Discharge Record Research Articles

How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

Backgroundthe purpose is to gather and analyze the statistical datas of wrist and hand injuries admitted to the Hand and Reconstructive Microsurgery and Replantation Hub center of Careggi Hospital, Florence during the first two months of COVID-19 epidemic in Italy. The Authors investigated how the drastic changes in daily activities modified the epidemiology of hand trauma lesions. MethodsThe Authors analyzed the characteristics of hand and wrist traumatic disorders during the months of February and March comparing 2019 to 2020. Collected data included age distribution, traumatic etiology, diagnosis and type of surgical procedures. ResultsThe total number of orthopedic and trauma patients significantly decrease in 2020 compared to 2019 (3360 vs 1470). The number of hand and wrist injuries didn’t show a significant difference between 2019 and 2020 instead (192 vs 131). The overall number of patients hospitalized and surgically treated at our Operative Unit (OU) was 168 in 2019 and 120 in 2020. Male patients resulted prevalent (60,7 M vs 39,3F/2019; 63,2 M vs 36,8F/2020). In terms of patient age, in 2020 we registered a significant reduction of cases in the 20-35-year-old age group and a significant increase in the 51–65 and 66-80-year-old age groups. Traffic-related, sport-related and fortuitous injuries significantly decreased in 2020, while the number of domestic accidents significantly increased. Analyzing the Hospital Discharge Records (HDR), we found a significant increase in the number of proximal and middle phalanx fractures; no significant differences were found for other kinds of discharge diagnosis. As for the choice of surgical treatment options, no differences were found between 2019 and 2020. ConclusionEven during drastic movement restrictions and the prolonged suspension of work and leisure activities secondary to COVID-19 epidemic in 2020, hand and wrist traumas rate remained almost the same compared to the same period of the previous year. Nevertheless, a significant change in the etiology and patient age was registered. In fact, sport and traffic-related traumas decreased respect to domestic traumas, while the previous prevalent involvement of young adults was surpassed by accidental hand traumas in the elderly and active adults.

The study of health and quality of operation of the transformer equipment electrical systems

Detection of defects at an early stage of their occurrence, especially for power transformers that have worked out the standard term, is an acute problem. This article discusses the possibility of using the system of monitoring, control and diagnosis of transformer equipment (SMUID) electrical systems in conjunction with the automated control system of electrical equipment (ASU ETO) and automated information-measuring system of commercial electricity metering (AIIS KUE) with the use of QR-code, as well as using TeamViewer for the operational elimination of accidents and identify abnormal operation of transformer equipment. Transformer monitoring system is designed for monitoring isolation, recording and analysis of partial discharges, monitoring of technical condition ensuring maximum fault-free service life of transformers. In addition, the introduction of automated diagnostics and electrical equipment is a necessary condition for the introduction of SmartGrid technology in industrial electric networks, contributes to the reduction of capital investments in the renewal of the equipment fleet. The methods currently used do not detect dangerous insulation degradation, are not sensitive to its aging, and in some cases mistakenly assess the isolation condition. The work analyses the operability and quality of the systems under consideration, shows the hierarchical structure of SMUID. By applying the proposed idea with the QR-code, it is possible to speed up the process of searching for information about the current technical state of electrical equipment.

Predicting difficult discharge from surgical wards: a cohort study in an Italian sample

Abstract Background Poor discharge planning (DP) can increase costs for European hospitals and worsen patient's experience. Validated scores are used in internal medicine to identify clinical or social difficulties in discharges upon admission but there is a lack of such a tool in the surgical context. This study aims to detect early predictors of difficult discharge. Methods Socio-demographic and clinical data from 15,165 surgical Hospital Discharge Records (SDOs) of the Molinette hospital of Turin, including an additional pre-surgery evaluation of social vulnerabilites from a subgroup of 388 patients, were collected between 2017 and 2019. Outcomes were length of stay (LOS), discharge destination (home, Long Term Care - LTC). Descriptive analysis and multivariable regressions were performed. Results 52.3% of patients were male and the median age was 61 (IQR 22). Median LOS was 6 days (IQR 6) but 15 (IQR 30) for patients discharged to LTC. 18.7% were admitted through the Emergency Department (ED) with a median LOS of 7 (IQR 10). 17.6% of the subsample declared living alone. Linear regression showed associations between discharge to LTC, admission through ED, diagnosis of neoplasia and a longer LOS (Bs 10.76, 5.21 and 2.57 respectively, p < 0.001). Logistic regression showed associations between admission by ED, age and discharge to LTC (OR 1.77 and 1.02 respectively, p < 0.001). Preliminary analysis of the subsample did not show any new association with social vulnerabilities, but 98.2% attended elective surgery and thus probably had time to prepare for discharge. Conclusions Surgery LOSs are extremely diversified among patients. This study identified several predictors of difficult discharge, mainly admission through ED, discharge to LTC and diagnosis of neoplasia, suggesting difficulties handling an unexpected event by patients' relatives. Further studies gathering patients' data at admission are required in order to develop a predictive tool useful for European hospitals. Key messages Clinical (cancer) and social (sudden event, no housing solutions) factors can determine a difficult discharge for European patients and should be investigated to anticipate discharge planning. Elective surgery patients seem less prone to social vulnerabilities (e.g. living alone), probably because relatives have time to prepare, while ED patients often need help in the discharge process.

Hospital management of patients with acute coronary syndrome: influence of age and gender

Abstract Background Although the improvement of therapeutic strategies is leading to a dramatic decline of in-hospital acute coronary syndrome (ACS) death rates, differences in care and prognosis of ACS patients exist when age, gender and admission department are considered. Methods The national administrative hospital discharge record (HDR) system was used. Only data recorded from January 1, 2017 to Dicember 31, 2018 were analyzed. This approach allowed to identify 205775 patients reporting ACS as primary or secondary diagnosis: 122812 with non-ST-elevation ACS (NSTE-ACS) and 82963 with ST-elevation ACS (STEMI). The ACS cohort was stratified by age (<75 and ≥75 years) and gender. The proportion of STEMI patients treated in general medicine or cardiology departments requiring a coronary procedure or extensive investigations were analyzed. Results Among the 205775 patients hospitalized for ACS, 6% of STEMI and 8.3% of NSTE-ACS patients have been treated only in a general medicine ward and have never passed through a specific cardiology ward. For STEMI patients, the proportion becomes 4% when males are considered, increases up to 10% for females and up to 13% for elderly patients (≥75 years). During the index hospitalization, about 25% of female and more than 30% of elderly patients with STEMI do not undergo a coronary procedure or other extensive investigations; the same happens only in about 10% of male and 6% of younger patients. The proportion of improperly managed patients reaches 35% for women aged ≥75 years. Conclusions In-hospital management of women and elderly patients with ST-elevation ACS does not completely comply with the recommended guidelines and exposes them to unfavourable prognosis. Key messages Women and elderly STEMI patients are markedly less intensively investigated and treated in cardiologic departments. This medical policy could lead to unfavourable prognosis.

A novel tool to predict in-hospital mortality after hip-fracture: the PRIMOF score

Abstract Background Increased life expectancy has led to an increased incidence of hip fractures in aged people. Patients reporting hip fractures often show relevant comorbidities leading to prolonged hospital stays, significant complications, and higher mortality rates. Being aware of the factors associated with in-hospital death or adverse events can help patients and healthcare providers make informed planning and management. The aims of this study were the development and validation of a score predicting in-hospital mortality among hip fractured patients. Methods Patients were selected from the hospital discharge record referring to the period 2006-15 and including data on the population aged 40 years or over in Abruzzo, a region of Southern Italy. The whole population was divided into 2 random samples in order to control the accuracy of predictions and to increase the reliability of all the statistical analyses. A multivariate logistic regression model was performed to identify the predictors of in-hospital mortality. All the diagnoses significantly associated with in-hospital mortality were included in the final model. Results The score ranged between 0 and 27 and was divided into four groups to facilitate the tool interpretation. An increase in odds ratio values was documented alongside the increase in PRIMOF score both in training and in validation groups. The score showed a good calibration and a good accuracy in predicting in-hospital mortality. Conclusions This study has shown that a simple score, based on the clinical history of the patient, allows to stratify the risk of hip fractured population in terms of in-hospital mortality. The identification of individuals at high risk of short-term death can be of great significance to health providers and public and private health services. Key messages Patients reporting hip fractures often show relevant comorbidities leading to higher in-hospital mortality rates. A simple score, based on the clinical history of the patient, allows to stratify the risk of hip fractured population in terms of in-hospital mortality.

Post-eruption morphological evolution and vegetation dynamics of the Blanco River, southern Chile

In this study, we analysed the morphological evolution of a channel segment in the Blanco River in southern Chile that was affected by the Chaitén Volcano eruption occurred in 2008–2009. Through a series of high-resolution satellite images from 2005 to 2019 that represents the entire pre- and post-eruptive dynamics and land covers, we tracked the geomorphological evolution of a 5.65-km-long river segment using channel form indices and also monitored the vegetation dynamics using object-based image analysis (OBIA). Discharge record for the Blanco River was also reconstructed to support the analysis of channel morphologic process. The study aims at examining whether a) the river channel is still adjusting 10 years after the eruption and if so, at what magnitude and, b) the recovered riparian vegetation plays a significant role in stabilising the river streambanks and terraces. We found that even 10 years after the eruption, the Blanco River channel planform is still adjusting, showing a simpler and stable channel configuration in the upstream reaches of the valley, where a certain degree of equilibrium appears to have been attained. More dynamic morphologies were observed in the reaches downstream that have to accommodate the arrival of large amounts of freshly eroded sediments. Our analysis showed that the occurrence of competent floods capable of reworking the river channel matches with the geomorphic indices and mark the post-eruption adjustments of the channel. Finally, the in-channel and riparian vegetation does not play a significant role in stabilising the active channel, streambanks, and terraces, reinforcing the recolonization of sedimentary active areas occurring elsewhere in the valley.

Severe maternal morbidity among U.S.- and foreign-born Asian and Pacific Islander women in California

PurposeThe purpose of the study was to examine the risk of severe maternal morbidity (SMM)—a composite of serious, potentially life-threatening conditions related to childbirth—among subgroups of nulliparous women with Asian and Pacific Islander race/ethnicity. MethodsThis study used linked hospital discharge and vital record data California to identify nulliparous Asian and Pacific Islander women from 1997 to 2012 (n = 453,525). We examined the risk of SMM for 15 Asian and Pacific Islander subgroups and compared the risk between U.S.- and foreign-born women. ResultsThe risk of SMM was higher among Pacific Islander women than that among Asian women (148 and 127 cases per 10,000 births, respectively). Among Asian women, the risk of SMM ranged from 94 (Korean) to 165 (Filipina) cases per 10,000 births, and among Pacific Islander women, the risk ranged from 125 (Hawaiian) to 162 (Other). With the exception of Korean and Filipina women, relative risks of SMM for U.S.- versus foreign-born Asian and Pacific Islander women were similar. ConclusionsDifferences in the risk of SMM exist between subgroups of the Asian and Pacific Islander community. These differences should be considered when conducting research on racial and ethnic differences of SMM and when counseling Asian and Pacific Islander women regarding their risk of SMM.

Hospital Disparities between Native Hawaiian and Other Pacific Islanders and Non-Hispanic Whites with Alzheimer's Disease and Related Dementias.

Objective: To compare important indicators of quality of care between Native Hawaiians and other Pacific Islanders (NHOPIs) and non-Hispanic Whites (NHWs) with Alzheimer's disease and related dementias (ADRD). Methods: We used the Health Care Cost and Utilization Project, Hawaii State Inpatient Databases, 2010-2014. They included 10,645 inpatient encounters from 7,145 NHOPI or NHW patients age ≥ 50years, residing in Hawaii, and with at least one ADRD diagnosis in the discharge record. Outcome variables were inpatient mortality, length of hospital stay, and hospital readmission. Results: NHOPIs with ADRD had, on average, a hospital stay of .94days less than NHWs with ADRD but were 1.16 times more likely than NHWs to be readmitted. Discussion: These patterns have important clinical care implications for NHOPIs and NHWs with ADRD as they are important indicators of quality of care. Future studies should consider specific contributors to these differences in order to develop appropriate interventions.

Unacylated Ghrelin Regulates Glucose-Sensitive Neurons Activity and Glycolipid Metabolism via Orexin-A Neurons in the Lateral Hypothalamic Area.

The objective of the study was to investigate the regulatory actions of unacylated ghrelin (UAG) on glucose-sensitive (GS) neurons and glycolipid metabolism in the lateral hypothalamus area (LHA) and its involvement with orexin-A-immunopositive neurons. The effects of UAG administered into the LHA on GS neurons discharges and glycolipid metabolism were detected by single neuron discharge recording, biochemical index analysis and quantitative real-time PCR; the level of c-fos protein in orexin-A-immunopositive neurons was observed using immunofluorescence staining. UAG microinjected into the LHA activated glucose-inhibited neurons, which were partially blocked by pre-administration of anti-orexin-A antibody in the LHA. Furthermore, UAG microinjected into the LHA significantly reduced serum triglycerides (TG), total cholesterol, low-density lipoprotein cholesterol, blood glucose, insulin and hepatic TG levels, while elevated serum high-density lipoprotein cholesterol levels. UAG elevated the mRNA expression of carnitine palmitoyltransferase-1 and reduced the mRNA expression of acetyl-CoA carboxylase-1 in the liver. The above-mentioned effects of UAG were partially blocked by pre-administration of anti-orexin-A antibody. The expressions of orexin-A and c-fos were observed in the LHA. After UAG injection into the LHA, some neurons showed double labeling, and the percentage of double-labeled orexin-A/c-fos neurons in orexin-A-immunopositive neurons increased significantly. UAG in the LHA regulates glycolipid metabolism by activating orexin-A-immunopositive neurons in the LHA.

Hospitalizations for Community-Acquired and Non-Ventilator-Associated Hospital-Acquired Pneumonia in Spain: Influence of the Presence of Bronchiectasis. A Retrospective Database Study

To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish Hospital Discharge Records, 2016–17. We identified 257,455 admissions with CAP (3.97% with BQ) and 17,069 with NV-HAP (2.07% with BQ). Patients with CAP and BQ had less comorbidity, lower IHM, and a longer mean length of hospital stay (p < 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. P. aeruginosa was more frequent (p = 0.028). IHM for CAP and NV-HAP with BQ was 7.89% and 20.06%, respectively. The factors associated with IHM in CAP with BQ were age, comorbidity, pressure ulcers, surgery, dialysis, and invasive ventilation, whereas in NV-HAP with BQ, the determinants were age, metastatic cancer, need for dialysis, and invasive ventilation. Patients with CAP and BQ have less comorbidity, lower IHM and a longer mean length of hospital stay than non-BQ patients. However, they had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality, or mean length of stay, but they had a greater frequency of infection by P. aeruginosa than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.

The impact of land use and climate change on surface runoff and groundwater in Cimanuk watershed, Indonesia

The Cimanuk River with a total watershed area of 4010.8 km2 flowing from the Garut Regency to Indramayu Delta is the longest in West Java Province. However, the cumulative effects of climate change, increased population, and fish farming in the coastal area have continuously pressured the availability of water resources in its watershed. This study was, therefore, aimed to analyze the impact of land use and climate change on surface runoff and groundwater using a SWAT model. This is a physically based semi-distributed hydrological model with various applications, particularly to simulate water balance and watershed management. Daily discharge record for 2005–2008, land use data for 2002–2017, and the simulated climate (1979–2003) and projected climate data (2075–2099) retrieved from MRI-AGCM3.2 20-km by the Meteorological Research Institute of Japan Meteorological Agency were used in this research. The result showed that the calibration and validation of SWAT model have exhibited satisfactory criteria for hydrological simulations. The modeled period showed land use changes caused a general increase in runoff and decline in base flow contribution to annual streamflow. The changes between the current and projected climate exhibited increase in Qmax/Qmin ratio in certain years.

Natural discharge changes of the Naryn River over the past 265 years and their climatic drivers

Originating in the Tianshan Mountains in arid Central Asia, the natural discharge change of the Naryn River is strongly affected by climate change. As the main source of water for the region, this river is crucial to both the natural environment and the socio-economic development. To extend the discharge record and better understand past and future changes in Naryn River discharge, we developed four tree-ring width chronologies and analyzed the relationship between tree growth and discharge. The resulting reconstruction dates back to 1753 and has an R2 of 0.374 (1939–2017). Interannual discharge variations of the Naryn River indicate that 1917 was the driest year of the past 265 years, while 1956 was the wettest. The record also indicates that the majority of extreme flood years occurred in the past century; prior to about 1900 C.E., the discharge of the Naryn River was relatively stable. Since 1900 C.E., discharge volume has gradually increased, as has discharge variability. At decadal time scales, the 2010s are notable for the frequency of major floods, whereas the 1910s were the driest. Between the 1870s and the 1910s, the Naryn River experienced a period of low discharge that continued for nearly half a century. The discharge of the Naryn River over the past 265 years appears to vary over quasi-periods of 60, 21, 11, and 2-4 years, which are driven by large-scale climate systems.

TO018ACUTE KIDNEY INJURY IDENTIFICATION: USE OF ELECTRONIC AKI ALERTS VERSUS ELECTRONIC HEALTH RECORDS IN HOSPITAL EPISODE STATISTICS

Abstract Background and Aims Acute kidney injury (AKI) refers to an abrupt decline in the glomerular filtration rate (GFR) which may be associated with significant morbidity and mortality. Since April 2015, an automated real-time electronic alert system for AKI has been introduced and progressively implemented in England, with alert data being sent to the UK Renal Registry (UKRR) for collection into a master patient index (MPI). Historically, the only way to routinely measure AKI incidence in hospital was to analyse the Hospital Episode Statistics (HES). The introduction of the MPI allows for the first time a comparison between warning-test score defined AKI and clinical coding. This project aims to determine whether episodes of AKI identified in the UKRR MPI correspond to coded diagnoses on the discharge record held in HES. Method The UKRR MPI of all AKI electronic alerts (AKI stages 1, 2 and 3) in patients ≥18 years of age, between 01/01/2017 and 31/12/2017 were linked to HES data to identify a hospitalised AKI population. Descriptive analyses were conducted to describe the demographics and to investigate whether those with electronic AKI alert also had an International Classification of Diseases (ICD)-10 code for AKI (N17) in HES. Results From 01/01/2017 to 31/12/2017, 301,504 hospitalised adults received an AKI electronic alert. AKI severity was positively associated with the percentage of AKI alerts which were coded in HES. There was also a significant variation in HES coding between hospitals, but generally, variation was most pronounced for AKI stage 1, with a mean of 48.2% [SD 14], versus AKI stage 3, with a mean of 83.3 % [SD 7.3] (figures 1, 2 and 3). There was an inverse trend with age in that younger adults AKI staging warning scores were less often coded in HES and this was true for all the three AKI stages (33% of AKI episodes coded in HES for people aged 18-29 versus 64% for people ≥ 85 years old) (Table 1). Conclusion In 2017, earlier stages AKI warning scores were poorly coded in HES. There was also high degree of inter-hospital variability, particularly for AKI warning score 1, reflecting potentially poor clinical recognition and documentation in medical record and subsequent clinical coding. AKI warning scores were poorly captured in HES for younger adults in comparison to those of older age; reasons for which need to be identified. Use of HES to identify cases of AKI is likely to underestimate the incidence of AKI, especially for AKI stage 1, though a high proportion of the most severe cases will be captured.

Streamflow Recession Analysis Using Water Height

AbstractRecession analysis is widely used for characterizing aquifer and basin properties based on the falling limb of the hydrograph. However, recession analysis using streamflow discharge requires a relationship (the rating curve) between simultaneous measurements of water height, h, and discharge, Q, across a wide range of flows, which is expensive to obtain, and changes in time. We leverage the relationship between h and Q (typical power law) to perform recession analysis using h directly, thus permitting identification of transient flow regimes, where only h is available. Recession analysis evaluates the rate of change in discharge, −dQ/dt, as a function of discharge, Q, in a bilogarithmic plot where the slope, b, contains information about aquifer characteristics. While values of b are not conserved when replacing Q with h, we find that the variability in values of b within and between events is captured in recession analysis for both Q and h. For example, when considering individual recessions from a large number of watersheds, a change from a smaller b at high discharge/stage to a larger b at lower discharge/stage occurs in most watersheds and suggests a transition to a more long‐lasting, and less drought‐sensitive, baseflow regime. With the advent of low‐cost reliable pressure loggers, as well as satellites that provide global reporting of river stage, recession analysis using water height expands the number of river systems where recession analysis can be conducted and provides the potential for insights into the variability of watershed drainage characteristics without the need for a discharge record.

Improved efficiency of patient admission with electronic health records in neurosurgery.

Electronic health records (EHRs) may be controversial but they have the potential to improve patient care. We investigated whether the introduction of an electronic template-based admission form for the collection of information about the patient's medical history and neurological and clinical state at admission in the neurosurgical unit might have an impact on the quality of documentation in a discharge record and the amount of time taken to produce this documentation. A new digital template-based admission form (EHR) was developed and assessed with QNOTE, an assessment tool of medical notes with standardised criteria and the possibility to benchmark the quality of documentations. This was compared to 30 prior paper-based handwritten documentations (HWD) regarding the utilisation of these medical notes for dictation of medical discharge records. Implementation of the EHR significantly improved the quality of patient admission documentation with a QNOTE mean grand score of 87 ± 22 (p < 0.0001) compared to prior HWD with 44 ± 30. The mean documentation time for HWD was 8.1 min ± 4.1 min and the dictation time for discharge records was 10.6 min ± 3.5 min. After implementation of EHR, the documentation time increased slightly to 9.6 min ± 2.3 min (n.s.), while the time for dictation of discharge records was reduced to 5.1 min ± 1.2 min (p < 0.0001). There was a clear correlation between a higher quality of documentation and a higher needed documentation time as well as higher quality of documentation and lower dictation times of discharge records. Implementation of the EHR improved the quality of patient admission documentation and reduced the dictation time of discharge records. It is crucial to involve stakeholders and users of EHRs in a timely manner during the stage of development and implementation phase to ensure optimal results and better usability.

Hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, and Taenia solium taeniasis/cysticercosis, Italy, 2011-2016.

To analyze epidemiology and burden of Neglected Tropical Diseases (NTDs)in Italy. We used Hospital Discharge Records and number of residents in Italy to calculate number and rate of hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, Taenia solium taeniasis, and cysticercosis by sex, citizenship group, and region in the period 2011-2016. 7195 hospitalizations for NTDs were retrieved, accounting for 7375 diagnoses, 60% in Italians and 40% in foreigners. Male-to-female ratio was 2; the age group more commonly affected was 25-44years (32.5%). The most common diagnoses were leishmaniasis (34%), schistosomiasis (29%), strongyloidiasis (12%), Chagas disease (8%), and dengue (8%). Average yearly hospitalization rate per 100,000 residents for all NTDs was 2.05, 1.33, and 10.39 in general population, Italians, and foreign citizens, respectively. Hospitalization rates higher than 100 per 100,000 subjects were found in citizens from Sub-Saharan Africa (SSA) and Bolivia. NTDs have a not negligible burden in Italy. The most clinically relevant NTDs in Italy are leishmaniasis and schistosomiasis, followed by strongyloidiasis, Chagas disease, and dengue. Cystic echinococcosis, that was not included in the analysis since a similar study on this disease was recently published, should also be listed among the leading NTD in Italy. While schistosomiasis has its highest burden on population coming from highly endemic areas such as SSA, leishmaniasis is especially relevant in Italian-born residents of southern regions. Education at university and post-graduate levels, to increase the awareness of healthcare professionals on these topics, as well as targeted public health interventions (such as screening or presumptive treatment in high-risk groups), are an asset to improve clinical management and control of these diseases.

Deep groundwater discharge after the 2011 Mw 6.6 Iwaki earthquake, Japan

Hot spring discharge was linked to the 2011 Mw 6.6 Iwaki earthquake. Periodic surveys revealed that the discharge continued for more than 7 years, which is a rare and valuable long-term record of hot spring discharge triggered by an earthquake in a non-volcanic area. In terms of coseismic changes, based on a comparison of the spatial distribution of changes in the coseismic water head and calculated crustal volumetric strain using a fault model, hot spring water discharge was found to be caused by a change in the coseismic crustal volumetric strain. As for the postseismic changes, observations over 7 years revealed a gradual rise in the temperature and chloride ion concentration of the hot spring water. Such long-term hot spring discharge may be explained by the following two causes: the rise of thermal water from the deep part and the permeability changes along the hot spring channels.

Determination of river design discharge (Tar River case study)

Abstract Rivers are usually exposed to floods that cause significant human and financial loss, for which structures are considered in the rivers for preventing floods and reducing damage. In this way, it is necessary to acquire design discharge for building these structures. The case study was conducted on the Tar River of Ghazi Station in Tehran Province, which originates from 1 km west of Tar Lake in 13 km east of Damavand. The Tar River is one of the tributaries of Damavand River. In this study, the cross section of the river was first measured through surveying and existing maps. The design discharge of flood control structures was designed using the methods described in this study. Moreover, the stage-discharge table was used to obtain the Manning roughness coefficient. The effective discharge was calculated using the sediment rating curve and sediment frequency histogram, while the bankfull discharge was derived from the return period of 17 years discharge record and fitting of Gumbel distribution to the data. The results indicated that the average of dominant, effective, and bankfull discharges could be the appropriate design discharge for the river, as their values are significantly close to each other. However, there is no need to use flood control structures in this river, due to the occurrence of medium frequent flood events in the river.

Modelling headwater channel response and suspended sediment yield to in-channel large wood using the Caesar-Lisflood landscape evolution model

Forest management activities have the potential to significantly modify large wood loads in riparian areas, and thus the availability of material for recruitment into the stream channel, hence it is important that forest management practices take account of the role wood supplied from riparian areas play in the development of channel structure and sediment retention capacity. In this study the cellular landscape and river reach process model CAESAR LISFLOOD (C-L) was used to simulate the effect of in-channel obstructions created by large wood on the distribution of erosion and deposition within a small headwater channel and suspended sediment yield at the catchment outlet. The process model was parameterised and calibrated against an observed discharge and suspended sediment record. Following calibration, 12 discharge and large wood obstruction scenarios were carried out to model erosion and suspended sediment transport over a timber harvesting cycle. The inclusion of obstructions into the model runs to simulate in-channel LW pieces substantially reduced suspended sediment yields in all three discharge scenarios and increased sediment storage along the channel. The modelled location of channel bed degradation and aggradation generally coincided with the pattern of sediment storage along the channel bed demonstrating that C_L was predicting the pattern of erosion and deposition in the channel reasonably well. Modelled erosion rates were extremely low for the respective discharge and large wood model scenarios, with the highest rates ranging from 0.02 t ha−1 year−1 to 0.1 t ha−1 year−1 for the no large wood model over the 22-year period. These findings reinforce the importance of maintaining sufficient volume of standing wood in buffer strips alongside small headwater channels to ensure ongoing recruitment of large wood to the channel network in forests managed for timber production.

Defining maternal obesity in studies of birth outcomes: Comparing ICD-9 codes at delivery and measures on the birth certificate.

Using ICD-9 codes underestimates the prevalence of obesity in adults; however, the validity of these codes in studies of pregnancy-related outcomes is not known. To compare classification of maternal obesity based on ICD-9 codes in hospital discharge records versus data from birth certificates in the same women, examine predictors of agreement, and assess how associations between obesity and two birth outcomes differ by source of weight data. This population-based study included 2329145 California births between 2007 and 2012. We compared data on obesity from childbirth hospital discharge records (ICD-9 codes for obesity) and birth certificates (pre-pregnancy body mass index (BMI) calculated from weight and height) and identified predictors of agreement between the two sources. Logistic regression models assessed whether the two definitions of obesity resulted in different estimates of the associations of obesity with caesarean birth and large-for-gestational age. Overall, 464754 women (20.0%) had obesity based on their pre-pregnancy BMI while only 100002 (4.3%) had an obesity-related ICD-9 code. The sensitivity of ICD-9-based obesity was low at 16.2%; however, obesity codes were highly specific at 98.7%, with a negative predictive value of 82.5% and a positive predictive value of 75.2%. Among women with obesity identified by the birth certificate, those with pre-pregnancy and pregnancy-related complications (eg diabetes and hypertension) were more likely to have an obesity-related diagnosis in their delivery hospital discharge record. Using ICD-9 codes overestimated the association of obesity with caesarean birth and newborn large-for-gestational age. ICD-9 codes in childbirth discharge records captured only one in five women with pre-pregnancy obesity. Sensitivity varied by maternal characteristics and conditions. This misclassification resulted in bias when examining the association of obesity and pregnancy-related outcomes.