For the past two months a small device in my car, the size of a credit card, has been tracking my every movement.
It knows how far I drive every day, the time of day I'm driving, how quickly I accelerate to get on to the highway and which highway that was. The wireless GPS monitor goes with the Desjardins Insurance Ajusto program which was launched in Ontario last May.
I've been testing the device to see how much I might save by exchanging some privacy in return for a discount based on my driving habits. So far, I'm looking at about $150 a year and I'm not sure whether the tradeoff is worth it.
I'm not alone in that. Desjardins has added 130,000 new customers in Ontario and Quebec in the past year and 50,000, or about 40 per cent, have opted for Ajusto. This is despite an incentive of 5 per cent off in the first year for trying it.
Ajusto is the first of a new tier of car insurance products coming your way. Companies are using wireless technology to monitor how you drive and sell you products based on that. In exchange for personal information, you'll get a better deal.
Ajusto's measures are clear and well explained. It monitors the time of day you drive, the distance you drive in a year and how fast you brake and accelerate. It passed a very stringent examination by the insurance regulator, the Financial Services Commission of Ontario (FSCO). The Ontario privacy commissioner approves of the program.
Fred Carter, a senior technology advisor to Privacy Commissioner Ann Cavoukian, says the agency supported the Desjardins application because the criteria was clear, the data collection transparent and consumer privacy protected.
"Ajusto nailed it down," Carter says.
Alex Veilleux, chief product manager in charge of telematics at Desjardins, says the company expected 25 per cent of new customers would try Ajusto, not 40 per cent. They are very happy with that. In Ontario, the take-up rate may be a testament to just how much drivers are chafing under the highest insurance rates in Canada.
Veilleux says the three things Desjardins is measuring have been shown over time to be the key factors in accidents and claims. He adds that anyone opting for Ajusto will not be punished for bad driving.
The device was simple to install and plugs into my car's diagnostic port underneath the steering column. At first, I found it creepy to think my trip to the grocery store for a dozen eggs was being recorded somewhere. I quickly forgot the device was there.
You can log in to the Desjardins web site and view a rolling tally of your annual savings. Veilleux says this information is a powerful motivator for better driving, because like a video game you're always aiming for a better score.
Desjardins advertises savings of 'up to 25 per cent' but the average is 12 per cent.
I'm at 8 per cent, hurt by the length of my commute and the construction mess on the Gardiner Expressway and Lake Shore Blvd. W. which is giving a new meaning to stop and go traffic.
If you drive more than 15,000 km a year no saving at all. As an Oakville commuter I drive more than that and so would normally get nothing. But how's this for an upside to the road construction: I'm back on the GO Train and driving less. I may sneak under the bar.
If you accelerate faster than 13 km/h or more in one second or decelerate 15 km/h or more in one second, the device will consider this sudden.
My dashboard shows almost 300 incidents in 10 weeks, with quick acceleration outnumbering quick braking by 3 to 1.
It's hard to translate 13 km/h per second into something meaningful. Veilleux says many customers are saying the same thing and Desjardins plans to post videos on its web site at different braking and acceleration speeds to show how it might look.
I rarely drive between midnight and 5 a.m. This is when accidents are statistically the most deadly because of fatigue and lack of visibility. I drive to work at 6 a.m. It's before rush hour, but it's getting light and drivers tend to be more alert.
The insurance industry is lining up at FSCO's door to apply for these programs. Those approved or already rolled out include CAA Insurance, The Co-operators, Intact and Allstate.
Carter says the biggest danger is 'function creep,' where insurers collect all kinds of secondary information and then use it without asking permission or sell it to third parties.
These might include: How often you travel out of province or to the U.S. When exactly you're prone to accelerating quickly. How often you stop at a McDonalds versus Wendy's, how long you stay at the grocery store and which ones you visit. Did the kids spend the weekend in Montreal when they borrowed the car or go to Ottawa?
Carter says insurers find it irresistible to collect data. The more they know about you, the more they can calculate risk and design products.
As for me, I'm not sure $150 gain is worth what I'm giving up. For now, anyway.
Lessons from a year of usage-based insurance in Ontario.
40 per cent of new customers are signing up for Ajusto, well head of their 25 per cent target.
Desjardins has gained 50,000 new customers in Ontario and Quebec through Ajusto.


text:
Ecological Issues
Environmental Crisis In The World
California Environmental Issues
ENVIRONMENT: The top 10 Southern California issues to ponder on Earth Day
Sand mining: the global environmental crisis youve never heard of
Earth Day, celebrated Friday, April 22, across the globe, reminds us of the fragile state of our planet.
From land contaminated with toxic chemicals to bad air spewed into the atmosphere, most of us have been affected by pollution in some way.
To bring all of this closer to home, we're listing the 10 most critical environmental problems in Southern California. Some are very recent; some have been going on for decades. But all are still relevant today. Especially today, when we turn our attention to the air, land, water and inhabitants of planet Earth.
1. Global Climate Change: While some parts of the country have experienced extreme weather, such as colder winters and massive flooding, the West has experienced hotter temperatures and unusually warmer winters these past several years. An overwhelming majority of scientists say man-made emissions, including carbon dioxide — produced from the burning of fossil fuels — become trapped in the atmosphere causing a heat or greenhouse effect.
Last year was the hottest year on Earth since record keeping began in 1880, according to scientists with the National Oceanic and Atmospheric Administration. February and March were even hotter than that mark.
The temperature rise in March was the 11th month in a row of record-breaking heat.
"It is a steady warming, with no evidence of change in the long term, " Gavin Schmidt, director of NASA's Goddard Institute for Space Studies in New York, told our sister newspaper, The Mercury News in January.
Overall, the planet's temperature has risen about 1.8 degrees Fahrenheit since the late 19th Century. While California's four-year drought was not caused by climate change, researchers from NASA and Columbia University said it aggravated the situation by causing more water evaporation and thereby making the state's drought about 20 percent worse.
On Friday, nearly 160 nations are expected to sign an accord agreeing to cut greenhouse gases. The goal is to keep the global temperature from rising more than 3.6 degrees Fahrenheit, measured since before industrialization.
2. Porter Ranch gas leak: What many may not know that the Aliso Canyon gas fields are not just a place where methane is pulled from the ground. It is a place where natural gas is stored after being injected into the ground. With 115 wells, it is one of four underground natural gas storage facilities operated by Southern California Gas Co.
About 100, 000 tons of methane leaked out of the underground storage field, the largest natural gas leak disaster in the United States, according to researchers with University of California, Irvine. Enough gas leaked every day for nearly four months starting in October 2015 to fill a balloon the size of the Rose Bowl, experts said. About 6, 000 residents were relocated after many complained of headaches, nosebleeds and vomiting. SoCalGas said experts agree there are no long-term health effects.
The next question is: Can Aliso Canyon be reopened as a gas-storage facility? A new report says without that capacity, there may be a shortage of natural gas to power generators that produce electricity, potentially causing scattered blackouts this summer. Meanwhile, an old gas field in Montebello had six new leaks found at the same time Aliso Canyon was leaking; all were repaired. SoCalGas pulls 1 million cubic feet of natural gas from residual supplies and 100 barrels of oil every day from Montebello, despite a closure order issued 15 years ago.
Source: www.pe.com November 10, 2018 – 09:59 am
Louisiana Environmental Issues
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Controversial Environmental Issues
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Local and Global Environmental Issues
The world s environment has emerged as a major subject of political, economic, scientific, ethical and theological discussion and inquiry. Issues related...
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Oil Industry Environmental Issues
Since the late 1980s, when the current tide of environmental concern began to rise, every improvement made by the oil industry has been followed by new...
Environmental Issues in World
In many tobacco growing countries, evidence indicates irreparable environmental damage from tobacco agriculture, particularly when associated with the...
Environmental Problems in American
Story Highlights Worry about most problems down after increasing in 2014 Americans are most worried about polluted drinking water Americans worry least...
List of Environmental Crisis
With Donald Trump s nomination of climate change denialist Scott Pruitt to head the Environmental Protection Agency, it comes as no surprise that he has...
Global Ecological Problems
Global-scale environmental problems are rarely regarded as amenable to traditional scientific experiment. We argue here that small-scale experiments using...
Ecological Problems in India
The interactive map, which shows the average levels of dangerous particulate matter in the air that can lodge in lungs and cause diseases, was made by...
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In the past Antarctica has been used with little regard to the consequences on the environment. Whales in the Southern Ocean and seals on the sub-Antarctic...
Thursday 13, July 2017 04:57 AM from chris
RT @EPAScottPruitt: I enjoyed a productive meeting today with U.S. Rep. Jim Costa @RepJimCosta on environmental issues facing California. h…
Friday 14, July 2017 09:33 PM from Suzanne Avila
@EDF_CA Southern California needs to step up to the plate and at least get to 1st base on tackling environmental issues.

redpajama_set_name: RedPajamaCommonCrawl


text:
Moto E7 Renders, Key Specifications Surface Online
12 November 2020 aioappz Mobile
Moto E7 official-looking renders have been leaked by a tipster on Twitter, where it is visible in two distinct colours. The smartphone has been subject to several leaks in the past and has also been spotted on multiple certification sites. Along with the renders, key specifications of the purported Motorola smartphone have also emerged, that differ from the earlier leaks. According to the tipster, the smartphone will feature a 6.5-inch HD+ display and pack a 4,000mAh battery. Moto E7 is expected to sport a 48-megapixel primary sensor and a 2-megapixel secondary sensor on the back.
The official-looking renders and specifications were tweeted by known tipster Abhishek Yadav. Moto E7 is seen in Blue and Grey colours in the alleged renders. The phone was recently spotted on US Federal Communications Commission (FCC), Thailand's National Broadcasting and Telecommunications Commission (NBTC), and TUV certification sites.
Moto E7 specifications (expected)
Moto E7 is expected to run on Android 10 out-of-the-box. Along with the 48-megapixel and 2-megapixel cameras in the rear, it could also sport a 5-megapixel selfie shooter at the front, as per the tipster. The smartphone by Motorola is tipped to feature a 6.5-inch HD+ display and pack a 4,000mAH battery.
A previous leak suggests that Moto E7 will come in a 2GB + 32GB storage configuration. It will have connectivity options such as 3.5mm headphone jack, Wi-Fi, LTE, GPS, and Bluetooth.
Moto E7 Plus was launched in India in September and is currently priced at Rs. 8,999. Moto E7 is expected to be a more affordable variant of Moto E7 Plus. While there has been no official word from Motorola about the upcoming phone, the recent leaks and official-looking renders suggest that a launch could be near.
Is OnePlus 8T the best 'value flagship' of 2020? We discussed this on Orbital, our weekly technology podcast, which you can subscribe to via Apple Podcasts, Google Podcasts, or RSS, download the episode, or just hit the play button below.
Previous Post:How much power in Huawei Y9 (2019)? At first sight
Next Post:Rocket League's PS5 and Xbox Series X update is puzzling


The Canadian manufacturing sector stagnated in April, an improvement from the contraction observed in March, according to the RBC Canadian Manufacturing Purchasing Managers' Index (RBC PMI). Read the report.
The provincial budget from the new Ontario government is a positive step forward in revitalizing the province's manufacturing sector, but more must be done to create jobs and support business growth, according to Canadian Manufacturers & Exporters (CME), the country's largest trade and industry association. Learn more.
Canadian manufacturers fear even more fees may be looming at the Canada-U.S. border as the U.S. Department of Agriculture recommends revenue-generating measures that could result in higher costs. Get the details.
Statistics Canada says the economy grew by 0.3 per cent in February, keeping pace with January's growth. Read more.
The demand for the production of defence components is growing by the day in India, and by their very nature, precision manufacture of these components is critical. But with long tool set-up times, one manufacturer needed to find a way to improve its processes. Here's how the company did it.
May 14: 2nd Annual Alberta Welder Town Hall - Edmonton, Alta.
May 14: The Automation Conference - Chicago, Ill.
May 18: AIHce 2013 - Montreal, Que.


text:
Home > Blog > Diane Fennell > Severity of Diabetic Complications Linked to Dementia Risk, Study Finds
Severity of Diabetic Complications Linked to Dementia Risk, Study Finds
By Diane Fennell | July 17, 2015
People with diabetes who experience high rates of complications are more likely to develop dementia than those who have fewer diabetic complications, according to a new study published in the Journal of Clinical Endocrinology & Metabolism. More than 29 million Americans have diabetes, and an estimated 5 million are living with age-related dementia.
Poorly controlled diabetes can lead to a number of complications, such as retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage), and diabetes is also known to be a risk factor for dementia (a group of symptoms linked with a decline in memory or other thinking skills). To determine how the severity and progression of diabetes affects the risk of developing dementia, researchers looked at records from the Taiwan National Health Insurance Research Database for 431,178 people older than 50 who had been newly diagnosed with diabetes. The subjects' severity and progression of diabetes was evaluated using a version of the Diabetes Complications Severity Index, which covers seven complications and is used to predict deaths and hospitalizations of people with diabetes.
The researchers found that 26,856, or 6.2%, of the people evaluated developed dementia within 12 years. The risk was higher among those with a high score on the Diabetes Complications Severity Index than those with a low score. Additionally, compared to those with mildly progressing diabetes, those with more rapidly progressing diabetes had a greater dementia risk.
"The study demonstrates why it is so crucial for people with diabetes to work closely with health-care providers on controlling their blood sugar," said study author Wei-Che Chiu, MD, PhD. "Managing the disease can help prevent the onset of dementia later in life."
In a related comment, Robert Lash, MD, who is a spokesperson for the Endocrine Society and was not involved in the research, stated that it is too soon to consider dementia to be a diabetic complication because there is a "complicated" relationship between the two conditions.
For more information, read the article "Diabetes complications linked to rising risk of dementia" or see the study's abstract in The Journal of Clinical Endocrinology & Metabolism. And for more strategies on keeping your mind sharp, see the article "Memory Fitness" by Dr. Cynthia Green, founding director of the Memory Enhancement Program at Mount Sinai School of Medicine.
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text:
"""BoundingBox built on Numpy, interoperable with bounding_box_pb2.

Composed of Numpy arrays (3-vectors actually) to support natural arithmetic
operations.  Easily instantiable from and convertible to a BoundingBox proto.
"""

from __future__ import absolute_import
from __future__ import division
from __future__ import print_function

from bisect import bisect_right
import copy
from typing import Optional

import numpy as np

from . import bounding_box_pb2
from . import geom_utils

from typing import Optional

class BoundingBox(object):
  """BoundingBox built on Numpy, interoperable with bounding_box_pb2."""

  def __init__(self, start=None, size=None, end=None):
    """Initialize a BoundingBox from an existing BoundingBox or explicit bounds.

    If start is not a BoundingBox object or proto, then exactly two of start,
    size, and end must be specified.

    Args:
      start: a Vector3j, 3-element sequence specifying the (inclusive) start
          bound, or BoundingBox proto/object, in which case no other arguments
          may be specified.
      size: a Vector3j or 3-element sequence specifying the size.
      end: a Vector3j or 3-element sequence specifying the (exclusive) end
          bound.

    Raises:
      ValueError: on bad inputs.
    """
    if start is not None:
      if (isinstance(start, bounding_box_pb2.BoundingBox) or
          isinstance(start, BoundingBox)):
        if size is not None or end is not None:
          raise ValueError('a BoundingBox object/proto must be specified alone')
        size = start.size
        start = start.start

    if (end is not None) + (start is not None) + (size is not None) != 2:
      raise ValueError('exactly two of start, end, and size must be specified')

    if start is not None:
      self.start = geom_utils.ToNumpy3Vector(start)
    if size is not None:
      self.size = geom_utils.ToNumpy3Vector(size)
    if end is not None:
      end = geom_utils.ToNumpy3Vector(end)

    if end is not None:
      if size is not None:
        self.start = end - size
      else:
        self.size = end - start

  def adjusted_by(self, start=None, end=None):
    """Adds an offset to the start and/or end bounds of the bounding box.

    Both arguments can be any argument type supported by
    geom_utils.ToNumpy3Vector, i.e. a Vector3j proto, a 3-tuple, or a
    3-element numpy array.

    Args:
      start: vector offset added to the start bound
      end: vector offset added to the end bound

    Returns:
      A new BoundingBox with adjusted bounds.

    Raises:
      ValueError: on bad inputs.
    """
    start_pos = self.start
    end_pos = self.end
    if start is not None:
      # We don't use += because that would modify our self.start in place.
      start_pos = start_pos + geom_utils.ToNumpy3Vector(start)  # pylint: disable=g-no-augmented-assignment
    if end is not None:
      end_pos = end_pos + geom_utils.ToNumpy3Vector(end)  # pylint: disable=g-no-augmented-assignment
    return BoundingBox(start=start_pos, end=end_pos)

  @property
  def end(self):
    """Returns the (exclusive) end bound as a 3-element int64 numpy array.

    Returns:
      self.start + self.size
    """
    return self.start + self.size

  def Sub(self, start=None, end=None, size=None):
    """Returns a new BoundingBox with the specified bounds relative to self.

    Args:
      start: Specifies the new start bound, relative to self.start.  If not
          specified, the current start bound is kept, unless end and size are
          both specified, in which case it is inferred.
      end: Specifies the new end bound, relative to self.start.  If not
          specified, the current end bound is kept, unless start and size are
          both specified, in which case it is inferred.
      size: In conjunction with start or end (but not both), specifies the new
          size.

    Returns:
      A new BoundingBox with adjusted bounds, or self if no arguments are
    specified.

    Raises:
      ValueError: if invalid arguments are specified.
    """
    if start is None:
      if end is None:
        if size is not None:
          raise ValueError('size must be specified with either end or start')
        return self
      else:
        end = geom_utils.ToNumpy3Vector(end)
        if size is None:
          return BoundingBox(self.start, end)
        else:
          size = geom_utils.ToNumpy3Vector(size)
          start = self.start + end - size
          return BoundingBox(start, size)
    else:
      # start specified.
      start = geom_utils.ToNumpy3Vector(start)
      if end is None:
        if size is None:
          size = self.size - start
        return BoundingBox(self.start + start, size)
      else:
        # end specified.
        if size is not None:
          raise ValueError(
              'size must not be specified if both start and end are given')
        return BoundingBox(self.start + start, end - start)

  def to_proto(self):
    """Returns a corresponding BoundingBox proto."""
    proto = bounding_box_pb2.BoundingBox()
    proto.start.CopyFrom(geom_utils.ToVector3j(self.start))
    proto.size.CopyFrom(geom_utils.ToVector3j(self.size))
    return proto

  def to_slice(self):
    """Returns slice in C-order (ZYX)."""
    return np.index_exp[self.start[2]:self.end[2],  #
                        self.start[1]:self.end[1],  #
                        self.start[0]:self.end[0]]

  def __repr__(self):
    return 'BoundingBox(start=%s, size=%s)' % (tuple(self.start),
                                               tuple(self.size))

  def __eq__(self, other):
    if isinstance(other, bounding_box_pb2.BoundingBox):
      other = BoundingBox(other)
    elif not isinstance(other, BoundingBox):
      return False
    return (np.all(self.start == other.start) and
            np.all(self.size == other.size))

  def __ne__(self, other):
    return not self.__eq__(other)

  def __hash__(self):
    return hash((tuple(self.start), tuple(self.size)))

def _required(bbox: Optional[BoundingBox]) -> BoundingBox:
  assert bbox is not None
  return bbox

def intersection(box0, box1):
  """Get intersection between two bounding boxes, or None."""
  if isinstance(box0, bounding_box_pb2.BoundingBox):
    box0 = BoundingBox(box0.start, box0.size)
  if isinstance(box1, bounding_box_pb2.BoundingBox):
    box1 = BoundingBox(box1.start, box1.size)
  if not isinstance(box0, BoundingBox):
    raise ValueError('box0 must be a BoundingBox')
  if not isinstance(box0, BoundingBox):
    raise ValueError('box1 must be a BoundingBox')
  start = np.maximum(box0.start, box1.start)
  end = np.minimum(box0.end, box1.end)
  if np.any(end <= start): return None
  return BoundingBox(start=start, end=end)

def intersections(boxes0, boxes1):
  """Get intersections between two sequences of boxes.

  Args:
    boxes0: a sequence of BoundingBoxes
    boxes1: a sequence of BoundingBoxes

  Returns:
    list of intersections between the two sequences.  Each element of boxes0 is
    intersected with each element of boxes1, and any non-None are added to the
    list.
  """
  intersections = []
  for box0 in boxes0:
    current_intersections = [intersection(box0, box1) for box1 in boxes1]
    intersections.extend([i for i in current_intersections if i is not None])
  return intersections

def containing(*boxes):
  """Get the minimum bounding box containing all specified boxes.

  Args:
    *boxes: one or more bounding boxes

  Returns:
    The minimum bounding box that contains all boxes.

  Raises:
    ValueError: if invalid arguments are 217specified.
  """
  if not boxes:
    raise ValueError('At least one bounding box must be specified')
  boxes_objs = map(BoundingBox, boxes)
  start = boxes_objs[0].start
  end = boxes_objs[0].end
  for box in boxes_objs[1:]:
    start = np.minimum(start, box.start)
    end = np.maximum(end, box.end)
  return BoundingBox(start=start, end=end)

class OrderlyOverlappingCalculator(object):
  """Helper for calculating orderly overlapping sub-boxes.

  Provides a serial generator as well as num_sub_boxes and index_to_sub_box to
  support parallel dynamic generation.
  """

  def __init__(self,
               outer_box,
               sub_box_size,
               overlap,
               include_small_sub_boxes=False,
               back_shift_small_sub_boxes=False):
    """Helper for calculating orderly overlapping sub-boxes.

    Args:
      outer_box: BoundingBox to be broken into sub-boxes.
      sub_box_size: 3-sequence giving desired 3d size of each sub-box.  Smaller
        sub-boxes may be included at the back edge of the volume, but not if
        they are smaller than overlap (in that case they are completely included
        in the preceding box) unless include_small_sub_boxes is True.  If an
        element is None, the entire range available within outer_box is used for
        that dimension.
      overlap: 3-sequence giving the overlap between neighboring sub-boxes. Must
        be < sub_box_size.
      include_small_sub_boxes: Whether to include small subvolumes at the back
        end which are smaller than overlap
      back_shift_small_sub_boxes: If True, do not produce undersized boxes at
        the back edge of the outer_box.  Instead, shift the start of these boxes
        back so that they can maintain sub_box_size.  This means that the boxes
        at the back edge will have more overlap than the rest of the boxes.

    Raises:
      ValueError: if overlap >= sub_box_size.
    """
    # Allow sub_box_size elements to be None, which means use the whole range.
    sub_box_size = list(sub_box_size)
    for i, x in enumerate(sub_box_size):
      if x is None:
        sub_box_size[i] = outer_box.size[i]

    overlap = np.array(overlap)
    stride = np.array(sub_box_size) - overlap
    if np.any(stride <= 0):
      raise ValueError('sub_box_size must be greater than overlap: %r versus %r'
                       % (sub_box_size, overlap))

    if not include_small_sub_boxes:
      # Don't include subvolumes at the back end that are smaller than overlap;
      # these are included completely in the preceding subvolume.
      end = outer_box.end - overlap
    else:
      end = outer_box.end

    self.start = outer_box.start
    self.stride = stride
    self.end = end
    self.sub_box_size = sub_box_size
    self.outer_box = outer_box

    size = end - self.start
    self.total_sub_boxes_xyz = (size + stride - 1) // stride  # ceil_div
    self.back_shift_small_sub_boxes = back_shift_small_sub_boxes

  def start_to_box(self, start):
    full_box = BoundingBox(start=start, size=self.sub_box_size)
    if self.back_shift_small_sub_boxes:
      shift = np.maximum(full_box.end - self.outer_box.end, 0)
      if shift.any():
        return BoundingBox(start=full_box.start - shift, size=self.sub_box_size)
      return full_box
    else:
      return intersection(full_box, self.outer_box)

  def index_to_sub_box(self, index):
    """Translates a linear index to appropriate sub box.

    Args:
      index: The linear index in [0, num_sub_boxes)

    Returns:
      The corresponding BoundingBox.

    The boxes are guaranteed to be generated in Fortran order, i.e. x fastest
    changing.  (This means that VolumeStore Subvolumes generated from contiguous
    indices will be near each other in x.)
    """
    coords = np.unravel_index(index, self.total_sub_boxes_xyz, order='F')
    return self.start_to_box(coords * self.stride + self.start)

  def offset_to_index(self, index, offset):
    """Calculate the index of another box at offset w.r.t.

    current index.

    Args:
      index: the current flat index from which to calculate the offset index.
      offset: the xyz offset from current index at which to calculate the new
        index.

    Returns:
      The flat index at offset from current index, or None if the given offset
      goes beyond the range of sub-boxes.

    This is usually used to calculate the boxes that neighbor the current box.
    """
    coords = np.unravel_index(index, self.total_sub_boxes_xyz, order='F')
    offset_coords = np.array(coords) + offset
    if np.any(offset_coords < 0) or np.any(
        offset_coords >= self.total_sub_boxes_xyz):
      return None
    return np.ravel_multi_index(
        offset_coords, self.total_sub_boxes_xyz, order='F')

  def num_sub_boxes(self):
    """Total number of sub-boxes."""
    prod = self.total_sub_boxes_xyz.astype(object).prod()
    return prod

  def generate_sub_boxes(self):
    """Generates all sub-boxes in raster order."""
    for z in range(self.start[2], self.end[2], self.stride[2]):
      for y in range(self.start[1], self.end[1], self.stride[1]):
        for x in range(self.start[0], self.end[0], self.stride[0]):
          yield _required(self.start_to_box((x, y, z)))

  def batched_sub_boxes(self,
                        batch_size,
                        begin_index=0,
                        end_index=None):
    """Generates iterators for batches of sub-boxes.

    Args:
      batch_size: how many sub-boxes per iterable.
      begin_index: the inclusive beginning numerical index.
      end_index: the exclusive ending numerical index.

    Yields:
      An iterable of sub-boxes for each batch.
    """
    if end_index is None:
      end_index = self.num_sub_boxes()
    for i_begin in range(begin_index, end_index, batch_size):
      i_end = min(i_begin + batch_size, end_index)
      yield (
          _required(self.index_to_sub_box(i)) for i in range(i_begin, i_end))

  def tag_border_locations(self, index):
    """Checks whether a box touches the border of the BoundingBox.

    Args:
      index: flat index identifying the box to check

    Returns:
      2-tuple of bool 3d ndarrays (dim order: x, y, z).
      True if the box touches the border at the start/end (respectively for the
      1st and 2nd element of the tuple) of the bbox along the given dimension.
    """
    coords_xyz = np.array(
        np.unravel_index(index, self.total_sub_boxes_xyz, order='F'))
    is_start = coords_xyz == 0
    is_end = coords_xyz == self.total_sub_boxes_xyz - 1
    return is_start, is_end

redpajama_set_name: RedPajamaGithub


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New Year's Resolutions were made to be broken, but I always make a few. This year's are: 1. pay off credit cards 2. get a better job 3. learn french. If I achieve all this next year I will be a happy camper.
You've got to shoot high with these things, otherwise it's not worth it.
I've achieved my New Year's Resolutions a few times, but mostly the problem has been that I don't have a resolution worth actually achieving.
Are there grad student specific New Year's Resolutions? I put this out there to you, because I honestly don't know.


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text:
Cross cultural adaptation and validation of burn specific health scale- brief in Nepali (BSHS-B-Np)
Regan Shakya1,
Misu Manandhar1,
Roshan Dangol2 &
Archana Shrestha3
Burns are a global health problem affecting the survivors and disrupting many aspects of their lives. It is the second most common injury in rural Nepal accounting 5% of disabilities. Burn Specific Health Scale (BSHS) is a valid and most commonly used tool to measure Health Related Quality of Life (HRQoL) of the patient with Burns. BSHS- B (Brief) has been translated, culturally adapted and validated in multiple languages but not in Nepali. Therefore we aim to translate, culturally adapt and validate the BSHS-B in Nepali language (BSHS-B-Np).
Standard guideline was followed to translate the scale into Nepali language. One hundred eleven participants were evaluated to establish the psychometric properties of BSHS-B-Np. Internal consistency, test retest, content validity, discriminant validity and construct validity were assessed using Cronbach's alpha, Interclass correlation coefficient, Factor analysis, Spearman rank test, and Mann- Whitney U test respectively.
The Cronbach's alpha for BSHS-B-Np was 0.93. Test retest inter-class correlation coefficient was between 0.92 and 0.98. The principal component factor analysis with varimax rotation resulted in separation of nine factors explaining 75.19% of total variance. BSHS-B-Np showed good discriminant validity in 35 out of 36 domain correlations confirming the construct of the scale. Furthermore, the scale was able to discriminate between face, upper limb and lower limb injury (p < 0.05).
BSHS-B-Np is a reliable and valid scale for Nepali burns survivors to assess their health related quality of life.
Burns are a global health problem affecting the survivors long after the injury and disrupting many aspects of patients' lives [1, 2]. The majority of the estimated 180,000 deaths due to burns occur in low- and middle- income countries. It is the second most common injury in rural Nepal accounting 5% of disabilities [3]. In Nepal based on extrapolation, 557,032 people have suffered a burn injury with potentially 113,470 unable to receive appropriate surgical care [4].
The spectrum of burn trauma consists of minor injuries to disabling injuries. It affects relatively all aspects of person's life in general and Health Related Quality of Life (HRQoL) in specific. Increasing complication and complexity of rehabilitation in burn victims make it essential for routine HRQoL evaluation, recommended as early as within 2 weeks of hospital discharge [5].
It is imperative to have valid and reliable tools to assess the HRQoL in patients with burns. Burn Specific Health Scale (BSHS) is a valid, commonly used and specific tool to assess the HRQoL in the patient with burns [6, 7].
BSHS is present in three different versions; Burn Specific Health Scale-Abbreviated (BSHS-A) [8], Burn Specific Health Scale- Brief (BSHS-B) [9] and the Burn Specific Health Scale Revised (BSHS-R) [10]. The BSHS-B is a 40 items a shortened scale with clinically meaningful factor domains improving the clinical use of the scale [7]. The scale has been translated, culturally adapted and validated in multiple languages [11,12,13,14,15,16]. Currently there is no validated Nepali version of BSHS-B available. Therefore we aim to translate, culturally adapt and validate the BSHS-B in Nepali language (BSHS-B-Np).
This study was conducted in two steps. First, we translated and adapted BSHS-B English scale into Nepali; then it was validated using a cross-sectional study.
Outcome tool: BSHS- B is a scale measuring condition-specific health status among patients with burn injuries. It has 40 items across nine domains. The domains are Hand functioning, Simple abilities, Affect, Work, Sexuality, Interpersonal relationships, Body image, Heat sensitivity, Treatment regimen. The domains of hand functioning and simple abilities are categorized as Physical function domain. The domains of heat sensitivity and treatment regimen are categorized as non-physical/ burn specific domain. The other remaining five domains are categorized as social & economic function domain. Each item is rated in five point likert scale with 0: 'Extremely' to 4: 'Not/none at all' with the total score of 160. The score with a higher value indicates better HRQoL [14] and score 146/160 or above indicates adequate recovery [17].
Translation of BSHS-B
The translation and adaptation was carried out with accepted procedure and standards [18]. First, two independent translators, an experienced cardiac surgeon fluent in English (medical background) and a non-medical professional translator did the forward translation. The non medical professional translator was not aware of the concepts in the scale. Both the translations were synthesized into a common version in consensus meeting between researchers and the translators. A psychiatrist was consulted for clarification of some items of the affect domain during the synthesis. Then two professionals, a qualified nurse fluent in English and non- medical professional translated the synthesized Nepali version to English. All of the translations were reviewed by an expert committee comprised of group of experts that included the translators, researchers, an experienced nurse of related practice, two senior physiotherapists and two non- health professionals. We encountered cultural irrelevance in translating two items; "I often feel sad and blue" and "getting in and out of chair". The expert committee addressed the related issues and other minor translation issues to bring out the culturally adapted final Nepali version of the scale. (See additional file 1).
Pretesting of BSHS-B-Np
Twenty patients with burn were provided BSHS-B- Np scale to complete and correspondingly rate the scale to assess its feasibility, understanding and clarity. We interviewed the participants in regard to their response wherein most of them had no problems with the scale. However two responders had difficulty in understanding the item "I have feeling of being trapped or caught". We discussed this with a committee of three members (Surgery ward in-charge nurse, physiotherapist and a patient attendant) and decided to keep the original sentence. The participants took on an average of 20 minutes to complete the scale.
Validation of BSHS-B-Np
Study setting and participants
We recruited a purposive sample of 111 patients with burns aged 18 years or older from two centers (Sushma Koirala Memorial Hospital, Kathmandu and Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel) from December 2016 to May 2018. Exclusion criteria were: (a) those less than 3 months since injury; (b) not fluent in Nepali; or (c) diagnosed psychiatric illness, chronic diseases, neurological disabilities, history of other trauma.
Participants' recruitment
The eligible participants were enrolled by two methods; (a) those whose data were registered in hospital database were approached via telephone, (b) those who visited the hospital for the follow up treatment were approached in-person. We informed the participants about the study procedure and obtained written consent.
We interviewed the participants using a standard questionnaire to collect the demographic and medical information such as age (in years), gender (male/ female), education level (<=10 standard/ > 10 standard), time since injury (in months), site of burn (Face& head, upper limb, lower limb, trunk, breast), thickness of burn (superficial, partial, full, deep bone), length of hospital stay (<=14 days/ > 14 days) and total body surface area of burn (%). In addition, we administered the BSHS-B-Np at this time and 2 weeks later [19]. Thirty six participants responded the second time.
The sample characteristics were summarized using mean (standard deviation) for continuous variables and frequency (percentage) for categorical variable. We assessed the test retest reliability for all the sub-domains and the total score of BSHS-B-Np using inter-class correlation coefficient (ICC) with two way mixed effects model. We used Kolgomorov- Smirnov's (K-S) normal distribution test to determine the distribution of the test score, the statistically significant results indicated a non-uniform distribution. The internal consistency was determined for BSHS-B-Np using Cronbach's alpha of each domain and total score. The principal components analysis was done with varimax rotation to compute the factor structure of items of BSHS-B-Np by extracting factors with eigen values greater than 1. Spearman's rank correlation coefficient was used to compare the scores between each domain to determine the discriminant validity. We compared the scores between the group according to the site of injury (face and head, upper limb, upper limb) to establish the construct validity for BSHS-B- Np using Mann-Whitney U test.
The mean age of the participants was 29 (SD = 11) years. Forty two percent were male and the mean duration after injury was 40 (SD = 81) months. The mean total affected body surface area was 16 (SD = 8) percent. The majority of the sample had upper limb injuries (78%), lower limb (49%), facial & head (40%), trunk (39%), breast (24%). The sample consisted of 78% partial thickness injury, 17% full thickness, 3% superficial, 2% deep injury. More than half the participants (57%) had hospital stays of less than 14 days (Table 1).
Table 1 Baseline demographics of the study participants. (n = 111)
Calculation of BSHS-B-Np
The total score range of BSHS-B- Np can be [0–160] with higher score indicating higher HRQoL. We observed the range of [37–157] with an average of 108.86 (SD 28). Each domain total score was calculated and results are shown in Table 2. To bring about the each domain values within the range of [0–4], we divided the total domain score with the total number of items in that domain. All observed all our average values are ranged [0–4] with highest mean observed in interpersonal relationship domain and least mean in work domain (Table 2).
Table 2 Means Standard deviation and Internal Consistency of BSHS-B- Np
The internal consistency of every domain was above 0.86 which suggests a high level of homogeneity of the test. The cronbach's alpha for BSHS-B-Np was 0.93 (Table 2).
The inter-class correlation coefficient score was excellent i.e. ranging above 0.8 for seven out of nine domains. The domain of sexuality had the minimum score of 0.48. The ICC score for the scale was 0.96 (Table 3).
Table 3 Test re-test reliability of BSHS-B- Np
The principal component analysis with varimax rotation resulted in separation of nine factors explaining 75.19% of total variance. Coefficients correspondent to the domain < 0.4 for the items were not shown in the table. Two items of simple ability (item 34 & item 35) corresponded additionally in the hand function domain with weak coefficient of less than 0.5. The analysis confirmed nine domains of BSHS-B-Np. In general, the result is similar to the findings of the original English version of the scale (Table 4).
Table 4 Rotated component matrix resultant from the Principal component analysis after Varimax with Kaiser Normalization
Construct validity
The Kolmogorov-Smirnov (K-S) test significantly showed that the scores for the seven out of nine domains except for heat sensitivity and work domain were non-normally distributed. The total BSHS-B-Np scores were also statistically significant for K-S test. Spearman rank correlation coefficient test was performed for all inter domains correlations whereas Pearson's correlation coefficient test was only performed between the domain of heat sensitivity and work domain. The correlations range of − 0.5 to 0.5 between the domains indicates good discriminant validity [20]. We obtained 34 out of 36 correlations within the range indicating the construct validity of the scale. The correlation of between domain of simple ability with the domains of hand function and work was observed to be greater than 0.5 (Table 5). All the domains except for the interpersonal relations domain significantly correlated with total score of BSHS-B-Np. The Mann Whitney U test was performed between two non-related groups of scores of each domain and total BSHS-B-Np score. There was significant difference in scores of heat sensitivity, body image and social emotional domain while comparing the patients with and without injury to face and head; scores of hand function, sexuality and physical function domain comparing those with and without upper limb injury; and scores of hand function and physical function domain comparing those with and without lower limb injury (Table 6).
Table 5 Correlation between the domains of BSHS-B-Np
Table 6 Subgroup comparison of BSHS-B- Np
In this study, we translated, culturally adapted and validated the BSHS-B scale into the Nepali language. We inserted "Np" suffix to the scale acronym for identification as Nepali version: BSHS-B-Np. The result showed that the Nepali version scale is a reliable and valid tool which can be used in clinical research and practice. The scale showed excellent internal consistency with recommended cronbach's alpha above 0.8 [21]. The coefficient of 0.93 for overall scale score reflected good homogeneity of the translation which is similar to finding of the original scale and similarly with other versions as well [9, 11, 22]. The high index of 0.96 was found for the domain of hand function. Another test to determine the reliability of the scale is the test retest reliability. We administered the scale a second time after 14 days for 36 participants and obtained the ICC of 0.96 (0.92–0.98) for the overall score. The value of hand function domain index of 0.91 showed excellent agreement. Similarly the domain of heat sensitivity, affect, treatment regimen, treatment regimens, work, body image and simple abilities demonstrated the value above 0.8 which showed good agreement. However the scale of sexuality demonstrated moderate agreement with the value of 0.48. The inconsistency in reporting sexually related behavior could have been influenced by many factors including socio-cultural norms, sexual health education, physical or psychological factors [23, 24]. Multiple studies have also reported tendency of participants with burns to underreport sexual problems and its consequences [12, 25, 26].
The sample size for principal component analysis with varimax rotation was poor but acceptable [27]. The total variance obtained was 75.19% with the eigen value kept greater than 1. The analysis created nine domains mirroring the original scale with each domain having higher load value on a common factor (> 0.4). Each domains resulted with good internal consistency can therefore be used as a separate subscale [9].
The correlation analysis was done between the domains created. We performed the KS normality test to determine the distribution of the sample obtained in each domain. We found the samples significantly didn't distribute normally for all domains except for the domains of heat sensitivity and work. Therefore spearman's rank correlation was used for non normal distribution and Pearson correlation coefficient was used for normally distributed samples. According to Carlson and Herdman convergent validity is claimed if the correlation coefficient is above 0.5 [28]. In our study the correlation coefficient between the obtained domains was below 0.5 for 34 out 36 correlations establishing the discriminant validity therefore confirming the construct validity of the scale. Correlations between simple ability domain with hand function and work domains were greater than 0.5 indicating the poor discriminant validity between the domains. The fact that simple tasks such as bathing and dressing requires hand functioning could explain the poor discriminant validity. Factor reports of additional weak coefficient between simple ability items (item 34 and item 35) in hand function domain indicate the positive correlation between them. Positive correlation between simple ability and work domains was also reported in the original paper [9]. Other versions researches have also demonstrated weak to moderate inter domain correlations [13, 20, 29].
To further confirm construct validity we assessed the burn injuries of the face and head, upper limb and lower limb. A valid scale produces the statistically significant difference between results of both groups. In this study the injury at the face and head discriminated significantly with heat sensitivity, body image, socio-emotional, non physical domain. Similar findings was observed in Hebrew version in which head and face discriminated with heat sensitivity, work, sexuality socio-economic, non-physical domain, BSHS total score [14]. It is well understood that the face is an important body part and facial injury influences the majority of the scale's domains. In our study participants with burns injury at both upper and lower limb discriminated significantly with hand function and physical function domain. Similarly, we observed that upper limb discriminated with sexuality. This suggests that activities of performance are dependent on the function of extremities. Similar findings were also observed in other studies [14, 16].
Strength and limitation
Our study's strength includes the use of factor analysis to test the factor structure of the scale. The factor analysis created nine domains mirroring the original scale [9].
Our study isn't devoid of limitations. The major limitation was the small sample size. This could be due to lack of burn rehabilitation centers in Nepal. The burn centers operating in Nepal chiefly provide services to acute and sub acute care for the burn victims. Subsequently, the rate of hospital visits decreases over period of time after the hospital discharge. Majority of our samples were burn survivors who visited hospital for the follow-up treatments. Similarly, it affected the retest samples as well since response rate after 2 weeks was poor which resulted in only 36 participants. Secondly, we didn't use any marker of stability to identify unchanged patient over 2 week period which could have resulted in poorer retest on sexuality. Further studies with larger sample size are recommended.
In conclusion, the Nepali version of BSHS-B is a valid and reliable scale for measuring the burn injury status of the Nepali people. It is culturally appropriate tools which can be used in clinical setting to determine the quality of life of Nepali burn survivors.
The dataset generated and/or analyzed during the current study are available from the corresponding author on a reasonable request.
HRQoL:
Health Related Quality of Life
BSHS:
Burn Specific Health Scale
BSHS-A:
Burn Specific Health Scale- Abbreviated
BSHS-B:
Burn specific Health Scale- Brief
BSHS-R:
Burn Specific Health Scale- Revised
BSHS-B-Np:
Burn Specific Health Scale- Brief- Nepali
ICC:
Interclass correlation coefficient
KS test:
Kolgomorov- Smirnov's test
Statistical Package for the Social Sciences
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Ling-Juan, Z., Jie, C., Jian, L., Xiao-Ying, L., Ping, F., & Zhao-Fan, X. (2012). Development of quality of life scale in Chinese burn patients: Cross-cultural adaptation process of burn-specific health scale – Brief. Burns, 38(8), 1216–1223.
We would like to thank all the individuals involved including the translators, committee members, and advisors for their valuable time and effort during this study. We would also like to thank Dhulikhel hospital and Sushma Koirala Memorial hospital for providing us permission to conduct the study at their centers. Finally, we would like to express special gratitude towards Dr. Bengt Gerdin, MD, PhD for permitting us to culturally adapt the questionnaire into Nepali language.
The authors declare that they have received no funding or support for this study and have no financial interests to declare.
Department of Physiotherapy, Kathmandu University School of Medical Sciences/ Dhulikhel Hospital, Dhulikhel, Nepal
Regan Shakya & Misu Manandhar
Department of Physiotherapy, Sushma Koirala Memorial Hospital, Kathmandu, Nepal
Roshan Dangol
Department of Community Programs, Kathmandu University School of Medical Sciences/ Dhulikhel Hospital, Dhulikhel, Nepal
Archana Shrestha
Regan Shakya
Misu Manandhar
REG conceived and designed the study. REG, MM, RD, AS revised critically for intellectual content. REG and MM were involved in literature search. MM, RD contributed to acquisition of data. REG, AS contributed to analysis, interpretation of the data. REG, MM contributed in drafting the first manuscript. REG, MM, RD and AS all reviewed, finalized and approved the manuscript for submission. All authors read and approved the final manuscript.
Correspondence to Regan Shakya.
The ethical approval was obtained from International Review committee of Kathmandu University School of Medical Sciences/ Dhulikhel Hospital (IRC-KUSMS) (Approval number: 19/16). The participants were informed about the study details, time requirement, voluntary participation, benefits and risks, and right to withdraw during the study. We assured that the personal information will be kept confidential. The informed written consent was obtained from the participant prior to the study.
Nepali Version of Burn Specific Health Scale- B- Np
Shakya, R., Manandhar, M., Dangol, R. et al. Cross cultural adaptation and validation of burn specific health scale- brief in Nepali (BSHS-B-Np). J Patient Rep Outcomes 4, 25 (2020). https://doi.org/10.1186/s41687-020-00190-0


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