In an emergency situation shelter space is crucial for people affected by natural hazards. Emergency planners in disaster relief and mass care can greatly benefit from a sound methodology that ...identifies suitable shelter areas and sites where shelter services need to be improved. A methodology to rank suitability of open spaces for contingency planning and placement of shelter in the immediate aftermath of a disaster is introduced. The Open Space Suitability Index uses the combination of two different measures: a qualitative evaluation criterion for the suitability and manageability of open spaces to be used as shelter sites and another quantitative criterion using a capacitated accessibility analysis based on network analysis. For the qualitative assessment implementation issues, environmental considerations and basic utility supply are the main categories to rank candidate shelter sites. A geographic information system is used to reveal spatial patterns of shelter demand. Advantages and limitations of this method are discussed on the basis of an earthquake hazard case study in the Kathmandu Metropolitan City. According to the results, out of 410 open spaces under investigation, 12.2% have to be considered not suitable (Category D and E) while 10.7% are Category A and 17.6% are Category B. Almost two-thirds (59.55%) are fairly suitable (Category C).
The CATDAT damaging earthquakes database Daniell, J. E.; Khazai, B.; Wenzel, F. ...
Natural hazards and earth system sciences,
01/2011, Letnik:
11, Številka:
8
Journal Article
Recenzirano
Odprti dostop
The global CATDAT damaging earthquakes and secondary effects (tsunami, fire, landslides, liquefaction and fault rupture) database was developed to validate, remove discrepancies, and expand greatly ...upon existing global databases; and to better understand the trends in vulnerability, exposure, and possible future impacts of such historic earthquakes. Lack of consistency and errors in other earthquake loss databases frequently cited and used in analyses was a major shortcoming in the view of the authors which needed to be improved upon. Over 17 000 sources of information have been utilised, primarily in the last few years, to present data from over 12 200 damaging earthquakes historically, with over 7000 earthquakes since 1900 examined and validated before insertion into the database. Each validated earthquake includes seismological information, building damage, ranges of social losses to account for varying sources (deaths, injuries, homeless, and affected), and economic losses (direct, indirect, aid, and insured). Globally, a slightly increasing trend in economic damage due to earthquakes is not consistent with the greatly increasing exposure. The 1923 Great Kanto ($214 billion USD damage; 2011 HNDECI-adjusted dollars) compared to the 2011 Tohoku (>$300 billion USD at time of writing), 2008 Sichuan and 1995 Kobe earthquakes show the increasing concern for economic loss in urban areas as the trend should be expected to increase. Many economic and social loss values not reported in existing databases have been collected. Historical GDP (Gross Domestic Product), exchange rate, wage information, population, HDI (Human Development Index), and insurance information have been collected globally to form comparisons. This catalogue is the largest known cross-checked global historic damaging earthquake database and should have far-reaching consequences for earthquake loss estimation, socio-economic analysis, and the global reinsurance field.
In hospitalized patients, both hyperglycemia and hypoglycemia have been associated with poor outcomes. During the inpatient period, hyperglycemia has been associated with increased risk of infection, ...cardiovascular events, and mortality. It is also associated with longer length of hospital stay. Hypoglycemia has also been associated with an increased risk of mortality. Therefore, current evidence supports avoidance of both conditions among hospitalized patients whether they are admitted to critical care units or noncritical care units.
At the end of October 2012, Hurricane Sandy moved from the Caribbean Sea into the Atlantic Ocean and entered the United States not far from New York. Along its track, Sandy caused more than 200 ...fatalities and severe losses in Jamaica, The Bahamas, Haiti, Cuba, and the US. This paper demonstrates the capability and potential for near-real-time analysis of catastrophes. It is shown that the impact of Sandy was driven by the superposition of different extremes (high wind speeds, storm surge, heavy precipitation) and by cascading effects. In particular the interaction between Sandy and an extra-tropical weather system created a huge storm that affected large areas in the US. It is examined how Sandy compares to historic hurricane events, both from a hydro-meteorological and impact perspective. The distribution of losses to different sectors of the economy is calculated with simple input-output models as well as government estimates. Direct economic losses are estimated about USD 4.2 billion in the Caribbean and between USD 78 and 97 billion in the US. Indirect economic losses from power outages is estimated in the order of USD 16.3 billion. Modelling sector-specific dependencies quantifies total business interruption losses between USD 10.8 and 15.5 billion. Thus, seven years after the record impact of Hurricane Katrina in 2005, Hurricane Sandy is the second costliest hurricane in the history of the United States.
Diabetes and fractures: an overshadowed association Khazai, Natasha B; Beck, Jr, George R; Umpierrez, Guillermo E
Current opinion in endocrinology, diabetes and obesity./Current opinion in endocrinology, diabetes and obesity
16, Številka:
6
Journal Article
Recenzirano
Odprti dostop
To review recent literature on fracture risk in patients with type 1 and type 2 diabetes.
Observational and population studies have reported a higher risk of fractures in patients with type 1 and ...type 2 diabetes, especially at the hip. Type 2 diabetic patients have a higher bone mineral density compared with the general population, and yet, remain unprotected from fractures. Type 1 diabetic patients have a greater risk of fractures and a lower bone mineral density compared with the general population. Their lower bone mineral density, however, does not fully account for the raised fracture risk. Therefore, impaired bone quality rather than lower bone density appears to mediate the increased fracture risk in patients with type 1 and 2 diabetes.Recently, studies have shown an association between advanced glycation end products with increased fracture risk in diabetic patients. These studies support the hypothesis of poor glycemic control and chronic hyperglycemia having a direct detrimental effect on bone quality. In addition, increased fracture risk has been reported in patients with peripheral and autonomic neuropathy, recurrent hypoglycemic events, vitamin D deficiency, and those receiving thiazolidinedione therapy.
Diabetes is associated with an increased risk of fractures in patients with type 1 and type 2 diabetes. Appropriate measures aimed at fracture prevention should be considered in the complex care of the diabetic patient.
Background: The optimal treatment for correcting or preventing vitamin D insufficiency in cystic fibrosis (CF) patients has not been established.
Objective: The aim of the study was to assess the ...relative efficacy of three modes of vitamin D therapy: cholecalciferol (D3), ergocalciferol (D2), and UV light in raising or maintaining 25(OH)D levels above 30 ng/ml.
Design: Thirty adult CF subjects with vitamin D insufficiency were randomized into one of three treatment arms: D3, D2, or UV light. Subjects randomized to D3 or D2 ingested 50,000 IU of vitamin D weekly, and those randomized to UV exposed their skin to UV light from a lamp five times a week. Serum was collected for 25(OH)D and PTH at baseline and at 12 wk.
Results: Treatment with D3 and D2 raised 25(OH)D levels significantly, from a mean of 21.2 ± 10.18 to 47.1 ± 20.5 ng/ml (P < 0.001) and 24.4 ± 10.3 to 32.7± 9.7 ng/ml (P = 0.01), with 100% and 60% reaching 25(OH)D levels above 30 ng/ml, respectively. Treatment with UV did not raise 25(OH)D levels significantly; however, only 55% of subjects were adherent with UV therapy.
Conclusion: This study demonstrates that CF subjects are able to achieve or maintain optimal vitamin D status (>30 ng/ml) with two oral regimens of either D3 or D2 treatment, the former being more efficacious. A confounding variable for this observation is the fact that the D3 and D2 capsules contained different carriers, powder-based vs. oil-based, respectively. UV therapy did not alter vitamin D status, possibly due to poor adherence to UV therapy.
Adult cystic fibrosis patients can be given an oral regimen of vitamin D to improve vitamin D status during the winter months.
Over 10,000 landslides were triggered by the September 21, 1999, Chi-Chi Earthquake. A large number of these landslides have been mapped from SPOT images and a smaller number were described in a ...detailed field investigation. Geographic information systems (GIS) was used to conduct a spatial characterization of the slope failures, including distribution of type, size, slope angle, bedrock geology, ground motion, and distance from earthquake source. The most abundant landslides were shallow, disaggregated rock and soil slides. Landslides occurred primarily in Tertiary sedimentary rocks, which are well known for their susceptibility to landsliding in many parts of the world. Landslide concentration values diminish beyond epicentral distances of 40 and 70 km from the epicenter and the surface projection of the fault plane, respectively. Ground motion was found to be the most significant factor in triggering the shallow landslides in the Chi-Chi earthquake. Overall, 74% of all slope failures occurred in regions with vertical ground motions greater than 0.2
g and 81% of all slope failures occurred in the region with mean horizontal peak ground accelerations (PGA) greater than 0.15
g. These factors were used to compare landslides generated by the Chi-Chi earthquake to the landslides triggered by the 1989 Loma Prieta earthquake and the 1994 Northridge earthquake. The major difference in distribution of landslides between the Chi-Chi earthquake and the two California earthquakes was the distribution of slope angles. In the Chi-Chi earthquake, 90% of the failures occurred on slopes steeper than 45°, while more than 80% of failures occurred on slopes less than 50° in California, apparently reflecting much steeper and tectonically more active geologic setting in Taiwan.
Thiazolidinedione (TZD) therapy has been associated with an increased risk of bone fractures. Studies in rodents have led to a model in which decreased bone quality in response to TZDs is due to a ...competition of lineage commitment between osteoblasts (OBs) and adipocytes (ADs) for a common precursor cell, resulting in decreased OB numbers. Our goal was to investigate the effects of TZD exposure on OB-AD lineage determination from primary human bone marrow stromal cells (hBMSCs) both in vitro and in vivo from nondiabetic subjects and patients with type 2 diabetics. Our experimental design included 2 phases. Phase 1 was an in vitro study of TZD effects on the differentiation of hBMSCs into OBs and ADs in nondiabetic subjects. Phase 2 was a randomized, placebo-controlled trial to determine the effects of 6-month pioglitazone treatment in vivo on hBMSC differentiation using AD/OB colony forming unit assays in patients with type 2 diabetes. In vitro, TZDs (pioglitazone and rosiglitazone) enhanced the adipogenesis of hBMSCs, whereas neither altered OB differentiation or function as measured by alkaline phosphatase activity, gene expression, and mineralization. The ability of TZDs to enhance adipogenesis occurred at a specific time/stage of the differentiation process, and pretreating with TZDs did not further enhance adipogenesis. In vivo, 6-month TZD treatment decreased OB precursors, increased AD precursors, and increased total colony number in patients with type 2 diabetes. Our results indicate that TZD exposure in vitro potently stimulates adipogenesis but does not directly alter OB differentiation/mineralization or lineage commitment from hBMSCs. However, TZD treatment in type 2 diabetic patients results in decreased osteoblastogenesis from hBMSCs compared with placebo, indicating an indirect negative effect on OBs and suggesting an alternative model by which TZDs might negatively regulate bone quality.
Although the neuroanatomy of transgender persons is slowly being charted, findings are presently discrepant. Moreover, the major body of work has focused on Western populations. One important factor ...is the issue of power and low signal‐to‐noise (SNR) ratio in neuroimaging studies of rare study populations including endocrine or neurological patient groups. The present study focused on the structural neuroanatomy of a Non‐Western (Iranian) sample of 40 transgender men (TM), 40 transgender women (TW), 30 cisgender men (CM), and 30 cisgender women (CW), while assessing whether the reliability of findings across structural anatomical measures including gray matter volume (GMV), cortical surface area (CSA), and cortical thickness (CTh) could be increased by using two back‐to‐back within‐session structural MRI scans. Overall, findings in transgender persons were more consistent with sex assigned at birth in GMV and CSA, while no group differences emerged for CTh. Repeated measures analysis also indicated that having a second scan increased SNR in all regions of interest, most notably bilateral frontal poles, pre‐ and postcentral gyri and putamina. The results suggest that a simple time and cost‐effective measure to improve SNR in rare clinical populations with low prevalence rates is a second anatomical scan when structural MRI is of interest.
This study assesses the reproducibility of previous neuroanatomical findings in Western transgender persons in a Non‐Western population. It then shows that repeating an anatomical MRI sequence can increase data reliability especially in brain regions that have previously been implicated to differ between transgender and cisgender persons. This scan–rescan method might enhance the power of studies with small samples due to low prevalence of target population.
Following disasters, governments often clamor to quickly reduce risk, rebuild communities and restore permanence. The pressure to urgently address complex, difficult decisions can result in reactive ...policies that may increase long-term vulnerability of affected populations. Sri Lanka in the aftermath of the 26 December 2004 tsunami represents such an example: a hastily designed coastal buffer zone policy has incited massive relocation of affected populations and resulted in social, economic and environmental problems that threaten the well-being of poor coastal communities. We review the impacts of this policy from its inception, days after the tsunami hit the island, until its revision, approximately 10 months following the disaster. We then apply a framework to conceptualize the components of vulnerability within Sri Lanka's coastal, human–environment system and to identify where post-disaster policies should focus to reduce vulnerability of coastal populations more effectively. From this analysis, it is apparent that the buffer zone policy gave disproportionate attention to reducing exposure to future tsunamis and, subsequently, did not address the critical social, economic and institutional factors that influenced sensitivity to the hazard. Post-disaster policies aimed at sustainable re-development should be informed by an analysis of the components of vulnerability that comprise a system and how these can be most effectively influenced during the separate short-term and long-term phases of rebuilding.
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