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We analyze data from a survey we administered during the COVID19 pandemic to investigate the relationship between people's subjective beliefs about risks and their private protective behaviors. On average, people substantially overestimate the absolute level of risk associated with economic activity, but have directionally correct signals about their relative risk based on their demographic characteristics. Subjective risk beliefs are predictive of changes in economic activities independently of government policies. Government mandates restricting economic behavior, in turn, attenuate the relationship between subjective risk beliefs and protective behaviors.

We address points raised by Anderson, Charles, and Rees (2022b), which comments on our prior work. After correcting unambiguous data mistakes, our revised estimates suggest that municipal water disinfection (filtration) explains 38 percent of the total mortality rate decline in our sample cities and years—a result not very different from our original estimate of 43 percent. However, effects on infant mortality rates are smaller than in our original analysis. Much of the difference between their analyses and ours is due to the coding of partial intervention years and to differences in population denominators, for which ideal data are difficult to find. (JEL H75, I12, I18, J13, Q18, Q51, Q53)

A central issue in designing performance incentive contracts is whether to reward the production of outputs versus use of inputs: the former rewards efficiency and innovation in production, while the latter imposes less risk on agents. Agents with varying levels of skill may perform better under different contracts as well – more skilled workers may be better able to innovate, for example. We study these issues empirically through an experiment enabling us to observe and verify outputs (health outcomes) and inputs (adherence to recommended medical treatment) in Indian maternity care. We find that both output and input incentive contracts achieved comparable reductions in post-partum hemorrhage rates, the dimension of maternity care most sensitive to provider behavior and the largest cause of maternal mortality. Interestingly, and in line with theory, providers with advanced qualifications performed better and used new strategies under output incentives, while under input incentives, providers with and without advanced qualifications performed equally.

We believe that the wealth of digital humanity research resources that is available in Institutional Repositories in Southern Africa is largely over-looked because it is not machine explorable as defined by Berners-Lee (2006). We argue that extracting research from Institutional Repositories, which Berners-Lee (2006) describes as One-Star Linked Data, and then enriching this research and storing it as tuples in a triple store (RDF data store) will expose the research to a greater audience; make it machine explorable; and integrate it with a broader network of Linked Data, known as the Linked Open Data Cloud (LODC). Our approach is to utilize software building blocks licensed under Free (Libre) Open Source Software (FLOSS) licences and to create a pipeline that can potentially transform any Institutional Repository into into a triple store, which can be published on the Internet as part of the LODC. Our transformation process embraces under-resourced institutions by utilizing FLOSS com- ponents and utilizing digital resources already published on the internet in order to promote the research from One-Star Linked data to Five-Star Linked Data in Berners-Lee (2006) taxonomy of linked data.

Responding to the continued and accelerating rise of Machine Learning (ML) in citizen science, we organized a discussion panel at the 3rd European Citizen Science 2020 Conference to initiate a dialogue on how citizen scientists interact and collaborate with algorithms. This brief summarizes a presentation about two Zooniverse projects which illustrated the impact that new developments in ML are having on citizen science projects which involve visual inspection of large datasets. We also share the results of a poll to elicit opinions and ideas from the audience on two statements, one positive and one critical of using ML in CS. The discussion with the participants raised several issues that we grouped into four main themes: a) democracy and participation; b) skill-biased technological change; c) data ownership vs public domain/digital commons, and d) transparency. All these issues warrant further research for those who are concerned about ML in citizen science.

Author(s): Alsan, Marcella; Atella, Vincenzo; Bhattacharya, Jay; Conti, Valentina; Mejia-Guevara, Ivan | Abstract: Throughout history, technological progress has transformed population health, but the distributional effects of these gains are unclear. New substitutes for older, more expensive health technologies can produce convergence in population health outcomes, but may also be prone to “elite capture” leading to divergence. This paper studies the case of penicillin using detailed mortality statistics and exploiting its sharply-timed introduction in Italy after World War II. We find penicillin reduced both the mean and standard deviation of infectious diseases mortality, leading to substantial convergence across disparate regions of Italy. Our results do not appear to be confounded by competing risks or mortality patterns associated with World War II.

India retains the world’s largest burden of anemia despite decades of economic growth and anemia prevention programming. Accurate screening and estimates of anemia prevalence are critical for successful anemia control. Evidence is mixed on the performance of HemoCue, a point-of-care testing device most widely used for large-scale surveys. The use of dried blood spots (DBS) to assess hemoglobin (Hb) concentration is a potential alternative, particularly in field settings. The objective of this study is to assess Hb measurement agreement between capillary HemoCue and DBS among two age groups, children 6–59 months and females age 12–40 years. We analyzed data from the baseline round of a cluster randomized rice fortification intervention in Cuddalore district of Tamil Nadu, India. Capillary blood was collected from a subset of participants for Hb assessment by HemoCue 301 and DBS methods. We calculated Lin’s concordance correlation coefficient, and tested bias by conducting paired t-tests of Hb concentration. Independence of the bias and Hb magnitude was examined visually using Bland–Altman plots and statistically tested by Pearson’s correlation. We assessed differences in anemia classification using McNemar’s test of marginal homogeneity. Concordance between HemoCue and DBS Hb measures was moderate for both children 6–59 months (ρc = 0.67; 95% CI 0.65, 0.71) and females 12–40 years (ρc = 0.67: 95% CI 0.64, 0.69). HemoCue measures were on average 0.06 g/dL higher than DBS for children (95% CI 0.002, 0.12; p = 0.043) and 0.29 g/dL lower than DBS for females (95% CI − 0.34, − 0.23; p

Exposure modeling is a valuable tool for assessing chemical vapor exposures that occur during transient events such as small spills of volatile liquids. Models are available to estimate liquid evaporation rates and resulting air concentrations. However, liquid evaporation rate models require the surface area of the puddle in order to provide vapor generation rates in terms of mass per time. This study developed an approach to model the surface area of small spills of pure liquids. A theoretical equation exists relating puddle depth to a liquid's surface tension, density, and contact angle. A contact angle is a characteristic of liquid-solid interactions at the edge of a puddle. If the depth of a puddle can be calculated and the volume of the liquid spilled is known, the surface area of the puddle can be determined. Values for density and surface tension are published. Contact angles, however, are not readily available. Five hundred and eighty experimental spills were conducted using acetone, ethanol and water. The effective contact angle for each spill was determined. Spill volumes varied from 1.0-30.0 mL. The height of the liquid release varied from 0-15 cm onto a variety of surfaces. The effective contact angle of a puddle was most strongly associated with the liquid's polarity. The height of the liquid release and type of surface had significant, but smaller effects on the puddle size. The effective contact angle of a puddle from a spill can be estimated as ln(ϴ

We report on the discovery and validation of TOI 813b (TIC 55525572 b), a transiting exoplanet identified by citizen scientists in data from NASA's Transiting Exoplanet Survey Satellite (TESS) and the first planet discovered by the Planet Hunters TESS project. The host star is a bright (V = 10.3 mag) subgiant ($R_\star=1.94\,R_\odot$, $M_\star=1.32\,M_\odot$). It was observed almost continuously by TESS during its first year of operations, during which time four individual transit events were detected. The candidate passed all the standard light curve-based vetting checks, and ground-based follow-up spectroscopy and speckle imaging enabled us to place an upper limit of $2 M_{Jup}$ (99 % confidence) on the mass of the companion, and to statistically validate its planetary nature. Detailed modelling of the transits yields a period of $83.8911_{ - 0.0031 } ^ { + 0.0027 }$ days, a planet radius of $6.71 \pm 0.38$ $R_{\oplus}$, and a semi major axis of $0.423_{ - 0.037 } ^ { + 0.031 }$ AU. The planet's orbital period combined with the evolved nature of the host star places this object in a relatively under-explored region of parameter space. We estimate that TOI-813b induces a reflex motion in its host star with a semi-amplitude of $\sim6$ ms$^{-1}$, making this system a promising target to measure the mass of a relatively long-period transiting planet., Accepted for publication in MNRAS (16 pages, 10 figures, 3 tables)

We analyze data from a survey we administered during the COVID-19 pandemic to investigate the relationship between people’s subjective beliefs about risks and their private protective behaviors. On average, people substantially overestimate the absolute level of risk associated with economic activity, but have correct signals about their relative risk. Subjective risk beliefs are predictive of changes in economic activities independently of government policies. Government mandates restricting economic behavior, in turn, attenuate the relationship between subjective risk beliefs and protective behaviors.

A key aim of Universal Health Coverage (UHC) is to protect individuals and households against the financial risk of illness, and large-scale health insurance expansions are a central focus of the UHC agenda. Importantly, however, health insurance does not protect against a key dimension of financial risk associated with illness: forgone wage income. In this paper, we quantify the economic burden of illness in India attributable - separately - to wage loss and to medical care spending, as well as differences in them across the socio-economic distribution.We use data from two longitudinal Indian household surveys: (i) the Village Dynamics in South Asia (VDSA) survey (1300 households surveyed every month for 60 months between 2010 and 2015) and (ii) the Indian Human Development Survey (IHDS) (more than 40,000 households surveyed in 2005 and again in 2011). Our regression models include a series of fixed effects that account for time-invariant household- (or individual-) level and time-varying unobservables common across households.We find that, in the VDSA sample, wage loss accounts for more than 80% of the total economic burden of illness among the poorest households, but only about 20% of the economic burden of illness among the most affluent. Estimates from the IHDS sample confirm that this socio-economic gradient is present in the Indian population generally.Wage loss accounts for a substantial share of the total economic burden of illness in India - and disproportionately so among the poorest households. Our findings imply that if UHC is to achieve its objective of protecting households against the financial risk of illness - particularly poor households, the inclusion of wage loss insurance or another illness-related income replacement benefit is needed.

BackgroundA key aim of Universal Health Coverage (UHC) is to protect individuals and households against the financial risk of illness. Large-scale health insurance expansions are therefore a central focus of the UHC agenda. Importantly, however, health insurance does not protect against a key dimension of financial risk associated with illness: forgone wage income (due to short-term disability). In this paper, we quantify the economic burden of illness in India attributable - separately - to wage loss and to medical care spending, as well as differences in them across the socio-economic distribution. MethodsWe use data from two Indian longitudinal household surveys: (i) the Village Dynamics in South Asia (VDSA) survey (1,350 households surveyed every month for 60 months between 2010 and 2015) and (ii) the Indian Human Development Survey (IHDS) (more than 40,000 households surveyed in 2005 and again in 2011). The VDSA allows us to study the economic dynamics of illness using high-frequency observations, and the IHDS allows us to confirm our findings in a nationally-representative sample. Both contain individual- and household-level information about illness, wage income, and medical spending over time. We use longitudinal variation in illness to estimate regression models of economic burden separately for wage loss and medical care spending across the socio-economic distribution. Our regression models include a series of fixed effects that control for differences in time-invariant household (or individual) characteristics and time-varying factors common across households. Findings1,184 households (88%) in the VDSA sample reported an episode of illness over 60 months, and 15770 households (40%) in the IHDS reported an illness in the preceding year. In the VDSA sample, on average, a day of illness was associated with a reduction in monthly per capita wage income of Rs 77 [95% CI -99 to -57] and an increase in monthly per capita medical spending of Rs 126 [95% CI 110-142]. Variation across the socio-economic distribution was substantial. Among the poorest households, wage loss due to illness is roughly 15% of total household spending - nearly three times greater than medical spending. Alternatively, among the most affluent households, wage loss is less than 5% of total household spending - and only one-third of medical spending. Put differently, wage loss accounts for more than 80% of the total economic burden of illness among the poorest households, but only about 20% of the economic burden of illness among the most affluent. Estimates from the IHDS sample show that this socio-economic gradient is present in the Indian population generally. InterpretationWage loss accounts for a substantial share of the total economic burden of illness in India - and disproportionately so among the poorest households. If Universal Health Coverage truly aims to protect households against the financial risk of illness - particularly poor households, the inclusion of wage loss insurance or another illness-related income replacement benefit is needed. O_TEXTBOXResearch in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched Google Scholar for the terms "burden of illness, economic impact of health shock, poor households" and found several systematic reviews of the economic burden of illness in low- and middle-income countries. We then reviewed these articles and the ones that they incorporate. The economic burden of illness among households in low- and middle-income countries is well-established and substantial. However, the vast majority of existing studies focus only on economic burden due to medical care spending, with limited and mixed evidence on wage loss. One systematic review concludes that the economic burden of illness on wage loss is unclear, with some studies showing no effect at all. Added value of this studyOur paper makes two contributions. First, it directly estimates and compares the magnitude of wage loss and direct medical care expenses due to illness using detailed, high frequency data on wage earnings and illness. Past studies have largely focused on either total economic burden or medical care costs, but our direct comparison informs health policies focused on strengthening financial protection. Our high frequency data allow us to pinpoint precise temporal relationships between illness and its economic burden that have not been possible with other commonly-used longitudinal surveys. Second, given the large number of longitudinal observations for each household in the data, our paper is the first to produce household-specific estimates of the burden of illness, enabling us to trace-out both wage loss and medical care expenses flexibly across the distribution of household economic status - enabling a more granular analysis of disparities between the poor and more affluent. We show that in India, which accounts for nearly half of those impoverished due to illness globally, wage loss accounts for more than 80% of the total economic burden of illness among the poorest households, but only about 20% of the economic burden of illness among the most affluent ones. Implications of the available evidenceIn contributing to existing evidence, the findings of this paper suggest that even if successful, the current Universal Health Coverage (UHC) agenda may still not protect poor households in India (and potentially many low- and middle-income countries) from substantial economic burden due to illness. If Universal Health Coverage in countries like India truly aims to protect households against the total economic burden of illness - particularly poor households, wage loss insurance or another health-related income-replacement benefit is required along with health insurance. C_TEXTBOX

Historically, improvements in municipal water quality led to substantial mortality decline in today’s wealthy countries. However, water disinfection has not consistently produced large benefits in lower-income countries. We study this issue by analyzing a large-scale municipal water disinfection program in Mexico that increased water chlorination coverage in urban areas from 58 percent to over 90 percent within 18 months. We estimate that the program reduced childhood diarrheal disease mortality rates by 45 to 67 percent. However, inadequate sanitation infrastructure and age (degradation) of water pipes may have attenuated these benefits substantially. (JEL I12, I18, L95, O13, O18, Q25, Q53)

Copyright © 2021 Oakden, Bridge, Armstrong, Reynolds, Wang, Panzone, Rivera, Kause, Ffoulkes, Krawczyk, Miller and Serjeant. To enhance sustainability, the food system requires significant shifts in the production, processing and supply of food. Ideally, a sustainable food system should operate, not only to protect the biosphere, but also to provide nutritious, high-quality food, and to support social values, an equitable economy, and human and animal health. It should also be governed responsibly within a supportive policy environment. Implementing these shifts is a task of immense scale; but citizen participation/engagement has the potential to help make sustainability a reality through distributed learning, dynamic sensing, and knowledge generation. Technological advancements in sensing and data processing have enabled new forms of citizen participation in research. When food system research is embedded within society it can help us to understand which changes towards sustainability work and which do not. Indeed, citizen engagement in food systems research has the potential to help bring citizens on side, supporting the growth of a food culture of resilience and of sustainable practises (including dietary change). This commentary provides examples of how existing research and alternative food production systems and agroecological practises may provide possible frameworks for citizen participation in food system studies. We highlight potential future food and citizen science approaches. Widening citizen participation and encouraging the involvement of other food system actors, including those in local, national and international governance, is essential to capture the full potential of citizen science in enabling transition to a sustainable food system. For the research community citizen science offers engagement and empowerment of wider communities with science; collecting and analysing data; and creating viable solutions to food system and diet issues. STFC Food Network+ pilot funding (ST/P003079/1); STFC 21st Century challenge funding (ST/T001410/1) Piloting Zooniverse for food, health and sustainability citizen science; HEFCE Catalyst-funded N8 AgriFood Resilience Programme and matched funding from the N8 group of Universities; Research England via the project Food based citizen science in UK as a policy tool; Food Standards Agency to conduct an additional Rapid Evidence Assessment in December 2020; ESCAPE—The European Science Cluster of Astronomy &Particle Physics ESFRI Research Infrastructures; European Union's Horizon 2020 research and innovation programme under Grant Agreement No. 824064.

In this paper, we introduce novel, holistic, electromigration-(EM) and dynamic voltage drop-aware power grid (PG) design and analysis methods that can help resolve the critical limitations that guard-band-driven approaches of today’s modern design closure flows enforce upon physical designers in their quest to achieve the best possible power/performance/area (PPA). These methods can easily be integrated into any existing design flow. The proposed structured strategies to co-optimize inherent trade-offs in PG reliability and PPA improvement can help enable higher transistor density and accurately quantify the impact of IR drop for block-level timing within conventional automatic place-and-route (PnR) flows through the use of an exhaustive, but low-cost in-house solution. We demonstrate up to 9% area savings and up to 5% power reduction while maintaining achievable frequency. The proposed flow updates pave the path for future work to apply our machine-learning-enhanced design space exploration approaches to better control trade-offs between PG reliability and PPA improvement.

NS acknowledges the support of the National Priorities Research Program (NPRP) grant #X-019-1-006 from the Qatar National Research Fund (a member of Qatar Foundation). ACC acknowledges support from the Science & Technology Facilities Council (STFC) consolidated grant number ST/R000824/1. SuperWASP, the Northern hemisphere WASP observatory, has been observing the skies from La Palma since 2004. In that time, more than 50 planets have been discovered with data contributions from SuperWASP. In the process of validating planets, many false-positive candidates have also been identified. The TESS telescope is set to begin observations of the northern sky in 2019. Similar to the WASP survey, the TESS pixel size is relatively large (13arcsec for WASP and 21arcsec for TESS), making it susceptible to many blended signals and false detections caused principally by grazing and blended stellar eclipsing binary systems. In order to reduce duplication of effort on targets, we present a catalogue of 1041 Northern hemisphere SuperWASP targets that have been rejected as planetary transits through follow-up observation. Publisher PDF

Unlike performance incentives for private sector managers, little is known about performance incentives for managers in public sector bureaucracies. Through a randomized trial in rural China, we study performance incentives rewarding school administrators for reducing student anemia—as well as complementarity between incentives and orthogonally assigned discretionary resources. Large (but not small) incentives and unrestricted grants both reduced anemia, but incentives were more cost-effective. Although unrestricted grants and small incentives do not interact, grants fully crowd-out the effect of larger incentives. Our findings suggest that performance incentives can be effective in bureaucratic environments, but they are not complementary to discretionary resources.

This document is designed to report on REINFORCE deliverable D5.3 ‘Citizen Science Projects on HEP’. Deliverable D5.3 is focused on the construction and delivery of the WP5 demonstrator project as described in task T5.3 (outlined below).

Standard measures of bodyweight (overweight and obese, for example) fail to reflect technological progress over time - and in particular, recent progress disproportionately promoting longevity at higher bodyweights (and differences in access to it). This paper builds on the pioneering work of Hans Waaler (Waaler, 1984) and Robert Fogel (Fogel, 1994) to empirically estimate how technological progress, and differential access to it, have fundamentally transformed the relationship between body mass index (BMI) and longevity in high-, middle-, and low-income countries. Importantly, we show that the combined effect of technological progress and access to it across countries is so profound that the share of national populations above mortality-minimizing bodyweight is not clearly greater in countries with higher overweight and obesity rates (as traditionally defined) - and in fact, relative to current standards, a larger share of low-income countries’ populations can be unhealthily heavy.

We analyze data from a survey we administered during the COVID-19 pandemic to investigate the relationship between people's subjective risk beliefs and their protective behaviors. We report three main findings. First, on average, people substantially overestimate the absolute level of risk associated with economic activity, but have correct signals about their relative risk. Second, people who believe that they face a higher risk of infection are more likely to report avoiding economic activities. Third, government mandates restricting economic behavior attenuate the relationship between subjective risk beliefs and protective behaviors.

Patient cost-sharing in medical care constrains total health spending, presumably with little harm to underlying patient health. This paper re-evaluates the link between cost-sharing and health, studying Colombia’s entire formal sector workforce with individual-level health care utilization records linked to payroll data and vital statistics. Given discrete breaks in outpatient cost-sharing imposed at multiple income thresholds by Colombia’s national health system, we use a regression discontinuity design and find that outpatient cost-sharing reduces use of outpatient care, resulting in fewer diagnoses of common chronic diseases and increasing subsequent emergency room visits and hospitalizations. Ultimately, these effects measurably increase mortality, and disproportionately so among the poor – raising the absolute difference in 7-year mortality risk by 0.80 and 0.23 deaths per 1,000 individuals at lower- and higher-income thresholds, respectively. To the best of our knowledge, this study is the first to show a relationship between cost-sharing and adult mortality risk in lower-income countries, a relationship important to incorporate into social welfare analyses of cost-sharing policies.One Sentence SummaryOutpatient cost-sharing in medical care discourages use – but over time, also increases costly hospital service use and raises mortality risk.

We report on the discovery and validation of a two-planet system around a bright (V = 8.85 mag) early G dwarf (1.43 $R_{\odot}$, 1.15 $M_{\odot}$, TOI 2319) using data from NASA's Transiting Exoplanet Survey Satellite (TESS). Three transit events from two planets were detected by citizen scientists in the month-long TESS light curve (sector 25), as part of the Planet Hunters TESS project. Modelling of the transits yields an orbital period of \Pb\ and radius of $3.41 _{ - 0.12 } ^ { + 0.14 }$ $R_{\oplus}$ for the inner planet, and a period in the range 19.26-35 days and a radius of $5.83 _{ - 0.14 } ^ { + 0.14 }$ $R_{\oplus}$ for the outer planet, which was only seen to transit once. Each signal was independently statistically validated, taking into consideration the TESS light curve as well as the ground-based spectroscopic follow-up observations. Radial velocities from HARPS-N and EXPRES yield a tentative detection of planet b, whose mass we estimate to be $11.56 _{ - 6.14 } ^ { + 6.58 }$ $M_{\oplus}$, and allow us to place an upper limit of $27.5$ $M_{\oplus}$ (99 per cent confidence) on the mass of planet c. Due to the brightness of the host star and the strong likelihood of an extended H/He atmosphere on both planets, this system offers excellent prospects for atmospheric characterisation and comparative planetology., Accepted for publication in MNRAS (15 pages, 10 figures, 3 tables)

7570 Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening inflammatory syndrome that may complicate hematologic malignancies (HM). We recently developed a simplified diagnostic and prognostic index termed the ‘optimized HLH inflammatory’ (OHI) index comprising the combined elevation of sCD25 ( > 3,900 U/mL) and serum ferritin ( > 1,000 ng/mL), which in HM patients both identifies HLH and predicts mortality more accurately than conventional criteria for HLH. In this study, we examined whether mortality in our cohort is directly related to progressive malignancy vs. HLH-associated causes in OHI+ and OHI- patients. Methods: We performed a multicenter, retrospective study of patients with newly diagnosed lymphoma from Israel, the USA, and Japan for whom sCD25 and ferritin levels were measured either as routine surveillance or during investigation for HLH and classified patients by their OHI status. The International Prognostic Index, International Prognostic Score, and Follicular Lymphoma International Prognostic Index were used to estimate the predicted prognosis of T/B cell non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma, and follicular lymphoma, respectively. Predicted five-year overall survival was calculated based on the relevant prognostic index and was compared between OHI+ and OHI- patients using the unpaired t-test. The actual survival at five years/last follow-up was recorded, as was the cause of death. The odds ratios (ORs) for observed vs. predicted mortality, and for HLH- vs. malignancy-related death were calculated using the Chi-square test. Results: 100 lymphoma patients were studied: 65% with B cell NHL, 18% with natural killer/ T cell lymphoma, 17% with Hodgkin’s lymphoma; 37 were OHI+, and 63 were OHI-. The disease-relevant international prognostic index-predicted five-year survival did not differ between OHI + and OHI- patients (a mean of 58% n OHI+ and 57% in OHI- p = 0.62). However, the observed five-year survival in OHI+ patients was lower (12%) than predicted, reflecting a mortality incidence that was four times higher than predicted by the relevant prognostic score (OR 3.9; CI 1.3-12.1). By contrast, OHI- patients had better survival (79%) than predicted by their prognostic scores (OR 0.15; CI 0.07-0.34). More than half of the OHI+ patients died from non-malignant causes (39% multi-organ dysfunction or HLH, 18% infection), while most OHI- patients (92%) died from progressive malignancy. The likelihood of dying from multi-organ dysfunction or HLH was 26 times higher in OHI+ vs. OHI- patients (OR 26.2; CI 4.1-286.7). Conclusions: OHI index status strongly correlated with mortality in patients with lymphoma within our cohort, and death in OHI+ patients was largely due to causes other than progressive malignancy. The OHI index appears to identify a harmful inflammatory state and deserves further prospective study.