Average Annual Rate Of Change Research Articles

Reliable information for cancer control in Cali, Colombia.

Background: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates.Methods: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method.Results: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8).Comment: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

Trends and differences in tuberculosis incidences and clustering among natives in Denmark, Sweden and Finland: comparison of native incidences and molecular epidemiology among three low-incidence countries

ObjectivesTo compare the epidemiology of tuberculosis (TB) in Denmark, Sweden and Finland, by focusing on the native population in order to identify epidemiologic differences and thus indirectly possible differences in TB control. MethodsTB incidence trends from 1990 through 2015 were compared among the countries. In addition, for the periods 2012–2013 and 2014–2015, genotyping data were compared. Genotyping was performed using the 24-locus mycobacterial interspersed repetitive unit–variable number of tandem repeat (MIRU-VNTR) method in Denmark and Sweden. For Finland, spoligotyping in conjunction with the 15-locus MIRU-VNTR method was used for 2012–2013 and translated into the 24-locus MIRU-VNTR when feasible, and for 2014–2015 only MIRU-VNTR was used. Both incidence trends and molecular epidemiology were assessed for native cases. ResultsThe average annual rate of change in TB incidence for native Danes was −2.4% vs. −6.1% and −6.9% for native Swedes and Finns respectively. In 2012–2013 Denmark had 52 native cases in the largest transmission chain vs. three cases in Sweden and ten in Finland, and during the same period the clustering rate for native Danes was 48.8% vs. 6.5% and 18.2% for native Swedes and Finns respectively. For 2014–2015, a similar pattern was seen. ConclusionsThe decline of TB among natives in Denmark is slower than for Sweden and Finland, and it seems Denmark has more active transmission among natives. The focused assessment on basic native TB epidemiology reveals striking differences in TB transmission among otherwise similar low-TB-incidence countries.

Medicine poisoning mortality trend by gender and age group, São Paulo State, Brazil, 1996-2012.

This study looked into mortality due to medicinal drug poisoning by age, gender and intent among the population of the state of São Paulo. The adjusted time sequence of mortality due to drug poisoning was developed based on data available in the DATASUS Mortality Data System for 1996 to 2012. We checked the variables for magnitude and trends. We found an increase in adjusted mortality starting in 2005, and more so as of 2009, confirmed by a 95% CI for the average annual rate of change. (AARC) We did not find the same trend in overall mortality in the state (AARC = -0.22%, 95% CI = -1.12 - 0.69) for specific, external cause mortality (AARC = -3.14%, 95% CI = -4.75 - -1.49) and for mortality due to accidental drug poisoning (AARC=+9,76%, 95% IC = -12.16 - 37.14). The largest increase was found in intentional self-poisoning with medicinal drugs (AARC = +10.64%, 95% CI = 6.92 - 14.40), and among the younger subjects (largest magnitude). The trend in mortality due to drug poisoning in the State of São Paulo, the importance of intent and mortality among the younger population reiterate the need to implement control measures.

Preliminary study on alterations of altitude road traffic in China from 2006 to 2013.

IntroductionRoad traffic can play an important role in strengthening regional economic activities, especially at high altitude, and it is necessary to know important traffic-related information. Although previous studies reported on road traffic in China, there has been little research on high-altitude road traffic to date.MethodThe annual official census of road traffic safety from 2006 to 2013 was used to obtain data on the general population, registered drivers, registered vehicles, newly built roads, road traffic accidents (RTAs), mortality rate per 100 000 populations and per 10 000 vehicles in high-altitude provinces, including Tibet, Qinghai, Xinjiang, Gansu, Yunnan, Sichuan, and Chongqing. These provincial data were reviewed retrospectively, with the national data as the reference. Statistical analysis (i.e., t test) was used to compare the estimated average annual change rate of population, number of registered drivers, registered vehicles, and newly built roads in high-altitude provinces with the national rates.ResultsCompared with the national data, there are significantly higher annual rates of population growth in Tibet and Xinjiang, registered drivers in Gansu, registered vehicles in Gansu, Sichuan, and Chongqing, and newly built roads in Tibet and Qinghai. Among the investigated provinces, Tibet, Qinghai, and Yunnan had a higher proportion of the roads with the high class. RTAs and RTA-induced casualties in the high-altitude provinces indicated a decreasing trend. The mortality rate per 10 000 vehicles and per 100 000 populations showed a decreasing trend, while the RTA-related mortality rate in Tibet, Qinghai, Xinjiang and Gansu remained high.ConclusionsMajor changes for road traffic in high-altitude provinces have occurred over the past decade; however, the RTA-related mortality rate in high-altitude provinces has remained high. This study furthers understanding about road traffic safety in China; further studies on road traffic safety at high altitude should be performed.

Education and disability trends of older Americans, 2000-2014.

Trends in disability among older Americans has declined since the 1980s. The study examines whether the trend continues to decline and whether educational disparities exist in the prevalence of functional limitations. I used the 2000-2014 National Health Interview Survey and included adults aged ≥65 years. Functional limitations was measured by three outcomes: the need for help with activities of daily living (ADLs) or instrumental activities of daily living (IADLs) and physical function limitations. I used a set of logistic models to estimate the average annual change rate of functional limitations. I examined whether the annual rate of change differed by education, age group and sex. During 2000-2014, the annual increase rate of ADL limitations was 1.7% (P<0.001) and was 2.0% (P<0.001) for physical function limitations; IADL limitation did not change significantly. All subgroups experienced an increase in ADL and physical function limitations except for adults with a more than high school education. The lower-educated group had a higher proportion and a higher annual rate of increase in all outcomes. Increasing trends in chronic conditions may contribute to the increasing trend in functional limitations. The study highlighted a large educational disparity in late-life disability among older Americans.

Efeitos da ilha de calor nos níveis de conforto em ambientes externos e internos para as condições climáticas de Curitiba

RESUMO: O crescimento urbano e o decorrente surgimento de ilhas de calor são fatores responsáveis não apenas por mudanças nos padrões de conforto e desconforto térmico urbanos mas também por possíveis impactos no aumento da demanda de energia (em climatização artificial) das edificações urbanas. Países em desenvolvimento, a maior parte deles localizada em regiões tropicais, apresentam taxas de crescimento urbano mais elevadas relativamente aos países desenvolvidos; segundo dados da ONU, no período de 2005 - 2010, a taxa de urbanização dos primeiros foi cerca de cinco vezes mais alta que a dos últimos. Nesse contexto, o objetivo do presente trabalho foi analisar a atual ilha de calor urbana de Curitiba, decorrente de seu considerável crescimento urbano nas últimas décadas, a partir de um monitoramento climático contínuo entre dezembro de 2011 e fevereiro de 2013 por meio de estações meteorológicas localizadas na mancha urbana. Adicionalmente à análise de diferenças na temperatura local, quantificaram-se níveis de conforto/desconforto térmico a fim de se verificar o efeito integrado das diversas variáveis meteorológicas em termos de percentuais de horas em frio, conforto e calor, e suas variações dentro e fora da área urbana. Complementarmente são analisadas implicações da ilha de calor urbana em níveis de conforto em ambientes internos. Verificou-se que a presença de uma ilha de calor na área urbana para combater o frio no inverno acarreta aumento desproporcional do calor em situação de verão, não havendo benefício térmico de maneira geral.

GROUND DEFORMATION MONITORING IN QINGDAO COASTAL AREAS BY TIME-SERIES TERRASAR-X IMAGES

As a new generation of high resolution and short revisit period of radar satellite, TerraSAR-X is not only able to meet the requirements of monitoring large scale surface subsidence, but also make it possible to monitor the small deformation of the short period. This articles takes the coastal areas of the west coast of Qingdao as the research object. With Small baselines subsets interferometry synthetic aperture radar (SBASI), this paper obtained the period the average annual rate of change from the time series analysis of TerraSAR-X data from April 2015 to October 2014.In order to enrich the historical deformation data of the study area, it analyse the time series of ALOS images from December 2010 to October 2008 with the same method. Finally,it analyse and demonstrate the experimental results.

GROUND DEFORMATION MONITORING IN QINGDAO COASTAL AREAS BY TIME-SERIES TERRASAR-X IMAGES

Abstract. As a new generation of high resolution and short revisit period of radar satellite, TerraSAR-X is not only able to meet the requirements of monitoring large scale surface subsidence, but also make it possible to monitor the small deformation of the short period. This articles takes the coastal areas of the west coast of Qingdao as the research object. With Small baselines subsets interferometry synthetic aperture radar (SBASI), this paper obtained the period the average annual rate of change from the time series analysis of TerraSAR-X data from April 2015 to October 2014.In order to enrich the historical deformation data of the study area, it analyse the time series of ALOS images from December 2010 to October 2008 with the same method. Finally,it analyse and demonstrate the experimental results.

Spatial and temporal characteristics of rainfall in a data-scarce region: case of Kinshasa and Bas-Congo in Democratic Republic of Congo

ABSTRACTThe aim of the present paper was to improve understanding of the rainfall dynamics in Bas-Congo and Kinshasa provinces, in Democratic Republic of Congo (DRC). The first objective of the study was achieved by analysing the spatial correlations of monthly, seasonal, annual and individual monthly rainfall amounts of Kinshasa and Bas-Congo. The second objective was achieved through investigating and quantifying the temporal trends and their spatial variations. The results demonstrated notably high average inter-station correlation of +0.63 for dry season series, followed by monthly rainfall series with an average inter-station correlation of +0.58. However, there was no station with a stable monthly rainfall regime, i.e. with mean precipitation concentration index lower than 10% (it varies between 14.2 and 21.9%). Moreover, Kinshasa experienced an increase of rainfall with an average annual rate of change of +4.59 mm/year for the period 1961–2006. The results will be helpful for efficient water resources management and for mitigating the adverse impacts of future extreme drought or flood occurrences.Editor M.C. Acreman Associate editor N. Verhoest

Land use and land cover (LULC) changes in semi-arid sub-watersheds of Laikipia and Athi River basins, Kenya, as influenced by expanding intensive commercial horticulture

Agriculturally productive watersheds in Kenya are experiencing important land transformations with consequences on environmental resources. Previous work identified spatial pockets of vegetation decline across sub-watersheds with intensive farming. While this is crucial information in delineating impacted regions, it is important to understand the type of occurring changes, spatial patterns and the rate of change. The study focused in the Athi River and Laikipia regions which have intensified commercial horticulture, yet marginalized semi-arid to arid environments. The study quantified land use and land cover changes between 1984 and 2009/2010, identifying areas of change and the average annual rate of change. Landsat (5 TM, MSS and 7 ETM+) multitemporal data were used in classification and change detection analysis. From the results, both regions experienced intense land transformation at varying magnitudes during the 25 years period. Woody grasslands covered vast areas. In Laikipia, the averaged percentage annual rate of land change to settlements/urban use was highest (20.2%). There was a decline in barren area, forest and wooded grasslands (−1.4%, −0.7% and −0.3% respectively). In the Athi River region, the averaged percentage annual rate of changes was in the order of agriculture, water, settlement, bare soils, woody grasslands (37.7%, 17.2%, 8.4%, 3.9, 2.9% respectively) while dark bare soils, and forest cover declined (−3.4% and −3.3% respectively). Observed LULC transformations were largely attributed to socio-economic drivers including increased human migration into agriculturally productive sub-watersheds fueling growth of settlement, increased irrigation farming and therefore increased area under water, and growth of cities and industrial areas.

Changes in bone mineral density over time by body mass index in the health ABC study.

Obesity appears protective against osteoporosis in cross-sectional studies. However, results from this longitudinal study found that obesity was associated with bone loss over time. Findings underscore the importance of looking at the longitudinal relationship, particularly given the increasing prevalence and duration of obesity among older adults. Cross-sectional studies have found a positive association between body mass index (BMI) and bone mineral density (BMD), but little is known about the longitudinal relationship in US older adults. We examined average annual rate of change in BMD by baseline BMI in the Health, Aging, and Body Composition Study. Repeated measurement of BMD was performed with dual-energy X-ray absorptiometry (DXA) at baseline and years 3, 5, 6, 8, and 10. Multivariate generalized estimating equations were used to predict mean BMD (femoral neck, total hip, and whole body) by baseline BMI (excluding underweight), adjusting for covariates. In the sample (n = 2570), 43% were overweight and 24% were obese with a mean baseline femoral neck BMD of 0.743g/cm(2), hip BMD of 0.888g/cm(2), and whole-body BMD of 1.09g/cm(2). Change in total hip or whole-body BMD over time did not vary by BMI groups. However, obese older adults lost 0.003g/cm(2) of femoral neck BMD per year more compared with normal weight older adults (p < 0.001). Femoral neck BMD change over time did not differ between the overweight and normal weight BMI groups (p = 0.74). In year 10, adjusted femoral neck BMD ranged from 0.696g/cm(2) among obese, 0.709g/cm(2) among normal weight, and 0.719g/cm(2) among overweight older adults. Findings underscore the importance of looking at the longitudinal relationship between body composition and bone mineral density among older adults, indicating that high body mass may not be protective for bone loss over time.

Aortic root dilatation rate in pediatric patients with Marfan syndrome treated with losartan

Medical therapy with angiotensin II receptor blockers/angiotensin-converting enzyme inhibitors and/or beta-blockers was reported to reduce aortic root dilatation rates in pediatric patients with Marfan syndrome. No data are available in the literature on losartan effects after 3 years of therapy. The aim of our study was to establish whether losartan reduces aortic root dilatation rates in pediatric patients with Marfan syndrome in the mid and long term. This is a retrospective analysis of 38 pediatric patients with Marfan syndrome followed at the Marfan Clinic of S. Orsola-Malpighi Hospital of the University of Bologna (Italy). Aortic diameters were measured at sinuses of Valsalva and proximal ascending aorta with transthoracic echocardiography. After a mean follow-up of 4.5 ± 2.5 years (range 2-9 years), aortic root z score at sinuses of Valsalva and proximal ascending aorta remained stable. The average annual rate of change in aortic root z score was -0.1 ± 0.4 and 0 ± 0.3 at sinuses of Valsalva and proximal ascending aorta, respectively. The mean dose of losartan was 0.7 ± 0.3 mg/kg/day. Three patients were non-responders, probably because of late beginning or low dose of therapy. Eight patients underwent cardiac surgery (aortic root surgery in 5 and mitral valve repair in 3), all of them started losartan later in life. Despite the retrospective design of the study and the small sample size, a beneficial effect of losartan therapy was observed in pediatric patients with Marfan syndrome in the mid and long term. Late beginning or low doses of losartan can turn off the effects of therapy.

Determinants of pulse pressure and annual rates of change in the Atherosclerosis Risk in Communities study.

The aim of this study was to examine the effect of vascular and lifestyle risk factors on the annual rate of change in pulse pressure (PP) in a biracial, middle-aged cohort. The study population, drawn from the Atherosclerosis Risk in Communities (ARIC) cohort, included 10, 071 participants, aged 45-64 years at baseline, with a complete set of SBP and DBP readings at each of four visits 3 years apart. The average annual increase in PP was 1.23 mmHg [standard error (SE 0.01], after adjusting for baseline age differences. Compared with white men, African-American women had the highest rate of annual increase in PP (0.41 (SE 0.05) mmHg/year greater) followed by white women [0.23 (SE 0.03) mmHg/year greater] and African-American men [0.19 (SE 0.06) mmHg/year greater]. There were significant differences in both average baseline PP and average annual rate of change in PP between men and women and African-Americans and whites. Diabetes and obesity had the strongest effect on the absolute value of baseline PP and the annual rate of change in PP.

Premature Mortality from Cardiovascular Disease in the Americas - Will the Goal of a Decline of "25% by 2025" be Met?

BackgroundCardiovascular diseases (CVD) are the underlying cause 1.6 million deaths per year in the Americas, accounting for 30% of total mortality and 38% of by non-communicable deaths diseases (NCDs). A 25% reduction in premature mortality due four main NCDs was targeted by the 2011 High-level Meeting of the General Assembly on the Prevention and Control of NCDs. While overall CVD mortality fell in the Americas during the past decade, trends in premature CVD mortality during the same period have not been described, particularly in the countries of Latin America and the Caribbean.MethodsThis is a population-based trend-series study based on a total of 6,133,666 deaths to describe the trends and characteristics of premature mortality due to CVD and to estimates of the average annual percentage of change during the period 2000–2010 in the Americas.FindingsPremature mortality due to CVD in the Americas fell by 21% in the period 2000–2010 with a -2.5% average annual rate of change in the last 5 year—a statistically significant reduction of mortality—. Mortality from ischemic diseases, declined by 25% - 24% among men and 26% among women. Cerebrovascular diseases declined by 27% -26% among men and 28% among women. Guyana, Trinidad and Tobago, the Dominican Republic, Bahamas, and Brazil had CVD premature mortality rates over 200 per 100,000 population, while the average for the Region was 132.7. US and Canada will meet the 25% reduction target before 2025. Mexico, Costa Rica, Venezuela, Dominican Republic, Panama, Guyana, and El Salvador did not significantly reduce premature mortality among men and Guyana, the Dominican Republic, and Panama did not achieve the required annual reduction in women.ConclusionsTrends in premature mortality due to CVD observed in last decade in the Americas would indicate that if these trends continue, the Region as a whole and a majority of its countries will be able to reach the goal of a 25% relative reduction in premature mortality even before 2025.

Farmland dataset reconstruction and farmland change analysis in China during 1661–1985

This research reconstructs China’s provincial farmland dataset in the last 300 years (1661–1985) by applying factor correction, citing replacement, linear interpolation, cohesion and contrast, man-land relationship test, farming trend test, provincial administrative area adjustment, etc. on available farmland data based on China’s current provincial administrative boundary. Based on this dataset, a quantitative analysis has been applied to study the farmland amount and its change characteristics at both national and provincial level. Three conclusions are derived: (1) Along with the rapid population growth, national farmland amount has increased by about 320% in the last 300 years from 424,480 km2 in the early Qing Dynasty to 1,368,600 km2 in 1985. Comparing with global and national farmland datasets, in terms of the overall trend of national farmland growth, very low deviation exists but significant variances do appear for some provinces. (2) At the beginning of the Qing Dynasty, China's farming activities mainly existed in the Yangtze River Plain, the North China Plain, the Guanzhong Basin and the Yinchuan Plain. Thereafter, reclamation activities expanded to outer agricultural areas. Regarding of the growth rate, national farmland increase can be divided into five phases. National policy, disasters, wars, and economic development, are the main factors affecting farmland changes. (3) Significant regional variances exist in farmland changes. In the space shaped by the average farmland amount and the average annual change rate of farmland, the nation can be divided into six areas.

Monitoring ground deformation in the settlement of Larissa in Central Greece by implementing SAR interferometry

The settlement of Larissa in the eastern part of Central Greece suffers from continued land deformation as evidenced by ground fissures, sinkholes and subsidence. We used three different interferometric synthetic aperture radar (InSAR) techniques to monitor ground deformation dynamics in the study area. Spatial patterns of short-term changes (35 days) were studied using conventional InSAR, longer-term changes (13 years) by interferometric stacking, and change dynamics of single objects was assessed by permanent scatterer technique. The results indicate co-occurring subsidence and uplift processes in the region with their average annual change rates reaching up to −2.9 and 6.6 mm a−1, respectively. Some of these changes may be attributed to tectonic fault movements, but there are also other mechanisms of continued ground deformation in the region, particularly the swelling and shrinking of expansive soils and human-induced changes in the groundwater level.

Dealing With Longitudinal Data

Dealing With Longitudinal Data

Land cover changes in the Brazilian Cerrado and Caatinga biomes from 1990 to 2010 based on a systematic remote sensing sampling approach

The main objective of our study was to provide consistent information on land cover changes between the years 1990 and 2010 for the Cerrado and Caatinga Brazilian seasonal biomes. These areas have been overlooked in terms of land cover change assessment if compared with efforts in monitoring the Amazon rain forest. For each of the target years (1990, 2000 and 2010) land cover information was obtained through an object-based classification approach for 243 sample units (10 km × 10 km size), using (E)TM Landsat images systematically located at each full degree confluence of latitude and longitude. The images were automatically pre-processed, segmented and labelled according to the following legend: Tree Cover (TC), Tree Cover Mosaic (TCM), Other Wooded Land (OWL), Other Land Cover (OLC) and Water (W). Our results indicate the Cerrado and Caatinga biomes lost (gross loss) respectively 265,595 km2 and 89,656 km2 of natural vegetation (TC + OWL) between 1990 and 2010. In the same period, these areas also experienced gain of TC and OWL. By 2010, the percentage of natural vegetation cover remaining in the Cerrado was 47% and in the Caatinga 63%. The annual (net) rate of natural vegetation cover loss in the Cerrado slowed down from −0.79% yr−1 to −0.44% yr−1 from the 1990s to the 2000s, while in the Caatinga for the same periods the rate increased from −0.19% yr−1 to −0.44% yr−1. In summary, these Brazilian biomes experienced both loss and gains of Tree Cover and Other Wooded Land; however a continued net loss of natural vegetation was observed for both biomes between 1990 and 2010. The average annual rate of change in this period was higher in the Cerrado (−0.6% yr−1) than in the Caatinga (−0.3% yr−1).

Cataract Surgery May Slow Cognitive Decline

Cataract surgery not only improves visual acuity in individuals with Alzheimer's disease and other dementias – it also appears to slow cognitive decline and improve neuropsychiatric symptoms, according to preliminary results from an ongoing study. An initial analysis comparing 28 surgical and 14 nonsurgical patients – about a third of whom were nursing home residents – is currently being expanded. “If these results hold up (with a larger study population), we will definitely see changes in practice,”Alan Lerner, MD, professor of neurology at Case Western Reserve University School of Medicine, who presented the findings at the Alzheimer's Association International Conference 2014, told Caring for the Ages. Currently, there is “tremendous reluctance and ambivalence” toward treating comorbidities in patients with Alzheimer's and other dementias,” he said. Yet the findings – including improvements on the Mini-Mental State Exam (MMSE) and the Neuropsychiatric Inventory (NPI) among surgical patients – demonstrate that “improving vision is a clear quality-of-life issue” for these individuals, said Dr. Lerner. “Yes, Alzheimer's is a brain disease, but we have to look at the whole person. There are other factors, including vision, that affect cognition,” he said. “And the effect of visual improvement on [behavior] – it's huge.” Cataracts can be even more troublesome in individuals with Alzheimer's than in those without the disease. Grover C. Gilmore, PhD, professor of psychology and social work, and dean of the Jack, Joseph and Morton Mandel School of Applied Social Services at Case Western Reserve, has shown in other research that patients with Alzheimer's disease commonly experience significant declines in contrast sensitivity in as little as 6 months after their diagnoses – impairments that he said may result from cellular disease-related changes in the vision system. “When you put a cataract on top of this, it becomes [even more serious],” said Dr. Gilmore, the study's lead investigator. Patients included in the current study of cataract surgery met the criteria for Alzheimer's disease or other neurodegenerative dementias and had at least one visually significant cataract. They either had surgery following enrollment and baseline testing (intervention group), or refused or delayed surgery (the control group). At 6 months, scores on the MMSE had improved by a mean of 0.39 points in the intervention group and declined by a mean of 2.31 points in the control group. The average annual rate of change in MMSE scores in this population is 2–3 points, Dr. Lerner said. As important – if not more – was a decline in the NPI, which assessed anxiety, confusion, depression, and other symptoms. The mean change in the NPI was −4.91 among individuals who had cataract surgery and +3.92 among those who declined or delayed the surgery. Caregivers also benefited from cataract surgery. Caregiver distress as measured by the NPI Caregiver Distress scale declined in the intervention group and increased in the control group. Cognitive function was assessed with the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) as well as the MMSE, but the investigators found only “trending” differences in the 6-month ADAS-cog scores rather than a clear reduction in cognitive decline after surgery – a finding that Dr. Lerner attributed to the small size of the study. Unease with cataract surgery in patients with Alzheimer's disease and other dementias often involves concern about anesthesia and the general stress of undergoing a procedure, but consideration of safety and risks must be better balanced with attention to the benefits, Dr. Lerner said. “In Alzheimer's disease,” said Dr. Gilmore, “hidden visual deficits can masquerade as hidden cognitive deficits. One reason (individuals with the disease) do poorly in neuropsychological tests is that they can't see very well. “If you want to know what the world looks like to patients with Alzheimer's disease, put on two pairs of heavy sunglasses and squint,” he said. When cataracts are diagnosed, surgical intervention can “benefit vision, cognition, and quality of life,” Dr. Gilmore said. Other ocular comorbidities that can affect vision – such as macular degeneration and end-stage glaucoma – should be ruled out by an ophthalmologist before cataract surgery is seriously considered, Dr. Lerner noted. The study was funded by the National Institute on Aging. Participants were recruited from the University Hospitals Case Medical Center and MetroHealth Medical Center.

Dynamic monitoring of wetland cover changes using time-series remote sensing imagery

Time-series remote sensing data, such as Moderate Resolution Imaging Spectroradiometer (MODIS) data hold considerable promise for investigating long-term dynamics of land use/cover change (LUCC), given their significant advantages of frequent temporal coverage and free cost. However, because of the complex ecological environment of wetlands, the applicability of these data for studying temporal dynamics of wetland-related land-cover types is limited. This is especially so for the Poyang Lake, China's largest freshwater lake, which has active seasonal and inter-annual dynamics. The primary objective of this study is to investigate the suitability of MODIS 250-m maximum value composite (MVC) vegetation indexes (VIs) for dynamics monitoring of the Poyang Lake. We applied a time-series 16-day MODIS NDVI from 2000 to 2012 and developed a method to classify wetland cover types based on timing of inundation. We combined techniques of applying iterative self-organizing data analysis (ISODATA) with varying numbers of clusters and a transformed divergence (TD) statistic, to implement annual classification of smoothed time-series NDVI. In addition, we propose a decision tree based on features derived from NDVI profiles, to characterize phenological differences among clusters. Supported by randomly generated validation samples from TM images and daily water level records, we obtained a satisfactory accuracy assessment report. Classification results showed various change patterns for four dominant land cover types. Water area showed a non-significant declining trend with average annual change rate 33.25km2, indicating a drier Poyang lake, and emergent vegetation area had weak change over the past 13years. Areas of submerged vegetation and mudflat expanded, with significant average annual change rate 23.51km2 for the former. The results suggest that MODIS' 250-m spatial resolution is appropriate and the classification method based on timing of inundation is useful for mapping general land cover patterns of Poyang Lake.