, cross-case analysis, and pattern matching. Data was gathered from historical records, questionnaires, and interviews. ^ The results of this research indicate that Rosenbaum-Kammerer theory can be a predictor of success or failure in implementing tax-base revenue sharing if it is amended as suggested by Messinger and further modified by a recommendation in this dissertation. Peterson's Functional and Legislative theories considered together were able to predict revenue sharing proposal outcomes. Many of the indicators of interjurisdictional cooperation forwarded in the Nunn-Rosentraub model appeared in the cases studied, but the model was not a reliable forecasting instrument. ^

Socioeconomic inequalities of cardiovascular risk factors among manufacturing employees in the Republic of Ireland: a cross-sectional study

Objectives: To explore socioeconomic differences in four cardiovascular disease risk factors (overweight/obesity, smoking, hypertension, height) among manufacturing employees in the Republic of Ireland (ROI). Methods: Cross-sectional analysis of 850 manufacturing employees aged 18–64 years. Education and job position served as socioeconomic indicators. Group-specific differences in prevalence were assessed with the Chi-squared test. Multivariate regression models were explored if education and job position were independent predictors of the CVD risk factors. Cochran–Armitage test for trend was used to assess the presence of a social gradient. Results: A social gradient was found across educational levels for smoking and height. Employees with the highest education were less likely to smoke compared to the least educated employees (OR 0.2, [95% CI 0.1–0.4]; p b 0.001). Lower educational attainment was associated with a reduction in mean height. Non-linear differences were found in both educational level and job position for obesity/overweight. Managers were more than twice as likely to be overweight or obese relative to those employees in the lowest job position (OR 2.4 [95% CI 1.3–4.6]; p = 0.008). Conclusion: Socioeconomic inequalities in height, smoking and overweight/obesity were highlighted within a sub-section of the working population in ROI.

What Makes Online Grocers Work? A Case Study Analysis of Factors Contributing to Online Grocery Store Profitability

This research examined the factors contributing to the performance of online grocers prior to, and following, the 2000 dot.com collapse. The primary goals were to assess the relationship between a company’s business model(s) and its performance in the online grocery channel and to determine if there were other company and/or market related factors that could account for company performance. To assess the primary goals, a case based theory building process was utilized. A three-way cross-case analysis comprising Peapod, GroceryWorks, and Tesco examined the common profit components, the structural category (e.g., pure-play, partnership, and hybrid) profit components, and the idiosyncratic profit components related to each specific company. Based on the analysis, it was determined that online grocery store business models could be represented at three distinct, but hierarchically, related levels. The first level was termed the core model and represented the basic profit structure that all online grocers needed in order to conduct operations. The next model level was termed the structural model and represented the profit structure associated with the specific business model configuration (i.e., pure-play, partnership, hybrid). The last model level was termed the augmented model and represented the company’s business model when idiosyncratic profit components were included. In relation to the five company related factors, scalability, rate of expansion, and the automation level were potential candidates for helping to explain online grocer performance. In addition, all the market structure related factors were deemed possible candidates for helping to explain online grocer performance. The study concluded by positing an alternative hypothesis concerning the performance of online grocers. Prior to this study, the prevailing wisdom was that the business models were the primary cause of online grocer performance. However, based on the core model analysis, it was hypothesized that the customer relationship activities (i.e., advertising, promotions, and loyalty program tie-ins) were the real drivers of online grocer performance.

Constructing Personal and Couple Narratives in Late Stage Cancer: A Narrative Analysis

An increasing number of people with terminal cancer are being cared for at home, often by their partner. This study explores the identity, experiences and relationships of people caring for their partner at the end of life and how they construct their experience through personal and couple narratives. It draws upon dialogical approaches to narrative analysis to focus on caring partners and the care relationship. Six participants were recruited for the study. Two methods of data collection are used: narrative interviews and journals. Following individual case analysis, two methods of cross-narrative analysis are used: an analysis of narrative themes and an identification of narrative types. The key findings can be summarised as follows. First, in the period since their partner's terminal prognosis, participants sustained and reconstructed self and couple relationship narratives. These narratives aided the construction of meaning and coherence at a time of major biographical disruption: the anticipated loss of a partner. Second, the study highlights the complexity of spoken and unspoken narratives in terminal cancer and how these relate to individual and couple identities. Third, a typology of archetypal narratives based upon the data is identified. The blow-by-blow narratives illustrate how participants sought to construct coherence and meaning in the illness story, while champion and resilience narratives demonstrate how participants utilised positive self and relational narratives to manage a time of biographical disruption. The study highlights how this narrative approach can enhance understanding of the experiences and identities of people caring for a terminally ill partner.

[evaluation Of Data On Live Birth Certificates From The Information System On Live Births (sinasc) In Campinas, São Paulo, 2009].

To assess the completeness and reliability of the Information System on Live Births (Sinasc) data. A cross-sectional analysis of the reliability and completeness of Sinasc's data was performed using a sample of Live Birth Certificate (LBC) from 2009, related to births from Campinas, Southeast Brazil. For data analysis, hospitals were grouped according to category of service (Unified National Health System, private or both), 600 LBCs were randomly selected and the data were collected in LBC-copies through mothers and newborns' hospital records and by telephone interviews. The completeness of LBCs was evaluated, calculating the percentage of blank fields, and the LBCs agreement comparing the originals with the copies was evaluated by Kappa and intraclass correlation coefficients. The percentage of completeness of LBCs ranged from 99.8%-100%. For the most items, the agreement was excellent. However, the agreement was acceptable for marital status, maternal education and newborn infants' race/color, low for prenatal visits and presence of birth defects, and very low for the number of deceased children. The results showed that the municipality Sinasc is reliable for most of the studied variables. Investments in training of the professionals are suggested in an attempt to improve system capacity to support planning and implementation of health activities for the benefit of maternal and child population.