Entire Time Period Research Articles

Chronic and non-communicable disease mortality and trends in Chinese elderly, 2004-2018

Objective: To analyze the mortality level and trend of chronic and non-communicable diseases (NCDs) among elderly residents aged 65 and over in China from 2004 to 2018, and predict the age-standardized mortality rate of NCDs from 2019 to 2023. Methods: Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates, age-standardized mortality rates, composition ratios and changing trends of NCDs among different genders, urban and rural areas, and geographical regions in China during 2004 to 2018. The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China. The Joinpoint Regression Models were fitted by the weighted least squares method. The average annual percent change (AAPC) and its 95% confidence interval for the entire time period were calculated. Log-linear models were used to predict age-standardized mortality rates. Results: From 2004 to 2018, the age-standardized mortality rates of NCDs decreased from 4 697.05 per 100 000 to 3 555.35 per 100 000, with an average annual decline of 2.0% (95%CI: -2.7%- -1.3%). The age-standardized mortality rates among different genders, urban and rural areas, and regions showed a downward trend. The age-standardized mortality rates of eastern region (AAPC = -2.1%, 95%CI: -2.8%- -1.3%) and central region (AAPC = -2.8%, 95%CI: -3.4%- -2.1%) fell faster than that of western region (AAPC = -0.8%, 95%CI: -1.8%-0.2%). The proportion of deaths caused by NCDs increased from 89.82% to 91.41%, with an average annual increase of 0.1% (95%CI: 0.1%-0.2%). Expected to 2023, the age-standardized mortality rates for male (3 906.23 per 100 000) will be significantly higher than female's (2 708.43 per 100 000); and that in rural areas (3 283.20 per 100 000) will be approximately equal to that in urban areas (3 250.01 per 100 000); the gap of age-standardized mortality rate between the western (3 782.48 per 100 000), eastern (3 037.01 per 100 000), and central region (3 249.24 per 100 000) will be further increased. Conclusion: From 2004 to 2018, age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend, and the proportion of deaths of NCDs showed an upward trend. Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.

Radar-based assessment of hail frequency in Europe

Abstract. In this study we present a unique 10 year climatology of severe convective storm tracks for a large European area covering Germany, France, Belgium and Luxembourg. For the period 2005–2014, a high-resolution hail potential composite of 1×1 km2 is produced from two-dimensional radar reflectivity and lightning data. Individual hailstorm tracks as well as their physical properties, such as radar reflectivity along the tracks, were reconstructed for the entire time period using the Convective Cell Tracking Algorithm (CCTA2D). A sea-to-continent gradient in the number of hail days per year is found to be present over the whole domain. In addition, the highest number of severe storms is found on the leeward side of low mountain ranges such as the Massif Central in France and the Swabian Jura in southwest Germany. A latitude shift in the hail peak month is observed between the northern part of Germany, where hail occurs most frequently in August, and southern France, where the maximum amount of hail is 2 months earlier. The longest footprints with high reflectivity values occurred on 9 June 2014 and on 28 July 2013 with lengths reaching up to 500 km. Both events were associated with hailstones measuring up to 10 cm diameter, which caused damage in excess of EUR 2 billion.

INFORMATION AND ACCOUNTING SUPPORT FOR INVESTMENT ANALYSIS OF BUSINESSFOR MANAGEMENT DECISION MAKING IN INDUSTRY 4.0

Directions for the development of information and accounting support for investment analysis of business structures for making management decisionsin Industry 4.0 are proposed. The key areas of changes in accounting in Industry 4.0 are defined as follows: expanding the display of the scope of theenterprise in the accounting; formation of approaches to the integration of accounting information for reporting; improving the efficiency of accounting,etc. The opportunities provided by the information and accounting platform for the development of the company's investment activities have beenanalyzed. Conceptual provisions of management accounting for investment analysis in the context of domestic practice are proposed. A model ofinformation flows generated by an investment project during the entire period of time from the inception of an investment idea and the selection ofinvestment proposals to the moment of evaluating the results of the project has been built. Approaches to the formation and disclosure of accountinginformation on the implementation of investment projects by companies, as well as methodological approaches to the analytical support of themanagement decision-making process, have been improved. The elements of the accounting policy for management accounting for the investmentprocess have been clarified. As objects of accounting for investment activities, the actual costs of creating investment activities by their types (materialand labor costs, depreciation deductions of fixed assets and intangible assets) and the movement of cash and non-cash funds as expenses in the areas oftheir expenditure are proposed. A methodological approach to the calculation of cash flows and disclosure of elements of accounting policies formanagement accounting is proposed. The study emphasizes the need to use special software products that automate the processes of accounting foreconomic activities and tools for studying the accumulated data from the perspectives that are most relevant for the enterprise.

Monitoring Sexual Violence Trends in Emergency Department Visits Using Syndromic Data From the National Syndromic Surveillance Program-United States, January 2017-December 2019.

Objectives. To report trends in sexual violence (SV) emergency department (ED) visits in the United States.Methods. We analyzed monthly changes in SV rates (per 100 000 ED visits) from January 2017 to December 2019 using Centers for Disease Control and Prevention's National Syndromic Surveillance Program data. We stratified the data by sex and age groups.Results. There were 196 948 SV-related ED visits from January 2017 to December 2019. Females had higher rates of SV-related ED visits than males. Across the entire time period, females aged 50 to 59 years showed the highest increase (57.33%) in SV-related ED visits, when stratified by sex and age group. In all strata examined, SV-related ED visits displayed positive trends from January 2017 to December 2019; 10 out of the 24 observed positive trends were statistically significant increases. We also observed seasonal trends with spikes in SV-related ED visits during warmer months and declines during colder months, particularly in ages 0 to 9 years and 10 to 19 years.Conclusions. We identified several significant increases in SV-related ED visits from January 2017 to December 2019. Syndromic surveillance offers near-real-time surveillance of ED visits and can aid in the prevention of SV.

Chinese and Indian Stock Markets: Linkages and Interdependencies

This paper examines the stock market linkages and interdependencies between China and India. We use the quantile regression approach as an alternative to Ordinary Least Squares estimation due to its flexibleness and robustness. Our results of the entire time period reveal the influence of Chinese CPI and ER on Nifty returns is not the same across the different quantiles. However, Chinese IR has no impact on Nifty returns. Further, Indian CPI has a negligible effect on SSE returns. In contrast, IR and ER do not affect SSE returns. This study also observes that the dependence structure between CPI and SSE returns indicates a negligible change post-recession period. However, the dependence structure between IR, ER, and SSE returns has not changed after the recession. Further, a significantly small change is found in the dependence structure between Chinese macroeconomic variables and Nifty returns post-recession.

Relative Performance of Real Estate Exchange-Traded Funds

This paper examines the performance of 34 real estate exchange-traded funds (REETFs) over the period of May 2003 through September 2019. We construct equally-weighted REETF portfolios every month and compare them with the overall U.S. stock market as proxied by the S&P 500 value-weighted ETF (IVV) and the S&P 500 equal-weighted ETF (RSP). Our results show that over the entire time period the REETF portfolios experienced higher monthly returns, but also had a slightly higher standard deviation of returns. We also provide results controlling for risk differentials using the Sharp, Sortino, and Omega ratios. The results show that IVV and RSP had higher risk-adjusted performance using all of the various measures compared with REETFs portfolios. REETFs also had much higher risk and losses during the 2007–2009 financial crisis.

Fairness‐Aware Resource Allocation in Full‐Duplex Backscatter‐Assisted Wireless Powered Communication Networks

In this paper, we introduce a full‐duplex backscatter‐assisted wireless powered communication network (FDBA‐WPCN) with a full‐duplex access point (FAP) and multiple energy harvesting wireless devices (WDs). The communication mode is a combination of backscatter communication (BC) and harvest‐then‐transmit (HTT). The entire time period of network is divided into energy harvesting/backscattering (EHB) period and information transmission (IT) period. In the EHB period, each WD either reflects information to the FAP by backscatter or harvests energy to prepare for the IT period. In the IT period, the WDs use their harvested energy to transmit information to FAP in time division multiple access (TDMA). However, under the setting, WDs with different distances from FAP will encounter unfairness in throughput due to the round‐trip path loss in backscatter and the doubly near‐far problem in HTT. To overcome the drawback, an optimization problem is considered to maximize the sum throughput under the condition of ensuring throughput fairness. By using convex optimization techniques, we obtain the optimal time allocation and the maximum same throughput of each WD. Comparing to the other two benchmark schemes, the simulation results prove the superiority of our proposed method.

The Value of Vaccination in Older Adults: The Why

The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

Navigating the COVID-19 pandemic: Initial impacts and responses of the Organ Procurement and Transplantation Network in the United States.

COVID‐19 has been sweeping the globe, hitting the United States particularly hard with a state of emergency declared on March 13, 2020. Transplant hospitals have taken various precautions to protect patients from potential exposure. OPTN donor, candidate, and transplant data were analyzed from January 5, 2020 to September 5, 2020. The number of new waiting list registrations decreased, with the Northeast seeing over a 50% decrease from the week of 3/8 versus the week of 4/5. The national transplant system saw near cessation of living donor transplantation (−90%) from the week of 3/8 to the week of 4/5. Similarly, deceased donor kidney transplant volume dropped from 367 to 202 (−45%), and other organs saw similar decreases: lung (−70%), heart (−43%), and liver (−37%). Deceased donors recovered dropped from 260 to 163 (−45%) from 3/8 compared to 4/5, including a 67% decrease for lungs recovered. The magnitude of this decrease varied by geographic area, with the largest percent change (−67%) in the Northeast. Despite the pandemic, discard rates across organ has remained stable. Although the COVID‐19 pandemic continues to evolve, OPTN data show recent evidence of stabilization, an indication that an early recovery of the number of living and deceased donors and transplants has ensued.

Diurnal Periodicity of Weak Earthquakes in the Zhongar North Tian Shan Region

A targeted exploration of the dependence of seismic activity on the time of day continues for about a century and a half. During this time, numerous scientific studies have been done on the diurnal periodicity in the occurrence of earthquakes. In this work, we present the first results of a study of diurnal periodicity in the occurrence of weak earthquakes by the example of individual seismically active zones of the Zhongar North Tian Shan region. The research was performed on the data on number of earthquakes with energy classes (K = logE, J) equal to 5, 6, 7 and 8, which arose within the North Tian Shan (1), Zhongar (2), Halyktau (3) and Ketmen (4) zones. To do this, by counting the number of earthquakes of corresponding energy that occurred during each hour, a time series of hourly values of number of shocks for the entire time period was compiled. Then, using the method of superposition of periods, the number of seismic events for each hour over the entire time interval is summed up, and a graph of the average daily course of the number of earthquakes was compiled. Studies have established the existence of diurnal periodicity in the realization of weak earthquakes and microquakes. It was most clearly observed for seismic events with K ≤ 6 for the North Tien Shan, Zhongar, Ketmen, and K ≤ 7 for Halyktau zones. With an increase in energy class (magnitude) of earthquakes, the observed pattern weakens and practically disappears for shocks with K ≥ 7 for the earthquakes, Zhongar, Ketmen and with K ≥ 8 for the Halyktau zones. The obtained graphs of the diurnal sequence of seismicity are identical to the analogous curves of diurnal variation in the numbers of weak earthquakes allocated for other regions (areas) of the globe.

Describing nearly two decades of Chagas disease in Germany and the lessons learned: a retrospective study on screening, detection, diagnosis, and treatment of Trypanosoma cruzi infection from 2000 \u2013 2018

BackgroundThe highly complex and largely neglected Chagas disease (CD) has become a global health problem due to population movements between Latin America and non-endemic countries, as well as non-vectorial transmission routes. Data on CD testing and treatment from routine patient care in Germany of almost two decades was collected and analysed.MethodsGerman laboratories offering diagnostics for chronic Trypanosoma cruzi (T. cruzi) infection in routine patient care were identified. All retrievable data on tests performed during the years of 2000–2018 were analysed. Additional clinical information regarding patients diagnosed with CD was collected through questionnaires.ResultsFive German laboratories with diagnostics for T. cruzi infection in routine patient care were identified. Centres in Hamburg and Munich offered two independent serological tests to confirm the CD diagnosis, as recommended by WHO during the entire time period 2000–2018. Overall, a total of n = 10,728 independent tests involving n = 5991 individuals were identified with a progressive increase in testing rates over time, only n = 130 (16.0%) of the tested individuals with known nationality came from CD endemic countries. Of all test units conducted at the included institutes, a total of n = 347/10,728 (3.2%) tests on CD were positive, of which n = 200/347 (57.6%) were ELISA, n = 133/347 (38.3%) IFT, n = 10/347 (2.9%) PCR, and n = 4/347 (1.2%) RDT. Of the n = 5991 individuals only n = 81 (1.4%) with chronic infection were identified, n = 52 females and n = 28 males. Additional clinical information could only be collected from n = 47.ConclusionThe results of this study give insight into the deployment of screening, detection, diagnosis, and treatment of T. cruzi over the last two decades in Germany and existing deficits therein; the creation of guidelines for Germany could be a step forward to improve the existing gaps.

Temporal and Age-Specific Trends in Acute Stroke Incidence: A 15-Year Population-Based Study of Administrative Data in Ontario, Canada.

Contemporary data on temporal trends in acute stroke incidence, specific to stroke type and age, are lacking. We sought to evaluate temporal trends in incidence of ischemic stroke and intracerebral hemorrhage over 15 years in a large population. We used linked administrative data to identify all emergency department visits and hospital admissions for first-ever ischemic stroke or intracerebral hemorrhage in Ontario, Canada from 2003-2017. We evaluated annual age-/sex-standardized incidence per 100,000 person-years for ischemic stroke and intracerebral hemorrhage across the study period. We used negative binomial regression to determine incidence rate ratios for each year compared to 2003, with assessment of modification by age, sex, or stroke type. Our cohort had 163,574 people with stroke (88% ischemic stroke). For ischemic stroke and intracerebral hemorrhage combined, age-/sex-standardized incidence decreased between 2003 and 2011 (standardized rate 109.4 to 85.8 per 100,000; 22%), then increased until 2017 (standardized rate 96.8 per 100,000; 13%). The pattern of change was similar for ischemic stroke and intracerebral hemorrhage, and for men and women, but was modified by age. For those aged 60 and above, adjusted incidence rate ratios decreased from 2003 to 2011 then subsequently increased, whereas for those aged <60 years incidence rate ratios increased throughout the entire study time period, particularly after 2011. Acute stroke incidence decreased from 2003 to 2011 but subsequently increased until 2017. Among those aged <60, incidence increased continuously from 2003 to 2017 but especially after 2011. The underlying reasons for these changes should be determined.

Multiple Myeloma Mortality Incidence Prevalence of Disease - Mmy Mind Study

Background Multiple myeloma (MM) is a heterogeneous and incurable disease that evolves from asymptomatic premalignant conditions. The worldwide incidence, prevalence and mortality are well known thanks to data reported by the International Agency for Research on Cancer (IARC) and by the GLOBOCAN World Cancer Observatory. The data provided by Colombia to these reports comes from the population cancer registries corresponding to 5 cities whose most up-to-date data are from 2018. National data can also be found in the base of the high-cost account. Although it is true that there are excellent sources of information, it is believed that there is a significant underreporting of the prevalence of the disease, which makes it necessary to optimize the information to achieve the establishment of programs oriented to work on better control of this type of hematological cancer. The study MiMENTe (Mieloma Múltiple Epidemiología Nacional y territorial) is a collaborative effort to know the reality of the disease in terms of incidence, prevalence and mortality in Colombia as a first step to control the disease even in the premalignant stages for the future wanting to position itself as a model for the control of MM in developing countries. Methods MiMENTE (Mieloma Múltiple, Epidemiología Nacional y territorial) is a multiphase study that is going through its first stage through a cross-sectional study in Colombia. The total population diagnosed with Multiple Myeloma (ICD Code 10 C900) during the 2008-2018 period was included in the RIPS Individual Service Delivery Registry in Colombia and a comparison was made with the available data from GLOBOCAN (Global Cancer Observatory) and High Cost Account. Records that had an unidentified diagnosis were excluded. For this phase, a comparison is made of the data from the registries of the three entities described, three measures of frequency are established: Incidence, prevalence and mortality, standardizing the latter by means of a direct method, making the Colombian population comparable with large countries such as the United States. and Spain cataloged as centers of reference in the management and diagnosis of Multiple Myeloma. Variables such as ethnicity, age, place of origin, health regime, place of death will be studied in the future in later phases of the study. Results Between 2009 and 2018 (10 years), 26,356 MM diagnoses were found throughout the national territory of Colombia. The departments where the most attention to patients with this diagnosis was presented were Cundinamarca, Valle del Cauca, Antioquia, Santander, Bolívar and Atlántico Figure 1. The standardized incidence rate for Colombia in 2018 was 1.79 x 100,000 inhabitants, being higher in the Andean region as shown in the heat map. Graph 1. The total number of prevalent cases per year varied from 1138 cases in 2009 to 4474 cases in 2018 being for this year the adjusted prevalence of 8.97 x 100,000 inhabitants / year Graph 2. When the prevalence is analyzed by regions it is higher in the Andean region Graph 3. During this entire period of time, 5481 deaths were found, being 20.80%. The highest mortality occurred in the departments of Vichada, Meta, Caquetá, Risaralda, Atlántico and the island of San Andrés. Figure 2. The age-standardized mortality rate for Colombia is 1,39x100,000 inhabitants (Adjusted with the population of the United States). The most up-to-date data from IARC and GLOBOCAN are those corresponding to the year 2018. A comparison was made of our data with those reported in this last registry for Colombia in addition to the high-cost account. Comparative data were developed with the population of the United States, standardizing this population and it was also compared with the data reported for Spain. The prevalence of the disease is higher in Colombia than reported by GLOBOCAN, IARC and High cost drug account Table 1. Conclusion This is the first report of the MiMENTe study that shows the incidence, prevalence and mortality of patients with 10-year-old multiple myeloma in Colombia. The prevalence of the disease is higher than that reported by international registries. The regions with the highest incidence were those belonging to the andean region. The highest prevalence was confirmed in Bogotá and Antioquia and the highest mortality was observed in the Orinoco region. Disclosures Idrobo: Takeda: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Tecnofarma: Honoraria, Speakers Bureau; Amgen: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau.

Changes in the Incidence and Overall Survival of Patients with Myeloproliferative Neoplasms between 2002 and 2016 in the United States

Background Patients (pts) with myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), have reduced overall survival (OS) compared with the general population. Previous reports have shown MPN incidence rates of 0.9-1.1, 0.7-1.0, and 0.3 per 100,000 person-years for PV, ET, and primary MF (PMF), respectively (Srour et al. Br J Haematol. 2016;174[3]:382; Deadmond et al. J Cancer Res Clin Oncol. 2015;141[12]:2131), with evidence of an increase in MPN incidence over time (Mesa et al. Blood. 2012;120[21]:2834). The median OS for pts with PV, ET, and PMF has been previously reported in the literature as 13.5, 19.8, and 5.2-5.9 years, respectively (Tefferi et al. Blood. 2014;124[16]:2507; Cervantes et al. Blood. 2009;113[13]:2895; Cervantes et al. J Clin Oncol. 2012;30[24]:2981). Contemporary analyses of MPN incidence and pt survival are needed, as the most recent available real-world analyses were conducted on time periods up to 2012. The objective of this analysis was to describe trends in incidence and OS among pts with MPNs in the United States using data through 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Study Design and Methods Adult pts with PV, ET, or PMF were identified from the SEER 18 registry (2002-2016) using the primary site of bone marrow (C421) and International Classification of Diseases for Oncology (ICD-O) histology codes (ICD-O-3: 9950 [PV], 9962 [ET], and 9961 [PMF]). Pts were excluded if they were aged &amp;lt;18 y on the index date (date of diagnosis) or were missing demographic or survival information. Age-adjusted incidence rates (per 100,000 person-years) were standardized to the 2000 US population by dividing the incidence rates among adult pts per year by the adult US population in the year 2000. Confidence intervals for rates and rate ratios were calculated using the Tiwari method (Tiwari et al. Stat Methods Med Res. 2006;15[6]:547). Kaplan-Meier methodology was used to compare mortality rates by diagnosis year, categorized into 3 groups: 2002-2006, 2007-2011, and 2012-2016. Pts were censored at the end of each 5-year analysis timeframe. Results Data for 34,031 pts (mean age, 65 y; female, 50.5%) were included in this analysis, including 15,141 pts diagnosed with PV, 14,676 with ET, and 4214 with PMF. Over the entire study period, incidence rates (95% CI) for PV, ET, and PMF were 1.57 (1.55-1.60), 1.55 (1.52-1.57), and 0.44 (0.43-0.45) per 100,000 person-years, respectively. The annual incidence rates of PV and PMF were higher for male vs female pts (1.94 vs 1.23 and 0.59 vs 0.33, respectively); however, the ET incidence rate was higher for female pts (1.73 vs 1.34; Table 1). ET and PMF incidence increased across the 3 time periods, whereas PV incidence remained relatively stable. Mortality rates at 1, 2, and 5 years for each MPN subtype are presented by time period in Table 2. Over the 3 time periods, mortality rates decreased for PV and PMF, but not for ET. Improved OS was observed in pts with PMF over time (median [95% CI]: 2002-2006, 3.3 [2.4-3.6] y; 2007-2011, 3.6 [3.3-4.3] y; 2012-2016, 3.8 [3.5-4.2] y). The median (95% CI) OS for the entire time period investigated was 12.0 (11.7-12.4) years for pts with PV, 12.0 (11.7-12.3) years for those with ET, and 3.6 (3.4-3.8) years for pts with PMF. Conclusions In this nationally representative real-world study, incidence of ET and PMF appeared to increase over time from 2002-2016. Median OS of patients with PV, ET, and PMF was shorter than previous reports. A trend of improved survival over time was observed in pts with PV and PMF, which was not observed in pts with ET. Further investigation into the varying OS rates between MPN subtypes is needed, as these data may suggest that ET is lacking improvements in supportive care strategies or therapies that are currently available in PV and MF. Disclosures Verstovsek: Sierra Oncology: Consultancy, Research Funding; Incyte Corporation: Consultancy, Research Funding; Roche: Research Funding; NS Pharma: Research Funding; Promedior: Research Funding; Gilead: Research Funding; ItalPharma: Research Funding; Blueprint Medicines Corp: Research Funding; Novartis: Consultancy, Research Funding; Genentech: Research Funding; CTI Biopharma Corp: Research Funding; AstraZeneca: Research Funding; Protagonist Therapeutics: Research Funding; Celgene: Consultancy, Research Funding; PharmaEssentia: Research Funding. Yu:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company. Scherber:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company. Pandya:STATinMED Research: Current Employment; Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation. Dieyi:STATinMED Research: Current Employment; Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation. Chen:Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation; STATinMED Research: Current Employment. Parasuraman:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company.

Detailing explanations in the recommender system based on matching temporal knowledge

The problem of matching knowledge in the temporal aspect when constructing explanations for recommendations is considered. Matching allows reducing the influence of conflicting knowledge on the explanation in a recommender system. A model of knowledge representation in the form of a temporal rule with the explanation constraint is proposed. The temporal rule sets the order for two sets of events of the same type that occurred at two different time intervals in time. An explanation constraint establishes a correspondence between the temporal order represented by the rule for a pair of intervals and the description of temporal dynamics for a given time period. This dynamic is represented by the explanation of the recommendation. The model is designed to match knowledge, taking into account the explanation constraint, as well as further use the matched knowledge to clarify explanations based on the results of the intelligent system. A method for clarifying explanations in a recommender system based on knowledge matching in the form of temporal rules is developed. The method uses records of purchases of goods, services or their ratings as input data. The method identifies a subset of rules matched in the temporal aspect, which represent the same dynamics of consumer demand for the target item (increase or decrease) as explanations in the recommender system. Matching of temporal knowledge makes it possible to form a refined list of explanations. This list includes basic and clarifying explanations. The basic explanation reflects the dynamics of user interests for the entire given period of time. Clarifying explanation specifies changes in demand for individual intervals within a given time period. The use of the temporal dynamics of user preferences in the explanation is aimed at increasing confidence in the received recommendations

Systemic risk: The coordination of macroprudential and monetary policies in China

The literature documents the effects of monetary and macroprudential policies in controlling systemic risk, but empirical evidence of a systemwide framework that effectively coordinates the two policies is lacking. This study assesses the effectiveness, channels, and timeliness of monetary and macroprudential policies’ impacts on systemic risk in China from January 2009 to June 2018, and contributes to the discussion of how to coordinate these policies. Using an index synthesized from 28 indicators to proxy China’s systemic risk, we find the following: (1) A contractionary monetary (macroprudential) shock increases (reduces) systemic risk over the entire shock time period. (2) Macroprudential (monetary) policy is effective in the long (short) term. (3) The systemic risk intervention effect of monetary (macroprudential) policy is channeled through inflation control (asset price stability).

Temporal trends in the number of men electing for conservative management for low-risk prostate cancer in the United States.

Concurrent with the decrease in the number of men diagnosed with prostate cancer (PCa), the proportion of men with low-risk PCa managed conservatively (active surveillance or watchful waiting) has increased in the United States. We aimed to determine whether this increase is a result of more men being managed conservatively or rather a higher proportion of the diminishing number of low-risk PCa managed this way. The SEER "Prostate Watchful Waiting Database" identified men managed initially with conservative management between 2010 and 2016. Men > 40 years old who were diagnosed with low-risk (Gleason score 3 + 3, T1-T2a, PSA level < 10 ng/mL) PCa were included. Age-standardized and age-specific PCa incidence and conservative management rates were calculated per 100,000 man-years. The annual percent change in rates for the entire time period was also calculated. The incidence of low-risk PCa declined by 11.8% per year (95% confidence interval [CI] -15.4% to -8.0%), whereas the number of men assigned to conservative management for low-risk disease did not increase significantly, rising by +3.7% per year (95% CI -0.7% to 8.4%). In age-specific analysis, the number of men < 60 years and those who were 60-69 years managed conservatively increased by +9.6% per year (95% CI 2.7% to 16.9%) and 4.5% per year (95% CI 0.1% to 9.1%), respectively, whereas the number of men ≥ 70 years electing conservative management remained stable at -4% per year (95% CI -11.2% to 3.7%). The number of men electing conservative management has remained largely stable between 2010 and 2016, despite an increase in the proportion of low-risk PCa managed in this manner.

Uncertainties in CERES Top-of-Atmosphere Fluxes Caused by Changes in Accompanying Imager

The Clouds and the Earth’s Radiant Energy System (CERES) project provides observations of Earth’s radiation budget using measurements from CERES instruments on board the Terra, Aqua, Suomi National Polar-orbiting Partnership (S-NPP), and NOAA-20 satellites. The CERES top-of-atmosphere (TOA) fluxes are produced by converting radiance measurements using empirical angular distribution models, which are functions of cloud properties that are retrieved from imagers flying with the CERES instruments. As the objective is to create a long-term climate data record, not only calibration consistency of the six CERES instruments needs to be maintained for the entire time period, it is also important to maintain the consistency of other input data sets used to produce this climate data record. In this paper, we address aspects that could potentially affect the CERES TOA flux data quality. Discontinuities in imager calibration can affect cloud retrieval which can lead to erroneous flux trends. When imposing an artificial 0.6 per decade decreasing trend to cloud optical depth, which is similar to the trend difference between CERES Edition 2 and Edition 4 cloud retrievals, the decadal SW flux trend changed from − 0.3 5 ± 0.18 Wm − 2 to 0.61 ± 0.18 Wm − 2 . This indicates that a 13% change in cloud optical depth results in about 1% change in the SW flux. Furthermore, different CERES instruments provide valid fluxes at different viewing zenith angle ranges, and including fluxes derived at the most oblique angels unique to S-NPP (&gt;66 ∘ ) can lead to differences of 0.8 Wm − 2 and 0.3 Wm − 2 in global monthly mean instantaneous SW flux and LW flux. To ensure continuity, the viewing zenith angle ranges common to all CERES instruments (&lt;66 ∘ ) are used to produce the long-term Earth’s radiation budget climate data record. The consistency of cloud properties retrieved from different imagers also needs to be maintained to ensure the TOA flux consistency.

CM6: a comprehensive geomagnetic field model derived from both CHAMP and Swarm satellite observations

From the launch of the Ørsted satellite in 1999, through the CHAMP mission from 2000 to 2010, and now with the Swarm constellation mission starting in 2013, satellite magnetometry has provided excellent monitoring of the near-Earth magnetic field regime. The advanced Comprehensive Inversion scheme has been applied to data before Swarm and to the Swarm data itself, but now for the first time to all the satellite data in this new era, culminating in the CM6 model. The highlights of this model include not only a continuous core magnetic field description over the entire time period 1999 to 2019.5 in good agreement with the CHAOS model series, but the addition of two new oceanic tidal magnetic sources: the larger lunar elliptic semi-diurnal constituent N_2 and the lunar diurnal constituent O_1. CM6 is also the parent model of the NASA/GSFC candidates for the DGRF2015 and IGRF2020 in response to the IGRF-13 call. This paper provides a full report on the development of CM6.

1521-P: State-Level Trends in Lower Extremity Amputations among U.S. Medicare Beneficiaries with Diabetes, 2000-2017

Non-traumatic lower extremity amputations (NLEA) are an important complication of diabetes. After a period of decline, some national U.S. data show that rates of diabetes-related NLEA have recently increased. Whether this varies by state is unknown. We used 100% Medicare claims for beneficiaries enrolled in Parts A and B during 2000-2017 to examine state-specific NLEA trends among adults ≥67 years with diabetes. NLEA was defined as the highest-level amputation per patient per calendar year. All rates were age-sex standardized to the 2000 study population. Trends were assessed using Joinpoint regression. National diabetes-related NLEA rates (per 1,000 persons) decreased from 8.5 in 2000 to 4.4 in 2009 (APC - 7.9, p&amp;lt;0.001), and then increased to 4.8 in 2017 (APC 1.2, p&amp;lt;0.001). However, standardized state-specific rates varied considerably over the entire time period from a maximum of 12.5 in Louisiana to a minimum of 2.6 in Hawaii. Many states showed an initial decline followed by an increase after 2009. Other states did not experience a similar increase. Our findings suggest that the recent national increase in NLEAs may be driven by only some states, while others have been able to maintain low rates. Determining reasons for the increase in some states and not others could help identify interventions to reverse the trend. Disclosure L.J. Andes: None. J. Harding: None. D.B. Rolka: None. G. Imperatore: None. Y. Li: None. E.W. Gregg: None. A.L. Albright: None.