2-step Approach Research Articles

Optimizing Use of Nonalcoholic Fatty Liver Disease Fibrosis Score, Fibrosis-4 Score, and Liver Stiffness Measurement to Identify Patients With Advanced Fibrosis

Measuring liver stiffness only in patients with indeterminate or high nonalcoholic fatty liver disease (NAFLD) fibrosis scores (called a 2-step approach) was reported to reduce indeterminate or discordant results while maintaining the accuracy to identify patients with advanced fibrosis. We aimed to validate this approach using data collected from the Gut and Obesity in Asia Workgroup. We performed a retrospective analysis of data from 759 patients with biopsy-proven NAFLD (24% with advanced fibrosis), seen at 10 centers in 9 countries in Asia, from 2006 through 2018. By using liver biopsies as the reference standard, we calculated percentages of misclassifications and indeterminate or discordant results from assessments made based on fibrosis scores (NAFLD fibrosis score [NFS] or Fibrosis-4 score) and liver stiffness measurements (LSMs), alone or in combination. The analysis was repeated using randomly selected subgroups with a different prevalence of advanced fibrosis (histologic fibrosis stage≥F3). In groups in which 3.7% and 10% of patients had advanced fibrosis, a 2-step approach (using the NFS followed by LSM only for patients with indeterminate or high NFS) and using a gray zone of 10 to 15 kPa for LSM, produced indeterminate or discordant results for 6.9% of patients and misclassified 2.7% of patients; only 25.6% of patients required LSM. In the group in which 10% of patients had advanced fibrosis, the same approach produced indeterminate or discordant results for 7.9% of patients and misclassified 6.6% of patients; only 27.4% of patients required LSM. In groups in which 24% and 50% of patients had advanced fibrosis, using LSM ≥10 kPa alone for the diagnosis of advanced fibrosis had the highest accuracy and misclassified 18.1% and 18.3% of patients, respectively. These results were similar when the Fibrosis-4 score was used in place of NFS. In a retrospective analysis, we found that a 2-step approach using fibrosis scores followed by LSM most accurately detects advanced fibrosis in populations with a low prevalence of advanced fibrosis. However, LSM ≥10 kPa identifies patients with advanced fibrosis with the highest level of accuracy in populations with a high prevalence of advanced fibrosis.

Fragmentation as a novel measure of stability in normalized trajectories of mood and attention measured by ecological momentary assessment.

Electronic diary data, such as that acquired through Ecological Momentary Assessments (EMA), has historically provided novel insights into diverse psychological processes. Analyses of these data typically focus on modeling participant-specific means, variability, and stability. We propose a novel statistical framework to determine participant stability by quantifying fragmentation of standardized trajectories using the following 2-step approach: (1) participant-level EMA scores are normalized, and (2) normalized scores are dichotomized into 2 states, inside and outside a range of 1 standard deviation. Within-participant fragmentation measures were calculated from dichotomized scores and modeled with various covariates. We used this method to study patterns of emotional states and showed that the proposed fragmentation measures differentiate mood disorder subtypes, including Bipolar I (BPI), Bipolar II, and major depressive disorder (MDD) compared with unaffected controls. Fragmentation measures were regressed on the mood disorder subtype, adjusting for age, sex, body mass index, and mean squared successive difference. The analyses revealed decreased stability (more fragmentation) among those with BPI when inside the participant-specific standard range of attention (β = 0.09, p = .004) and decreased stability among those with MDD inside the standard range of mood (β = 0.04, p = .039) and attention (β = 0.05, p = .017). This work provides an illustration of the clinical significance of EMA in characterizing the stability of mood, attention, or other psychological states that may underlie psychological disorders and phenomena. The application of fragmentation provides a novel statistical approach that can characterize within-participant stability beyond currently available traditional approaches. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Finding the Optimal Imputation Strategy for Small Cattle Populations.

The imputation from lower density SNP chip genotypes to whole-genome sequence level is an established approach to generate high density genotypes for many individuals. Imputation accuracy is dependent on many factors and for small cattle populations such as the endangered German Black Pied cattle (DSN), determining the optimal imputation strategy is especially challenging since only a low number of high density genotypes is available. In this paper, the accuracy of imputation was explored with regard to (1) phasing of the target population and the reference panel for imputation, (2) comparison of a 1-step imputation approach, where 50 k genotypes are directly imputed to sequence level, to a 2-step imputation approach that used an intermediate step imputing first to 700 k and subsequently to sequence level, (3) the software tools Beagle and Minimac, and (4) the size and composition of the reference panel for imputation. Analyses were performed for 30 DSN and 30 Holstein Frisian cattle available from the 1000 Bull Genomes Project. Imputation accuracy was assessed using a leave-one-out cross validation procedure. We observed that phasing of the target populations and the reference panels affects the imputation accuracy significantly. Minimac reached higher accuracy when imputing using small reference panels, while Beagle performed better with larger reference panels. In contrast to previous research, we found that when a low number of animals is available at the intermediate imputation step, the 1-step imputation approach yielded higher imputation accuracy compared to a 2-step imputation. Overall, the size of the reference panel for imputation is the most important factor leading to higher imputation accuracy, although using a larger reference panel consisting of a related but different breed (Holstein Frisian) significantly reduced imputation accuracy. Our findings provide specific recommendations for populations with a limited number of high density genotyped or sequenced animals available such as DSN. The overall recommendation when imputing a small population are to (1) use a large reference panel of the same breed, (2) use a large reference panel consisting of diverse breeds, or (3) when a large reference panel is not available, we recommend using a smaller same breed reference panel without including a different related breed.

Multivariate approach for identifying environmental indicator species in estuarine systems

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 611:19-29 (2019) - DOI: https://doi.org/10.3354/meps12864 Multivariate approach for identifying environmental indicator species in estuarine systems Wen Y. Lee1, Nathan L. Kuhn2,* 1Ecosystem Resources Program, Coastal Fisheries Division, Texas Parks and Wildlife Department, Austin, TX 78744, USA 2Research and Technical Program, Wildlife Division, Texas Parks and Wildlife Department, Austin, TX 78744, USA *Corresponding author: nathan.kuhn@tpwd.texas.gov ABSTRACT: Over time, several indices have been developed for assessing estuarine environmental conditions. In many cases, these indicators were chosen at least partly based on human value judgements that may or may not be justified or defensible. We present a new, 2-step multivariate approach that impartially identifies a suite of ecological indicators and then determines their relationship to environmental conditions in San Antonio Bay, Texas. A total of 12 fisheries indicator species were identified by the PRIMER BEST analysis procedure, including Leiostomus xanthurus, Bairdiella chrysoura, Pogonias cromis, Portunus gibbesii, Callinectes similis, Ictalurus furcatus, Harengula jaguana, Polydactylus octonemus, Lolliguncula brevis, Macrobrachium ohione, Opisthonema oglinum, and Libinia dubia. This suite of indicators showed the highest rank correlation with variation in the environmental variables measured. Subsequent redundancy analysis of the relationship between these indicators and environmental variables revealed salinity as the most influential variable shaping the indicator assemblage, with turbidity the second most influential. When freshwater inflow increased or salinity was low, I. furcatus, M. ohione, and O. oglinum were at their highest relative numbers in the assemblage; conversely, when salinity was high, L. brevis, L. dubia, and C. similis were at their highest relative abundances. Additionally, the euryhaline species L. xanthurus and B. chrysoura were negatively related to water turbidity. The 2-step analysis presented provides a statistically robust way to impartially identify biological indicators most responsive to the environmental variables of interest, and thus provides managers with a robust method for monitoring the effects of their management actions. KEY WORDS: Indicator assemblages · Estuarine condition · Salinity · Turbidity · Multivariate analysis · Texas Full text in pdf format PreviousNextCite this article as: Lee WY, Kuhn NL (2019) Multivariate approach for identifying environmental indicator species in estuarine systems. Mar Ecol Prog Ser 611:19-29. https://doi.org/10.3354/meps12864 Export citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 611. Online publication date: February 14, 2019 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2019 Inter-Research.

Effect of empirical correction of sea-surface temperature biases on the CRCM5-simulated climate and projected climate changes over North America

Dynamical downscaling (DD) consists in using archives of Coupled Global Climate Models (CGCM) simulations as the atmospheric and sea-surface boundary conditions (BC) to drive nested, Regional Climate Model (RCM) simulations. Biases in the CGCM-generated driving BC, however, can have detrimental impacts on RCM performance. It is well documented for the historical period that CGCM-simulated sea-surface temperatures (SST) suffer substantial biases, especially important near coastal regions. Assuming that these SST biases are time-invariant, they could in principle be subtracted from century-long CGCM projections before being used to drive RCMs. This paper investigates the performance of a 3-step DD approach as follows. The CGCM-simulated sea-surface temperatures (SST) are first empirically corrected by subtracting their systematic biases; the corrected SST are then used as ocean surface BC for an atmosphere-only GCM (AGCM) simulation; finally this AGCM simulation provides the atmospheric lateral BC to drive an RCM simulation. This is what we refer to as the 3-step approach CGCM–AGCM–RCM of DD, which can be compared to the traditional 2-step approach CGCM–RCM consisting of driving an RCM simulation directly by CGCM-generated BC. In this paper we compare the results obtained with the two approaches, for present and future climates under RCP8.5, using the fifth-generation Canadian Regional Climate Model (CRCM5) with a grid mesh of 0.22° over the North American CORDEX domain, driven by two CMIP5 models: the Canadian Earth System Model of the Canadian Centre for Climate modelling and analysis (CanESM2) and the Earth System Model of the Max-Planck-Institut für Meteorologie (MPI-ESM-MR). The results show that, in current climate, the seasonal-mean 2-m temperature fields simulated with the 3-step DD have generally smaller biases with respect to the observations than those simulated with the 2-step DD; in fact the performance of the 3-step DD simulations often approaches that of the reanalyses-driven simulation. For the seasonal-mean precipitation field, however, the differences between the two DD methods are not conclusive. Differences between the projected climate changes with the two DD methods vary substantially depending upon the variable being considered. Differences are particularly important for temperature: over the bulk of the North American continent, the 3-step DD projects more warming in winter and less in summer. This result highlights the nonlinearities of the climate system, and constitutes an additional measure of uncertainty with DD.

Extracting Word Synonyms from Text using Neural Approaches

Extracting synonyms from textual corpora using computational techniques is an interesting research problem in the Natural Language Processing (NLP) domain. Neural techniques (such as Word2Vec) have been recently utilized to produce distributional word representations (also known as word embeddings) that capture semantic similarity/relatedness between words based on linear context. Nevertheless, using these techniques for synonyms extraction poses many challenges due to the fact that similarity between vector word representations does not indicate only synonymy between words, but also other sense relations as well as word association or relatedness. In this paper, we tackle this problem using a novel 2-step approach. We first build distributional word embeddings using Word2Vec then use the induced word embeddings as an input to train a feed-forward neutral network using annotated dataset to distinguish between synonyms and other semantically related words

K-Means Clustering of Self-Organizing Maps: An Empirical Study on the Information Content of Self-Classification of Hedge Fund Managers

With the implementation of the 2-step approach according to Vesanto & Alhoniemi (2000), this article extends the procedure of visual evaluation of the Kohonen Maps usually chosen in the hedge fund literature for classification with Self-Organizing Maps. It introduces an automated procedure which guarantees a consistent combination of adjacent output units and thus an objective classification. The practical application of this method results in a reduction of the strategy groups specified by the database. This is also accompanied by a significant reduction in the Davies Bouldin Index (DBI) of the SOM partitions. Since a small dispersion within the clusters and large distances between the clusters lead to small DBIs, a minimization of this measure is desired. This significantly better partitioning of SOMs in comparison to the classification of hedge funds into the categorization scheme specified by the database provider can be observed in all examined data samples (robustness analyses). Ultimately, none of the original 23 strategy groups can be empirically validated. Furthermore, no stable classification can be found. Both the number of empirically determined categories (SOM clusters) and the composition of these clusters differ significantly in the subsamples examined. Thus the results essentially confirm the results and conclusions in the literature, according to which the original, self-classified strategy labels of the database providers are misleading and therefore do not contain any information content.

Do macroprudential policy instruments reduce the procyclical impact of capital ratio on bank lending? Cross-country evidence

ABSTRACTIn this paper, we ask about the capacity of macroprudential policies to reduce the procyclical impact of capital ratio on bank lending. We focus on aggregated macroprudential policy measures and on individual instruments and test whether their effect on the association between lending and capital depends on bank size. Applying the GMM 2-step Blundell and Bond approach to a sample covering over 60 countries, we find that macroprudential policy instruments reduce the procyclical impact of capital on bank lending during both crisis and non-crisis times. This result is stronger in large banks than in other banks. Of individual macroprudential instruments, only borrower-targeted LTV caps and DTI ratio weaken the association between lending and capital and thus act countecyclically. Generally, with our study we are able to support the view that macroprudential policy has the potential to curb the procyclical impact of bank capital on lending and therefore, the introduction of more restrictive international capital standards included in Basel III and of macroprudential policies are fully justified.

Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13\xa0years of ivermectin

BackgroundA high epilepsy prevalence has been reported in several onchocerciasis-endemic villages along the Mbam and Sanaga river valleys in Cameroon, including Bilomo and Kelleng. We sought to determine the prevalence of epilepsy in these two villages following more than 13 years of community-directed treatment with ivermectin (CDTI).MethodsDoor-to-door surveys were performed on the entire resident population in the villages in August 2017 and January 2018. Epilepsy was diagnosed using a 2-step approach: administration of a standardized 5-item questionnaire followed by confirmation by a neurologist. Previously published diagnostic criteria for onchocerciasis-associated epilepsy (OAE) were used. Ov16 serology was done for children aged 7–10 years to assess onchocerciasis transmission. Findings were compared with previous data from these two villages.ResultsA total of 1525 individuals (1321 in Bilomo and 204 in Kelleng) in 233 households were surveyed in both villages. The crude prevalence of epilepsy was 4.6% in Bilomo (2017) and 7.8% in Kelleng (2018), including 12 (15.6% of cases) persons with epilepsy (PWE) with nodding seizures. The age and sex-standardized prevalence in Kelleng decreased from 13.5% in 2004 to 9.3% in 2018 (P < 0.001). The median age of PWE shifted from 17 (IQR: 12–22) years to 24 (IQR: 20–30) years in Bilomo (P < 0.001); and slightly from 24 (IQR: 14–34) years to 28 (IQR: 21.25–36.75) years in Kelleng (P = 0.112). Furthermore, 47.6% of all tested children between 7 and 10 years had Ov16 antibodies.ConclusionsThere is a decrease in epilepsy prevalence after 13 years and more of CDTI in both villages. The age-shift observed in PWE suggests that ivermectin may prevent OAE in younger residents. Ov16 seropositivity in children indicates ongoing onchocerciasis transmission possibly due to suboptimal control measures. Our findings support the existence of OAE in Cameroon and highlight the need to strengthen onchocerciasis elimination programs.

Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon

BackgroundA high prevalence of epilepsy has been observed in several onchocerciasis-endemic countries, including Cameroon. However, little is known on the clinical presentations of the affected persons with epilepsy (PWE). A community-based study was conducted with the aim of describing the spectrum of seizures in selected onchocerciasis-endemic villages in Cameroon and documenting relevant medical history in patients with onchocerciasis-associated epilepsy (OAE). MethodsWe carried out door-to-door surveys in 5 onchocerciasis-endemic villages in Cameroon and recruited all consenting PWE. Epilepsy was diagnosed using a 2-step approach consisting of the administration of a standardized 5-item questionnaire followed by confirmation of the suspected cases by a neurologist. Onchocerciasis-associated epilepsy was defined as ≥2 seizures without an obvious cause, starting between the ages of 3–18 years in previously healthy persons having resided for at least 3 years in an onchocerciasis-endemic area. Ivermectin use by PWE was verified. Seizure history, relevant past medical, and family history, as well as neurological findings, were noted. ResultsIn all, 156 PWE were recruited in the 5 villages. The modal age group for epilepsy onset was 10–14 years. The diagnostic criteria for OAE were met by 93.2% of the PWE. Participants had one or more of the following seizure types: generalized tonic–clonic seizures (89.1%), absences (38.5%), nodding (21.8%), focal nonmotor (7.7%), and focal motor seizures (1.9%). One case (0.6%) with the “Nakalanga syndrome” was identified. More than half (56.4%) of PWE had at least one seizure per month. In one village, 56.2% of PWE had onchocercal skin lesions. ConclusionPeople with epilepsy in onchocerciasis-endemic villages in Cameroon present with a wide clinical spectrum including nodding seizures and Nakalanga features. A great majority of participants met the diagnostic criteria for OAE, suggesting that better onchocerciasis control could prevent new cases. Epilepsy management algorithms in these areas must be adjusted to reflect the varied seizure types.

Exploring the Relationship between Consumer Price Index (CPI) and Producer Price Index (PPI) in Nigeria

The study investigated the relationship between consumer price index (CPI) and producer price index (PPI) in Nigerian economy, using monthly data from 2013: 01 to 2018: 05. The study employed DF-GLS unit root test to verify the stationarity of the series. Cointegration tests involving Johansen and Engle-Granger approaches could not detect long run relationship between CPI and PPI, implying that the variables could not be substituted for each other in measuring inflation rate in Nigeria. Vector Autoregressive (VAR) technique was used to analyse the variables and the results revealed that there was no causality between CPI and PPI in Nigeria. However, the OLS result in Engle-Granger 2-step approach to cointegration provided a useful insight into the relationship between the variables. An increase in either CPI or PPI exerted a statistically significant reduction effect on the rate of other in the long run.

A Phase 1 First-in-Human Study of AMG 330, an Anti-CD33 Bispecific T-Cell Engager (BiTE®) Antibody Construct, in Relapsed/Refractory Acute Myeloid Leukemia (R/R AML)

A Phase 1 First-in-Human Study of AMG 330, an Anti-CD33 Bispecific T-Cell Engager (BiTE®) Antibody Construct, in Relapsed/Refractory Acute Myeloid Leukemia (R/R AML)

Quantitative easing and sovereign yield spreads: Euro-area time-varying evidence

We assess the determinants of sovereign bond yield spreads in the period 1999:01–2016:07, considering non-conventional monetary policy measures in the Euro area. We use a 2-step approach to: (i) confirm and estimate the determinants of sovereign bond yield spreads; (ii) compute bivariate time-varying coefficient (TVC) models of each determinant and analyse the temporal dynamics. The baseline determinants of sovereign bond yield spreads in the Euro area are the bid-ask spread, the VIX, fiscal developments and rating developments, REER, and economic growth. QE measures implemented by the ECB in the aftermath of the crisis are also relevant. From the TVC analysis, the Covered Bond Purchase Programme contributed to reduce yield spreads, particularly in the 2011–2013 period. Longer-term refinancing operations contributed to reduce yield spreads in most countries.

Genomic prediction of lactation curves for milk, fat, protein, and somatic cell score in Holstein cattle

Application of random regression models (RRM) in a 2-step genomic prediction might be a feasible way to select young animals based on the complete pattern of the lactation curve. In this context, the prediction reliability and bias of genomic estimated breeding value (GEBV) for milk, fat, and protein yields and somatic cell score over days in milk (DIM) using a 2-step genomic approach were investigated. In addition, the effect of including cows in the training and validation populations was investigated. Estimated breeding values for each DIM (from 5 to 305 d) from the first 3 lactations of Holstein animals were deregressed and used as pseudophenotypes in the second step. Individual additive genomic random regression coefficients for each trait were predicted using RRM and genomic best linear unbiased prediction and further used to derive GEBV for each DIM. Theoretical reliabilities of GEBV obtained by the RRM were slightly higher than theoretical reliabilities obtained by the accumulated yield up to 305 d (P305). However, validation reliabilities estimated for GEBV using P305 were higher than for GEBV using RRM. For all traits, higher theoretical and validation reliabilities were estimated when incorporating genomic information. Less biased GEBV estimates were found when using RRM compared with P305, and different validation reliability and bias patterns for GEBV over time were observed across traits and lactations. Including cows in the training population increased the theoretical reliabilities and bias of GEBV; nonetheless, the inclusion of cows in the validation population does not seem to affect the regression coefficients and the theoretical reliabilities. In summary, the use of RRM in 2-step genomic prediction produced fairly accurate GEBV over the entire lactation curve for all analyzed traits. Thus, selecting young animals based on the pattern of lactation curves seems to be a feasible alternative in genomic selection of Holstein cattle for milk production traits.

A Novel Method for Clinical Cochlear Duct Length Estimation toward Patient-Specific Cochlear Implant Selection.

ObjectiveIn the field of cochlear implantation, the current trend toward patient-specific electrode selection and the achievement of optimal audiologic outcomes has resulted in implant manufacturers developing a large portfolio of electrodes. The aim of this study was to bridge the gap between the known variability of cochlea length and this electrode portfolio.DesignRetrospective analysis on cochlear length and shape in micro–computed tomography and cone beam computed tomography data.SettingTertiary care medical center.Subjects and MethodsA simple 2-step approach was developed to accurately estimate the individual cochlear length as well as the projected length of an electrode array inside the cochlea. The method is capable of predicting the length of the cochlea and the inserted electrode length at any specific angle. Validation of the approach was performed with 20 scans of human temporal bones (micro–computed tomography) and 47 pre- and postoperative clinical scans (cone beam computed tomography).ResultsMean ± SD absolute errors in cochlear length estimations were 0.12 ± 0.10 mm, 0.38 ± 0.26 mm, and 0.71 ± 0.43 mm for 1, 1.5, and 2 cochlea turns, respectively. Predicted insertion angles based on clinical cone beam computed tomography data showed absolute deviations of 27° ± 18° to the corresponding postoperative measurements.ConclusionWith accuracy improvements of 80% to 90% in comparison with previously proposed approaches, the method is well suited for the use in individualized cochlear implantation.

Detecting Mild Cognitive Deficits in Parkinson's Disease: Comparison of Neuropsychological Tests.

Numerous neuropsychological tests and test versions are used in Parkinson's disease research, but their relative capacity to detect mild cognitive deficits and their comparability across studies are unknown. The objective of this study was to identify neuropsychological tests that consistently detect cognitive decline in PD across studies. Data from 30 normed neuropsychological tests across 20 international studies in up to 2908 nondemented PD patients were analyzed. A subset of 17 tests was administered to up to 1247 healthy controls. A 2-step meta-analytic approach using standardized scores compared performance in PD with normative data. Pooled estimates of the differences between PD and site-specific healthy controls identified significant cognitive deficits in PD patients on 14 test scores across 5 commonly assessed cognitive domains (attention or working memory, executive, language, memory, and visuospatial abilities), but healthy control performance was statistically above average on 7 of these tests. Analyses based on published norms only, as opposed to direct assessment of healthy controls, showed high between-study variability that could not be accounted for and led to inconclusive results. Normed neuropsychological tests across multiple cognitive domains consistently detect cognitive deficits in PD when compared with site-specific healthy control performance, but relative PD performance was significantly affected by the inclusion and type of healthy controls versus the use of published norms only. Additional research is needed to identify a cognitive battery that can be administered in multisite international studies and that is sensitive to cognitive decline, responsive to therapeutic interventions, and superior to individual cognitive tests. © 2018 International Parkinson and Movement Disorder Society.

GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community.

This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. A 2-step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re-considered every 3-5 years.

PS01.174: AN EXAMINATION OF OUTCOMES AFTER ANTE-THORACIC ROUTE WITH RIGHT HEMICOLON RECONSTRUCTION AFTER ESOPHAGECTOMY.

Abstract Background In our institute, we usually use gastric tube for reconstruction organ after esophagectomy. When we can’t use gastric tube, we use right hemi-colon with ante-thoracic route. Previously, we reconstructed by 1-step after esophagectomy, but from 2012, we have done by 2-step for reduce postoperative complications. Methods We enrolled 15 esophageal cancer patients who underwent esophagectomy and right hemicolon reconstruction between April 2004 and December 2016. Results The average age of 15 patients is 67.3. The reasons of using right hemicolon are as follows; post gastrectomy 13, stomach double cancer 2. The reasons of gastrectomy are as follows; gastric cancer 8, duodenum cancer 1, gastric ulcer 4. The average duration from gastrectomy to esophagectomy is 12.5 year. We reconstructed by 1-step for 5 patients, and after 2012, we reconstructed by 2-step for 10 patients. Anastomotic leakages were found in 2 cases (40.0%) in 1-step reconstruction group, and 3 cases (20.0%) in 2-step reconstruction group. In 1-step reconstruction group, 1 case occurred multiple anastomotic leakages and DIC, and another 1 case was found necrosis of reconstructive colon. In 2-step reconstruction group, we found 1 case of major leakage and 1 case of recurrent nerve paralysis and 2 cases of postoperative pneumonia. However, there were no case of tracheotomy. The incidence of pneumonia did not differ between the two groups. And the term of postoperative oral intake tend to shorter in 2-step reconstruction group (P = 0.06). 2 severe postoperative complications (Clavian-Dindo V or IVa) cases were found in 1-step reconstruction group, on the other hand, 2 cases severe complications (CD IIIa) in 2-step reconstruction group. Conclusion In the case of using right hemicolon as a reconstructive organ, 2-step reconstruction approach is useful and superior from the viewpoints of postoperative complications. Disclosure All authors have declared no conflicts of interest.

Laparoscopic sacrocolpopexy with or without midurethral sling insertion: Is a two- step approach justified? A prospective study.

Most data support the fact that women with symptomatic pelvic organ prolapse (POP) with concomitant symptomatic or occult stress urinary incontinence (SUI) benefit from concurrent POP and anti-incontinence procedure. However some data support a delayed or 2-step approach. The aim of this study was to demonstrate the effectiveness and safety of laparoscopic sacrocolpopexy (SCP) alone with a delayed approach for SUI to prove the justification of a 2-step approach. A prospective study from 2014 to 2016 including women with symptomatic POP ≥ stage 2 prolapse and concomitant SUI or occult SUI. Laparoscopic SCP for apical or multi-compartment POP with or without concomitant MUS insertion was performed. Primary outcome measures were asymptomatic regarding SUI after prolapse surgery alone, persisting SUI with or without subsequent anti-incontinence surgery. A SCP alone was performed on 62 women. Stress urinary incontinence was seen in 31% with SCP alone and a third of those women needed an additional midurethral sling for persisting SUI. Women who chose a combined surgery for POP and incontinence with SCP and a suburethral sling the postoperative success rate regarding SUI was 100% with two women needing a sling release. We showed that women with POP with concomitant stress urinary incontinence undergoing sacrocolpopexy benefitted from a two-step approach as only 11% needed an additional incontinence procedure. This study highlights the importance of pre-operative counselling. It should be tailored to the individual woman.

TOWARD AUTOMATIC GEOREFERENCING OF ARCHIVAL AERIAL PHOTOGRAMMETRIC SURVEYS

Abstract. Images from archival aerial photogrammetric surveys are a unique and relatively unexplored means to chronicle 3D land-cover changes over the past 100 years. They provide a relatively dense temporal sampling of the territories with very high spatial resolution. Such time series image analysis is a mandatory baseline for a large variety of long-term environmental monitoring studies. The current bottleneck for accurate comparison between epochs is their fine georeferencing step. No fully automatic method has been proposed yet and existing studies are rather limited in terms of area and number of dates. State-of-the art shows that the major challenge is the identification of ground references: cartographic coordinates and their position in the archival images. This task is manually performed, and extremely time-consuming. This paper proposes to use a photogrammetric approach, and states that the 3D information that can be computed is the key to full automation. Its original idea lies in a 2-step approach: (i) the computation of a coarse absolute image orientation; (ii) the use of the coarse Digital Surface Model (DSM) information for automatic absolute image orientation. It only relies on a recent orthoimage+DSM, used as master reference for all epochs. The coarse orthoimage, compared with such a reference, allows the identification of dense ground references and the coarse DSM provides their position in the archival images. Results on two areas and 5 dates show that this method is compatible with long and dense archival aerial image series. Satisfactory planimetric and altimetric accuracies are reported, with variations depending on the ground sampling distance of the images and the location of the Ground Control Points.