Polychlorinated dibenzo-p-dioxins, dibenzofurans, biphenyls and 2,3,7,8-tetrachlorodibenzo-p-dioxin equivalents in fishes from Saginaw Bay, Michigan

USGS Publications Warehouse

Giesy, John P.; Jude, David J.; Tillitt, Donald E.; Gale, Robert W.; Meadows, John C.; Zajieck, James L.; Peterman, Paul H.; Verbrugge, David A.; Sanderson, J. Thomas; Schwartz, Ted R.; Tuchman, Marc L.

1997-01-01

Concentrations of polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated naphthalenes (PCNs), polychlorinated dibenzothiophenes (PCDTs), and 2,3,7,8-tetrachlo-rodibenzo-p-dioxin (2,3,7,8-TCDD) equivalents were measured in composite samples of forage fishes and several sizes of walleyes (Stizostedion vitreum) and common carp (Cyprinus carpio) collected from Saginaw Bay, Michigan, USA. The concentrations of 2,3,7,8-TCDD equivalents determined from the use of TCDD equivalency factors (TEFs) and instrumentally determined concentrations of individual congeners were designated TEq. The 2,3,7,8-TCDD equivalents determined on the same extracts with the H4IIE bioassay were defined as TCDD-EQ. Concentrations of TCDD-EQ and TEq were significantly, but poorly correlated (R2 = 0.44). Concentrations of TCDD-EQ and TEq ranged from 10.6 to 348 and 13.5 to 69.5 ng/kg, wet weight, respectively. The ratio of TCDD-EQ to TEq ranged from 0.5 to 5.0, with the greatest ratio observed in common carp but the average ratio between TEq and TCDD-EQ was approximately 1.0. In common carp, larger walleye, and medium-sized alewife (Alosa pseudoharengus) there were significant concentrations of TCDD-EQ that could not be accounted for by TEq calculated from an additive model of PCBs, PCDDs, or PCDFs. As much as 75% of the TCDD-EQ in some samples could not be accounted for by TEqs. It is unlikely that PCNs, PCDTs, or polychlorinated diphenyl ethers (PCDEs) occurred at concentrations that were, based on their relative potencies, great enough to contribute significant quantities of TCDD-EQ. The discrepency between TCDD-EQs and TEqs was not due to antagonisms among congeners or extraction efficiencies.

Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

PubMed Central

Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

2013-01-01

The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

33 CFR 236.6 - Other agencies EQ measures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEFENSE WATER RESOURCE POLICIES AND AUTHORITIES: CORPS OF ENGINEERS PARTICIPATION IN IMPROVEMENTS FOR ENVIRONMENTAL QUALITY § 236.6 Other agencies EQ measures. The selected plan may include EQ measures not proposed...

Effect of patiromer on reducing serum potassium and preventing recurrent hyperkalaemia in patients with heart failure and chronic kidney disease on RAAS inhibitors.

PubMed

Pitt, Bertram; Bakris, George L; Bushinsky, David A; Garza, Dahlia; Mayo, Martha R; Stasiv, Yuri; Christ-Schmidt, Heidi; Berman, Lance; Weir, Matthew R

2015-10-01

We evaluated the effects of patiromer, a potassium (K(+))-binding polymer, in a pre-specified analysis of hyperkalaemic patients with heart failure (HF) in the OPAL-HK trial. Chronic kidney disease (CKD) patients on renin-angiotensin-aldosterone system inhibitors (RAASi) with serum K(+) levels ≥5.1 mEq/L to <6.5 mEq/L (n = 243) received patiromer (4.2 g or 8.4 g BID initially) for 4 weeks (initial treatment phase); the primary efficacy endpoint was mean change in serum K(+) from baseline to week 4. Eligible patients (those with baseline K(+) ≥5.5 mEq/L to <6.5 mEq/L and levels ≥3.8 mEq/L to <5.1 mEq/L at the end of week 4) entered an 8-week randomized withdrawal phase and were randomly assigned to continue patiromer or switch to placebo; the primary efficacy endpoint was the between-group difference in median change in the serum K(+) over the first 4 weeks of that phase. One hundred and two patients (42%) had heart failure (HF). The mean [± standard error (SE)] change in serum K(+) from baseline to week 4 was -1.06 ± 0.05 mEq/L [95% confidence interval (CI), -1.16,-0.95; P < 0.001]; 76% (95% CI, 69,84) achieved serum K(+), 3.8 mEq/L to <5.1 mEq/L. In the randomized withdrawal phase, the median increase in serum K(+) from baseline of that phase was greater with placebo (n = 22) than patiromer (n = 27) (P < 0.001); recurrent hyperkalaemia (serum K(+), ≥5.5 mEq/L) occurred in 52% on placebo and 8% on patiromer (P < 0.001). Mild-to-moderate constipation was the most common adverse event (11%); hypokalaemia occurred in 3%. In patients with CKD and HF who were hyperkalaemic on RAASi, patiromer was well tolerated, decreased serum K(+), and, compared with placebo, reduced recurrent hyperkalaemia. © 2015 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Determination of enzyme thermal parameters for rational enzyme engineering and environmental/evolutionary studies.

PubMed

Lee, Charles K; Monk, Colin R; Daniel, Roy M

2013-01-01

Of the two independent processes by which enzymes lose activity with increasing temperature, irreversible thermal inactivation and rapid reversible equilibration with an inactive form, the latter is only describable by the Equilibrium Model. Any investigation of the effect of temperature upon enzymes, a mandatory step in rational enzyme engineering and study of enzyme temperature adaptation, thus requires determining the enzymes' thermodynamic parameters as defined by the Equilibrium Model. The necessary data for this procedure can be collected by carrying out multiple isothermal enzyme assays at 3-5°C intervals over a suitable temperature range. If the collected data meet requirements for V max determination (i.e., if the enzyme kinetics are "ideal"), then the enzyme's Equilibrium Model parameters (ΔH eq, T eq, ΔG (‡) cat, and ΔG (‡) inact) can be determined using a freely available iterative model-fitting software package designed for this purpose.Although "ideal" enzyme reactions are required for determination of all four Equilibrium Model parameters, ΔH eq, T eq, and ΔG (‡) cat can be determined from initial (zero-time) rates for most nonideal enzyme reactions, with substrate saturation being the only requirement.

Validation and comparison of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in Greece.

PubMed

Yfantopoulos, John N; Chantzaras, Athanasios E

2017-05-01

To validate and compare the psychometric properties of the EQ-5D-3L with the EQ-5D-5L classification systems in Greece. Participants (n = 2279) over 40 years old, sampled from the greater area of Athens using a multistage stratified quota sampling method, completed both EQ-5D versions, while information was also collected on socio-demographics and health-related characteristics. The EQ-5D-5L and EQ-5D-3L were evaluated in terms of agreement, ceiling effects, redistribution and inconsistency, informativity, and convergent and known-groups validity. The agreement between the EQ-5D-3L and EQ-5D-5L was high (ICC = 0.85). Ceiling effects decreased significantly in the EQ-5D-5L in all domains (P < 0.001), with "usual activities" (-21.4 %) and "self-care" (-20.1 %) showing the highest absolute and "anxiety/depression" the highest relative reduction (-32.46 %). Inconsistency was low (5.7 %). The increase in prevalence of problems was larger than the decrease in their severity, resulting in a lower mean health utility for the EQ-5D-5L. Overall absolute and relative informativity improved by 70.5 % and 16.4 %, respectively, in the EQ-5D-5L. Both instruments exhibited good convergent and known-groups validity, with evidence of a considerably better convergent performance and discriminatory ability of the EQ-5D-5L. Both EQ-5D versions demonstrated good construct validity and had consistent redistribution. The EQ-5D-5L system may be preferable to the EQ-5D-3L, as it exhibited superior performance in terms of lower ceiling effects, higher absolute and relative informativity, and improved convergent and known-groups validity efficiency.

33 CFR 236.6 - Other agencies EQ measures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL QUALITY § 236.6 Other agencies EQ measures. The selected plan may include EQ measures not proposed..., implementation of such measures will not be required as local cooperation for the works proposed for Corps...

Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors.

PubMed

Andrew, Emily; Nehme, Ziad; Bernard, Stephen; Smith, Karen

2016-10-01

Although a number of validated health-related quality of life (HR-QOL) instruments exist for critical care populations, a standardised approach to assessing the HR-QOL of out-of-hospital cardiac arrest (OHCA) survivors has not been developed. We sought to compare the responses of 12-month OHCA survivors to three HR-QOL and functional recovery instruments, and assess instrument validity. The Victorian Ambulance Cardiac Arrest Registry invited 12-month OHCA survivors to participate in telephone follow-up between January 2011 and December 2015. Responders provided answers to the 12 Item Short Form Health Survey (SF-12), Three-Level EuroQol-5D (EQ-5D-3L) and the Glasgow Outcome Scale-Extended (GOSE). The SF-12 was also used to derive the SF-6D. Responses were used to assess the interpretability and construct validity of the instruments. A total of 1188 patients and proxies responded. Large ceiling effects were observed for the EQ-5D-3L (patients=46%, proxies=23%). Substantial variability was also observed in SF-6D responses for patients who reported full health according to the EQ-5D-3L. For patient responders, the strongest correlations were observed between the EQ-5D-3L index score and SF-6D (ρ=0.65, p<0.001), and between the SF-6D and SF-12 physical component (ρ=0.69, p<0.001). The distribution of the SF-6D and EQ-5D-3L differed significantly for patients reporting a lower or upper moderate GOSE outcome and lower or upper good recovery (p<0.001 for all comparisons). The EQ-5D-3L demonstrated limited interpretability due to the presence of ceiling effects. However, the measurement properties of the SF-12, SF-6D and GOSE suggest that these may be useful measures of HR-QOL and functional recovery in OHCA survivors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes.

PubMed

Singer, Adam J; Thode, Henry C; Peacock, W Frank

2017-06-01

Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected. Univariate and multivariate analyses, presented as adjusted odds ratios, were used to compare outcomes by K levels. Of 100,260 visits in 2014, an ED K level was ordered in 48,827 (49%). A total of 1,738 patients (3.6%) were excluded because of sample hemolysis. The K was low (<3.5 mEq/L) in 5.5%, normal (3.5 to 5.0 mEq/L) in 90.9%, and elevated (>5.0 mEq/L) in 3.6% of patients. Patients with hyperkalemia were older (64 vs. 49 years, P<0.001) and more likely male (58% vs. 40%, P<0.001). Treatment for hyperkalemia varied greatly. After adjusting for confounders, both hyperkalemia and hypokalemia were associated with inpatient hospitalization and death. At least one medication was used to manage hyperkalemia in 11.5% of patients with a K of 5.1 to 5.4 mEq/L, 36.4% of those with a K 5.5 to 6 mEq/L and 77.0% of the cohort with K >6 mEq/L. Hyperkalemia or hypokalemia occur in 1 of 11 ED patients and are associated with inpatient admission and mortality. Treatment of hyperkalemia varies greatly suggesting the need for evidence-based treatment guidelines.

EQS Goes R: Simulations for SEM Using the Package REQS

ERIC Educational Resources Information Center

Mair, Patrick; Wu, Eric; Bentler, Peter M.

2010-01-01

The REQS package is an interface between the R environment of statistical computing and the EQS software for structural equation modeling. The package consists of 3 main functions that read EQS script files and import the results into R, call EQS script files from R, and run EQS script files from R and import the results after EQS computations.…

Three isomers detected for the whisky lactone: 5-butyl-4-methyl tetrahydrofuran-2-one by Fourier transform microwave spectroscopy and quantum chemical calculations

NASA Astrophysics Data System (ADS)

Kawashima, Yoshiyuki; Katsuragi, Ryusuke; Hirota, Eizi

2017-05-01

The ground-state rotational spectra of the whisky lactone (WL) : 5-butyl-4-methyl tetrahydrofuran-2-one were observed and analyzed by molecular beam Fourier transform microwave spectroscopy combined with quantum chemical calculations. We have detected three stereo-isomers: the trans-TTT form with a methyl CH3 group attached to C(4) in an equatorial position (eq) and a butyl C4H9 group to C(5) in an eq position, for which 110 b-type and 113 a-type transitions were assigned, the cis-TTT form with a CH3 to C(4) in an axial position (ax) and a C4H9 to C(5) in eq, for which 96 a-type, 101 b-type, and 45 c-type transitions were observed, and the cis-GTT form with a CH3 to C(4) in ax and a C4H9 to C(5) in eq, for which 158 a-type, 52 b-type, and 17 c-type transitions were observed, where TTT and GTT denote the conformations about the C(6)sbnd C(5), C(7)sbnd C(6), and C(8)sbnd C(7) bonds, with T and G designating trans and gauche, respectively. The rotational constants thus derived agree with the predictions made by quantum chemical calculations, MP2/6-311++G(d, p) within 1.2%. The trans-TTT form was calculated to be the most stable. The splittings due to internal rotation of the terminal methyl in the butyl group were observed for all the three stereo-isomers and were analyzed by the XIAM program to determine the threefold potential barrier V3 to be 966.4 (25), 978.8 (11), and 1098.7 (48) in cm-1 for the trans-TTT (eq, eq), the cis-TTT (ax, eq), and the cis-GTT (ax, eq) forms, respectively, to be compared with quantum chemically calculated values: 1055, 1055, and 1053 in cm-1.

Antihypertensive Medications and the Prevalence of Hyperkalemia in a Large Health System

PubMed Central

Chang, Alex R.; Sang, Yingying; Leddy, Julia; Yahya, Taher; Kirchner, H. Lester; Inker, Lesley A.; Matsushita, Kunihiro; Ballew, Shoshana H.; Coresh, Josef; Grams, Morgan E.

2016-01-01

Little is known about the frequency and patterns of hyperkalemia in clinical settings. We evaluated the association between baseline antihypertensive medications that may affect potassium levels (angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta-blockers, loop/thiazide diuretics, and potassium-sparing diuretics) and hyperkalemia, defined by potassium >5 mEq/L and >5.5 mEq/L, over a 3-year time period in 194,456 outpatients in the Geisinger Health System, as well as actions taken after an episode of hyperkalemia. The proportions of patients with 0, <2, 2–4, and ≥4 potassium measurements per year were 20%, 58%, 16%, and 6%. Potassium levels >5 mEq/L and >5.5 mEq/L occurred in 10.8% and 2.3% of all patients over the 3-year period; among patients with ≥4 measurements per year, corresponding values were 39.4% and 14.6%. Most cases of hyperkalemia occurred only once during follow-up. The antihypertensive medication class most strongly associated with hyperkalemia was ACEIs. Among patients with a measurement of potassium >5.5 mEq/L, only 24% were seen by a nephrologist and 5.2% were seen by a dietician during the 3-year period. Short-term actions after a potassium measurement >5.5 mEq/L included emergency room visit (3.1% within 7 days), re-measurement of potassium (44.3% with 14 days), and change in a potassium-altering medication (26.4% within 60 days). The most common medication changes were discontinuation/dose reduction of an ACEI/ARB or potassium-sparing diuretic, which occurred in 29.1% and 49.6% of persons taking these medications, respectively. In conclusion, hyperkalemia is common. Future research may enable optimal RAAS inhibitor use with improved management of hyperkalemia. PMID:27067721

EQ-5D-5L and SF-6D Utility Measures in Symptomatic benign Thyroid Nodules: Acceptability and Psychometric Evaluation.

PubMed

Wong, Carlos K H; Lang, Brian H H; Yu, Hill M S; Lam, Cindy L K

2017-08-01

The aim of this study was to examine the acceptability, validity, and reliability of the EuroQoL Five-Dimension Five-Level (EQ-5D-5L) and Short-Form Six-Dimension (SF-6D) health utility measures in patients with symptomatic benign thyroid nodules. Data from a randomized controlled trial (ClinicalTrials.gov identifier: NCT02398721) of 294 patients with symptomatic benign thyroid nodules were utilized for this psychometric evaluation of health-related quality of life (HR-QOL) measurement. Three HR-QOL questionnaires-the generic 12-item Short Form Health Survey (SF-12v2), EQ-5D-5L, and SF-6D-were interviewer-administered at baseline and 2 weeks afterwards. Responses to SF-6D were transformed to SF-6D utility scores using a Hong Kong population scoring algorithm derived by standard gamble, whereas responses to EQ-5D-5L were mapped onto EQ-5D-3L response via interim mapping algorithms and then converted to EQ-5D-5L utility scores using a Chinese-specific value set. Construct validity was determined by evaluating Spearman correlation between SF-12v2 scores and utility scores. Two-week test-retest reliability was assessed using intra-class correlation coefficient. No significant (>15%) floor and ceiling effects were observed for SF-6D utility scores. The SF-6D utility scores had a moderate Spearman rank correlation with the SF-12v2 domain score providing evidence for adequate construct validity. The SF-6D utility scores showed good test-retest reliability (0.794; range 0.696-0.860). Better reliability was observed in SF-6D utility scores than in EQ-5D-5L utility scores. While the EQ-5D-5L instrument was less reproducible, the SF-6D instrument appeared to be an applicable, valid, and reliable measure in assessing the HR-QOL of Chinese patients with symptomatic benign thyroid nodules. The impact of utility score selection on the effectiveness and cost effectiveness of clinical interventions targeted to these patients needs further exploration. NCT02398721, ClinicalTrials.gov.

Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation.

PubMed

Hunger, Matthias; Sabariego, Carla; Stollenwerk, Björn; Cieza, Alarcos; Leidl, Reiner

2012-09-01

To analyse the psychometric properties of the EQ-5D in German stroke survivors undergoing neurological rehabilitation. The EQ-5D, the Hospital Anxiety and Depression Scale (HADS) and the Stroke Impact Scale (SIS) were completed before (210 subjects) and after (183 subjects) a patient education programme in seven rehabilitation clinics in Bavaria, Germany. A postal follow-up was conducted after 6 months. Acceptance, validity, reliability and responsiveness of the EQ-5D were tested. The SIS subscales were used as external anchors to classify the patients into change groups between the measurements. The proportion of missing answers ranged from 4.7 to 8.6%. Between 16 and 19% reported no problems in any EQ-5D dimension. At baseline, correlations between EQ-5D index and the SIS subscales ranged from 0.15 (communication) to 0.60 (mobility). Correlations with the EQ VAS were slightly smaller. All scores were reliable in test-retest with intraclass correlations ranging from 0.67 to 0.81. EQ-5D index and EQ VAS were consistently responsive only to improvements in health, showing small- to medium effect sizes (0.27-0.42). The EQ-5D has shown reasonable validity, reliability and, more limited, responsiveness in stroke patients with mild to moderate limitations of functional status, allowing it to be used in clinical trials in rehabilitation.

Life Cycle Assessment of Biofertilizer Production and Use Compared with Conventional Liquid Digestate Management.

PubMed

Styles, David; Adams, Paul; Thelin, Gunnar; Vaneeckhaute, Céline; Chadwick, David; Withers, Paul J A

2018-06-12

Handling of digestate produced by anaerobic digestion impacts the environment through emission of greenhouse gases, reactive nitrogen, and phosphorus. Previous life cycle assessments (LCA) evaluating the extraction of nutrients from digestate using struvite precipitation and ammonia stripping did not relate synthetic fertilizer substitution (SFS) to nutrient use efficiency consequences. We applied an expanded LCA to compare the conventional management of 1 m 3 of liquid digestate (LD) from food waste against the production and use of digestate biofertilizer (DBF) extracted from LD, accounting for SFS efficacy. Avoidance of CH 4 , N 2 O, and NH 3 emissions from LD handling and enhanced SFS via more targeted use of nutrients in the versatile DBF product could generate environmental savings of up to 0.129 kg Sb eq, 4.16 kg SO 2 eq, 1.22 kg PO 4 eq, 33 kg CO 2 eq, and 20.6 MJ eq per m 3 LD, for abiotic resource depletion, acidification, eutrophication, global warming, and cumulative energy demand burdens, respectively. However, under worst-case assumptions, DBF extraction could increase global warming and cumulative energy demand by 7.5 kg CO 2 e and 251 MJ eq per m 3 LD owing to processing inputs. Normalizing these results against per capita environmental loadings, we conclude that DBF extraction is environmentally beneficial.

Radar Imaging with a Network of Digital Noise Radar Systems

DTIC Science & Technology

2009-03-01

This chapter develops the theoretical foundations of noise radar technology. Comprehensive theoretical models are developed for UWB noise radar, digital...Power to the Antenna +23 dBm Polarization HH Antenna Gain 6 dB ADC 8 Bits Sampling Rate 1.5 GHz/per channel Dynamic Range (0.8 Pd, 0.2 Pf ) 20 dB Range...from Eq. 3.25, can be found by solving Eq. 3.23 for E[XY ]. µrXY = E[XY ] = 〈xy〉 = ρσ2 (3.26) σrXY , from Eq. 3.25 can be derived through the

Comparing the performance of the EQ-5D-3L and the EQ-5D-5L in young Portuguese adults.

PubMed

Ferreira, Lara N; Ferreira, Pedro L; Ribeiro, Filipa P; Pereira, Luis N

2016-06-08

Some studies have reported a ceiling effect in EQ-5D-3L, especially in healthy and/or young individuals. Recently, two further levels have been included in its measurement model (EQ-5D-5L). The purposes of this study were (1) to assess the properties of the EQ-5D-5L in comparison with the standard EQ-5D-3L in a sample of young adults, (2) to foreground the importance of collecting qualitative data to confirm, validate or refine the EQ-5D questionnaire items and (3) to raise questions pertaining to the wording in these questionnaire items. The data used came from a sample of respondents aged 30 or under (n = 624). They completed both versions of the EQ-5D, which were compared in terms of feasibility, level of inconsistency and ceiling effect. Agreement between the instruments was assessed using correlation coefficients and Bland-Altman plots. Known-groups validity of the EQ-5D-5L was also assessed using non-parametric tests. The discriminative properties were compared using receiver operating characteristic curves. Finally, four interviews were conducted for retrospective reports to elicit respondents' understanding and perceptions of the format, instructions, items, and responses. Quantitative results show a ceiling effect reduction of 25.3 % and a high level agreement between both indices. Known-groups validity was confirmed for the EQ-5D-5L. Explorative interviews indicated ambiguity and low degree of certainty in regards to conceptualizing differences between levels moderate-slight across three dimensions. The EQ-5D-5L performed better than the EQ-5D-3L. However, the explorative interviews demonstrated several limitations in the EQ-5D questionnaire wording and high context-dependent answers point to lack of illnesses' experience amongst young adults.

The Codacs™ direct acoustic cochlear implant actuator: exploring alternative stimulation sites and their stimulation efficiency.

PubMed

Grossöhmichen, Martin; Salcher, Rolf; Kreipe, Hans-Heinrich; Lenarz, Thomas; Maier, Hannes

2015-01-01

This work assesses the efficiency of the Codacs system actuator (Cochlear Ltd., Sydney Australia) in different inner ear stimulation modalities. Originally the actuator was intended for direct perilymph stimulation after stapedotomy using a piston prosthesis. A possible alternative application is the stimulation of middle ear structures or the round window (RW). Here the perilymph stimulation with a K-piston through a stapes footplate (SFP) fenestration (N = 10) as well as stimulation of the stapes head (SH) with a Bell prosthesis (N = 9), SFP stimulation with an Omega/Aerial prosthesis (N = 8) and reverse RW stimulation (N = 10) were performed in cadaveric human temporal bones (TBs). Codacs actuator output is expressed as equivalent sound pressure level (eq. SPL) using RW and SFP displacement responses, measured by Laser Doppler velocimetry as reference. The axial actuator coupling force in stimulation of stapes and RW was adjusted to ~5 mN. The Bell prosthesis and Omega/Aerial prosthesis stimulation generated similar mean eq. SPLs (Bell: 127.5-141.8 eq. dB SPL; Omega/Aerial: 123.6-143.9 eq. dB SPL), being significantly more efficient than K-piston perilymph stimulation (108.6-131.6 eq. dB SPL) and RW stimulation (108.3-128.2 eq. dB SPL). Our results demonstrate that SH, SFP and RW are adequate alternative stimulation sites for the Codacs actuator using coupling prostheses and an axial coupling force of ~5 mN. Based on the eq. SPLs, all investigated methods were adequate for in vivo hearing aid applications, provided that experimental conditions including constant coupling force will be implemented.

Responsiveness Comparison of the EQ-5D, PROMIS Global Health, and VR-12 Questionnaires in Knee Arthroscopy.

PubMed

Oak, Sameer R; Strnad, Gregory J; Bena, James; Farrow, Lutul D; Parker, Richard D; Jones, Morgan H; Spindler, Kurt P

2016-12-01

The EuroQol 5 dimensions questionnaire (EQ-5D), Patient-Reported Outcomes Measurement Information System (PROMIS) 10 Global Health, and Veterans RAND 12-Item Health Survey (VR-12) are generic patient-reported outcome (PRO) questionnaires that assess a patient's general health. In choosing a PRO to track general health status, it is necessary to consider which measure will be the most responsive to change after treatment. To date, no studies exist comparing responsiveness among the EQ-5D, PROMIS 10 Global Health, and the Veterans Rand 12-Item Health Survey (VR-12). To determine which of the generic PROs are most responsive internally and externally in the setting of knee arthroscopy. Cohort study (diagnosis); Level of evidence, 3. Fifty patients who underwent knee arthroscopy were surveyed preoperatively and a mean 3.6 months postoperatively, with 90% follow-up. PROs included the EQ-5D, EQ-5D visual analog scale, PROMIS 10 Global Health (PROMIS 10) physical and mental components, VR-12 physical and mental components, and the Knee injury and Osteoarthritis Outcome Score (KOOS)-pain subscale. Internal responsiveness was evaluated by performing paired t tests on the changes in measures and calculating 2 measures of effect size: Cohen d and standardized response mean (SRM). External responsiveness was evaluated by comparing Pearson correlation measures between the disease-specific reference KOOS-pain and generic PROs. For internal responsiveness, 3 PROs showed a statistically significant improvement in score after treatment (EQ-5D: +0.10 [95% CI, 0.06-0.15], VR-12 physical: +7.2 [95% CI, 4.0-10.4]), and PROMIS 10 physical: +4.4 [95% CI, 2.6-6.3]) and effect size statistics with moderate change (Cohen d and SRM, 0.5-0.8). Assessing external responsiveness, a high correlation with the disease-specific reference (KOOS-pain score) was found for EQ-5D (0.65), VR-12 physical (0.57), and PROMIS 10 physical (0.77). For both internal and external responsiveness, the EQ-5D, VR-12 physical, and PROMIS 10 physical showed significantly greater responsiveness compared with the other general PRO measures but no statistical differences among themselves. There is no statistical difference in internal or external responsiveness to change among the EQ-5D, VR-12 physical, and PROMIS 10 physical instruments. In tracking longitudinal patient health, researchers and administrators have the flexibility to choose any of the general PROs among the EQ-5D, VR-12 physical, and PROMIS 10 physical. We recommend that any study tracking PROs in knee arthroscopy include 1 of these generic instruments.

Estimating EQ-5D values from the Neck Disability Index and numeric rating scales for neck and arm pain.

PubMed

Carreon, Leah Y; Bratcher, Kelly R; Das, Nandita; Nienhuis, Jacob B; Glassman, Steven D

2014-09-01

The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease-specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting. The purpose of this study is to determine if the EQ-5D values can be estimated from commonly available cervical spine disease-specific health-related quality of life measures, much like the SF-6D. The EQ-5D, NDI, neck pain score, and arm pain score were prospectively collected in 3732 patients who presented to the authors' clinic with degenerative cervical spine disorders. Correlation coefficients for paired observations from multiple time points between the NDI, neck pain and arm pain scores, and EQ-5D were determined. Regression models were built to estimate the EQ-5D values from the NDI, neck pain, and arm pain scores. The mean age of the 3732 patients was 53.3 ± 12.2 years, and 43% were male. Correlations between the EQ-5D and the NDI, neck pain score, and arm pain score were statistically significant (p < 0.0001), with correlation coefficients of -0.77, -0.62, and -0.50, respectively. The regression equation 0.98947 + (-0.00705 × NDI) + (-0.00875 × arm pain score) + (-0.00877 × neck pain score) to predict EQ-5D had an R-square of 0.62 and a root mean square error (RMSE) of 0.146. The model using NDI alone had an R-square of 0.59 and a RMSE of 0.150. The model using the individual NDI items had an R-square of 0.46 and an RMSE of 0.172. The correlation coefficient between the observed and estimated EQ-5D scores was 0.79. There was no statistically significant difference between the actual EQ-5D score (0.603 ± 0.235) and the estimated EQ-5D score (0.603 ± 0.185) using the NDI, neck pain score, and arm pain score regression model. However, rounding off the coefficients to fewer than 5 decimal places produced less accurate results. The regression model estimating the EQ-5D from the NDI, neck pain score, and arm pain score accounted for 60% of the variability of the EQ-5D with a relatively large RMSE. This regression model may not be sufficient to accurately or reliably estimate actual EQ-5D values.

Unchained Melody: Revisiting the Estimation of SF-6D Values

PubMed Central

Craig, Benjamin M.

2015-01-01

Purpose In the original SF-6D valuation study, the analytical design inherited conventions that detrimentally affected its ability to predict values on a quality-adjusted life year (QALY) scale. Our objective is to estimate UK values for SF-6D states using the original data and multi-attribute utility (MAU) regression after addressing its limitations and to compare the revised SF-6D and EQ-5D value predictions. Methods Using the unaltered data (611 respondents, 3503 SG responses), the parameters of the original MAU model were re-estimated under 3 alternative error specifications, known as the instant, episodic, and angular random utility models. Value predictions on a QALY scale were compared to EQ-5D3L predictions using the 1996 Health Survey for England. Results Contrary to the original results, the revised SF-6D value predictions range below 0 QALYs (i.e., worse than death) and agree largely with EQ-5D predictions after adjusting for scale. Although a QALY is defined as a year in optimal health, the SF-6D sets a higher standard for optimal health than the EQ-5D-3L; therefore, it has larger units on a QALY scale by construction (20.9% more). Conclusions Much of the debate in health valuation has focused on differences between preference elicitation tasks, sampling, and instruments. After correcting errant econometric practices and adjusting for differences in QALY scale between the EQ-5D and SF-6D values, the revised predictions demonstrate convergent validity, making them more suitable for UK economic evaluations compared to original estimates. PMID:26359242

Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets.

PubMed

Mulhern, Brendan; Feng, Yan; Shah, Koonal; Janssen, Mathieu F; Herdman, Michael; van Hout, Ben; Devlin, Nancy

2018-06-01

Three EQ-5D value sets (EQ-5D-3L, crosswalk, and EQ-5D-5L) are now available for cost-utility analysis in the UK and/or England. The value sets' characteristics differ, and it is important to assess the implications of these differences. The aim of this paper is to compare the three value sets. We carried out analysis comparing the predicted values from each value set, and investigated how differences in health on the descriptive system is reflected in the utility score by assessing the value of adjacent states. We also assessed differences in values using data from patients who completed both EQ-5D-3L and EQ-5D-5L. The distribution of the value sets systematically differed. EQ-5D-5L values were higher than EQ-5D-3L/crosswalk values. The overall range and difference between adjacent states was smaller. In the patient data, the EQ-5D-5L produced higher values across all conditions and there was some evidence that the value sets rank different health conditions in a similar severity order. There are important differences between the value sets. Due to the smaller range of EQ-5D-5L values, the possible change in quality-adjusted life years (QALYs) might be reduced, but they will apply to both control and intervention groups, and will depend on whether the gain is in quality of life, survival, or both. The increased sensitivity of EQ-5D-5L may also favour QALY gains even if the changes in utility are smaller. Further work should assess the impact of the different value sets on cost effectiveness by repeating the analysis on clinical trial data.

Laser weldability of 21Cr-6Ni-9Mn stainless steel: Part II - Weldability diagrams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tate, Stephen B.; Javernick, Daniel Anthony; Lienert, Thomas J.

In this second part of the study, weldability diagrams developed to relate solidification crack susceptibility and chemical composition for laser welded type 21Cr-6Ni-9Mn (21-6-9) stainless steel are presented. Sigmajig testing on 14 commercial 21-6-9 alloys, 20 experimental 21-6-9 alloys, and 7 other high-N, high-Mn austenitic stainless steels was used to develop weldability diagrams for solidification crack susceptibility for laser welding of type 21-6-9. Three travel speeds were used to show the changes in minimum Cr eq/Ni eq for primary ferrite solidification as solidification rate increase d with travel speed . Primary austenite solidification was observed below 1.55 Cr eq/Ni eqmore » (Espy equivalents) at 21 mm/s travel speed. At 42 mm/s travel speed , a mix of solidification modes were displayed for alloys from 1.55-1.75 Cr eq/Ni eq. Primary ferrite solidification was observed above 1.75 Cr eq/Ni eq at both 42 and 85 mm/s travel speeds. No solidification cracking was observed for alloys with primary ferrite solidification. Lastly, variable cracking behavior was found in alloys with primary austenite solidification, but in general cracking was observed in alloys with greater than 0.02 wt-% combined impurity content according to (P+0.2S).« less

Laser weldability of 21Cr-6Ni-9Mn stainless steel: Part II - Weldability diagrams

DOE PAGES

Tate, Stephen B.; Javernick, Daniel Anthony; Lienert, Thomas J.; ...

2016-11-02

In this second part of the study, weldability diagrams developed to relate solidification crack susceptibility and chemical composition for laser welded type 21Cr-6Ni-9Mn (21-6-9) stainless steel are presented. Sigmajig testing on 14 commercial 21-6-9 alloys, 20 experimental 21-6-9 alloys, and 7 other high-N, high-Mn austenitic stainless steels was used to develop weldability diagrams for solidification crack susceptibility for laser welding of type 21-6-9. Three travel speeds were used to show the changes in minimum Cr eq/Ni eq for primary ferrite solidification as solidification rate increase d with travel speed . Primary austenite solidification was observed below 1.55 Cr eq/Ni eqmore » (Espy equivalents) at 21 mm/s travel speed. At 42 mm/s travel speed , a mix of solidification modes were displayed for alloys from 1.55-1.75 Cr eq/Ni eq. Primary ferrite solidification was observed above 1.75 Cr eq/Ni eq at both 42 and 85 mm/s travel speeds. No solidification cracking was observed for alloys with primary ferrite solidification. Lastly, variable cracking behavior was found in alloys with primary austenite solidification, but in general cracking was observed in alloys with greater than 0.02 wt-% combined impurity content according to (P+0.2S).« less

Bruxism and health related quality of life in southern Italy's prison inmates.

PubMed

Cavallo, P; Savarese, G; Carpinelli, L

2014-06-01

The aim of this study was to determine the prevalence of self-assessed bruxism, the level of Health Related Quality of Life (HRQoL) and their relationship in a group of male inmates. BASIC RESEARCH DESIGN, SETTING: The present study was cross-sectional, its setting was two penal institutions in Italy. A sample of 280 male prisoners (mean age 39.7 years). Due to the very small number of female prisoners, it was not possible to study both genders. Subjects were administered a questionnaire with items investigating demographic data, self-assessed bruxism and HRQoL using EuroQoL EQ-5D instrument. Bruxism was present in 29.7% of inmates. Results for EQ-5D (in brackets are data for the general population age and gender matched) were: EQ-index 1.3 (0.8), EQ-VAS 62 (80). Percentage reporting a problem for each dimension: Mobility (MO): 7.5 (9.6), Self Care (SC): 6.1 (4.3), Usual Activities (UA): 17.9 (10.1), Pain/discomfort (PD): 43.9 (40.8), Anxiety/depression (AD): 54.6 (31.9). There was a strong correlation between bruxism and EQ-index, showing concordance and dependence and, as expected, discordance and dependence between bruxism and EQ-VAS. Bruxism prevalence is higher and HRQoL is worse in the prison population than in the general population; the presence of bruxism is correlated with lower HRQoL levels, and correlation is stronger for subjects at first prison experience and for higher education levels, thus suggesting higher effect of stress on these subjects.

Excessive sleep duration and quality of life.

PubMed

Ohayon, Maurice M; Reynolds, Charles F; Dauvilliers, Yves

2013-06-01

Using population-based data, we document the comorbidities (medical, neurologic, and psychiatric) and consequences for daily functioning of excessive quantity of sleep (EQS), defined as a main sleep period or 24-hour sleep duration ≥ 9 hours accompanied by complaints of impaired functioning or distress due to excessive sleep, and its links to excessive sleepiness. A cross-sectional telephone study using a representative sample of 19,136 noninstitutionalized individuals living in the United States, aged ≥ 18 years (participation rate = 83.2%). The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental, and organic disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision; International Classification of Sleep Disorders: Diagnostic and Coding Manual II, International Classification of Diseases and Related Health Problems, 10th edition). Sleeping at least 9 hours per 24-hour period was reported by 8.4% (95% confidence interval = 8.0-8.8%) of participants; EQS (prolonged sleep episode with distress/impairment) was observed in 1.6% (1.4-1.8%) of the sample. The likelihood of EQS was 3 to 12× higher among individuals with a mood disorder. EQS individuals were 2 to 4× more likely to report poor quality of life than non-EQS individuals as well as interference with socioprofessional activities and relationships. Although between 33 and 66% of individuals with prolonged sleep perceived it as a major problem, only 6.3 to 27.5% of them reported having sought medical attention. EQS is widespread in the general population, co-occurring with a broad spectrum of sleep, medical, neurologic, and psychiatric disorders. Therefore, physicians must recognize EQS as a mixed clinical entity indicating careful assessment and specific treatment planning. © 2013 American Neurological Association.

Evaluating the sensitivity of EQ-5D in a sample of patients with type 2 diabetes mellitus in two tertiary health care facilities in Nigeria.

PubMed

Ekwunife, Obinna Ikechukwu; Ezenduka, Charles C; Uzoma, Bede Emeka

2016-01-12

The EQ-5D instrument is arguably the most well-known and commonly used generic measure of health status internationally. Although the instrument has been employed in outcomes studies of diabetes mellitus in many countries, it has not yet been used in Nigeria. This study was carried out to assess the sensitivity of the EQ-5D instrument in a sample of Nigerian patients with type 2 diabetes mellitus (T2DM). A cross-sectional study was conducted using the EQ-5D instrument to assess the self-reported quality of life of patients with T2DM attending two tertiary healthcare facilities in south eastern Nigeria consenting patients completed the questionnaire while waiting to see a doctor. A priori hypotheses were examined using multiple regression analysis to model the relationship between the dependent variables (EQ VAS and EQ-5D Index) and hypothesized independent variables. A total of 226 patients with T2DM participated in the study. The average age of participants was 57 years (standard deviation 10 years) and 61.1% were male. The EQ VAS score and EQ-5D index averaged 66.19 (standard deviation 15.42) and 0.78 (standard deviation 0.21) respectively. Number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ VAS score by -6.76, -6.15, -0.22, and 4.51 respectively. Also, number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ-5D index by -0.12, -0.07, -0.003, and 0.06 respectively.. Our findings indicate that the EQ-5D could adequately capture the burden of type 2 diabetes and related complications among Nigerian patients.

Development of an equine coronavirus-specific enzyme-linked immunosorbent assay to determine serologic responses in naturally infected horses.

PubMed

Kooijman, Lotte J; Mapes, Samantha M; Pusterla, Nicola

2016-07-01

Equine coronavirus (EqCoV) infection has been documented in most reports through quantitative qPCR analysis of feces and viral genome sequencing. Although qPCR is used to detect antigen during the acute disease phase, there is no equine-specific antibody test available to study EqCoV seroprevalence in various horse populations. We developed an enzyme-linked immunosorbent assay (ELISA) targeting antibodies to the spike (S) protein of EqCoV and validated its use, using acute and convalescent sera from 83 adult horses involved in 6 outbreaks. The EqCoV S protein-based ELISA was able to reliably detect antibodies to EqCoV in naturally infected horses. The greatest seroconversion rate was observed in horses with clinical signs compatible with EqCoV infection and EqCoV qPCR detection in feces. The EqCoV S protein-based ELISA could be used effectively for seroepidemiologic studies in order to better characterize the overall infection rate of EqCoV in various horse populations. © 2016 The Author(s).

A comparison of the scaling properties of the English, Spanish, French, and Chinese EQ-5D descriptive systems.

PubMed

Luo, Nan; Li, Minghui; Chevalier, Julie; Lloyd, Andrew; Herdman, Michael

2013-10-01

To compare the scaling properties of the English, Spanish, French, and Chinese versions of the EQ-5D-3L and EQ-5D-5L descriptive systems. Members of the general populations in the UK, Spain, France, and China were interviewed to measure the severity of health problems represented by the response labels used in the EQ-5D descriptive systems using a visual analog scale. Multiple linear regression models were used to compare the perceived label severity across the four language groups. Severity scores for labels from each EQ-5D-5L dimension scale were compared with each other to assess ordinality. EQ-5D-5L and EQ-5D-3L labels used for describing different levels of health problems were rated differently, while those describing the same level of health problems were rated similarly. For example, the deviation of any group mean from the grand severity mean score for the label 'slight(ly)' was no larger than 5 points on a 0-100 scale for all five EQ-5D dimensions (p > 0.05 for all, t tests). Label ratings violating hypothesized ordinality of the EQ-5D-5L scales were observed in only a small proportion of respondents. Our study provided some preliminary evidence supporting the ordinality and equivalence of the EQ-5D-5L and EQ-5D-3L descriptive systems across four major languages.

Estimation of health-related-quality of life depends on which utility measure is selected for patients with carpal tunnel syndrome.

PubMed

Nazari, Goris; MacDermid, Joy C; Bain, James; Levis, Carolyn M; Thoma, Achilleas

Cross-sectional. Carpal tunnel syndrome (CTS) refers to the compression neuropathy of the median nerve at the wrist. To establish the interinstrument reliability, convergent construct validity, and the levels of agreement of health utility indexes 2 and 3 (HUI-2 and HUI-3), EuroQol 5-dimensions (EQ-5D), EuroQol-visual analog scale (EQ-VAS) and to determine the difference of these utility measures based on age and gender in patients with carpal tunnel syndrome. Seventy-four patients with a confirmed diagnosis of carpal tunnel syndrome completed the 3 questionnaires and EQ-VAS a month before surgery. Demographic characteristics were reported. Intraclass correlation coefficients were used to assess relative interinstrument reliability. Pearson correlation coefficients (r) were used to establish convergent construct validity. Bland-Altman plots and t tests were used to describe the levels of agreement between the 4 utility measures. A 2-way analysis of variance was performed to determine the effect of age and gender on the utility measures; HUI-2, HUI-3, and EQ-5D. The intraclass correlation coefficients were 0.85 for HUI-3 vs HUI-2 and 0.80 for HUI-2 vs EQ-VAS. Pearson correlation coefficients ranged from 0.60 to 0.89; HUI-3 vs HUI-2: 0.89, and HUI-3 vs EQ-5D: 0.60. One-sample t test demonstrated significant differences between HUI-3 vs HUI-2, HUI-3 vs EQ-5D, and HUI-3 vs EQ-VAS measures, with mean differences of -0.12, -0.15, and -0.14, respectively. A 2-way analysis of variance test controlling for age and gender indicated neither as predictors of outcome scores. The HUI-3 vs HUI-2 and HUI-2 vs EQ-VAS demonstrated excellent interinstrument relative reliability measures. The HUI-3 vs HUI-2 displayed very strong convergent construct validity measures, and strong validity measures were established between the remaining utility measures. In addition, the pair-wise utility comparisons demonstrated minimal bias between HUI-2 vs EQ-5D, HUI-2 vs EQ-VAS, and EQ-VAS vs EQ-5D measures. N/A. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients.

PubMed

Kontodimopoulos, Nick; Bozios, Panagiotis; Yfantopoulos, John; Niakas, Dimitris

2013-04-01

The purpose of this methodological study was to to provide insight into the under-addressed issue of the longitudinal predictive ability of mapping models. Post-intervention predicted and reported utilities were compared, and the effect of disease severity on the observed differences was examined. A cohort of 120 rheumatoid arthritis (RA) patients (60.0% female, mean age 59.0) embarking on therapy with biological agents completed the Modified Health Assessment Questionnaire (MHAQ) and the EQ-5D at baseline, and at 3, 6 and 12 months post-intervention. OLS regression produced a mapping equation to estimate post-intervention EQ-5D utilities from baseline MHAQ data. Predicted and reported utilities were compared with t test, and the prediction error was modeled, using fixed effects, in terms of covariates such as age, gender, time, disease duration, treatment, RF, DAS28 score, predicted and reported EQ-5D. The OLS model (RMSE = 0.207, R(2) = 45.2%) consistently underestimated future utilities, with a mean prediction error of 6.5%. Mean absolute differences between reported and predicted EQ-5D utilities at 3, 6 and 12 months exceeded the typically reported MID of the EQ-5D (0.03). According to the fixed-effects model, time, lower predicted EQ-5D and higher DAS28 scores had a significant impact on prediction errors, which appeared increasingly negative for lower reported EQ-5D scores, i.e., predicted utilities tended to be lower than reported ones in more severe health states. This study builds upon existing research having demonstrated the potential usefulness of mapping disease-specific instruments onto utility measures. The specific issue of longitudinal validity is addressed, as mapping models derived from baseline patients need to be validated on post-therapy samples. The underestimation of post-treatment utilities in the present study, at least in more severe patients, warrants further research before it is prudent to conduct cost-utility analyses in the context of RA by means of the MHAQ alone.

On precursory ULF/ELF electromagnetic signatures for the Kobe earthquake on April 12, 2013

NASA Astrophysics Data System (ADS)

Schekotov, A.; Izutsu, J.; Hayakawa, M.

2015-12-01

After the 2011 Tohoku earthquake (EQ), there have been numerous aftershocks in the eastern and Pacific Ocean of Japan, but EQs are still rare in the western part of Japan. In this situation a relatively large (magnitude (M) ∼ 6) EQ happened on April 12 (UT), 2013 at a place close to the 1995 Kobe EQ (M ∼ 7), so we have tried to find whether there existed any electromagnetic precursors to this EQ. Two precursory signatures are detected: one is the depression of ULF (ultra-low-frequency, 0.01-0.02 Hz) geomagnetic variations on April 9, and the second is wideband ELF (extremely low frequency) electromagnetic radiation on April 11. These results for the 2013 Kobe EQ are compared with the corresponding results for the former 1995 Kobe EQ.

Reliability and validity of the EQ-5D-3L for Kashin-Beck disease in China.

PubMed

Fang, Hua; Farooq, Umer; Wang, Dimiao; Yu, Fangfang; Younus, Mohammad Imran; Guo, Xiong

2016-01-01

Kashin-Beck Disease (KBD) is an endemic osteoarthropathy in areas which extend from the North-East to the South-West of China. Most of the patients with KBD suffer multiple dysfunctions in major joints causing decreased health status. However because of their low education level and unique living habits, it is hard to find tools to measure the health-related quality of life (HRQOL). European quality of life (EQ-5D-3L) patient-reported instrument is widely used to measure HRQOL. This study aimed to establish the validity and reliability of the Chinese version of the EQ-5D-3L for evaluating HRQOL of KBD individuals in rural area. 368 individuals who were suffering from KBD were recruited through stratified multistage random sampling from Shaanxi province, China. The EQ-5D-3L and the WHOQOL-BREF were administrated in each individual by face to face interview. Test-retest reliability was assessed at 10-14 days intervals. The test-retest reliability was measured by calculating the Kappa coefficients for EQ-5D-3L five dimensions. For the EQ VAS, the intraclass correlation coefficient (ICC) was computed. Convergent and divergent analysis, construct validity was established using Spearman's rank correlation between the EQ-5D-3L and the WHOQOL-BREF. Known groups' validity was examined by comparing groups with a priori expected differences in health-related quality of life (HRQOL). For 362 individuals (98%), comprehensive data of all the EQ-5D-3L dimensions were available. Kappa values of the EQ-5D-3L five items ranged from 0.324 to 0.554. ICC of the EQ VAS was 0.497. For convergent validity, the three items (self-care, usual activity, and mobility) of EQ-5D-3L, index scores, and VAS showed moderate correlations with the physical health domain of the WHOQOL-BREF (r absolute value ranged from 0.339 to 0.475). For divergent validity, the 5 items of EQ-5D-3L showed weak or no correlations with environment and social relationship domains of WHOQOL-BREF. The Chinese EQ-5D-3L clearly demarcated between groups which were reporting severe disease degree, poorer general health, more number of painful joints with worse HRQOL. The EQ-5D-3L Chinese Version demonstrated fair to moderate levels of test-retest reliability and adequate construct validity in KBD individuals in China.

The Codacs™ Direct Acoustic Cochlear Implant Actuator: Exploring Alternative Stimulation Sites and Their Stimulation Efficiency

PubMed Central

Grossöhmichen, Martin; Salcher, Rolf; Kreipe, Hans-Heinrich; Lenarz, Thomas; Maier, Hannes

2015-01-01

This work assesses the efficiency of the Codacs system actuator (Cochlear Ltd., Sydney Australia) in different inner ear stimulation modalities. Originally the actuator was intended for direct perilymph stimulation after stapedotomy using a piston prosthesis. A possible alternative application is the stimulation of middle ear structures or the round window (RW). Here the perilymph stimulation with a K-piston through a stapes footplate (SFP) fenestration (N = 10) as well as stimulation of the stapes head (SH) with a Bell prosthesis (N = 9), SFP stimulation with an Omega/Aerial prosthesis (N = 8) and reverse RW stimulation (N = 10) were performed in cadaveric human temporal bones (TBs). Codacs actuator output is expressed as equivalent sound pressure level (eq. SPL) using RW and SFP displacement responses, measured by Laser Doppler velocimetry as reference. The axial actuator coupling force in stimulation of stapes and RW was adjusted to ~ 5 mN. The Bell prosthesis and Omega/Aerial prosthesis stimulation generated similar mean eq. SPLs (Bell: 127.5–141.8 eq. dB SPL; Omega/Aerial: 123.6–143.9 eq. dB SPL), being significantly more efficient than K-piston perilymph stimulation (108.6–131.6 eq. dB SPL) and RW stimulation (108.3–128.2 eq. dB SPL). Our results demonstrate that SH, SFP and RW are adequate alternative stimulation sites for the Codacs actuator using coupling prostheses and an axial coupling force of ~ 5 mN. Based on the eq. SPLs, all investigated methods were adequate for in vivo hearing aid applications, provided that experimental conditions including constant coupling force will be implemented. PMID:25785860

Comparing and transforming PROMIS utility values to the EQ-5D.

PubMed

Hartman, John D; Craig, Benjamin M

2018-03-01

Summarizing patient-reported outcomes (PROs) on a quality-adjusted life year (QALY) scale is an essential component to any economic evaluation comparing alternative medical treatments. While multiple studies have compared PRO items and instruments based on their psychometric properties, no study has compared the preference-based summary of the EQ-5D-3L and Patient Reported Outcomes Measurement Information System (PROMIS-29) instruments. As part of this comparison, a major aim of this manuscript is to transform PROMIS-29 utility values to an EQ-5D-3L scale. A nationally representative survey of 2623 US adults completed the 29-item PROMIS health profile instrument (PROMIS-29) and the 3-level version of the EQ-5D instrument (EQ-5D-3L). Their responses were summarized on a health utility scale using published estimates. Using regression analysis, PROMIS-29 and EQ-5D-3L utility weights were compared with each other as well as with self-reported general health. PROMIS-29 utility weights were much lower than the EQ-5D-3L weights. However, a correlation coefficient of 0.769 between the utility values of the two instruments suggests that the main discordance is simply a difference in scale between the measures. It is also possible to map PROMIS-29 utility weights onto an EQ-5D-3L scale. EQ-5D-3L losses equal .1784 × (PROMIS-29 Losses) .7286 . The published estimates of the PROMIS-29 produce lower utility values than many other health instruments. Mapping the PROMIS-29 estimates to an EQ-5D-3L scale alleviates this issue and allows for a more straightforward comparison between the PROMIS-29 and other common health instruments.

Antihypertensive Medications and the Prevalence of Hyperkalemia in a Large Health System.

PubMed

Chang, Alex R; Sang, Yingying; Leddy, Julia; Yahya, Taher; Kirchner, H Lester; Inker, Lesley A; Matsushita, Kunihiro; Ballew, Shoshana H; Coresh, Josef; Grams, Morgan E

2016-06-01

Little is known about the frequency and patterns of hyperkalemia in clinical settings. We evaluated the association between baseline antihypertensive medications that may affect potassium levels (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, loop/thiazide diuretics, and potassium-sparing diuretics) and hyperkalemia, defined by potassium >5 mEq/L and >5.5 mEq/L, over a 3-year time period in 194 456 outpatients in the Geisinger Health System, as well as actions taken after an episode of hyperkalemia. The proportions of patients with 0, <2, 2 to 4, and ≥4 potassium measurements per year were 20%, 58%, 16%, and 6%. Potassium levels >5 mEq/L and >5.5 mEq/L occurred in 10.8% and 2.3% of all patients over the 3-year period; among patients with ≥4 measurements per year, corresponding values were 39.4% and 14.6%. Most cases of hyperkalemia occurred only once during follow-up. The antihypertensive medication class most strongly associated with hyperkalemia was angiotensin-converting enzyme inhibitors. Among patients with a measurement of potassium >5.5 mEq/L, only 24% were seen by a nephrologist and 5.2% were seen by a dietician during the 3-year period. Short-term actions after a potassium measurement >5.5 mEq/L included emergency room visit (3.1% within 7 days), remeasurement of potassium (44.3% with 14 days), and change in a potassium-altering medication (26.4% within 60 days). The most common medication changes were discontinuation/dose reduction of an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or potassium-sparing diuretic, which occurred in 29.1% and 49.6% of people taking these medications, respectively. In conclusion, hyperkalemia is common. Future research may enable optimal renin-angiotensin-aldosterone system inhibitor use with improved management of hyperkalemia. © 2016 American Heart Association, Inc.

Whole-grain intake in middle school students achieves dietary guidelines for Americans and MyPlate recommendations when provided as commercially available foods: a randomized trial.

PubMed

Radford, Allyson; Langkamp-Henken, Bobbi; Hughes, Christine; Christman, Mary C; Jonnalagadda, Satya; Boileau, Thomas W; Thielecke, Frank; Dahl, Wendy J

2014-09-01

In accordance with the 2010 Dietary Guidelines for Americans, at least half of total grain intake should be whole grains. Adolescents are currently not consuming the recommended daily intake of whole grains. Research is needed to determine whether whole grains are acceptable to adolescents and whether changing their food environment to include whole-grain foods will improve intake. The aim of this study was to determine the effect of providing refined-grain or whole-grain foods to adolescents, with encouragement to eat three different grain-based foods per day, on total grain and whole-grain intakes. Middle school students (n=83; aged 11 to 15 years) were randomly assigned to either refined-grain or whole-grain foods for 6 weeks. Participants and their families were provided with weekly grains (eg, bread, pasta, and cereals), and participants were provided grain snacks at school. Intake of grains in ounce equivalents (oz eq) was determined through eight baseline and intervention targeted 24-hour diet recalls. Participants consumed 1.1±1.3 oz eq (mean±standard deviation) of whole grains at baseline, out of 5.3±2.4 oz eq of total grains. During intervention, whole-grain intake increased in the whole-grain group (0.9±1.0 to 3.9±1.8 oz eq/day), whereas those in the refined-grain group reduced whole-grain intake (1.3±1.6 to 0.3±0.3 oz eq/day; P<0.002, group by time period interaction). Total grain intake achieved was 6.4±2.1 oz eq/day and did not differ across intervention groups. Providing adolescents with whole-grain foods in their school and home environments was an effective means of achieving recommendations. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Hypervolemia During Drinking of ISO and Hypertonic Fluids by Men at Rest and Exercise

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Looft-Wilson, R.; Wisherd, J. L.; Fung, P. P.; Erti, A. C.; Jackson, C. G. R.; Barnes, P. R.; Wong, L. G.

1994-01-01

To test the hypothesis that drink composition is more important than osmolality (osm) for maintaining and increasing plasma vol. (PV, hypervolemia) at rest and exercise (21.8C Tdb, 50% rh), 6 men (22-39 vr) underwent six treatments while sitting for 90 min (0.39 l/min) followed by 70 min of sitting ergometer exercise (2.08 l/min, 70%vO2 peak). Resting, intermittent drinking (10 ml/kg, 768 ml) beverages were: P1 (20 mEq Na+, 365 mosmol/kg), P2 (40 mEq Na+. 791 mosm), P2G (40 mEq Na+, 80 ml glycerol, 1.392 mosm). AA (157 mEq Na+, 253 mosm), and 01 and 02 (nothing). The exercise drink (10 ml/kg, 768 ml) was P1 for all experiments, except 02 (nothing). Resting % delta PV (Hb-Hct) increased (P<0.05) by 3-6% only with P2 and AA, respectively, Exercise % delta PV was + 1 to + 3% (NS) with AA, -6% to 0% (KS) with P1, P2. P2G, and 01,and 8% to -5% (P<0.05) with 02- Thus, AA with 157 mEq Na+ and the lowest osmolality maintained PV at rest and exercise, while the other beverages with low Na+ and higher osmolality (365 to 1.382 mosm) did not.

Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation.

PubMed

Chen, Poyu; Lin, Keh-Chung; Liing, Rong-Jiuan; Wu, Ching-Yi; Chen, Chia-Ling; Chang, Ku-Chou

2016-06-01

To examine the criterion validity, responsiveness, and minimal clinically important difference (MCID) of the EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L) and visual analog scale (EQ-VAS) in people receiving rehabilitation after stroke. The EQ-5D-5L, along with four criterion measures-the Medical Research Council scales for muscle strength, the Fugl-Meyer assessment, the functional independence measure, and the Stroke Impact Scale-was administered to 65 patients with stroke before and after 3- to 4-week therapy. Criterion validity was estimated using the Spearman correlation coefficient. Responsiveness was analyzed by the effect size, standardized response mean (SRM), and criterion responsiveness. The MCID was determined by anchor-based and distribution-based approaches. The percentage of patients exceeding the MCID was also reported. Concurrent validity of the EQ-Index was better compared with the EQ-VAS. The EQ-Index has better power for predicting the rehabilitation outcome in the activities of daily living than other motor-related outcome measures. The EQ-Index was moderately responsive to change (SRM = 0.63), whereas the EQ-VAS was only mildly responsive to change. The MCID estimation of the EQ-Index (the percentage of patients exceeding the MCID) was 0.10 (33.8 %) and 0.10 (33.8 %) based on the anchor-based and distribution-based approaches, respectively, and the estimation of EQ-VAS was 8.61 (41.5 %) and 10.82 (32.3 %). The EQ-Index has shown reasonable concurrent validity, limited predictive validity, and acceptable responsiveness for detecting the health-related quality of life in stroke patients undergoing rehabilitation, but not for EQ-VAS. Future research considering different recovery stages after stroke is warranted to validate these estimations.

Newborn screening for cystic fibrosis with the chloride electrode and neutron activation analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guerson, C.T.; Sertel, H.; Guerkan, M.

From third annual meeting of the European Working Group of Cystic Fibrosis; Erbach, Germany (6 Sep 1972). In 6,061 newborns, the chloride electrode technique was used for the detection of cystic fibrosis. The electrolyte values obtained were found to vary with the type of electrode used (45.9 plus or minus 9.9 mEq/l Beckman and 22.3 plus or minus 12 mEq/l Orion), and in both cases a value greater than the mean + 2 standard deviation was held as suspect and retested. In the group studied, the incidence of cystic fibrosis was calculated to be 1 in 3,000. In 590 ofmore » these cases the sodium values of nail clippings were measured by neutron activation analysis and were found to differ according to the washing method used; wash in vivo with ethanol 211.26 plus or minus 85.9 mEq/ kg water wash and acetone rinse 93.00 plus or minus 47.24 mEq/ kg; washing with H/sub 2/O/sub 2/ + absolute ethanol + diethyl ether, 183.42 plus or minus 61.26 mEq/k g. In addition, no correlation was found between chloride in sweat and the sodium content of nails. (auth)« less

Dialysate Potassium and Mortality in a Prospective Hemodialysis Cohort.

PubMed

Ferrey, Antoney; You, Amy S; Kovesdy, Csaba P; Nakata, Tracy; Veliz, Mary; Nguyen, Danh V; Kalantar-Zadeh, Kamyar; Rhee, Connie M

2018-06-07

Studies examining the association of dialysate potassium concentration and mortality in hemodialysis patients show conflicting findings. We hypothesized that low dialysate potassium concentrations are associated with higher mortality, particularly in patients with high pre-dialysis serum potassium concentrations. We evaluated 624 hemodialysis patients from the prospective Malnutrition, Diet, and Racial Disparities in Kidney Disease study recruited from 16 outpatient dialysis facilities over 2011-2015 who underwent protocolized collection of dialysis treatment characteristics every 6 months. We examined the association of dialysate potassium concentration, categorized as 1, 2, and 3 mEq/L, with all-cause mortality risk in the -overall cohort, and stratified by pre-dialysis serum potassium (< 5 vs. ≥5 mEq/L) using case-mix adjusted Cox models. In baseline analyses, dialysate potassium concentrations of 1 mEq/L were associated with higher mortality, whereas concentrations of 3 mEq/L were associated with similar mortality in the overall cohort (reference: 2 mEq/L): adjusted hazard ratios (aHRs; 95% CI) 1.70 (1.01-2.88) and 0.95 (0.64-1.39), respectively. In analyses stratified by serum potassium, baseline dialysate potassium concentrations of 1 mEq/L were associated with higher mortality in patients with serum potassium ≥5 mEq/L but not in those with serum potassium < 5 mEq/L: aHRs (95% CI) 2.87 (1.51-5.46) and 0.74 (0.27-2.07), respectively (p interaction = 0.04). These findings were robust with incremental adjustment for serum potassium, potassium-binding resins, and potassium-modifying medications. Low (1 mEq/L) dialysate potassium -concentrations were associated with higher mortality, particularly in hemodialysis patients with high pre-dialysis serum potassium. Further studies are needed to identify therapeutic strategies that mitigate inter-dialytic serum potassium accumulation and subsequent high dialysate serum potassium gradients in this population. © 2018 S. Karger AG, Basel.

Gibbs Energy Changes during Cobalt Complexation: A Thermodynamics Experiment for the General Chemistry Laboratory

ERIC Educational Resources Information Center

DeGrand, Michael J.; Abrams, M. Leigh; Jenkins, Judith L.; Welch, Lawrence E.

2011-01-01

By adding a large quantity of Cl[superscript -] to an aqueous solution of CoCl[subscript 2][multiplied by]6H[subscript 2]O, a mixture containing a red octahedral cobalt complex and a blue tetrahedral complex is produced. When the solution temperature is modified, the equilibrium constant, K[subscript eq], of the complexation reaction is shifted…

Health-Related Quality of Life and Functional Ability of Patients with Rheumatoid Arthritis: A Study from a Tertiary Care Hospital in Thailand.

PubMed

Munchey, Ratree; Pongmesa, Tipaporn

2018-05-01

To assess the health-related quality of life and functional ability of patients with rheumatoid arthritis (RA) using the Thai EuroQol five-dimensional questionnaire (EQ-5D) and the Thai Health Assessment Questionnaire (HAQ), and to analyze correlations between the scores from both questionnaires. This cross-sectional study was conducted among 221 patients with RA aged 18 years or older at a tertiary care hospital in Thailand. Data collection methods included individual patient interviews and data gathering from medical records. The correlations between the EQ-5D and HAQ scores were analyzed using Spearman's rank correlation coefficients. Most patients were female (78.3%), aged 41 to 60 years (57.0%), having had RA for 12 to 60 months (43.0%), and being in an active disease state (60.6%). From the EQ-5D, most patients reported no problems in each dimension, except for mobility and pain/discomfort. For the HAQ, most patients reported no difficulty for almost all activities, except for arising. The medians (interquartile ranges) for the EQ-5D utility, EuroQol visual analogue scale (EQ VAS), and HAQ scores were 0.65 (0.55-0.73), 70 (50-80), and 0.25 (0.00-0.81), respectively. The Spearman's rank correlation coefficients were 0.42 for the EQ-5D utility and EQ VAS scores (P = 0.01), -0.65 for the EQ-5D utility and HAQ scores (P < 0.001), and -0.39 for the EQ VAS and HAQ scores (P < 0.001). The health-related quality of life and functional ability of most patients in our study were partially affected by the disease. The EQ-5D and HAQ scores significantly correlated at a moderate to strong level. Copyright © 2018. Published by Elsevier Inc.

Ion transport in proximal colon of the rat. Sodium depletion stimulates neutral sodium chloride absorption.

PubMed Central

Foster, E S; Budinger, M E; Hayslett, J P; Binder, H J

1986-01-01

The model of sodium and chloride transport proposed for the colon is based on studies performed in the distal segment and tacitly assumes that ion transport is similar throughout the colon. In rat distal colon, neutral sodium-chloride absorption accounts for the major fraction of overall sodium absorption and aldosterone stimulates electrogenic, amiloride-sensitive sodium absorption. Since we have demonstrated qualitative differences in potassium transport in proximal and distal segments of rat colon, unidirectional 22Na and 36Cl fluxes were performed under short-circuit conditions across isolated proximal colon of control and sodium-depleted rats with secondary hyperaldosteronism. In the control group, net sodium absorption (JNanet) (7.4 +/- 0.5 mu eq/h . cm2) was greater than Isc (1.4 +/- 0.1 mu eq/h . cm2), and JClnet was 0 in Ringer solution. Residual flux (JR) was -5.2 +/- 0.5 mu eq/h . cm2 consistent with hydrogen ion secretion suggesting that neutral sodium absorption may represent sodium-hydrogen exchange. 1 mM mucosal amiloride, which inhibits sodium-hydrogen exchange in other epithelia, produced comparable decreases in JNanet and JR (4.1 +/- 0.6 and 3.2 +/- 0.6 mu eq/h . cm2, respectively) without a parallel fall in Isc. Sodium depletion stimulated JNanet, JClnet, and Isc by 7.0 +/- 1.4, 6.3 +/- 1.9, and 0.8 +/- 0.2 mu eq/h . cm2, respectively, and 1 mM amiloride markedly inhibited JNanet and JClnet by 6.0 +/- 1.1 and 4.0 +/- 1.6 mu eq/h . cm2, respectively, with only a minimal reduction in Isc. Conclusions: the predominant neutral sodium-absorptive mechanism in proximal colon is sodium-hydrogen exchange. Sodium depletion stimulates electroneutral chloride-dependent sodium absorption (most likely as a result of increasing sodium-hydrogen and chloride-bicarbonate exchanges), not electrogenic chloride-independent sodium transport. The model of ion transport in the proximal colon is distinct from that of the distal colon. PMID:2418060

Radiation design and control features of a hospital room for a low dose rate remote afterloading unit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glasgow, G.P.; Corrigan, K.W.

We have renovated, and used for four years, a small 3.4 m x 4.3 m conventional patient second floor hospital room to accommodate a low dose rate remote afterloading unit containing 13 GBq (0.35 Ci) of {sup 137}Cs. Supplemental room shielding consists of a power assisted door (536 kg, 1.7 cm thickness of lead), 1.3 cm lead wall shielding at selected wall locations and on a projector shield beneath the bed, and 0.6 cm of lead over the floor above. Radiation control features consisted of a room interior radiation detector independent of the remote afterloading unit, a redundant patient/nurse communicationmore » system, a remote control system, a door interlock system to insert and retract the radioactive pellets, and a visible and audible status indictator system located at a nearby nurses` work station. Renovation costs (in 1990 dollars) were $383 per square foot; total project costs were $187,000. Nursing personnel radiation exposure was reduced from about 6 {mu}Sv (mg Ra eq){sup -1} (0.6 mrem (mg Ra eq){sup -1}) to about 0.7 {mu}Sv (mg Ra eq){sup -1} (0.07 mrem (mg Ra eq){sup -1}), almost a tenfold reduction. 6 refs., 2 figs., 1 tab.« less

Relationship between serum nonesterified fatty acids at calving and the incidence of periparturient diseases in Holstein dairy cows.

PubMed

Melendez, P; Marin, M P; Robles, J; Rios, C; Duchens, M; Archbald, L

2009-10-01

The objective was to describe the relationship between concentration of serum nonesterified fatty acids (NEFAs) at calving and the incidence of periparturient disorders in Chilean Holstein dairy cows (Bos taurus). The study was conducted at two dairies (central Chile) with 700 milking cows each and similar management. Between July 2006 and March 2007, 350 cows were selected, and concentrations of serum NEFAs were determined at calving. The incidence of milk fever (MF), retained fetal membranes (RFMs), metritis, and clinical mastitis from calving to 100 d in lactation were consistently recorded. The relationship between concentration of serum NEFAs at calving and the incidence of periparturient diseases was determined using logistic regression. The main explanatory variable was concentration of serum NEFAs at calving. The incidence of MF, RFM, metritis, and mastitis was 5.4%, 15.6%, 10.8%, and 14.4%, respectively. There was no association between concentration of NEFAs at calving and the incidence of these conditions when the median value of NEFAs (0.9 mEq/L) was used as a cutoff. However, when the 75th percentile (1.2 mEq/L) was used as the cutoff, cows with values <1.2 mEq/L were 0.45 and 0.32 times as likely to develop clinical mastitis and MF, respectively, compared with cows with values >or=1.2 mEq/L. When the 90th percentile (1.6 mEq/L) was used as a cutoff, cows with values <1.6 mEq/L were 0.25 times as likely to develop clinical mastitis compared with cows with values >or=1.6 mEq/L. As a continuous variable, for every 0.1 mEq/L increment in NEFAs at calving, cows were 1.11 times more likely to experience clinical mastitis. In conclusion, cows with NEFA concentrations >or=1.2 mEq/L had a higher incidence of clinical mastitis and MF than that of cows with values <1.2 mEq/L.

Differential Infection Patterns and Recent Evolutionary Origins of Equine Hepaciviruses in Donkeys

PubMed Central

Walter, Stephanie; Rasche, Andrea; Moreira-Soto, Andrés; Pfaender, Stephanie; Bletsa, Magda; Corman, Victor Max; Aguilar-Setien, Alvaro; García-Lacy, Fernando; Hans, Aymeric; Todt, Daniel; Schuler, Gerhard; Shnaiderman-Torban, Anat; Steinman, Amir; Roncoroni, Cristina; Veneziano, Vincenzo; Rusenova, Nikolina; Sandev, Nikolay; Rusenov, Anton; Zapryanova, Dimitrinka; García-Bocanegra, Ignacio; Jores, Joerg; Carluccio, Augusto; Veronesi, Maria Cristina; Cavalleri, Jessika M. V.; Drosten, Christian; Lemey, Philippe

2016-01-01

ABSTRACT The hepatitis C virus (HCV) is a major human pathogen. Genetically related viruses in animals suggest a zoonotic origin of HCV. The closest relative of HCV is found in horses (termed equine hepacivirus [EqHV]). However, low EqHV genetic diversity implies relatively recent acquisition of EqHV by horses, making a derivation of HCV from EqHV unlikely. To unravel the EqHV evolutionary history within equid sister species, we analyzed 829 donkeys and 53 mules sampled in nine European, Asian, African, and American countries by molecular and serologic tools for EqHV infection. Antibodies were found in 278 animals (31.5%), and viral RNA was found in 3 animals (0.3%), all of which were simultaneously seropositive. A low RNA prevalence in spite of high seroprevalence suggests a predominance of acute infection, a possible difference from the mostly chronic hepacivirus infection pattern seen in horses and humans. Limitation of transmission due to short courses of infection may explain the existence of entirely seronegative groups of animals. Donkey and horse EqHV strains were paraphyletic and 97.5 to 98.2% identical in their translated polyprotein sequences, making virus/host cospeciation unlikely. Evolutionary reconstructions supported host switches of EqHV between horses and donkeys without the involvement of adaptive evolution. Global admixture of donkey and horse hepaciviruses was compatible with anthropogenic alterations of EqHV ecology. In summary, our findings do not support EqHV as the origin of the significantly more diversified HCV. Identification of a host system with predominantly acute hepacivirus infection may enable new insights into the chronic infection pattern associated with HCV. IMPORTANCE The evolutionary origins of the human hepatitis C virus (HCV) are unclear. The closest animal-associated relative of HCV occurs in horses (equine hepacivirus [EqHV]). The low EqHV genetic diversity implies a relatively recent acquisition of EqHV by horses, limiting the time span for potential horse-to-human infections in the past. Horses are genetically related to donkeys, and EqHV may have cospeciated with these host species. Here, we investigated a large panel of donkeys from various countries using serologic and molecular tools. We found EqHV to be globally widespread in donkeys and identify potential differences in EqHV infection patterns, with donkeys potentially showing enhanced EqHV clearance compared to horses. We provide strong evidence against EqHV cospeciation and for its capability to switch hosts among equines. Differential hepacivirus infection patterns in horses and donkeys may enable new insights into the chronic infection pattern associated with HCV. PMID:27795428

Options to reduce greenhouse gas emissions during wastewater treatment for agricultural use.

PubMed

Fine, Pinchas; Hadas, Efrat

2012-02-01

Treatment of primarily-domestic sewage wastewater involves on-site greenhouse gas (GHG) emissions due to energy inputs, organic matter degradation and biological nutrient removal (BNR). BNR causes both direct emissions and loss of fertilizer value, thus eliminating possible reduction of emissions caused by fertilizer manufacture. In this study, we estimated on-site GHG emissions under different treatment scenarios, and present options for emission reduction by changing treatment methods, avoiding BNR and by recovering energy from biogas. Given a typical Israeli wastewater strength (1050mg CODl(-1)), the direct on-site GHG emissions due to energy use were estimated at 1618 and 2102g CO(2)-eq m(-3), respectively, at intermediate and tertiary treatment levels. A potential reduction of approximately 23-55% in GHG emissions could be achieved by fertilizer preservation and VS conversion to biogas. Wastewater fertilizers constituted a GHG abatement potential of 342g CO(2)-eq m(-3). The residual component that remained in the wastewater effluent following intermediate (oxidation ponds) and enhanced (mechanical-biological) treatments was 304-254g CO(2)-eq m(-3) and 65-34g CO(2)-eq m(-3), respectively. Raw sludge constituted approximately 47% of the overall wastewater fertilizers load with an abatement potential of 150g CO(2)-eq m(-3) (385kg CO(2)-eq dry tonne(-1)). Inasmuch as anaerobic digestion reduced it to 63g CO(2)-eq m(-3) (261kg CO(2)-eq dry tonne(-1)), the GHG abatement gained through renewable biogas energy (approx. 428g CO(2)-eq m(-3)) favored digestion. However, sludge composting reduced the fertilizer value to 17g CO(2)-eq m(-3) (121kg CO(2)-eq dry tonne(-1)) or less (if emissions, off-site inputs and actual phytoavailability were considered). Taking Israel as an example, fully exploiting the wastewater derived GHG abatement potential could reduce the State overall GHG emissions by almost 1%. This demonstrates the possibility of optional carbon credits which might be exploited in the construction of new wastewater treatment facilities, especially in developing countries. Copyright © 2011 Elsevier B.V. All rights reserved.

Long-term changes of patient-reported quality of life after major trauma: The importance of the time elapsed after injury.

PubMed

Fleischhacker, Evi; Trentzsch, Heiko; Kuppinger, David; Meigel, Franziska; Beyer, Felix; Hartl, Wolfgang H

2018-02-01

Numerous studies have identified various risk factors for a poor health-related quality of life (HRQOL) after severe trauma. The relative importance of the time elapsed after injury, however, is unknown and results of clinical studies have been conflicting. A cross-sectional study was performed in two trauma centres using data from the German TraumaRegister DGU ® , which contained prospectively collected information on the type and severity of the injury, on critical care, and on outcome. To evaluate HRQOL in patients surviving more than 500days after the injury, we used a self-rating instrument, the EQ-5D which contains a visual analogue scale (EQ-VAS), and which allows the calculation of a global outcome indicator, the EQ-D5 index value. Complex statistical models were used to evaluate independent associations between the time elapsed after injury and a poor HRQOL. Of 380 contacted patients, follow-up assessments could be obtained in 168 patients (44.2%) 3.6±1.6 (SD) years after the injury. There was a linear association between the time elapsed after the injury and the% of contacted patients not participating in the study (p=0.013). In participating subjects, average EQ-5D index value was 0.599±0.299, and average EQ-VAS rating 67.8±22.0. A very poor quality of life (EQ-5D index value<0.6, EQ-VAS rating≤50) could be found in 43.5% and 28.0% of the patients, respectively. After adjusting for multiple confounders, the number of days elapsed after injury showed a complex non-linear and independent association with a poor HRQOL (low EQ-5D index value: p=0.027; low EQ-VAS rating: p=0.008). Frequencies of a poor HRQOL reached their minimum about four to five years after the injury and increased thereafter. There is an independent, U-shaped association between the frequency of extreme values of HRQOL and the time elapsed after injury. Time patterns of HRQOL may be sensitive to increasing rates of attrition since patients with a good outcome are less likely to respond to questionnaires. Time from injury should be incorporated into all future cross sectional studies trying to identify predictors of HRQOL. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of the Immunologic Impact of RAF Inhibitors to Guide Optimal Combination of RAF Inhibitors and Immunotherapy for the Treatment of Advanced Melanoma

DTIC Science & Technology

2016-03-01

TILS (Vehicle) Fr eq o f P ar en t CD4+ T cells CD4+CD25+Foxp3+ CD8+ CD8+PD1+ CD8+GrzB...PDL1+ CD 4+ T ce lls CD 4+ CD 25 +F ox p3 + CD 8+ CD 8+ PD 1+ CD 8+ Gr zB + CD 8+ Ki6 7+ 0 10 20 30 40 Day 5 - TILS (BRAFi) Fr eq o f P ar en t...ce lls CD 4+ CD 25 +F ox p3 + CD 8+ CD 8+ PD 1+ CD 8+ Gr zB + CD 8+ Ki6 7+ 0 10 20 30 40 Day 2 - TILS (Vehicle) Fr eq o f P ar en t CD4+ T cells

General stability of composite panels reinforced with flexible rods taking account of the side boundary conditions

NASA Astrophysics Data System (ADS)

Dudchenko, A. A.; Elpat'evskii, A. N.

1995-07-01

Reinforced panels are the basic load-bearing elements of various structures. Optimization of massive structures requires consideration of deformation of the panel cross-sections. This is particularly important in determining the bearing strength at buckling. The load scheme, conditions for fixation of the panel cross-section, and bend-torsional stiffness taking account of the deformation of the rod cross-section affect the buckling load in real structures. The stress distribution prior to buckling must be known to solve the buckling problem properly. The stress in the panel is proportional to the active load. The stress distribution is assumed to be known according to our previous method [1]. The load scheme and panel dimensions are shown in Fig. 1. The stress distribution in the panel prior to buckling can be found using Eqs. (1)-(3). A view of the cross-section is given in Fig. 1. The displacements in the panel at buckling for the boundary area are found using Eqs. (4)-(6), while the stresses in the skin and stiffness are found using Eq. (7). Roots k1 and k2 are those of the characteristic equation and β is a dimensionless coordinate. The problem was solved using variational theory. The potential energy is given by Eqs. (8) and (9) by orihogonalization of Eqs. (5). The basic equations are converted to Eqs. (10) by evaluation of the components in Eqs. (8) and (9). Its calculation (11) gives the compression load. Optimization of parameter α gives the critical strength P1 = 6.93 kN (without taking account of the boundary area) and P2 = 5.31 kN (taking account of the boundary area).

Stewart analysis of apparently normal acid-base state in the critically ill.

PubMed

Moviat, Miriam; van den Boogaard, Mark; Intven, Femke; van der Voort, Peter; van der Hoeven, Hans; Pickkers, Peter

2013-12-01

This study aimed to describe Stewart parameters in critically ill patients with an apparently normal acid-base state and to determine the incidence of mixed metabolic acid-base disorders in these patients. We conducted a prospective, observational multicenter study of 312 consecutive Dutch intensive care unit patients with normal pH (7.35 ≤ pH ≤ 7.45) on days 3 to 5. Apparent (SIDa) and effective strong ion difference (SIDe) and strong ion gap (SIG) were calculated from 3 consecutive arterial blood samples. Multivariate linear regression analysis was performed to analyze factors potentially associated with levels of SIDa and SIG. A total of 137 patients (44%) were identified with an apparently normal acid-base state (normal pH and -2 < base excess < 2 and 35 < PaCO2 < 45 mm Hg). In this group, SIDa values were 36.6 ± 3.6 mEq/L, resulting from hyperchloremia (109 ± 4.6 mEq/L, sodium-chloride difference 30.0 ± 3.6 mEq/L); SIDe values were 33.5 ± 2.3 mEq/L, resulting from hypoalbuminemia (24.0 ± 6.2 g/L); and SIG values were 3.1 ± 3.1 mEq/L. During admission, base excess increased secondary to a decrease in SIG levels and, subsequently, an increase in SIDa levels. Levels of SIDa were associated with positive cation load, chloride load, and admission SIDa (multivariate r(2) = 0.40, P < .001). Levels of SIG were associated with kidney function, sepsis, and SIG levels at intensive care unit admission (multivariate r(2) = 0.28, P < .001). Intensive care unit patients with an apparently normal acid-base state have an underlying mixed metabolic acid-base disorder characterized by acidifying effects of a low SIDa (caused by hyperchloremia) and high SIG combined with the alkalinizing effect of hypoalbuminemia. © 2013.

Nonequilibrium thermodynamic potentials for continuous-time Markov chains.

PubMed

Verley, Gatien

2016-01-01

We connect the rare fluctuations of an equilibrium (EQ) process and the typical fluctuations of a nonequilibrium (NE) stationary process. In the framework of large deviation theory, this observation allows us to introduce NE thermodynamic potentials. For continuous-time Markov chains, we identify the relevant pairs of conjugated variables and propose two NE ensembles: one with fixed dynamics and fluctuating time-averaged variables, and another with fixed time-averaged variables, but a fluctuating dynamics. Accordingly, we show that NE processes are equivalent to conditioned EQ processes ensuring that NE potentials are Legendre dual. We find a variational principle satisfied by the NE potentials that reach their maximum in the NE stationary state and whose first derivatives produce the NE equations of state and second derivatives produce the NE Maxwell relations generalizing the Onsager reciprocity relations.

Converting Parkinson-Specific Scores into Health State Utilities to Assess Cost-Utility Analysis.

PubMed

Chen, Gang; Garcia-Gordillo, Miguel A; Collado-Mateo, Daniel; Del Pozo-Cruz, Borja; Adsuar, José C; Cordero-Ferrera, José Manuel; Abellán-Perpiñán, José María; Sánchez-Martínez, Fernando Ignacio

2018-06-07

The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with three multi-attribute utility (MAU) instruments (EQ-5D-3L, EQ-5D-5L, and 15D) and to develop mapping algorithms that could be used to transform PDQ-8 scores into MAU scores. A cross-sectional study was conducted. A final sample of 228 evaluable patients was included in the analyses. Sociodemographic and clinical data were also collected. Two EQ-5D questionnaires were scored using Spanish tariffs. Two models and three statistical techniques were used to estimate each model in the direct mapping framework for all three MAU instruments, including the most widely used ordinary least squares (OLS), the robust MM-estimator, and the generalized linear model (GLM). For both EQ-5D-3L and EQ-5D-5L, indirect response mapping based on an ordered logit model was also conducted. Three goodness-of-fit tests were employed to compare the models: the mean absolute error (MAE), the root-mean-square error (RMSE), and the intra-class correlation coefficient (ICC) between the predicted and observed utilities. Health state utility scores ranged from 0.61 (EQ-5D-3L) to 0.74 (15D). The mean PDQ-8 score was 27.51. The correlation between overall PDQ-8 score and each MAU instrument ranged from - 0.729 (EQ-5D-5L) to - 0.752 (EQ-5D-3L). A mapping algorithm based on PDQ-8 items had better performance than using the overall score. For the two EQ-5D questionnaires, in general, the indirect mapping approach had comparable or even better performance than direct mapping based on MAE. Mapping algorithms developed in this study enable the estimation of utility values from the PDQ-8. The indirect mapping equations reported for two EQ-5D questionnaires will further facilitate the calculation of EQ-5D utility scores using other country-specific tariffs.

Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial.

PubMed

Kosiborod, Mikhail; Rasmussen, Henrik S; Lavin, Philip; Qunibi, Wajeh Y; Spinowitz, Bruce; Packham, David; Roger, Simon D; Yang, Alex; Lerma, Edgar; Singh, Bhupinder

2014-12-03

Hyperkalemia is a common electrolyte abnormality that may be difficult to manage because of a lack of effective therapies. Sodium zirconium cyclosilicate is a nonabsorbed cation exchanger that selectively binds potassium in the intestine. To evaluate the efficacy and safety of zirconium cyclosilicate for 28 days in patients with hyperkalemia. HARMONIZE was a phase 3, multicenter, randomized, double-blind, placebo-controlled trial evaluating zirconium cyclosilicate in outpatients with hyperkalemia (serum potassium ≥5.1 mEq/L) recruited from 44 sites in the United States, Australia, and South Africa (March-August 2014). Patients (n = 258) received 10 g of zirconium cyclosilicate 3 times daily in the initial 48-hour open-label phase. Patients (n = 237) achieving normokalemia (3.5-5.0 mEq/L) were then randomized to receive zirconium cyclosilicate, 5 g (n = 45 patients), 10 g (n = 51), or 15 g (n = 56), or placebo (n = 85) daily for 28 days. The primary end point was mean serum potassium level in each zirconium cyclosilicate group vs placebo during days 8-29 of the randomized phase. In the open-label phase, serum potassium levels declined from 5.6 mEq/L at baseline to 4.5 mEq/L at 48 hours. Median time to normalization was 2.2 hours, with 84% of patients (95% CI, 79%-88%) achieving normokalemia by 24 hours and 98% (95% CI, 96%-99%) by 48 hours. In the randomized phase, serum potassium was significantly lower during days 8-29 with all 3 zirconium cyclosilicate doses vs placebo (4.8 mEq/L [95% CI, 4.6-4.9], 4.5 mEq/L [95% CI, 4.4-4.6], and 4.4 mEq/L [95% CI, 4.3-4.5] for 5 g, 10 g, and 15 g; 5.1 mEq/L [95% CI, 5.0-5.2] for placebo; P < .001 for all comparisons). The proportion of patients with mean potassium <5.1 mEq/L during days 8-29 was significantly higher in all zirconium cyclosilicate groups vs placebo (36/45 [80%], 45/50 [90%], and 51/54 [94%] for the 5-g, 10-g, and 15-g groups, vs 38/82 [46%] with placebo; P < .001 for each dose vs placebo). Adverse events were comparable between zirconium cyclosilicate and placebo, although edema was more common in the 15-g group (edema incidence: 2/85 [2%], 1/45 [2%], 3/51 [6%], and 8/56 [14%] patients in the placebo, 5-g, 10-g, and 15-g groups). Hypokalemia developed in 5/51 (10%) and 6/56 patients (11%) in the 10-g and 15-g zirconium cyclosilicate groups, vs none in the 5-g or placebo groups. Among outpatients with hyperkalemia, open-label sodium zirconium cyclosilicate reduced serum potassium to normal levels within 48 hours; compared with placebo, all 3 doses of zirconium cyclosilicate resulted in lower potassium levels and a higher proportion of patients with normal potassium levels for up to 28 days. Further studies are needed to evaluate the efficacy and safety of zirconium cyclosilicate beyond 4 weeks and to assess long-term clinical outcomes. clinicaltrials.gov Identifier: NCT02088073.

Effectiveness of revised fluid replacement guidelines for military training in hot weather.

PubMed

Kolka, Margaret A; Latzka, Willliam A; Montain, Scott J; Corr, William P; O'Brien, Karen K; Sawka, Michael N

2003-03-01

This study compared the revised U.S. Army fluid replacement guidelines (REV) with the old guidelines (OLD) on daily changes in serum sodium concentration (Na+) and body mass (BM) during Basic Combat Training at Fort Benning, GA during two successive summers. Recruits (n = 550; OLD = 277, REV = 273) were evaluated before and after 8-12 h of outdoor military combat training in hot weather. The WBGT (mean +/- SD) averaged 26.6 +/- 1.7 degrees C for OLD and 27.4 +/- 0.9 degrees C for REV (NS). Serum Na+ decreased from 137.5 +/- 1.6 mEq x L(-1) to 137.0 +/- 2.1 mEq x L(-1) after outdoor military training in OLD (p < 0.05). Twenty-two recruits (8%) had serum sodium fall to below 135 mEq x L(-1) during OLD. Serum Na+ increased from 139.0 +/- 1.7 mEq x L(-1) to 139.4 +/- 2.1 mEq x L(-1) after outdoor military training in REV (p < 0.05). Only two recruits (1%) had serum Na+ fall to below 135 mEq x L(-1) during REV. BM increased an average of 1.3 +/- 1.4 kg (p < 0.05) in OLD and an average of 0.4 +/- 1.7 kg in REV (p < 0.05). The revised guidelines effectively reversed the decrease in serum sodium, reduced the increase in body mass, maintained hydration and minimized overdrinking during hot weather military training compared with the old fluid replacement guidelines.

Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales for back and leg pain.

PubMed

Carreon, Leah Y; Bratcher, Kelly R; Das, Nandita; Nienhuis, Jacob B; Glassman, Steven D

2014-04-15

Cross-sectional cohort. The purpose of this study is to determine whether the EuroQOL-5D (EQ-5D) can be derived from commonly available low back disease-specific health-related quality of life measures. The Oswestry Disability Index (ODI) and numeric rating scales (0-10) for back pain (BP) and leg pain (LP) are widely used disease-specific measures in patients with lumbar degenerative disorders. Increasingly, the EQ-5D is being used as a measure of utility due to ease of administration and scoring. The EQ-5D, ODI, BP, and LP were prospectively collected in 14,544 patients seen in clinic for lumbar degenerative disorders. Pearson correlation coefficients for paired observations from multiple time points between ODI, BP, LP, and EQ-5D were determined. Regression modeling was done to compute the EQ-5D score from the ODI, BP, and LP. The mean age was 53.3 ± 16.4 years and 41% were male. Correlations between the EQ-5D and the ODI, BP, and LP were statistically significant (P < 0.0001) with correlation coefficients of -0.77, -0.50, and -0.57, respectively. The regression equation: [0.97711 + (-0.00687 × ODI) + (-0.01488 × LP) + (-0.01008 × BP)] to predict EQ-5D, had an R2 of 0.61 and a root mean square error of 0.149. The model using ODI alone had an R2 of 0.57 and a root mean square error of 0.156. The model using the individual ODI items had an R2 of 0.64 and a root mean square error of 0.143. The correlation coefficient between the observed and estimated EQ-5D score was 0.78. There was no statistically significant difference between the actual EQ-5D (0.553 ± 0.238) and the estimated EQ-5D score (0.553 ± 0.186) using the ODI, BP, and LP regression model. However, rounding off the coefficients to less than 5 decimal places produced less accurate results. Unlike previous studies showing a robust relationship between low back-specific measures and the Short Form-6D, a similar relationship was not seen between the ODI, BP, LP, and the EQ-5D. Thus, the EQ-5D cannot be accurately estimated from the ODI, BP, and LP. 2.

Effect of Patiromer on Serum Potassium Level in Patients With Hyperkalemia and Diabetic Kidney Disease: The AMETHYST-DN Randomized Clinical Trial.

PubMed

Bakris, George L; Pitt, Bertram; Weir, Matthew R; Freeman, Mason W; Mayo, Martha R; Garza, Dahlia; Stasiv, Yuri; Zawadzki, Rezi; Berman, Lance; Bushinsky, David A

2015-07-14

Hyperkalemia is a potentially life-threatening condition predominantly seen in patients treated with renin-angiotensin-aldosterone system (RAAS) inhibitors with stage 3 or greater chronic kidney disease (CKD) who may also have diabetes, heart failure, or both. To select starting doses for a phase 3 study and to evaluate the long-term safety and efficacy of a potassium-binding polymer, patiromer, in outpatients with hyperkalemia. Phase 2, multicenter, open-label, dose-ranging, randomized clinical trial (AMETHYST-DN), conducted at 48 sites in Europe from June 2011 to June 2013 evaluating patiromer in 306 outpatients with type 2 diabetes (estimated glomerular filtration rate, 15 to <60 mL/min/1.73 m2 and serum potassium level >5.0 mEq/L). All patients received RAAS inhibitors prior to and during study treatment. Patients were stratified by baseline serum potassium level into mild or moderate hyperkalemia groups and received 1 of 3 randomized starting doses of patiromer (4.2 g [n = 74], 8.4 g [n = 74], or 12.6 g [n = 74] twice daily [mild hyperkalemia] or 8.4 g [n = 26], 12.6 g [n = 28], or 16.8 g [n = 30] twice daily [moderate hyperkalemia]). Patiromer was titrated to achieve and maintain serum potassium level 5.0 mEq/L or lower. The primary efficacy end point was mean change in serum potassium level from baseline to week 4 or prior to initiation of dose titration. The primary safety end point was adverse events through 52 weeks. Secondary efficacy end points included mean change in serum potassium level through 52 weeks. A total of 306 patients were randomized. The least squares mean reduction from baseline in serum potassium level at week 4 or time of first dose titration in patients with mild hyperkalemia was 0.35 (95% CI, 0.22-0.48) mEq/L for the 4.2 g twice daily starting-dose group, 0.51 (95% CI, 0.38-0.64) mEq/L for the 8.4 g twice daily starting-dose group, and 0.55 (95% CI, 0.42-0.68) mEq/L for the 12.6 g twice daily starting-dose group. In those with moderate hyperkalemia, the reduction was 0.87 (95% CI, 0.60-1.14) mEq/L for the 8.4 g twice daily starting-dose group, 0.97 (95% CI, 0.70-1.23) mEq/L for the 12.6 g twice daily starting-dose group, and 0.92 (95% CI, 0.67-1.17) mEq/L for the 16.8 g twice daily starting-dose group (P < .001 for all changes vs baseline by hyperkalemia starting-dose groups within strata). From week 4 through week 52, statistically significant mean decreases in serum potassium levels were observed at each monthly point in patients with mild and moderate hyperkalemia. Over the 52 weeks, hypomagnesemia (7.2%) was the most common treatment-related adverse event, mild to moderate constipation (6.3%) was the most common gastrointestinal adverse event, and hypokalemia (<3.5 mEq/L) occurred in 5.6% of patients. Among patients with hyperkalemia and diabetic kidney disease, patiromer starting doses of 4.2 to 16.8 g twice daily resulted in statistically significant decreases in serum potassium level after 4 weeks of treatment, lasting through 52 weeks. clinicaltrials.gov Identifier:NCT01371747.

Differential Infection Patterns and Recent Evolutionary Origins of Equine Hepaciviruses in Donkeys.

PubMed

Walter, Stephanie; Rasche, Andrea; Moreira-Soto, Andrés; Pfaender, Stephanie; Bletsa, Magda; Corman, Victor Max; Aguilar-Setien, Alvaro; García-Lacy, Fernando; Hans, Aymeric; Todt, Daniel; Schuler, Gerhard; Shnaiderman-Torban, Anat; Steinman, Amir; Roncoroni, Cristina; Veneziano, Vincenzo; Rusenova, Nikolina; Sandev, Nikolay; Rusenov, Anton; Zapryanova, Dimitrinka; García-Bocanegra, Ignacio; Jores, Joerg; Carluccio, Augusto; Veronesi, Maria Cristina; Cavalleri, Jessika M V; Drosten, Christian; Lemey, Philippe; Steinmann, Eike; Drexler, Jan Felix

2017-01-01

The hepatitis C virus (HCV) is a major human pathogen. Genetically related viruses in animals suggest a zoonotic origin of HCV. The closest relative of HCV is found in horses (termed equine hepacivirus [EqHV]). However, low EqHV genetic diversity implies relatively recent acquisition of EqHV by horses, making a derivation of HCV from EqHV unlikely. To unravel the EqHV evolutionary history within equid sister species, we analyzed 829 donkeys and 53 mules sampled in nine European, Asian, African, and American countries by molecular and serologic tools for EqHV infection. Antibodies were found in 278 animals (31.5%), and viral RNA was found in 3 animals (0.3%), all of which were simultaneously seropositive. A low RNA prevalence in spite of high seroprevalence suggests a predominance of acute infection, a possible difference from the mostly chronic hepacivirus infection pattern seen in horses and humans. Limitation of transmission due to short courses of infection may explain the existence of entirely seronegative groups of animals. Donkey and horse EqHV strains were paraphyletic and 97.5 to 98.2% identical in their translated polyprotein sequences, making virus/host cospeciation unlikely. Evolutionary reconstructions supported host switches of EqHV between horses and donkeys without the involvement of adaptive evolution. Global admixture of donkey and horse hepaciviruses was compatible with anthropogenic alterations of EqHV ecology. In summary, our findings do not support EqHV as the origin of the significantly more diversified HCV. Identification of a host system with predominantly acute hepacivirus infection may enable new insights into the chronic infection pattern associated with HCV. The evolutionary origins of the human hepatitis C virus (HCV) are unclear. The closest animal-associated relative of HCV occurs in horses (equine hepacivirus [EqHV]). The low EqHV genetic diversity implies a relatively recent acquisition of EqHV by horses, limiting the time span for potential horse-to-human infections in the past. Horses are genetically related to donkeys, and EqHV may have cospeciated with these host species. Here, we investigated a large panel of donkeys from various countries using serologic and molecular tools. We found EqHV to be globally widespread in donkeys and identify potential differences in EqHV infection patterns, with donkeys potentially showing enhanced EqHV clearance compared to horses. We provide strong evidence against EqHV cospeciation and for its capability to switch hosts among equines. Differential hepacivirus infection patterns in horses and donkeys may enable new insights into the chronic infection pattern associated with HCV. Copyright © 2016 American Society for Microbiology.

Estimating an exchange rate between the EQ-5D-3L and ASCOT.

PubMed

Stevens, Katherine; Brazier, John; Rowen, Donna

2018-06-01

The aim was to estimate an exchange rate between EQ-5D-3L and the Adult Social Care Outcome Tool (ASCOT) using preference-based mapping via common time trade-off (TTO) valuations. EQ-5D and ASCOT are useful for examining cost-effectiveness within the health and social care sectors, respectively, but there is a policy need to understand overall benefits and compare across sectors to assess relative value for money. Standard statistical mapping is unsuitable since it relies on conceptual overlap of the measures but EQ-5D and ASCOT have different conceptualisations of quality of life. We use a preference-based mapping approach to estimate the exchange rate using common TTO valuations for both measures. A sample of health states from each measure was valued using TTO by 200 members of the UK adult general population. Regression analyses are used to generate separate equations between EQ-5D-3L and ASCOT values using their original value set and TTO values elicited here. These are solved as simultaneous equations to estimate the relationship between EQ-5D-3L and ASCOT. The relationship for moving from ASCOT to EQ-5D-3L is a linear transformation with an intercept of -0.0488 and gradient of 0.978. This enables QALY gains generated by ASCOT and EQ-5D to be compared across different interventions. This paper estimated an exchange rate between ASCOT and EQ-5D-3L using a preference-based mapping approach that does not compromise the descriptive systems of the two measures. This contributes to the development of preference-based mapping through the use of TTO as the common metric used to estimate the exchange rate between measures.

Translation, validity and reliability of the British Sign Language (BSL) version of the EQ-5D-5L.

PubMed

Rogers, Katherine D; Pilling, Mark; Davies, Linda; Belk, Rachel; Nassimi-Green, Catherine; Young, Alys

2016-07-01

To translate the health questionnaire EuroQol EQ-5D-5L into British Sign Language (BSL), to test its reliability with the signing Deaf population of BSL users in the UK and to validate its psychometric properties. The EQ-5D-5L BSL was developed following the international standard for translation required by EuroQol, with additional agreed features appropriate to a visual language. Data collection used an online platform to view the signed (BSL) version of the tests. The psychometric testing included content validity, assessed by interviewing a small sample of Deaf people. Reliability was tested by internal consistency of the items and test-retest, and convergent validity was assessed by determining how well EQ-5D-5L BSL correlates with CORE-10 BSL and CORE-6D BSL. The psychometric properties of the EQ-5D-5L BSL are good, indicating that it can be used to measure health status in the Deaf signing population in the UK. Convergent validity between EQ-5D-5L BSL and CORE-10 BSL and CORE-6D BSL is consistent, demonstrating that the BSL version of EQ-5D-5L is a good measure of the health status of an individual. The test-retest reliability of EQ-5D-5L BSL, for each dimension of health, was shown to have Cohen's kappa values of 0.47-0.61; these were in the range of moderate to good and were therefore acceptable. This is the first time EQ-5D-5L has been translated into a signed language for use with Deaf people and is a significant step forward towards conducting studies of health status and cost-effectiveness in this population.

The Link Between Excessive Quantity of Sleep and Deteriorated Quality of Wakefulness – Implications for the DSM-5

PubMed Central

Ohayon, Maurice M.; Reynolds, Charles F.; Dauvilliers, Yves

2013-01-01

Objectives Using population-based data, we document the comorbidities (medical, neurologic and psychiatric) and consequences for daily functioning of excessive quantity of sleep (EQS), defined as a main sleep period or 24-hour sleep duration ≥9 hours accompanied by complaints of impaired functioning or distress due to excessive sleep, and its links to excessive sleepiness. Methods A cross-sectional telephone study using a representative sample of 19,136 non-institutionalized individuals living in the United States, aged ≥18 (participation rate: 83.2%). The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental and organic disorders (DSM-IV-TR, ICSD-II, ICD-10). Results Sleeping at least 9 hours per 24-hour period was reported by 8.4% (95% confidence intervals: 8.0%-8.8%) of participants; EQS (prolonged sleep episode with distress/impairment) was observed in 1.6% (1.4% to 1.8%) of the sample. The likelihood of EQS was 3-12 times higher among individuals with a mood disorder. EQS individuals were 2-4 times more likely to report poor quality of life than non-EQS individuals as well as interference with socio-professional activities and relationships. Although between 33% and 66% of individuals with prolonged sleep perceived it as a major problem, only 6.3% to 27.5% of them reported having sought medical attention. Interpretation Excessive Quantity of Sleep is widespread in the general population, co-occurring with a broad spectrum of sleep, medical, neurologic and psychiatric disorders. Therefore, physicians must recognize EQS as a mixed clinical entity indicating careful assessment and specific treatment planning. PMID:23846792

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction

PubMed Central

Grodzinsky, Anna; Goyal, Abhinav; Gosch, Kensey; McCullough, Peter A.; Fonarow, Gregg C.; Mebazaa, Alexandre; Masoudi, Frederick A.; Spertus, John A.; Palmer, Biff F.; Kosiborod, Mikhail

2016-01-01

Background Hyperkalemia is common and potentially dangerous in hospitalized patients; its contemporary prevalence and prognostic importance following acute myocardial infarction are not well described. Methods In 38,689 consecutive acute myocardial infarction patients from the Cerner Health Facts database, we evaluated the association between maximum in-hospital potassium levels (max K) and in-hospital mortality. Patients were stratified by dialysis status, and grouped by max K as follows: <5 mEq/L, 5–<5.5 mEq/L, 5.5–<6.0 mEq/L, 6.0–<6.5 mEq/L, and ≥ 6.5 mEq/L. Multivariable logistic regression was used to adjust for multiple patient and site characteristics. The relationship between number of hyperkalemic values and in-hospital mortality was also evaluated. Results Of 38,689 acute myocardial infarction patients, 886 were on dialysis. The rate of hyperkalemia (max K ≥ 5.0 mEq/L) was 22.6% in non-dialysis and 66.8% in dialysis patients. Moderate-severe hyperkalemia (max K ≥ 5.5 mEq/L) occurred in 9.8% of patients. There was a steep increase in mortality with higher max K levels. In-hospital mortality exceeded 15% once max K ≥5.5 mEq/L regardless of dialysis status. The relationship between higher max K and increased mortality risk persisted after multivariable adjustment. In addition, patients with greater number of hyperkalemic values (vs. a single value) experienced higher in-hospital mortality. Conclusions Hyperkalemia is common in patients hospitalized with acute myocardial infarction. Higher max K levels and number of hyperkalemic events are associated with a steep mortality increase; with higher risks for adverse outcomes observed even at mild levels of hyperkalemia. Whether more intensive management of hyperkalemia may improve outcomes in acute myocardial infarction patients merits further study. PMID:27060233

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction.

PubMed

Grodzinsky, Anna; Goyal, Abhinav; Gosch, Kensey; McCullough, Peter A; Fonarow, Gregg C; Mebazaa, Alexandre; Masoudi, Frederick A; Spertus, John A; Palmer, Biff F; Kosiborod, Mikhail

2016-08-01

Hyperkalemia is common and potentially dangerous in hospitalized patients; its contemporary prevalence and prognostic importance after acute myocardial infarction are not well described. In 38,689 consecutive patients with acute myocardial infarction from the Cerner Health Facts database, we evaluated the association between maximum in-hospital potassium levels and in-hospital mortality. Patients were stratified by dialysis status and grouped by maximum potassium as follows: <5 mEq/L, 5 to <5.5 mEq/L, 5.5 to <6.0 mEq/L, 6.0 to <6.5 mEq/L, and ≥6.5 mEq/L. Multivariable logistic regression was used to adjust for multiple patient and site characteristics. The relationship between the number of hyperkalemic values and the in-hospital mortality was evaluated. Of 38,689 patients with acute myocardial infarction, 886 were on dialysis. The rate of hyperkalemia (maximum potassium ≥5.0 mEq/L) was 22.6% in patients on dialysis and 66.8% in patients not on dialysis. Moderate to severe hyperkalemia (maximum potassium ≥5.5 mEq/L) occurred in 9.8% of patients. There was a steep increase in mortality with higher maximum potassium levels. In-hospital mortality exceeded 15% once maximum potassium was ≥5.5 mEq/L regardless of dialysis status. The relationship between higher maximum potassium and increased mortality risk persisted after multivariable adjustment. In addition, patients with a greater number of hyperkalemic values (vs a single value) experienced higher in-hospital mortality. Hyperkalemia is common in patients who are hospitalized with acute myocardial infarction. Higher maximum potassium levels and number of hyperkalemic events are associated with a steep mortality increase, with higher risks for adverse outcomes observed even at mild levels of hyperkalemia. Whether more intensive management of hyperkalemia may improve outcomes in patients with acute myocardial infarction merits further study. Copyright © 2016 Elsevier Inc. All rights reserved.

Gastric secretory function in coeliac disease.

PubMed

Marcello, U; Deganello, A; Consolaro, G; Zoppi, G

1979-01-18

Volume, total titrable acidity, total proteolytic activity and pepsin activity have been determined in 14 coeliac patients and in 8 controls of comparable ages and body weights. Basal secretion (B.O.), total outputs (T. O.) and peak outputs (P.O.) after pentagastrin injection have been determined. Peak outputs (values 60 min/kg) of these parameters are as follows: volume 5.0+/-1.7 ml in coeliacs, 4.3+/-1.2 ml in controls; total titrable acidity 406.1+/-155.0 mEq in patients, 296.1+/-182.4 in conttrols; total proteolytic activity 962.1+/-501.1 micronEq in coeliacs, 569.6+/-272.2 in controls; pepsin activity 789.1+/-521.8 micronEq in patients, 447.6+/-150.4 in controls.

Evaluation of fatty liver by using in-phase and opposed-phase MR images and in-vivo proton MR spectroscopy

NASA Astrophysics Data System (ADS)

Lee, Jae-Seung; Im, In-Chul; Goo, Eun-Hoe; Park, Hyong-Hu; Kwak, Byung-Joon

2012-12-01

The purpose of this study was to evaluate the necessity of in-phase and opposed-phase MR images and their correlations with weight, the aspartate aminotransferase/alanine aminotransferase (AST/ALT) value, and age. Magnetic resonance spectroscopy (MRS) was used as a reference in this study. We selected 68 people as subjects, among which 14 were volunteers with normal AST/ALT values ( <40/35 U/L) on a liver function study and 54 were non-alcoholic fatty liver patients for whom ultrasonic images had been obtained within 3 months of the study. In this study, the liver was more enhanced than the spleen or kidney. When the Eq. (3) formula was applied to normal volunteers, the difference between the in-phase and the opposed-phase images was -3.54 ± 12.56. The MRS study result showed a high sensitivity of 96.6% and a specificity of 100% ( p = 0.000) when the cutoff value was 20%. Furthermore, this result showed a high sensitivity of 94% and a specificity of 80% with a similar cutoff when the Eq. (2) formula was applied to non-alcoholic fatty liver patients ( p = 0.000). The MRS study revealed a strong correlation between normal volunteers and non-alcoholic fatty liver patients (r = 0.59, p = 0.04). The correlations between AST/ALT and Eq. (3) (r = 0.45, p = 0.004), age and Eq. (3) (r = 0.73, p = 0.03), and weight and Eq. (3) (r = 0.77, p = 0.000) values were all statistically significant. In the case of non-alcoholic liver disease, MRS was found to be significantly correlated with Eq. (1) (r = 0.39, p = 0.002), Eq. (2) (r = 0.68, p = 0.04), Eq. (3) (r = 0.67, p = 0.04), and AST/ALT (r = 0.77, p = 0.000). In conclusion, in-phase and opposed-phase images can help to distinguish a normal liver from a fatty liver in order to identify non-alcoholic fatty liver patients. The intensity difference between the in-phase and opposed-phase MR signals showed valuable correlations with respect to weight, AST/ALT value, and age, with all values being above the mild lipid value (r = 0.3).

EQ-5D in Central and Eastern Europe: 2000-2015.

PubMed

Rencz, Fanni; Gulácsi, László; Drummond, Michael; Golicki, Dominik; Prevolnik Rupel, Valentina; Simon, Judit; Stolk, Elly A; Brodszky, Valentin; Baji, Petra; Závada, Jakub; Petrova, Guenka; Rotar, Alexandru; Péntek, Márta

2016-11-01

Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.

Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS.

PubMed

Svedbom, Axel; Borgström, Fredrik; Hernlund, Emma; Ström, Oskar; Alekna, Vidmantas; Bianchi, Maria Luisa; Clark, Patricia; Curiel, Manuel Díaz; Dimai, Hans Peter; Jürisson, Mikk; Uusküla, Anneli; Lember, Margus; Kallikorm, Riina; Lesnyak, Olga; McCloskey, Eugene; Ershova, Olga; Sanders, Kerrie M; Silverman, Stuart; Tamulaitiene, Marija; Thomas, Thierry; Tosteson, Anna N A; Jönsson, Bengt; Kanis, John A

2018-03-01

The International Costs and Utilities Related to Osteoporotic fractures Study is a multinational observational study set up to describe the costs and quality of life (QoL) consequences of fragility fracture. This paper aims to estimate and compare QoL after hip, vertebral, and distal forearm fracture using time-trade-off (TTO), the EuroQol (EQ) Visual Analogue Scale (EQ-VAS), and the EQ-5D-3L valued using the hypothetical UK value set. Data were collected at four time-points for five QoL point estimates: within 2 weeks after fracture (including pre-fracture recall), and at 4, 12, and 18 months after fracture. Health state utility values (HSUVs) were derived for each fracture type and time-point using the three approaches (TTO, EQ-VAS, EQ-5D-3L). HSUV were used to estimate accumulated QoL loss and QoL multipliers. In total, 1410 patients (505 with hip, 316 with vertebral, and 589 with distal forearm fracture) were eligible for analysis. Across all time-points for the three fracture types, TTO provided the highest HSUVs, whereas EQ-5D-3L consistently provided the lowest HSUVs directly after fracture. Except for 13-18 months after distal forearm fracture, EQ-5D-3L generated lower QoL multipliers than the other two methods, whereas no equally clear pattern was observed between EQ-VAS and TTO. On average, the most marked differences between the three approaches were observed immediately after the fracture. The approach to derive QoL markedly influences the estimated QoL impact of fracture. Therefore the choice of approach may be important for the outcome and interpretation of cost-effectiveness analysis of fracture prevention.

One-Dimensional Numerical Analysis of the Transient Response of Thermal Protection Systems

DTIC Science & Technology

1965-09-01

for the second layer (eqs. (Bl5) and ( Bl6 )) are k’ I Tn-i - Tn k Tn -Tn+ln-l.,n it n• n+l • + (6Tn+ - 3Tn - 1n-1 - Tn+2 )i + j-n p’p ’ p’Cp ATn +_-_ _n...l) ( B16 ) Insulation (i + j + 1 1 n *_ i + j + m - 1).- The differential equation for the third layer is (eq. (3)) ( ) = PuCp (B17) The second

An experimental investigation on the performance of conical nozzles for argon cluster formation in supersonic jets.

PubMed

Lu, Haiyang; Ni, Guoquan; Li, Ruxin; Xu, Zhizhan

2010-03-28

This work intends to get a better understanding of cluster formation in supersonic nozzles of different geometries. The throat diameters d are within 0.26 mm < or = d < or = 0.62 mm, the half-opening-angle alpha within 4.2 degrees < or = alpha < or = 11.3 degrees, and the length L of the conical section is 17.5 mm (eight nozzles) or 12 mm (two nozzles). Thus the so-called "equivalent sonic-nozzle diameter d(eq)" for these conical nozzle geometries, defined by d(eq)=0.74 d/tan alpha (for monatomic gases), is in the range of 1.59 mm < or = d(eq) < or = 5.21 mm. Source temperature for the clustering experiments was T(0)=298 K, and the backing pressure P(0) was between 0.5 and 30 bars. The (average) cluster sizes observed for these conical nozzles deviate from the predictions of the simple stream-tube-model. These deviations are accounted for by introducing the so-called "effective equivalent sonic-nozzle diameter d(eq)*," defined as the product of the equivalent sonic-nozzle diameter d(eq) and a new parameter delta, d(eq)*=deltad(eq). The parameter delta serves to modify the equivalent diameters d(eq) of the conical nozzles, which are applied in the idealized cases where the gas flows are suggested to be formed through free jet expansion. Then, delta represents the deviation of the performance in cluster formation of the practical conical nozzles from those predicted based on the idealized picture. The experimental results show that the values of delta can be described by an empirical formula, depending on the gas backing pressure P(0) and the parameter d(eq) of the conical nozzles. The degradation of the performance of the present conical nozzles was found with the increase in P(0) and the larger d(eq). It was revealed that delta is inversely proportional to a fractional power (approximately 0.5-0.6) of the molecular density n(mol) in the gas flows under the present experimental conditions. The boundary layers effects are considered to be mainly responsible for the restriction of the performance of the conical nozzles in cluster formation.

Bile salt induced back diffusion of hydrogen ions across gastric mucosa in man. Fact or fiction?

PubMed

Ivey, K J

1981-01-01

We studied the effect of 5.5 mM bile salts, consisting of taurine conjugates in 5 normal subjects. Bile salts caused a significant increase in H+ loss from and Na+ movement into the gastric lumen (controls 1.5 mEq H+, 1.5 mEq Na+; bile salts -3.1 mEq H+ (p less than 0.001), Na+ 2.5 mEq (p less than 0.01) per 15 min.) To determine the effect of acid secretion, studies were repeated after i.v. atropine 2 mg/70 kg b.w. Atropine reduced net H+ flux to -0.2 mEq and Na+ gain to 0.9 mEq. When the bile salt studies were repeated after i.v. atropine, net H+ loss was increased to -5.4 mEq H+, significantly greater than with bile salts alone; corresponding Na+ gain was 3.2 mEq/15 min. The volume of fluid secreted was 25.0 ml in the bile salt study compared with 14.0 ml in the atropine and bile salt study. Even if all the additional volume 'secreted' (14 ml) were bicarbonate from the stomach or pancreatic juice with a concentration of 145 mEq/liter, it could account for a loss of only 2.0 mEq H+. In conclusion, atropine with bile salts is associated with a loss of H+ ions too great to be accounted for by bicarbonate neutralization. We conclude that back diffusion of H+ ions is the most likely explanation of H+ loss after bile salts in man.

Estimated 24-hour urine sodium excretion is correlated with blood pressure in Korean population: 2009-2011 Korean National Health and Nutritional Examination Survey.

PubMed

Oh, Jieun; Lee, Jeonghwan; Koo, Ho Seok; Kim, Suhnggwon; Chin, Ho Jun

2014-09-01

No large-scale studies have investigated the association between salt intake and hypertension in Korean population. To investigate the relationship of blood pressure to salt consumption, we analyzed data from 19,476 participants in the 2009-2011 Korean National Health and Nutritional Examination Survey (KNHANES). Urinary sodium excretion over 24-hr (24HUNa) was estimated from spot urine tests using Tanaka's equation. The study subjects were stratified into hypertensive and normotensive groups. Hypertensive participants (n=6,552, 33.6%) had higher estimated 24HUNa, 150.4±38.8 mEq/day, than normotensive participants, 140.5±34.6 mEq/day (P<0.001). The association between 24HUNa and blood pressure outcomes was not affected by adjustment for other risk factors for hypertension (odds ratio 0.001; 95% confidence interval 0.001-0.003; P<0.001). Increases in 24HUNa of 100 mEq/day were associated with a 6.1±0.3/2.9±0.2 mmHg increase in systolic/diastolic blood pressure in all participants. This effect was stronger in hypertensive participants (increase of 8.1±0.5/3.4±0.3 mmHg per 100 mEq/day) and smaller in normotensive participants (2.9±0.3/1.3±0.2 mmHg). These results support recommendations for low salt intake in Korean population to prevent and control adverse blood pressure levels.

Expansion Formulation of General Relativity: the Gauge Functions for Energy-Momentum Tensor

NASA Astrophysics Data System (ADS)

Beloushko, Konstantin; Karbanovski, Valeri

At present the one of the GR (General Relativity) basic problem remains a definition of the gravitation field (GF) energy. We shall analyze this content. As well known, the energy-momentum ``tensor'' (EMT) of GF was introduced by Einstein [1] with purpose of the SRT (Special Relativity Theory) generalization. It supposed also, that EMT of matter satisfy to the condition begin{equation} ⪉bel{GrindEQ__1_1_} T^{ik} _{;i} =0 (a semicolon denotes a covariant differentiation with respect to coordinates). In absence of GF the equation (ref{GrindEQ__1_1_}) reduces to a corresponding SRT expression begin{equation} ⪉bel{GrindEQ__1_2_} T^{ik} _{,i} =0 (a comma denotes a differentiation with respect to coordinates of space-time). Obviously, the ``conservation law'' (ref{GrindEQ__1_2_}) is not broken by transformation begin{equation} ⪉bel{GrindEQ__1_3_} T^{ik} to tilde{T}^{ik} =T^{ik} +h^{ikl} _{,l} , where for h(ikl) takes place a constrain begin{equation} ⪉bel{GrindEQ__1_4_} h^{ikl} =-h^{ilk} Later the given property has been used for a construction ``pseudo-tensor'' tau (ik) of ``pure'' GF [2, S 96] begin{equation} ⪉bel{GrindEQ__1_5_} -gleft(frac{c^{4} }{8pi G} left(R^{ik} -frac{1}{2} g^{ik} Rright)+tau ^{ik} right)=h^{ikl} _{,l} However such definition was a consequence of non-covariant transition from a reference system with condition g(ik) _{,l} =0 to an arbitrary frame. Therefore the Landau-Lifshitz pseudo-tensor has no physical contents and considered problem remains actual. ``The non-covariant character'' of GF energy was the reason for criticism of GR as Einstein's contemporaries [3, 4], as and during the subsequent period (see, for example, [5]). In [6] were analyzed the grounds of given problem, which are connected with a formulation indefiniteness of ``the conservation law'' in curved space-time. In [7] contends, that the gravitational energy in EMT can be separated only ``artificially'' by a choice of the certain coordinate system. In [8] is concluded, that the problem consist not in a existence of the GF energy, and in it localization which is forbidden by an equivalence principle. We shall consider the possibility for generalization of transformation (ref{GrindEQ__1_3_}) on the Riemann space-time for EMT satisfying a condition (ref{GrindEQ__1_1_}). This problem reduce to construction of tensor h(ikl) which will be consistent with a constraint (ref{GrindEQ__1_4_}) and with requirement begin{equation} ⪉bel{GrindEQ__2_1_} h^{ikl} _{;l;k} =0. For such EMT a following transformation is permissible begin{equation} ⪉bel{GrindEQ__2_2_} T^{ik} to tilde{T}^{ik} =T^{ik} +h^{ikl} _{;l} , which not violate the property (ref{GrindEQ__1_1_}). As begin{equation} ⪉bel{GrindEQ__2_3_} h^{ikl} _{;l;k} =frac{1}{2} left(h^{ikl} -h^{ilk} right)_{;l;k} =frac{1}{2} R^{i} _{mlk} h^{mlk} , then from (ref{GrindEQ__2_1_}) it is follows begin{equation} ⪉bel{GrindEQ__2_4_} R^{i} _{mlk} h^{mlk} =0. For a flat space-time the last condition is reduced to identity (i.e. R(i) _{klm} =0). Therefore the requirement (ref{GrindEQ__2_4_}) can be interpreted as a ``Riemann's constraint'' for h(ikl) . References begin{enumerate} A. Einstein and M. Grossman - Z. Math. und Phys., 1913, B62, s.225. L.D. Landau and E.M. Lifshitz. The Classical Theory of Fields - New York, Pergamon, 1994. W. Pauli, A. Sommerfeld. Theory of Relativity - New York, Pergamon, 1985. D. Gilbert - Göttingen Nachrichten, 4 (1917) 4. A.A. Logunov “Lectures on the relativity and gravity theory”, N.P. Konopleva, V.N. Popov. The gauge field - Moscow, Atomizdat, 1988. (in Russian) V.A. Fock. The Theory of Space, Time and Gravitation - London, Pergamon, 1959. Ch. Misner, Kip S. Thorne, Jh. A. Wheeler. Gravitation. - San Francisco, W.H. Freeman and Company, 1973.

Temporal-Spatial Pattern of Pre-earthquake Signatures in Atmosphere and Ionosphere Associated with Major Earthquakes in Greece.

NASA Astrophysics Data System (ADS)

Calderon, I. S.; Ouzounov, D.; Anagnostopoulos, G. C.; Pulinets, S. A.; Davidenko, D.; Karastathis, V. K.; Kafatos, M.

2015-12-01

We are conducting validation studies on atmosphere/ionosphere phenomena preceding major earthquakes in Greece in the last decade and in particular the largest (M6.9) earthquakes that occurred on May 24, 2014 in the Aegean Sea and on February 14, 2008 in South West Peloponisos (Methoni). Our approach is based on monitoring simultaneously a series of different physical parameters from space: Outgoing long-wavelength radiation (OLR) on the top of the atmosphere, electron and electron density variations in the ionosphere via GPS Total Electron Content (GPS/TEC), and ULF radiation and radiation belt electron precipitation (RBEP) accompanied by VLF wave activity into the topside ionosphere. In particular, we analyzed prospectively and retrospectively the temporal and spatial variations of various parameters characterizing the state of the atmosphere and ionosphere several days before the two M6.9 earthquakes. Concerning the Methoni EQ, DEMETER data confirm an almost standard profile before large EQs, with TEC, ULF, VLF and RBEP activity preceding some (four) days the EQ occurrence and silence the day of EQ; furthermore, during the period before the EQ, a progressive concentration of ULF emission centers around the future epicenter was confirmed. Concerning the recent Greek EQ of May 24, 2014, thermal anomaly was discovered 30 days and TEC anomaly 38 hours in advance accordingly. The spatial characteristics of pre-earthquake anomalous behavior were associated with the epicentral region. Our analysis of simultaneous space measurements before the great EQs suggests that they follow a general temporal-spatial pattern, which has been seen in other large EQs worldwide.

The association between observed mobility and quality of life in the near elderly

PubMed Central

Sullivan, Jeff; Goldman, Dana P.; Gill, Thomas M.

2017-01-01

Introduction Chronic diseases associated with aging, such as arthritis, frequently cause reduced mobility, pain and diminished quality of life. To date, research on the association between mobility and quality of life has primarily focused in the elderly; hence, much less is known about this association in the near elderly. This cross-sectional study aimed to assess the association between mobility and quality of life measures in the near elderly. Methods A prospective observational study of persons aged 50–69 years was conducted. The primary endpoint was quality of life measured by EQ-5D-5L, and the primary explanatory variable was observed mobility assessed using the 6-minute walk distance (6MWD). We applied regression models controlling for demographic, health status and other factors to evaluate the association between 6MWD and EQ-5D-5L. Results Of the 183 participants analyzed in the study, 37% were male and the average age was 59.8 years. After adjusting for differences in demographic characteristics and health status, EQ-5D-5L-based utility values were 0.046 points (p<0.001), or 5.2% (95% CI: 2.7% to 7.8%), higher on average for individuals with 100 meters longer 6MWD. Holding constant the mobility-specific component of EQ-5D-5L, we still found that walking an additional 100 meters was associated with an EQ-5D-5L utility value that was 0.029 points (p<0.001), or 3.5% (95% CI: 1.7% to 5.5%), higher than the average participant. Among persons with arthritis, the association between 6MWD and EQ-5D-5L was slightly stronger. Conclusions Near elderly persons with better mobility had higher quality of life. Diseases that decrease mobility, such as arthritis, are likely to have a significant impact on quality of life. PMID:28827806

In vitro assessment of thyroid hormone disrupting activities in drinking water sources along the Yangtze River.

PubMed

Hu, Xinxin; Shi, Wei; Zhang, Fengxian; Cao, Fu; Hu, Guanjiu; Hao, Yingqun; Wei, Si; Wang, Xinru; Yu, Hongxia

2013-02-01

The thyroid hormone disrupting activities of drinking water sources from the lower reaches of Yangtze River were examined using a reporter gene assay based on African green monkey kidney fibroblast (CV-1) cells. None of the eleven tested samples showed thyroid receptor (TR) agonist activity. Nine water samples exhibited TR antagonist activities with the equivalents referring to Di-n-butyl phthalate (DNBP) (TR antagonist activity equivalents, ATR-EQ(50)s) ranging from 6.92 × 10(1) to 2.85 × 10(2) μg DNBP/L. The ATR-EQ(50)s and TR antagonist equivalent ranges (ATR-EQ(30-80) ranges) for TR antagonist activities indicated that the water sample from site WX-8 posed the greatest health risks. The ATR-EQ(80)s of the water samples ranging from 1.56 × 10(3) to 6.14 × 10(3) μg DNBP/L were higher than the NOEC of DNBP. The results from instrumental analysis showed that DNBP might be responsible for the TR antagonist activities in these water samples. Water sources along Yangtze River had thyroid hormone disrupting potential. Copyright © 2012 Elsevier Ltd. All rights reserved.

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion.

PubMed

Sarkar, Sanjay; Bailey, Ernest; Go, Yun Young; Cook, R Frank; Kalbfleisch, Ted; Eberth, John; Chelvarajan, R Lakshman; Shuck, Kathleen M; Artiushin, Sergey; Timoney, Peter J; Balasuriya, Udeni B R

2016-12-01

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10-70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s) of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS) using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16) that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A) within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1) having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb) encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001) and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R) was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence) in the male reproductive tract. EqCXCL16Sa and EqCXCL16Sb exert a dominant mode of inheritance. Most importantly, the protein isoform EqCXCL16S but not EqCXCL16R can function as an EAV cellular receptor. Although both molecules have equal chemoattractant potential, EqCXCL16S has significantly higher scavenger receptor and adhesion properties compared to EqCXCL16R.

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion

PubMed Central

Cook, R. Frank; Eberth, John; Chelvarajan, R. Lakshman; Artiushin, Sergey; Timoney, Peter J.

2016-01-01

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10–70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s) of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS) using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16) that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A) within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1) having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb) encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001) and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R) was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence) in the male reproductive tract. EqCXCL16Sa and EqCXCL16Sb exert a dominant mode of inheritance. Most importantly, the protein isoform EqCXCL16S but not EqCXCL16R can function as an EAV cellular receptor. Although both molecules have equal chemoattractant potential, EqCXCL16S has significantly higher scavenger receptor and adhesion properties compared to EqCXCL16R. PMID:27930647

Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries.

PubMed

Janssen, M F; Szende, A; Cabases, J; Ramos-Goñi, J M; Vilagut, G; König, H H

2018-02-14

This study provides EQ-5D population norms for 20 countries (N = 163,838), which can be used to compare profiles for patients with specific conditions with data for the average person in the general population in a similar age and/or gender group. Descriptive EQ-5D data are provided for the total population, by gender and by seven age groups. Provided index values are based on European VAS for all countries, based on TTO for 11 countries and based on VAS for 10 countries. Important differences exist in EQ-5D reported health status across countries after standardizing for population structure. Self-reported health according to all five dimensions and EQ VAS generally decreased with increasing age and was lower for females. Mean self-rated EQ VAS scores varied from 70.4 to 83.3 in the total population by country. The prior living standards (GDP per capita) in the countries studied are correlated most with the EQ VAS scores (0.58), while unemployment appeared to be significantly correlated in people over the age of 45 only. A country's expenditure on health care correlated moderately with higher ratings on the EQ VAS (0.55). EQ-5D norms can be used as reference data to assess the burden of disease of patients with specific conditions. Such information, in turn, can inform policy-making and assist in setting priorities in health care.

Study of quality of life in patients with benign prostatic hyperplasia under treatment with silodosin.

PubMed

Castro-Díaz, D; Callejo, D; Cortés, X; Pérez, M

2014-01-01

To assess the impact of urinary symptoms associated with benign prostatic hyperplasia and its treatment with silodosin, on quality of life (QoL) and sexual function, depending on age, severity of symptoms, time on treatment and prostate size. A cross-sectional, observational study was conducted in 305 urology practices all around Spain. Socio-demographic and clinical data were collected and patients filled the following questionnaires: EQ-5D, Sexual Function Index (SFI) and International Prostate Symptom Score (IPSS). Multiple regression models were used to determine factors independently associated with patients' QoL. A total of 1,019 patients were enrolled, mean (SD) for: age 62.7 (5.7), EQ-5D 89.9 (13.9), sexual drive-SFI 3.71 (1.67), erection-SFI 6.11 (3.08), ejaculation-SFI 4.50 (2.06) problems-SFI 6.85 (3.37) and overall satisfaction-SFI 2.00 (0.99). The EQ-5D and SFI score were statistically lower with: older age, severe LUTS and greater prostate size (P<.01), but no differences were found related to time on treatment with silodosin. The EQ-5D score was positively associated with sexual satisfaction and desire size of SFI and the EQ-5D VAS score, and negatively with disability, semi-urban residence and comorbidities in the multiple regression analyses. Severe LUTS and older age are associated to a greater deterioration in sexual function and quality of life. However time on treatment with silodosin does not produce deterioration in the quality of life. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Biomagnification of bioassay derived 2,3,7,8-tetrachlorodibenzo-p-dioxin equivalents

USGS Publications Warehouse

Jones, P.D.; Ankley, G.T.; Best, D. A.; Crawford, R.; DeGalan, N.; Giesy, J.P.; Kubiak, T.J.; Ludwig, J. P.; Newsted, J.L.; Tillitt, D. E.; Verbrugge, D.A.

1993-01-01

In recent years contamination of the Great Lakes ecosystem with planar chlorinated hydrocarbons (PCHs) has attracted considerable concern due to their known reproductive and teratogenic effects. The H4IIE bioassay has been standardized as a means of measuring the biological potency of a PCH mixture as 2,3,7,8-tetrachloro-p-dibenzodioxin equivalents (TCDD-EQ). Using this bioassay we have investigated the biomagnification of TCDD-EQ in a semi-closed ecosystem. The biomagnification of TCDD-EQ is demonstrated and results indicate that the food chain is the major pathway for TCDD-EQ through this ecosystem. The H4IIE assay system is demonstrated to be a viable integrative measure of the total concentration of TCDD-EQ in different trophic levels.

Health-related quality of life in pregnant women living with HIV: a comparison of EQ-5D and SF-12.

PubMed

Wang, Xiaowen; Guo, Guangping; Zhou, Ling; Zheng, Jiarui; Liang, Xiumin; Li, Zhanqin; Luo, Hongzhuan; Yang, Yuyan; Yang, Liyuan; Tan, Ting; Yu, Jun; Lu, Lin

2017-08-30

This paper investigates the properties and performance of the two generic measures, EQ-5D and SF-12, for Health-Related Quality of Life (HRQoL) assessments of pregnant women living with HIV in Kunming City, Yiliang County, Daguan County, Longchuan County, Tengchong County, Longling County and Fengqing County in Yunnan Province, China. As part of a screening programme for the prevention of mother-to-child transmission of HIV (PMTCT), a retrospective cross-sectional survey was conducted in the seven Maternal and Infant Health Care centers in Yunnan Province, China, between April and June of 2016. The demographic and HIV infection-related information used in the study was collected through questionnaires designed by the study's staff. HRQoL information was collected using two generic scales: EQ-5D and SF-12. A total sample of one hundred and one pregnant women with a mean age of 30.4 ± 5.1 years was investigated. Average time elapsed since infection diagnoses was 5.8 ± 3.4 years. Only one infant (1.0%) was HIV positive, and 56 (55.4%) infants were HIV negative. The HIV status of 44 (43.6%) infants was unknown. The relationship between the EQ-5D functional dimensions and the PCS-12 and the relationship between the EQ-5D anxiety/depression dimension and the MCS-12 were stronger. Those whose PCS-12 and MCS-12 scores were at the median or lower were classified as being in worse health, while those over the median were classified as being in better health. Respondents who reported no problem on each of the EQ-5D dimensions was divided according to the median SF-12 component scores. Those who scored at the median or lower than the median were classified as being in worse health, while those higher than the median were classified as being in better health. The VAS scores were also significantly different than the median split of the SF-12 scores for these subjects. EQ-5D and SF-12 showed a discrimination ability in measuring the HRQoL of pregnant women living with HIV. The construct validity was identified for EQ-5D and SF-12 in the study. The respective constructs of EQ-5D and EQ-VAS may not overlap. Pregnant women living with HIV in the study gave more weight to their mental health when they provided a total health rating in EQ-VAS. EQ-VAS could explain the limitations of the EQ-5D dimension scores with ceiling effects in the survey. The results of our study could help to determine the suitable HRQoL instruments for pregnant women living with HIV and provide evidence for the proper comparison of EQ-5D and SF-12.

Electron Conduction in Organic Solutions

DTIC Science & Technology

1991-11-10

solutions, both eq(3) and eq(4) are diffusion controlled reactions, in agreement with Geske and Maid’s polarographic study of NB 10 . The decrease in... Geske , D.H., Maki, A. H. J. Am. Chem. Soc. 1960, 82, 2671. 11. Keq is calculated using EI/2 values obtained in dilute solutions (ref. 10) for eq. (3) (El

Pole tide triggering of seismicity

NASA Astrophysics Data System (ADS)

Gorshkov, V.

2015-08-01

The influence of the pole tide (PT) on intensity of seismic process is searched on base of Harvard Centroid-moment tensors catalogue (CMT). The normal and shear stresses excited by PT were calculated for each earthquake (EQ) from CMT (32.3 thousands of EQ events after for- and aftershock declustering). There was revealed that there are two maxima of PT influence on weak (less 5.5 magnitudes) thrust-slip EQ near the both extrema (min and max) of shear stress. This influence has 95 % level of statistical significance by Schuster and χ^2 criteria and could explain the 0.6-year periodicity in seismic intensity spectrum. The PT influence on seismicity becomes negligible when PT variations decrease up to 100~mas. This could explain 6-7 years periodicity in seismic intensity spectrum.

The Bear Brook Watershed, Maine (BBWM), USA

USGS Publications Warehouse

Norton, S.; Kahl, J.; Fernandez, I.; Haines, T.; Rustad, L.; Nodvin, S.; Scofield, J.; Strickland, T.; Erickson, H.; Wigington, P.; Lee, J.

1999-01-01

The Bear Brook Watershed Manipulation project in Maine is a paired calibrated watershed study funded by the U.S. EPA. The research program is evaluating whole ecosystem response to elevated inputs of acidifying chemicals. The consists of a 2.5 year calibration period (1987-1989), nine years of chemical additions of (NH4)2SO4 (15N- and 34S-enriched for several years) to West Bear watershed (1989-1998), followed by a recovery period. The other watershed, East Bear, serves as a reference. Dosing is in six equal treatments/yr of 1800 eq SO4 and NH4/ha/yr, a 200% increase over 1988 loading (wet plus dry) for SO4 300% for N (wet NO3 + NH4). The experimental and reference watersheds are forested with mixed hard- and softwoods, and have thin acidic soils, areas of 10.2 and 10.7 ha and relief of 210 m. Thin till of variable composition is underlain by metasedimentary pelitic rocks and calc-silicate gneiss intruded by granite dikes and sills. For the period 1987-1995, precipitation averaged 1.4 m/yr, had a mean pH of 4.5, with SO4, NO3, and NH4 concentrations of 26, 14, and 7 ??eq/L, respectively. The nearly perrenial streams draining each watershed have discharges ranging from 0 (East Bear stops flowing for one to two months per year) to 150 L/sec. Prior to manipulation, East Bear and West Bear had a volume weighted annual mean pH of approximately 5.4, alkalinity = 0 to 4 ??eq/L, total base cations = 184 ??eq/L (sea-salt corrected = 118 ??eq/L), and SO4 = 100 to 111 ??eq/L. Nitrate ranged from 0 to 30 ??eq/L with an annual mean of 6 to 25 ??eq/L; dissolved organic carbon (DOC) ranged from 1 to 7 mg/L but was typically less than 3. Episodic acidification occurred at high discharge and was caused by dilution of cations, slightly increased DOC, significantly higher NO3, and the sea-salt effect. Depressions in pH were accompanied by increases in inorganic Al. The West Bear catchment responded to the chemical additions with increased export of base cations, Al, SO4, NO3, and decreased pH, ANC, and DOC. Silica remained relatively constant. Neutralization of the acidifying chemicals occurred dominantly by cation desorption and mobilization of Al.

More sound of church bells: Authors' correction

NASA Astrophysics Data System (ADS)

Vogt, Patrik; Kasper, Lutz; Burde, Jan-Philipp

2016-01-01

In the recently published article "The Sound of Church Bells: Tracking Down the Secret of a Traditional Arts and Crafts Trade," the bell frequencies have been erroneously oversimplified. The problem affects Eqs. (2) and (3), which were derived from the elementary "coffee mug model" and in which we used the speed of sound in air. However, this does not make sense from a physical point of view, since air only acts as a sound carrier, not as a sound source in the case of bells. Due to the excellent fit of the theoretical model with the empirical data, we unfortunately failed to notice this error before publication. However, all other equations, e.g., the introduction of the correction factor in Eq. (4) and the estimation of the mass in Eqs. (5) and (6) are not affected by this error, since they represent empirical models. However, it is unfortunate to introduce the speed of sound in air as a constant in Eqs. (4) and (6). Instead, we suggest the following simple rule of thumb for relating the radius of a church bell R to its humming frequency fhum:

Approved Methods and Algorithms for DoD Risk-Based Explosives Siting

DTIC Science & Technology

2009-07-21

Parameter used in determining probability of hit ( Phit ) by debris. [Table 31, Table 32, Table 33, Eq. (157), Eq. (158)] CCa Variable “Actual...being in the glass hazard area”. [Eq. (60), Eq. (78)] Phit Variable “Probability of hit”. An array value indexed by consequence and mass bin...Eq. (156), Eq. (157)] Phit (f) Variable “Probability of hit for fatality”. [Eq. (157), Eq. (158)] Phit (maji) Variable “Probability of hit for major

The influence of lower-extremity function in elderly individuals' quality of life (QOL): an analysis of the correlation between SPPB and EQ-5D.

PubMed

Oh, Bumjo; Cho, Belong; Choi, Ho-Chun; Son, Ki-Young; Park, Sang Min; Chun, Sohyun; Cho, Sung-Il

2014-01-01

If an association between a decline in physical performance and subjective QOL is confirmed, the SPPB could be used as a predictor for declining QOL in older people. This study aimed to elucidate the association between the short physical performance battery (SPPB) and QOL (EQ-5D) to determine the utility of the SPPB as a predictor of declining QOL. The SPPB and the EQ-5D test were performed with a random sample of participants nested in the Korean Longitudinal Study of Aging (KLoSA) panel. Comparisons of the adjusted mean scores on the EQ-5D index between normal and abnormal SPPB groups were performed. We selected the quartiles of the EQ-5D index variables for the analysis. The association between the EQ-5D index and SPPB abnormality was examined using multinomial logistic regression analysis. Additionally, the associations between gait speed and chair stand time and the EQ-5D index were examined using the same analysis. Four hundred and twenty-two subjects were included in the analysis. The adjusted means for the EQ-5D index were significantly lower when the SPPB score was abnormal (p=0.022 for men, p=0.047 for women). An abnormal SPPB score was significantly associated with the lowest quartile of EQ-5D index score (adjusted OR 3.54 in the lowest quartile for men; adjusted OR 2.50 and 3.37 in the lowest and second quartiles for women). Gait speed was significantly associated with the EQ-5D index for participants of both sexes, but standup time was associated with the EQ-5D index only for men. An abnormal SPPB score was associated with lower QOL. Thus, the SPPB has the potential to be used as an early predictor of declining QOL in clinical settings and epidemiological studies. Copyright © 2013. Published by Elsevier Ireland Ltd.

Evaluation of a Cordia-IC enzyme-linked immunosorbent assay kit for the detection of circulating immune complexes.

PubMed Central

Landoy, Z; West, T E; Vladutiu, A O; Fitzpatrick, J E

1985-01-01

A commercial kit (Cordia-IC) from Cordis Laboratory, Miami, Fla., was compared with the Raji cell radioimmunoassay for its ability to detect circulating immune complexes (CIC) in sera from 30 control subjects and 118 patients with infectious diseases. The 118 patients were categorized into the following groups: (i) 23 patients with bacterial endocarditis, (ii) 41 patients with bacteremia from an infected intravascular catheter or access device, and (iii) 54 patients with Staphylococcus aureus bacteremia related to a deep tissue infection. The Cordia-IC was comparable to the Raji cell radioimmunoassay in intraassay variability (4.0 versus 8.0%) and interassay reproducibility (8.7 versus 20.0%). Neither assay found CIC amounts above 12.5 micrograms equivalents (eq) of aggregated human gamma globulin (AHG) per ml in any of the 30 control individuals. In group 1, Cordia-IC detected 19 of 23 positives (mean, 73.6 micrograms eq of AHG per ml), whereas the Raji cell detected 16 of 23 positives (mean, 54.8 micrograms eq of AHG per ml). In group 2, Cordia-IC detected 19 of 41 positives (mean, 20.6 micrograms eq of AHG per ml), whereas the Raji cell detected 16 of 41 positives (mean, 15.1 micrograms eq of AHG per ml). In group 3, Cordia-IC found 38 of 54 positives (mean, 28.0 micrograms eq of AHG per ml), whereas the Raji cell found 32 of 54 positives (mean, 23.9 micrograms eq of AHG per ml). Statistically, these findings were not significantly different in any of the three patient groups (P> 0.15), and there was an overall good correlation between the results obtained by the two assays (r+0.64, P<0.001). The Cordia-IC provided a suitable assay for the detection of CIC and might find application in routine clinical laboratories. PMID:3897269

Effects of dietary cation-anion difference on intake, milk yield, and blood components of the early lactation cow.

PubMed

Chan, P S; West, J W; Bernard, J K; Fernandez, J M

2005-12-01

Early lactation Holsteins cows (15 primiparous and 18 multiparous) were offered rations with dietary cation-anion difference, calculated as mEq (Na + K - Cl - S)/100 g of feed dry matter (DCAD:S), of 20, 35, or 50 mEq from d 0 (calving) to 42 d postpartum (August 20, 2000 to January 9, 2001) to determine the effects of increasing DCAD:S on dry matter intake (DMI), milk yield, and blood metabolites. For DCAD:S of 20, 35, and 50, DMI was 3.30, 3.38, 2.96 kg/100 kg of body weight (BW); milk yield was 25.5, 24.2, and 22.4 kg/d, respectively. No differences were observed for concentration or yield of milk fat or milk protein. Serum Ca, P, Mg, Na, K, Cl, cation-anion difference, insulin, and glucose did not differ with DCAD. Serum HCO3- was 26.07, 25.88, and 27.64 mEq/L for 20, 35, and 50 DCAD:S. Serum Ca, Mg, Na, and K concentrations were greater for primiparous cows (9.52 mg/dL, 2.35 mg/dL, 140.03 mEq/L, 4.66 mEq/L, respectively) than for multiparous cows (9.27 mg/dL, 2.12 mg/dL, 137.63 mEq/L, 4.46 mEq/ L, respectively). A DCAD:S between 23 and 33 mEq/100 g of dry matter (DM) appears to be adequate during cool weather for the milk yield that occurred in the present study based on DMI (kg/100 kg of BW), whereas DCAD:S of 50 mEq/100 g of DM may be excessive and could be too alkaline or unpalatable, resulting in decreased DMI (kg/100 kg of BW).

Inequalities in Health Status from EQ-5D Findings: A Cross-Sectional Study in Low-Income Communities of Bangladesh

PubMed Central

Sultana, Marufa; Sarker, Abdur Razzaque; Mahumud, Rashidul Alam; Ahmed, Sayem; Ahmed, Wahid; Chakrovorty, Sanchita; Rahman, Hafizur; Islam, Ziaul; Khan, Jahangir A. M.

2016-01-01

Background: Measuring health status by using standardized and validated instrument has become a growing concern over the past few decades throughout the developed and developing countries. The aim of the study was to investigate the overall self-reported health status along with potential inequalities by using EuroQol 5 dimensions (EQ-5D) instrument among low-income people of Bangladesh. Methods: A cross-sectional household survey was conducted in Chandpur district of Bangladesh. Bangla version of the EQ-5D questionnaire was employed along with socio-demographic information. EQ-5D questionnaire composed of 2-part measurements: EQ-5D descriptive system and the visual analogue scale (VAS). For measuring health status, UK-based preference weights were applied while higher score indicated better health status. For facilitating the consistency with EQ-5D score, VASs were converted to a scale with scores ranging from 0 to 1. Multiple logistic regression models were also employed to examine differences among EQ-5D dimensions. Results: A total of 1433 respondents participated in the study. The mean EQ-5D and VAS score was 0.76 and 0.77, respectively. The females were more likely to report any problem than the males (P < 0.001). Compared to the younger, elderly were more than 2-3 times likely to report any health problem in all EQ-5D dimensions (OR [odds ratio] = 3.17 for mobility, OR = 3.24 for self-care). However, the respondents of the poorest income group were significantly suffered more from every EQ-5D dimension than the richest income quintile. Conclusion: Socio-economic and demographic inequalities in health status was observed in the study. Study suggests to do further investigation with country representative sample to measure the inequalities of overall health status. It would be helpful for policy-maker to find a new way aiming to reduce such inequalities. PMID:27239879

Intermittency-induced criticality in the lower ionosphere prior to the 2016 Kumamoto earthquakes as embedded in the VLF propagation data observed at multiple stations

NASA Astrophysics Data System (ADS)

Potirakis, Stelios M.; Contoyiannis, Yiannis; Asano, Tomokazu; Hayakawa, Masashi

2018-01-01

A network of 8 VLF/LF receivers has recently been established across Japan, receiving subionospheric signals from different transmitters located both in the same and other countries. The primary purpose of this network is to study disturbances in the VLF/LF propagation through the lower ionosphere in possible relation to earthquake (EQ) preparation processes. Ionospheric perturbations of possible seismic origin have long been investigated and considered very promising for short-term EQ prediction. The raw amplitude data on reception of the above-mentioned network, after being appropriately filtered, were analyzed by means of the method of critical fluctuations (MCF) in analogy to thermal critical systems. The MCF analysis of the VLF/LF propagation revealed that intermittency-induced criticality was reached in the lower ionosphere from 1 week to 3 days prior to the catastrophic 2016 Kumamoto EQs. These fault-type EQs occurred within a two-day period (14 April: MW = 6.2 and MW = 6.0, 15 April: MW = 7.0) at shallow depths ( 10 km) and very close epicenters, while the main event was as huge as the former 1995 Kobe EQ. MCF analysis results are compared to those by the conventional nighttime fluctuation method as well as to those by natural time analysis method obtained for the same dataset, and are found to exhibit remarkable consistency.

The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery.

PubMed

Fermont, Jilles M; Blazeby, Jane M; Rogers, Chris A; Wordsworth, Sarah

2017-01-01

Bariatric surgery is considered an effective treatment for individuals with severe and complex obesity. Besides reducing weight and improving obesity related comorbidities such as diabetes, bariatric surgery could improve patients' health-related quality of life. However, the frequently used instrument to measure quality of life, the EQ-5D has not been validated for use in bariatric surgery, which is a major limitation to its use in this clinical context. Our study undertook a psychometric validation of the 5 level EQ-5D (EQ-5D-5L) using clinical trial data to measure health-related quality of life in patients with severe and complex obesity undergoing bariatric surgery. Health-related quality of life was assessed at baseline (before randomisation) and six months later in 189 patients in a randomised controlled trial of bariatric surgery. Patients completed two generic health-related quality of life instruments, the EQ-5D-5L and SF-12, which were used together for the validation using data from all patients in the trial as the trial is ongoing. Psychometric analyses included construct and criterion validity and responsiveness to change. Of the 189 validation patients, 141 (75%) were female, the median age was 49 years old (range 23-70 years) and body mass index ranged from 33-70 kg/m2. For construct validity, there were significant improvements in the distribution of responses in all EQ-5D dimensions between baseline and 6 months after randomisation. For criterion validity, the highest degree of correlation was between the EQ-5D pain/discomfort and SF-12 bodily pain domain. For responsiveness the EQ-5D and SF-12 showed statistically significant improvements in health-related quality of life between baseline and 6 months after randomisation. The EQ-5D-5L is a valid generic measure for measuring health-related quality of life in bariatric surgery patients.

Oxidative status and paraoxonase activity in children with asthma.

PubMed

Cakmak, Alpay; Zeyrek, Dost; Atas, Ali; Selek, Sahabettin; Erel, Ozcan

2009-10-01

To compare paraoxonase activity and changes in oxidative status in asthmatic children and healthy children by determining serum paraoxonase activity and total oxidative status, total antioxidant capacity and lipid hydroperoxidation. Forty two asthmatic children were compared with 32 healthy children of similar age and sex. To evaluate the paraoxonase and oxidative status, total antioxidant capacity and lipid hydroperoxidation were examined. Serum paraoxonase activity was evaluated by measuring the rate of paraoxon hydrolosis. Oxidative status was evaluated by the method developed by Erel. Lipid hydroperoxide was measured by an iodometric method. In comparison with the healthy control group, the paraoxonase activity of the asthmatic children was found to be low (163.7 +/- 73.0 (U/L) and 349.2 +/- 153.9 (U/L), P = 0.002) and total oxidant status (9.0 +/- 3.5 micromol H2O2 Eq/L and 13.4 +/- 7.0 micromol H2O2 Eq/L, P =0.002), total antioxidant capacity (5.5 +/- 2.5 micromol Trolox Eq/L and 1.0 +/- 0.6 micromol Trolox Eq/L, P < 0.001), and lipid hydroperoxidation values (9.9 +/- 3.4 micromol H2O2 Eq/L and 4.4 +/- 1.5 micromol H2O2 Eq/L, P < 0.001) were found to be high. The high density lipoprotein (HDL) concentration of the asthmatic children was lower than that in the control group (40.1 +/- 9.2 mg/dl and 54.5 +/- 15.9 mg/dl, P < 0.001) In asthmatic children, when total oxidant status, total antioxidant capacity and lipid hydroperoxidation levels increase, paraoxonase activity decreased.

Development of the EQ-5D-Y: a child-friendly version of the EQ-5D

PubMed Central

Wille, Nora; Badia, Xavier; Bonsel, Gouke; Burström, Kristina; Cavrini, Gulia; Devlin, Nancy; Egmar, Ann-Charlotte; Greiner, Wolfgang; Gusi, Narcis; Herdman, Michael; Jelsma, Jennifer; Kind, Paul; Scalone, Luciana

2010-01-01

Purpose To develop a self-report version of the EQ-5D for younger respondents, named the EQ-5D-Y (Youth); to test its comprehensibility for children and adolescents and to compare results obtained using the standard adult EQ-5D and the EQ-5D-Y. Methods An international task force revised the content of EQ-5D and wording to ensure relevance and clarity for young respondents. Children’s and adolescents’ understanding of the EQ-5D-Y was tested in cognitive interviews after the instrument was translated into German, Italian, Spanish and Swedish. Differences between the EQ-5D and the EQ-5D-Y regarding frequencies of reported problems were investigated in Germany, Spain and South Africa. Results The content of the EQ-5D dimensions proved to be appropriate for the measurement of HRQOL in young respondents. The wording of the questionnaire had to be adapted which led to small changes in the meaning of some items and answer options. The adapted EQ-5D-Y was satisfactorily understood by children and adolescents in different countries. It was better accepted and proved more feasible than the EQ-5D. The administration of the EQ-5D and of the EQ-5D-Y causes differences in frequencies of reported problems. Conclusions The newly developed EQ-5D-Y is a useful tool to measure HRQOL in young people in an age-appropriate manner. PMID:20405245

Prime Contract Awards by Service Category and Federal Supply Classification, Fiscal Years 1988, 1987, 1986, and 1985

DTIC Science & Technology

1988-01-01

SVCS/ENGINES & TURBINES 189 127 633 588 H230 EQUIP TESTING SVCS/MECH POWER TRANS EQ 0 51 0 0 H238 EQUIP TESTING SVCS/CONSTRUCTION EQUIP 255 0 560 350...26,720 31,352 3030 MAINT-REPAIR OF EQ/MECH POWER TRANS EQ 291 437 1,002 1,445 J031 MAINT-REPAIR OF EQ/BEARINGS 490 566 559 603 J032 rAINT-REPAIR OF EQ...EQ/ POWER DISTRIBUTION EQ 1,793 2,514 4,678 4,577 3062 MAINT-REPAIR OF EQ/LIGHTING FIXTURES 30 298 37 58 3063 MAINT-REPAIR OF EQ/ALARM & SIGNAL SYSTEM

Population norms for the EQ-5D index scores using Singapore preference weights.

PubMed

Abdin, Edimansyah; Subramaniam, Mythily; Vaingankar, Janhavi Ajit; Luo, Nan; Chong, Siow Ann

2015-06-01

To provide norms for the EQ-5D index scores based on Singapore preference weights according to age, sex, ethnicity, and language version and compare the EQ-5D index scores for respondents with and without psychiatric disorders and chronic medical conditions. The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of the resident (citizens and permanent residents) population in Singapore. The diagnoses of psychiatric disorders were established using the World Mental Health Composite International Diagnostic Interview version 3.0 (CIDI 3.0). Index scores were derived using the Singapore preference weights. In general, the mean EQ-5D index score using Singapore preference weights decreased with increased age. The EQ-5D Malay version reported lower mean EQ-5D index than the English version. In multivariate analysis, the mean EQ-5D index for respondents with MDD, dysthymia, bipolar disorder, GAD, OCD, diabetes, hypertension, arthritis or rheumatism, neurological condition, stroke or major paralysis, heart attack, back problems, stomach ulcer, kidney failure, migraine headaches, and chronic lung disease was significantly lower than those without these conditions. These findings support the use of the Singapore preference weights for EQ-5D valuations when measuring health-related quality of life and comparing the health burden of psychiatric and chronic physical conditions among adults in Singapore.

Tree species influence soil-atmosphere fluxes of the greenhouse gases CO2, CH4 and N2O

NASA Astrophysics Data System (ADS)

Steffens, Christina; Vesterdal, Lars; Pfeiffer, Eva-Maria

2016-04-01

In the temperate zone, forests are the greatest terrestrial sink for atmospheric CO2, and tree species affect soil C stocks and soil CO2 emissions. When considering the total greenhouse gas (GHG) balance of the forest soil, the relevant GHGs CH4 and N2O should also be considered as they have a higher global warming potential than CO2. The presented data are first results from a field study in a common garden site in Denmark where tree species with ectomycorrhizal colonization (beech - Fagus sylvatica, oak - Quercus robur) and with arbuscular mycorrhizal colonization (maple - Acer pseudoplatanus, ash - Fraxinus excelsior) have been planted in monocultures in adjacent blocks of about 0.25 ha in the year 1973 on former arable land. The soil-atmosphere fluxes of all three gases were measured every second week since August 2015. The hypothesis is that the total GHG efflux from forest soil would differ between species, and that these differences could be related to the type of mycorrhizal association and leaf litter quality. Preliminary results (August to December 2015) indicate that tree species influence the fluxes (converted to CO2-eq) of the three GHGs. Total soil CO2 efflux was in the low end of the range reported for temperate broadleaved forests but similar to the measurements at the same site approximately ten years ago. It was highest under oak (9.6±2.4 g CO2 m-2 d-1) and lowest under maple (5.2±1.6 g CO2 m-2 d-1). In contrast, soil under oak was a small but significant sink for CH4(-0.005±0.003 g CO2-eq m-2 d-1), while there were almost no detectable CH4 fluxes in maple. Emissions of N2O were highest under beech (0.6±0.6 g CO2-eq m-2 d-1) and oak (0.2±0.09 g CO2-eq m-2 d-1) and lowest under ash (0.03±0.04 g CO2-eq m-2 d-1). In the total GHG balance, soil CH4 uptake was negligible (≤0.1% of total emissions). Emissions of N2O (converted to CO2-eq) contributed <1% (ash) to 8% (beech) to total GHG emissions. Summing up all GHG emissions, the tree species were divided in two groups as hypothesized: Beech and oak, both colonized by ectomycorrhiza and producing leaf litter with a high lignin:N ratio, had higher total GHG emissions (8.9±3.5 and 10.3±2.9 g CO2-eq m-2 d-1) than maple and ash (6.2±1.4 and 6.2±0.9 g CO2-eq m-2 d-1) that are colonized by arbuscular mycorrhiza and produce leaf litter with a lower lignin:N ratio.

Health-related utility values of patients with primary Sjögren's syndrome and its predictors.

PubMed

Lendrem, Dennis; Mitchell, Sheryl; McMeekin, Peter; Bowman, Simon; Price, Elizabeth; Pease, Colin T; Emery, Paul; Andrews, Jacqueline; Lanyon, Peter; Hunter, John; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Vadivelu, Saravanan; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Ng, Wan-Fai

2014-07-01

EuroQoL-5 dimension (EQ-5D) is a standardised preference-based tool for measurement of health-related quality of life and EQ-5D utility values can be converted to quality-adjusted life years (QALYs) to aid cost-utility analysis. This study aimed to evaluate the EQ-5D utility values of 639 patients with primary Sjögren's syndrome (PSS) in the UK. Prospective data collected using a standardised pro forma were compared with UK normative data. Relationships between utility values and the clinical and laboratory features of PSS were explored. The proportion of patients with PSS reporting any problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 42.2%, 16.7%, 56.6%, 80.6% and 49.4%, respectively, compared with 5.4%, 1.6%, 7.9%, 30.2% and 15.7% for the UK general population. The median EQ-5D utility value was 0.691 (IQR 0.587-0.796, range -0.239 to 1.000) with a bimodal distribution. Bivariate correlation analysis revealed significant correlations between EQ-5D utility values and many clinical features of PSS, but most strongly with pain, depression and fatigue (R values>0.5). After adjusting for age and sex differences, multiple regression analysis identified pain and depression as the two most important predictors of EQ-5D utility values, accounting for 48% of the variability. Anxiety, fatigue and body mass index were other statistically significant predictors, but they accounted for <5% in variability. This is the first report on the EQ-5D utility values of patients with PSS. These patients have significantly impaired utility values compared with the UK general population. EQ-5D utility values are significantly related to pain and depression scores in PSS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

AGARD Flight Test Instrumentation Series. Volume 15. Gyroscopic Instruments and Their Application to Flight Testing

DTIC Science & Technology

1982-09-01

center of gravity, Eq. (J.Z.,5)r [in radius of light been, Eq. (3.5.1) r aplitude of baCkscattere•d light with respect to incident light of a mirror , Eq...output, see Eq. (3.5.9)). High quality sensors are being4 built using three or more mirrors within a linear dimension of 10 co. At the present time...Fig. 3.5.1, showed an effect. The SRI shown in fjt.ýj consists of a light source (LS). a beam splitter (8S). three fully re- flecting; mirrors ,. M1I.iF

Responsiveness of the anxiety/depression dimension of the 3- and 5-level versions of the EQ-5D in assessing mental health.

PubMed

Crick, Katelynn; Al Sayah, Fatima; Ohinmaa, Arto; Johnson, Jeffrey A

2018-06-01

Anxiety and depression disorders are associated with significantly lower health-related quality of life (HRQL). The EQ-5D is a commonly used generic measure of HRQL; it captures mental health through a single domain-the anxiety/depression dimension. Evidence on the responsiveness of this measure in assessing changes in mental health changes is limited. To examine the performance of the anxiety/depression dimension (A/D) of the 3- and 5-level (3L and 5L) versions of the EQ-5D in assessing changes in mental health. Data from two patient populations were used: 495 adults post-discharge from general internal medicine ward (EQ-5D-3L), and 225 type 2 diabetes patients who screened positive for depressive symptoms (EQ-5D-5L). Anchor-based approach along with effect sizes (ES) and ROC analysis was used. Anchors included patient health questionnaire 9-items "PHQ9" and generalized anxiety disorder 2-item questionnaire "GAD2" for EQ-5D-3L, and PHQ9 and SF-12 mental composite summary scores (MCS) for EQ-5D-5L. A/D change was quantified as the difference between follow-up and baseline levels. The A/D dimension of the EQ-5D-3L showed limited responsiveness to changes in depressive symptoms measured by PHQ9 and for anxiety symptoms measured by GAD2, whereby in those who improved or deteriorated in either symptom, more than half of the patients did not have an A/D change. In the ROC analysis, the A/D dimension of the EQ-5D-3L showed weak performance with C-indices ranging from 0.58 to 0.63 and probability of detection of depressive or anxiety symptoms ranging between 20 and 40%, which are all well below acceptable ranges. Similar results were observed for the A/D dimension of the EQ-5D-5L; although the performance was slightly better, it was still below acceptable range. In patients who improved or deteriorated based on the PHQ9 or MCS, around a third had no changes on the A/D dimension. The performance of the A/D dimension of the EQ-5D-5L was also very limited with C-indices ranging between 0.67 and 0.76, and probability of detection between 50 and 67%, slightly better than that of the 3L, yet unsatisfactory. Although the A/D of both EQ-5D-3L and 5L was limited in capturing changes in mental health in these populations, the 5L was slightly more responsive than the 3L. While the performance was better for depressive than anxiety symptoms, it varied by the direction of change. Further research using other measures of mental health in other populations is warranted.

Treating child and adolescent anxiety effectively: Overview of systematic reviews.

PubMed

Bennett, Kathryn; Manassis, Katharina; Duda, Stephanie; Bagnell, Alexa; Bernstein, Gail A; Garland, E Jane; Miller, Lynn D; Newton, Amanda; Thabane, Lehana; Wilansky, Pamela

2016-12-01

We conducted an overview of systematic reviews about child and adolescent anxiety treatment options (psychosocial; medication; combination; web/computer-based treatment) to support evidence informed decision-making. Three questions were addressed: (i) Is the treatment more effective than passive controls? (ii) Is there evidence that the treatment is superior to or non-inferior to (i.e., as good as) active controls? (iii) What is the quality of evidence for the treatment? Pre-specified inclusion criteria identified high quality systematic reviews (2000-2015) reporting treatment effects on anxiety diagnosis and symptom severity. Evidence quality (EQ) was rated using Oxford evidence levels [EQ1 (highest); EQ5 (lowest)]. Twenty-two of 39 eligible reviews were high quality (AMSTAR score≥3/5). CBT (individual or group, with or without parents) was more effective than passive controls (EQ1). CBT effects compared to active controls were mixed (EQ1). SSRI/SNRI were more effective than placebo (EQ1) but comparative effectiveness remains uncertain. EQ for combination therapy could not be determined. RCTs of web/computer-based interventions showed mixed results (EQ1). CBM/ABM was not more efficacious than active controls (EQ1). No other interventions could be rated. High quality RCTs support treatment with CBT and medication. Findings for combination and web/computer-based treatment are encouraging but further RCTs are required. Head-to-head comparisons of active treatment options are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality of life assessment in interstitial lung diseases:a comparison of the disease-specific K-BILD with the generic EQ-5D-5L.

PubMed

Szentes, Boglárka Lilla; Kreuter, Michael; Bahmer, Thomas; Birring, Surinder S; Claussen, Martin; Waelscher, Julia; Leidl, Reiner; Schwarzkopf, Larissa

2018-05-25

Patients with interstitial lung diseases (ILD) have impaired health-related quality of life (HRQL). Little is known about the applicability of the disease-specific King's Brief Interstitial Lung Disease questionnaire (K-BILD) and the generic EQ-5D-5L in a German setting. We assessed disease-specific (K-BILD) and generic HRQL (EQ-5D experience based value set (EBVS) and Visual Analog Scale (VAS)) in 229 patients with different ILD subtypes in a longitudinal observational study (HILDA). Additionally, we assessed the correlation of the HRQL measures with lung function and comorbidities. In a linear regression model, we investigated predictors (including age, sex, ILD subtype, FVC percentage of predicted value (FVC%pred), DLCO percentage of predicted value, and comorbidities). Among the 229 patients mean age was 63.2 (Standard deviation (SD): 12.9), 67.3% male, 24.0% had idiopathic pulmonary fibrosis, and 22.3% sarcoidosis. Means scores were as follows for EQ-5D EBVS 0.66(SD 0.17), VAS 61.4 (SD 19.1) and K-BILD Total 53.6 (SD 13.8). K-BILD had good construct validity (high correlation with EQ-5D EBVS (0.71)) and good internal consistency (Cronbach's alpha 0.89). Moreover, all HRQL measures were highly accepted by patients including low missing items and there were no ceiling or floor effects. A higher FVC % pred was associated with higher HRQL in all measures meanwhile comorbidities had a negative influence on HRQL. K-BILD and EQ-5D had similar HRQL trends and were associated similarly to the same disease-related factors in Germany. Our data supports the use of K-BILD in clinical practice in Germany, since it captures disease specific effects of ILD. Additionally, the use of the EQ-5D-5L could provide comparison to different disease areas and give an overview about the position of ILD patients in comparison to general population.

Evaluation of an individualized dose titration regimen of patiromer to prevent hyperkalaemia in patients with heart failure and chronic kidney disease

PubMed Central

Bushinsky, David A.; Kitzman, Dalane W.; Ruschitzka, Frank; Metra, Marco; Filippatos, Gerasimos; Rossignol, Patrick; Du Mond, Charles; Garza, Dahlia; Berman, Lance; Lainscak, Mitja

2018-01-01

Abstract Aims Hyperkalaemia risk precludes optimal renin–angiotensin–aldosterone system inhibitor use in patients with heart failure (HF), particularly those with chronic kidney disease (CKD). Patiromer is a sodium‐free, non‐absorbed potassium (K+)‐binding polymer approved for the treatment of hyperkalaemia. In PEARL‐HF, patiromer 25.2 g (fixed dose) prevented hyperkalaemia in HF patients with or without CKD initiating spironolactone. The current study evaluated the effectiveness of a lower starting dose of patiromer (16.4 g/day) followed by individualized titration in preventing hyperkalaemia and hypokalaemia when initiating spironolactone. Methods and results This open‐label 8‐week study enrolled 63 patients with CKD, serum K+ 4.3–5.1 mEq/L, and chronic HF, who, based on investigator opinion, should receive spironolactone. Eligible patients started spironolactone 25 mg/day and patiromer 16.8 g/day (divided into two doses), with patiromer titrated to maintain serum K+ 4.0–5.1 mEq/L. Mean (standard deviation) serum K+ was 4.78 (0.51) mEq/L at baseline; weekly values were 4.48–4.70 mEq/L during treatment. Serum K+ of 3.5–5.5 mEq/L at the end of study treatment (primary endpoint) was achieved by 57 (90.5%) patients; 53 (84.1%) had serum K+ 4.0–5.1 mEq/L. One patient (1.6%) developed hypokalaemia, and two patients (3.2%) developed hypomagnesaemia. Spironolactone was increased to 50 mg/day in all patients; 43 (68%) patients required one or more patiromer dose titration. Adverse events (AEs) occurred in 36 (57.1%) patients, with a low rate of discontinuations [four (6.3%) patients]. The most common AE was mild to moderate abdominal discomfort [four (6.3%) patients]. Conclusions In this open‐label study, patiromer 16.8 g/day followed by individualized titration maintained serum K+ within the target range in the majority of patients with HF and CKD, all of whom were uptitrated to spironolactone 50 mg/day, patiromer was well tolerated, with a low incidence of hyperkalaemia, hypokalaemia, and hypomagnesaemia. PMID:29369537

[Serum potassium levels and long-term mortality in the elderly with hypertension].

PubMed

Heras Benito, M; Fernández-Reyes, M J; Guerrero Díaz, M T; Muñoz Pascual, A

There is increasing evidence that small variations within the normal range (3.5-5mEq/L) of potassium are associated with mortality. To determine whether there is an association between serum potassium level (sK) and mortality in a cohort of elderly hypertensive patients. A retrospective, observational study was conducted on patients who had sK levels available in a period of clinical stability during their recruitment between January and April 2006 and followed-up for 10 years. The study obtained a total of 62 stable patients, with a mean age of 82.19±6 years (range 69-97), with 74.2% women, 33.9% diabetics, 20.3% with a history of heart failure, Ischaemic heart disease was observed in 19.4% and 44.3% received Angiotensin Converting Enzyme (ACE) inhibitors. An analysis was performed on the mortality rate during the 10 year period. The statistics were performed using the SPSS15.0 package. There were 49 deaths. The sK had a normal distribution. Baseline mean sK levels and median were 4.45±0.5mEq/L (range 3.1-5.5 mEq/L). Baseline sK levels were significantly higher in diabetic patients and patients on ACE inhibitors. The patients that died had higher sK levels (4.53±0.49mEq/L versus 4.14±0.40mEq/L, P=.011). Survival estimated using Kaplan Meier showed that patients with sK levels higher than the median and P75 had higher mortality. In our study, sK levels greater than 4.45mEq/L were associated with mortality. When selecting antihypertensive treatment in hypertensive elderly patients,, the use of ACE inhibitors should be assessed individually, with close monitoring at sK levels and try to keep them in the lower limit of the normal range (<4.45 mEq/L). Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Correspondence between EQ-5D health state classifications and EQ VAS scores.

PubMed

Whynes, David K

2008-11-07

The EQ-5D health-related quality of life instrument comprises a health state classification followed by a health evaluation using a visual analogue scale (VAS). The EQ-5D has been employed frequently in economic evaluations, yet the relationship between the two parts of the instrument remains ill-understood. In this paper, we examine the correspondence between VAS scores and health state classifications for a large sample, and identify variables which contribute to determining the VAS scores independently of the health states as classified. A UK trial of management of low-grade abnormalities detected on screening for cervical pre-cancer (TOMBOLA) provided EQ-5D data for over 3,000 women. Information on distress and multi-dimensional health locus of control had been collected using other instruments. A linear regression model was fitted, with VAS score as the dependent variable. Independent variables comprised EQ-5D health state classifications, distress, locus of control, and socio-demographic characteristics. Equivalent EQ-5D and distress data, collected at twelve months, were available for over 2,000 of the women, enabling us to predict changes in VAS score over time from changes in EQ-5D classification and distress. In addition to EQ-5D health state classification, VAS score was influenced by the subject's perceived locus of control, and by her age, educational attainment, ethnic origin and smoking behaviour. Although the EQ-5D classification includes a distress dimension, the independent measure of distress was an additional determinant of VAS score. Changes in VAS score over time were explained by changes in both EQ-5D severities and distress. Women allocated to the experimental management arm of the trial reported an increase in VAS score, independently of any changes in health state and distress. In this sample, EQ VAS scores were predictable from the EQ-5D health state classification, although there also existed other group variables which contributed systematically and independently towards determining such scores. These variables comprised psychological disposition, socio-demographic factors such as age and education, clinically-important distress, and the clinical intervention itself. ISRCTN34841617.

Assessing Health-Related Quality of Life of Chinese Adults in Heilongjiang Using EQ-5D-3L.

PubMed

Huang, Weidong; Yu, Hongjuan; Liu, Chaojie; Liu, Guoxiang; Wu, Qunhong; Zhou, Jin; Zhang, Xin; Zhao, Xiaowen; Shi, Linmei; Xu, Xiaoxue

2017-02-23

This study aimed to assess health-related quality of life (HRQOL) of Heilongjiang adult populations by using the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire and to identify factors associated with HRQOL. Data from the National Health Services Survey (NHSS) 2008 in Heilongjiang province were obtained. Results of EQ-5D-3L questionnaires completed by 11,523 adult respondents (18 years or older) were converted to health index scores using a recently developed Chinese value set. Multivariate linear regression and logistic regression models were established to determine demographic, socioeconomic, health, and lifestyle factors that were associated with HRQOL and reported problems in the five dimensions of EQ-5D-3L. The Heilongjiang population had a mean EQ-5D-3L index score of 0.959. Lower EQ-5D-3L index scores were associated with older age, lower levels of education, chronic conditions, temporary accommodation, poverty, unemployment, and lack of regular physical activities. Older respondents and those who were unemployed, had chronic conditions, and lived in poverty were more likely to report problems in all of the five health dimensions. Higher educational attainment was associated with lower odds of reporting health problems in mobility, pain/discomfort, and anxiety/depression. Low socioeconomic status is associated with poor HRQOL. Regional population norms for EQ-5D-3L are needed for health economic studies due to great socioeconomic disparities across regions in China. Overall, the Heilongjiang population has a similar level of HRQOL compared with the national average.

BAG3 protects bovine papillomavirus type 1-transformed equine fibroblasts against pro-death signals.

PubMed

Cotugno, Roberta; Gallotta, Dario; d'Avenia, Morena; Corteggio, Annunziata; Altamura, Gennaro; Roperto, Franco; Belisario, Maria Antonietta; Borzacchiello, Giuseppe

2013-07-22

In human cancer cells, BAG3 protein is known to sustain cell survival. Here, for the first time, we demonstrate the expression of BAG3 protein both in equine sarcoids in vivo and in EqS04b cells, a sarcoid-derived fully transformed cell line harbouring bovine papilloma virus (BPV)-1 genome. Evidence of a possible involvement of BAG3 in equine sarcoid carcinogenesis was obtained by immunohistochemistry analysis of tumour samples. We found that most tumour samples stained positive for BAG3, even though to a different grade, while normal dermal fibroblasts from healthy horses displayed very weak staining pattern for BAG3 expression. By siRNA technology, we demonstrate in EqS04b the role of BAG3 in counteracting basal as well as chemical-triggered pro-death signals. BAG3 down-modulation was indeed shown to promote cell death and cell cycle arrest in G0/G1. In addition, we found that BAG3 silencing sensitized EqS04b cells to phenethylisothiocyanate (PEITC), a promising cancer chemopreventive/chemotherapeutic agent present in edible cruciferous vegetables. Notably, such a pro-survival role of BAG3 was less marked in E. Derm cells, an equine BPV-negative fibroblast cell line taken as a normal counterpart. Altogether our findings might suggest a mutual cooperation between BAG3 and viral oncoproteins to sustain cell survival.

BAG3 protects Bovine Papillomavirus type 1-transformed equine fibroblasts against pro-death signals

PubMed Central

2013-01-01

In human cancer cells, BAG3 protein is known to sustain cell survival. Here, for the first time, we demonstrate the expression of BAG3 protein both in equine sarcoids in vivo and in EqS04b cells, a sarcoid-derived fully transformed cell line harbouring bovine papilloma virus (BPV)-1 genome. Evidence of a possible involvement of BAG3 in equine sarcoid carcinogenesis was obtained by immunohistochemistry analysis of tumour samples. We found that most tumour samples stained positive for BAG3, even though to a different grade, while normal dermal fibroblasts from healthy horses displayed very weak staining pattern for BAG3 expression. By siRNA technology, we demonstrate in EqS04b the role of BAG3 in counteracting basal as well as chemical-triggered pro-death signals. BAG3 down-modulation was indeed shown to promote cell death and cell cycle arrest in G0/G1. In addition, we found that BAG3 silencing sensitized EqS04b cells to phenethylisothiocyanate (PEITC), a promising cancer chemopreventive/chemotherapeutic agent present in edible cruciferous vegetables. Notably, such a pro-survival role of BAG3 was less marked in E. Derm cells, an equine BPV-negative fibroblast cell line taken as a normal counterpart. Altogether our findings might suggest a mutual cooperation between BAG3 and viral oncoproteins to sustain cell survival. PMID:23876161

Comparing the performance of the SF-6D and the EQ-5D in different patient groups.

PubMed

Ferreira, Lara N; Ferreira, Pedro L; Pereira, Luis N

2014-01-01

This research aims to explore the performance of the SF-6D and the EQ-5D in patients suffering from asthma, chronic obstructive pulmonary disease, cataracts, and rheumatoid arthritis. In particular, the aim of this research is twofold: 1) to study the level of agreement between the indexes and the descriptive systems of the dimensions of the SF-6D and the EQ-5D, and 2) to analyze the discriminative ability of the instruments. A sample of 643 patients completed both the SF-36v2 and the EQ-5D. The discriminative ability of the instruments was analyzed. Furthermore, the level of agreement between the indexes and the descriptive systems of the dimensions of the SF-6D and the EQ-5D were studied. The level of agreement between instruments was investigated using correlation coefficients and the Bland-Altman plots, while the influence of medical condition and other socio-demographic variables was analyzed using nonparametric tests. Paired-samples tests were used to identify differences between the scores. The results show a strong correlation and agreement between both indexes. Overall, questionnaire indexes differ by medical condition and socio-demographic groups and both instruments are able to discriminate between socio-demographic groups. This study confirmed the hypothesis that the SF-6D generates higher utility values in less healthy individuals. The SF-6D and the EQ-5D seem to perform differently in each of the diseases studied since the descriptive statistics differ between instruments and the level of correlation is not uniform. Results show that the instruments generate different utility values, but there is a strong agreement between both indexes. Thus, the two instruments are not interchangeable and their results cannot be directly comparable.

Physical Compatibility of Magnesium Sulfate and Sodium Bicarbonate in a Pharmacy-compounded Bicarbonate-buffered Hemofiltration Solution

PubMed Central

Moriyama, Brad; Henning, Stacey A.; Jin, Haksong; Kolf, Mike; Rehak, Nadja N.; Danner, Robert L.; Walsh, Thomas J.; Grimes, George J.

2011-01-01

PURPOSE To assess the physical compatibility of magnesium sulfate and sodium bicarbonate in a pharmacy-compounded bicarbonate-buffered hemofiltration solution used at the National Institutes of Health Clinical Center (http://www.cc.nih.gov). METHODS Two hemofiltration fluid formulations with a bicarbonate of 50 mEq/L and a magnesium of 1.5 mEq/L or 15 mEq/L were prepared in triplicate with an automated compounding device. The hemofiltration solution with a bicarbonate of 50 mEq/L and a magnesium of 1.5 mEq/L contains the maximum concentration of additives that we use in clinical practice. The hemofiltration solution of 15 mEq/L of magnesium and 50 mEq/L of bicarbonate was used to study the physicochemical properties of this interaction. The solutions were stored without light protection at 22 to 25 °C for 48 hours. Physical compatibility was assessed by visual inspection and microscopy. The pH of the solutions was assayed at 3 to 4 hours and 52 to 53 hours after compounding. In addition, electrolyte and glucose concentrations in the solutions were assayed at two time points after preparation: 3 to 4 hours and 50 to 51 hours. RESULTS No particulate matter was observed by visual and microscopic inspection in the compounded hemofiltration solutions at 48 hours. Electrolyte and glucose concentrations and pH were similar at both time points after solution preparation. CONCLUSION Magnesium sulfate (1.5 mEq/L) and sodium bicarbonate (50 mEq/L) were physically compatible in a pharmacy-compounded bicarbonate-buffered hemofiltration solution at room temperature without light protection at 48 hours. PMID:20237384

Stochastic and Centrifuge Modelling of Jointed Rock. Volume 3. Stochastic and Topological Fracture Geometry Model

DTIC Science & Technology

1990-08-31

IPATRr 3DOFN) = 0 110 CONTINUEI CCTMX(IPATR) = 0. CCTMY(IPATR) = 0. 120 CONTINUE C START SEARCHING :1ST IF ( XCONN(1,ICOLl) .EQ.0. )GO TO 300 NCTM (,1...EQ.ICOL1.OR.ICOL4.EQ.1COL2 ) GO TO 270 NCTMX(4,1) = ICOL3 NCTM ~X(4,2) = ICOL4I CCTMX(4) = XCONN(ICOL3,ICOL4) CCTMY(4) = YCONN(ICOL3,ICOL4) IT ( CCTMX(4

Cross-cultural measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) in patients with type 2 diabetes mellitus in Singapore.

PubMed

Wang, Ye; Tan, Ngiap-Chuan; Tay, Ee-Guan; Thumboo, Julian; Luo, Nan

2015-07-16

This study aimed to assess the measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) among the English, Chinese, and Malay versions. A convenience sample of patients with type 2 diabetes mellitus were enrolled from a public primary health care institution in Singapore. The survey questionnaire comprised the EQ-5D-5L and questions assessing participants' socio-demographic and clinical characteristics. Multiple linear regression models were used to assess the difference in EQ-5D-5L index (calculated using an interim algorithm) and EQ-visual analog scale (EQ-VAS) scores across survey language (Chinese vs. English, Malay vs. English, and Malay vs. Chinese). Measurement equivalence was examined by comparing the 90% confidence interval of difference in the EQ-5D-5L index and EQ-VAS scores with a pre-determined equivalence margin. Multiple logistic regression models were used to assess the response patterns of the 5 Likert-type items of the EQ-5D-5L across survey language. Equivalence was demonstrated between the Chinese and English versions and between the Malay and English versions of the EQ-5D-5L index scores. Equivalence was also demonstrated between the Chinese and English versions and between the Malay and Chinese versions of the EQ-VAS scores. Equivalence could not be determined between the Malay and Chinese versions of the EQ-5D-5L index score and between the Malay and English versions of the EQ-VAS score. No significant difference was found in responses to EQ-5D-5L items between any languages, except that patients who chose to complete the Chinese version were more likely to report "no problems" in mobility compared to those who completed the Malay version of the questionnaire. This study provided evidence for the measurement equivalence of the different language versions of EQ-5D-5L in Singapore.

EQ-5D-3L as a health measure of Brazilian adult population.

PubMed

Menezes, Renata de Miranda; Andrade, Mônica Viegas; Noronha, Kenya Valéria Micaela de Souza; Kind, Paul

2015-11-01

This study explores the use of EQ-5D-3L as a measure of population health status in a Brazilian region with significant socioeconomic, demographic, and epidemiological heterogeneity. Data came from a study of 3363 literate individuals aged between 18 and 64 years living in urban areas of the state of Minas Gerais. Descriptive analysis and logistic and OLS regression models were performed to analyze the relationship between EQ-5D-3L (descriptive system and EQ VAS) and other health (self-assessed health status and 8 self-reported diagnosed chronic diseases), socioeconomic (educational level and economic class), and demographic (gender and age) measures. Additionally, a grade of membership (GoM) analysis was performed to identify multidimensional health profiles. A total of 76 health statuses were identified in the Brazilian population. The most prevalent one is full health (44 % of the sample). Elderly people, women, and individuals with poor health and lower socioeconomic conditions generally report more health problems in the EQ-5D-3L dimensions. The GoM analysis demonstrated that health status of older individuals is associated with the socioeconomic condition. Arthritis exhibited the strongest association with the EQ-5D-3L instrument. The results indicate that EQ-5D-3L is a good measure of health status for the Brazilian population. The instrument has a good discriminatory capacity in terms of demographic, socioeconomic, and health measures. The high prevalence of individuals with full health may indicate the presence of ceiling effect. However, this prevalence is smaller than that in other countries.

Dietary Acid Load is Associated With Serum Bicarbonate but not Insulin Sensitivity in Chronic Kidney Disease.

PubMed

Ikizler, Halil O; Zelnick, Leila; Ruzinski, John; Curtin, Laura; Utzschneider, Kristina M; Kestenbaum, Bryan; Himmelfarb, Jonathan; de Boer, Ian H

2016-03-01

In chronic kidney disease (CKD), dietary acid may promote metabolic acidosis and insulin resistance, which in turn may contribute to adverse clinical health outcomes. We examined associations between dietary acid load, serum bicarbonate, and insulin sensitivity in CKD. In a cross-sectional study, we collected 3-day prospective food diaries to quantify dietary acid load as net endogenous acid production (NEAP, the nonvolatile acid load produced by the diet's acid balance) and potential renal acid load (PRAL). We measured urine net acid excretion (NAE) in 24-hour urine samples. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp. Forty-two patients with CKD Stages 3 to 5 attending nephrology clinics in the Pacific Northwest and 21 control subjects (estimated glomerular filtration rate [eGFR] ≥ 60 mL/minute/1.73 m(2)). Serum bicarbonate and insulin sensitivity (SIclamp). Mean age was 60.8 ± 13.6 years, and 54% of participants were men. Mean eGFR and serum bicarbonate concentrations were 34.4 ± 13.1 mL/minute/1.73 m(2) and 24.1 ± 2.9 mEq/L for participants with CKD and 88.6 ± 14.5 mL/minute/1.73 m(2) and 26.3 ± 1.8 mEq/L for control subjects, respectively. Mean NEAP, PRAL, and NAE were 58.2 ± 24.3, 9.7 ± 18.4, and 32.1 ± 19.8 mEq/day, respectively. Considering all participants, dietary acid load was significantly, inversely associated with serum bicarbonate, adjusting for age, gender, race, eGFR, body mass index, and diuretic use: -1.2 mEq/L per standard deviation (SD) NEAP (95% confidence interval [CI] -1.8 to -0.6, P < .0001); -0.9 mEq/L bicarbonate per SD PRAL (95% CI -1.5 to -0.4, P = .0005); -0.7 mEq/L bicarbonate per SD NAE (95% CI -1.2 to -0.1, P = .01). These associations were similar in participants with and without CKD. However, neither NEAP and PRAL nor NAE was significantly associated with SIclamp. Serum bicarbonate was also not significantly associated with SIclamp. In CKD, dietary acid load is associated with serum bicarbonate, suggesting that acidosis may be improved by dietary changes, but not with insulin sensitivity. Published by Elsevier Inc.

Impact of a community-based lifestyle intervention program on health-related quality of life.

PubMed

Eaglehouse, Yvonne L; Schafer, Gerald L; Arena, Vincent C; Kramer, M Kaye; Miller, Rachel G; Kriska, Andrea M

2016-08-01

The presence of risk factors for type 2 diabetes and cardiovascular disease, or the conditions themselves, contributes to lower health-related quality of life (HRQoL) among adults. Although community-based lifestyle intervention programs have been shown to be effective for improving risk factors for these diseases, the impact of these interventions on HRQoL has rarely been described. To examine changes in HRQoL following participation in the Group Lifestyle Balance program, a community translation of the Diabetes Prevention Program lifestyle intervention for adults with prediabetes and/or the metabolic syndrome. Participants enrolled in the 12-month, 22-session intervention program (N = 223) completed the EuroQol Health Questionnaire (EQ-5D-3L) at baseline, 6, and 12 months. Linear mixed-effects regression models determined change in EQ-5D-visual analog scale (VAS) and Index scores post-intervention. Mean EQ-5D-VAS was improved by +7.38 (SE = 1.03) at 6 months and by +6.73 (SE = 1.06) at 12 months post-intervention (both; p < 0.0001). Mean changes in EQ-5D index values were +0.00 (SE = 0.01; NS) and +0.01 (SE = 0.01; p < 0.05), respectively. Adjusted for age, baseline score, and achieving intervention goals, mean change in EQ-5D-VAS was +11.83 (SE = 1.61) at 6 months and +11.23 (SE = 1.54) at 12 months (both; p < 0.0001). Adjusted mean change in EQ-5D index value was +0.04 (SE = 0.01) at 6 months and +0.05 (SE = 0.01) at 12 months (both; p < 0.01). Participation in a community lifestyle intervention program resulted in improved HRQoL among adults with prediabetes and/or the metabolic syndrome. These benefits to HRQoL, together with improved clinical and behavioral outcomes, should increase the appeal of such programs for improving health.

Analysis of three different equations for predicting quadriceps femoris muscle strength in patients with COPD *

PubMed Central

Nellessen, Aline Gonçalves; Donária, Leila; Hernandes, Nidia Aparecida; Pitta, Fabio

2015-01-01

Abstract Objective: To compare equations for predicting peak quadriceps femoris (QF) muscle force; to determine the agreement among the equations in identifying QF muscle weakness in COPD patients; and to assess the differences in characteristics among the groups of patients classified as having or not having QF muscle weakness by each equation. Methods: Fifty-six COPD patients underwent assessment of peak QF muscle force by dynamometry (maximal voluntary isometric contraction of knee extension). Predicted values were calculated with three equations: an age-height-weight-gender equation (Eq-AHWG); an age-weight-gender equation (Eq-AWG); and an age-fat-free mass-gender equation (Eq-AFFMG). Results: Comparison of the percentage of predicted values obtained with the three equations showed that the Eq-AHWG gave higher values than did the Eq-AWG and Eq-AFFMG, with no difference between the last two. The Eq-AHWG showed moderate agreement with the Eq-AWG and Eq-AFFMG, whereas the last two also showed moderate, albeit lower, agreement with each other. In the sample as a whole, QF muscle weakness (< 80% of predicted) was identified by the Eq-AHWG, Eq-AWG, and Eq-AFFMG in 59%, 68%, and 70% of the patients, respectively (p > 0.05). Age, fat-free mass, and body mass index are characteristics that differentiate between patients with and without QF muscle weakness. Conclusions: The three equations were statistically equivalent in classifying COPD patients as having or not having QF muscle weakness. However, the Eq-AHWG gave higher peak force values than did the Eq-AWG and the Eq-AFFMG, as well as showing greater agreement with the other equations. PMID:26398750

A Multiscale Gradient Theory for Single Crystalline Elastoviscoplasticity

DTIC Science & Technology

2006-02-01

ferentiation with respect to the Levi - Civita connection on Bcur whose Christoffel symbols stem from the components of the metric gab of Eq. (6)3 and thus...denoting covariant differentiation with respect to the symmetric Levi – Civita connection on bref . Notice that Eq. (29) are applicable locally, for points...brevity, thermal effects (i.e., temperature rates and heat fluxes) and dynamic effects (i.e., acceleration and body forces) are often neglected. We employ

Equine Botulinum Antitoxin for the Treatment of Infant Botulism ▿

PubMed Central

Vanella de Cuetos, Elida E.; Fernandez, Rafael A.; Bianco, María I.; Sartori, Omar J.; Piovano, María L.; Lúquez, Carolina; de Jong, Laura I. T.

2011-01-01

Infant botulism is the most common form of human botulism in Argentina and the United States. BabyBIG (botulism immune globulin intravenous [human]) is the antitoxin of choice for specific treatment of infant botulism in the United States. However, its high cost limits its use in many countries. We report here the effectiveness and safety of equine botulinum antitoxin (EqBA) as an alternative treatment. We conducted an analytical, observational, retrospective, and longitudinal study on cases of infant botulism registered in Mendoza, Argentina, from 1993 to 2007. We analyzed 92 medical records of laboratory-confirmed cases and evaluated the safety and efficacy of treatment with EqBA. Forty-nine laboratory-confirmed cases of infant botulism demanding admission in intensive care units and mechanical ventilation included 31 treated with EqBA within the 5 days after the onset of signs and 18 untreated with EqBA. EqBA-treated patients had a reduction in the mean length of hospital stay of 23.9 days (P = 0.0007). For infants treated with EqBA, the intensive care unit stay was shortened by 11.2 days (P = 0.0036), mechanical ventilation was reduced by 11.1 days (P = 0.0155), and tube feeding was reduced by 24.4 days (P = 0.0001). The incidence of sepsis in EqBA-treated patients was 47.3% lower (P = 0.0017) than in the untreated ones. Neither sequelae nor adverse effects attributable to EqBA were noticed, except for one infant who developed a transient erythematous rash. These results suggest that prompt treatment of infant botulism with EqBA is safe and effective and that EqBA could be considered an alternative specific treatment for infant botulism when BabyBIG is not available. PMID:21918119

Equine botulinum antitoxin for the treatment of infant botulism.

PubMed

Vanella de Cuetos, Elida E; Fernandez, Rafael A; Bianco, María I; Sartori, Omar J; Piovano, María L; Lúquez, Carolina; de Jong, Laura I T

2011-11-01

Infant botulism is the most common form of human botulism in Argentina and the United States. BabyBIG (botulism immune globulin intravenous [human]) is the antitoxin of choice for specific treatment of infant botulism in the United States. However, its high cost limits its use in many countries. We report here the effectiveness and safety of equine botulinum antitoxin (EqBA) as an alternative treatment. We conducted an analytical, observational, retrospective, and longitudinal study on cases of infant botulism registered in Mendoza, Argentina, from 1993 to 2007. We analyzed 92 medical records of laboratory-confirmed cases and evaluated the safety and efficacy of treatment with EqBA. Forty-nine laboratory-confirmed cases of infant botulism demanding admission in intensive care units and mechanical ventilation included 31 treated with EqBA within the 5 days after the onset of signs and 18 untreated with EqBA. EqBA-treated patients had a reduction in the mean length of hospital stay of 23.9 days (P = 0.0007). For infants treated with EqBA, the intensive care unit stay was shortened by 11.2 days (P = 0.0036), mechanical ventilation was reduced by 11.1 days (P = 0.0155), and tube feeding was reduced by 24.4 days (P = 0.0001). The incidence of sepsis in EqBA-treated patients was 47.3% lower (P = 0.0017) than in the untreated ones. Neither sequelae nor adverse effects attributable to EqBA were noticed, except for one infant who developed a transient erythematous rash. These results suggest that prompt treatment of infant botulism with EqBA is safe and effective and that EqBA could be considered an alternative specific treatment for infant botulism when BabyBIG is not available.

What matters most? Evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states.

PubMed

Andrade, Monica Viegas; Noronha, Kenya Valeria Micaela de Souza; Maia, Ana Carolina; Kind, Paul

2013-11-01

This study analyzes how different health dimensions defined by the EQ-5D-3L instrument affect average individual preferences for health states. This analysis is an important benchmark for the incorporation of health technologies as it takes into consideration Brazilian population preferences in health resource allocation decisions. The EQ-5D instrument defines health in terms of five dimensions (mobility, daily activities, self-care activities, pain/discomfort, and anxiety/depression) each divided into three levels of severity. Data came from a valuation study with 3,362 literate individuals aged between 18 and 64 living in urban areas of Minas Gerais State, Brazil. The main results reveal that health utility decreases as the level of severity increases. With regard to health issues, mobility stands out as the most important EQ-5D dimension. Independently of severity levels of the other EQ-5D-3L dimensions, the highest decrements in utilities are associated with severe mobility problems.

Integrated Coding and Waveform Design Study.

DTIC Science & Technology

1980-08-01

values of M, CDMA offers an efficiency of around 33%. Comparing these numbers to the fixed assigned system given in Section 2.2, we note that for the...is shown in Figure 3.1. The behavior of the ad- justable weight W2 is governed by a first order differential equation which Gabriel solves as W = w...the weight behavior is governed by Eq. (3.1), with the parameters in Eq. (3.1) defined by Eqs. (3.2), (3.5), (3.11), (3.15), (3.17), (3.18), (3.19), and

SU-F-T-124: Radiation Biological Equivalent Presentations OfLEM-1 and MKM Approaches in the Carbon-Ion Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hsi, W; Jiang, G; Sheng, Y

Purpose: To study the correlations of the radiation biological equivalent doses (BED) along depth and lateral distance between LEM-1 and MKM approaches. Methods: In NIRS-MKM (Microdosimetric Kinetic Model) approach, the prescribed BED, referred as C-Eq, doses aims to present the relative biological effectiveness (RBE) for different energies of carbon-ions on a fixed 10% survival value of HCG cell with respect to convention X-ray. Instead of a fixed 10% survival, the BED doses of LEM-1 (Local Effect Model) approach, referred as X-Eq, aims to present the RBE over the whole survival curve of chordoma-like cell with alpha/beta ratio of 2.0. Themore » relationship of physical doses as a function of C-Eq and X-Eq doses were investigated along depth and lateral distance for various sizes of cubic targets in water irradiated by carbon-ions. Results: At the center of each cubic target, the trends between physical and C-Eq or X-Eq doses can be described by a linear and 2nd order polynomial functions, respectively. Using fit functions can then calculate a scaling factor between C-Eq and X-Eq doses to have similar physical doses. With equalized C-Eq and X-Eq doses at the depth of target center, over- and under-estimated X-Eq to C-Eq are seen for depths before and after the target center, respectively. Near the distal edge along depth, sharp rising of RBE value is observed for X-Eq, but sharp dropping of RBE value is observed for C-Eq. For lateral locations near and just outside 50% dose level, sharp raising of RBE value is also seen for X-Eq, while only minor increasing with fast dropping for C-Eq. Conclusion: An analytical function to model the differences between the CEq and X-Eq doses along depth and lateral distance need to further investigated to explain varied clinic outcome of specific cancers using two different approaches to calculated BED doses.« less

Determination of strong ion gap in healthy dogs.

PubMed

Fettig, Pamela K; Bailey, Dennis B; Gannon, Kristi M

2012-08-01

To determine and compare reference intervals of the strong ion gap (SIG) in a group of healthy dogs determined with 2 different equations. Prospective observational study. Tertiary referral and teaching hospital. Fifty-four healthy dogs. None. Serum biochemistry and blood gas analyses were performed for each dog. From these values, SIG was calculated using 2 different equations: SIG(1) = SID(a) {[Na (+)] + [K(+)] - [Cl(-)]+ [2 × Ca(2+)] + [2 × Mg(2+)] - [L-lactate]}- SID(e) {TCO(2) + A(-)} and SIG(2) = [albumin] × 4.9-anion gap. Reference intervals were established for each SIG equation using the mean ± 1.96 × standard deviation (SD). For SIG(1), the median was 7.13 mEq/L (range, 1.05-11.30 mEq/L) and the derived reference interval was 1.85-10.61 mEq/L. Median SIG(2) was -0.22 mEq/L (range, -5.34-6.61 mEq/L) and the mean SIG(2) was -0.09 mEq/L (95% confidence interval for the mean, -0.82-0.65 mEq/L). The derived reference interval was -5.36-5.18 mEq/L. The results of the SIG calculations were significantly different (P < 0.0001) between the 2 equations used. The 2 equations used to calculate SIG yielded significantly different results and cannot be used interchangeably. The authors believe SIG(2) to be a more accurate reflection of acid-base status in healthy dogs, and recommend that this calculation be used for future studies. © Veterinary Emergency and Critical Care Society 2012.

The use of subionospheric VLF/LF propagation for the study of lower ionospheric perturbations associated with earthquakes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayakawa, M.

It is recently recognized that the ionosphere is very sensitive to seismic effects, and the detection of ionospheric perturbations associated with earthquakes (EQs), attracts a lot of attention as a very promising candidate for short-term EQ prediction. In this review we propose a possible use of VLF/LF (very low frequency (3-30 kHz)/low frequency (30-300 kHz)) radio sounding of seismo-ionospheric perturbations. We first present the first convincing evidence on the presence of ionospheric perturbations for the disastrous Kobe EQ in 1995. The significant shift in terminator times in the VLF/LF diurnal variation, is successfully interpreted in terms of lowering of themore » lower ionosphere prior to the EQ, which is the confirmation of seismo-ionospheric perturbations. In order to avoid the overlapping with my own previous reviews [1, 2], we try to present the latest results including the statistical evidence on the correlation between the VLF/LF propagation anomalies (ionospheric perturbations) and EQs (especially with large magnitude and with shallow depth), a case study on the Indonesia Sumatra EQ (wavelike structures in the VLF/LF data), medium-distance (6{approx}8 Mm) propagation anomalies, the fluctuation spectra of subionospheric VLF/LF data (atmospheric gravity waves effect, the effect of Earth's tides etc.), and the mechanism of lithosphere - atmosphere - ionosphere coupling. Finally, we indicate the present situation of this kind of VLF/LF activities going on in different parts of the globe and we suggest the importance of international collaboration in this seismo-electromagnetics study.« less

The impacts of permafrost thaw on land-atmosphere greenhouse gas exchange

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayes, Daniel J; Kicklighter, David W.; McGuire, A. David

2014-01-01

Permafrost thaw and the subsequent mobilization of carbon stored in previously frozen soil organic matter (SOM) would be a strong positive feedback to climate1. As the northern permafrost region experiences double the rate of warming as the rest of the Earth2, the vast amount of carbon in permafrost soils3 is vulnerable to thaw, decomposition and release as atmospheric greenhouse gases (GHG). Here, we employ a process-based model simulation experiment to assess the net effect of this so-called permafrost carbon feedback (PCF) in recent decades. Results show a wide-spread increase in the depth to permafrost between 1990 and 2006, with simulatedmore » active layer thickness (ALT) capturing the mean and spatial variability of the observational data. Analysis of the simulation experiment provides an estimate of a 2.8 mm/yr increase in permafrost depth, which translates to 281 TgC/yr thawed from previously frozen SOM. Overall, we estimate a net GHG forcing of 534 MtCO2eq/yr directly tied to ALT dynamics, while accounting for CO2 (562 MtCO2eq/yr) and CH4 (52 MtCO2eq/yr) release as well as CO2 uptake by vegetation (-80 MtCO2eq/yr). This net forcing represents a significant factor in the estimated 640 MtCO2eq/yr pan-arctic GHG source4, and an additional 6.9% contribution on top of the combined 7792 MtCO2eq/yr fossil fuel emissions from the eight Arctic nations over this time period5.« less

Chemical composition of precipitation in a Mexican Maya region

NASA Astrophysics Data System (ADS)

Bravo, H. A.; Saavedra, M. I. R.; Sánchez, P. A.; Torres, R. J.; Granada, L. M. M.

The chemical characteristics of wet precipitation in Puerto Morelos, Quintana Roo State, Mexico, were measured from April 1994 to December 1995. Puerto Morelos is located in the Caribbean Mayan coastal region of the Peninsula of Yucatan, and is normally exposed to winds from the Caribbean region. Wetfall was analyzed for pH, conductivity and Cl -, NO 3-, SO 42-, Na +, NH 4+, K +, Mg 2+ and Ca 2+ ion concentrations. Volume-weighted mean pH for the whole sampling period was 5.35, although values as low as 4.6 were measured in several rain samples. Concentrations of all species correlated negatively with rain volume. Sea-salt aerosols contributed with most of the Na +, Cl -, Mg 2+, K + and SO 42- found in wet precipitation. The mean [SO 42-excess] was 9.7 μEq l -1, which agrees with the background hemispheric values of ≈10 μEq l -1 reported elsewhere. The mean [NO 3-] was 11.4 μEq l -1, almost four times higher than the background hemispheric value of ≈2.5 μEq l -1 reported elsewhere. However, a major component causing the slight acidity character of rain in Puerto Morelos seems to be H 2SO 4.

Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets.

PubMed

Bailey, Henry; Kind, Paul

2010-10-01

Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or 'similar' population. Factors other than geographic proximity can affect the relative values of EQ-5D states. This study explores the links between national culture and EQ-5D value sets. Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede's framework which operationalizes national culture in five dimensions. For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression. The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.

Theoretical Studies Relating to the Interaction of Radiation with Matter: Atomic Collision Processes Occurring in the Presence of Radiation Fields.

DTIC Science & Technology

1982-09-15

u, the assumption Iy I << I no longer holds. As a rough approximation, however, we can average the exponent in Eq. (68) over y rather than the...averaging the exponent in Eq. sions usually produce a shift as well as a broadening (68), it is easier to perform the averaging in the ex- of the profiles...in the second term in the exponent in transitions which enter (see Refs. 2 and 3). Eq. (A4) of this reference and that, in Eq. 0 8), one should

Comparison of the Multiattribute Utility Instruments EQ-5D and SF-6D in a Europe-Wide Population-Based Cohort of Patients with Inflammatory Bowel Disease 10 Years after Diagnosis.

PubMed

Huppertz-Hauss, Gert; Aas, Eline; Lie Høivik, Marte; Langholz, Ebbe; Odes, Selwyn; Småstuen, Milada; Stockbrugger, Reinhold; Hoff, Geir; Moum, Bjørn; Bernklev, Tomm

2016-01-01

Background. The treatment of chronic inflammatory bowel disease (IBD) is costly, and limited resources call for analyses of the cost effectiveness of therapeutic interventions. The present study evaluated the equivalency of the Short Form 6D (SF-6D) and the Euro QoL (EQ-5D), two preference-based HRQoL instruments that are broadly used in cost-effectiveness analyses, in an unselected IBD patient population. Methods. IBD patients from seven European countries were invited to a follow-up visit ten years after their initial diagnosis. Clinical and demographic data were assessed, and the Short Form 36 (SF-36) was employed. Utility scores were obtained by calculating the SF-6D index values from the SF-36 data for comparison with the scores obtained with the EQ-5D questionnaire. Results. The SF-6D and EQ-5D provided good sensitivities for detecting disease activity-dependent utility differences. However, the single-measure intraclass correlation coefficient was 0.58, and the Bland-Altman plot indicated numerous values beyond the limits of agreement. Conclusions. There was poor agreement between the measures retrieved from the EQ-5D and the SF-6D utility instruments. Although both instruments may provide good sensitivity for the detection of disease activity-dependent utility differences, the instruments cannot be used interchangeably. Cost-utility analyses performed with only one utility instrument must be interpreted with caution.

Comparison of the Multiattribute Utility Instruments EQ-5D and SF-6D in a Europe-Wide Population-Based Cohort of Patients with Inflammatory Bowel Disease 10 Years after Diagnosis

PubMed Central

Aas, Eline; Odes, Selwyn; Småstuen, Milada; Stockbrugger, Reinhold; Hoff, Geir; Moum, Bjørn; Bernklev, Tomm

2016-01-01

Background. The treatment of chronic inflammatory bowel disease (IBD) is costly, and limited resources call for analyses of the cost effectiveness of therapeutic interventions. The present study evaluated the equivalency of the Short Form 6D (SF-6D) and the Euro QoL (EQ-5D), two preference-based HRQoL instruments that are broadly used in cost-effectiveness analyses, in an unselected IBD patient population. Methods. IBD patients from seven European countries were invited to a follow-up visit ten years after their initial diagnosis. Clinical and demographic data were assessed, and the Short Form 36 (SF-36) was employed. Utility scores were obtained by calculating the SF-6D index values from the SF-36 data for comparison with the scores obtained with the EQ-5D questionnaire. Results. The SF-6D and EQ-5D provided good sensitivities for detecting disease activity-dependent utility differences. However, the single-measure intraclass correlation coefficient was 0.58, and the Bland-Altman plot indicated numerous values beyond the limits of agreement. Conclusions. There was poor agreement between the measures retrieved from the EQ-5D and the SF-6D utility instruments. Although both instruments may provide good sensitivity for the detection of disease activity-dependent utility differences, the instruments cannot be used interchangeably. Cost-utility analyses performed with only one utility instrument must be interpreted with caution. PMID:27630711

The Relationship Between Emotional Intelligence and Leader Performance

DTIC Science & Technology

2002-03-01

independence, and self-actualization), (2) Interpersonal EQ (comprising empathy, social responsibility, and interpersonal relationships), (3) Stress ...management EQ (comprising stress tolerance and impulse control), (4) Adaptability EQ (comprising reality testing, flexibility, and problem solving), and (5...explain the significance of the model or its particular sub- scales or categories. Thus, mixed models, and the claims associated with them have been

Experimental Work Conducted on MgO Inundated Hydration in WIPP-Relevant Brines

NASA Astrophysics Data System (ADS)

Deng, H.; Xiong, Y.; Nemer, M. B.; Johnsen, S.

2009-12-01

Magnesium oxide (MgO) is being emplaced in the Waste Isolation Pilot Plant (WIPP) as an engineered barrier to mitigate the effect of microbial CO2 generation on actinide mobility in a postclosure repository environment. MgO will sequester CO2 and consume water in brine or water vapor in the gaseous phase. Martin Marietta (MM) MgO is currently being emplaced in the WIPP. A fractional-factorial experiment has been performed to study the inundated-hydration of MM MgO as a function of its particle size, solid-to-liquid ratio, and brine type. MgO hydration experiments have been carried out with three MgO particle sizes and two solid-to-liquid ratios in three WIPP-related brines: ERDA-6, GWB and simplified GWB. ERDA-6 is a synthetic NaCl-rich brine typical of a Castile brine reservoir below the repository. GWB is a synthetic MgCl2- and NaCl-rich brine representative of intergranular brines from the Salado Formation at or near the stratigraphic horizon of the repository. Simplified GWB contains amounts of Mg, Na, and Cl similar to those in GWB without other minor constituents. The hydration products include brucite (Mg(OH)2) and phase 5 (Mg3(OH)5Cl4H2O). In addition to phase 5, MgO hydration in GWB or simplified GWB produces brucite, whereas MgO hydrated in ERDA-6 only produces brucite. The MgO particle size has had a significant effect on the formation of hydration products: small MgO particles have hydrated before the large particles. MgO has hydrated faster in simplified GWB than in the other two brines. In ERDA-6, the solid-to-liquid ratio has affected the brine pH due to the presence of CaO (~1 wt %) as an impurity in MM MgO. GWB has sufficient dissolved Mg to buffer pH despite small amounts of CaO. Both our results and thermodynamic modeling indicate that phase-5 is the stable Mg-OH-Cl phase in Mg-Na-Cl-dominated brines with ionic strengths and chemical compositions similar to that of GWB. In contrast, phase-3 (Mg2(OH)3Cl4H2O) is the stable phase in the MgCl2-saturated Q-brine, a high-ionic-strength (up to 15 m) brine from Asse, Germany. We used EQ3/6 to simulate MgO hydration and carbonation in a closed system containing brine and CO2 at atmospheric concentration by titrating periclase into the system. (EQ3/6 is a geochemical software package for speciation, solubility calculations and reaction path modeling.) EQ3/6 predicted Mg and Cl concentrations and pH similar to the experimentally observed values. EQ3/6 also predicted hydration products similar to thsoe observed experimentally. * This research is funded by WIPP programs administered by the U.S. Department of Energy. ** Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy’s National Nuclear Security Administration under contract DE-AC04-94AL85000.

Injectable Ammonium Chloride Used Enterally for the Treatment of Persistent Metabolic Alkalosis in Three Pediatric Patients

PubMed Central

Mathew, Jennie T.; Bio, Laura L.

2012-01-01

Enteral administration of injectable ammonium chloride may offer an effective method for the treatment of persistent metabolic alkalosis, without the adverse effects associated with the intravenous route. This case series describes 3 pediatric patients who received ammonium chloride enterally for the treatment of persistent metabolic alkalosis. The patients were a 2-month-old female infant, a 6-week-old male infant, and a 3-year-old male toddler. Four to 18 doses of ammonium chloride were administered enterally (range, 3-144 mEq/dose). Two of the 3 patients achieved resolution of metabolic alkalosis with ammonium chloride, while 1 patient's condition was refractory to treatment. Resolution of metabolic alkalosis occurred at 4 and 8 days, which required a total weight-based dose of 10.7 mEq/kg and 18 mEq/kg, respectively. No adverse effects were recorded. The use of ammonium chloride injection administered enterally was a safe and effective option in 2 of the 3 pediatric patients with persistent metabolic alkalosis. PMID:23118664

Incidence of Hyponatremia with High-Dose Trimethoprim-Sulfamethoxazole Exposure.

PubMed

Tsapepas, Demetra; Chiles, Mariana; Babayev, Revekka; Rao, Maya K; Jaitly, Manasvi; Salerno, David; Mohan, Sumit

2016-12-01

Trimethoprim-sulfamethoxazole (TMP-SMX) is a commonly prescribed antibiotic used at high doses for treatment of pneumocystis pneumonia and other infections. Trimethoprim is structurally related to the potassium-sparing diuretic amiloride and has been associated with hyperkalemia and hyponatremia through blocking of epithelial sodium channels in the distal nephron. The incidence of hyponatremia in hospitalized patients treated with high-dose TMP-SMX is unknown. We performed a single-center retrospective chart review of all hospitalized patients who received high-dose TMP-SMX (n = 235) from January 2012 to July 2014. Patients with congestive heart failure, cirrhosis, estimated glomerular filtration rate <30 mL/min/1.73 m 2 , baseline hyponatremia, and those on other medications associated with hyponatremia were excluded. Hyponatremia was defined as a serum sodium level <136 mEq/L. Analysis was restricted to 76 unique patients who received more than 8 mg/kg/d of TMP for ≥3 days. Mean starting serum sodium at time of TMP-SMX initiation was 138.4 ± 2.1 mEq/L. Fifty-five patients (72.3%) developed hyponatremia while on therapy, of which 43.6% (n = 24) were cases of serum sodium <130 mEq/L. Mean sodium at the time of nadir was 131.6 ± 5.1 mEq/L. Hyponatremia was noted, on average, 5.5 days after initiation of therapy, with more severe hyponatremia development among African American patients. Urine sodium concentrations were available for 40.0% (22/55) of incident hyponatremia cases, with mean urinary sodium of 104.8 ± 55.9 mEq/L. Hyponatremia often resolved within 3 weeks of drug discontinuation. There is a high incidence (72.3%) of hyponatremia associated with the use of high-dose TMP-SMX among hospitalized patients. This is an overlooked and potentially reversible cause of hyponatremia. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Stormwater and Snowmelt Runoff on ELISA-EQ Concentrations of PCDD/PCDF and Triclosan in an Urban River

PubMed Central

Urbaniak, Magdalena; Tygielska, Adrianna; Krauze, Kinga; Mankiewicz-Boczek, Joanna

2016-01-01

The aim of the study was to determine the effects of stormwater and snowmelt runoff on the ELISA EQ PCDD/PCDF and triclosan concentrations in the small urban Sokołówka River (Central Poland). The obtained results demonstrate the decisive influence of hydrological conditions occurring in the river itself and its catchment on the quoted PCDD/PCDF ELISA EQ concentrations. The lowest PCDD/PCDF values of 87, 60 and 67 ng EQ L-1 in stormwater, the river and its reservoirs, respectively, were associated with the highest river flow of 0.02 m3 s-1 and high precipitation (11.2 mm) occurred five days before sampling. In turn, the highest values of 353, 567 and 343 ng EQ L-1 in stormwater, the river and its reservoirs, respectively, were observed during periods of intensive snow melting (stormwater samples) and spring rainfall preceded by a rainless phase (river and reservoir samples) followed by low and moderate river flows of 0.01 and 0.005 m3 s-1. An analogous situation was observed for triclosan, with higher ELISA EQ concentrations (444 to 499 ng EQ L-1) noted during moderate river flow and precipitation, and the lowest (232 to 288 ng EQ L-1) observed during high river flow and high precipitation preceded by violent storms. Stormwater was also found to influence PCDD/PCDF EQ concentrations of the river and reservoirs, however only during high and moderate flow, and no such effect was observed for triclosan. The study clearly demonstrates that to mitigate the high peaks of the studied pollutants associated with river hydrology, the increased in-site stormwater infiltration and purification, the development of buffering zones along river course and the systematic maintenance of reservoirs to avoid the accumulation of the studied micropollutants and their subsequent release after heavy rainfall are required. PMID:26985830

Effects of Stormwater and Snowmelt Runoff on ELISA-EQ Concentrations of PCDD/PCDF and Triclosan in an Urban River.

PubMed

Urbaniak, Magdalena; Tygielska, Adrianna; Krauze, Kinga; Mankiewicz-Boczek, Joanna

2016-01-01

The aim of the study was to determine the effects of stormwater and snowmelt runoff on the ELISA EQ PCDD/PCDF and triclosan concentrations in the small urban Sokołówka River (Central Poland). The obtained results demonstrate the decisive influence of hydrological conditions occurring in the river itself and its catchment on the quoted PCDD/PCDF ELISA EQ concentrations. The lowest PCDD/PCDF values of 87, 60 and 67 ng EQ L-1 in stormwater, the river and its reservoirs, respectively, were associated with the highest river flow of 0.02 m3 s-1 and high precipitation (11.2 mm) occurred five days before sampling. In turn, the highest values of 353, 567 and 343 ng EQ L-1 in stormwater, the river and its reservoirs, respectively, were observed during periods of intensive snow melting (stormwater samples) and spring rainfall preceded by a rainless phase (river and reservoir samples) followed by low and moderate river flows of 0.01 and 0.005 m3 s-1. An analogous situation was observed for triclosan, with higher ELISA EQ concentrations (444 to 499 ng EQ L-1) noted during moderate river flow and precipitation, and the lowest (232 to 288 ng EQ L-1) observed during high river flow and high precipitation preceded by violent storms. Stormwater was also found to influence PCDD/PCDF EQ concentrations of the river and reservoirs, however only during high and moderate flow, and no such effect was observed for triclosan. The study clearly demonstrates that to mitigate the high peaks of the studied pollutants associated with river hydrology, the increased in-site stormwater infiltration and purification, the development of buffering zones along river course and the systematic maintenance of reservoirs to avoid the accumulation of the studied micropollutants and their subsequent release after heavy rainfall are required.

The Aerothermodynamics of Aircraft Gas Turbine Engines

DTIC Science & Technology

1978-07-01

engine will deteriorate. 1.6.2 Experimental Testing It is easy to fall int9 the organiza- tional trap of four isolated groups . One group does the... Quasi -Dne-Dimensional Fluid Flows The First Law for a F1mdng System-- The Control Volume • . • The Channel Flow Equations Stagnation Properties...exit to control volume (Eq • 2. 14 . 2) CHAPTER TWO THERMODYNAMICS AND QUASI -ONE-DUlENSIONAL FLUID FLO’’{S 2.0 INTRODUCTION This chapter "ill be

Anomalous geomagnetic variations associated with Parkfield (Ms=6.0, 28-SEP-2004, California, USA) earthquake

NASA Astrophysics Data System (ADS)

Kotsarenko, A. A.; Pilinets, S. A.; Perez Enriquez, R.; Lopez Cruz Abeyro, J. A.

2007-05-01

Analysis of geomagnetic and telluric data, measured at the station PRK (Parkfield, ULF flux-gate 3-axial magnetometer) 1 week before (including) the day of the major EQ (EarthQuake, Ms=6.0, 28-SEP-2004, 17:15:24) near Parkfield, California, USA, are presented. Spectral analysis reveal the ULF geomagnetic disturbances observed the day before the event, Sep 27, at 15:00- 20:00 by UT, and at the day of the EQ, Sep 28, at 11:00-19:00. Filtering in the corresponding frequency band f = 0.25-0.5 Hz gives the following estimations of the amplitudes of the signals: up to 20 pT for the magnetic channels and 1.5 mkV/km for the telluric ones. Observed phenomena occurs under quiet geomagnetic conditions (|Dst|<20 nT); revision of the referent stations data situated far away from the EQ epicenter (330 km) does not reveal any similar effect. Moreover, the Quake Finder research group (http:www.quakefinder.com) received very similar results (ELF range instrument, placed about 50 km from the EQ epicenter) for the day of the EQ. Mentioned above suggests the localized character of the source, possibly of the ionosphere or tectonic origin rather than of magnetosphere. Comparative analysis of the mentioned 2 stations show that we observed the lower-frequency part of the ULF- ELF burst, localized in the frequency range 0.25-1 Hz, generated 9 hours before the earthquake. Acknowledgements. The authors are grateful to Malcolm Johnston for providing us with the geomagnetic data.

The effect of cation source and dietary cation-anion difference on rumen ion concentrations in lactating dairy cows.

PubMed

Catterton, T L; Erdman, R A

2016-08-01

Many studies have focused on the influence of dietary cation-anion difference (DCAD) on animal performance but few have examined the effect of DCAD on the rumen ionic environment. The objective of this study was to examine the effects of DCAD, cation source (Na vs. K), and anion source (Cl vs. bicarbonate or carbonate) on rumen environment and fermentation. The study used 5 rumen-fistulated dairy cows and 5 dietary treatments that were applied using a 5×5 Latin square design with 2-wk experimental periods. Treatments consisted of (1) the basal total mixed ration (TMR); (2) the basal TMR plus 340mEq/kg of Na (dry matter basis) using NaCl; (3) the basal TMR plus 340mEq/kg of K using KCl; (4) the basal TMR plus 340mEq/kg of Na using NaHCO3; and (5) the basal TMR plus 340mEq/kg of K using K2CO3. On the last day of each experimental period, rumen samples were collected and pooled from 5 different locations at 0, 1.5, 3, 4.5, 6, 9, and 12h postfeeding for measurement of rumen pH and concentrations of strong ions and volatile fatty acids (VFA). Dietary supplementation of individual strong ions increased the corresponding rumen ion concentration. Rumen Na was decreased by 24mEq/L when K was substituted for Na in the diet, but added dietary Na had no effect on rumen K. Rumen Cl was increased by 10mEq/L in diets supplemented with Cl. Cation source had no effect on rumen pH or total VFA concentration. Increased DCAD increased rumen pH by 0.10 pH units and increased rumen acetate by 4mEq/L but did not increase total VFA. This study demonstrated that rumen ion concentrations can be manipulated by dietary ion concentrations. If production and feed efficiency responses to DCAD and ionophores in the diet are affected by rumen Na and K concentrations, then manipulating dietary Na and K could be used either to enhance or diminish those responses. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Evaluation of the Pharmacodynamic Effects of the Potassium Binder RDX7675 in Mice.

PubMed

Davidson, James P; King, Andrew J; Kumaraswamy, Padmapriya; Caldwell, Jeremy S; Korner, Paul; Blanks, Robert C; Jacobs, Jeffrey W

2018-05-01

Hyperkalemia is a common complication in patients with heart failure or chronic kidney disease, particularly those who are taking inhibitors of the renin-angiotensin-aldosterone system. RDX7675, the calcium salt of a reengineered polystyrene sulfonate-based resin, is a potassium binder that is being investigated as a novel treatment for hyperkalemia. This study evaluated the pharmacodynamic effects of RDX7675 in mice, compared to 2 current treatments, sodium polystyrene sulfonate (SPS) and patiromer. Seven groups of 8 male CD-1 mice were given either standard chow (controls) or standard chow containing 4.0% or 6.6% active moiety of RDX7675, patiromer, or SPS for 72 hours. Stool and urine were collected over the final 24 hours of treatment for ion excretion analyses. RDX7675 increased stool potassium (mean 24-hour excretion: 4.0%, 9.19 mg; 6.6%, 18.11 mg; both P < .0001) compared with controls (4.47 mg) and decreased urinary potassium (mean 24-hour excretion: 4.0%, 12.05 mg, P < .001; 6.6%, 6.68 mg, P < .0001; vs controls, 20.38 mg). The potassium-binding capacity of RDX7675 (stool potassium/gram of resin: 4.0%, 1.14 mEq/g; 6.6%, 1.32 mEq/g) was greater (all P < .0001) than for patiromer (4.0%, 0.63 mEq/g; 6.6%, 0.48 mEq/g) or SPS (4.0%, 0.73 mEq/g; 6.6% 0.55 mEq/g). RDX7675 and patiromer decreased urinary sodium (mean 24-hour excretion: 0.07-1.38 mg; all P < .001) compared to controls (5.01 mg). In contrast, SPS increased urinary sodium excretion (4.0%, 13.31 mg; 6.6%, 17.60 mg; both P < .0001) compared to controls. RDX7675 reduced intestinal potassium absorption and had a greater potassium-binding capacity than patiromer or SPS in mice. The calcium-based resins RDX7675 and patiromer reduced intestinal sodium absorption, unlike sodium-based SPS. These results support further studies in humans to confirm the potential of RDX7675 for the treatment of patients with hyperkalemia.

Colloidal Dynamics Simulations of Rheology and Stability of Concentrated Fuel Slurries.

DTIC Science & Technology

1987-04-10

Weals potential as the adsorbed polymer concentration and Hamaker con- stant are changed. These calculations provide quantitative evidence for the...derived by Hamaker : 3 6 U (r) A d 2 2 +2Ln( 2- d2(3 A T2 2 2 2 2 A value of 5.0 x 10" 2 0 j was used for the Hamaker constant, A. A plot of Eq. (31) is...parameter controlling the strength of the repulsive steric potential. The Hamaker constant A (Eq. (33)) is the nat- ural choice for the attractive

DOE Office of Scientific and Technical Information (OSTI.GOV)

Suzuki, Minoru; Sakurai, Yoshinori; Masunaga, Shinichiro

Purpose: To investigate the feasibility of boron neutron capture therapy (BNCT) for malignant pleural mesothelioma (MPM) from a viewpoint of dose distribution analysis using Simulation Environment for Radiotherapy Applications (SERA), a currently available BNCT treatment planning system. Methods and Materials: The BNCT treatment plans were constructed for 3 patients with MPM using the SERA system, with 2 opposed anterior-posterior beams. The {sup 1}B concentrations in the tumor and normal lung in this study were assumed to be 84 and 24 ppm, respectively, and were derived from data observed in clinical trials. The maximum, mean, and minimum doses to the tumorsmore » and the normal lung were assessed for each plan. The doses delivered to 5% and 95% of the tumor volume, D{sub 05} and D{sub 95}, were adopted as the representative dose for the maximum and minimum dose, respectively. Results: When the D{sub 05} to the normal ipsilateral lung was 5 Gy-Eq, the D{sub 95} and mean doses delivered to the normal lung were 2.2-3.6 and 3.5-4.2 Gy-Eq, respectively. The mean doses delivered to the tumors were 22.4-27.2 Gy-Eq. The D{sub 05} and D{sub 95} doses to the tumors were 9.6-15.0 and 31.5-39.5 Gy-Eq, respectively. Conclusions: From a viewpoint of the dose-distribution analysis, BNCT has the possibility to be a promising treatment for MPM patients who are inoperable because of age and other medical illnesses.« less

A Multiple-Scales Partial Solution of the Pulse-Forced Rayleigh-Plesset Equation of Cavitation Bubble Dynamics

DTIC Science & Technology

1988-02-01

d 3 ’iN3131iJ303 HiJnSSjHd QBOV^AV fcmwt^flomsx^^ <lNWWlWW\\’WWlWVNWiy»UVVTiniinilf^»1lll>Wf%|rrw<rv*rviiV"jw- j »-,w\\iW¥ *« ■ \\ iLn mit...0) T3 U 0 -0 0) CQ 0) £ u 9 <U « Ä f-t * J 4J 0 0 (0 .H U-t H PL, 0 • cn 0J l-l 3 00 d D ’iN3101dJ3O3 HanSSBHd QBOVHJAV...34dTdT • (2.3) where dS D J „ dx 57" 2 or ds" r ’ (2.4) from Eq. (2.1). By substitution of Eq. (2.2) and Eq. (2.4) into Eq. (2.3)

The impact of high serum bicarbonate levels on mortality in hemodialysis patients.

PubMed

Chang, Kyung Yoon; Kim, Hyung Wook; Kim, Woo Jeong; Kim, Yong Kyun; Kim, Su-Hyun; Song, Ho Chul; Kim, Young Ok; Jin, Dong Chan; Choi, Euy Jin; Yang, Chul Woo; Kim, Yong-Lim; Kim, Nam-Ho; Kang, Shin-Wook; Kim, Yon-Su; Kim, Young Soo

2017-01-01

The optimal serum bicarbonate level is controversial for patients who are undergoing hemodialysis (HD). In this study, we analyzed the impact of serum bicarbonate levels on mortality among HD patients. Prevalent HD patients were selected from the Clinical Research Center registry for End Stage Renal Disease cohort in Korea. Patients were categorized into quartiles according to their total carbon dioxide (tCO 2 ) levels: quartile 1, a tCO 2 of < 19.4 mEq/L; quartile 2, a tCO 2 of 19.4 to 21.5 mEq/L; quartile 3, a tCO 2 of 21.6 to 23.9 mEq/L; and quartile 4, a tCO 2 of ≥ 24 mEq/L. Cox regression analysis was used to calculate the adjusted hazard ratio (HR) and confidence interval (CI) for mortality. We included 1,159 prevalent HD patients, with a median follow-up period of 37 months. Kaplan-Meier analysis revealed that the all-cause mortality was significantly higher in patients from quartile 4, compared to those from the other quartiles ( p = 0.009, log-rank test). The multivariate Cox proportional hazard model revealed that patients from quartile 4 had significantly higher risk of mortality than those from quartile 1, 2 and 3, after adjusting for the clinical variables in model 1 (HR, 1.99; 95% CI, 1.15 to 3.45; p = 0.01) and model 2 (HR, 1.82; 95% CI, 1.03 to 3.22; p = 0.04). Our data indicate that high serum bicarbonate levels (a tCO2 of ≥ 24 mEq/L) were associated with increased mortality among prevalent HD patients. Further effort might be necessary in finding the cause and correcting metabolic alkalosis in the chronic HD patients with high serum bicarbonate levels.

Derivation of Pitzer Interaction Parameters for an Aqueous Species Pair of Sodium and Iron(II)-Citrate Complex

NASA Astrophysics Data System (ADS)

Jang, J. H.; Nemer, M.

2015-12-01

The U.S. DOE Waste Isolation Pilot Plant (WIPP) is a deep underground repository for the permanent disposal of transuranic (TRU) radioactive waste. The WIPP is located in the Permian Delaware Basin near Carlsbad, New Mexico, U.S.A. The TRU waste includes, but is not limited to, iron-based alloys and the complexing agent, citric acid. Iron is also present from the steel used in the waste containers. The objective of this analysis is to derive the Pitzer activity coefficients for the pair of Na+ and FeCit- complex to expand current WIPP thermodynamic database. An aqueous model for the dissolution of Fe(OH)2(s) in a Na3Cit solution was fitted to the experimentally measured solubility data. The aqueous model consists of several chemical reactions and related Pitzer interaction parameters. Specifically, Pitzer interaction parameters for the Na+ and FeCit- pair (β(0), β(1), and Cφ) plus the stability constant for species of FeCit- were fitted to the experimental data. Anoxic gloveboxes were used to keep the oxygen level low (<1 ppm) throughout the experiments due to redox sensitivity. EQ3NR, a computer program for geochemical aqueous speciation-solubility calculations, packaged in EQ3/6 v.8.0a, calculates the aqueous speciation and saturation index using an aqueous model addressed in EQ3/6's database. The saturation index indicates how far the system is from equilibrium with respect to the solid of interest. Thus, the smaller the sum of squared saturation indices that the aqueous model calculates for the given number of experiments, the more closely the model attributes equilibrium to each individual experiment with respect to the solid of interest. The calculation of aqueous speciation and saturation indices was repeated by adjusting stability constant of FeCit-, β(0), β(1), and Cφ in the database until the values are found that make the sum of squared saturation indices the smallest for the given number of experiments. Results will be presented at the time of conference.

Comparing Generic and Condition-Specific Preference-Based Measures in Epilepsy: EQ-5D-3L and NEWQOL-6D.

PubMed

Mulhern, Brendan; Pink, Joshua; Rowen, Donna; Borghs, Simon; Butt, Thomas; Hughes, Dyfrig; Marson, Antony; Brazier, John

2017-04-01

There is debate about the psychometric characteristics of the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L) for use in epilepsy. In response to the concerns, an epilepsy-specific preference-based measure (NEWQOL-6D) was developed. The psychometric characteristics of the NEWQOL-6D, however, have not been assessed. To investigate the validity and responsiveness of the EQ-5D-3L and the Quality of Life in Newly Diagnosed Epilepsy Instrument-six dimensions (NEWQOL-6D) for use in the assessment of treatments for newly diagnosed focal epilepsy. The analysis used data from the Standard And New Antiepileptic Drugs trial including patients with focal epilepsy. We assessed convergent validity using correlations, and known-group validity across different epilepsy and general health severity indicators using analysis of variance and effect sizes. The responsiveness of the measures to change over time was assessed using standardized response means. We also assessed agreement between the measures. There was some level of convergence and agreement between the measures in terms of utility score but divergence in the concepts measured by the descriptive systems. Both instruments displayed known-group validity, with significant differences between severity groups, and generally slightly larger effect sizes for the NEWQOL-6D across the epilepsy-specific indicators. Evidence for responsiveness was less clear, with small to moderate standardized response means demonstrating different levels of change across different indicators. There was an overall tendency for the NEWQOL-6D to better reflect differences across groups, but this does not translate into large absolute utility differences. Both the EQ-5D-3L and the NEWQOL-6D show some evidence of validity for providing utility values for economic evaluations in newly diagnosed focal epilepsy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A comparative study on carbon footprint of rice production between household and aggregated farms from Jiangxi, China.

PubMed

Yan, Ming; Luo, Ting; Bian, Rongjun; Cheng, Kun; Pan, Genxing; Rees, Robert

2015-06-01

Quantifying the carbon footprint (CF) for crop production can help identify key options to mitigate greenhouse gas (GHG) emissions in agriculture. In the present study, both household and aggregated farm scales were surveyed to obtain the data of rice production and farming management practices in a typical rice cultivation area of Northern Jiangxi, China. The CFs of the different rice systems including early rice, late rice, and single rice under household and aggregated farm scale were calculated. In general, early rice had the lower CF in terms of land use and grain production being 4.54 ± 0.44 t CO2-eq./ha and 0.62 ± 0.1 t CO2-eq./t grain than single rice (6.84 ± 0.79 t CO2-eq./ha and 0.80 ± 0.13 t CO2-eq./t grain) and late rice (8.72 ± 0.54 t CO2-eq./ha and 1.1 ± 0.17 t CO2-eq./t grain). The emissions from nitrogen fertilizer use accounted for 33 % of the total CF on average and the direct CH4 emissions for 57 %. The results indicated that the CF of double rice cropping under aggregated farm being 0.86 ± 0.11 t CO2-eq./t grain was lower by 25 % than that being 1.14 ± 0.25 t CO2-eq./t grain under household farm, mainly due to high nitrogen use efficiency and low methane emissions. Therefore, developing the aggregated farm scale with efficient use of agro-chemicals and farming operation for greater profitability could offer a strategy for reducing GHG emissions in China's agriculture.

The use of nicotinic acid to induce sustained low plasma nonesterified fatty acids in feed-restricted Holstein cows.

PubMed

Pires, J A A; Grummer, R R

2007-08-01

The objectives were to determine the effects of nicotinic acid (NA) on blood metabolites (experiment 1) and whether successive doses of NA could induce sustained reductions of plasma nonesterified fatty acids (NEFA; experiment 2) in feed-restricted, nonlactating Holstein cows. Experiment 1 was a single 4 x 4 Latin square with 1-wk periods. Each period consisted of 2.5 d of feed restriction to increase plasma NEFA and 4.5 d of ad libitum feeding. Treatments were abomasal administration of 0, 6, 30, or 60 mg of NA/kg of body weight (BW), given as a single bolus 48 h after initiation of feed restriction. Plasma NEFA concentration decreased from 546 microEq/L to 208 +/- 141 microEq/L at 1 h after the infusion of 6 mg of NA/kg of BW, and to less than 100 +/- 148 microEq/L at 3 h after the abomasal infusion of the 2 highest doses of NA. A rebound occurred after the initial decrease of plasma NEFA concentration. The rebound lasted up to 9 h for the 30-mg dose of NA, and up to 6 h for the 6-mg dose. Experiment 2 was a randomized complete block design with 3 treatments and 6 cows. Starting at 48 h of feed restriction, cows received 9 hourly abomasal infusions of 0, 6, or 10 mg of NA/kg of BW. Plasma NEFA concentrations decreased from 553 microEq/L +/- 24 immediately before the initiation of treatments to <100 microEq/L during hourly infusions of 6 or 10 mg of NA/kg. Data suggest that the maximal antilipolytic response was achieved with the lowest dose of NA. A rebound of NEFA started 2 to 3 h after NA infusions were terminated. In both experiments, the NEFA rebound period coincided with increases in insulin and no change or increased glucose concentrations, suggesting a state of insulin resistance induced by elevated NEFA. This model for reducing plasma NEFA concentration by abomasal infusions of NA can be used to study the metabolic ramifications of elevated vs. reduced NEFA concentrations. The data demonstrate potential benefits and pitfalls of using NA to regulate plasma NEFA and prevent lipid-related metabolic disorders.

Theoretical Efficiency of 3rd Generation Solar Cells: Comparison between Carrier Multiplication and Down-Conversion

DTIC Science & Technology

2012-01-01

rewrite this equation using a generalization of Eq. (6), for a given multiplicity mrM : ym Z 1 mEg E2dE eE=kTS1 Z 1 Eg E2dE eE=kTS1 ð13Þ Note that...vectorized quadrature algorithms . We used the quadgk function in Matlab to evaluate all function, since it is best at handling the pole at EqV¼0 in the

The Features of Condensate Water and Its Guide on Gas Proudction in upper Triassic Gas Reservoir of Western Sichuan Depression, China

NASA Astrophysics Data System (ADS)

Shang, C.; Lou, Z.

2012-12-01

In upper Triassic Xujiahe Formation of western Sichuan depression, China, there developed ultrathight sandstones reservoirs, of which the mean porosity is 4.02% and the permeability mode is less than 0.1×10-3μm2. Because of the ultrathight sandstones, thick gaseous- liquid phase transition develops in the upper Trassic Xujiahe Formation. The absolute quantity of gaseous water is lager. Due to the change of temperature and pressure at the wellhead, the gaseous water in gas reservoir becomes condensate water. Therefore, the condensate water of low salinity can be widely found at the original productive process in the Xujiahe Formation reservoir, such as wells named Lian 150, Xin 851, Xin 853, Xin 856, Dayi 101, Dayi 103. The main cations are K++Na+, while the anions are HCO3- and Cl-. The main water type is CaCl2, followed by NaHCO3, Na2SO4 and MgCl2. The PH of condensate water is 5.28-8.20 with mean value 6.40. The salinity of condensate water is lower than that of formation water. The milligram equivalent (mEq) percent of ion is used to study the features of condensate water. The anions (mEq) distribution of condensate water are scattered in ternary diagram, while that of formation water concentrate upon the SO42- and Cl- endpoints. The percent of HCO3-(mEq) in condensate water is higher than that of formation water. There is no obvious difference of cations mEq percent between condensate water and formation water, which indicates that condensate water strongly affected by formation water. Through this study, condensate water may originate from formation water and then be affected by complicated physical and chemical interactions. The condensate water is affected by gas and formation water. The relationship between condensate water and gas yield is very close. The variations of water yield, salinity and ions composition can reflect the change of gas yield. Taking well Xin 856 for example, which is located in Xinchang gas felid, there exist a relationship between the condensate water yield and the gas yield. The sequence of high- medial -low gas yield is in consistent with the variation of condensate water - mixture water- formation water, in well Xin 856. In addition, water-gas ratio increases gradually from 0.049 m3/104m3 to 258.54 m3/104m3, in the whole process. Based on water yield of well Xin 856, the transition from condensate water to formation water can be indicated by the increase of salinity and the decrease of mEq percent of HCO3-. The percent of ions (mEq) of condensate water and formation water in Xujiahe formation gas reservoir of western Sichuan depression. a the percent of cations (mEq); b the percent of anions (mEq)

A Live Attenuated Equine H3N8 Influenza Vaccine Is Highly Immunogenic and Efficacious in Mice and Ferrets

PubMed Central

Baz, Mariana; Paskel, Myeisha; Matsuoka, Yumiko; Zengel, James; Cheng, Xing; Treanor, John J.; Jin, Hong

2014-01-01

ABSTRACT Equine influenza viruses (EIV) are responsible for rapidly spreading outbreaks of respiratory disease in horses. Although natural infections of humans with EIV have not been reported, experimental inoculation of humans with these viruses can lead to a productive infection and elicit a neutralizing antibody response. Moreover, EIV have crossed the species barrier to infect dogs, pigs, and camels and therefore may also pose a threat to humans. Based on serologic cross-reactivity of H3N8 EIV from different lineages and sublineages, A/equine/Georgia/1/1981 (eq/GA/81) was selected to produce a live attenuated candidate vaccine by reverse genetics with the hemagglutinin and neuraminidase genes of the eq/GA/81 wild-type (wt) virus and the six internal protein genes of the cold-adapted (ca) A/Ann Arbor/6/60 (H2N2) vaccine donor virus, which is the backbone of the licensed seasonal live attenuated influenza vaccine. In both mice and ferrets, intranasal administration of a single dose of the eq/GA/81 ca vaccine virus induced neutralizing antibodies and conferred complete protection from homologous wt virus challenge in the upper respiratory tract. One dose of the eq/GA/81 ca vaccine also induced neutralizing antibodies and conferred complete protection in mice and nearly complete protection in ferrets upon heterologous challenge with the H3N8 (eq/Newmarket/03) wt virus. These data support further evaluation of the eq/GA/81 ca vaccine in humans for use in the event of transmission of an equine H3N8 influenza virus to humans. IMPORTANCE Equine influenza viruses have crossed the species barrier to infect other mammals such as dogs, pigs, and camels and therefore may also pose a threat to humans. We believe that it is important to develop vaccines against equine influenza viruses in the event that an EIV evolves, adapts, and spreads in humans, causing disease. We generated a live attenuated H3N8 vaccine candidate and demonstrated that the vaccine was immunogenic and protected mice and ferrets against homologous and heterologous EIV. PMID:25410860

Systematic Review and Meta-Analysis of Patiromer and Sodium Zirconium Cyclosilicate: A New Armamentarium for the Treatment of Hyperkalemia.

PubMed

Meaney, Calvin J; Beccari, Mario V; Yang, Yang; Zhao, Jiwei

2017-04-01

To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia. A systematic review and meta-analysis of phase II and III clinical trial data was completed. Eight studies (two phase II and four phase III trials with two subgroup analyses) were included in the qualitative analysis, and six studies (two phase II and four phase III trials) were included in the meta-analysis. Significant heterogeneity was found in the meta-analysis with an I 2 value ranging from 80.6-99.6%. A random-effects meta-analysis was applied for all end points. Each clinical trial stratified results by hyperkalemia severity and dosing; therefore, these were considered separate treatment groups in the meta-analysis. For patiromer, a significant -0.70 mEq/L (95% confidence interval [CI] -0.48 to -0.91 mEq/L) change was noted in potassium at 4 weeks. At day 3 of patiromer treatment, potassium change was -0.36 mEq/L (range of standard deviation 0.07-0.30). The primary end point for ZS-9-change in potassium at 48 hours-was -0.67 mEq/L (95% CI -0.45 to -0.89 mEq/L). By 1 hour after ZS-9 administration, change in potassium was -0.17 mEq/L (95% CI -0.05 to -0.30). Analysis of pooled adverse effects from these trials indicates that patiromer was associated with more gastrointestinal upset (7.6% constipation, 4.5% diarrhea) and electrolyte depletion (7.1% hypomagnesemia), whereas ZS-9 was associated with the adverse effects of urinary tract infections (1.1%) and edema (0.9%). Patiromer and ZS-9 represent significant pharmacologic advancements in the treatment of hyperkalemia. Both agents exhibited statistically and clinically significant reductions in potassium for the primary end point of this meta-analysis. Given the adverse effect profile and the observed time-dependent effects, ZS-9 may play more of a role in treating acute hyperkalemia. © 2017 Pharmacotherapy Publications, Inc.

Systematic Review and Meta-Analysis of Patiromer and Sodium Zirconium Cyclosilicate: A New Armamentarium for the Treatment of Hyperkalemia

PubMed Central

Meaney, Calvin J.; Beccari, Mario V.; Yang, Yang; Zhao, Jiwei

2017-01-01

Objective To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia. Design A systematic review and meta-analysis of phase II and III clinical trial data was completed. Patients or Participants Eight studies (2 phase II and 4 phase III trials with 2 subgroup analyses) were included in the qualitative analysis whereas six studies (2 phase II and 4 phase III trials) were included in the meta-analysis. Measurements and Results There was significant heterogeneity in the meta-analysis with an I2 value ranging from 80.6–99.6%. A random-effects meta-analysis was applied for all endpoints. Each clinical trial stratified results by hyperkalemia severity and dosing; therefore, these were considered separate treatment groups in the meta-analysis. For patiromer, there was a significant −0.70mEq/L (95% confidence interval [CI] −0.48 to −0.91mEq/L) change in potassium at 4 weeks. At day 3 of patiromer treatment, potassium change was −0.36mEq/L (range of standard deviation: 0.07 to 0.30). The primary endpoint for ZS-9-- change in potassium at 48 hours-- was −0.67mEq/L (95% CI −0.45 to −0.89mEq/L). By 1 hour after ZS-9 administration, change in potassium was −0.17mEq/L (95% CI −0.05 to −0.30). Analysis of pooled adverse effects from these trials indicates that patiromer was associated with more gastrointestinal upset (7.6% constipation, 4.5% diarrhea) and electrolyte depletion (7.1% hypomagnesemia), whereas ZS-9 was associated with adverse effects of urinary tract infections (1.1%) and edema (0.9%). Conclusion Patiromer and ZS-9 represent significant pharmacologic advancements in the treatment of hyperkalemia. Both agents exhibited statistically and clinically significant reductions in potassium for the primary endpoint of this meta-analysis. Given the adverse effect profile and the observed time dependent effects, ZS-9 may play more of a role in treating acute hyperkalemia. PMID:28122118

Emotional intelligence and the relationship to resident performance: a multi-institutional study.

PubMed

Talarico, Joseph F; Varon, Albert J; Banks, Shawn E; Berger, Jeffrey S; Pivalizza, Evan G; Medina-Rivera, Glorimar; Rimal, Jyotsna; Davidson, Melissa; Dai, Feng; Qin, Li; Ball, Ryan D; Loudd, Cheryl; Schoenberg, Catherine; Wetmore, Amy L; Metro, David G

2013-05-01

To test the hypothesis that emotional intelligence, as measured by a BarOn Emotional Quotient Inventory (EQ-i), the 125-item version personal inventory (EQ-i:125), correlates with resident performance. Survey (personal inventory) instrument. Five U.S. academic anesthesiology residency programs. Postgraduate year (PGY) 2, 3, and 4 residents enrolled in university-based anesthesiology residency programs. Residents confidentially completed the BarOn EQ-i:125 personal inventory. The deidentified resident evaluations were sent to the principal investigator of a separate data collection study for data analysis. Data collected from the inventory were correlated with daily evaluations of the residents by residency program faculty. Results of the individual BarOn EQ-i:125 and daily faculty evaluations of the residents were compiled and analyzed. Univariate correlation analysis and multivariate canonical analysis showed that some aspects of the BarOn EQ-i:125 were significantly correlated with, and likely to be predictors of, resident performance. Emotional intelligence, as measured by the BarOn EQ-i personal inventory, has considerable promise as an independent indicator of performance as an anesthesiology resident. Copyright © 2013 Elsevier Inc. All rights reserved.

Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial.

PubMed

Sandberg, Magnus; Jakobsson, Ulf; Midlöv, Patrik; Kristensson, Jimmie

2015-12-01

To evaluate the effects of a case management intervention for frail older people (aged 65+ years) by cost and utility. One hundred and fifty-three frail older people living at home were randomly assigned to either an intervention (n = 80) or a control group (n = 73). The 1-year intervention was carried out by nurses and physiotherapists working as case managers, who undertook home visits at least once a month. Differences in costs and quality-adjusted life years (QALYs) based on the health-related quality-of-life instruments EQ-5D and EQ-VAS, and also the incremental cost-effectiveness ratio were investigated. All analyses used the intention-to-treat principle. There were no significant differences between the intervention group and control group for total cost, EQ-5D-based QALY or EQ-VAS-based QALY for the 1-year study. Incremental cost-effectiveness ratio was not conducted because no significant differences were found for either EQ-5D- or EQ-VAS-based QALY, or costs. However, the intervention group had significantly lower levels of informal care and help with instrumental activities of daily living both as costs (3,927 vs. 6,550, p = 0.037) and provided hours (200 vs. 333 hours per year, p = 0.037). The intervention was cost neutral and does not seem to have affected health-related quality of life for the 1-year study, which may be because the follow-up period was too short. The intervention seems to have reduced hours and cost of informal care and help required with instrumental activities of daily living. This suggests that the intervention provides relief to informal caregivers.

StarHorse: a Bayesian tool for determining stellar masses, ages, distances, and extinctions for field stars

NASA Astrophysics Data System (ADS)

Queiroz, A. B. A.; Anders, F.; Santiago, B. X.; Chiappini, C.; Steinmetz, M.; Dal Ponte, M.; Stassun, K. G.; da Costa, L. N.; Maia, M. A. G.; Crestani, J.; Beers, T. C.; Fernández-Trincado, J. G.; García-Hernández, D. A.; Roman-Lopes, A.; Zamora, O.

2018-05-01

Understanding the formation and evolution of our Galaxy requires accurate distances, ages, and chemistry for large populations of field stars. Here, we present several updates to our spectrophotometric distance code, which can now also be used to estimate ages, masses, and extinctions for individual stars. Given a set of measured spectrophotometric parameters, we calculate the posterior probability distribution over a given grid of stellar evolutionary models, using flexible Galactic stellar-population priors. The code (called StarHorse) can accommodate different observational data sets, prior options, partially missing data, and the inclusion of parallax information into the estimated probabilities. We validate the code using a variety of simulated stars as well as real stars with parameters determined from asteroseismology, eclipsing binaries, and isochrone fits to star clusters. Our main goal in this validation process is to test the applicability of the code to field stars with known Gaia-like parallaxes. The typical internal precisions (obtained from realistic simulations of an APOGEE+Gaia-like sample) are {˜eq } 8 {per cent} in distance, {˜eq } 20 {per cent} in age, {˜eq } 6 {per cent} in mass, and ≃ 0.04 mag in AV. The median external precision (derived from comparisons with earlier work for real stars) varies with the sample used, but lies in the range of {˜eq } [0,2] {per cent} for distances, {˜eq } [12,31] {per cent} for ages, {˜eq } [4,12] {per cent} for masses, and ≃ 0.07 mag for AV. We provide StarHorse distances and extinctions for the APOGEE DR14, RAVE DR5, GES DR3, and GALAH DR1 catalogues.

Can Mapping Algorithms Based on Raw Scores Overestimate QALYs Gained by Treatment? A Comparison of Mappings Between the Roland-Morris Disability Questionnaire and the EQ-5D-3L Based on Raw and Differenced Score Data.

PubMed

Madan, Jason; Khan, Kamran A; Petrou, Stavros; Lamb, Sarah E

2017-05-01

Mapping algorithms are increasingly being used to predict health-utility values based on responses or scores from non-preference-based measures, thereby informing economic evaluations. We explored whether predictions in the EuroQol 5-dimension 3-level instrument (EQ-5D-3L) health-utility gains from mapping algorithms might differ if estimated using differenced versus raw scores, using the Roland-Morris Disability Questionnaire (RMQ), a widely used health status measure for low back pain, as an example. We estimated algorithms mapping within-person changes in RMQ scores to changes in EQ-5D-3L health utilities using data from two clinical trials with repeated observations. We also used logistic regression models to estimate response mapping algorithms from these data to predict within-person changes in responses to each EQ-5D-3L dimension from changes in RMQ scores. Predicted health-utility gains from these mappings were compared with predictions based on raw RMQ data. Using differenced scores reduced the predicted health-utility gain from a unit decrease in RMQ score from 0.037 (standard error [SE] 0.001) to 0.020 (SE 0.002). Analysis of response mapping data suggests that the use of differenced data reduces the predicted impact of reducing RMQ scores across EQ-5D-3L dimensions and that patients can experience health-utility gains on the EQ-5D-3L 'usual activity' dimension independent from improvements captured by the RMQ. Mappings based on raw RMQ data overestimate the EQ-5D-3L health utility gains from interventions that reduce RMQ scores. Where possible, mapping algorithms should reflect within-person changes in health outcome and be estimated from datasets containing repeated observations if they are to be used to estimate incremental health-utility gains.

Where's WALY? : A proof of concept study of the 'wellbeing adjusted life year' using secondary analysis of cross-sectional survey data.

PubMed

Johnson, Rebecca; Jenkinson, David; Stinton, Chris; Taylor-Phillips, Sian; Madan, Jason; Stewart-Brown, Sarah; Clarke, Aileen

2016-09-08

The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE ( https://www.nice.org.uk/process/pmg9/ ). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson's and Spearman's correlations, linear regression, and receiver operating characteristic curves. Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R(2) being 0.104 for the index and 0.141 for the visual analogue scale). The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure - a Wellbeing Adjusted Life Year - is needed.

A Simplified Procedure for Direct Determination of Real Height from Virtual Height Data.

DTIC Science & Technology

1981-03-06

in terms of ’(s), takes the form 9 2 iT-s - ’F(s) - cb s ds (G68)(s2 1 - -b-,) / 2 1--b6 S S S s The inverse transform of Eq. (68) is then Ft" dh c...73) which enables us to now write E]q. (63) in the form I (I a) 2( /2 (s) a(l + a/2) 2s 2"(s) d - 1 -a ss (74) Taking the inverse transform of Eq

Validity of the Thai EQ-5D in an occupational population in Thailand.

PubMed

Kimman, Merel; Vathesatogkit, Prin; Woodward, Mark; Tai, E-Shyong; Thumboo, Julian; Yamwong, Sukit; Ratanachaiwong, Wipa; Wee, Hwee-Lin; Sritara, Piyamitr

2013-08-01

To assess the construct validity of the Thai EuroQoL (EQ-5D) among an occupational population in Thailand. Data were derived from a large cohort study among employees of the Electricity Generating Authority of Thailand. In 2008 and 2009, 4,850 participants completed the Thai EQ-5D and Short-Form 36 version 2 (SF-36v2). Thai preferences weights were used to convert EQ-5D health states into EQ-5D index scores. Construct validity of the Thai EQ-5D was examined by specifying and testing hypotheses about the relationships between the EQ-5D, SF-36v2, and participants' demographic and medical characteristics. Construct validity of the Thai EQ-5D was supported by expected relationships with SF-36v2 scale and summary scores. For example, SF-36v2 scores on the mental health scale were much lower for participants who reported having problems on the EQ-5D anxiety/depression dimension compared to those reporting no problems (mean norm-based SF-36v2 scores: 52.9 vs. 41.8, p < 0.001). Additionally, reporting a problem in a given EQ-5D dimension was generally associated with lower SF-36v2 summary scores. The EQ-5D index score distinguished between groups of participants in the expected manner, on the basis of sex, age, education and self-reported health, thus providing evidence of known-groups validity. The study demonstrated good construct validity of the Thai EQ-5D in a large occupational population in Thailand.

Criticality features in ULF magnetic fields prior to the 2011 Tohoku earthquake

PubMed Central

HAYAKAWA, Masashi; SCHEKOTOV, Alexander; POTIRAKIS, Stelios; EFTAXIAS, Kostas

2015-01-01

The criticality of ULF (Ultra-low-frequency) magnetic variations is investigated for the 2011 March 11 Tohoku earthquake (EQ) by natural time analysis. For this attempt, some ULF parameters were considered: (1) Fh (horizontal magnetic field), (2) Fz (vertical magnetic field), and (3) Dh (inverse of horizontal magnetic field). The first two parameters refer to the ULF radiation, while the last parameter refers to another ULF effect of ionospheric signature. Nighttime (L.T. = 3 am ± 2 hours) data at Kakioka (KAK) were used, and the power of each quantity at a particular frequency band of 0.03–0.05 Hz was averaged for nighttime hours. The analysis results indicate that Fh fulfilled all criticality conditions on March 3–5, 2011, and that the additional parameter, Dh reached also a criticality on March 6 or 7. In conclusion, criticality has reached in the pre-EQ fracture region a few days to one week before the main shock of the Tohoku EQ. PMID:25743063

Seismogenic ionospheric anomalies associated with the strong Indonesian earthquake occurred on 11 April 2012 (M = 8.5)

NASA Astrophysics Data System (ADS)

Pandey, Uma; Singh, Ashutosh K.; Kumar, Sanjay; Singh, A. K.

2018-03-01

Ionospheric perturbations in possible association with a major earthquake (EQ) (M = 8.5) which occurred in India-Oceania region are investigated by monitoring subionospheric propagation of VLF signals transmitted from the NWC transmitter (F = 19.8 kHz), Australia to a receiving station at Varanasi (geographic lat. 25.3°N, long 82.99°E), India. The EQ occurred on 11 April 2012 at 08:38:35 h UT (magnitude ≈ 8.5, depth = 10 km, and lat. = 2.3°N, long. = 93.0°E). A significant increase of few days before the EQ has been observed by using the VLF nighttime amplitude fluctuation method (fixed frequency transmitter signal). The analysis of total electron contents (TEC) derived from the global positioning system (GPS) at three different stations namely, Hyderabad (latitude 17.38°N, longitude 78.48°E), Singapore (latitude 1.37°N, longitude 103.84°E) and Port Blair (latitude 11.62°N, longitude 92.72°E) due to this EQ has also been presented. Significant perturbation in TEC data (enhancements and depletion) is noted before and after the main shock of the EQ. The possible mechanisms behind these perturbations due to EQ have also been discussed.

Environmental sustainability assessment of family house alternatives and application of green technologies

NASA Astrophysics Data System (ADS)

Moňoková, A.; Vilčeková, S.; Mečiarová, Ľ.; Krídlová Burdová, E.

2017-10-01

Transition to environmentally friendly technologies provides a comprehensive solution to problem of creating an economic value without destroying the nature. Buildings using green technologies lead to lower operating costs, healthier living and working environment and protect the environment more. The aim of this paper is to assess the environmental impact of two alternatives of family house designed as conventional building and building with green technologies. Evaluated family house are located in village Kokšov Bakša, which is situated 12 km south-east from city of Košice, a metropolis of eastern Slovakia. This analysis investigates the role of applied green technologies in single family houses for impact categories: global warming potential (GWP), acidification potential (AP) and eutrophication potential (EP) expressed as CO2eq, SO2eq and PO4 3- eq within “Cradle to Grave” boundary by using the LCA assessment method. The main contribution of the study is a proof that green technologies have significant part in the reduction of environmental impacts. Results show that alternative of family house designed as green one contributes to CO2eq, SO2eq and PO4 3- eq emissions by 81%, 73% and 35% less than alternative of conventional family house, respectively.

Acute gastrointestinal disease in 27 New World camelids: clinical and surgical findings.

PubMed

Cebra, C K; Cebra, M L; Garry, F B; Larsen, R S; Baxter, G M

1998-01-01

To describe clinical and surgical findings from New World camelids with acute gastrointestinal disease. Retrospective study. 20 llamas and 7 alpacas. Camelids were grouped based on surgical lesions. Clinical and surgical findings were compared between groups and between surviving and nonsurviving camelids. Twelve of 27 initial celiotomies and 3 of 4 repeat celiotomies were successful. Death occurred from euthanasia during surgery (nine camelids), peritonitis or sepsis (five), aspiration pneumonia (one), and respiratory distress (one). Survival was lowest after celiotomy for proximal obstruction (3 of 10 camelids), ruptured viscus (0 of 4), and necrotizing enteritis (0 of 2) and highest after celiotomy for distal obstruction (10 of 13) and septic peritonitis without ruptured viscus (2 of 2). Before surgery, camelids with proximal obstruction had significantly lower (P < .05) serum chloride concentrations (median, 97 mEq/L) than those with distal obstruction (median, 109 mEq/L) or ruptured viscus (median, 117 mEq/L). Serum bicarbonate concentration also was highest (median, 34.6 mEq/L) and often greater than 28 mEq/L in camelids with proximal obstruction. Camelids with distal obstruction had significantly lower (P < .05) nucleated cell counts in peritoneal fluid (median, 700 cells/microL) than those with ruptured viscus (median, 20,600 cells/microL) or septic peritonitis (median, 88,300 cells/microL). Camelids with proximal obstruction often had hypochloremic metabolic alkalosis. Camelids with distal obstruction had less metabolic derangement and tissue compromise and a higher survival rate. Awareness of the characteristics of the various types of acute gastrointestinal disease in camelids will augment veterinarians' ability to diagnose and treat these disorders.

Temperature Dependence on the Low and High Frequency Raman Scattering from Liquid Water.

DTIC Science & Technology

1986-10-01

elaboration of the Young- Westerdahl (YW) thermodynamic model, assuming conservation of hydrogen-bonded (HB) and nonhydrogen-bonded (NHB = bent and/or...Al*= -RB, and AS’ = RC. previously.3 The total integrated BE corrected Raman intensities, I/ Young and Westerdahl (YW) successfully used Eq. (1to...Scherer. M. K. Go. and S. Kint. 1. Phys. Chem. 78. 1304 (1974). in wudb xetdfrv! .Ti ekplrztion 3T. F. Young and R. P. Westerdahl . ARL 135. Office of

Geoelectric potential changes: Possible precursors to earthquakes in Japan

PubMed Central

Uyeda, S.; Nagao, T.; Orihara, Y.; Yamaguchi, T.; Takahashi, I.

2000-01-01

Whether electromagnetic precursors to earthquakes (EQs) exist is an important question not only for EQ prediction but also for understanding the physical processes of EQ generation. Slow transient geoelectric potential changes have been observed before several recent EQs in Japan. In most cases, they appeared 1–19 days before the EQs, and their duration and intensity were several minutes to 1 h and 1–2 mV/100 m. The changes appeared before five of all six EQs with magnitude ≥ 5 that occurred within 20 km of our stations during the observation period. Changes were also detected at greater epicentral distances (up to 75 km) before two other EQs, including one EQ of magnitude 4.7, which was preceded by a signal simultaneously recorded at three widely separated stations. These geoelectric potential changes have been distinguished through the following criteria from a multitude of other changes, which were noise of various origins. (i) The selected changes were proportional in amplitude to the length of the recording station's short (≈100 m) dipoles and were simultaneously detected also on long (1–10 km) dipoles when the latter were in operation. (ii) No such changes occurred during the observation period that were not followed by EQs. Although the EQ precursory nature of these geoelectric potential changes is admittedly unproven, it seems that the present results warrant continued serious research into the occurrence, generation, and transmission of these signals and their possible causal relationship to EQs. PMID:10781060

Geoelectric potential changes: possible precursors to earthquakes in Japan.

PubMed

Uyeda, S; Nagao, T; Orihara, Y; Yamaguchi, T; Takahashi, I

2000-04-25

Whether electromagnetic precursors to earthquakes (EQs) exist is an important question not only for EQ prediction but also for understanding the physical processes of EQ generation. Slow transient geoelectric potential changes have been observed before several recent EQs in Japan. In most cases, they appeared 1-19 days before the EQs, and their duration and intensity were several minutes to 1 h and 1-2 mV/100 m. The changes appeared before five of all six EQs with magnitude >/= 5 that occurred within 20 km of our stations during the observation period. Changes were also detected at greater epicentral distances (up to 75 km) before two other EQs, including one EQ of magnitude 4.7, which was preceded by a signal simultaneously recorded at three widely separated stations. These geoelectric potential changes have been distinguished through the following criteria from a multitude of other changes, which were noise of various origins. (i) The selected changes were proportional in amplitude to the length of the recording station's short ( approximately 100 m) dipoles and were simultaneously detected also on long (1-10 km) dipoles when the latter were in operation. (ii) No such changes occurred during the observation period that were not followed by EQs. Although the EQ precursory nature of these geoelectric potential changes is admittedly unproven, it seems that the present results warrant continued serious research into the occurrence, generation, and transmission of these signals and their possible causal relationship to EQs.

Changes in ginsenoside compositions and antioxidant activities of hydroponic-cultured ginseng roots and leaves with heating temperature

PubMed Central

Hwang, Cho Rong; Lee, Sang Hoon; Jang, Gwi Yeong; Hwang, In Guk; Kim, Hyun Young; Woo, Koan Sik; Lee, Junsoo; Jeong, Heon Sang

2014-01-01

Background This study evaluated changes in ginsenoside compositions and antioxidant activities in hydroponic-cultured ginseng roots (HGR) and leaves (HGL) with heating temperature. Methods Heat treatment was performed at temperatures of 90°C, 110°C, 130°C, and 150°C for 2 hours. Results The ginsenoside content varied significantly with heating temperature. The levels of ginsenosides Rg1 and Re in HGR decreased with increasing heating temperature. Ginsenosides F2, F4, Rk3, Rh4, Rg3 (S form), Rg3 (R form), Rk1, and Rg5, which were absent in the raw ginseng, were formed after heat treatment. The levels of ginsenosides Rg1, Re, Rf, and Rb1 in HGL decreased with increasing heating temperature. Conversely, ginsenosides Rk3, Rh4, Rg3 (R form), Rk1, and Rg5 increased with increasing heating temperature. In addition, ginsenoside contents of heated HGL were slightly higher than those of HGR. The highest extraction yield was 14.39% at 130°C, whereas the lowest value was 10.30% at 150°C. After heating, polyphenol contents of HGR and HGL increased from 0.43 mg gallic acid equivalent/g (mg GAE eq/g) and 0.74 mg GAE eq/g to 6.16 mg GAE eq/g and 2.86 mg GAE eq/g, respectively. Conclusion Antioxidant activities of HGR and HGL, measured by 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid radical scavenging ability, increased with increasing heating temperature. These results may aid in improving the biological activity and quality of ginseng subjected to heat treatments. PMID:25378992

Data Qualification Report For: Thermodynamic Data File, DATA0.YMP.R0 For Geochemical Code, EQ3/6 

DOE Office of Scientific and Technical Information (OSTI.GOV)

P.L. Cloke

The objective of this work is to evaluate the adequacy of chemical thermodynamic data provided by Lawrence Livermore National Laboratory (LLNL) as DataO.ymp.ROA in response to an input request submitted under AP-3.14Q. This request specified that chemical thermodynamic data available in the file, Data0.com.R2, be updated, improved, and augmented for use in geochemical modeling used in Process Model Reports (PMRs) for Engineered Barrier Systems, Waste Form, Waste Package, Unsaturated Zone, and Near Field Environment, as well as for Performance Assessment. The data are qualified in the temperature range 0 to 100 C. Several Data Tracking Numbers (DTNs) associated with Analysis/Modelmore » Reports (AMR) addressing various aspects of the post-closure chemical behavior of the waste package and the Engineered Barrier System that rely on EQ316 outputs to which these data are used as input, are Principal Factor affecting. This qualification activity was accomplished in accordance with the AP-SIII.2Q using the Technical Assessment method. A development plan, TDP-EBS-MD-000044, was prepared in accordance with AP-2.13Q and approved by the Responsible Manager. In addition, a Process Control Evaluation was performed in accordance with AP-SV.1Q. The qualification method, selected in accordance with AP-SIII.2Q, was Technical Assessment. The rationale for this approach is that the data in File Data0.com.R2 are considered Handbook data and therefore do not themselves require qualification. Only changes to Data0.com.R2 required qualification. A new file has been produced which contains the database Data0.ymp.R0, which is recommended for qualification as a result of this action. Data0.ymp.R0 will supersede Data0.com.R2 for all Yucca Mountain Project (YMP) activities.« less

Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore.

PubMed

Luo, N; Chew, L H; Fong, K Y; Koh, D R; Ng, S C; Yoon, K H; Vasoo, S; Li, S C; Thumboo, J

2003-09-01

We assessed the psychometric properties of a Singaporean Chinese version of the EQ-5D, a health-related quality of life (HRQoL) instrument. Consecutive outpatients with rheumatic diseases seen for routine follow-up consultations at the National University Hospital, Singapore were interviewed twice within 2 weeks using a standardised questionnaire containing the EQ-5D, the Short-Form 36 Health Survey (SF-36), the Learned Helplessness Subscale, a pain Visual Analogue Scale (VAS) and assessing demographic and psychosocial characteristics. To assess the validity of the EQ-5D, 13 hypotheses relating the EQ-5D self-classifier (5 dimensions) or visual analogue scale (EQ-VAS) to SF-36 scores or other variables were examined using the Mann-Whitney U test, Kruskal-Wallis or Spearman's correlation coefficient. Test-retest reliability was assessed using Cohen's kappa. Forty-eight subjects were studied (osteoarthritis: 16; rheumatoid arthritis: 22; systemic lupus erythematosus: 8; spondyloarthropathy: 2; female: 93.8%; mean age: 56.4 years). Seven of 13 a-priori hypotheses relating EQ-5D to external variables were fulfilled, supporting the validity of the EQ-5D. For example, subjects reporting moderate or extreme problems for EQ-5D dimensions generally had lower median SF-36 scores than those without such problems. Cohen's kappa for test-retest reliability of the self-classifier ranged from 0.41 to 1.00 (n = 42; median interval: 7 days, interquartile range: 7 to 11 days). The Singaporean Chinese EQ-5D self-classifier appears to be a valid measure of HRQoL in Singaporeans with rheumatic diseases; however, the reliability of the EQ-VAS requires further investigation. These data provide a basis for further studies of the Singaporean Chinese EQ-5D.

Is EQ-5D a valid quality of life instrument in patients with Parkinson's disease? A study in Singapore.

PubMed

Luo, Nan; Low, Serena; Lau, Puay-Ngoh; Au, Wing-Lok; Tan, Louis C S

2009-06-01

The purpose of the present study was to evaluate the validity of the EQ-5D in patients with Parkinson's disease (PD) in Singapore. In a cross-sectional survey, patients with PD completed English or Chinese version of the EQ-5D, the 8-item Parkinson's disease questionnaire (PDQ-8), and questions assessing socio-demographic and health characteristics. Clinical data were retrieved from patients' medical records. The validity of the EQ-5D was assessed by testing a-priori hypotheses relating the EQ-5D to the PDQ-8 and clinical data. Two hundred and eight PD patients (English speaking: 135) participated in the study. Spearman correlation coefficients between the EQ-5D and PDQ-8 ranged from 0.25 to 0.75 for English-speaking patients and from 0.16 to 0.67 for Chinese-speaking patients. By and large, the EQ-5D scores were weakly or moderately correlated with Hoehn and Yahr stage (correlation coefficients: 0.05 to 0.43), Schwab and England Activities of Daily Living score (correlation coefficients: 0.10 to 0.60), and duration of PD (correlation coefficients: 0.16 to 0.43). The EQ-5D index scores for patients with dyskinesia or "wearing off" periods were significantly lower than those without these problems. The EQ-5D Visual Analog Scale (EQ-VAS) scores also differed for English-speaking patients with deferring dyskinesia, "wearing off" periods, or health transition status; however, such differences were not observed in patients who completed the survey in Chinese. The EQ-5D questionnaire appears valid for measuring quality of life in patients with PD in Singapore. However, the validity of EQ-VAS in Chinese-speaking patients with PD should be further assessed.

Land Spreading of Wastewaters from the Fruit-Packaging Industry and Potential Effects on Soil Microbes: Effects of the Antioxidant Ethoxyquin and Its Metabolites on Ammonia Oxidizers.

PubMed

Papadopoulou, Evangelia S; Tsachidou, Bella; Sułowicz, Sławomir; Menkissoglu-Spiroudi, Urania; Karpouzas, Dimitrios G

2016-01-15

Thiabendazole (TBZ), imazalil (IMZ), ortho-phenylphenol (OPP), diphenylamine (DPA), and ethoxyquin (EQ) are used in fruit-packaging plants (FPP) with the stipulation that wastewaters produced by their application would be depurated on site. However, no such treatment systems are currently in place, leading FPP to dispose of their effluents in agricultural land. We investigated the dissipation of those pesticides and their impact on soil microbes known to have a key role on ecosystem functioning. OPP and DPA showed limited persistence (50% dissipation time [DT50], 0.6 and 1.3 days) compared to TBZ and IMZ (DT50, 47.0 and 150.8 days). EQ was rapidly transformed to the short-lived quinone imine (QI) (major metabolite) and the more persistent 2,4-dimethyl-6-ethoxyquinoline (EQNL) (minor metabolite). EQ and OPP exerted significant inhibition of potential nitrification, with the effect of the former being more persistent. This was not reflected in the abundance (determined by quantitative PCR [qPCR]) of the amoA gene of ammonia-oxidizing bacteria (AOB) and archaea (AOA). Considering the above discrepancy and the metabolic pattern of EQ, we further investigated the hypothesis that its metabolites and not only EQ were toxic to ammonia oxidizers. Potential nitrification, amoA gene abundance, and amoA gene transcripts of AOB and AOA showed that QI was probably responsible for the inhibition of nitrification. Our findings have serious ecological and practical implications for soil productivity and N conservation in agriculturally impacted ecosystems and stress the need to include metabolites and RNA-based methods when the soil microbial toxicity of pesticides is assessed. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Land Spreading of Wastewaters from the Fruit-Packaging Industry and Potential Effects on Soil Microbes: Effects of the Antioxidant Ethoxyquin and Its Metabolites on Ammonia Oxidizers

PubMed Central

Papadopoulou, Evangelia S.; Tsachidou, Bella; Sułowicz, Sławomir; Menkissoglu-Spiroudi, Urania

2015-01-01

Thiabendazole (TBZ), imazalil (IMZ), ortho-phenylphenol (OPP), diphenylamine (DPA), and ethoxyquin (EQ) are used in fruit-packaging plants (FPP) with the stipulation that wastewaters produced by their application would be depurated on site. However, no such treatment systems are currently in place, leading FPP to dispose of their effluents in agricultural land. We investigated the dissipation of those pesticides and their impact on soil microbes known to have a key role on ecosystem functioning. OPP and DPA showed limited persistence (50% dissipation time [DT50], 0.6 and 1.3 days) compared to TBZ and IMZ (DT50, 47.0 and 150.8 days). EQ was rapidly transformed to the short-lived quinone imine (QI) (major metabolite) and the more persistent 2,4-dimethyl-6-ethoxyquinoline (EQNL) (minor metabolite). EQ and OPP exerted significant inhibition of potential nitrification, with the effect of the former being more persistent. This was not reflected in the abundance (determined by quantitative PCR [qPCR]) of the amoA gene of ammonia-oxidizing bacteria (AOB) and archaea (AOA). Considering the above discrepancy and the metabolic pattern of EQ, we further investigated the hypothesis that its metabolites and not only EQ were toxic to ammonia oxidizers. Potential nitrification, amoA gene abundance, and amoA gene transcripts of AOB and AOA showed that QI was probably responsible for the inhibition of nitrification. Our findings have serious ecological and practical implications for soil productivity and N conservation in agriculturally impacted ecosystems and stress the need to include metabolites and RNA-based methods when the soil microbial toxicity of pesticides is assessed. PMID:26590271

Characterization of Alpha-fetoprotein Levels in Three Dolphin Species: Development of Sensitive Immunoassays for Analysis of the Pregnancy-associated Variations

PubMed Central

MORITA, Yuka; HIRAMATSU, Naoshi; FUJITA, Toshiaki; AMANO, Haruna; KATSUMATA, Etsuko; ARAI, Kazutoshi; IWASAKI, Toshihide; TODO, Takashi; HARA, Akihiko

2013-01-01

Abstract A single radial immunodiffusion (SRID) assay and a chemiluminescent immunoassay (CLIA) were initially developed for alpha-fetoprotein (AFP) of the striped dolphin. Utilizing these developed assays, we investigated pregnancy-associated changes in the levels of AFP in the sera of fetuses and pregnant females of three dolphin species; samples were either collected from captive individuals or obtained as fishery by-products. The concentrations of AFP in the fetal serum ranged from 419.0 to 2026.3 μg/ml in the striped dolphin, 12.6 to 1218.7 μg/ml (for an AFP equivalent; eqAFP) in the common bottlenose dolphin and 770.6 to 3129.1 μg eqAFP/ml in the Risso's dolphin. AFP levels decreased with increased fetal size in fetuses over 20 cm in length. The concentrations of AFP in sera of pregnant females ranged from 7.18 to 8068.7 ng/ml in the striped dolphin, 6.6 to 1241.1 ng eqAFP/ml in the common bottlenose dolphin and 3.4 to 2868.7 ng eqAFP/ml in the Risso's dolphin. The levels in most pregnant females were equal to or lower than those found in males and nonpregnant individuals, although a few pregnant females exhibited extremely high levels (in the range of hundreds to thousands of nanograms per milliliter). Such high levels of AFP were not observed during pseudopregnancy. To our knowledge, this is the first report on basal profiles for serum AFP levels in small odontocetes. The profiles indicated that AFP may play a significant role during embryonic development, although maternal levels do not appear to be a diagnostic biomarker for monitoring pregnancy. PMID:23656975

Cost-effectiveness analyses of elective orthopaedic surgical procedures in patients with inflammatory arthropathies.

PubMed

Osnes-Ringen, H; Kvamme, M K; Kristiansen, I S; Thingstad, M; Henriksen, J E; Kvien, T K; Dagfinrud, H

2011-03-01

To examine the costs per quality-adjusted life year (QALY) gained for surgical interventions in patients with inflammatory arthropathies, and to compare the costs per QALY gained for replacement versus non-replacement surgical interventions. In total, 248 patients [mean age 57 (SD 13) years, 77% female] with inflammatory arthropathies underwent orthopaedic surgical treatment and responded to mail surveys at baseline and during follow-up (3, 6, 9, and 12 months). Questionnaires included the quality-of-life EuroQol-5D (EQ-5D) and Short Form-6D (SF-6D) utility scores. The health benefit from surgery was subsequently translated into QALYs. The direct treatment costs in the first year were, for each patient, derived from the hospital's cost per patient accounting system (KOSPA). The costs per QALY were estimated and future costs and benefits were discounted at 4%. Improvement in utility at 1-year follow-up was 0.10 with EQ-5D and 0.03 with SF-6D (p < 0.05). The estimated 10-year cost per QALY gained was EUR 5000 for hip replacement surgery (EUR18 600 using SF-6D) and EUR 10 500 (EUR 48 500 using SF-6D) for all replacement procedures. The 5-year cost per QALY was EUR 17 800 for non-replacement surgical procedures measured by EQ-5D (SF-6D: EUR 67 500). Elective orthopaedic surgery in patients with inflammatory arthropathies was cost-effective when measured with EQ-5D, and some procedures were also cost-effective when SF-6D was used in the economic evaluations. Hip replacement surgery was most cost-effective, irrespective of the method of analysis.

Hourly oral sodium chloride for the rapid and predictable treatment of hyponatremia.

PubMed

Kerns, Eric; Patel, Shweta; Cohen, David M

2014-12-01

Hypertonic NaCl is first-line therapy for acute, severe and symptomatic hyponatremia; however, its use is often restricted to the intensive care unit (ICU). A 35-year-old female inpatient with an optic chiasm glioma and ventriculoperitoneal shunt for hydrocephalus developed acute hyponatremia (sodium 122 mEq/l) perhaps coinciding with haloperidol treatment. The sum of her urinary sodium and potassium concentrations was markedly hypertonic vis-à-vis plasma; it was inferred that serum sodium concentration would continue to fall even in the complete absence of fluid intake. Intravenous (i.v.) 3% NaCl was recommended; however, a city-wide public health emergency precluded her transfer to the ICU. She was treated with hourly oral NaCl tablets in a dose calculated to deliver the equivalent of 0.5 ml/kg/h of 3% NaCl with an objective of increasing the serum sodium concentration by 6 mEq/l. She experienced a graded and predictable increase in serum sodium concentration. A slight overshoot to 129 mEq/l was rapidly corrected with 0.25 l of D5W, and she stabilized at 127 mEq/l. We conclude that hourly oral NaCl, in conjunction with careful monitoring of the serum sodium concentration, may provide an attractive alternative to i.v. 3% NaCl for selected patients with severe hyponatremia.

Establishing utility values for the 22-item Sino-Nasal Outcome Test (SNOT-22) using a crosswalk to the EuroQol-five-dimensional questionnaire-three-level version (EQ-5D-3L).

PubMed

Crump, R Trafford; Lai, Ernest; Liu, Guiping; Janjua, Arif; Sutherland, Jason M

2017-05-01

Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L). This study used data collected from patients diagnosed with CRS awaiting bilateral endoscopic sinus surgery in Vancouver, Canada. Study participants completed both the SNOT-22 and the EQ-5D-3L. Ordinary least squares was used for 3 models that estimated the EQ-5D-3L utility values as a function of the SNOT-22 items. A total of 232 participants completed both the SNOT-22 and the EQ-5D-3L. As expected, there was a negative relationship between the SNOT-22 global scores and EQ-5D-3L utility values. Adjusted R 2 for the 3 models ranged from 0.28 to 0.33, and root mean squared errors between 0.23 and 0.24. A nonparametric bootstrap analysis demonstrated robustness of the findings. This study successfully developed a mapping model to associate utility values with responses to the SNOT-22. This model could be used to conduct comparative effectiveness research in CRS to evaluate the various interventions available for treating this condition. © 2017 ARS-AAOA, LLC.

Time Domain Aperture Antenna Study. Volume 1

DTIC Science & Technology

1974-10-01

IS. KF.Y WORDS (Vo, wo em e•,.’*I aIdv ft # .ce.-y ws4 tdanti, &Ow W•Ai nw* Ab ) Antennas Tranalent Aperture Radiation t.•’t. hiNATIONAL TECHNICAL...aL3 Cora 4 la V%") AA C05 (11c) Substituting Eq. (11) into (8), and using Eq. (5) gives - Ab . c ~ ve Gv (12A) (12B The bracketed terms in Eq. (12) may...experimental data on an ab :;olute basis in thi.; report. S57 - CHAPTER 3 TRANSIENT RADIATION FROM A PARABOLOID 3.1 INTRODUC T ION This chapter is intended to

The impact of social isolation on the health status and health-related quality of life of older people.

PubMed

Hawton, Annie; Green, Colin; Dickens, Andy P; Richards, Suzanne H; Taylor, Rod S; Edwards, Rachel; Greaves, Colin J; Campbell, John L

2011-02-01

To investigate for socially isolated older people, and older people at risk of social isolation: (1) health status and health-related quality of life (HRQL); (2) the relationship between social isolation and health status/HRQL; (3) the relationship between two alternative measures of health status/HRQL. Older people at risk of social isolation (n = 393) completed the EQ-5D and the SF-12. Multiple regression analyses were performed to examine the relationship between levels of social isolation and health status/HRQL, controlling for demographic/clinical characteristics. The agreement between EQ-5D and SF-6D (SF-12) scores was explored using descriptive psychometric techniques. Health status and health state values were much lower than UK general population age-matched norms. After controlling for depression, physical co-morbidities, age, gender, living alone status, employment and accommodation, social isolation was significantly associated, to a degree that was clinically relevant, with EQ-5D DSI, SF-6D (SF-12) and SF-12 MCS scores. The potential for ceiling effects on the EQ-5D with this population was identified. This work highlights the burden that social isolation may have on the health and well-being of older people. The potential HRQL gains from addressing social isolation may be considerable, with those at risk of social isolation also a key target group.

Large-Scale Cooperative Dissemination of Governmental Information in Emergency — An Experiment and Future Strategies

NASA Astrophysics Data System (ADS)

Horiba, Katsuhiro; Okawa, Keiko; Murai, Jun

On the 11th of March, 2011, a massive earthquake hit the northeast region of Japan. The government of Japan needed to publish information regarding the earthquake and its influences. However, their capacity of Web services overflowed. They called the industry and academia for help for providing stable information service to the people. Industry and academia formed a team to answer the call and named themselves the “EQ project”. This paper describes how the EQ Project was organized and operated, and gives analyses of the statistics. An academic organization took the lead in the EQ Project. Ten organizations which consisted of commercial IT industry and academics specialized in Internet technology, were participating in the EQ Project and they structured the three clusters based on their relationships and technological approach. In WIDE Cluster, one of three clusters in the structure of EQ, the peak number of file accesses per day was over 90 thousand, the mobile browsers was 3.4% and foreign languages (translated contents) were referred 35%. We have also discussed the future information distribution strategies in emergency situation based on the experiences of the EQ Project, and proposed nine suggestions to the MEXT as a future strategy.

Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

PubMed

Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

2018-04-13

The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as moderate responsiveness in patients with upper extremity conditions.

Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample

PubMed Central

Dalton, M; Finlayson, G; Walsh, B; Halseth, A E; Duarte, C; Blundell, J E

2017-01-01

Background: Food cravings are associated with dysregulated eating behaviour and obesity, and may impede successful weight loss attempts. Gaining control over food craving is therefore a component in the management of obesity. The current paper examined whether early changes in control over food craving (assessed using the Craving Control subscale on the Control of Eating Questionnaire (CoEQ)) was predictive of weight loss in four phase 3 clinical trials investigating a sustained-release combination of naltrexone/bupropion (NB) in obese adults. The underlying component structure of the CoEQ was also examined. Method: In an integrated analysis of four 56-week phase 3 clinical trials, subjects completed the CoEQ and had their body weight measured at baseline and at weeks 8, 16, 28 and 56. All analyses were conducted on subjects who had complete weight and CoEQ measurements at baseline and week 56, and had completed 56 weeks of NB (n=1310) or placebo (n=736). A latent growth curve model was used to examine whether early changes in the CoEQ subscales were associated with decreases in weight loss over time. Confirmatory factor analysis (CFA) was used to determine the psychometric properties of the CoEQ. Results: The factor structure of the CoEQ was consistent with previous findings with a four-factor solution being confirmed: Craving Control, Positive Mood, Craving for Sweet and Craving for Savoury with good internal consistency (Cronbach’s α=0.72–0.92). Subjects with the greatest improvement in Craving Control at week 8 exhibited a greater weight loss at week 56. Conclusions: These findings highlight the importance of the experience of food cravings in the treatment of obesity and support the use of the CoEQ as a psychometric tool for the measurement of food cravings in research and the pharmacological management of obesity. PMID:28373674

Comorbidity and health-related quality of life in patients with severe chronic obstructive pulmonary disease attending Swedish secondary care units.

PubMed

Sundh, Josefin; Johansson, Gunnar; Larsson, Kjell; Lindén, Anders; Löfdahl, Claes-Göran; Janson, Christer; Sandström, Thomas

2015-01-01

Our understanding of how comorbid diseases influence health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) is limited and in need of improvement. The aim of this study was to examine the associations between comorbidities and HRQL as measured by the instruments EuroQol-5 dimension (EQ-5D) and the COPD Assessment Test (CAT). Information on patient characteristics, chronic bronchitis, cardiovascular disease, diabetes, renal impairment, musculoskeletal symptoms, osteoporosis, depression, and EQ-5D and CAT questionnaire results was collected from 373 patients with Forced Expiratory Volume in one second (FEV1) <50% of predicted value from 27 secondary care respiratory units in Sweden. Correlation analyses and multiple linear regression models were performed using EQ-5D index, EQ-5D visual analog scale (VAS), and CAT scores as response variables. Having more comorbid conditions was associated with a worse HRQL as assessed by all instruments. Chronic bronchitis was significantly associated with a worse HRQL as assessed by EQ-5D index (adjusted regression coefficient [95% confidence interval] -0.07 [-0.13 to -0.02]), EQ-5D VAS (-5.17 [-9.42 to -0.92]), and CAT (3.78 [2.35 to 5.20]). Musculoskeletal symptoms were significantly associated with worse EQ-5D index (-0.08 [-0.14 to -0.02]), osteoporosis with worse EQ-5D VAS (-4.65 [-9.27 to -0.03]), and depression with worse EQ-5D index (-0.10 [-0.17 to -0.04]). In stratification analyses, the associations of musculoskeletal symptoms, osteoporosis, and depression with HRQL were limited to female patients. The instruments EQ-5D and CAT complement each other and emerge as useful for assessing HRQL in patients with COPD. Chronic bronchitis, musculoskeletal symptoms, osteoporosis, and depression were associated with worse HRQL. We conclude that comorbid conditions, in particular chronic bronchitis, depression, osteoporosis, and musculoskeletal symptoms, should be taken into account in the clinical management of patients with severe COPD.

Variability in monthly serum bicarbonate measures in hemodialysis patients: a cohort study.

PubMed

Patel, Ravi; Paredes, William; Hall, Charles B; Nader, Mark A; Sapkota, Deepak; Folkert, Vaughn W; Abramowitz, Matthew K

2015-12-21

Some nephrologists have advocated an individualized approach to the prescription of bicarbonate hemodialysis. However, the utility of monthly serum bicarbonate levels for guiding and evaluating such treatment decisions has not been evaluated. We sought to define the variability of these measurements and to determine factors that are associated with month-to-month variability in pre-dialysis serum bicarbonate. We examined the monthly variability in serum bicarbonate measurements among 181 hemodialysis patients admitted to a free-standing dialysis unit in the Bronx, NY from 1/1/2008-6/30/2012. All patients were treated with a uniform bicarbonate dialysis prescription (bicarbonate 35 mEq/L, acetate 8 mEq/L). Pre-dialysis serum bicarbonate values were obtained from monthly laboratory reports. Month-to-month variability was defined using a rolling measurement for each time point. Only 34 % of high serum bicarbonate values (>26 mEq/L) remained high in the subsequent month, whereas 60 % converted to normal (22-26 mEq/L). Of all low values (<22 mEq/L), 41 % were normal the following month, while 58 % remained low. Using the mean 3-month bicarbonate, only 29 % of high values remained high in the next 3-month period. In multivariable-adjusted longitudinal models, both low and high serum bicarbonate values were associated with greater variability than were normal values (β = 0.12 (95 % CI 0.09-0.15) and 0.24 (0.18 to 0.29) respectively). Variability decreased with time, and was significantly associated with age, phosphate binder use, serum creatinine, potassium, and normalized protein catabolic rate. Monthly pre-dialysis serum bicarbonate levels are highly variable. Even if a clinician takes no action, approximately 50 % of bicarbonate values outside a normal range of 22-26 mEq/L will return to normal in the subsequent month. The decision to change the bicarbonate dialysis prescription should not be based on a single bicarbonate value, and even a 3-month mean may be insufficient.

Historical Characteristics of Combat for Wargames. (Benchmarks)

DTIC Science & Technology

1988-07-01

0 __ ,7_ .. ,ILIUBIN T. O0 .. 0./ /. 7.5 CALCIUM 77- q. 6" CAR8oN DIOXIDE .21 mEQ/, -2i - ;2. CHLORIDE ;ý a n-EQ/1 J06’ CHOLESTEROL )9-/iq...Battle narratives for Volume I, No. 1. (Original source of data on 1967 and 1973 Arab Israeli Wars. Revised by Volume II, No. 1.) Volume I, No. 3, Summer...1975. (Original source of data on 1948 and 1956 Arab -Israeli Wars. Table on World War II tank battles (p 69).) Volume II, No. 1, Winter, 1976

The impact of maternal emotional intelligence and parenting style on child anxiety and behavior in the dental setting.

PubMed

Aminabadi, Naser-Asl; Pourkazemi, Maryam; Babapour, Jalil; Oskouei, Sina-Ghertasi

2012-11-01

The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind's parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children's anxiety and behavior was evaluated using the Spence Children's Anxiety Scale (SCAS) and Frankl behavior scale. Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother's total EQ and child's total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother's EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (β=0.340; p<0.01). This study provides preliminary evidence that the child's behavior in the dental setting is correlated to mother's emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style.

Factors influencing quality of life (QOL) for Korean patients with rheumatoid arthritis (RA).

PubMed

Cho, Soo-Kyung; Kim, Dam; Jun, Jae-Bum; Bae, Sang-Cheol; Sung, Yoon-Kyoung

2013-01-01

The aim of the study was to identify factors influencing the health-related quality of life (HR-QOL) for Korean RA patients and factors associated with each dimension of the EQ-5D. Two hundred and twenty-five RA patients were recruited from one University Hospital in Seoul, South Korea. Their clinical and socio-demographic data were widely collected by means of interviews, self-administered questionnaires, and clinical examinations. Multiple logistic regression analyses were performed to determine the factors influencing QOL and factors associated with each dimension of the EQ-5D. The mean EQ-5D utility observed for Korean RA patients was 0.60 (-0.29 to 1.0). Functional disability measured with Health Assessment Questionnaire (OR = 10.0, CI 2.8-34.5), disease activity score (DAS) 28 (OR = 2.6, CI 1.4-4.9), and pain VAS (OR = 2.2, CI 1.2-4.1) was three main factors influencing on QOL of RA patients. Although the functional disability consistently showed significant associations with all dimensions, various factors were associated with the each five specific dimension of EQ-5D. Pain (OR = 2.5, CI 1.4-4.6), history of hospitalization (OR = 2.1, CI 1.0-4.3), and men (OR = 2.6, CI 1.0-6.8) were associated with lower QOL in mobility. Use of alternative medicine (OR = 2.0, CI 1.1-3.7) and disease activity (OR = 3.1, CI 1.7-5.7) were associated with lower self-care QOL. For the patients with discomfort in usual activity, pain (OR = 4.7, CI 2.4-9.2) and the presence of anemia (OR = 2.3, CI 1.2-4.5) were major influencing factors. Higher disease activity (OR = 4.5, CI 1.0-21.2) and pain (OR = 3.3, CI 1.9-5.8) were associated with the pain/discomfort dimension of EQ-5D, and the pain (OR = 3.3, CI 1.9-5.8) was an independent associating factor of anxiety/depression. The strongest determinants of lower QOL in Korean RA patients were functional disability, higher disease activity, and subjective pain. However, various factors are influencing on the QOL for RA patients according to aspects of QOL. It suggested that clinicians should pay more attention to other factors of RA patients as well as clinical remission to improve their QOL.

A Computer Simulation Analysis of Conventional and Trunked Land Mobile Radio Systems at Wright Patterson Air Force Base

DTIC Science & Technology

1988-11-01

ATRIB(1) .EQ.21,CD20; ACTIVITY,ND,ATRIB(1) .EQ.22, CD22 ; ACTIVITY,MD,ATRIB(l) .EQ.23,CD23; ACTIVITY,MD,ATRIB(1).EQ.24,CD24; ACTIVITY,MD,ATRIB(1) .EQ.25...TCD; CD20 COLCT,INT(5),FLT 20 CH DELAY; ACT,, ,TCD; CD21 COLCT,INT(5),FLT 21 CH DELAY; ACT,, ,TCD; CD22 COLCT,INT(5),FLT 22 CH DELAY; ACT,, ,TCD

Health-related quality of life effects of enzalutamide in patients with metastatic castration-resistant prostate cancer: an in-depth post hoc analysis of EQ-5D data from the PREVAIL trial.

PubMed

Devlin, Nancy; Herdman, Michael; Pavesi, Marco; Phung, De; Naidoo, Shevani; Beer, Tomasz M; Tombal, Bertrand; Loriot, Yohann; Ivanescu, Cristina; Parli, Teresa; Balk, Mark; Holmstrom, Stefan

2017-06-23

The effect of enzalutamide on health-related quality of life (HRQoL) in the PREVAIL trial in chemotherapy-naïve men with metastatic castration-resistant prostate cancer was analyzed using the generic EQ-5D instrument. Patients received oral enzalutamide 160 mg/day (n = 872) or placebo (n = 845). EQ-5D index and EQ-5D visual analogue scale (EQ-5D VAS) scores were evaluated at baseline, week 13, and every 12 weeks until week 61 due to sample size reduction thereafter. Changes on individual dimensions were assessed, and Paretian Classification of Health Change (PCHC) and time-to-event analyses were conducted. With enzalutamide, EQ-5D index and EQ-5D VAS scores declined more slowly versus placebo and time to diverge from full health was prolonged. Average decline in EQ-5D index (-0.042 vs. -0.070; P < .0001) and EQ-5D VAS (-1.3 vs. -4.4; P < .0001) was significantly smaller with enzalutamide. There were significant (P < .05) between-group differences favoring enzalutamide in Pain/Discomfort to week 37, Anxiety/Depression at week 13, and Usual Activities at week 25, but no significant differences for Mobility and Self-care. The PCHC analysis showed more enzalutamide patients reporting improvement than placebo patients at weeks 13, 25, and 49 (all P < .05) and week 37 (P = .0512). Enzalutamide was superior (P ≤ .0003) to placebo for time to diverge from full health and time to first deterioration on Pain/Discomfort and Anxiety/Depression dimensions. This in-depth post hoc analysis showed that enzalutamide delayed HRQoL deterioration and had beneficial effects on several HRQoL domains, including Pain/Discomfort and the proportion of patients in full health, compared with placebo, and may help to support future analyses of this type. NCT01212991.

Computer Simulation and Experiments on the Quasi-Static Mechanics and Transport Properties of Granular Materials

DTIC Science & Technology

1993-10-01

ismalzO cif(iprepk.eq.2)istp=1 c--anumber of cyclic shearings for packing or steps for simple shear do 598 istaistold+1,istold+istp 3 icheck =0 iter3O0...lowstrn=0 highstrna=0 nostop=O I692 i~tr.e3adnso~qOte icheck ~ icheck +1 call rmatx-.copy(3,3,struO,stru)I else if(lowstrn.it .2)then icheck ~ icheck +1 do...690 i=1,3 do 690 j=1,3 strn(i,j)=strn(i,j)/2.0 690 continueI lowstrn=lowstrn+l iter3O0 if(nostop. eq. 1)nostop=0 if (highutrn. eq. 0)then icheck

Hyperkalemia develops in some thyroidectomized patients undergoing thyroid hormone withdrawal in preparation for radioactive iodine ablation for thyroid carcinoma.

PubMed

Horie, Ichiro; Ando, Takao; Imaizumi, Misa; Usa, Toshiro; Kawakami, Atsushi

2015-05-01

Hyponatremia is observed in hypothyroidism, but it is not known if hypo- or hyperkalemia is associated with hypothyroidism. To study these questions, we determined serum potassium (K(+)) levels in thyroidectomized patients undergoing levothyroxine withdrawal before radioactive iodine (RAI) therapy for thyroid carcinoma. We retrospectively studied the records of 108 patients who had undergone total thyroidectomy for thyroid carcinoma followed by levothyroxine withdrawal and then ablation with RAI at Nagasaki University Hospital from 2009-2013. Blood samples were analyzed for serum K(+) concentrations when patients were euthyroid just before levothyroxine withdrawal and hypothyroid 21 days after levothyroxine withdrawal. We determined the proportion of patients who developed hyperkalemia (K(+) ≥5 mEq/L) and hypokalemia (K(+) ≤3.5 mEq/L). Five (4.6%) patients developed hyperkalemia and 2 (1.9%) patients developed hypokalemia after levothyroxine withdrawal. The mean serum K(+) level after levothyroxine withdrawal was significantly higher than before levothyroxine withdrawal (4.23 ± 0.50 mEq/L vs. 4.09 ± 0.34 mEq/L; P<.001). After levothyroxine withdrawal, serum K(+) values were significantly correlated with age, serum sodium and creatinine levels, and the estimated glomerular filtration rate but not with serum free thyroxine or thyroid-stimulating hormone concentrations. The finding of an elevated serum K(+) of >0.5 mEq/L after levothyroxine withdrawal was more prevalent with age >60 years (odds ratio [OR], 4.66; P = .026) and with the use of angiotensin-II receptor blockers or angiotensin-converting enzyme inhibitors (OR, 3.53; P = .033) in a multivariate analysis. Hyperkalemia develops in a small percentage of hypothyroid patients after thyroid hormone withdrawal, especially in patients over 60 years of age who are using antihypertensive agents that inhibit the reninangiotensin-aldosterone system.

Co-morbidity but not dysglycaemia reduces quality of life in patients with type-2 diabetes treated with oral mono- or dual combination therapy – an analysis of the DiaRegis registry

PubMed Central

2013-01-01

Background Type-2 diabetes mellitus has a major impact on health related quality of life (HRQoL). We aimed to identify patient and treatment related variables having a major impact. Methods DiaRegis is a prospective diabetes registry. The EQ-5D was used to describe differences in HRQoL at baseline. Odds ratios (OR) with 95% confidence intervals (CI) were determined from univariable regression analysis. For the identification of independent predictors of a low score on the EQ-5D, multivariable unconditional logistic regression analysis was performed. Results A total of 2,760 patients were available for the present analysis (46.7% female, median age 66.2 years). Patients had considerable co-morbidity (18.3% coronary artery disease, 10.6% heart failure, 5.9% PAD and 5.0% stroke/TIA). Baseline HbA1c was 7.4%, fasting- and postprandial plasma glucose 139 mg/dl and 183 mg/dl. The median EQ-5D was 0.9 (interquartile range [IQR] 0.8–1.0). Independent predictors for a low EQ-5D were age > 66 years (OR 1.49; 95%CI 1.08–2.06), female gender (2.11; 1.55–2.86), hypertension (1.73; 1.03–2.93), peripheral neuropathy (1.62; 0.93–2.84) and clinically relevant depression (11.01; 3.97–30.50). There was no influence of dysglycaemia on the EQ-5D score. Conclusion The present study suggests, that co-morbidity but not average glycaemic control reduces health related quality of life in type 2 diabetes mellitus. PMID:23510200

Co-morbidity but not dysglycaemia reduces quality of life in patients with type-2 diabetes treated with oral mono- or dual combination therapy--an analysis of the DiaRegis registry.

PubMed

Wasem, Jürgen; Bramlage, Peter; Gitt, Anselm K; Binz, Christiane; Krekler, Michael; Deeg, Evelin; Tschöpe, Diethelm

2013-03-20

Type-2 diabetes mellitus has a major impact on health related quality of life (HRQoL). We aimed to identify patient and treatment related variables having a major impact. DiaRegis is a prospective diabetes registry. The EQ-5D was used to describe differences in HRQoL at baseline. Odds ratios (OR) with 95% confidence intervals (CI) were determined from univariable regression analysis. For the identification of independent predictors of a low score on the EQ-5D, multivariable unconditional logistic regression analysis was performed. A total of 2,760 patients were available for the present analysis (46.7% female, median age 66.2 years). Patients had considerable co-morbidity (18.3% coronary artery disease, 10.6% heart failure, 5.9% PAD and 5.0% stroke/TIA). Baseline HbA1c was 7.4%, fasting- and postprandial plasma glucose 139 mg/dl and 183 mg/dl.The median EQ-5D was 0.9 (interquartile range [IQR] 0.8-1.0). Independent predictors for a low EQ-5D were age > 66 years (OR 1.49; 95%CI 1.08-2.06), female gender (2.11; 1.55-2.86), hypertension (1.73; 1.03-2.93), peripheral neuropathy (1.62; 0.93-2.84) and clinically relevant depression (11.01; 3.97-30.50). There was no influence of dysglycaemia on the EQ-5D score. The present study suggests, that co-morbidity but not average glycaemic control reduces health related quality of life in type 2 diabetes mellitus.

Loss of quality of life associated with genital warts: baseline analyses from a prospective study.

PubMed

Sénécal, Martin; Brisson, Marc; Maunsell, Elizabeth; Ferenczy, Alex; Franco, Eduardo L; Ratnam, Sam; Coutlée, François; Palefsky, Joel M; Mansi, James A

2011-04-01

The quadrivalent human papillomavirus (HPV) vaccine is effective against HPV types responsible for 90% of anogenital warts. This study estimated the quality of life lost to genital warts using the EQ-5D, a generic instrument widely used for applications in economic analyses. The findings are described in terms that are more specific to individuals with genital warts using psychosocial questions adapted from the HPV impact profile, a measure developed for HPV-related conditions. Between September 2006 and February 2008, 42 physicians across Canada recruited 330 consenting patients 18 years and older with genital warts, either at the first or follow-up visit for an initial or recurrent episode. The quality of life lost associated with genital warts was estimated by the difference between participants' EQ-5D scores and age and gender-specific population norms. The study questionnaire was self-completed by 270 participants who were aged 31.5 years (SD 10.4) on average. The majority of participants were women (53.3%), heterosexual (93.5%) and in a stable relationship (66.0%). Genital warts were associated with detriments in the EQ-5D domains of anxiety/depression, pain/discomfort and usual activities. The absolute difference in the EQ-5D utility score and the EQ-VAS health status between genital warts patients and population norms was 9.9 (95% CI 7.3 to 12.5) and 6.0 (95% CI 4.1 to 7.9) percentage points, respectively. These results did not vary significantly according to patient age, gender, time since first episode or number of episodes. The results suggest that genital warts negatively affect the wellbeing of men and women as reflected by poorer quality of life scores compared with population norms.

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

PubMed

Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

2015-01-01

The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at p<0.05. Of the 2000 respondents, 98.3% were edentulous, 73.0% reported half or more missing teeth, 76.9% used dental prostheses and 23.7% had related eating problems. Older age, lower social class and lower education were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (p<0.05) and dental prosthesis did not improve EQ-VAS scores (p=0.22). Edentulism also showed a significant negative correlation with EQ-VAS scores (rho= -0.102, p<0.01). In summary, EQ-VAS is a useful tool for measuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups.

PubMed

Little, Matthew H R; Reitmeir, Peter; Peters, Annette; Leidl, Reiner

2014-06-01

Health states can be valued by those who currently experience a health state (experienced health states [EHS]) or by the general public, who value a set of given health states (GHS) described to them. There has been debate over which method is more appropriate when making resource allocation decisions. This article informs this debate by assessing whether differences between these methods have an effect on the mean EQ-5D-3L tariff scores of different patient groups. The European tariff based on GHS valuations was compared with a German EHS tariff. Comparison was made in the context of EQ-5D-3L health states describing a number of diagnosed chronic diseases (stroke, diabetes, myocardial infarction, and cancer) taken from the Cooperative Health Research in the Augsburg Region population surveys. Comparison was made of both the difference in weighting of the dimensions of the EQ-5D-3L and differences in mean tariff scores for patient groups. Weighting of the dimensions of the EQ-5D-3L were found to be systematically different. The EHS tariff gave significantly lower mean scores for most, but not all, patient groups despite tariff scores being lower for 213 of 243 EQ-5D-3L health states using the GHS tariff. Differences were found to vary between groups, with the largest change in difference being 5.45 in the multiple stoke group. The two tariffs have systematic differences that in certain patient groups could drive the results of an economic evaluation. Therefore, the choice as to which is used may be critical when making resource allocation decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Structural analysis of the asparagine-linked oligosaccharides of cholinesterases. N-linked carbohydrates of cholinesterases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saxena, A.; Doctor, B.P.

1995-12-31

Cholinesterases are serine esterases that hydrolyse choline esters faster than other substrates. They are highly glycosylated proteins with up to 24% of their molecular weight constituted of carbohydrates. Here we report the results of our studies on the glycosylation of fetal bovine serum acetylcholinesterase (FBS AChE) and horse serum butyrylcholinesterase (Eq BChE). Analysis of the monosaccharide content of the two enzymes indicated that Eq BChE contained 520 nmoles of monosaccharide/mg protein, as compared to 1290 nmoles/mg protein for Eq BChE. Both enzymes contained mannose, galactose, N-acetylglucosamine and sialic acid. Fucose was present in Eq BChE only. The structures of themore » two major oligosaccharides from FBS AChE and one major oligosaccharide from Eq BChE were determined and found to be very similar except that one of the oligosaccharides from FBS AChE contained a galactose alphal-3 galactose betal-4-determinant which has been identified as a potentially immunogenic determinant.« less

Effects of dietary electrolyte balance and addition of electrolyte-betaine supplements in feed or water on performance, acid-base balance and water retention in heat-stressed broilers.

PubMed

Sayed, M A M; Downing, J

2015-04-01

The effects of dietary electrolyte balance (DEB) and electrolyte-betaine (El-Be) supplements on heat-stressed broiler performance, acid-base balance and water retention were evaluated during the period 31-40 d of age in a 2 × 3 factorial arrangement of treatments. A total of 240 broilers were assigned to 6 treatment groups each with 8 replicates of 5 birds per cage and were exposed to cyclic high temperature (32 - 24 ± 1°C). Birds were provided with diets having DEB of either 180 or 220 mEq/kg. El-Be supplements were either added to the diet, water or not added to either of them to complete the array of 6 treatment groups. An additional 80 birds were kept at thermoneutral temperature (20 ± 1°C) and were provided with tap water and diets with DEB of either 180 or 220 mEq/kg to serve as negative controls. Exposure to high temperature depressed growth performance, increased rectal temperature and decreased potassium (K(+)) retention. In high-temperature room, birds fed on diets with DEB of 220 mEq/kg tended to increase BW from 35-40 d of age. However, at thermoneutral temperature, broilers fed on diets with DEB of 220 mEq/kg increased K(+) retention. Adding El-Be supplements in feed or water improved feed conversion ratio (FCR), enhanced water consumption and increased K(+) and sodium (Na(+)) retention. Interactions between DEB and El-Be supplements tended to affect body weight gain and FCR during the periods 35-40 and 31-40 d of age, respectively. It is suggested that when using a diet with DEB of 180 mEq/kg, adding the El-Be supplements in drinking water was more beneficial than in feed. Adding the supplements in feed or water was equally useful when using DEB of 220 mEq/kg.

Household income, income inequality, and health-related quality of life measured by the EQ-5D in Shaanxi, China: a cross-sectional study.

PubMed

Tan, Zhijun; Shi, Fuyan; Zhang, Haiyue; Li, Ning; Xu, Yongyong; Liang, Ying

2018-03-14

In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P < 0.01; for people in the urban region: 95.5 v 96.8, P < 0.01). Compared with people with moderate inequality, the EQ-5D index of those with high inequality was relatively lower (for people living in the rural region: 91.1 v 95.8, P < 0.01; for people living in the urban region: 95.6 v 97.3, P < 0.01). Adjusted by age, gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors.

Weak acid-concentration Atot and dissociation constant Ka of plasma proteins in racehorses.

PubMed

Stampfli, H R; Misiaszek, S; Lumsden, J H; Carlson, G P; Heigenhauser, G J

1999-07-01

The plasma proteins are a significant contributor to the total weak acid concentration as a net anionic charge. Due to potential species difference, species-specific values must be confirmed for the weak acid anionic concentrations of proteins (Atot) and the effective dissociation constant for plasma weak acids (Ka). We studied the net anion load Atot of equine plasma protein in 10 clinically healthy mature Standardbred horses. A multi-step titration procedure, using a tonometer covering a titration range of PCO2 from 25 to 145 mmHg at 37 degrees C, was applied on the plasma of these 10 horses. Blood gases (pH, PCO2) and electrolytes required to calculate the strong ion difference ([SID] = [(Na(+) + K(+) + Ca(2+) + Mg(2+))-(Cl(-) + Lac(-) + PO4(2-))]) were simultaneously measured over a physiological pH range from 6.90-7.55. A nonlinear regression iteration to determine Atot and Ka was performed using polygonal regression curve fitting applied to the electrical neutrality equation of the physico-chemical system. The average anion-load Atot for plasma protein of 10 Standardbred horses was 14.89 +/- 0.8 mEq/l plasma and Ka was 2.11 +/- 0.50 x 10(-7) Eq/l (pKa = 6.67). The derived conversion factor (iterated Atot concentration/average plasma protein concentration) for calculation of Atot in plasma is 0.21 mEq/g protein (protein-unit: g/l). This value compares closely with the 0.24 mEq/g protein determined by titration of Van Slyke et al. (1928) and 0.22 mEq/g protein recently published by Constable (1997) for horse plasma. The Ka value compares closely with the value experimentally determined by Constable in 1997 (2.22 x 10(7) Eq/l). Linear regression of a set of experimental data from 5 Thoroughbred horses on a treadmill exercise test, showed excellent correlation with the regression lines not different from identity for the calculated and measured variables pH, HCO3 and SID. Knowledge of Atot and Ka for the horse is useful especially in exercise studies and in clinical conditions to quantify the mechanisms of the acid-base disturbances occurring.

EQ-5D Portuguese population norms.

PubMed

Ferreira, Lara Noronha; Ferreira, Pedro L; Pereira, Luis N; Oppe, Mark

2014-03-01

The EQ-5D is a widely used preference-based measure. Normative data can be used as references to analyze the effects of healthcare, determine the burden of disease and enable regional or country comparisons. Population norms for the EQ-5D exist for other countries but have not been previously published for Portugal. The purpose of this study was to derive EQ-5D Portuguese population norms. The EQ-5D was applied by phone interview to a random sample of the Portuguese general population (n = 1,500) stratified by age, gender and region. The Portuguese value set was used to derive the EQ-5D index. Mean values were computed by gender and age groups, marital status, educational attainment, region and other variables to obtain the EQ-5D Portuguese norms. Health status declines with advancing age, and women reported worse health status than men. These results are similar to other EQ-5D population health studies. This study provides Portuguese population health-related quality of life data measured by the EQ-5D that can be used as population norms. These norms can be used to inform Portuguese policy makers, health care professionals and researchers in issues related to health care policy and planning and quantification of treatment effects on health status.

Body Mass Index Class Is Independently Associated With Health-Related Quality of Life After Primary Total Hip Arthroplasty: An Institutional Registry-Based Study.

PubMed

McLawhorn, Alexander S; Steinhaus, Michael E; Southren, Daniel L; Lee, Yuo-Yu; Dodwell, Emily R; Figgie, Mark P

2017-01-01

The purpose of this study was to compare the health-related quality of life (HRQoL) of patients across World Health Organization (WHO) body mass index (BMI) classes before and after total hip arthroplasty (THA). Patients with end-stage hip osteoarthritis who received elective primary unilateral THA were identified through an institutional registry and categorized based on the World Health Organization BMI classification. Age, sex, laterality, year of surgery, and Charlson-Deyo comorbidity index were recorded. The primary outcome was the EQ-5D-3L index and visual analog scale (EQ-VAS) scores at 2 years postoperatively. Inferential statistics and regression analyses were performed to determine associations between BMI classes and HRQoL. EQ-5D-3L scores at baseline and at 2 years were statistically different across BMI classes, with higher EQ-VAS and index scores in patients with lower BMI. There was no difference observed for the 2-year change in EQ-VAS scores, but there was a statistically greater increase in index scores for more obese patients. In the regression analyses, there were statistically significant negative effect estimates for EQ-VAS and index scores associated with increasing BMI class. BMI class is independently associated with lower HRQoL scores 2 years after primary THA. While absolute scores in obese patients were lower than in nonobese patients, obese patients enjoyed more positive changes in EQ-5D index scores after THA. These results may provide the most detailed information on how BMI influences HRQoL before and after THA, and they are relevant to future economic decision analyses on the topic. Copyright © 2016 Elsevier Inc. All rights reserved.

New technologies reduce greenhouse gas emissions from nitrogenous fertilizer in China

PubMed Central

Dou, Zheng-xia; He, Pan; Ju, Xiao-Tang; Powlson, David; Chadwick, Dave; Norse, David; Lu, Yue-Lai; Zhang, Ying; Wu, Liang; Chen, Xin-Ping; Cassman, Kenneth G.; Zhang, Fu-Suo

2013-01-01

Synthetic nitrogen (N) fertilizer has played a key role in enhancing food production and keeping half of the world’s population adequately fed. However, decades of N fertilizer overuse in many parts of the world have contributed to soil, water, and air pollution; reducing excessive N losses and emissions is a central environmental challenge in the 21st century. China’s participation is essential to global efforts in reducing N-related greenhouse gas (GHG) emissions because China is the largest producer and consumer of fertilizer N. To evaluate the impact of China’s use of N fertilizer, we quantify the carbon footprint of China’s N fertilizer production and consumption chain using life cycle analysis. For every ton of N fertilizer manufactured and used, 13.5 tons of CO2-equivalent (eq) (t CO2-eq) is emitted, compared with 9.7 t CO2-eq in Europe. Emissions in China tripled from 1980 [131 terrogram (Tg) of CO2-eq (Tg CO2-eq)] to 2010 (452 Tg CO2-eq). N fertilizer-related emissions constitute about 7% of GHG emissions from the entire Chinese economy and exceed soil carbon gain resulting from N fertilizer use by several-fold. We identified potential emission reductions by comparing prevailing technologies and management practices in China with more advanced options worldwide. Mitigation opportunities include improving methane recovery during coal mining, enhancing energy efficiency in fertilizer manufacture, and minimizing N overuse in field-level crop production. We find that use of advanced technologies could cut N fertilizer-related emissions by 20–63%, amounting to 102–357 Tg CO2-eq annually. Such reduction would decrease China’s total GHG emissions by 2–6%, which is significant on a global scale. PMID:23671096

New technologies reduce greenhouse gas emissions from nitrogenous fertilizer in China.

PubMed

Zhang, Wei-Feng; Dou, Zheng-Xia; He, Pan; Ju, Xiao-Tang; Powlson, David; Chadwick, Dave; Norse, David; Lu, Yue-Lai; Zhang, Ying; Wu, Liang; Chen, Xin-Ping; Cassman, Kenneth G; Zhang, Fu-Suo

2013-05-21

Synthetic nitrogen (N) fertilizer has played a key role in enhancing food production and keeping half of the world's population adequately fed. However, decades of N fertilizer overuse in many parts of the world have contributed to soil, water, and air pollution; reducing excessive N losses and emissions is a central environmental challenge in the 21st century. China's participation is essential to global efforts in reducing N-related greenhouse gas (GHG) emissions because China is the largest producer and consumer of fertilizer N. To evaluate the impact of China's use of N fertilizer, we quantify the carbon footprint of China's N fertilizer production and consumption chain using life cycle analysis. For every ton of N fertilizer manufactured and used, 13.5 tons of CO2-equivalent (eq) (t CO2-eq) is emitted, compared with 9.7 t CO2-eq in Europe. Emissions in China tripled from 1980 [131 terrogram (Tg) of CO2-eq (Tg CO2-eq)] to 2010 (452 Tg CO2-eq). N fertilizer-related emissions constitute about 7% of GHG emissions from the entire Chinese economy and exceed soil carbon gain resulting from N fertilizer use by several-fold. We identified potential emission reductions by comparing prevailing technologies and management practices in China with more advanced options worldwide. Mitigation opportunities include improving methane recovery during coal mining, enhancing energy efficiency in fertilizer manufacture, and minimizing N overuse in field-level crop production. We find that use of advanced technologies could cut N fertilizer-related emissions by 20-63%, amounting to 102-357 Tg CO2-eq annually. Such reduction would decrease China's total GHG emissions by 2-6%, which is significant on a global scale.

Dietary acid load is associated with serum bicarbonate but not insulin sensitivity in chronic kidney disease

PubMed Central

Ikizler, H. Omer; Zelnick, Leila; Ruzinski, John; Curtin, Laura; Utzschneider, Kristina M.; Kestenbaum, Bryan; Himmelfarb, Jonathan; de Boer, Ian H.

2015-01-01

Objective In chronic kidney disease (CKD), dietary acid may promote metabolic acidosis and insulin resistance, which in turn may contribute to adverse clinical health outcomes. We examined associations between dietary acid load, serum bicarbonate, and insulin sensitivity in CKD. Design In a cross-sectional study, we collected 3-day prospective food diaries to quantify dietary acid load as net endogenous acid production (NEAP, the nonvolatile acid load produced by the diet’s acid balance) and potential renal acid load (PRAL). We measured urine net acid excretion (NAE) in 24-hour urine samples. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp. Subjects 42 patients with CKD stages 3–5 attending nephrology clinics in the Pacific Northwest and 21 control subjects (eGFR ≥60mL/min/1.73m2). Main outcome measures Serum bicarbonate and insulin sensitivity (SIclamp). Results Mean age was 60.8±13.6 years and 54% of participants were men. Mean eGFR and serum bicarbonate concentrations were 34.4±13.1 mL/min/1.73m2 and 24.1±2.9 mEq/L for participants with CKD and 88.6±14.5 mL/min/1.73m2 and 26.3±1.8 mEq/L for control subjects, respectively. Mean NEAP, PRAL, and NAE were 58.2±24.3, 9.7±18.4, and 32.1±19.8 mEq/day, respectively. Considering all participants, dietary acid load was significantly, inversely associated with serum bicarbonate, adjusting for age, sex, race, eGFR, BMI, and diuretic use: −1.2 mEq/L per SD NEAP (95% CI −1.8, −0.6, p<0.0001); −0.9 mEq/L bicarbonate per SD PRAL (95% CI −1.5, −0.4, p=0.0005); −0.7 mEq/L bicarbonate per SD NAE (95% CI −1.2, −0.1, p=0.01). These associations were similar in participants with and without CKD. However, neither NEAP, PRAL, nor NAE was significantly associated with SIclamp. Serum bicarbonate was also not significantly associated with SIclamp. Conclusions In CKD, dietary acid load is associated with serum bicarbonate, suggesting that acidosis may be improved by dietary changes, but not with insulin sensitivity. Practical application We observed that a diet with a greater acid load was associated with lower serum bicarbonate but not insulin resistance in patients with chronic kidney disease. It may be beneficial to limit dietary acid in patients with chronic kidney disease to improve metabolic acidosis and its long-term adverse health effects, but additional, experimental studies are needed to establish the safety and usefulness of such interventions. PMID:26508542

A comparison of EuroQol 5-Dimension health-related utilities using Italian, UK, and US preference weights in a patient sample.

PubMed

Mozzi, Adelaide; Meregaglia, Michela; Lazzaro, Carlo; Tornatore, Valentina; Belfiglio, Maurizio; Fattore, Giovanni

2016-01-01

Weights associated with the EuroQol 5-Dimension 3-Level (EQ-5D-3L) instrument represent preferences for health states elicited from general population's samples. Weights have not been calculated for every country; however, empirical research shows that cross-country differences exist. This empirical study aims at investigating the impact of recently developed Italian weights in comparison with UK and US scores on health-related utility calculation using a sample of patients with Crohn's disease. The study is based on a survey on health-related quality of life in patients (n=552) affected by active Crohn's disease conducted in Italy from 2012 to 2013. Utilities computed through the Italian algorithm (mean: 0.76; SD: 0.20; median: 0.81) are generally higher than US (mean: 0.69; SD: 0.22; median: 0.77) and UK (mean: 0.57; SD: 0.32; median: 0.69) utilities, except for extremely severe health states where US values outweigh the Italian ones. UK preference weights generate the highest number of negative results. All the three value distributions are left-skewed due to very low scores associated with the most serious health states (ie, three or four levels equal to 3). As expected, despite the tariff set considered, more severe disease (Harvey Bradshaw Index >16) reduces the mean conditional EQ-5D-3L index (P<0.0001). Kendall's rank correlation between EQ Visual Analog Scale score and EQ-5D-3L index is positive (P<0.0001), even though patients tend to value their health-related quality of life more when responding to EQ-5D-3L questions than on EQ Visual Analog Scale. Regardless of the tariff set considered, ordinary least-square results highlight that more severe disease (Harvey Bradshaw Index >16) reduces the mean conditional EQ-5D-3L index (P<0.0001). Results reveal remarkable differences among the three national tariff sets and especially when severe health states occur, suggesting the need for country-specific preference weights when evaluating utilities, which can be problematic since they have not been calculated for every country yet.

Enantioselective excited-state quenching of racemic Tb (III) and Eu (III) Tris (pyridine-2,6-dicarboxylate) by vitamin B 12 derivatives

NASA Astrophysics Data System (ADS)

Meskers, Stefan C. J.; Dekkers, Harry P. J. M.

1999-08-01

Enantioselectivity in the dynamic quenching of the luminescence of the Δ and Λ enantiomers of racemic Tb(III)(pyridine-2,6-dicarboxylate=DPA) 33- and Eu(DPA) 33- by a series of corrinoids is demonstrated by time resolved luminescence and circular-polarization-of-luminescence (CPL) spectroscopy. Studied are cyanocobalamin (vitamin B 12), aquacobalamin (B 12a) and its conjugated base hydroxocobalamin (HOCbl), dicyanocobinamide ((CN) 2Cbi) and the heptamethyl ester of dicyanocobyrinic acid ((CN) 2Cby(OMe) 7). For this set of quenchers (Q), the diastereomeric quenching rate constants ( kqΔ and kqΛ) are reported together with the degree of enantioselectivity Eq=( kqΔ- kqΛ)/( kqΔ+ kqΛ). In the systems with Tb, values of the average rate constant kqavg(=( kqΔ+ kqΛ)/2) are 1.0, 2.9 and 0.53 10 8 M -1 s -1 for CNCbl, (CN) 2Cbi, (CN) 2Cby(OMe) 7 with Eq=-0.24, -0.20, +0.01 (standard error of Eq is 0.01). The quenching by B 12a is strongly dependent on pH and ionic strength ( I); when I=12 mM we find kqavg=5.3, Eq=-0.23 at pH 6.7 and kqavg=1.3, Eq=-0.27 at pH 8.9. Corresponding rates for Eu are 0.41, 27, 3.4 10 7 M -1 s -1 and for B 12a, 7.3 and 1.2 10 7 M -1 s -1, corresponding values for Eq -0.27, -0.29, +0.02, -0.21 and -0.29. The quenching reaction is modeled as a pre-equilibrium involving the formation of an encounter complex (association constant K) followed by the actual electronic energy transfer step (rate ket). By relating the quenching data with molecular structure it is argued that the binding in the encounter complex involves two hydrogen bonds between the uncoordinated carboxylate oxygen atom of two DPA ligands of Ln(DPA) 33- and two amide groups of the corrinoid, presumably involving the a and g, the a and b, or the b and g side chains. For some corrinoid/Ln(DPA) 33- complexes the association constants and enantioselectivities in the ground state are known (Spectrochimica Acta 55A (1999) 1837-1855), which allows for an estimate of the average rate of energy transfer, ketavg (i.e. ( ketΔ+ ketΛ)/2). The enantioselectivity in the quenching reaction is lower than in the ground state association which is interpreted in terms of different values of ket in the two diastereomeric Ln-corrinoid complexes; for both Tb and Eu we find ketΔ/ ketΛ˜0.3 with CNCbl, B 12a at pH 6.7 and (CN) 2Cbi. These data imply that the chiral discrimination in the energy transfer is considerable and counteracts that in the binding but does not dominate it.

Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness.

PubMed

Palta, Mari; Chen, Han-Yang; Kaplan, Robert M; Feeny, David; Cherepanov, Dasha; Fryback, Dennis G

2011-01-01

Standard errors of measurement (SEMs) of health-related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics, and is a component of reliability. To estimate the SEM of 5 HRQoL indexes. The National Health Measurement Study (NHMS) was a population-based survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures. A total of 3844 randomly selected adults from the noninstitutionalized population aged 35 to 89 y in the contiguous United States and 265 cataract patients. The SF6-36v2™, QWB-SA, EQ-5D, HUI2, and HUI3 were included. An item-response theory approach captured joint variation in indexes into a composite construct of health (theta). The authors estimated 1) the test-retest standard deviation (SEM-TR) from COMHS, 2) the structural standard deviation (SEM-S) around theta from NHMS, and 3) reliability coefficients. SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2), and 0.134 (HUI3), whereas SEM-S was 0.071, 0.094, 0.084, 0.074, and 0.117, respectively. These yield reliability coefficients 0.66 (COMHS) and 0.71 (NHMS) for SF-6D, 0.59 and 0.64 for QWB-SA, 0.61 and 0.70 for EQ-5D, 0.64 and 0.80 for HUI2, and 0.75 and 0.77 for HUI3, respectively. The SEM varied across levels of health, especially for HUI2, HUI3, and EQ-5D, and was influenced by ceiling effects. Limitations. Repeated measures were 5 mo apart, and estimated theta contained measurement error. The 2 types of SEM are similar and substantial for all the indexes and vary across health.

Mitigating the environmental impacts of milk production via anaerobic digestion of manure: case study of a dairy farm in the Po Valley.

PubMed

Battini, F; Agostini, A; Boulamanti, A K; Giuntoli, J; Amaducci, S

2014-05-15

This work analyzes the environmental impacts of milk production in an intensive dairy farm situated in the Northern Italy region of the Po Valley. Three manure management scenarios are compared: in Scenario 1 the animal slurry is stored in an open tank and then used as fertilizer. In scenario 2 the manure is processed in an anaerobic digestion plant and the biogas produced is combusted in an internal combustion engine to produce heat (required by the digester) and electricity (exported). Scenario 3 is similar to scenario 2 but the digestate is stored in a gas-tight tank. In scenario 1 the GHG emissions are estimated to be equal to 1.21 kg CO2 eq.kg(-1) Fat and Protein Corrected Milk (FPCM) without allocation of the environmental burden to the by-product meat. With mass allocation, the GHG emissions associated to the milk are reduced to 1.18 kg CO2 eq.kg(-1) FPCM. Using an economic allocation approach the GHG emissions allocated to the milk are 1.13 kg CO2 eq.kg(-1) FPCM. In scenarios 2 and 3, without allocation, the GHG emissions are reduced respectively to 0.92 (-23.7%) and 0.77 (-36.5%) kg CO2 eq.kg(-1) FPCM. If land use change due to soybean production is accounted for, an additional emission of 0.53 kg CO2 eq. should be added, raising the GHG emissions to 1.74, 1.45 and 1.30 kg CO2 eq kg(-1) FPCM in scenarios 1, 2 and 3, respectively. Primary energy from non-renewable resources decreases by 36.2% and 40.6% in scenarios 2 and 3, respectively, with the valorization of the manure in the biogas plant. The other environmental impact mitigated is marine eutrophication that decreases by 8.1% in both scenarios 2 and 3, mostly because of the lower field emissions. There is, however, a trade-off between non-renewable energy and GHG savings and other environmental impacts: acidification (+6.1% and +5.5% in scenarios 2 and 3, respectively), particulate matter emissions (+1.4% and +0.7%) and photochemical ozone formation potential (+41.6% and +42.3%) increase with the adoption of a biogas plant. The cause of the increase is mostly emissions from the CHP engine. These impacts can be tackled by improving biogas combustion technologies to reduce methane and NOx emissions. Freshwater eutrophication slightly increases (+0.8% in both scenarios 2 and 3) because of the additional infrastructures needed. In conclusion, on-farm manure anaerobic digestion with the production of electricity is an effective technology to significantly reduce global environmental impacts of dairy farms (GHG emissions and non-renewable energy consumption), however local impacts may increase as a consequence (especially photochemical ozone formation). Copyright © 2014 Elsevier B.V. All rights reserved.

Validation of the Spine Oncology Study Group-Outcomes Questionnaire to assess quality of life in patients with metastatic spine disease.

PubMed

Janssen, Stein J; Teunis, Teun; van Dijk, Eva; Ferrone, Marco L; Shin, John H; Hornicek, Francis; Schwab, Joseph H

2017-06-01

General questionnaires are often used to assess quality of life in patients with spine metastases, although a disease-specific survey did not exist until recently. The Spine Oncology Study Group has developed an outcomes questionnaire (SOSG-OQ) to measure quality of life in these patients. However, a scoring system was not developed, and the questionnaire was not validated in a group of patients, nor was it compared with other general quality of life questionnaires such as the EuroQol 5 Dimensions (EQ-5D) questionnaire. Our primary null hypothesis is that there is no association between the SOSG-OQ and EQ-5D. Our secondary null hypothesis is that there is no difference in coverage and internal consistency between the SOSG-OQ and EQ-5D. We also assess coverage, consistency, and validity of the domains within the SOSG-OQ. A survey study from a tertiary care spine referral center was used for this study. The patient sample consisted of 82 patients with spine metastases, myeloma, or lymphoma. The SOSG-OQ (27 questions, 6 domains) score ranges from 0 to 80, with a higher score indicating worse quality of life. The EQ-5D (5 questions, 5 domains) index score ranges from 0 to 1, with a higher score indicating better quality of life. The association between the SOSG-OQ and EQ-5D index score was assessed using the Spearman rank correlation. Instrument coverage and precision were assessed by determining item completion rate, median score with range, and floor and ceiling effect. Internal consistency was assessed using Cronbach alpha. Multitrait analysis and exploratory factor analysis were used to analyze properties of the individual domains in the SOSG-OQ. The Spearman rank correlation between the SOSG-OQ and EQ-5D questionnaire was high (r=-0.83, p<.001). Internal consistency of the SOSG-OQ (0.92, 95% CI: 0.89-0.94) was higher as compared to the internal consistency of the EQ-5D (0.73, 95% CI: 0.63-0.84; p<.001). The SOSG-OQ score had no floor or ceiling effect indicating good coverage (median 30, range 3-64), whereas the EQ-5D had a ceiling effect of 10% (median 0.71, range 0.05-1). In conclusion, our study proposes a scoring methodology-after reversing four inversely scored items-for the SOSG-OQ and shows that the questionnaire is a valid tool for the assessment of quality of life in patients with metastatic spine disease. The SOSG-OQ is superior to the EQ-5D in terms of coverage and internal consistency but consists of more questions. Copyright © 2015 Elsevier Inc. All rights reserved.

The Effect of Prophylactic Phenylephrine and Ephedrine Infusions on Umbilical Artery Blood pH in Women With Preeclampsia Undergoing Cesarean Delivery With Spinal Anesthesia: A Randomized, Double-Blind Trial.

PubMed

Higgins, Nicole; Fitzgerald, Paul C; van Dyk, Dominique; Dyer, Robert A; Rodriguez, Natalie; McCarthy, Robert J; Wong, Cynthia A

2018-06-01

Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. This study was a randomized double-blind clinical trial. Nonlaboring women with preeclampsia scheduled for cesarean delivery with spinal anesthesia at Prentice Women's Hospital of Northwestern Medicine were randomized to receive prophylactic infusions of phenylephrine or ephedrine titrated to maintain systolic blood pressure >80% of baseline. Spinal anesthesia consisted of hyperbaric 0.75% bupivacaine 12 mg, fentanyl 15 µg, and morphine 150 µg. The primary outcome was umbilical arterial blood pH and the secondary outcome was umbilical artery base excess. One hundred ten women were enrolled in the study and 54 per group were included in the analysis. There were 74 and 72 infants delivered in the ephedrine and phenylephrine groups, respectively. The phenylephrine:ephedrine ratio for umbilical artery pH was 1.002 (95% confidence interval [CI], 0.997-1.007). Mean [standard deviation] umbilical artery pH was not different between the ephedrine 7.20 [0.10] and phenylephrine 7.22 [0.07] groups (mean difference -0.02, 95% CI of the difference -0.06 to 0.07; P = .38). Median (first, third quartiles) umbilical artery base excess was -3.4 mEq/L (-5.7 to -2.0 mEq/L) in the ephedrine group and -2.8 mEq/L (-4.6 to -2.2mEq/L) in the phenylephrine group (difference -0.6 mEq/L, 95% CI of the difference -1.6 to 0.3 mEq/L; P = .10). When adjusted for gestational age and infant gender, umbilical artery pH did not differ between groups. There were also no differences in the umbilical artery pH stratified by magnesium therapy or by the severity of preeclampsia. We were unable to demonstrate a beneficial effect of phenylephrine on umbilical artery pH compared with ephedrine. Our findings suggest that phenylephrine may not have a clinically important advantage compared with ephedrine with regard to improved neonatal acid-base status when used to prevent spinal anesthesia-induced hypotension in women with preeclampsia undergoing cesarean delivery.

Preparatory study for the revaluation of the EQ-5D tariff: methodology report.

PubMed

Mulhern, Brendan; Bansback, Nick; Brazier, John; Buckingham, Ken; Cairns, John; Devlin, Nancy; Dolan, Paul; Hole, Arne Risa; Kavetsos, Georgios; Longworth, Louise; Rowen, Donna; Tsuchiya, Aki

2014-02-01

EQ-5D is a widely used generic measure of health with a 'tariff', or preference weights, obtained from the general population, using time trade-off (TTO). PRET (Preparatory study for the Re-valuation of the EQ-5D Tariff project) contributes towards the methodology for its revaluation. Stage 1 examined key assumptions typically involved in health-state valuations through a series of binary choice exercises, namely that health-state preferences are independent of (1) duration of the state; (2) whose health it is (i.e. perspective); (3) length of 'lead time' (a mechanism to value all states on the same scale, including those who are worse than being dead); (4) when health events take place (time preference); and (5) satisfaction associated with the state. Further topics addressed were (6) exhaustion of lead time in the worst state; (7) health-state valuation using discrete choice experiments (DCEs) with a duration attribute; and (8) binary choice administration of lead time - time trade-off (LT-TTO). Stage 1 consisted of an online survey with 6000 respondents. Stage 2 compared the results above to those of an identical survey conducted in 200 face-to-face computer-assisted personal interviews (CAPIs), covering topics (1) to (7). Stages 3 and 4 examined - in more detail and depth - issues taken from stage 1. Stage 3 consisted of CAPI surveys of a representative UK sample of 300, using examples of TTO, LT-TTO, and DCE with duration, each followed by extensive feedback questions. Stage 4 was a more intensive exercise involving a qualitative analysis of people's thought processes during both binary choice and iterative health-state valuation exercises. Data were collected through 'think-aloud' methods in 30 interviews of a convenience sample. Stage 1 found that health-state values are not independent of (1) duration of the state but there is no clear pattern; (2) whose health it is; (3) the duration of 'lead time' but there was no clear pattern; (4) when health events take place; or (5) satisfaction associated with the state. Furthermore, (6) exhaustion of lead time in the worst state was subject to substantial framing effects; (7) the five-level version of the EQ-5D (EQ-5D-5L) can be valued using DCE with duration as an attribute; and (8) binary choice LT-TTO can be administered in an online environment. Stage 2 found that although online surveys and CAPI surveys resulted in different compositions of respondents, at the aggregate, their responses to the experimental questions covering (1) to (7) above were not statistically significantly different from each other. Stages 3 and 4 found that TTO and LT-TTO were easier than DCE with duration; respondents did not necessarily trade across all attributes of EQ-5D; some respondents found it difficult to distinguish between the two worst levels of EQ-5D-5L, and some respondents may be thinking about the impact of their ill health on their family. In order for the National Institute for Health and Care Excellence to make the most appropriate decisions, the EQ-5D tariff needs to incorporate the latest understanding of health-state preferences. PRET contributed to the knowledge base on the conduct of health-state valuation studies. The Medical Research Council (MRC)-National Institute for Health Research (NIHR) Methodology Research Programme funded the PRET project (MRC ref. G0901500), and the EuroQol Group funded the PRET-AS project (Preparatory study for the Re-valuation of the EQ-5D Tariff project - Additional Sample) as an extension to the PRET project with formal agreement from the MRC.

[Lung diffusion capacity and quality of life 6 months after discharge from the ICU among survivors of acute respiratory distress syndrome due to influenza A H1N1].

PubMed

Quispe-Laime, A M; Fiore, C; González-Ros, M N; Bettini, J E; Rolfo, V E; Campagne, C G; Barberio, P A

2012-01-01

An evaluation is made of lung function and quality of life 6 months after discharge from the Intensive Care Unit (ICU) among survivors of acute respiratory distress syndrome (ARDS) due to pandemic 2009 influenza A H1N1, based on studies of lung function and the EQ-5D health questionnaire. Case series. The ICU of Dr. Leónidas Lucero Acute Cases Municipal Hospital, Bahía Blanca, Argentina. PATIENTS discharged from the ICU who had been admitted with ARDS in 2009 due to influenza A H1N1. Eleven patients were studied. Seven were positive for influenza H1N1 and four were negative. The mean age was 37±9.5 years, and 73% were males. Quality of life, as measured by the EQ-5D, showed changes in the 5 components in all patients, particularly in the pain/discomfort dimension 1.55±0.52; health status (EQ%health) was 70%±24. The indices adjusted for Argentina were Time Trade Off (TTO) 0.903±0.085 and Visual Analog Scale (VAS) 0.827±0.153. In all patients, spirometry and the study of pulmonary diffusion (DLCO) showed values of >80%. There was no correlation between lung diffusion and quality of life (%DLCO and EQ%health). A correlation was observed between quality of life and TTO (EQ%health and TTO), and between quality of life and the VAS score (EQ%health and VAS). Although the sample is small, our results suggest that patients with ARDS due to influenza A H1N1 evaluated 6 months after discharge from the ICU show no deterioration of lung function, and the impact on quality of life is moderate-in contrast to the situation found in patients with ARDS of other etiologies. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Hospital Anxiety and Depression Scale Score Is an Independent Factor Associated With the EuroQoL 5-Dimensional Descriptive System in Patients With Rheumatoid Arthritis.

PubMed

Hattori, Yosuke; Katayama, Masao; Kida, Daihei; Kaneko, Atsushi

2018-05-01

This study aimed to examine anxiety and depression experienced by patients with rheumatoid arthritis (RA) using EuroQoL 5-Dimensional Descriptive System (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) scores. We analyzed 1005 Japanese patients with RA. Stepwise multiple linear regression analysis was performed to evaluate the independent influence of variables on EQ-5D and HADS scores. Pearson correlation coefficients were also calculated to explore relationships between variables. The mean EQ-5D score was 0.74 for all patients (mean age, 63.2 years; mean disease duration, 13.6 years; mean Health Assessment Questionnaire Disability Index [HAQ-DI], 0.78; mean HADS total [HADS-T] score, 10.3; mean disease activity score assessed by 28 joints based on CRP [DAS28-CRP], 2.8). The EQ-5D score was strongly correlated with HAQ-DI and was moderately correlated with age, Steinbrocker functional class, HADS-T score, tender joint count assessed by 28 joints, pain on a visual analog scale (pain-VAS), patient's global assessment of disease activity (general-VAS), and DAS28-CRP. The HADS-T score was moderately correlated with HAQ-DI, pain-VAS, general-VAS, and DAS28-CRP. Factors that influenced the EQ-5D score included HAQ-DI (β = -0.533), pain-VAS (β = -0.128), HADS-T score (β = -0.142), DAS28-CRP (β = -0.187), and prednisolone use (β = -0.056). Factors that influenced the HADS score included HAQ-DI (β = 0.348), general-VAS (β = 0.145), disease duration (β = 0.094), and worklessness (β = 0.083). The HADS score is an independent factor associated with EQ-5D in patients with RA. Our findings suggest that the assessment of anxiety and depression is essential in achieving better quality of life for patients with RA.

Greenhouse gas emissions from heavy-duty natural gas, hybrid, and conventional diesel on-road trucks during freight transport

NASA Astrophysics Data System (ADS)

Quiros, David C.; Smith, Jeremy; Thiruvengadam, Arvind; Huai, Tao; Hu, Shaohua

2017-11-01

Heavy-duty on-road vehicles account for 70% of all freight transport and 20% of transportation-sector greenhouse gas (GHG) emissions in the United States. This study measured three prevalent GHG emissions - carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) - from seven heavy-duty vehicles, fueled by diesel and compressed natural gas (CNG), and compliant to the MY 2007 or 2010 U.S. EPA emission standards, while operated over six routes used for freight movement in California. Total combined (tractor, trailer, and payload) weights were 68,000 ± 1000 lbs. for the seven vehicles. Using the International Panel on Climate Change (IPCC) radiative forcing values for a 100-year time horizon, N2O emissions accounted for 2.6-8.3% of total tailpipe CO2 equivalent emissions (CO2-eq) for diesel vehicles equipped with Diesel Oxidation Catalyst, Diesel Particulate Filter, and Selective Catalytic Reduction system (DOC + DPF + SCR), and CH4 emissions accounted for 1.4-5.9% of CO2-eq emissions from the CNG-powered vehicle with a three-way catalyst (TWC). N2O emissions from diesel vehicles equipped with SCR (0.17-0.30 g/mi) were an order of magnitude higher than diesel vehicles without SCR (0.013-0.023 g/mi) during highway operation. For the vehicles selected in this test program, we measured 11-22% lower CO2-eq emissions from a hybrid compared to conventional diesel vehicles during transport over lower-speed routes of the freight transport system, but 20-27% higher CO2-eq emissions during higher-speed routes. Similarly, a CNG vehicle emitted up to 15% lower CO2-eq compared to conventional diesel vehicles over more neutral-grade highway routes, but emitted up to 12% greater CO2-eq emissions over routes with higher engine loads.

A comparison of the EQ-5D-3L and ICECAP-O in an older post-acute patient population relative to the general population.

PubMed

Couzner, Leah; Crotty, Maria; Norman, Richard; Ratcliffe, Julie

2013-08-01

The measurement and valuation of quality of life forms a major component of economic evaluation in health care and is a major issue in health services research. However, differing approaches exist in the measurement and valuation of quality of life from a health economics perspective. While some instruments such as the EQ-5D-3L focus on health-related quality of life alone, others assess quality of life in broader terms, for example, the newly developed ICECAP-O. The aim of this study was to utilize two generic preference-based instruments, the EQ-5D-3L and the ICECAP-O, to measure and value the quality of life of older adult patients receiving post-acute care. An additional objective was to compare the values obtained by each instrument with those generated from two community-based general population samples. Data were collected from a clinical patient population of older adults receiving post-acute outpatient rehabilitation or residential transition care and two Australian general population samples of individuals residing in the general community. The individual responses to the ICECAP-O and EQ-5D-3L instruments were scored using recently developed Australian general population algorithms. Empirical comparisons were made of the resulting patient and general population sample values for the total population and dis-aggregated according to age (65-79 and 80+ years) and gender. A total of 1,260 participants aged 65-99 years (n = 86 clinical patient sample, n = 385 EQ-5D-3L general population sample, n = 789 ICECAP-O general population sample) completed one or both of the EQ-5D-3L and ICECAP-O instruments. As expected, the patient group demonstrated lower quality of life than the general population sample as measured by both quality-of-life instruments. The difference in values between the patient and general population groups was found to be far more pronounced for the EQ-5D-3L than for the ICECAP-O. The ICECAP-O was associated with a mean difference in values of 0.04 (patient group mean 0.753, SD 0.18; general population group mean 0.795, SD 0.17, respectively, p = 0.033). In contrast, the EQ-5D-3L was associated with a mean difference in values of 0.19 (patient group mean 0.595, SD 0.20; general population group mean 0.789, SD 0.02, respectively, p ≤ 0.001). The study findings illustrate the magnitude of the difference in patient and general population values according to the instrument utilized, and highlight the differences in both the theoretical underpinnings and valuation algorithms for the EQ-5D-3L and ICECAP-O instruments. Further empirical work is required in larger samples and alternative patient groups to investigate the generalizability of the findings presented here.

The impact of maternal emotional intelligence and parenting style on child anxiety and behavior in the dental setting

PubMed Central

Pourkazemi, Maryam; Babapour, Jalil; Oskouei, Sina-Ghertasi

2012-01-01

Objective. The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. Study design. One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind�s parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children�s anxiety and behavior was evaluated using the Spence Children�s Anxiety Scale (SCAS) and Frankl behavior scale. Results. Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother�s total EQ and child�s total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother�s EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (?=0.340; p<0.01). Conclusion. This study provides preliminary evidence that the child�s behavior in the dental setting is correlated to mother�s emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style. Key words:Anxiety, child behavior, parenting, pediatric dentistry. PMID:22926462

The Role of Emotional Intelligence in Perioperative Nursing and Leadership: Developing Skills for Improved Performance.

PubMed

Beydler, Kathy Williams

2017-10-01

Many responsibilities of perioperative professionals involve concrete tasks that require high technical competence. Emotional intelligence, referred to as EQ, which involves the ability to relate to and influence others, may also be important for perioperative professionals. High EQ has been linked to higher performance in the workplace, higher job satisfaction, lower turnover intentions, and less burnout. Perioperative professionals who demonstrate a combination of technical skills and EQ could be more attuned to the humanity of health care (ie, providing more holistic care for the patient). Perioperative nurses who value providing holistic care for their patients may possess many of the elements of EQ. Leaders who recognize the importance of their own EQ and actively assist staff members to enhance and develop their EQ competency may help to create a competitive advantage by establishing a workforce of nurses who possess strong technical skills and high EQ. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The effects of earthquake measurement concepts and magnitude anchoring on individuals' perceptions of earthquake risk

USGS Publications Warehouse

Celsi, R.; Wolfinbarger, M.; Wald, D.

2005-01-01

The purpose of this research is to explore earthquake risk perceptions in California. Specifically, we examine the risk beliefs, feelings, and experiences of lay, professional, and expert individuals to explore how risk is perceived and how risk perceptions are formed relative to earthquakes. Our results indicate that individuals tend to perceptually underestimate the degree that earthquake (EQ) events may affect them. This occurs in large part because individuals' personal felt experience of EQ events are generally overestimated relative to experienced magnitudes. An important finding is that individuals engage in a process of "cognitive anchoring" of their felt EQ experience towards the reported earthquake magnitude size. The anchoring effect is moderated by the degree that individuals comprehend EQ magnitude measurement and EQ attenuation. Overall, the results of this research provide us with a deeper understanding of EQ risk perceptions, especially as they relate to individuals' understanding of EQ measurement and attenuation concepts. ?? 2005, Earthquake Engineering Research Institute.

Association of dialysate bicarbonate concentration with mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Tentori, Francesca; Karaboyas, Angelo; Robinson, Bruce M; Morgenstern, Hal; Zhang, Jinyao; Sen, Ananda; Ikizler, T Alp; Rayner, Hugh; Fissell, Rachel B; Vanholder, Raymond; Tomo, Tadashi; Port, Friedrich K

2013-10-01

Most hemodialysis patients worldwide are treated with bicarbonate dialysis using sodium bicarbonate as the base. Few studies have assessed outcomes of patients treated with different dialysate bicarbonate levels, and the optimal concentration remains uncertain. The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective cohort study. This study included 17,031 patients receiving thrice-weekly in-center hemodialysis from 11 DOPPS countries (2002-2011). Dialysate bicarbonate concentration. All-cause and cause-specific mortality and first hospitalization, using Cox regression to estimate the effects of dialysate bicarbonate concentration, adjusting for potential confounders. Demographics, comorbid conditions, laboratory values, and prescriptions were abstracted from medical records. Mean dialysate bicarbonate concentration was 35.5 ± 2.7 (SD) mEq/L, ranging from 32.2 ± 2.3 mEq/L in Germany to 37.0 ± 2.6 mEq/L in the United States. Prescription of high dialysate bicarbonate concentration (≥38 mEq/L) was most common in the United States (45% of patients). Approximately 50% of DOPPS facilities used a single dialysate bicarbonate concentration. 3,913 patients (23%) died during follow-up. Dialysate bicarbonate concentration was associated positively with mortality (adjusted HR, 1.08 per 4 mEq/L higher [95% CI, 1.01-1.15]; HR for dialysate bicarbonate ≥38 vs 33-37 mEq/L, 1.07 [95% CI, 0.97-1.19]). Results were consistent across levels of pre-dialysis session serum bicarbonate and between facilities that used a single dialysate bicarbonate concentration and those that prescribed different concentrations to individual patients. The association of dialysis bicarbonate concentration with mortality was stronger in patients with longer dialysis vintage. Due to the observational nature of the present study, we cannot rule out that the reported associations may be biased by unmeasured confounders. High dialysate bicarbonate concentrations, especially prolonged exposure, may contribute to adverse outcomes, likely through the development of postdialysis metabolic alkalosis. Additional studies are warranted to identify the optimal dialysate bicarbonate concentration. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Association of Dialysate Bicarbonate Concentration With Mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

PubMed Central

Tentori, Francesca; Karaboyas, Angelo; Robinson, Bruce M.; Morgenstern, Hal; Zhang, Jinyao; Sen, Ananda; İkizler, T. Alp; Rayner, Hugh; Fissell, Rachel B.; Vanholder, Raymond; Tomo, Tadashi; Port, Friedrich K.

2013-01-01

Background Most hemodialysis patients worldwide are treated with bicarbonate dialysis using sodium bicarbonate as the base. Few studies have assessed outcomes of patients treated with different dialysate bicarbonate levels, and the optimal concentration remains uncertain. Study Design The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective cohort study. Setting & Participants This study included 17,031 patients receiving thrice-weekly in-center hemodialysis from 11 DOPPS countries (2002–2011). Predictor Dialysate bicarbonate. Outcomes All-cause and cause-specific mortality and first hospitalization, using Cox regression to estimate the effects of dialysate bicarbonate concentration, adjusting for potential confounders. Measurements Demographics, comorbid conditions, laboratory values, and prescriptions were abstracted from medical records. Results Mean dialysate bicarbonate was 35.5 ± 2.7 (SD) mEq/L, ranging from 32.2 ± 2.3 mEq/L in Germany to 37.0 ± 2.6 mEq/L in the US. Prescription of high dialysate bicarbonate (≥38 mEq/L) was most common in the US (45% of patients). Approximately 50% of DOPPS facilities used a single dialysate bicarbonate concentration. 3,913 patients (23%) died during follow-up. Dialysate bicarbonate concentration was positively associated with mortality (adjusted HR, 1.08 per 4 mEq/L higher [95% CI, 1.01–1.15]; HR for dialysate bicarbonate ≥38 vs. 33–37 mEq/L, 1.07 [95% CI, 0.97–1.19]). Results were consistent across levels of pre-dialysis session serum bicarbonate and between facilities that used a single dialysate bicarbonate concentration and those that prescribed different concentrations to individual patients. The association of dialysis bicarbonate with mortality was stronger in patients with longer dialysis vintage. Limitations Due to the observational nature of the current study, we cannot rule out that the reported associations may be biased by unmeasured confounders. Conclusions High dialysate bicarbonate, especially prolonged exposure, may contribute to adverse outcomes, likely through development of post-dialysis metabolic alkalosis. Additional studies are warranted to identify the optimal dialysate bicarbonate concentration. PMID:23707043

[Impact of disease progression on health status, quality of life and costs in rheumatoid arthritis in Hungary].

PubMed

Péntek, Márta; Szekanecz, Zoltán; Czirják, László; Poór, Gyula; Rojkovich, Bernadette; Polgár, Anna; Genti, György; Kiss, Csaba György; Sándor, Zsuzsa; Májer, István; Brodszky, Valentin; Gulácsi, László

2008-04-20

Rheumatoid arthritis (RA) is a chronic, progressive polyarthritis leading to substantial disability. Standardised data on consequences of disease progression are needed for clinical assessments and also for cost-effectiveness models. To analyse the impact of disease progression on health status, disease specific quality of life and costs in Hungary. A cross-sectional survey was performed between April and August, 2004, involving consecutive RA patients of 6 hospital based rheumatology outpatient centres. Self-completed questionnaires were used to assess functional (HAQ) and health status (EQ-5D), quality of life (RAQoL). Disease activity (DAS) and costs were also surveyed, statistical analysis was performed. 255 patients were involved [mean age 55.5 +/- 12.3 years; disease duration 9.0 +/- 9.3 years; HAQ 1.38 +/- 0.76; EQ-5D 0.46 +/- 0.33; RAQoL 16.2 +/- 8.1; DAS 5.09 +/- 1.42; costs 1,043,163 (+/- 844,750) HUF/patient/year, conversion 1 Euro = 250 HUF]. Correlation was significant between the parameters ( p < 0.01): EQ-5D index = 1.014 - 0.25 x HAQ-0.041 x DAS; HAQ = 0.314 + 0.065 x RAQoL. Analysis by disease severity levels (HAQ groups 0.5 difference) revealed that health status worsens (mean EQ-5D: 0.784; 0.576; 0.504; 0.367; 0.211; 0.022) and costs increase (mean 628,280; 888,187; 953,759; 1,291,218; 1,346,112; 1,371,674 HUF/patient/year) with disease progression. Minimally important worsening of functional ability (0.25 HAQ increase) corresponds to -0.0705 EQ-5D and +1.884 RAQoL change. Lower health status difference (EQ-5D -0.05725) was calculated in patients with lower disease activity (DAS < 5.1). Correlation between disease progression, health status, quality of life and costs does not differ significantly from international results. The amount of costs is much lower in all disease severity levels than in developed European countries. Our study serves baseline data for health economic analysis in RA in Hungary.

Effects of sodium intake and diet on racial differences in urinary potassium excretion: results from the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial.

PubMed

Turban, Sharon; Thompson, Carol B; Parekh, Rulan S; Appel, Lawrence J

2013-01-01

We previously showed that African Americans excreted less urinary potassium than whites, even while consuming similar diets in the Dietary Approaches to Stop Hypertension (DASH) trial. We hypothesized that a low-sodium diet may eliminate these differences. Data from the DASH-Sodium randomized controlled feeding trial were analyzed. 412 adults with prehypertension or stage 1 hypertension. Random assignment to either a typical American "control" diet (1.7 g [43 mEq] potassium/2,100 kcal/d) or the DASH diet (4.1 g [105 mEq] potassium/2,100 kcal/d). Within each diet, participants received 3 levels of sodium intake in random order for 30 days. 24-hour urine samples were analyzed at the end of each period. The primary outcome was urinary potassium excretion. On the DASH diet, African Americans consistently excreted significantly less urinary potassium (mean 24-hour urinary potassium excretion, 2,594 ± 961 mg [66 ± 25 mEq]) than whites (3,412 ± 1,016 mg [87 ± 26 mEq]) at the highest sodium level; adjusted (P < 0.001); this difference was not altered by sodium level (P = 0.6 comparing white to African American difference in urinary potassium excretion on high- vs low-sodium diet). In contrast, there was a smaller but significant white-African American difference in mean daily urinary potassium excretion in participants fed the control/high-sodium diet that was not present in the control/low-sodium diet (adjusted differences of 281 mg [7 mEq]/d vs 20 mg [0.5 mEq]/d, respectively; P = 0.007). Significant interactions were found between race and diet (P < 0.001) and between race and sodium (P = 0.02). Single rather than multiple urine collections were available at each time. Lack of stool potassium and sweat potassium values. Racial differences in urinary potassium excretion depend on sodium intake and diet. Our results may help explain the previously documented large variability in urinary potassium excretion. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Geology, mineralization, and fluid inclusion study of the Kuru-Tegerek Au-Cu-Mo skarn deposit in the Middle Tien Shan, Kyrgyzstan

NASA Astrophysics Data System (ADS)

Soloviev, Serguei G.; Kryazhev, Sergey; Dvurechenskaya, Svetlana

2018-02-01

The Kuru-Tegerek Cu-Au-Mo deposit is situated in a system of Late Carboniferous subduction-related magmatic arcs of the Middle Tien Shan, which together constitute a metallogenic belt of Cu-Au-Mo (±W) porphyry, with local skarns, deposits. The deposit is related to magnetite-series gabbro-diorite to tonalite intrusion. It contains prograde magnesian and calcic skarns with abundant magnetite, associated with gabbro-diorite, and retrograde skarn with Cu mineralization, formed after intrusion of tonalite. Subsequent propylitic alteration introduced abundant chalcopyrite and pyrrhotite, and native Au culminating in zones overprinting magnetite and garnet skarn. Later quartz-muscovite-carbonate veins, formed after intrusion of late mafic quartz monzogabbro dikes, contain chalcopyrite, pyrite, arsenopyrite and other sulfides and sulfosalts, tellurides, and native Au. The earliest retrograde skarn garnet contains gaseous low-salinity (1.7-3.4 wt.% NaCl eq.) fluid inclusions homogenizing at 460-500 °C into vapor, indicating that the early fluid released from crystallizing magma was a low-density vapor. It was followed by more saline (4.0-5.0 wt.% NaCl eq.), high-temperature (400-440 °C) aqueous fluid, as fluid release from the magma progressed. Boiling of this fluid at temperatures of 420 to 370 °C and a pressure of 350-300 bar produced a low-salinity (0.6-1.2 wt.% NaCl eq.), essentially gaseous, and high-salinity (from 39 to 31 wt.% NaCl eq.) brine, with possible metal (including Cu) partitioning into both gaseous and aqueous-saline phases. Boiling was coeval with sulfide deposition in the retrograde skarn. The latest episode of the retrograde skarn stage included direct separation of saline ( 40-42 wt.% NaCl eq.) fluid from crystallizing magma. The separation of saline ( 40 to 14 wt.% NaCl eq.) fluids from a crystallizing magmatic melt continued during the propylitic stage, when fluid cooling from 370 to 320 °C, together with decreasing fO2, caused Cu and especially Au precipitation. A new influx of possibly magma-derived, low-salinity (4.5-6.7 wt.% NaCl eq.) aqueous, and then NaCl-CO2-H2O fluids, corresponds to the phyllic (quartz-muscovite-carbonate-sulfide) stage. These fluids may have a deeper source, associated with the late mafic quartz monzogabbro dikes. Fluid cooling (from 340 to 255 °C) and boiling of the NaCl-CO2-H2O fluid, together with increased fS2, increased the Au endowment.

The Empathy and Systemizing Quotient: The Psychometric Properties of the Dutch Version and a Review of the Cross-Cultural Stability.

PubMed

Groen, Y; Fuermaier, A B M; Den Heijer, A E; Tucha, O; Althaus, M

2015-09-01

The 'Empathy Quotient' (EQ) and 'Systemizing Quotient' (SQ) are used worldwide to measure people's empathizing and systemizing cognitive styles. This study investigates the psychometric properties of the Dutch EQ and SQ in healthy participants (n = 685), and high functioning males with autism spectrum disorder (n = 42). Factor analysis provided support for three subscales of the abridged 28-item EQ: Cognitive Empathy, Emotional Empathy and Social Skills. Overall, the Dutch EQ and SQ appeared reliable and valid tools to assess empathizing and systemizing cognitive style in healthy adults and high functioning adults with autism. The literature showed good cross-cultural stability of the SQ and EQ in Western countries, but in Asian countries EQ is less stable and less sensitive to sex differences.

Long Range Materials Research

DTIC Science & Technology

1975-06-01

for forming Si-C bonds; the two most general are Grignard reactions (eq. 3) and hydrosilylations of olefins (eq. 4); -76- wm RMgX + R3SiY Y...October, 1973. (4) D. N. Marquardt, Ph.D. Thesis, Stanford University, May, 1974. (5) L. F. Fieser and M. Fieser, Reagents for Organic Synthesis, John

High serum bicarbonate level within the normal range prevents the progression of chronic kidney disease in elderly chronic kidney disease patients

PubMed Central

2013-01-01

Background Metabolic acidosis leads to chronic kidney disease (CKD) progression. The guidelines recommend a lower limit of serum bicarbonate level, but no upper limit. For serum bicarbonate level to be clinically useful as a therapeutic target marker, it is necessary to investigate the target serum bicarbonate level within the normal range to prevent CKD progression. Methods One hundred and thirteen elderly CKD patients, whose serum bicarbonate level was controlled within the normal range, were enrolled in this retrospective cohort study in Ibaraki, Japan. Outcome was defined as a decrease of 25% or more in estimated glomerular filtration rate (eGFR) or starting dialysis. We used Cox proportional hazard models adjusted for patients’ characteristics to examine the association between serum bicarbonate level and the outcome. Results Female patients were 36.3%: average age (SD), 70.4 (6.6) years; eGFR, 25.7 (13.6) ml/min/1.73 m2; serum bicarbonate level, 27.4 (3.2) mEq/l. Patients with the lowest quartile of serum bicarbonate levels [23.4 (1.8) mEq/l] showed a high risk of CKD progression compared with patients with high serum bicarbonate levels [28.8 (2.3) mEq/l]: adjusted hazard ratio (HR), 3.511 (95% CI, 1.342-9.186). A 1 mEq/l increase in serum bicarbonate level was associated with a low risk of CKD progression: adjusted HR, 0.791 [95% confidence interval (CI), 0.684-0.914]. Conclusions In elderly CKD patients, our findings suggest that serum bicarbonate level is independently associated with CKD progression, and that a high serum bicarbonate level is associated with a low risk of CKD progression. A high target serum bicarbonate level within the normal range may be effective for preventing CKD progression. PMID:23298330

Assessment and analysis of noise levels in and around Ib river coalfield, Orissa, India.

PubMed

Mohapatra, Haraprasad; Goswami, Shreerup

2012-05-01

Heavy earth moving machineries, different capacities of dumpers and loaders, blasting and drilling make the mining environment noisy. A study was carried out to assess the noise level in different opencast projects in and around Belpahar and Brajarajnagar areas of Ib river coalfield. Noise assessment was carried out in various residential, commercial and industrial places. The noise levels, especially L(eq) values of different wheel loaders, dumpers, shovel and crusher units were also assessed and were more than permissible limit (90dB) in some of their operating conditions. Sound ressure level measurements while drilling into coal and overburden at Lakhanpur opencast project yielded noise levels (L(eq)) of 81.33 to 96.2 dB. Thus, these L(eq) values of drilling machines in most of the operating conditions were above permissible limit. The average noise intensities (6 a.m.-10 p.m.: 51.6-60.875dB and 10 p.m.-6 a.m.: 42.6-49.8dB) and L(eq) values (6 a.m.-10 p.m.: 50.9-67.0dB and 10 p.m.-6 a.m.: 40.8-53.3dB) during both day and night time of the residential areas around the Ib river coalfield were in close proximity or beyond the permissible limit. The L(eq) values at some of the commercial and industrial places were beyond (6 a.m.-10 p.m.: 61.6-88.3 dB and 10 p.m.-6 a.m.: 55.4-64.8dB) permissible limit. However, in most of the cases, the L(max) noise values were more (6 a.m.-10 p.m.: 68.5-91.4 dB and 10 p.m.-6 a.m.: 69.3-76.4dB) than the permissible limit. Analysis of variance was also computed for heavy earth moving machineries in different operating conditions and also for different residential, commercial and industrial places to infer the level of significance. The difference of noise intensity produced by different wheel loaders at Lakhanpur and Lilari opencast projects, drilling machines at Lakhanpur opencast project, 50 tons capacity dumpers at various conditions of Ib river coalfield within the same operating condition was significant at both 5% and 1% levels of significance. Similarly, the variance of estimated noise level in residential places during day time and commercial and industrial places during day and night time was significant at both 5% and 1% levels of significance. Moreover, a preliminary survey adopting questionnaire method amongst the mine workers and local inhabitants was also carried out to evaluate their perception about the mining related noise.

Inequalities in health status among rural residents: EQ-5D findings from household survey China.

PubMed

Li, Haitao; Wei, Xiaolin; Ma, Aixia; Chung, Roger Y

2014-05-19

This study analyzed inequalities in health status among different socioeconomic and demographic rural residents covered by the New Rural Cooperative Medical System in China. A cross-sectional study was conducted in Lian Yungang City, China. A total of 337 respondents, who were selected by using a multistage stratified systematic random sampling method, completed the surveys. A questionnaire consisting of EQ-5D and demographic and socioeconomic information was adopted for data collection, and was administered by face-to-face interviews. Multiple regression models were employed to examine the differences in the Visual Analogue Scale (VAS) score and the EQ-5D dimensions. Compared with those with lower education attainment, the respondents with higher education levels tended to report a higher VAS score (β = 2.666, 95% CI: 0.978 to 6.310), and were less likely to suffer from pain/discomfort (OR = 3.968; 95% CI: 1.447 to 10.880). The singles were more likely than the married to report moderate or extreme problems in usual activities (OR = 4.583; 95% CI: 1.188 to 17.676) and mobility (OR = 10.666; 95% CI: 2.464 to 6.171). However, no statistically significant differences were identified between the respondents with different income levels in the VAS score and EQ-5D dimensions. This study suggests that the singles and the people with lower education levels are high-risk groups for poorer health status in the Chinese rural population. The findings from this study warrant further investigation.

Comparison of EQ-5D-5L health state utilities using four country-specific tariffs on a breast cancer patient sample in mainland China.

PubMed

Liu, Liu; Li, Shunping; Wang, Min; Chen, Gang

2017-01-01

The objective of this study was to compare the differences in the five-level EuroQol-5 dimensions (EQ-5D-5L) health state utility scores derived from Chinese, Japanese, Korean, and UK tariffs. Six hundred and twenty-one breast cancer patients were invited for a face-to-face interview in Qingdao Municipal Hospital, China. EQ-5D-5L was scored using tariffs from China, Japan, Korea, and the UK. The null hypothesis of normal distribution of the EQ-5D-5L utility score was tested by the Shapiro-Wilk test. Nonparametric Friedman test and Wilcoxon signed-rank test were used to determine the difference among the four tariffs. The intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to study the agreement among the four EQ-5D-5L scores. Known-groups validity was studied using a regression framework. There were 608 participants in the final analysis, with a mean ± standard deviation (SD) age of 48.0±9.6 years. EQ-5D-5L utility scores were non-normally distributed. The means (median) ± SD of EQ-5D-5L utilities derived from Chinese, Japanese, Korean, and UK tariffs were 0.828 (0.879) ±0.184, 0.802 (0.823) ±0.164, 0.831 (0.829) ±0.137, and 0.838 (0.866) ±0.154, respectively. Among pairwise comparisons, the difference of median EQ-5D-5L utility scores was only insignificant between Chinese and UK tariffs. Excellent agreements (with ICCs >0.9) were found among the four tariffs albeit the limits of agreement between each pair of tariffs were wide. Known-groups validity was supported. Although four country-specific EQ-5D-5L tariffs have shown an overall high level of correlation and agreement, none of them could be regarded as interchangeable. The higher correlation and agreement between Chinese and UK tariffs may be due to the similar functions that were used in the tariff development. In the absence of Chinese-specific tariff, the UK tariff is the second-best option to be applied in the Chinese population. Results of this study further contribute to the explanation of variations among country-specific tariffs.

Micro and Macro Mechanics of Fracture in Ceramics.

DTIC Science & Technology

1982-10-30

XrP /Kc)21 (2.2) The validity of Eq. (2.2) has been tested with Vickers indentation in a wide range of ceramic materials (Anstis et al. 1981). J6...basis that the replacement of Kr in Eq. (2.1) with any function of the form Kr - XrP /cn (n > 0) yields a set of equations of the same form as (2.2) to...superposition of two components, one due to the residual stress (Eqn. 8) and the other due to the applied load (Eqn. 2) -272- K XrP /C 3/2 + G(7SIc)1/2

Relationship between menopause and health-related quality of life in middle-aged Chinese women: a cross-sectional study.

PubMed

Liu, Kuo; He, Liu; Tang, Xun; Wang, Jinwei; Li, Na; Wu, Yiqun; Marshall, Roger; Li, Jingrong; Zhang, Zongxin; Liu, Jianjiang; Xu, Haitao; Yu, Liping; Hu, Yonghua

2014-01-10

Chinese menopausal women comprise a large population and the women in it experience menopausal symptoms in many different ways. Their health related quality of life (HRQOL) is not particularly well studied. Our study intends to evaluate the influence of menopause on HRQOL and explore other risk factors for HRQOL in rural China. An interview study was conducted from June to August 2010 in Beijing based on cross-sectional design. 1,351 women aged 40-59 were included in the study. HRQOL was measured using the EuroQol Group's 5-domain (EQ5D) questionnaire. Comparison of HRQOL measures (EQ5D index and EQ5D-VAS scores) was done between different menopausal groups. Logistic regression and multiple regression analysis were performed to adjust potential confounders and explore other risk factors for health problems and HRQOL measures. Postmenopausal women who had menopause for 2-5 years (+1b stage) were more likely to suffer mobility problems (OR = 1.835, p = 0.008) after multiple adjustment. Menopause was also related to impaired EQ5D index and EQ5D-VAS scores after adjustment for age. Among menopausal groups categorized by menopausal duration, a consistent decrement in EQ5D index and EQ5D-VAS scores, that is, worsening HRQOL, was observed (p < 0.05). Multiple regression analysis revealed low education level and physical activity were associated with EQ5D index (β = -0.080, p = 0.003, and β = 0.056, p = 0.040, respectively). Cigarette smoking and chronic disease were associated with EQ5D index (β = -0.135, p < 0.001 and β = -0.104, p < 0.001, respectively) and EQ5D-VAS (β = -0.057, P = 0.034 and β = -0.214, p < 0.001, respectively). Reduction in physical function was found within the first five years after menopause. Worsening EQ5D index and EQ5D-VAS scores were related to menopause. Education level, physical activity, cigarette smoking, and chronic disease history were associated with HRQOL in middle aged Chinese rural women.

Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF.

PubMed

Purba, Fredrick Dermawan; Hunfeld, Joke A M; Iskandarsyah, Aulia; Fitriana, Titi Sahidah; Sadarjoen, Sawitri S; Passchier, Jan; Busschbach, Jan J V

2018-01-01

The objective of this study is to obtain population norms and to assess test-retest reliability of EQ-5D-5L and WHOQOL-BREF for the Indonesian population. A representative sample of 1056 people aged 17-75 years was recruited from the Indonesian general population. We used a multistage stratified quota sampling method with respect to residence, gender, age, education level, religion and ethnicity. Respondents completed EQ-5D-5L and WHOQOL-BREF with help from an interviewer. Norms data for both instruments were reported. For the test-retest evaluations, a sub-sample of 206 respondents completed both instruments twice. The total sample and test-retest sub-sample were representative of the Indonesian general population. The EQ-5D-5L shows almost perfect agreement between the two tests (Gwet's AC: 0.85-0.99 and percentage agreement: 90-99%) regarding the five dimensions. However, the agreement of EQ-VAS and index scores can be considered as poor (ICC: 0.45 and 0.37 respectively). For the WHOQOL-BREF, ICCs of the four domains were between 0.70 and 0.79, which indicates moderate to good agreement. For EQ-5D-5L, it was shown that female and older respondents had lower EQ-index scores, whilst rural, younger and higher-educated respondents had higher EQ-VAS scores. For WHOQOL-BREF: male, younger, higher-educated, high-income respondents had the highest scores in most of the domains, overall quality of life, and health satisfaction. This study provides representative estimates of self-reported health status and quality of life for the general Indonesian population as assessed by the EQ-5D-5L and WHOQOL-BREF instruments. The descriptive system of the EQ-5D-5L and the WHOQOL-BREF have high test-retest reliability while the EQ-VAS and the index score of EQ-5D-5L show poor agreement between the two tests. Our results can be useful to researchers and clinicians who can compare their findings with respect to these concepts with those of the Indonesian general population.

Life cycle impact assessment of ammonia production in Algeria: A comparison with previous studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Makhlouf, Ali, E-mail: almakhsme@gmail.com; Serradj, Tayeb; Cheniti, Hamza

In this paper, a Life Cycle Analysis (LCA) from “cradle to gate” of one anhydrous ton of ammonia with a purity of 99% was achieved. Particularly, the energy and environmental performance of the product (ammonia) were evaluated. The eco-profile of the product and the share of each stage of the Life Cycle on the whole environmental impacts have been evaluated. The flows of material and energy for each phase of the life cycle were counted and the associated environmental problems were identified. Evaluation of the impact was achieved using GEMIS 4.7 software. The primary data collection was executed at themore » production installations located in Algeria (Annaba locality). The analysis was conducted according to the LCA standards ISO 14040 series. The results show that Cumulative Energy Requirement (CER) is of 51.945 × 10{sup 3} MJ/t of ammonia, which is higher than the global average. Global Warming Potential (GWP) is of 1.44 t CO{sub 2} eq/t of ammonia; this value is lower than the world average. Tropospheric ozone precursor and Acidification are also studied in this article, their values are: 549.3 × 10{sup −6} t NMVOC eq and 259.3 × 10{sup −6} t SO{sub 2} eq respectively.« less

English Translation of Seven Papers on Thermophysical Properties

DTIC Science & Technology

1980-09-01

capillary constant (eq. 18) *- a = surface tension (eq. 18) g = acceleration of gravity (eq. 18) v = atomic volume at the melting point - . .. M-16...Accuracyoft/"m Ex*Ceperiment C 1941 r1143 oil 181-195 0.4610.01 Specific gravity flask 1946 [20 - t, Ar (up to 332-160 0.517 1.01 Specific gravity ...i 65 arm) flask, 0.52 1ś No1 P, 1 Kb 16 319T 400-1125 0.503 1.021 Specific gravity 1970 163) was - 242.-917 0.304 0.95 Hydrostatic sun-pension. -. 3

Saxitoxins and okadaic acid group: accumulation and distribution in invertebrate marine vectors from Southern Chile.

PubMed

García, Carlos; Pérez, Francisco; Contreras, Cristóbal; Figueroa, Diego; Barriga, Andrés; López-Rivera, Américo; Araneda, Oscar F; Contreras, Héctor R

2015-01-01

Harmful algae blooms (HABs) are the main source of marine toxins in the aquatic environment surrounding the austral fjords in Chile. Huichas Island (Aysén) has an history of HABs spanning more than 30 years, but there is limited investigation of the bioaccumulation of marine toxins in the bivalves and gastropods from the Region of Aysén. In this study, bivalves (Mytilus chilenses, Choromytilus chorus, Aulacomya ater, Gari solida, Tagelus dombeii and Venus antiqua) and carnivorous gastropods (Argobuccinum ranelliformes and Concholepas concholepas) were collected from 28 sites. Researchers analysed the accumulation of STX-group toxins using a LC with a derivatisation post column (LC-PCOX), while lipophilic toxins (OA-group, azapiracids, pectenotoxins and yessotoxins) were analysed using LC-MS/MS with electrospray ionisation (+/-) in visceral (hepatopancreas) and non-visceral tissues (mantle, adductor muscle, gills and foot). Levels of STX-group and OA-group toxins varied among individuals from the same site. Among all tissue samples, the highest concentrations of STX-group toxins were noted in the hepatopancreas in V. antiqua (95 ± 0.1 μg STX-eq 100 g(-1)), T. dombeii (148 ± 1.4 μg STX-eq 100 g(-1)) and G. solida (3232 ± 5.2 μg STX-eq 100 g(-1); p < 0.05); in the adductor muscle in M. chilensis (2495 ± 6.4 μg STX-eq 100 g(-1); p < 0.05) and in the foot in C. concholepas (81 ± 0.7 μg STX-eq 100 g(-1)) and T. dombeii (114 ± 1.2 μg STX-eq 100 g(-1)). The highest variability of toxins was detected in G. solida, where high levels of carbamate derivatives were identified (GTXs, neoSTX and STX). In addition to the detected hydrophilic toxins, OA-group toxins were detected (OA and DTX-1) with an average ratio of ≈1:1. The highest levels of OA-group toxins were in the foot of C. concholepas, with levels of 400.3 ± 3.6 μg OA eq kg(-1) (p < 0.05) and with a toxic profile composed of 90% OA. A wide range of OA-group toxins was detected in M. chilensis with a toxicity < 80 μg OA eq kg(-1), but with 74% of those toxins detected in the adductor muscle. In all evaluated species, there was no detection of lipophilic toxins associated with biotransformation in molluscs and carnivorous gastropods. In addition, the STX-group and OA-group toxin concentrations in shellfish was not associated with the presence of HAB. The ranking of toxin concentration in the tissues of most species was: digestive glands > mantle > adductor muscle for the STX-group toxins and foot > digestive gland for the OA-group toxins. These results gave a better understanding of the variability and compartmentalisation of STX-group and OA-group toxins in different bivalve and gastropod species from the south of Chile, and the analyses determined that tissues could play an important role in the biotransformation of STX-group toxins and the retention of OA-group toxins.

Natural time analysis on the ultra-low frequency magnetic field variations prior to the 2016 Kumamoto (Japan) earthquakes

NASA Astrophysics Data System (ADS)

Potirakis, Stelios M.; Schekotov, Alexander; Asano, Tomokazu; Hayakawa, Masashi

2018-04-01

On 15 April 2016 a very strong and shallow earthquake (EQ) (MW = 7.0 , depth ∼ 10 km) occurred in Southwest Japan under the city of Kumamoto, while two very strong foreshocks (MW = 6.2 and MW = 6.0) preceded by about one day. The Kumamoto EQs being very catastrophic, have already attracted much attention among the scientific community in a quest for understanding the generation mechanism, as well as for reporting any preseismic anomalies in various observables and assessing the effectivity of the current early warning systems. In the present article we report precursory behavior of the ground-based observed ultra-low frequency (ULF) magnetic field variations before the Kumamoto EQs. By analyzing specific ULF magnetic field characteristics in terms of the recently introduced natural time (NT) analysis method, we identified that ULF magnetic field variations presented critical features from 2 weeks up to 1 month before the Kumamoto EQs. Specifically, the ULF magnetic field characteristics Fh , Fz , Dh and δDep were analyzed. The first two represent variations of the horizontal and vertical components of the geomagnetic field. The third and fourth characteristics correspond to the depression (decrease) and a relative depression of the horizontal magnetic field variations, respectively. The latter depends on the degree of ionospheric disturbance. All of them were found to reach criticality before the Kumamoto EQs; however, in different time periods for each characteristic.

Distance-dependent diffusion-controlled reaction of •NO and O2•- at chemical equilibrium with ONOO-.

PubMed

Botti, Horacio; Möller, Matías N; Steinmann, Daniel; Nauser, Thomas; Koppenol, Willem H; Denicola, Ana; Radi, Rafael

2010-12-16

The fast reaction of (•)NO and O(2)(•-) to give ONOO(-) has been extensively studied at irreversible conditions, but the reasons for the wide variations in observed forward rate constants (3.8 ≤ k(f) ≤ 20 × 10(9) M(-1) s(-1)) remain unexplained. We characterized the diffusion-dependent aqueous (pH > 12) chemical equilibrium of the form (•)NO + O(2)(•-) = ONOO(-) with respect to its dependence on temperature, viscosity, and [ONOO(-)](eq) by determining [ONOO(-)](eq) and [(•)NO](eq). The equilibrium forward reaction rate constant (k(f)(eq)) has negative activation energy, in contrast to that found under irreversible conditions. In contradiction to the law of mass action, we demonstrate that the equilibrium constant depends on ONOO(-) concentration. Therefore, a wide range of k(f)(eq) values could be derived (7.5-21 × 10(9) M(-1) s(-1)). Of general interest, the variations in k(f) can thus be explained by its dependence on the distance between ONOO(-) particles (sites of generation of (•)NO and O(2)(•-)).

A review of health utilities using the EQ-5D in studies of cardiovascular disease

PubMed Central

2010-01-01

Background The EQ-5D has been extensively used to assess patient utility in trials of new treatments within the cardiovascular field. The aims of this study were to review evidence of the validity and reliability of the EQ-5D, and to summarise utility scores based on the use of the EQ-5D in clinical trials and in studies of patients with cardiovascular disease. Methods A structured literature search was conducted using keywords related to cardiovascular disease and EQ-5D. Original research studies of patients with cardiovascular disease that reported EQ-5D results and its measurement properties were included. Results Of 147 identified papers, 66 met the selection criteria, with 10 studies reporting evidence on validity or reliability and 60 reporting EQ-5D responses (VAS or self-classification). Mean EQ-5D index-based scores ranged from 0.24 (SD 0.39) to 0.90 (SD 0.16), while VAS scores ranged from 37 (SD 21) to 89 (no SD reported). Stratification of EQ-5D index scores by disease severity revealed that scores decreased from a mean of 0.78 (SD 0.18) to 0.51 (SD 0.21) for mild to severe disease in heart failure patients and from 0.80 (SD 0.05) to 0.45 (SD 0.22) for mild to severe disease in angina patients. Conclusions The published evidence generally supports the validity and reliability of the EQ-5D as an outcome measure within the cardiovascular area. This review provides utility estimates across a range of cardiovascular subgroups and treatments that may be useful for future modelling of utilities and QALYs in economic evaluations within the cardiovascular area. PMID:20109189

Prime Contract Awards by Service Category and Federal Supply Classification, Fiscal Years 1981, 1982, 1983, 1984.

DTIC Science & Technology

1984-01-01

SERVICE/VALVES 77 0 0 0 11349 INSPECTION SERVICE’MAINTENANCE SHOP EQ 0 855 0 131 11352 INSPECTIONf SERVICE’IMEASURING TOOLS 0 0 00 H354 INPECTION...INST-RADIO-TV 46 226 254 06 J307: MAINTr-REPAIR OF EQ/RECREATIONAL EQUIP ISO 434 302 347 J3076 MAINY-REPAI OF EQ/ CL EANING EQUIP 106 44 111 62 .1060...VALVES 0 0 40 0 LO4 TECH REP SERVICES /MAINTENANCE SHOP EO 2,294 300 1,212 ISO LO52 TECH REP SERVICES /MEASURING TOOLS NA 161 ,695 3.264 LO3 TECH REP

Mapping from disease-specific measures to health-state utility values in individuals with migraine.

PubMed

Gillard, Patrick J; Devine, Beth; Varon, Sepideh F; Liu, Lei; Sullivan, Sean D

2012-05-01

The objective of this study was to develop empirical algorithms that estimate health-state utility values from disease-specific quality-of-life scores in individuals with migraine. Data from a cross-sectional, multicountry study were used. Individuals with episodic and chronic migraine were randomly assigned to training or validation samples. Spearman's correlation coefficients between paired EuroQol five-dimensional (EQ-5D) questionnaire utility values and both Headache Impact Test (HIT-6) scores and Migraine-Specific Quality-of-Life Questionnaire version 2.1 (MSQ) domain scores (role restrictive, role preventive, and emotional function) were examined. Regression models were constructed to estimate EQ-5D questionnaire utility values from the HIT-6 score or the MSQ domain scores. Preferred algorithms were confirmed in the validation samples. In episodic migraine, the preferred HIT-6 and MSQ algorithms explained 22% and 25% of the variance (R(2)) in the training samples, respectively, and had similar prediction errors (root mean square errors of 0.30). In chronic migraine, the preferred HIT-6 and MSQ algorithms explained 36% and 45% of the variance in the training samples, respectively, and had similar prediction errors (root mean square errors 0.31 and 0.29). In episodic and chronic migraine, no statistically significant differences were observed between the mean observed and the mean estimated EQ-5D questionnaire utility values for the preferred HIT-6 and MSQ algorithms in the validation samples. The relationship between the EQ-5D questionnaire and the HIT-6 or the MSQ is adequate to use regression equations to estimate EQ-5D questionnaire utility values. The preferred HIT-6 and MSQ algorithms will be useful in estimating health-state utilities in migraine trials in which no preference-based measure is present. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Cost-effectiveness of total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain: a Norwegian multicenter RCT.

PubMed

Johnsen, Lars Gunnar; Hellum, Christian; Storheim, Kjersti; Nygaard, Øystein P; Brox, Jens Ivar; Rossvoll, Ivar; Rø, Magne; Andresen, Hege; Lydersen, Stian; Grundnes, Oliver; Pedersen, Marit; Leivseth, Gunnar; Olafsson, Gylfi; Borgström, Fredrik; Fritzell, Peter

2014-01-01

Randomized clinical trial with 2-year follow-up. To evaluate the cost-effectiveness of total disc replacement (TDR) versus multidisciplinary rehabilitation (MDR) in patients with chronic low back pain (CLBP). The existing studies on CLBP report cost-effectiveness of fusion surgery versus disc replacement and fusion versus rehabilitation. This study evaluated the cost-effectiveness of TDR versus MDR. Between April 2004 and May 2007, 173 patients with CLBP (>1 yr) were randomized to TDR (n = 86) or MDR (n = 87). Treatment effects (Euro Qol 5D [EQ-5D] and Short Form 6D [SF-6D]) and relevant direct and indirect costs at 6 weeks and at 3, 6, 12, and 24 months after treatment were assessed. Gain in quality-adjusted life years (QALYs) after 2 years was estimated. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio. The mean QALYs gained (standard deviation) using EQ-5D was 1.29 (0.53) in the TDR group and 0.95 (0.52) in the MDR group, a significant difference of 0.34 (95% confidence interval 0.18-0.50). The mean total cost per patient in the TDR group was &OV0556;87,622 (58,351) compared with &OV0556;74,116 (58,237) in the MDR group, which was not significantly different (95% confidence interval: -4041 to 31,755). The incremental cost-effectiveness ratio for the TDR procedure varied from &OV0556;39,748 using EQ-5D (TDR cost-effective) to &OV0556;128,328 using SF-6D (TDR not cost-effective). The dropout rate was 20% (15% TDR group, 24% MDR group). Five patients moved from the MDR to the TDR group, whereas 9 patients randomized to TDR declined surgery. Using per-protocol analysis instead of intention-to-treat analysis indicated that TDR was not cost-effective, irrespective of the use of EQ-5D or SF-6D. In this study, TDR was cost-effective compared with MDR after 2 years when using EQ-5D for assessing QALYs gained and a willingness to pay of &OV0556;74,600 (kr500,000/QALY). TDR was not cost-effective when SF-6D was used; therefore, our results should be interpreted with caution. Longer follow-up is needed to accurately assess the cost-effectiveness of TDR. 2.

A comparison of individual and social time trade-off values for health states in the general population.

PubMed

Burström, Kristina; Johannesson, Magnus; Diderichsen, Finn

2006-05-01

This study aimed to compare directly elicited individual time trade-off (TTO) values in a general population sample with the social values derived using the UK EQ-5D index tariff. In the Stockholm County 1998 postal Public Health Survey (n=4950, 20-88 years), the EQ-5D self-classifier, a TTO and a rating scale (RS) question were included (n=2549 for all three questions). The mean TTO (EQ-5D) value was 0.943 (0.890) in the youngest age-group and 0.699 (0.733) in the oldest age-group. The difference between TTO and EQ-5D values was greater in more severe health status groups was. The same equation as for the UK EQ-5D index tariff was estimated for TTO and RS and resulted in significant and consistent coefficients for nearly all dimensions. The coefficients for moderate problems were closer to the EQ-5D index tariff than the coefficients for severe problems. Age was also significant after controlling for the EQ-5D dimensions (p<0.05). The results suggest that individual and social TTO values differ systematically and that the difference is greater the more severe the health status is. The social EQ-5D index tariff may also underestimate the severity in health status at older ages; age appears to correlate with additional health problems not captured by the EQ-5D classification.

On the use of the partitioning approach to derive Environmental Quality Standards (EQS) for persistent organic pollutants (POPs) in sediments: a review of existing data.

PubMed

Dueri, Sibylle; Castro-Jiménez, Javier; Comenges, José-Manuel Zaldívar

2008-09-15

A review of experimental data has been performed to study the relationships between the concentration in water, pore water and sediments for different families of organic contaminants. The objective was to determine whether it is possible to set EQS for sediments from EQS defined for surface waters in the Daughter Directive of the European Parliament (COM (2006) 397). The analysis of experimental data showed that even though in some specific cases there is a coupling between water column and sediments, this coupling is rather the exception. Therefore it is not recommendable to use water column data to assess the chemical quality status of sediments and it is necessary to measure in both media. At the moment EQS have been defined for the water column and will assess only the compliance with good chemical status of surface waters. Since the sediment toxicity depends on the dissolved pore water concentration, the EQS developed for water could be applied to pore water (interstitial water); hence, there would be no need of developing another set of EQS. The partitioning approach has been proposed as a solution to calculate sediment EQS from water EQS, but the partitioning coefficient strongly depends on sediment characteristics and its use introduces an important uncertainty in the definition of sediment EQS. Therefore, the direct measurement of pore water concentration is regarded as a better option.

Continuous equilibrium scores: factoring in the time before a fall.

PubMed

Wood, Scott J; Reschke, Millard F; Owen Black, F

2012-07-01

The equilibrium (EQ) score commonly used in computerized dynamic posturography is normalized between 0 and 100, with falls assigned a score of 0. The resulting mixed discrete-continuous distribution limits certain statistical analyses and treats all trials with falls equally. We propose a simple modification of the formula in which peak-to-peak sway data from trials with falls is scaled according the percent of the trial completed to derive a continuous equilibrium (cEQ) score. The cEQ scores for trials without falls remain unchanged from the original methodology. The cEQ factors in the time before a fall and results in a continuous variable retaining the central tendencies of the original EQ distribution. A random set of 5315 Sensory Organization Test trials were pooled that included 81 falls. A comparison of the original and cEQ distributions and their rank ordering demonstrated that trials with falls continue to constitute the lower range of scores with the cEQ methodology. The area under the receiver operating characteristic curve (0.997) demonstrates that the cEQ retained near-perfect discrimination between trials with and without falls. We conclude that the cEQ score provides the ability to discriminate between ballistic falls from falls that occur later in the trial. This approach of incorporating time and sway magnitude can be easily extended to enhance other balance tests that include fall data or incomplete trials. Copyright © 2012 Elsevier B.V. All rights reserved.

Measuring engagement with music: development of an informant-report questionnaire.

PubMed

Vanstone, Ashley D; Wolf, Michael; Poon, Tina; Cuddy, Lola L

2016-01-01

This study describes the development of the Music Engagement Questionnaire (MusEQ), a 35-item scale to measure engagement with music in daily life. Music has implications for well-being and for therapy, notably for individuals living with dementia. A number of excellent scales or questionnaires are now available to measure music engagement. Unlike these scales, the MusEQ may be completed by either the participant or an informant. Study 1 drew on a community-based sample of 391 participants. Exploratory factor analysis revealed six interpretable factors, which formed the basis for construction of six subscales. Study 2 applied the MusEQ to a group of participants with Alzheimer's disease (AD; n = 16) as well as a group of neurotypical older adults (OA; n = 16). Informants completed the MusEQ, and the OA group also completed the self-report version of the MusEQ. Both groups had an interview in which they described the place music had in their lives. These interviews were scored by three independent raters. The MusEQ showed excellent internal consistency. Five of the factor-derived subscales showed good or excellent internal consistency. MusEQ scores were moderately correlated with a global rating of 'musicality' and with music education. There was strong agreement between self-report and informant-report data. MusEQ scores showed a significant positive relationship to independent ratings of music engagement. The MusEQ provides a meaningful and reliable option for measuring music engagement among participants who are unable to complete a self-report questionnaire.

Cation Dependence of the Dimerization Enthalpy for A2 [tetracyanoethylene]2 (A=NMe4 , Mepy, NEt4 ) Possessing a Long, Multicenter Bond.

PubMed

Graham, Adora G; Fedin, Matvey V; Miller, Joel S

2017-09-12

[TCNE] .- (TCNE=tetracyanoethylene) has been isolated as D 2h π-[TCNE] 2 2- possessing a long, 2.9 Å multicenter 2-electron-4-center (2e - /4c) C-C bond, and as C 2 π-[TCNE] 2 2- possessing a longer, 3.04 Å multicenter 2e - /6c (4 C+2 N atoms) bond. Temperature-dependent UV/Vis spectroscopic measurements in 2-methyltetrahydrofuran (MeTHF) has led to the determination of the dimerization, 2[TCNE] .- ⇌π-[TCNE] 2 2- , equilibrium constants, K eq (T), [[TCNE] 2 2- ]/[[TCNE] .- ] 2 , enthalpy, ΔH, and entropy, ΔS, of dimerization for [Mepy] 2 [TCNE] 2 (Mepy=N-methylpyridinium, H 3 CNC 5 H 5 + ) possessing D 2h π-[TCNE] 2 2- and [NMe 4 ] 2 [TCNE] 2 possessing C 2 π-[TCNE] 2 2- conformations in the solid state; however, both form D 2h π-[TCNE] 2 2- in MeTHF solution. Based on ΔH=-3.6±0.1 kcal mol -1 (-15.2 kJ mol -1 ), and ΔS=-11±1 eu (-47 J mol -1  K -1 ) and ΔH=-2.4±0.2 kcal mol -1 (-10.2 kJ mol -1 ), and ΔS=-8±1 eu (-32 J mol -1  K -1 ) in MeTHF for [NMe 4 ] 2 [TCNE] 2 and [Mepy] 2 [TCNE] 2 , respectively, the calculated K eq (298 K) are 1.6 and 1.3 m -1 , respectively. The observed K eq (145 K) are 3 and 2 orders of magnitude greater for [NMe 4 ] 2 [TCNE] 2 and [Mepy] 2 [TCNE] 2 , respectively. The K eq (130 K) is 4470, 257, ≈0.8, and ≪0.1 m -1 for [NMe 4 ] 2 [TCNE] 2 , [Mepy] 2 [TCNE] 2 , [NEt 4 ] 2 [TCNE] 2 , and [N(nBu) 4 ] 2 [TCNE] 2 , respectively, decreasing with increasing cation size. At standard conditions and below ambient temperature the equilibrium favors the dimer for the NMe 4 + and Mepy + cations. From the decreasing enthalpy, NMe 4 + >Mepy + , along with the decrease in dimer formation K eq (T) as NMe 4 + >Mepy + >NEt 4 + >N(nBu) 4 + , the dimer bond energy decreases with increasing cation size in MeTHF. This is attributed to a decrease in the [A] + ⋅⋅⋅[TCNE] - attractive interactions with increasing cation size. Solid state UV/Vis spectroscopic determinations of [NMe 4 ] 2 [TCNE] 2 are reported and compared to D 2h π-[TCNE] 2 2- conformers. The feasibility and limitations of temperature-dependent electron paramagnetic resonance (EPR) measurements for the determination of K eq (T) are also discussed. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Radioactivity level in Chinese building ceramic tile.

PubMed

Xinwei, L

2004-01-01

The activity concentrations of (226)Ra, (232)Th and (40)K have been determined by gamma ray spectrometry. The concentrations of (226)Ra, (232)Th and (40)K range from 158.3 to 1087.6, 91.7 to 1218.4, and 473.8 to 1031.3 Bq kg(-1) for glaze, and from 63.5 to 131.4, 55.4 to 106.5, and 386.7 to 866.8 Bq kg(-1) for ceramic tile, respectively. The measured activity concentrations for these radionuclides were compared with the reported data of other countries and with the typical world values. The radium equivalent activities (Ra(eq)), external hazard index (H(ex)) and internal hazard index (H(in)) associated with the radionuclides were calculated. The Ra(eq) values of all ceramic tiles are lower than the limit of 370 Bq kg(-1). The values of H(ex) and H(in) calculated according to the Chinese criterion for ceramic tiles are less than unity. The Ra(eq) value for the glaze of glazed tile collected from some areas are >370 Bq kg(-1).

Submerged Culture of Grifola gargal and G. sordulenta (Higher Basidiomycetes) from Argentina as a Source of Mycelia with Antioxidant Activity.

PubMed

Postemsky, Pablo Daniel; Curvetto, Néstor Raúl

2015-01-01

Submerged culture is an alternative mycelium source for Grifola gargal and G. sordulenta, two rare edible mushrooms related to Grifola frondosa. This work studies their mycelia as a source of antioxidants. The efficient concentrations of methanolic extracts in both radical scavenging (RS) and reducing power (RP) abilities in G. gargal and in G. sordulenta showed a high antioxidant activity. In the experimental design used, the antioxidant activity mainly depended on the culture conditions rather than on the media composition. Irrespective of the basal culture medium, mycelium methanolic extracts of G. sordulenta obtained from culture in Erlenmeyer flasks showed equivalents to ascorbic acid (EQ(AA)) RS-EQ(AA) and RP-EQ(AA) contents higher than the corresponding values obtained with jar cultures. Under stationary cultivation, G. sordulenta produced approximately 50% higher content in both RS-EQ(AA) and RP-EQ(AA) than the medicinal mushroom G. frondosa. Phenolics correlated with RS-EQ(AA) and RP-EQ(AA) in G. gargal and with RP-EQ(AA) in G. sordulenta; besides, thin-layer chromatography showed these compounds to be at least in part related to the RS capacity. It is concluded that G. gargal and G. sordulenta mycelia are excellent sources of antioxidant metabolites.

Effects of sodium citrate, citric acid and lactic acid on human blood coagulation.

PubMed

Scaravilli, Vittorio; Di Girolamo, Luca; Scotti, Eleonora; Busana, Mattia; Biancolilli, Osvaldo; Leonardi, Patrizia; Carlin, Andrea; Lonati, Caterina; Panigada, Mauro; Pesenti, Antonio; Zanella, Alberto

2018-05-01

Citric acid infusion in extracorporeal blood may allow concurrent regional anticoagulation and enhancement of extracorporeal CO 2 removal. Effects of citric acid on human blood thromboelastography and aggregometry have never been tested before. In this in vitro study, citric acid, sodium citrate and lactic acid were added to venous blood from seven healthy donors, obtaining concentrations of 9 mEq/L, 12 mEq/L and 15 mEq/L. We measured gas analyses, ionized calcium (iCa ++ ) concentration, activated clotting time (ACT), thromboelastography and multiplate aggregometry. Repeated measure analysis of variance was used to compare the acidifying and anticoagulant properties of the three compounds. Sodium citrate did not affect the blood gas analysis. Increasing doses of citric and lactic acid progressively reduced pH and HCO 3 - and increased pCO 2 (p<0.001). Sodium citrate and citric acid similarly reduced iCa ++ , from 0.39 (0.36-0.39) and 0.35 (0.33-0.36) mmol/L, respectively, at 9 mEq/L to 0.20 (0.20-0.21) and 0.21 (0.20-0.23) mmol/L at 15 mEq/L (p<0.001). Lactic acid did not affect iCa ++ (p=0.07). Sodium citrate and citric acid similarly incremented the ACT, from 234 (208-296) and 202 (178-238) sec, respectively, at 9 mEq/L, to >600 sec at 15 mEq/L (p<0.001). Lactic acid did not affect the ACT values (p=0.486). Sodium citrate and citric acid similarly incremented R-time and reduced α-angle and maximum amplitude (MA) (p<0.001), leading to flat-line thromboelastograms at 15 mEq/L. Platelet aggregometry was not altered by any of the three compounds. Citric acid infusions determine acidification and anticoagulation of blood similar to lactic acid and sodium citrate, respectively.

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

PubMed

Yamada, Shunsuke; Ueki, Kenji; Tokumoto, Masanori; Suehiro, Takaichi; Kimura, Hiroshi; Taniguchi, Masatomo; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

2016-02-01

Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Theory of Laser-Stimulated Surface Processes.

DTIC Science & Technology

1983-05-01

variables9 4 via the Fourier expansion of AW. The correlation function can be written in terms of specific collective properties of the phonons by...9 -Eg/g 2 T - 11 IgL Ik odK 6(Udk-\\) (2.338)13 dk 1 \\f2k/ d(zk Using the selection rule, Eq. (2.334), along with Eq. (2.323), this can be

Electrolyte status in birth asphyxia.

PubMed

Basu, Pallab; Som, Sabyasachi; Das, Harendranath; Choudhuri, Nabendu

2010-03-01

To study electrolyte status in asphyxiated newborns of different severity in early neonatal period and compare with controls. Sodium, potassium and total calcium levels were estimated in the serum samples of asphyxiated newborns of different severity and control group immediately after birth. Mean serum sodium level was significantly lower (122.1 +/- 6.0 mEq/L vs 138.8 +/- 2.7 mEq/L; P < 0.001), mean serum potassium was higher (5.05 +/- 0.63 mEq/L vs 4.19 +/- 0.40 mEq/L; P < 0.001) and mean serum calcium level was found lower (6.85 +/- 0.95 mg/dl vs 9.50 +/- 0.51 mg/dl; P < 0.001) in cases than controls. Among cases, a strong positive linear correlation was found between the serum sodium, serum calcium levels and their Apgar scores, between sodium levels and total calcium levels and significant negative linear correlation between Apgar scores and serum potassium level. Among cases, hyponatremia and hypocalcemia developed early and simultaneously and the decrease in their serum levels was directly proportional to each other and to the degree of asphyxia. Though, mean potassium level was within the normal limit, the value was higher among cases than controls and directly proportional to asphyxia.

Development of Core Data Set of the Officer Longitudinal Research Data Base

DTIC Science & Technology

1987-07-01

FR EQ U EN CI ES FR OM TH E OM F. J DA TA OM FF RE Q; IN FI LE...OC FR EQ ; n ~ > t-3 ctJ ~ 10 q ts:l z n t< n 0 q z t-3 (/) 0 I’Jj ~ t-3 > ts:l t’i ts:l ~ ts:l z t-3 (/) 0 1󈧏 )I ’t1 ’U tz j z 0 H X 0... FR EQ U EN CI ES FR OM TH E SO M F. I DA TA SO M FF RE Q; IN FI LE IN ; IN PU T SS N IB 4. TY R $C H A R2

Standard error of measurement of five health utility indexes across the range of health for use in estimating reliability and responsiveness

PubMed Central

Palta, Mari; Chen, Han-Yang; Kaplan, Robert M.; Feeny, David; Cherepanov, Dasha; Fryback, Dennis

2011-01-01

Background Standard errors of measurement (SEMs) of health related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics and provides guidance on using indexes on the individual and group level. SEM is also a component of reliability. Purpose To estimate SEM of five HRQoL indexes. Design The National Health Measurement Study (NHMS) was a population based telephone survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures 1 and 6 months post cataract surgery. Subjects 3844 randomly selected adults from the non-institutionalized population 35 to 89 years old in the contiguous United States and 265 cataract patients. Measurements The SF6-36v2™, QWB-SA, EQ-5D, HUI2 and HUI3 were included. An item-response theory (IRT) approach captured joint variation in indexes into a composite construct of health (theta). We estimated: (1) the test-retest standard deviation (SEM-TR) from COMHS, (2) the structural standard deviation (SEM-S) around the composite construct from NHMS and (3) corresponding reliability coefficients. Results SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2) and 0.134 (HUI3), while SEM-S was 0.071, 0.094, 0.084, 0.074 and 0.117, respectively. These translate into reliability coefficients for SF-6D: 0.66 (COMHS) and 0.71 (NHMS), for QWB: 0.59 and 0.64, for EQ-5D: 0.61 and 0.70 for HUI2: 0.64 and 0.80, and for HUI3: 0.75 and 0.77, respectively. The SEM varied considerably across levels of health, especially for HUI2, HUI3 and EQ-5D, and was strongly influenced by ceiling effects. Limitations Repeated measures were five months apart and estimated theta contain measurement error. Conclusions The two types of SEM are similar and substantial for all the indexes, and vary across the range of health. PMID:20935280

Multiple imputation to deal with missing EQ-5D-3L data: Should we impute individual domains or the actual index?

PubMed

Simons, Claire L; Rivero-Arias, Oliver; Yu, Ly-Mee; Simon, Judit

2015-04-01

Missing data are a well-known and widely documented problem in cost-effectiveness analyses alongside clinical trials using individual patient-level data. Current methodological research recommends multiple imputation (MI) to deal with missing health outcome data, but there is little guidance on whether MI for multi-attribute questionnaires, such as the EQ-5D-3L, should be carried out at domain or at summary score level. In this paper, we evaluated the impact of imputing individual domains versus imputing index values to deal with missing EQ-5D-3L data using a simulation study and developed recommendations for future practice. We simulated missing data in a patient-level dataset with complete EQ-5D-3L data at one point in time from a large multinational clinical trial (n = 1,814). Different proportions of missing data were generated using a missing at random (MAR) mechanism and three different scenarios were studied. The performance of using each method was evaluated using root mean squared error and mean absolute error of the actual versus predicted EQ-5D-3L indices. In large sample sizes (n > 500) and a missing data pattern that follows mainly unit non-response, imputing domains or the index produced similar results. However, domain imputation became more accurate than index imputation with pattern of missingness following an item non-response. For smaller sample sizes (n < 100), index imputation was more accurate. When MI models were misspecified, both domain and index imputations were inaccurate for any proportion of missing data. The decision between imputing the domains or the EQ-5D-3L index scores depends on the observed missing data pattern and the sample size available for analysis. Analysts conducting this type of exercises should also evaluate the sensitivity of the analysis to the MAR assumption and whether the imputation model is correctly specified.

Health Utility of Pregnant Women Living with HIV/AIDS: Prevention of Mother-to-Child Transmission of HIV (PMTCT) Programs in Yunnan Province: A Cross-Sectional Study.

PubMed

Wang, Xiaowen; Guo, Guangping; Liang, Xiumin; Zhou, Ling; Zheng, Jiarui; Li, Shaoqin; Luo, Hongzhuan; Yang, Yuyan; Yang, Liyuan; Tan, Ting; Yu, Jun; Lu, Lin

2018-05-01

Health utility (HU) is essential to understanding the effects of HIV infection as a chronic disease. No HU data on pregnant women living with human immunodeficiency virus (HIV) in Yunnan Province are available. This study aims to construct a database on HU and explore factors associated with HU by pregnant women living with HIV/acquired immunodeficiency syndrome (AIDS) who were enrolled in the Prevention of mother-to-child transmission of HIV (PMTCT) programs in Yunnan Province. A cross-sectional study was conducted in Yunnan Province on pregnant women living with HIV who were selected by convenience sampling. Sociodemographic, HIV-related, social support, and HU data were collected through face-to-face interviews. The European quality of life five-dimensional three-level (EQ-5D-3L) questionnaire and the social support rate scale (SSRS) were applied. One hundred and one pregnant women (mean age of 30.4 ± 5.1 years) participated in the survey. The mean EQ-5D index score and the EQ visual analogue scale (EQ-VAS) score of participants were 0.77 (95% confidence interval [CI] 0.74-0.79) and 75.77 (95% CI 75.00-80.00), respectively. The effect of social support on HU was maintained significant difference even after adjusting for such factors as education level, household income per year, and HIV disclosure, demonstrating a significant difference within EQ-5D index scores and EQ-VAS scores. Pregnant women living with HIV/AIDS who were enrolled in PMTCT programs reported the same level of HU as other patients living with HIV/AIDS. Integrating measurements of HU by using the EQ-5D-3L questionnaire could be helpful for economic evaluation of the PMTCT program. This study also suggests a potential benefit of appropriate social support. Copyright © 2018. Published by Elsevier Inc.

Quality of life profile of general Vietnamese population using EQ-5D-5L.

PubMed

Nguyen, Long Hoang; Tran, Bach Xuan; Hoang Le, Quynh Ngoc; Tran, Tung Thanh; Latkin, Carl A

2017-10-11

Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

The Factors Influencing Depression Endpoints Research (FINDER) study: final results of Italian patients with depression

PubMed Central

2010-01-01

Background Factors Influencing Depression Endpoints Research (FINDER) is a 6-month, prospective, observational study carried out in 12 European countries aimed at investigating health-related quality of life (HRQoL) in outpatients receiving treatment for a first or new depressive episode. The Italian HRQoL data at 6 months is described in this report, and the factors associated with HRQoL changes were determined. Methods Data were collected at baseline, 3 and 6 months of treatment. HRQoL was measured using components of the 36-item Short Form Health Survey (SF-36; mental component summary (MCS), physical component summary (PCS)) and the European Quality of Life-5 Dimensions (EQ-5D; visual analogue scale (VAS) and health status index (HSI)). The Hospital Anxiety and Depression Scale (HADS) was adopted to evaluate depressive symptoms, while somatic and painful physical symptoms were assessed by using the 28-item Somatic Symptom Inventory (SSI-28) and a VAS. Results Of the initial 513 patients, 472 completed the 3-month observation and 466 the 6-month observation. The SF-36 and EQ-5D mean (± SD) scores showed HRQoL improvements at 3 months and a further smaller improvement at 6 months, with the most positive effects for SF-36 MCS (baseline 22.0 ± 9.2, 3 months 34.6 ± 10.0; 6 months 39.3 ± 9.5) and EQ-5D HSI (baseline 0.4 ± 0.3; 3 months 0.7 ± 0.3; 6 months 0.7 ± 0.2). Depression and anxiety symptoms (HADS-D mean at baseline 13.3 ± 4.2; HADS-A mean at baseline 12.2 ± 3.9) consistently decreased during the first 3 months (8.7 ± 4.3; 7.5 ± 3.6) and showed a further positive change at 6 months (6.9 ± 4.3; 5.8 ± 3.4). Somatic and painful symptoms (SSI and VAS) significantly decreased, with the most positive changes in the SSI-28 somatic item (mean at baseline 2.4 ± 0.7; mean change at 3 months: -0.5; 95% CI -0.6 to -0.5; mean change at 6 months: -0.7; 95% CI -0.8 to -0.7); in 'interference of overall pain with daily activities' (mean at baseline 45.2 ± 30.7; mean change at 3 months -17.4; 95% CI -20.0 to -14.8; mean change at 6 months -24.4; 95% CI -27.3 to -21.6) and in 'having pain while awake' (mean at baseline 41.1 ± 29.0; mean change at 3 months -13.7; 95% CI -15.9 to -11.5; mean change at 6 months -20.2; 95% CI -22.8 to -17.5) domains. The results from linear regression analyses showed that the antidepressant switch within classes was consistently associated with a worsening in SF-36 MCS, EQ-5D VAS and HSI compared to non-switching treatment. Furthermore, between-group antidepressants (AD) switch was associated with a worse SF-36 MCS and EQ-5D HSI. MCS (P = 0.028), PCS (P = 0.036) and HSI (P = 0.002) were inversely related to the number of each previous additional depressive episode. PCS (P = 0.009) and HSI (P = 0.005) were also less improved in patients suffering from a chronic medical condition. Moreover, PCS (P = 0.044) and EQ-5D VAS (P < 0.0001) worsening was consistently associated with the presence of a psychiatric illness in the 24 months before baseline. For every additional point on the SSI-somatic score and on the overall pain VAS score at baseline, HSI score were on average 0.062 (P < 0.001) and 0.001 (P = 0.005) smaller, respectively. Conclusions After starting AD treatment, HRQoL improvements at 3 and 6 months were observed. However, several factors can negatively influence HRQoL, such as the presence of somatic and painful symptoms, the presence of any chronic medical condition or previous psychiatric illness. PMID:20670396

Health-Related Quality of Life among Nonprescription Medicine Customers in Malaysia.

PubMed

Shafie, Asrul Akmal; Hassali, Mohamed Azmi; Mohamad Yahaya, Abdul Haniff

2013-05-01

To describe the health-related quality of life (HRQOL) among nonprescription medicine customers in Malaysia and the factors that affect it. A nationwide cross-sectional survey was conducted among pharmacy customers in 59 randomly selected community pharmacies in Malaysia. The self-administered questionnaire included the EuroQoL five-dimensional (EQ-5D) questionnaire, the EuroQol visual analogue scale (EQ-VAS), nonprescription medicines purchase, and demographic questions. Data were analyzed by using the multivariate analysis of variance and multiple logistic regressions. A total of 2729 customers enrolled in this study, with a mean EQ-5D questionnaire score of 0.92±0.15 and a mean EQ-VAS score of 69.92±24.80. Compared with the Malaysian adult population, nonprescription medicine customers have a lower mean EQ-5D questionnaire score (t =-4.49, P<0.01) and EQ-VAS score (t =-25.87, P<0.01). We found that pain/discomfort (25.6%) and anxiety/depression (13.7%) were the major HRQOL problems. Locality, age, ethnicity, household income per month, type of occupation, and type of nonprescription medicine purchased were associated with health status of nonprescription medicine customers (F 22,5286 = 2.555; Wilks' lambda = 0.979; P< 0.01). The HRQOL of nonprescription medicine customers is lower than that of the general Malaysian population. Lower health status was independently associated with older age, living in rural areas, having low income and education level, and purchasing blood and blood-forming medicines from community pharmacy. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Hydromagnetic Waves and Instabilities in Kappa Distribution Plasma

DTIC Science & Technology

2009-01-01

perpendicular effective particle temperatures, respec- tively. Two other parameters related to pM and pnl which naturally occur in the study of...role in determin- ing the excitation conditions of the field swelling and mirror instabilities [see Eqs. (60) and (65)]. Calculating pnl /pni from Eq...more convenient form of the perturbed distribution function /„ that may be used in- stead of Eq. (12) to obtain nn, pM, and pnl given by Eqs. (72

Influence of sodium chloride on the beta-glucuronidase activity of Clostridium perfringens and Escherichia coli.

PubMed

Fujisawa, T; Aikawa, K; Takahashi, T; Yamai, S

2000-09-01

While the beta-glucuronidase activity of intact cells of Clostridium perfringens was higher in 0.95% sodium chloride (NaCl) than that in 0, 0.1 or 0.5%, that of Escherichia coli was higher in 0.1% NaCl than that in 0, 0.5 or 0.95% NaCl in 0.1 mol l-1 KH2PO4. However, the enzyme activity of both species of intact cells was higher in buffer containing 16 mEq sodium, 134 mEq potassium and 16 mEq chloride per litre than in that containing 146 mEq sodium, 13 mEq potassium and 146 mEq chloride. These findings suggest that bacterial cells are affected by the presence of NaCl and that the effect of NaCl on the activity of bacterial beta-glucuronidase may differ by location in the large intestine.

Long-term changes in soil and stream chemistry across an acid deposition gradient in the northeastern United States

USGS Publications Warehouse

Siemion, Jason; McHale, Michael; Lawrence, Gregory B.; Burns, Douglas A.; Antidormi, Michael

2018-01-01

Declines in acidic deposition across Europe and North America have led to decreases in surface water acidity and signs of chemical recovery of soils from acidification. To better understand the link between recovery of soils and surface waters, chemical trends in precipitation, soils, and streamwater were investigated in three watersheds representing a depositional gradient from high to low across the northeastern United States. Significant declines in concentrations of H+ (ranging from −1.2 to −2.74 microequivalents [μeq] L−1 yr−1), NO3− (ranging from −0.6 to −0.84 μeq L−1 yr−1), and SO42− (ranging from −0.95 to −2.13 μeq L−1 yr−1) were detected in precipitation in the three watersheds during the period 1999 to 2013. Soil chemistry in the A horizon of the watershed with the greatest decrease in deposition showed significant decreases in exchangeable Al and increases in exchangeable bases. Soil chemistry did not significantly improve during the study in the other watersheds, and base saturation in the Oa and upper B horizons significantly declined in the watershed with the smallest decrease in deposition. Streamwater SO42−concentrations significantly declined in all three streams (ranging from −2.01 to −2.87 μeq L−1 yr−1) and acid neutralizing capacity increased (ranging from 1.38 to 1.60 μeq L−1 yr−1) in the two streams with the greatest decreases in deposition. Recovery of soils has likely been limited by decades of acid deposition that have leached base cations from soils with base-poor parent material.

Health-related quality of life measured using the EQ-5D-5L: South Australian population norms.

PubMed

McCaffrey, Nikki; Kaambwa, Billingsley; Currow, David C; Ratcliffe, Julie

2016-09-20

Although a five level version of the widely-used EuroQol 5 dimensions (EQ-5D) instrument has been developed, population norms are not yet available for Australia to inform the future valuation of health in economic evaluations. The aim of this study was to estimate HrQOL normative values for the EQ-5D-5L preference-based measure in a large, randomly selected, community sample in South Australia. The EQ-5D-5L instrument was included in the 2013 South Australian Health Omnibus Survey, an interviewer-administered, face-to-face, cross-sectional survey. Respondents rated their level of impairment across dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and global health rating on a visual analogue scale (EQ-VAS). Utility scores were derived using the newly-developed UK general population-based algorithm and relationships between utility and EQ-VAS scores and socio-demographic factors were also explored using multivariate regression analyses. Ultimately, 2,908 adults participated in the survey (63.4 % participation rate). The mean utility and EQ-VAS scores were 0.91 (95 CI 0.90, 0.91) and 78.55 (95 % CI 77.95, 79.15), respectively. Almost half of respondents reported no problems across all dimensions (42.8 %), whereas only 7.2 % rated their health >90 on the EQ-VAS (100 = the best health you can imagine). Younger age, male gender, longer duration of education, higher annual household income, employment and marriage/de facto relationships were all independent, statistically significant predictors of better health status (p < 0.01) measured with the EQ-VAS. Only age and employment status were associated with higher utility scores, indicating fundamental differences between these measures of health status. This is the first Australian study to apply the EQ-5D-5L in a large, community sample. Overall, findings are consistent with EQ-5D-5L utility and VAS scores reported for other countries and indicate that the majority of South Australian adults report themselves in full health. When valuing health in Australian economic evaluations, the utility population norms can be used to estimate HrQOL. More generally, the EQ-VAS score may be a better measure of population health given the smaller ceiling effect and broader coverage of HrQOL dimensions. Further research is recommended to update EQ-5D-5L population norms using the Australian general population specific scoring algorithm once this becomes publically available.

Serine protease activity in m-1 cortical collecting duct cells.

PubMed

Liu, Lian; Hering-Smith, Kathleen S; Schiro, Faith R; Hamm, L Lee

2002-04-01

An apical serine protease, channel-activating protease 1 (CAP1), augments sodium transport in A6 cells. Prostasin, a novel serine protease originally purified from seminal fluid, has been proposed to be the mammalian ortholog of CAP1. We have recently found functional evidence for a similar protease activity in the M-1 cortical collecting duct cell line. The purposes of the present studies were to determine whether prostasin (or CAP1) is present in collecting duct cells by use of mouse M-1 cells, to sequence mouse prostasin, and to further characterize the identity of the serine protease activity and additional functional features in M-1 cells. Using mouse expressed sequence tag sequences that are highly homologous to the published human prostasin sequence as templates, reverse transcription-polymerase chain reaction and RACE (rapid amplification of cDNA ends) were used to sequence mouse prostasin mRNA, which shows 99% identical to published mouse CAP1 sequence. A single 1800-bp transcript was found by Northern analysis, and this was not altered by aldosterone. Equivalent short-circuit current (I(eq)), which represents sodium transport in these cells, dropped to 59+/-3% of control value within 1 hour of incubation with aprotinin, a serine protease inhibitor. Trypsin increased the I(eq) in aprotinin-treated cells to the value of the control group within 5 minutes. Application of aprotinin not only inhibited amiloride sensitive I(eq) but also reduced transepithelial resistance (R(te)) to 43+/-2%, an effect not expected with simple inhibition of sodium channels. Trypsin partially reversed the effect of aprotinin on R(te). Another serine protease inhibitor, soybean trypsin inhibitor (STI), decreased I(eq) in M-1 cells. STI inhibited I(eq) gradually over 6 hours, and the inhibition of I(eq) by 2 inhibitors was additive. STI decreased transepithelial resistance much less than did aprotinin. Neither aldosterone nor dexamethasone significantly augmented protease activity or prostasin mRNA levels, and in fact, dexamethasone decreased prostasin mRNA expression. In conclusion, although prostasin is present in M-1 cells and probably augments sodium transport in these cells, serine proteases probably have other effects (eg, resistance) in the collecting duct in addition to effects on sodium channels. Steroids do not alter these effects in M-1 cells. Additional proteases are likely also present in mouse collecting duct cells.

Does the Introduction of the Ranking Task in Valuation Studies Improve Data Quality and Reduce Inconsistencies? The Case of the EQ-5D-5L.

PubMed

Ramos-Goñi, Juan M; Rand-Hendriksen, Kim; Pinto-Prades, Jose Luis

2016-06-01

Time trade-off (TTO)-based valuation studies for the three-level version of the EuroQol five-dimensional questionnaire (EQ-5D) typically started off with a ranking task (ordering the health states by preference). This was not included in the protocol for the five-level EQ-5D (EQ-5D-5L) valuation study. To test whether reintroducing a ranking task before the composite TTO (C-TTO) could help to reduce inconsistencies in C-TTO responses and improve the data quality. Respondents were randomly assigned to three study arms. The control arm was the present EQ-5D-5L study protocol, without ranking. The second arm (ranking without sorting) preceded the present protocol by asking respondents to rank the target health states using physical cards. The states were then valued in random order using C-TTO. In the third arm (ranking and sorting), the ranked states remained visible through the C-TTO tasks and the order of valuation was determined by the ranking. The study used only 10 EQ-5D-5L health states. We compared the C-TTO-based inconsistent pairs of health states and ties. The final sample size was 196 in the control arm, 205 in the ranking without sorting arm, and 199 in the ranking and sorting arm. The percentages of ties by respondents were 15.1%, 12.5%, and 12.6% for the control arm, the ranking without sorting arm, and the ranking and sorting arm, respectively. The extra cost for adding the ranking task was about 15%. The benefit does not justify the effort involved in the ranking task. For this reason, the addition of the ranking task to the present EQ-5D-5L valuation protocol is not an attractive option. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Social tension as precursor of large damaging earthquake: legend or reality?

NASA Astrophysics Data System (ADS)

Molchanov, O.

2008-11-01

Using case study of earthquake (EQ) activity and war conflicts in Caucasus during 1975 2002 time interval and correlation analysis of global distribution of damaging EQs and war-related social tension during 1901 2005 period we conclude:

• There is a statistically reliable increase of social tension several years (or several months in case study) before damaging EQs,
• There is evident decrease of social tension several years after damaging EQs, probably due to society consolidation,
• Preseismic effect is absent for the large EQs in unpopulated areas,
• There is some factual background for legendary belief in Almighty retribution for social abnormal behavior.

Program Derivation by Proof Transformation

DTIC Science & Technology

1993-10-01

variable name. InfA (rA)I-[ #e1 (A, el F vF 0’ P) 4. e2 [node(x, v) :: u/gA XsINDTS [u o v/ lA f [] = ei (1,A )F P1 P2 f(node(x’,V)::U) u’)[ 0fl/A [node(z...iforalle 1 (foralle n (md ( En ) iforall El ] implies (eq n (tisize 1)) (A 1)) (iforalli E1] impliesi [q: I- (eq zero (tisize 1)) (leq-.subst..o ( El ] A 1) (P...nl 1 q) Base-.case)) ( En [p’: I- (iforall El ] implies (eq n (tisize 1) (A 1)) (iforalli El ) iinpliesi Eq: I- (eq (succ n) (tisize 1)) (existse (Ex

The impact of type 2 diabetes on health related quality of life in Bangladesh: results from a matched study comparing treated cases with non-diabetic controls.

PubMed

Safita, Novie; Islam, Sheikh Mohammed Shariful; Chow, Clara K; Niessen, Louis; Lechner, Andreas; Holle, Rolf; Laxy, Michael

2016-09-13

Little is known about the association between diabetes and health related quality of life (HRQL) in lower-middle income countries. This study aimed to investigate HRQL among individuals with and without diabetes in Bangladesh. The analysis is based on data of a case-control study, including 591 patients with type 2 diabetes (cases) who attended an outpatient unit of a hospital in Dhaka and 591 age -and sex-matched individuals without diabetes (controls). Information about socio-demographic characteristics, health conditions, and HRQL were assessed in a structured interview. HRQL was measured with the EuroQol (EQ) visual analogue scale (VAS) and the EQ five-dimensional (5D) descriptive system. The association between diabetes status and quality of life was examined using multiple linear and logistic regression models. Mean EQ-VAS score of patients with diabetes was 11.5 points lower (95 %-CI: -13.5, -9.6) compared to controls without diabetes. Patients with diabetes were more likely to report problems in all EQ-5D dimensions than controls, with the largest effect observed in the dimensions 'self-care' (OR = 5.9; 95 %-CI: 2.9, 11.8) and 'mobility' (OR = 4.5; 95 %-CI: 3.0, -6.6). In patients with diabetes, male gender, high education, and high-income were associated with higher VAS score and diabetes duration and foot ulcer associated with lower VAS scores. Other diabetes-related complications were not significantly associated with HRQL. Our findings suggest that the impact of diabetes on HRQL in the Bangladeshi population is much higher than what is known from western populations and that unlike in western populations comorbidities/complications are not the driving factor for this effect.

The use of a biplot in studying outcomes after stroke.

PubMed

De Wit, Liesbet; Molas, Marek; Dejaeger, Eddy; De Weerdt, Willy; Feys, Hilde; Jenni, Walter; Lincoln, Nadina; Putman, Koen; Schupp, Wilfried; Lesaffre, Emmanuel

2009-10-01

This study aimed to unravel the multidimensional profile of stroke outcomes by investigating the global correlation structure of motor, functional, and emotional problems of patients, as well as their caregivers' strain, at 6 months after stroke. Potential differential associations based on patients' level of functioning on admission to the rehabilitation center were analyzed. Data were collected within the CERISE-study (Collaborative Evaluation of Rehabilitation in Stroke across Europe). Six months after stroke, the Rivermead Motor Assessment (RMA), Extended Activities of Daily Living (EADL), Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Hospital Anxiety and Depression Scale-Depression (HADS-D), EuroQol-Health State (EQ-HS), EuroQol-Visual Analogue Scale (EQ-VAS), and Caregiver Strain Index (CSI) were administered. Patients were classified into 3 categories according to their Barthel Index (BI) score on admission to the rehabilitation center. Principal component analysis was carried out, and a biplot was constructed. Data were available on 510 patients. One cluster was formed by RMA and EADL, and a second one by HADS-A, HADS-D, and EQ-VAS. EQ-HS was situated between these two. CSI formed a third dimension. Patients with low BI scores on admission to the rehabilitation center had higher HADS-A and HADS-D scores 6 months after stroke. High BI scores were associated with large variations in HADS-A and HADS-D scores. This novel biplot strategy for rehabilitation studies revealed 2 clusters: one of motor/functional problems and one of emotional problems. Patients with mild functional deficit measured on admission to the rehabilitation center can suffer from mild to severe anxiety and depression at 6 months poststroke. Screening for emotional disorders in all patients is recommended.

Patiromer Lowers Serum Potassium When Taken without Food: Comparison to Dosing with Food from an Open-Label, Randomized, Parallel Group Hyperkalemia Study.

PubMed

Pergola, Pablo E; Spiegel, David M; Warren, Suzette; Yuan, Jinwei; Weir, Matthew R

2017-01-01

Patiromer is a sodium-free, nonabsorbed, potassium binder approved for treatment of hyperkalemia. This open-label study compares the efficacy and safety of patiromer administered without food versus with food. Adults with hyperkalemia (potassium ≥5.0 mEq/L) were randomized (1:1) to receive patiromer once daily without food or with food for 4 weeks. The dosage was adjusted (maximum: 25.2 g/day) using a prespecified titration schedule to achieve and maintain potassium within a target range (3.8-5.0 mEq/L). The primary efficacy endpoint was the proportion of patients with serum potassium in the target range at either week 3 or week 4. Safety was assessed by adverse events (AEs) and laboratory testing. Efficacy was evaluated in 112 patients; 65.2% were ≥65 years of age, 75.9% had chronic kidney disease, and 82.1% had diabetes. Baseline mean serum potassium was similar in the without-food (5.44 mEq/L) and with-food (5.34 mEq/L) groups. The primary endpoint was achieved by 87.3% (95% CI 75.5-94.7) and 82.5% (95% CI 70.1-91.3) of patients in the with-food and without-food groups, respectively; least squares mean changes in serum potassium from baseline to week 4 were -0.65 and -0.62 mEq/L, respectively (p < 0.0001). The most common AEs were diarrhea and constipation. Serum K+ remained ≥3.5 mEq/L in all patients; 5 patients developed serum magnesium <1.4 mg/dL, including 4 whose baseline magnesium was below the lower limit of normal. Patiromer is equally effective and well tolerated when taken without food or with food, thereby offering the potential for dosing flexibility. © 2017 The Author(s) Published by S. Karger AG, Basel.

Development and validation of the alcohol Expectancy Questionnaire Short Form (EQ-SF).

PubMed

Mezquita, Laura; Camacho, Laura; Suso-Ribera, Carlos; Ortet, Generós; Ibáñez, Manuel I

2018-01-15

Alcohol expectancies are proximal variables to alcohol use and misuse. In recent decades, different measures have been developed to assess this construct. One of the most frequently used and recommended instruments is the Expectancy Questionnaire (EQ; Leigh y Stacy, 1993). Our aim is to develop a short version of the EQ (EQ-SF) for suitable use in time-limited administrations. Two samples, adolescents (N = 514, 57.20% females) and adults (N = 548, 61.50% females), completed the EQ together with alcohol-use measures. Different item selection strategies were applied to select the 24 items. The EQ-SF structure was explored using confirmatory factor analysis, and measurement invariance was tested running a multi-group analysis comparing groups by sex and age. Reliability was tested using Cronbach's alpha and omega coefficients. Concurrent validity was investigated with regression analyses. The EQ-SF showed acceptable between-groups measurement invariance. Alphas and omegas ranged from .77 to .93. Positive expectancies predicted both alcohol use and alcohol-related problems. Negative expectancies predicted alcohol-related problems. Sex and age moderated these associations. Males with high positive alcohol expectancies showed higher alcohol consumption than females, while adults with high negative alcohol expectancies showed greater alcohol-related problems than adolescents. Different evidence on the validity and reliability of the EQ-SF suggest that it is a suitable instrument to assess alcohol expectancies in the Spanish population.

Estrogenic activity and nutrient losses in surface runoff after winter manure application to small watersheds.

PubMed

Shappell, N W; Billey, L O; Shipitalo, M J

2016-02-01

Confined Animal Feeding Operations generate large amounts of wastes that are land-applied to provide nutrients for crop production and return organic matter to the soil. Production practices and storage limitations often necessitate that wastes be applied to frozen and snow-covered soil. Use of application setbacks have reduced concerns related to nutrient losses in surface runoff from manure, but the estrogenic activity of runoff under these conditions has not been evaluated. Therefore, we measured and sampled surface runoff when manure was applied in the winter at a rate to meet crop N needs and measured estradiol equivalents (E2Eqs) using E-Screen. In year one, six small watersheds used to produce corn were evaluated, treatments: 2 no-manure controls, 2 liquid swine manure with 30-m setbacks, and 2 turkey litter with 30-m setbacks. In addition, beef manure was applied to six frozen plots of forage. For years 2 and 3, applications were repeated on the swine manure watersheds and one control watershed. E2Eqs and nutrient concentrations generally peaked in the first runoff event after application. The highest measured E2Eq (5.6 ng L(-1)) was in the first event after swine manure application and was less than the 8.9 ng L(-1) Lowest Observable Effect Concentration (LOEC) for aquatic species and well below the concentrations measured in other studies using ELISAs to measure hormone concentrations. No runoff occurred from plots planted with forage, indicating low risk for environmental impact, and therefore plots were discontinued from study. In years 2 and 3, estrogenic activity never exceeded the Predicted No Effect Concentrations for E2 of 2 ng L(-1). When post-application runoff contained high estrogenic activity, strong correlations (R(2) 0.86 to 0.96) of E2Eq to Ca(2+), Mg(2+), and K(+) concentrations were observed, indicating under some condition these cations might be useful surrogates for E2Eq measurements. Published by Elsevier B.V.

Comparison of the clinical efficacy of twice-daily Ritalin and once-daily Equasym XL with placebo in children with Attention Deficit/Hyperactivity Disorder.

PubMed

Findling, Robert L; Quinn, Declan; Hatch, Simon J; Cameron, Sara J; DeCory, Heleen H; McDowell, Michael

2006-12-01

To compare the efficacy and safety of two methylphenidate (MPH) formulations--once-daily modified-release MPH (EqXL, Equasym XL) and twice-daily immediate-release methylphenidate (MPH-IR, Ritalin)--and placebo in children with Attention Deficit/Hyperactivity Disorder (ADHD). Children aged 6-12 years on a stable dose of MPH were randomized into a double-blind, three-arm, parallel-group, multi-center study and received 3 weeks of EqXL (20, 40, or 60 mg qd), MPH-IR (10, 20, or 30 mg bid) or placebo. Non-inferiority of EqXL to MPH-IR was assessed by the difference in the inattention/overactivity component of the overall teacher's IOWA Conners' Rating Scale on the last week of treatment (per protocol population). Safety was monitored by adverse events, laboratory parameters, vital signs, physical exam, and a Side Effect Rating Scale. The lower 97.5% confidence interval bound of the difference between MPH groups fell above the non-inferiority margin (-1.5 points) not only during the last week of treatment but during all three treatment weeks. Both MPH-treatment groups experienced superior benefit when compared to placebo during all treatment weeks (P < 0.001). All treatments were well tolerated. EqXL given once-daily was non-inferior to MPH-IR given twice-daily. Both treatments were superior to placebo in reducing ADHD symptoms.

Obstetric patients' health-related quality of life before and after intensive care.

PubMed

Pia, Seppänen; Reijo, Sund; Tero, Ala-Kokko; Mervi, Roos; Jukka, Uotila; Mika, Helminen; Tarja, Suominen

2018-03-23

Intensive care admissions during pregnancy, childbirth, and postpartum period are relatively well investigated. However, very little is known about these obstetric patients' health-related quality of life (HRQoL) before and after critical care. The objective of this study was to assess obstetric patients' HRQoL before intensive care admission (baseline) and at 6 months after discharge (follow-up) DESIGN: This was a retrospective database study. In a 5-year period, the data of all women admitted to the intensive care unit (ICU) during pregnancy, delivery, or up to 42 days postpartum were analysed. Four multidisciplinary ICUs of Finnish University hospitals participated. The HRQoL was assessed using the EuroQol-5D (EQ-5D) instrument with utility score (EQsum) and visual analogue scale (EQ-VAS). A total of 283 obstetric patients were identified from the clinical information system. Of these, 99 (35%) completed the EQ-5D questionnaires both at baseline and follow-up, and 65 of them (23%) completed EQ-VAS. The comparison of patients' EQsum scores before intensive care admission and after discharge showed that patients' HRQoL remained good (0.970 vs 0.972) (max 1.0) or increased (0.788 vs 0.982) in 80.8% of the patients. Patients reported improved overall health on the EQ-VAS at 6 months follow-up (EQ-VAS mean, 71.86 vs 88.20; p ≤ 0.001) (max 100). However, 19.2% of the patients had lower HRQoL (EQsum mean 0.987 vs 0.798) at follow-up. Following intensive care, 15% of the patients had more pain/discomfort, and 11% expressed more depression/anxiety. Multiparous patients were more likely to suffer from worsened depression/anxiety (p = 0.024). In the majority of the obstetric patients, HRQoL at 6 months follow-up remained good or had increased from baseline. However, nearly one-fifth of the patients had impaired HRQoL after discharge. Thus, intensive care management should take in to consideration follow-up program after intensive care of ICU-admitted obstetric patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Environmental effects of shifts in a regional heating mix through variations in the utilization of solid biofuels.

PubMed

Wolf, Christian; Klein, Daniel; Richter, Klaus; Weber-Blaschke, Gabriele

2016-07-15

Solid Biofuels, i.e. wood, play an important role in present and future national and global climate change mitigation policies. Wood energy, while displaying favorable properties for the mitigation of climate change also exhibits several drawbacks, such as potentially high emission of particulate matter. To assess the environmental effects of shifts in the heating mix, emission factors of the comprising energy carriers and the Bavarian heating mix were determined. Through the application of regionalized substitution percentiles the environmental effects caused by shifts in the amount of final energy provided by solid biofuels could be identified. For this purpose, four scenarios, based on political and scientific specifications were assessed. In 2011 a total amount of 663.715 TJ of final energy was used for the provision of heat in Bavaria, with solid biofuels exhibiting the third largest share of 12.6% (83% of renewable heat). Environmental effects were evaluated through life cycle assessments assessing the impact categories of Global Warming (GW), Particulate Matter emissions (PM), Freshwater Eutrophication (ET) and Acidification (AC). Additionally, the non-renewable primary energy consumption (PE) was analyzed. The heating mix in Bavaria (Baseline) causes emissions of 49.6 Mt CO2-eq. * yr(-1)(GW), 14.555 t of PM2.5-eq. * yr(-1) (PM), 873.4 t P-eq. * yr(-1) (ET), and 82.299 kmol H(+) eq. * yr(-1) (AC), for which 721,745 TJ of primary energy were expended. Current policies entail a GHG reduction potential of approximately 1 Mt CO2-eq. * yr(-1) while increasing the amount of energy wood by 15%. The maximum, hypothetical share of solid biofuels of the heating mix cannot surpass 25%, while the climate change mitigation performance of the current use of solid biofuels is approximately 6.4 Mt CO2-eq. * yr(-1). GHG-emissions would be 13% higher and PM emissions 77% lower without this energetic use of wood. Furthermore, our calculations allow for new specified displacement factors through energy substitution, based on the current wood energy mix for regionalized conditions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preference weights for the spectrum of alcohol use in the U.S. Population.

PubMed

Chavez, Laura J; Bradley, Katharine; Tefft, Nathan; Liu, Chuan-Fen; Hebert, Paul; Devine, Beth

2016-04-01

Little is known about the cost-utility of population-based alcohol interventions. One barrier to research has been the lack of preference weights needed to calculate Quality Adjusted Life Years (QALYs). Preference weights can be estimated from measures of health-related quality of life (HRQOL). The objective of this study was to describe preference weights for the full spectrum of alcohol use. This cross-sectional study included participants in both the National Health Interview Survey (NHIS; 1999-2002) and the Medical Expenditure Panel Survey (MEPS; 2000-2003). The AUDIT-C alcohol screen was derived from NHIS with scores categorized into 6 groups (0,1-3, 4-5, 6-7, 8-9, 10-12 points), ranging from nondrinking (0) to very severe unhealthy alcohol use (10-12). AUDIT-C scores were mapped to EQ-5D and SF-6D preference weights using the linked datasets and analyses adjusted for demographics. Among 17,440 participants, mean EQ-5D and SF-6D preference weights were 0.82 (95% CI 0.82-0.83) and 0.79 (95% CI 0.79-0.80), respectively. Adjusted EQ-5D preference weights for nondrinking (0.80; 95% CI 0.79-0.81) and moderate unhealthy drinking (0.85; 95% CI 0.84-0.86) were significantly different from low-risk drinking (0.83; 95% CI 0.83-0.84), but no other differences were significant. Results for the SF-6D were similar. This study provides EQ-5D and SF-6D preference weights for various alcohol use categories in a representative U.S. adult sample. However, neither measure suggested meaningful differences in HRQOL based on AUDIT-C categories. Self-reported alcohol consumption may not be associated with preference weights or generic instruments may not capture alcohol-related differences in HRQOL. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Metal Slurry Droplet and Spray Combustion

DTIC Science & Technology

1993-09-15

N (So(1 - AFNuR’/2So) S14 vaporization source in fuel conservation eq., S,, = N ’(1 - Y )S• S•,, vaporization source in oxygen conservation eq., S",2...In;( I n +YM’CT-~ + Ct~T •~ N 5 1t J 1 Y -. A J I 1 *]4zr~ ,1.(-) ,.+ - Y =, , A + C,(T, - T.) - 3,,(7) = ,- + ""j =AH - hf " -+ - qjj qI + ’ {hfg...velocity u. 152 1.0 N %4000 0.YoN - 3800 0 .8 Y 3600 w 0.7 Y.P’Sat.30 0.6-I 3200 0.5- N 3000 2 0.4 2800 0.32600 < 0.2 -

Testing mapping algorithms of the cancer-specific EORTC QLQ-C30 onto EQ-5D in malignant mesothelioma.

PubMed

Arnold, David T; Rowen, Donna; Versteegh, Matthijs M; Morley, Anna; Hooper, Clare E; Maskell, Nicholas A

2015-01-23

In order to estimate utilities for cancer studies where the EQ-5D was not used, the EORTC QLQ-C30 can be used to estimate EQ-5D using existing mapping algorithms. Several mapping algorithms exist for this transformation, however, algorithms tend to lose accuracy in patients in poor health states. The aim of this study was to test all existing mapping algorithms of QLQ-C30 onto EQ-5D, in a dataset of patients with malignant pleural mesothelioma, an invariably fatal malignancy where no previous mapping estimation has been published. Health related quality of life (HRQoL) data where both the EQ-5D and QLQ-C30 were used simultaneously was obtained from the UK-based prospective observational SWAMP (South West Area Mesothelioma and Pemetrexed) trial. In the original trial 73 patients with pleural mesothelioma were offered palliative chemotherapy and their HRQoL was assessed across five time points. This data was used to test the nine available mapping algorithms found in the literature, comparing predicted against observed EQ-5D values. The ability of algorithms to predict the mean, minimise error and detect clinically significant differences was assessed. The dataset had a total of 250 observations across 5 timepoints. The linear regression mapping algorithms tested generally performed poorly, over-estimating the predicted compared to observed EQ-5D values, especially when observed EQ-5D was below 0.5. The best performing algorithm used a response mapping method and predicted the mean EQ-5D with accuracy with an average root mean squared error of 0.17 (Standard Deviation; 0.22). This algorithm reliably discriminated between clinically distinct subgroups seen in the primary dataset. This study tested mapping algorithms in a population with poor health states, where they have been previously shown to perform poorly. Further research into EQ-5D estimation should be directed at response mapping methods given its superior performance in this study.

Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea.

PubMed

Kim, Seon-Ha; Jo, Min-Woo; Ock, Minsu; Lee, Sang-Il

2017-11-01

This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea. Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions. Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores. This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.

Effectiveness of the Stewart Method in the Evaluation of Blood Gas Parameters.

PubMed

Gezer, Mustafa; Bulucu, Fatih; Ozturk, Kadir; Kilic, Selim; Kaldirim, Umit; Eyi, Yusuf Emrah

2015-03-01

In 1981, Peter A. Stewart published a paper describing his concept for employing Strong Ion Difference. In this study we compared the HCO3 levels and Anion Gap (AG) calculated using the classic method and the Stewart method. Four hundred nine (409) arterial blood gases of 90 patients were collected retrospectively. Some were obtained from the same patients in different times and conditions. All blood samples were evaluated using the same device (ABL 800 Blood Gas Analyzer). HCO3 level and AG were calculated using the Stewart method via the website AcidBase.org. HCO3 levels, AG and strong ion difference (SID) were calculated using the Stewart method, incorporating the parameters of age, serum lactate, glucose, sodium, and pH, etc. According to classic method, the levels of HCO3 and AG were 22.4±7.2 mEq/L and 20.1±4.1 mEq/L respectively. According to Stewart method, the levels of HCO3 and AG were 22.6±7.4 and 19.9±4.5 mEq/L respectively. There was strong correlation between the classic method and the Stewart method for calculating HCO3 and AG. The Stewart method may be more effective in the evaluation of complex metabolic acidosis.

The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study.

PubMed

Gillard, Patrick J; Sucharew, Heidi; Kleindorfer, Dawn; Belagaje, Samir; Varon, Sepideh; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Khatri, Pooja; Flaherty, Matthew L; Adeoye, Opeolu; Ferioli, Simona; Kissela, Brett

2015-09-29

Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. We studied whether spasticity has a negative impact on health-related quality of life (HRQoL). As part of the Greater Cincinnati/Northern Kentucky Stroke Study (NCT00642213), 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. HRQoL was measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form-12 (SF-12), EuroQol-5 dimension (EQ-5D), and Stroke-Specific Quality of Life (SSQOL) instruments, with lower scores indicating worse health. HRQoL differences between stroke survivors with and without spasticity were compared, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities. Of the 460 ischemic stroke patients, 328 had spasticity data available 3 months after their stroke (mean age of 66 years, 49% were female, and 26% were black). Of these patients, 54 (16%) reported having spasticity. Three months following their stroke, patients who reported spasticity had lower mean scores on the PCS (29.6 ± 1.4 vs 37.3 ± 0.6; P < .001), EQ-5D (0.59 ± 0.03 vs 0.71 ± 0.01; P < .001), and SSQOL (3.57 ± 0.08 versus 3.78 ± 0.03; P = .03) compared with patients who did not report spasticity. Lower HRQoL scores were also observed at the 1-year (PCS, EQ-5D, and SSQOL) and 2-year (EQ-5D and SSQOL) interviews in those with spasticity compared with those without spasticity. Statistically and clinically meaningful differences in HRQoL exist between stroke survivors with and without spasticity.

Quality of sweat test (ST) based on the proportion of sweat sodium (Na) and sweat chloride (Cl) as diagnostic parameter of cystic fibrosis: are we on the right way?

PubMed

Faria, Alethéa Guimarães; Marson, Fernando Augusto Lima; Gomez, Carla Cristina de Souza; Ribeiro, Maria Ângela Gonçalves de Oliveira; Morais, Lucas Brioschi; Servidoni, Maria de Fátima; Bertuzzo, Carmen Sílvia; Sakano, Eulália; Goto, Maura; Paschoal, Ilma Aparecida; Pereira, Mônica Corso; Hessel, Gabriel; Levy, Carlos Emílio; Toro, Adyléia Aparecida Dalbo Contrera; Peixoto, Andressa Oliveira; Simões, Maria Cristina Ribeiro; Lomazi, Elizete Aparecida; Nogueira, Roberto José Negrão; Ribeiro, Antônio Fernando; Ribeiro, José Dirceu

2016-10-26

To assess the quality of sweat test (ST) based on the proportion of sweat sodium and sweat chloride as diagnostic parameter of cystic fibrosis (CF). A retrospective study of 5,721 sweat samples and subsequent descriptive analysis were carried out. The test was considered "of good quality" (correct) when: (i) sweat chloride was lower than 60 mEq/L, and sweat sodium was higher than sweat chloride; (ii) sweat chloride was higher than 60 mEq/L, and sweat sodium was lower than sweat chloride. The study included 5,692/5,721 sweat samples of ST which had been requested due to clinical presentations compatible with CF and/or neonatal screenings with altered immunoreactive trypsinogen values. Considering the proportion of sweat sodium and sweat chloride as ST quality parameter, the test was performed correctly in 5,023/5,692 (88.2 %) sweat samples. The sweat chloride test results were grouped into four reference ranges for chloride (i) chloride < 30 mEq/L: 3,651/5,692 (64.1 %); (ii) chloride ≥ 30 mEq/L to < 40 mEq/L: 652/5,692 (11.5 %); (iii) ≥ 40 mEq/L to < 60 mEq/L: 673/5,692 (11.8 %); (iv) ≥ 60 mEq/L: 716/5,692 (12.6 %). In the comparative analysis, there was no association between ST quality and: (i) symptoms to indicate a ST [respiratory (p = 0.084), digestive (p = 0.753), nutritional (p = 0.824), and others (p = 0.136)], (ii) sweat weight (p = 0.416). However, there was a positive association with: (i) gender, (ii) results of ST (p < 0.001), (iii) chloride/sodium ratio (p < 0.001), (iv) subject's age at the time of ST [grouped according to category (p < 0.001) and numerical order (p < 0.001)]. For the subset of 169 patients with CF and two CFTR mutations Class I, II and/or III, in comparative analysis, there was a positive association with: (i) sweat chloride/sodium ratio (p < 0.001), (ii) sweat chloride values (p = 0.047), (iii) subject's age at the time of the ST grouped by numerical order (p = 0.001). Considering that the quality of ST can be assessed by levels of sweat sodium and sweat chloride, an increasing number of low-quality tests could be observed in our sweat samples. The quality of the test was associated with important factors, such as gender, CF diagnosis, and subjects' age.

Contaminants in fishes from Great Lakes-influenced sections and above dams of three Michigan rivers. II: Implications for health of mink

USGS Publications Warehouse

Giesy, J.P.; Verbrugge, D.A.; Othoudt, R. A.; Bowerman, W.W.; Mora, M.A.; Jones, P.D.; Newsted, J.L.; Vandervoort, C.; Heaton, S. N.; Aulerich, R.J.; Bursian, S.J.; Ludwig, J. P.; Dawson, G. A.; Kubiak, T.J.; Best, D. A.; Tillitt, D. E.

1994-01-01

Populations of mink (Mustela vison) have declined in many areas of the world. Such declines have been linked to exposures to synthetic, halogenated hydrocarbons. In the Great Lakes region, mink are fewer in areas along the shore of the Great Lakes and their tributaries where mink have access to fish from the Great Lakes. Recently, there has been discussion of the relative merits of passage of fishes around hydroelectric dams on rivers in Michigan. A hazard assessment was conducted to determine the potential for adverse effects on mink, which could consume such fishes from above or below dams on the rivers. Concentrations of organochlorine insecticides, polychlorinated biphenyls (PCBs), 2,3,7,8-tetrachloridibenzo-p-dioxin equivalents (TCDD-EQ), and total mercury were measured in composite samples of fishes from above or below hydroelectric dams on the Manistee and Muskegon Rivers, which flow into Lake Michigan, and the Au Sable River, which flows into Lake Huron. Concentrations of organochlorine insecticides, PCBs, and TCDD-EQ were all greater in fishes from below the dams than those from above. Concentrations of neither organochlorine insecticides nor mercury in fishes are currently a risk to mink above or below the dams. All of the species of fishes collected from downstream of the dams contained concentrations of PCBs and TCDD-EQ, which represent a hazard to mink. The hazard index for PCBs was less than one for the average of all species from the upstream reaches of the Manistee and Au Sable Rivers, but not the Muskegon. The hazard index (concentration in fish/NOAEC) was greater than 1 for all of the species collected from below the dams, in all three rivers. The greatest hazard index was observed for carp (Cyprinus carpio) downstream on the Muskegon River. Because the concentrations of PCBs used in the hazard assessment were corrected for relative toxic potencies, the hazard ratios based on PCBs should be similar to those based on TCDD-EQ. This was found to be true. Thus, either total PCBs or TCDD-EQ could be used as the critical toxicant in the hazard assessment. However, if uncorrected concentrations of PCBs, expressed as Aroclors®, were used in the hazard assessment, the toxicity of the weathered mixture would have been underestimated by approximately five-fold, and, in that instance, TCDD-EQ would be the critical contaminant for the hazard assessment. The average maximum allowable percentage of fish from above the dams, which would result in no observable adverse effects of TCDD-EQ, was 70%. Based on the average TCDD-EQ concentrations in the fishes, an average of 8.6% of the diet could be made up of fishes from below dams on the rivers. The most restrictive daily allowable intakes were for carp on the Muskegon and steelhead trout (Onchorhyncus mykiss) on the Manistee Rivers. Only 2.7% of the diet could be made up of these two species from influenced portion of the Au Sable River, they would be exposed to 390 μg PCBs and 8.55 ng of TCDD-EQ per day, respectively (Giesy et al. 1994b). Thus, it would take 15.1 or 77 days for mink to receive their total annual dose of PCBs or TCDD-EQ, respectively. At least for chinook salmon, the critical contaminant for the purposes of hazard assessment would be total concentrations of PCBs. Consuming chinook salmon for as little as 2 weeks would deliver the annual allowable dose of PCBs to mink.

Equilibrium sampling to determine the thermodynamic potential for bioaccumulation of persistent organic pollutants from sediment.

PubMed

Jahnke, Annika; MacLeod, Matthew; Wickström, Håkan; Mayer, Philipp

2014-10-07

Equilibrium partitioning (EqP) theory is currently the most widely used approach for linking sediment pollution by persistent hydrophobic organic chemicals to bioaccumulation. Most applications of the EqP approach assume (I) a generic relationship between organic carbon-normalized chemical concentrations in sediments and lipid-normalized concentrations in biota and (II) that bioaccumulation does not induce levels exceeding those expected from equilibrium partitioning. Here, we demonstrate that assumption I can be obviated by equilibrating a silicone sampler with chemicals in sediment, measuring chemical concentrations in the silicone, and applying lipid/silicone partition ratios to yield concentrations in lipid at thermodynamic equilibrium with the sediment (CLip⇌Sed). Furthermore, we evaluated the validity of assumption II by comparing CLip⇌Sed of selected persistent, bioaccumulative and toxic pollutants (polychlorinated biphenyls (PCBs) and hexachlorobenzene (HCB)) to lipid-normalized concentrations for a range of biota from a Swedish background lake. PCBs in duck mussels, roach, eel, pikeperch, perch and pike were mostly below the equilibrium partitioning level relative to the sediment, i.e., lipid-normalized concentrations were ≤CLip⇌Sed, whereas HCB was near equilibrium between biota and sediment. Equilibrium sampling allows straightforward, sensitive and precise measurement of CLip⇌Sed. We propose CLip⇌Sed as a metric of the thermodynamic potential for bioaccumulation of persistent organic chemicals from sediment useful to prioritize management actions to remediate contaminated sites.

Long-term modeling of glass waste in portland cement- and clay-based matrices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stockman, H.W.; Nagy, K.L.; Morris, C.E.

A set of ``templates`` was developed for modeling waste glass interactions with cement-based and clay-based matrices. The templates consist of a modified thermodynamic database, and input files for the EQ3/6 reaction path code, containing embedded rate models and compositions for waste glass, cement, and several pozzolanic materials. Significant modifications were made in the thermodynamic data for Th, Pb, Ra, Ba, cement phases, and aqueous silica species. It was found that the cement-containing matrices could increase glass corrosion rates by several orders of magnitude (over matrixless or clay matrix systems), but they also offered the lowest overall solubility for Pb, Ra,more » Th and U. Addition of pozzolans to cement decreased calculated glass corrosion rates by up to a factor of 30. It is shown that with current modeling capabilities, the ``affinity effect`` cannot be trusted to passivate glass if nuclei are available for precipitation of secondary phases that reduce silica activity.« less

Convergent validation of EQ-5D-5L in patients with Parkinson's disease.

PubMed

Alvarado-Bolaños, Alonso; Cervantes-Arriaga, Amin; Rodríguez-Violante, Mayela; Llorens-Arenas, Rodrigo; Calderón-Fajardo, Humberto; Millán-Cepeda, Roxanna; Leal-Ortega, Roberto; Estrada-Bellmann, Ingrid; Zuñiga-Ramírez, Carlos

2015-11-15

The European Quality of Life Questionnaire 5 level version (EQ-5D-5L) is a recently updated instrument to assess Health-Related Quality of Life (HRQoL) that has not been validated extensively. The main objective of this study was to evaluate the internal consistency and convergent validation of the EQ-5D-5L in a large sample of subjects with Parkinson's disease (PD). A cross-sectional study was carried out. Consecutive Mexican subjects with PD were included. HRQoL was assessed using the EQ-5D-5L and the PDQ-8. Validity of the EQ-5D-5L was assessed determining its association with clinical ratings of disease severity, as well as correlation with PDQ-8. Additionally, performance was evaluated along predefined groups based on clinical and demographic data of known determinants of quality of life. A total of 585 patients were included for this study. A strong correlation was found between EQ-5D-5L index and PDQ-8 index (Spearman's correlation coefficient=-0.75; p<0.001). Correlation between EQ-5D-5L index and PDQ-8 index remained strong (-0.60 to -0.78; p values <0.001) through all predefined groups. EQ-5D-5L scored higher in those patients with dyskinesia, wearing off, freezing, postural instability, cognitive impairment or depressive mood (p values <0.001). The EQ-5D-5L is a valid instrument for evaluating HRQoL in PD, performing adequately irrespective of heterogeneous clinical and demographic characteristics, and showing to be sensitive to features of advanced disease and treatment complications. Copyright © 2015 Elsevier B.V. All rights reserved.

Chinese Version of the EQ-5D Preference Weights: Applicability in a Chinese General Population

PubMed Central

Wu, Chunmei; Gong, Yanhong; Wu, Jiang; Zhang, Shengchao; Yin, Xiaoxv; Dong, Xiaoxin; Li, Wenzhen; Cao, Shiyi; Mkandawire, Naomie; Lu, Zuxun

2016-01-01

Objectives This study aimed to test the reliability, validity and sensitivity of Chinese version of the EQ-5D preference weights in Chinese general people, examine the differences between the China value set and the UK, Japan and Korea value sets, and provide methods for evaluating and comparing the EQ-5D value sets of different countries. Methods A random sample of 2984 community residents (15 years or older) were interviewed using a questionnaire including the EQ-5D scale. Level of agreement, convergent validity, known-groups validity and sensitivity of the EQ-5D China, United Kingdom (UK), Japan and Korea value sets were determined. Results The mean EQ-5D index scores were significantly (P<0.05) different among the UK (0.964), Japan (0.981), Korea (0.987), and China (0.985) weights. High level of agreement (intraclass correlations coefficients > 0.75) and convergent validity (Pearson’s correlation coefficients > 0.95) were found between each paired schemes. The EQ-5D index scores discriminated equally well for the four versions between levels of 10 known-groups (P< 0.05). The effect size and the relative efficiency statistics showed that the China weights had better sensitivity. Conclusions The China EQ-5D preference weights show equivalent psychometric properties with those from the UK, Japan and Korea weights while slightly more sensitive to known group differences than those from the Japan and Korea weights. Considering both psychometric and sociocultural issues, the China scheme should be a priority as an EQ-5D based measure of the health related quality of life in Chinese general population. PMID:27711169

The carbon footprint of a renal service in the United Kingdom.

PubMed

Connor, A; Lillywhite, R; Cooke, M W

2010-12-01

Anthropogenic climate change presents a major global health threat. However, the very provision of healthcare itself is associated with a significant environmental impact. Carbon footprinting techniques are increasingly used outside of the healthcare sector to assess greenhouse gas emissions and inform strategies to reduce them. This study represents the first assessment of the carbon footprint of an individual specialty service to include both direct and indirect emissions. This was a component analysis study. Activity data were collected for building energy use, travel and procurement. Established emissions factors were applied to reconcile this data to carbon dioxide equivalents (CO(2)eq) per year. The Dorset Renal Service has a carbon footprint of 3006 tonnes CO(2)eq per annum, of which 381 tonnes CO(2)eq (13% of overall emissions) result from building energy use, 462 tonnes CO(2)eq from travel (15%) and 2163 tonnes CO(2)eq (72%) from procurement. The contributions of the major subsectors within procurement are: pharmaceuticals, 1043 tonnes CO(2)eq (35% of overall emissions); medical equipment, 753 tonnes CO(2)eq (25%). The emissions associated with healthcare episodes were estimated at 161 kg CO(2)eq per bed day for an inpatient admission and 22 kg CO(2)eq for an outpatient appointment. These results suggest that carbon-reduction strategies focusing upon supply chain emissions are likely to yield the greatest benefits. Sustainable waste management and strategies to reduce emissions associated with building energy use and travel will also be important. A transformation in the way that clinical care is delivered is required, such that lower carbon clinical pathways, treatments and technologies are embraced. The estimations of greenhouse gas emissions associated with outpatient appointments and inpatient stays calculated here may facilitate modelling of the emissions of alternative pathways of care.

Quantifying and managing regional greenhouse gas emissions: waste sector of Daejeon, Korea.

PubMed

Yi, Sora; Yang, Heewon; Lee, Seung Hoon; An, Kyoung-Jin

2014-06-01

A credible accounting of national and regional inventories for the greenhouse gas (GHG) reduction has emerged as one of the most significant current discussions. This article assessed the regional GHG emissions by three categories of the waste sector in Daejeon Metropolitan City (DMC), Korea, examined the potential for DMC to reduce GHG emission, and discussed the methodology modified from Intergovernmental Panel on Climate Change and Korea national guidelines. During the last five years, DMC's overall GHG emissions were 239 thousand tons CO2 eq./year from eleven public environmental infrastructure facilities, with a population of 1.52 million. Of the three categories, solid waste treatment/disposal contributes 68%, whilst wastewater treatment and others contribute 22% and 10% respectively. Among GHG unit emissions per ton of waste treatment, the biggest contributor was waste incineration of 694 kg CO2 eq./ton, followed by waste disposal of 483 kg CO2 eq./ton, biological treatment of solid waste of 209 kg CO2 eq./ton, wastewater treatment of 0.241 kg CO2 eq./m(3), and public water supplies of 0.067 kg CO2 eq./m(3). Furthermore, it is suggested that the potential in reducing GHG emissions from landfill process can be as high as 47.5% by increasing landfill gas recovery up to 50%. Therefore, it is apparent that reduction strategies for the main contributors of GHG emissions should take precedence over minor contributors and lead to the best practice for managing GHGs abatement. Copyright © 2014 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.

Maternal transfer and sublethal immune system effects of brevetoxin exposure in nesting loggerhead sea turtles (Caretta caretta) from western Florida.

PubMed

Perrault, Justin R; Bauman, Katherine D; Greenan, Taylor M; Blum, Patricia C; Henry, Michael S; Walsh, Catherine J

2016-11-01

Blooms of Karenia brevis (also called red tides) occur almost annually in the Gulf of Mexico. The health effects of the neurotoxins (i.e., brevetoxins) produced by this toxic dinoflagellate on marine turtles are poorly understood. Florida's Gulf Coast represents an important foraging and nesting area for a number of marine turtle species. Most studies investigating brevetoxin exposure in marine turtles thus far focus on dead and/or stranded individuals and rarely examine the effects in apparently "healthy" free-ranging individuals. From May-July 2014, one year after the last red tide bloom, we collected blood from nesting loggerhead sea turtles (Caretta caretta) on Casey Key, Florida USA. These organisms show both strong nesting and foraging site fidelity. The plasma was analyzed for brevetoxin concentrations in addition to a number of health and immune-related parameters in an effort to establish sublethal effects of this toxin. Lastly, from July-September 2014, we collected unhatched eggs and liver and yolk sacs from dead-in-nest hatchlings from nests laid by the sampled females and tested these samples for brevetoxin concentrations to determine maternal transfer and effects on reproductive success. Using a competitive enzyme-linked immunosorbent assay (ELISA), all plasma samples from nesting females tested positive for brevetoxin (reported as ng brevetoxin-3[PbTx-3] equivalents [eq]/mL) exposure (2.1-26.7ng PbTx-3eq/mL). Additionally, 100% of livers (1.4-13.3ng PbTx-3eq/mL) and yolk sacs (1.7-6.6ng PbTx-3eq/mL) from dead-in-nest hatchlings and 70% of eggs (<1.0-24.4ng PbTx-3eq/mL) tested positive for brevetoxin exposure with the ELISA. We found that plasma brevetoxin concentrations determined by an ELISA in nesting females positively correlated with gamma-globulins, indicating a potential for immunomodulation as a result of brevetoxin exposure. While the sample sizes were small, we also found that plasma brevetoxin concentrations determined by an ELISA in nesting females significantly correlated with liver brevetoxin concentrations of dead-in-nest hatchlings and that brevetoxins could be related to a decreased reproductive success in this species. This study suggests that brevetoxins can still elicit negative effects on marine life long after a bloom has dissipated. These results improve our understanding of maternal transfer and sublethal effects of brevetoxin exposure in marine turtles. Copyright © 2016 Elsevier B.V. All rights reserved.

Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N(2)QOD data.

PubMed

Carreon, Leah Y; Glassman, Steven D; Ghogawala, Zoher; Mummaneni, Praveen V; McGirt, Matthew J; Asher, Anthony L

2016-06-01

OBJECTIVE Transforaminal lumbar interbody fusion (TLIF) has become the most commonly used fusion technique for lumbar degenerative disorders. This suggests an expectation of better clinical outcomes with this technique, but this has not been validated consistently. How surgical variables and choice of health utility measures drive the cost-effectiveness of TLIF relative to posterolateral fusion (PSF) has not been established. The authors used health utility values derived from Short Form-6D (SF-6D) and EQ-5D and different cost-effectiveness thresholds to evaluate the relative cost-effectiveness of TLIF compared with PSF. METHODS From the National Neurosurgery Quality and Outcomes Database (N(2)QOD), 101 patients with spondylolisthesis who underwent PSF were propensity matched to patients who underwent TLIF. Health-related quality of life measures and perioperative parameters were compared. Because health utility values derived from the SF-6D and EQ-5D questionnaires have been shown to vary in patients with low-back pain, quality-adjusted life years (QALYs) were derived from both measures. On the basis of these matched cases, a sensitivity analysis for the relative cost per QALY of TLIF versus PSF was performed in a series of cost-assumption models. RESULTS Operative time, blood loss, hospital stay, and 30-day and 90-day readmission rates were similar for the TLIF and PSF groups. Both TLIF and PSF significantly improved back and leg pain, Oswestry Disability Index (ODI) scores, and EQ-5D and SF-6D scores at 3 and 12 months postoperatively. At 12 months postoperatively, patients who had undergone TLIF had greater improvements in mean ODI scores (30.4 vs 21.1, p = 0.001) and mean SF-6D scores (0.16 vs 0.11, p = 0.001) but similar improvements in mean EQ-5D scores (0.25 vs 0.22, p = 0.415) as patients treated with PSF. At a cost per QALY threshold of $100,000 and using SF-6D-based QALYs, the authors found that TLIF would be cost-prohibitive compared with PSF at a surgical cost of $4830 above that of PSF. However, with EQ-5D-based QALYs, TLIF would become cost-prohibitive at an increased surgical cost of $2960 relative to that of PSF. With the 2014 US per capita gross domestic product of $53,042 as a more stringent cost-effectiveness threshold, TLIF would become cost-prohibitive at surgical costs $2562 above that of PSF with SF-6D-based QALYs or at a surgical cost exceeding that of PSF by $1570 with EQ-5D-derived QALYs. CONCLUSIONS As with all cost-effectiveness studies, cost per QALY depended on the measure of health utility selected, durability of the intervention, readmission rates, and the accuracy of the cost assumptions.

The prevalence of excessive daytime sleepiness among academic physicians and its impact on the quality of life and occupational performance.

PubMed

Ozder, Aclan; Eker, Hasan Huseyin

2015-01-01

Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS) among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D). A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p < 0.05. Three hundred and ninety six academic physicians were e-mailed and a total of 252 subjects replied resulting in a 63.6% response rate. There were 84 (33.3%) female and 168 (66.7%) male academic physicians participating in the study. One hundred and eight out of 252 (42.8%) academic physicians were taking night calls (p < 0.001). Ninety study subjects (35.7%) felt they had enough sleep and 84 (33.3%) reported napping daily (p < 0.001). In our sample, 28.6% (N = 72) of the physicians felt sleepy during the day (ESS score > 10) (p < 0.001). In the case of the EQ-5D index and visual analogue scale of the EQ-5D questionnaire (EQ-5D VAS), the status of sleepiness of academic physicians was associated with a poorer quality of life (p < 0.001). More than a 1/4 of the academic physicians suffered from sleepiness. There was an association between the poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Associations of Smoking, Physical Inactivity, Heavy Drinking, and Obesity with Quality-Adjusted Life Expectancy among US Adults with Depression.

PubMed

Jia, Haomiao; Zack, Matthew M; Gottesman, Irving I; Thompson, William W

2018-03-01

To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults. Copyright © 2018. Published by Elsevier Inc.

Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases.

PubMed

Kim, Myoung-Hee; Cho, Young-Shin; Uhm, Wan-Sik; Kim, Sehyun; Bae, Sang-Cheol

2005-06-01

This study aimed to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D in rheumatic conditions. Translation, back-translation and cognitive debriefing were performed according to the EuroQol group's guidelines. For validity, 508 patients were recruited and administered the EQ-5D, Short-Form 36 and condition-specific measures. Construct validity and sensitivity were evaluated by testing a-priori hypotheses. For reliability, another 57 patients repeated the EQ-5D at 1-week interval, and intra-class correlations (ICC) and kappa statistics were estimated. For responsiveness, another 60 patients repeated it at 12-week interval within the context of clinical trial, and standardized response mean(SRM) were calculated. The cross-cultural adaptation produced no major modifications in the scale. The associations of the EQ-5D with the generic- and condition-specific measures were observed as expected in hypotheses: the higher EQ-5Dindex and EQ-5D(VAS) scores, the better health status by generic- or condition-specific measures, and the better functional class. The ICCs were 0.751 and 0.767, respectively, and kappa ranged from 0.455 to 0.772. The SRM were 0.649 and 0.410, respectively. The Korean EQ-5D exhibits good validity and sensitivity in various rheumatic conditions. Although its reliability and responsiveness were not excellent, it seems acceptable if condition-specific measures are applied together.

Health state utility instruments compared: inquiring into nonlinearity across EQ-5D-5L, SF-6D, HUI-3 and 15D.

PubMed

Gamst-Klaussen, Thor; Chen, Gang; Lamu, Admassu N; Olsen, Jan Abel

2016-07-01

Different health state utility (HSU) instruments produce different utilities for the same individuals, thereby compromising the intended comparability of economic evaluations of health care interventions. When developing crosswalks, previous studies have indicated nonlinear relationships. This paper inquires into the degree of nonlinearity across the four most widely used HSU-instruments and proposes exchange rates that differ depending on the severity levels of the health state utility scale. Overall, 7933 respondents from six countries, 1760 in a non-diagnosed healthy group and 6173 in seven disease groups, reported their health states using four different instruments: EQ-5D-5L, SF-6D, HUI-3 and 15D. Quantile regressions investigate the degree of nonlinear relationships between these instruments. To compare the instruments across different disease severities, we split the health state utility scale into utility intervals with 0.2 successive decrements in utility starting from perfect health at 1.00. Exchange rates (ERs) are calculated as the mean utility difference between two utility intervals on one HSU-instrument divided by the difference in mean utility on another HSU-instrument. Quantile regressions reveal significant nonlinear relationships across all four HSU-instruments. The degrees of nonlinearities differ, with a maximum degree of difference in the coefficients along the health state utility scale of 3.34 when SF-6D is regressed on EQ-5D. At the lower end of the health state utility scale, the exchange rate from SF-6D to EQ-5D is 2.11, whilst at the upper end it is 0.38. Comparisons at different utility levels illustrate the fallacy of using linear functions as crosswalks between HSU-instruments. The existence of nonlinear relationships between different HSU-instruments suggests that level-specific exchange rates should be used when converting a change in utility on the instrument used, onto a corresponding utility change had another instrument been used. Accounting for nonlinearities will increase the validity of the comparison for decision makers when faced with a choice between interventions whose calculations of QALY gains have been based on different HSU-instruments.

Structural change as a key component for agricultural non-CO2 mitigation efforts.

PubMed

Frank, Stefan; Beach, Robert; Havlík, Petr; Valin, Hugo; Herrero, Mario; Mosnier, Aline; Hasegawa, Tomoko; Creason, Jared; Ragnauth, Shaun; Obersteiner, Michael

2018-03-13

Agriculture is the single largest source of anthropogenic non-carbon dioxide (non-CO 2 ) emissions. Reaching the climate target of the Paris Agreement will require significant emission reductions across sectors by 2030 and continued efforts thereafter. Here we show that the economic potential of non-CO 2 emissions reductions from agriculture is up to four times as high as previously estimated. In fact, we find that agriculture could achieve already at a carbon price of 25 $/tCO 2 eq non-CO 2 reductions of around 1 GtCO 2 eq/year by 2030 mainly through the adoption of technical and structural mitigation options. At 100 $/tCO 2 eq agriculture could even provide non-CO 2 reductions of 2.6 GtCO 2 eq/year in 2050 including demand side efforts. Immediate action to favor the widespread adoption of technical options in developed countries together with productivity increases through structural changes in developing countries is needed to move agriculture on track with a 2 °C climate stabilization pathway.

A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

PubMed Central

2012-01-01

Background Economic viability of treatments for primary open-angle glaucoma (POAG) should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs) most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified. Methods A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off) and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25) were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods. Results Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08) whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively). The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001); most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D. Conclusions The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages. PMID:22909264

The impact of irritable bowel syndrome on health-related quality of life: a Singapore perspective.

PubMed

Wang, Yu Tien; Lim, Hwee Yong; Tai, David; Krishnamoorthy, Thinesh L; Tan, Tira; Barbier, Sylvaine; Thumboo, Julian

2012-08-09

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. The prevalence of IBS in Asian countries varies from 2.9% to 15.6%. IBS does not result in increased mortality, but is associated with psychological distress and disruption of work and sleep. Consequently, the evaluation of health-related quality of life (HRQoL) is an important outcome measure for patients with IBS since it provides a holistic assessment of the patient's emotional, social and physical function. However, some HRQoL tools can be time-consuming to apply. EQ-5D is a brief HRQoL tool which has been validated in the Western IBS population but has thus far not been used in Asia. This study was conducted to determine whether persons with self-reported symptoms that met the Rome III criteria for IBS had a poorer quality of life than those without these symptoms. We also aimed to determine which specific aspects of quality of life were most affected and whether any risk factors distinguished those with and without IBS. Self-administered questionnaires which included the Rome III diagnostic questionnaire modules for IBS and the EQ-5D questionnaire were obtained from participants of a health symposium in Singapore on 31th October 2010. IBS was diagnosed based on the Rome III Criteria. The main outcome measure was the EQ-5D index score. The relationship between the presence of IBS and the EQ-5D index score, individual dimensions of EQ-5D and demographic risk factors were examined. 449 completed questionnaires were analyzed. The mean EQ-5D index score for IBS was 0.739 which was a significant reduction compared to non-IBS participants [-0.11 (95% CI: -0.15 to -0.07), p<0.001]. Multivariate analysis showed that IBS was significantly associated with younger age and higher education level. Of the five EQ-5D dimensions, IBS sufferers were significantly affected in mobility, anxiety or depression, usual activity and pain. There was a "dose related" increase in likelihood of having IBS with increased severity of pain and anxiety or depression. IBS sufferers have significantly poorer quality of life. Assessment of HRQoL in IBS using the EQ-5D should be considered in further studies and routine clinical practice.

Increasing runoff and sediment load from the Greenland ice sheet at kangerlussuaq (Sonder Stromfjord) in a 30-year perspective, 1979-2008

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mernild, Sebastian Haugard; Liston, Glen; Hasholt, Bent

2009-01-01

This observation and modeling study provides insights into runoff and sediment load exiting the Watson River drainage basin, Kangerlussuaq, West Greenland during a 30 year period (1978/79-2007/08) when the climate experienced increasing temperatures and precipitation. The 30-year simulations quantify the terrestrial freshwater and sediment output from part of the Greenland Ice Sheet (GrIS) and the land between the GrIS and the ocean, in the context of global warming and increasing GrIS surface melt. We used a snow-evolution modeling system (SnowModel) to simulate the winter accumulation and summer ablation processes, including runoff and surface mass balance (SMB), of the Greenland icemore » sheet. Observed sediment concentrations were related to observed runoff, producing a sediment-load time series. To a large extent, the SMB fluctuations could be explained by changes in net precipitation (precipitation minus evaporation and sublimation), with 8 out of 30 years having negative SMB, mainly because of relatively low annual net precipitation. The overall trend in net precipitation and runoff increased significantly, while 5MB increased insignificantly throughout the simulation period, leading to enhanced precipitation of 0.59 km{sup 3} w.eq. (or 60%), runoff of 0.43 km{sup 3} w.eq (or 54%), and SMB of 0.16 km3 w.eq. (or 86%). Runoff rose on average from 0.80 km{sup 3} w.eq. in 1978/79 to 1.23 km{sup 3} w.eq. in 2007/08. The percentage of catchment oudet runoff explained by runoff from the GrIS decreased on average {approx} 10%, indicating that catchment runoff throughout the simulation period was influenced more by precipitation and snowmelt events, and less by runoff from the GrIS. Average variations in the increasing Kangerlussuaq runoff from 1978/79 through 2007/08 seem to follow the overall variations in satellite-derived GrIS surface melt, where 64% of the variations in simulated runoff were explained by regional melt conditions on the GrIS. Throughout the simulation period, the sediment load varied from a minimum of 0.96 x 10{sup 6} t y{sup -1} in 1991/92 to a maximum of 3.52 x 10{sup 6} t y{sup -1} in 2006/07, showing an average increase of sediment load of 9.42 x 10{sup 5} t (or 72%) throughout the period.« less

Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer: a real-world cross-sectional study.

PubMed

Doherty, M K; Leung, Y; Su, J; Naik, H; Patel, D; Eng, L; Kong, Q Q; Mohsin, F; Brown, M C; Espin-Garcia, O; Vennettilli, A; Renouf, D J; Faluyi, O O; Knox, J J; MacKay, H; Wong, R; Howell, D; Mittmann, N; Darling, G E; Cella, D; Xu, W; Liu, G

2018-06-14

Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG. Symptom complexes were constructed from FACT-E domains. Responses were categorized by disease state: pre-, during, and post-treatment, surveillance, progression, and palliative chemotherapy. Spearman correlation and multivariable linear regression characterized these associations. In total, 199 patients completed 317 questionnaires. Mean FACT-E and subscale scores dropped from baseline through treatment and recovered during post-treatment surveillance (P < 0.001); EQ-5D health utility scores (HUS) displayed a similar pattern but with smaller differences (P = 0.07), and with evidence of ceiling effect. Among patients with stage II/III esophageal cancer, mean EQ-5D HUS varied across disease states (P < 0.001), along with FACT-E and subscales (P < 0.001). Among patients with advanced disease, there was no significant difference between baseline and on-treatment total scores, but improved esophageal cancer-specific scales were noted (P = 0.003). Strong correlation was observed between EQ-5D and FACT-E (R = 0.73), along with physical and functional subscales. In addition, the association between FACT-E and EQ-5D HUS was maintained in a multivariable model (P < 0.001). We interpret these results to suggest that in a real-world clinic setting, FACT-E, EQ-5D HUS, and symptoms were strongly correlated. Most HRQOL and symptom parameters suggested that patients had worse HRQOL and symptoms during curative therapy, but recovered well afterwards. In contrast, palliative chemotherapy had a neutral to positive impact on HRQOL/symptoms when compared to their baseline pre-treatment state.

2,3,7,8-Tetrachlorodibenzo-p-dioxin equivalents in tissues of birds at Green Bay, Wisconsin, USA

USGS Publications Warehouse

Jones, Paul D.; Giesy, John P.; Newsted, John L.; Verbrugge, David A.; Beaver, Donald L.; Ankley, Gerald T.; Tillitt, Donald E.; Lodge, Keith B.; Niemi, Gerald J.

1993-01-01

The environment has become contaminated with complex mixtures of planar, chlorinated hydrocarbons (PCHs) such as polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and structurally similar compounds. Because the potencies of individual congeners to cause the same adverse effects vary greatly and the relative as well as absolute concentrations of individual PCH vary among samples from different locations, it is difficult to assess the toxic effects of these mixtures on wildlife. These compounds can cause a number of adverse effects, however, because the toxic effects which occur at ecologically-relevant concentrations such as embryo-lethality and birth defects appear to be mediated through the same mechanism, the potency of individual congeners can be reported relative to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) which is the most toxic congener in the PCH class. The concentations of 2,3,7,8-TCDD Equivalents (TCDD-EQ) were determined in the tissues of aquatic and terrestrial birds of Green Bay, Wisconsin by the H4IIE bioassay system and compared toxic equivalency factors (TEFs) with the concentration predicted by the use of toxic equivalency factors applied to concentrations of PCH, which were determined by instrumental analyses. Concentrations of TCDD-EQ ranged from 0.52 to 440 ng/kg, wet weight. The greatest concentrations occurred in the fish-eating birds. Concentrations of TCDD-EQ, which were determined by the two methods were significantly correlated, but the additive model which used the TEFs with concentrations of measured PCB, PCDD and PCDF congeners underestimated the concentrations of TCDD-EQ measured by the H4IIE bioassay by an average of 57%. This is thought to be due to contributions from un-quantified PCH, which are known to occur in the environment. Of the quantified PCH congeners, PCDD and PCDF contributed a small portion of the TCDD-EQ in the aquatic birds, while most of the TCDD-EQ were due to non-ortho-substituted PCBs. In the terrestrial birds, the proportion of the TCDD-EQ contributed by the PCDD and PCDF was greater.This paper has been reviewed in accord with U.S. Environmental Protection Agency policy. Mention of specific products or trade names does not imply endorsement by the U.S. Government.

Fractionated Boron Neutron Capture Therapy in Locally Recurrent Head and Neck Cancer: A Prospective Phase I/II Trial.

PubMed

Wang, Ling-Wei; Chen, Yi-Wei; Ho, Ching-Yin; Hsueh Liu, Yen-Wan; Chou, Fong-In; Liu, Yuan-Hao; Liu, Hong-Ming; Peir, Jinn-Jer; Jiang, Shiang-Huei; Chang, Chi-Wei; Liu, Ching-Sheng; Lin, Ko-Han; Wang, Shyh-Jen; Chu, Pen-Yuan; Lo, Wen-Liang; Kao, Shou-Yen; Yen, Sang-Hue

2016-05-01

To investigate the efficacy and safety of fractionated boron neutron capture therapy (BNCT) for recurrent head and neck (H&N) cancer after photon radiation therapy. In this prospective phase 1/2 trial, 2-fraction BNCT with intravenous L-boronophenylalanine (L-BPA, 400 mg/kg) was administered at a 28-day interval. Before each fraction, fluorine-18-labeled-BPA-positron emission tomography was conducted to determine the tumor/normal tissue ratio of an individual tumor. The prescription dose (D80) of 20 Gy-Eq per fraction was selected to cover 80% of the gross tumor volume by using a dose volume histogram, while minimizing the volume of oral mucosa receiving >10 Gy-Eq. Tumor responses and adverse effects were assessed using the Response Evaluation Criteria in Solid Tumors v1.1 and the Common Terminology Criteria for Adverse Events v3.0, respectively. Seventeen patients with a previous cumulative radiation dose of 63-165 Gy were enrolled. All but 2 participants received 2 fractions of BNCT. The median tumor/normal tissue ratio was 3.4 for the first fraction and 2.5 for the second, whereas the median D80 for the first and second fraction was 19.8 and 14.6 Gy-Eq, respectively. After a median follow-up period of 19.7 months (range, 5.2-52 mo), 6 participants exhibited a complete response and 6 exhibited a partial response. Regarding acute toxicity, 5 participants showed grade 3 mucositis and 1 participant showed grade 4 laryngeal edema and carotid hemorrhage. Regarding late toxicity, 2 participants exhibited grade 3 cranial neuropathy. Four of six participants (67%) receiving total D80 > 40 Gy-Eq had a complete response. Two-year overall survival was 47%. Two-year locoregional control was 28%. Our results suggested that 2-fraction BNCT with adaptive dose prescription was effective and safe in locally recurrent H&N cancer. Modifications to our protocol may yield more satisfactory results in the future. Copyright © 2016 Elsevier Inc. All rights reserved.

Fractionated Boron Neutron Capture Therapy in Locally Recurrent Head and Neck Cancer: A Prospective Phase I/II Trial

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Ling-Wei, E-mail: lwwang@vghtpe.gov.tw; National Yang-Ming University, Taiwan; Chen, Yi-Wei

Purpose: To investigate the efficacy and safety of fractionated boron neutron capture therapy (BNCT) for recurrent head and neck (H&N) cancer after photon radiation therapy. Methods and Materials: In this prospective phase 1/2 trial, 2-fraction BNCT with intravenous L-boronophenylalanine (L-BPA, 400 mg/kg) was administered at a 28-day interval. Before each fraction, fluorine-18-labeled-BPA–positron emission tomography was conducted to determine the tumor/normal tissue ratio of an individual tumor. The prescription dose (D80) of 20 Gy-Eq per fraction was selected to cover 80% of the gross tumor volume by using a dose volume histogram, while minimizing the volume of oral mucosa receiving >10 Gy-Eq.more » Tumor responses and adverse effects were assessed using the Response Evaluation Criteria in Solid Tumors v1.1 and the Common Terminology Criteria for Adverse Events v3.0, respectively. Results: Seventeen patients with a previous cumulative radiation dose of 63-165 Gy were enrolled. All but 2 participants received 2 fractions of BNCT. The median tumor/normal tissue ratio was 3.4 for the first fraction and 2.5 for the second, whereas the median D80 for the first and second fraction was 19.8 and 14.6 Gy-Eq, respectively. After a median follow-up period of 19.7 months (range, 5.2-52 mo), 6 participants exhibited a complete response and 6 exhibited a partial response. Regarding acute toxicity, 5 participants showed grade 3 mucositis and 1 participant showed grade 4 laryngeal edema and carotid hemorrhage. Regarding late toxicity, 2 participants exhibited grade 3 cranial neuropathy. Four of six participants (67%) receiving total D80 > 40 Gy-Eq had a complete response. Two-year overall survival was 47%. Two-year locoregional control was 28%. Conclusions: Our results suggested that 2-fraction BNCT with adaptive dose prescription was effective and safe in locally recurrent H&N cancer. Modifications to our protocol may yield more satisfactory results in the future.« less

EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care.

PubMed

Mathews, William C; May, Susanne

2007-01-25

Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). We conducted a retrospective analysis of HIV clinic based cohort (1996-2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on VAS using reference cell coding of health states and random effects linear models. Survival models were fit using Cox modelling. Hospitalization and ED rate models were estimated using population-averaged Poisson models. 965 patients met eligibility criteria. 12% were female; 42% were non-white. Median time-at-risk was 1.2 years. Median CD4 was 233. Median log10(pVL) was 4.6. 47 deaths occurred. In two Cox models controlling for CD4 and pVL, the adjusted hazard ratios (aHR) for VAS and pVAS as time-varying covariates were 0.73 (95% CI: 0.63-0.83) and 0.66 (95% CI: 0.56-0.77) respectively, for every 10 point increase in (p)VAS rating. In Poisson regression models predicting ED visit rates and hospital discharge rates controlling for current CD4 and pVL, each of the EQ-5D health dimensions, VAS, and health change items were significantly (p < 0.05) associated with the outcomes. For ED visit rates, the adjusted incidence rate ratios (aIRR) were 0.86 (0.83-0.89) and 0.79 (0.75-0.82) for VAS and pVAS, respectively. For hospital discharge rates, the aIRR's were 0.85 (0.82-0.88) and 0.79 (0.75-0.82) for VAS and pVAS, respectively. EQ-5D is a brief and prognostically useful predictor of mortality, hospitalization, and ED utilization among adults under care for HIV infection, even after adjusting for CD4 and HIV plasma viral load.

75 FR 33369 - EQ Advisors Trust, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

...] EQ Advisors Trust, et al.; Notice of Application June 4, 2010. AGENCY: Securities and Exchange... trusts (``UITs'') that are within or outside the same group of investment companies, and (b) permit... to invest in certain financial instruments. Applicants: EQ Advisors Trust, AXA Premier VIP Trust...

Preseismic Changes of the Level and Temperature of Confined Groundwater related to the 2011 Tohoku Earthquake

PubMed Central

Orihara, Yoshiaki; Kamogawa, Masashi; Nagao, Toshiyasu

2014-01-01

Anomalous groundwater changes started three months before the 2011 M9.0 Off the Pacific coast of the Tohoku Earthquake (Tohoku EQ), Japan. Groundwater level and temperature decreased almost simultaneously in a 2000-m well at a spa, Goyo-onsen, in Iwate Prefecture, 155 km northwest of the epicenter. Since the source of Goyo-onsen, located above the edge of a coseismic rupture area of the Tohoku EQ fault, is probably confined, the observed anomalies were caused probably by preseismic crustal deformation. Preseismic groundwater anomalies have been observed prior to similar large subduction EQs such as the 1946 M8.1 Nankai EQ. Thus, monitoring confined groundwater may be useful to identify precursors of large subduction EQs. PMID:25366123

Modifications of the ionosphere prior to large earthquakes: report from the Ionosphere Precursor Study Group

NASA Astrophysics Data System (ADS)

Oyama, K.-I.; Devi, M.; Ryu, K.; Chen, C. H.; Liu, J. Y.; Liu, H.; Bankov, L.; Kodama, T.

2016-12-01

The current status of ionospheric precursor studies associated with large earthquakes (EQ) is summarized in this report. It is a joint endeavor of the "Ionosphere Precursor Study Task Group," which was formed with the support of the Mitsubishi Foundation in 2014-2015. The group promotes the study of ionosphere precursors (IP) to EQs and aims to prepare for a future EQ dedicated satellite constellation, which is essential to obtain the global morphology of IPs and hence demonstrate whether the ionosphere can be used for short-term EQ predictions. Following a review of the recent IP studies, the problems and specific research areas that emerged from the one-year project are described. Planned or launched satellite missions dedicated (or suitable) for EQ studies are also mentioned.

Implication of Broadband Dispersion Measurements in Constraining Upper Mantle Velocity Structures

NASA Astrophysics Data System (ADS)

Kuponiyi, A.; Kao, H.; Cassidy, J. F.; Darbyshire, F. A.; Dosso, S. E.; Gosselin, J. M.; Spence, G.

2017-12-01

Dispersion measurements from earthquake (EQ) data are traditionally inverted to obtain 1-D shear-wave velocity models, which provide information on deep earth structures. However, in many cases, EQ-derived dispersion measurements lack short-period information, which theoretically should provide details of shallow structures. We show that in at least some cases short-period information, such as can be obtained from ambient seismic noise (ASN) processing, must be combined with EQ dispersion measurements to properly constrain deeper (e.g. upper-mantle) structures. To verify this, synthetic dispersion data are generated using hypothetical velocity models under four scenarios: EQ only (with and without deep low-velocity layers) and combined EQ and ASN data (with and without deep low-velocity layers). The now "broadband" dispersion data are inverted using a trans-dimensional Bayesian framework with the aim of recovering the initial velocity models and assessing uncertainties. Our results show that the deep low-velocity layer could only be recovered from the inversion of the combined ASN-EQ dispersion measurements. Given this result, we proceed to describe a method for obtaining reliable broadband dispersion measurements from both ASN and EQ and show examples for real data. The implication of this study in the characterization of lithospheric and upper mantle structures, such as the Lithosphere-Asthenosphere Boundary (LAB), is also discussed.

Current affairs in earthquake prediction in Japan

NASA Astrophysics Data System (ADS)

Uyeda, Seiya

2015-12-01

As of mid-2014, the main organizations of the earthquake (EQ hereafter) prediction program, including the Seismological Society of Japan (SSJ), the MEXT Headquarters for EQ Research Promotion, hold the official position that they neither can nor want to make any short-term prediction. It is an extraordinary stance of responsible authorities when the nation, after the devastating 2011 M9 Tohoku EQ, most urgently needs whatever information that may exist on forthcoming EQs. Japan's national project for EQ prediction started in 1965, but it has made no success. The main reason for no success is the failure to capture precursors. After the 1995 Kobe disaster, the project decided to give up short-term prediction and this stance has been further fortified by the 2011 M9 Tohoku Mega-quake. This paper tries to explain how this situation came about and suggest that it may in fact be a legitimate one which should have come a long time ago. Actually, substantial positive changes are taking place now. Some promising signs are arising even from cooperation of researchers with private sectors and there is a move to establish an "EQ Prediction Society of Japan". From now on, maintaining the high scientific standards in EQ prediction will be of crucial importance.

Differences between true mean daily, monthly and annual air temperatures and air temperatures calculated with three equations: a case study from three Croatian stations

NASA Astrophysics Data System (ADS)

Bonacci, Ognjen; Željković, Ivana; Trogrlić, Robert Šakić; Milković, Janja

2013-10-01

Differences between true mean daily, monthly and annual air temperatures T0 [Eq. (1)] and temperatures calculated with three different equations [(2), (3) and (4)] (commonly used in climatological practice) were investigated at three main meteorological Croatian stations from 1 January 1999 to 31 December 2011. The stations are situated in the following three climatically distinct areas: (1) Zagreb-Grič (mild continental climate), (2) Zavižan (cold mountain climate), and (3) Dubrovnik (hot Mediterranean climate). T1 [Eq. (2)] and T3 [Eq. (4)] mean temperatures are defined by the algorithms based on the weighted means of temperatures measured at irregularly spaced, yet fixed hours. T2 [Eq. (3)] is the mean temperature defined as the average of daily maximum and minimum temperature. The equation as well as the time of observations used introduces a bias into mean temperatures. The largest differences occur for mean daily temperatures. The calculated daily difference value from all three equations and all analysed stations varies from -3.73 °C to +3.56 °C, from -1.39 °C to +0.79 °C for monthly differences and from -0.76 °C to +0.30 °C for annual differences.

Proposal of Environmental Impact Assessment Method for Concrete in South Korea: An Application in LCA (Life Cycle Assessment)

PubMed Central

Kim, Tae Hyoung; Tae, Sung Ho

2016-01-01

This study aims to develop a system for assessing the impact of the substances discharged from concrete production process on six environmental impact categories, i.e., global warming (GWP), acidification (AP), eutrophication (EP), abiotic depletion (ADP), ozone depletion (ODP), and photochemical oxidant creation (POCP), using the life a cycle assessment (LCA) method. To achieve this, this study proposed an LCA method specifically applicable to the Korean concrete industry by adapting the ISO standards to suit the Korean situations. The proposed LCA method involves a system that performs environmental impact assessment on the basis of input information on concrete mix design, transport distance, and energy consumption in a batch plant. The Concrete Lifecycle Assessment System (CLAS) thus developed provides user-friendly support for environmental impact assessment with specialized database for concrete mix materials and energy sources. In the case analysis using the CLAS, among the substances discharged from the production of 24 MPa concrete, those contributing to GWP, AP, EP, ADP, ODP, and POCP were assessed to amount to 309 kg-CO2 eq/m3, 28.7 kg-SO2 eq/m3, 5.21 kg-PO43− eq/m3, 0.000049 kg-CFC11 eq/m3, 34 kg/m3, and 21 kg-Ethylene eq/m3, respectively. Of these six environmental impact categories selected for the LCA in this study, ordinary Portland cement (OPC) was found to contribute most intensely to GWP and POCP, and aggregates, to AP, EP, ODP, and ADP. It was also found that the mix design with increased prop proportion of recycled aggregate was found to contribute to reducing the impact in all other categories. PMID:27827843

The level of physical exercise is associated with self-reported health status (EQ-5D) in adults with congenital heart disease.

PubMed

Sandberg, Camilla; Engström, Karl Gunnar; Dellborg, Mikael; Thilén, Ulf; Wadell, Karin; Johansson, Bengt

2015-02-01

The prognosis in adults with congenital aortic valve disease is usually favourable; nevertheless, a number of medical and social factors might hamper long-term prognosis and quality of life. With a focus on physical exercise level, data from the Swedish National Registry on Congenital Heart Disease (SWEDCON) were analysed and variables associated with health-related quality of life in adults with congenital aortic valve disease were identified. In this registry study, SWEDCON was searched for adult patients with isolated congenital aortic valve disease and valid EuroQol-5Dimensions health questionnaire (EQ-5D) data. This study identified 315 patients. The majority (n = 202, 64%) reported best possible health status (EQ-5D(index) = 1) whereas 113 (35%) reported some impairment (EQ-5D(index) < 1) with mean EQ-5D(index) 0.73 ± 0.17. In a multivariate logistic regression model, self-reported physical exercise > 3 h/week was independently associated with best possible health status (EQ-5D(index) = 1; p = 0.013). Moreover presence of cardiovascular symptoms (p < 0.001), active smoking (p = 0.002), history of valve surgery (p = 0.017), low educational level (p = 0.022), and higher systolic blood pressure (p = 0.029) were independently associated with impaired health status (EQ-5D(index) < 1). Physical exercise >3 h/week was, as a single variable, associated with best possible health status in adults with congenital aortic valve disease. In contrast, a number of medical and social factors are associated with worse self-reported health status. Among these, symptoms, smoking, and educational level are potential targets for modification and intervention. There is a need for studies investigating the effect of increased level of physical exercise in patients with congenital aortic valve disease. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Design Guide for Bolted Joints in Composite Structures

DTIC Science & Technology

1986-03-01

I PR N E 0 0.AND. BI’ 11C. 1 .0) tBP22 00005800 IF(IIBP EO.1) 11LIM2%1 00005810 ^O 71 LOtol1.NLIM2 00005820 DO 22 IL0I.115P 00005350 LiC 20...00006970 IF(JNT.EQ.0) G0 TO 410 -- 00006980 IF~tJLIM2.EQ.1) 00 10 90 00006990 IF04TFL.EQ.0.ANO.’:L1M2.GT.1) 00 TO 90 00007000 71 CONTINUE 00007010 410...00020910 Do 70 I:NI,NZ 00020920 JaI-2 00020930 e.IFCT.EO.N1) 00 TO 71 00020950 145 00 TO 7200020970Ii1: -XC.~~-.A2NLKNLC)2 00020980 7 -2, A MA(I 2)6.1C2

Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea

PubMed Central

2017-01-01

Objectives This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea. Methods Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions. Results Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores. Conclusions This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument. PMID:29207449

Application of EQ-5D-5L questionnaire in patients suffering from urinary incontinence.

PubMed

Garcia-Gordillo, M A; Collado-Mateo, D; Olivares, P R; Adsuar, J C

2016-09-01

Urinary incontinence is associated with reduced quality of life and given the high prevalence of people with this condition, it could be useful to know the impact of having urinary incontinence on physical, psychological and social aspects. The Spanish value set of EQ-5D was used to assign single scores to the EQ-5D-5L health states. EQ-5D-5L is a health-related quality of life questionnaire, which allows assessing health status. The aim of this study was to provide normative values of EQ-5D-5L in a population sample with urinary incontinence. Cross-sectional study. A total of 965 people with urinary incontinence (297 men and 668 women) were included in this study. EQ-5D-5L index, VAS and health status are showed in the current study considering gender, age group, region, marital status, smoking status, net monthly incomes of household and educational level. Higher prevalence was observed in women (69.22%) compared with men (30.78%). Mean (SD) EQ-5D-5L utility index and VAS score were 0.58 (0.40) and 53.91 (22.16), respectively, for overall population. The 16.1% (155 people) reported perfect health status (11111). The utility equivalent to set values 55555 was not reported by anyone. This study provides normative values of EQ-5D-5L in a Spanish population sample with urinary incontinence. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of Heat Acclimation on Heat-Exercise Tolerance in Untrained and Endurance-Trained Men Wearing NBC Protective Clothing

DTIC Science & Technology

1993-08-01

2-1 + 273.15]’.(A.A"•1 ) (Eq. 5) h. = 23.4.v,.ŗ" (Eq. 6) in which a is the Stefan -Boltzmann constant (20.4-10-8 UNCLASSIFIED 8 UNCLASSIFIED kJ-m-’-h...Vallerand AL, Limmer R, Schmegner IF (1989) Computer acquisition and analysis of skin temperature and heat flow data from heat flux transducers. Computer

Infrared Spectroscopy with a Cavity Ring-Down Spectrometer

DTIC Science & Technology

2014-08-01

excitation source wavelength. This relationship is the Beer - Lambert law that describes electromagnetic radiation spectroscopy: (2) We can...absorption coefficient on the right. The modified Beer - Lambert law in Eq. 6 is used in the numerical analysis of data collected by the CRDS. The...take Beer - Lambert and express the fraction of transmitted light (I/I0) on the left-hand side of Eq. 2 as a function of time. This expression is

Flow, stock, and impact assessment of refrigerants in the Japanese household air conditioner sector.

PubMed

Xue, Mianqiang; Kojima, Naoya; Machimura, Takashi; Tokai, Akihiro

2017-05-15

Refrigerants provide society with great benefits while have the potential to cause adverse effects on the environment and human health. The present study estimated time-dependent flows and stocks and assessed the effects of refrigerants (R-22, R-410a, and R-32) in household air conditioners in Japan. It was found that stock of R-22 and R-410a peaked at 49,147t in 2000 and 55,994t in 2017, respectively. The largest flow of R-22 and R-410a to waste phase occurred at 3417t/yr. in 2005 and 4011t/yr. in 2023, respectively. The total global warming potential (GWP) due to refrigerant emissions increased from 3.6kt CO 2 eq. in 1952 to 6999kt CO 2 eq. in 2019, and then decreased to 5314kt CO 2 eq. in 2030. The ozone depletion potential (ODP) peaked at 141t CFC-11 eq. in 2002. When substituting R-410a for R-22, the ODP decreased 50% while the GDP increased 8%. When substituting R-32 for R-410a, there was no effect on the ODP while the GDP decreased 6%. The human health damage due to the global warming effect of refrigerant emission was much higher than that due to the ozone depleting effect. The refrigerant emission in use and waste management phases dominated the human health damage. The dynamic estimation not only allows us to evaluate the performance of past policies but also supports the future sustainable management associated with the health effects of refrigerants. Copyright © 2017 Elsevier B.V. All rights reserved.

Global emissions of fluorinated greenhouse gases until 2050: technical mitigation potentials and costs

NASA Astrophysics Data System (ADS)

Purohit, Pallav; Hoglund-Isaksson, Lena

2016-04-01

The anthropogenic fluorinated (F-gases) greenhouse gas emissions have increased significantly in recent years and are estimated to rise further in response to increased demand for cooling services and the phase out of ozone-depleting substances (ODS) under the Montreal Protocol. F-gases (HFCs, PFCs and SF6) are potent greenhouse gases, with a global warming effect up to 22,800 times greater than carbon dioxide (CO2). This study presents estimates of current and future global emissions of F-gases, their technical mitigation potential and associated costs for the period 2005 to 2050. The analysis uses the GAINS model framework to estimate emissions, mitigation potentials and costs for all major sources of anthropogenic F-gases for 162 countries/regions, which are aggregated to produce global estimates. For each region, 18 emission source sectors with mitigation potentials and costs were identified. Global F-gas emissions are estimated at 0.7 Gt CO2eq in 2005 with an expected increase to about 3.6 Gt CO2eq in 2050. There are extensive opportunities to reduce emissions by over 95 percent primarily through replacement with existing low GWP substances. The initial results indicate that at least half of the mitigation potential is attainable at a cost of less than 20€ per t CO2eq, while almost 90 percent reduction is attainable at less than 100€ per t CO2eq. Currently, several policy proposals have been presented to amend the Montreal Protocol to substantially curb global HFC use. We analyze the technical potentials and costs associated with the HFC mitigation required under the different proposed Montreal Protocol amendments.

Association of generic health-related quality of life (EQ-5D dimensions) and inactivity with lung function in lung-healthy German adults: results from the KORA studies F4L and Age.

PubMed

Luzak, Agnes; Karrasch, Stefan; Wacker, Margarethe; Thorand, Barbara; Nowak, Dennis; Peters, Annette; Schulz, Holger

2018-03-01

Among patients with lung disease, decreased lung function is associated with lower health-related quality of life. However, whether this association is detectable within the physiological variability of respiratory function in lung-healthy populations is unknown. We analyzed the association of each EQ-5D-3L dimension (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and self-reported physical inactivity with spirometric indices in lung-healthy adults. Modulating effects between inactivity and EQ-5D dimensions were considered. 1132 non-smoking, apparently lung-healthy participants (48% male, aged 64 ± 12 years) from the population-based KORA F4L and Age surveys in Southern Germany were analyzed. Associations of each EQ-5D dimension and inactivity with spirometric indices serving as outcomes (forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC, and mid-expiratory flow) were examined by linear regression, considering possible confounders. Interactions between EQ-5D dimensions (no problems/any problems) and inactivity (four categories of time spent engaging in exercise: inactive to most active) were assessed. Among all participants 42% reported no problems in any EQ-5D dimension, 24% were inactive and 32% exercised > 2 h/week. After adjustment, FEV 1 was - 99 ml (95% CI - 166; - 32) and FVC was - 109 ml (95% CI - 195; - 24) lower among subjects with mobility problems. Comparable estimates were observed for usual activities. Inactivity was negatively associated with FVC (β-coefficient: - 83 ml, 95% CI - 166; 0), but showed no interactions with EQ-5D. Problems with mobility or usual activities, and inactivity were associated with slightly lower spirometric parameters in lung-healthy adults, suggesting a relationship between perceived physical functioning and volumetric lung function.

Workshop on environmental qualification of electric equipment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lofaro, R.; Gunther, W.; Villaran, M.

1994-05-01

Questions concerning the Environmental Qualification (EQ) of electrical equipment used in commercial nuclear power plants have recently become the subject of significant interest to the US Nuclear Regulatory Commission (NRC). Initial questions centered on whether compliance with the EQ requirements for older plants were adequate to support plant operation beyond 40 years. After subsequent investigation, the NRC Staff concluded that questions related to the differences in EQ requirements between older and newer plants constitute a potential generic issue which should be evaluated for backfit, independent of license renewal activities. EQ testing of electric cables was performed by Sandia National Laboratoriesmore » (SNL) under contract to the NRC in support of license renewal activities. Results showed that some of the environmentally qualified cables either failed or exhibited marginal insulation resistance after a simulated plant life of 20 years during accident simulation. This indicated that the EQ process for some electric cables may be non-conservative. These results raised questions regarding the EQ process including the bases for conclusions about the qualified life of components based upon artificial aging prior to testing.« less

An exploration of the relationship between emotional intelligence (EI) and the Multiple Mini-Interview (MMI).

PubMed

Yen, Wendy; Hovey, Richard; Hodwitz, Kathryn; Zhang, Su

2011-03-01

The present study explored the relationship between the Multiple Mini-Interview (MMI) admissions process and the Bar-On EQ-i emotional intelligence (EI) instrument in order to investigate the potential for the EQ-i to serve as a proxy measure to the MMI. Participants were 196 health science candidates who completed both the MMI and the EQ-i as part of their admissions procedure at the Michener Institute for Applied Health Sciences. Three types of analyses were conducted to examine the relationship between the two tools: reliability analyses, correlational analyses, and a t-test. The tools were found to be moderately reliable. No significant relationships were found between the MMI and the EQ-i at the total or subscale level. The ability of the EQ-i to discriminate between accepted and not-accepted students was also not supported. These findings do not support the use of the EQ-i as a potential pre-screening tool for the MMI, but rather highlight the need to exercise caution when using emotional intelligence instruments for high-stakes admissions purposes.

Some blood chemistry values for the juvenile coho salmon (Oncorhynchus kisutch)

USGS Publications Warehouse

Wedemeyer, Gary; Chatterton, K.

1971-01-01

Overlapping Gaussian distribution curves were resolved into normal ranges for 1800 clinical test values obtained from caudal arterial blood or plasma of more than 1000 juvenile coho salmon (Oncorhynchus kisutch) held under defined conditions of diet and temperature. Estimated normal blood chemistry ranges were bicarbonate, 9.5–12.6 mEq/liter; blood urea nitrogen (BUN), 0.9–3.4 mg/100 ml; chloride, 122–136 mEq/liter; cholesterol, 88–262 mg/100 ml;pCO2, 2.6–6.1 mm Hg (10 C); glucose, 41–135 mg/100 ml; hematocrit, 32.5–52.5%; hemoglobin, 6.5–9.9 g/100 ml; total protein, 1.4–4.3 g/100 ml; blood pH (10 C), 7.51–7.83. The calculated range of normal acid–base balance vs. water temperature is also presented.

The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS).

PubMed

Falk Hvidberg, Michael; Brinth, Louise Schouborg; Olesen, Anne V; Petersen, Karin D; Ehlers, Lars

2015-01-01

Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a common, severe condition affecting 0.2 to 0.4 per cent of the population. Even so, no recent international EQ-5D based health-related quality of life (HRQoL) estimates exist for ME/CFS patients. The main purpose of this study was to estimate HRQoL scores using the EQ-5D-3L with Danish time trade-off tariffs. Secondary, the aims were to explore whether the results are not influenced by other conditions using regression, to compare the estimates to 20 other conditions and finally to present ME/CFS patient characteristics for use in clinical practice. All members of the Danish ME/CFS Patient Association in 2013 (n=319) were asked to fill out a questionnaire including the EQ-5D-3L. From these, 105 ME/CFS patients were identified and gave valid responses. Unadjusted EQ-5D-3L means were calculated and compared to the population mean as well as to the mean of 20 other conditions. Furthermore, adjusted estimates were calculated using ordinary least squares (OLS) regression, adjusting for gender, age, education, and co-morbidity of 18 self-reported conditions. Data from the North Denmark Health Profile 2010 was used as population reference in the regression analysis (n=23,392). The unadjusted EQ-5D-3L mean of ME/CFS was 0.47 [0.41-0.53] compared to a population mean of 0.85 [0.84-0.86]. The OLS regression estimated a disutility of -0.29 [-0.21;-0.34] for ME/CFS patients in this study. The characteristics of ME/CFS patients are different from the population with respect to gender, relationship, employment etc. The EQ-5D-3L-based HRQoL of ME/CFS is significantly lower than the population mean and the lowest of all the compared conditions. The adjusted analysis confirms that poor HRQoL of ME/CFS is distinctly different from and not a proxy of the other included conditions. However, further studies are needed to exclude the possible selection bias of the current study.

The response of soil and stream chemistry to decreases in acid deposition in the Catskill Mountains, New York, USA

USGS Publications Warehouse

McHale, Michael; Burns, Douglas A.; Siemion, Jason; Antidormi, Michael

2017-01-01

The Catskill Mountains have been adversely impacted by decades of acid deposition, however, since the early 1990s, levels have decreased sharply as a result of decreases in emissions of sulfur dioxide and nitrogen oxides. This study examines trends in acid deposition, stream-water chemistry, and soil chemistry in the southeastern Catskill Mountains. We measured significant reductions in acid deposition and improvement in stream-water quality in 5 streams included in this study from 1992 to 2014. The largest, most significant trends were for sulfate (SO42−) concentrations (mean trend of −2.5 μeq L−1 yr−1); hydrogen ion (H+) and inorganic monomeric aluminum (Alim) also decreased significantly (mean trends of −0.3 μeq L−1 yr−1 for H+ and −0.1 μeq L−1 yr−1 for Alim for the 3 most acidic sites). Acid neutralizing capacity (ANC) increased by a mean of 0.65 μeq L−1 yr−1 for all 5 sites, which was 4 fold less than the decrease in SO42−concentrations. These upward trends in ANC were limited by coincident decreases in base cations (−1.3 μeq L−1 yr−1 for calcium + magnesium). No significant trends were detected in stream-water nitrate (NO3−) concentrations despite significant decreasing trends in NO3− wet deposition. We measured no recovery in soil chemistry which we attributed to an initially low soil buffering capacity that has been further depleted by decades of acid deposition. Tightly coupled decreasing trends in stream-water silicon (Si) (−0.2 μeq L−1 yr−1) and base cations suggest a decrease in the soil mineral weathering rate. We hypothesize that a decrease in the ionic strength of soil water and shallow groundwater may be the principal driver of this apparent decrease in the weathering rate. A decreasing weathering rate would help to explain the slow recovery of stream pH and ANC as well as that of soil base cations.

[Contribution for the validation of the Portuguese version of EQ-5D].

PubMed

Ferreira, Pedro Lopes; Ferreira, Lara Noronha; Pereira, Luis Nobre

2013-01-01

The EQ-5D allows the achievement of two essential components of any measure of health-related quality of life to be used in cost-utility economic evaluations: (i) a profile describing the health status in terms of domains or dimensions; and (ii) a numeric value associated with the health status described. The Portuguese version of the EQ-5D questionnaire was completed in 1998, based on guidelines set by the EuroQol Group, including translation and back translation procedures. Despite its wide use in Portugal, until now it had not yet been published studies that initially led to the Portuguese version and the guarantee of acceptability, reliability and validity. The purpose of this article is to document these first values relating to the Portuguese version of the EQ-5D. We used three different samples: a first one with 1,500 individuals representative of the Portuguese population; a second with 140 individuals just intended for the reliability test; and a third sample with 643 individual patients with cataracts, asthma, chronic obstructive pulmonary disease, or rheumatoid arthritis. The acceptability was assessed by the number of missing responses. It was also found a marked ceiling effect, with a large part of the sample not reporting any problems in the dimensions of the EQ-5D. The construct validity was tested by examining the degree to which low values of EQ-5D were positively associated with increasing age, being female, and the sick, as well as the values of dimensions of the SF-36v2 scale. Convergent validity was based on correlations between EQ-5D values and other specific measures. The EQ-5D showed moderate to high correlations with other disease-specific measures of health status and health related quality of life. We can state that the Portuguese version of the EQ-5D has a good accessibility, reliability and validity in measuring health.

Inhibitory activities of the heterotrimers formed from two α-type phospholipase A2 inhibitory proteins with different enzyme affinities and importance of the intersubunit electrostatic interaction in trimer formation.

PubMed

Nishida, Masanori; Okamoto, Masataka; Ohno, Ai; Okumura, Kohji; Hayashi, Kyozo; Ikeda, Kiyoshi; Inoue, Seiji

2010-11-01

α-type phospholipase A2 inhibitory protein (PLIα) isolated from the serum of the venomous snake Glyoidius brevicaudus, GbPLIα, is a homotrimer of subunits having a C-type lectin-like domain. The serum protein from nonvenomous snake Elaphe quadrivirgata, EqPLIα-LP, is homologous to GbPLIα, but it does not show any inhibitory activity against PLA2s. When a mixture of denaturant-treated monomeric forms of GbPLIα and EqPLIα-LP was used to reconstitute their trimers, no significant amounts of heterotrimers composed of GbPLIα and EqPLIα-LP subunits could be formed. On the other hand, when a mixture of denaturant-treated monomeric forms of GbPLIα and the recombinant chimeric EqPLIα-LP, Eq13Gb37Eq, in which the residues 13-36 were replaced by those of GbPLIα, was used to reconstitute their trimers, significant amounts of their heterotrimers were observed. Furthermore, when a mixture of denaturant-treated monomeric forms of EqPLIα-LP and the recombinant chimeric GbPLIα, Gb13Eq37Gb, in which the residues 13-36 were replaced by those of EqPLIα-LP, was used, significant amounts of their heterotrimers were observed. By comparison of the respective inhibitory activities of the heterotrimeric subspecies, it was suggested that the inhibitory activity of the trimer was governed by one subunit with the highest activity, and not affected by the number of these subunits. The intermolecular electrostatic interactions between Glu23 and Lys28 of GbPLIα were also suggested to be important in stabilizing the trimeric structure. The importance of the electrostatic interaction was supported by the less stability of the homotrimeric structure of a mutant GbPLIα with a single amino acid substitution, GbPLIα(K28E). Copyright © 2010 Elsevier B.V. All rights reserved.

Quality of life following hip fractures: results from the Norwegian hip fracture register.

PubMed

Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

2016-07-07

Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

Operator-Adjustable Frame Rate, Resolution, and Gray Scale Tradeoff in Fixed-Bandwidth Remote Manipulator Control.

DTIC Science & Technology

1980-09-01

WFLOR(2,3,4) IWAIT FOR FLAG CALL READEF(3,IUU) ICHECK 010 FLAG IF(IUU.NE.2) GO TO 587 IF(.NOT.LCONT) GO TO 999 K-K-54 IMAKE 7,8,9 LOOK LIKE 1,2,3 IF...K.EQ.-6) GO TO 999 IF(K.EQ.3) GO TO 223 IF(K.LT.1) GO TO 223 GO TO 588 587 CALL READEF(4,ITT) ICHECK 5 SEC FLAG IF(ITT.NE.2) GO TO 546 ISKIP IF NOT SET...ISEC,NESC,NYNESC,NESC 1092 FORMAT(’ ’,2A,"-Q’,’TIME 1,12o’s’,I2,2A,’l1, *-86- 1 A, 111A,AW GO TO 222 546 CALL READEF(2,ITS) ICHECK STOP FLAG IF

Fractional State Feedback Control of Undamped and Viscoelastically-Damped Structures

DTIC Science & Technology

1990-03-01

and apply the inverse transform to Eq (99) then 0 DaO zt z In t (n -a ) (1)te = r(n-as+) n=O Eq (101) is the fractional derivative of a complex...s)] 2 ( [F(s)] es t d (110) the inverse transform of Eq (109) may be expressed as 40 D a e t ] =13 e at.. s z do t L 7-ZJ 27i = iW 1-i j and Eq...Il) can be evaluated using the residue theorem from the calculus of complex variables. The closed contour of integration for the inverse transform , in

Climate Change Increasing Calcium and Magnesium Leaching from Granitic Alpine Catchments.

PubMed

Kopáček, Jiří; Kaňa, Jiří; Bičárová, Svetlana; Fernandez, Ivan J; Hejzlar, Josef; Kahounová, Marie; Norton, Stephen A; Stuchlík, Evžen

2017-01-03

Climate change can reverse trends of decreasing calcium and magnesium [Ca + Mg] leaching to surface waters in granitic alpine regions recovering from acidification. Despite decreasing concentrations of strong acid anions (-1.4 μeq L -1 yr -1 ) during 2004-2016 in nonacidic alpine lakes in the Tatra Mountains (Central Europe), the average [Ca + Mg] concentrations increased (2.5 μeq L -1 yr -1 ), together with elevated terrestrial export of bicarbonate (HCO 3 - ; 3.6 μeq L -1 yr -1 ). The percent increase in [Ca + Mg] concentrations in nonacidic lakes (0.3-3.2% yr -1 ) was significantly and positively correlated with scree proportion in the catchment area and negatively correlated with the extent of soil cover. Leaching experiments with freshly crushed granodiorite, the dominant bedrock, showed that accessory calcite and (to a lesser extent) apatite were important sources of Ca. We hypothesize that elevated terrestrial export of [Ca + Mg] and HCO 3 - resulted from increased weathering caused by accelerated physical erosion of rocks due to elevated climate-related mechanical forces (an increasing frequency of days with high precipitation amounts and air temperatures fluctuating around 0 °C) during the last 2-3 decades. These climatic effects on water chemistry are especially strong in catchments where fragmented rocks are more exposed to weathering, and their position is less stable than in soil.

Health-related quality of life of day-case surgery patients: a pre/posttest survey using the EuroQoL-5D.

PubMed

Suhonen, Riitta; Virtanen, Heli; Heikkinen, Katja; Johansson, Kirsi; Kaljonen, Anne; Leppänen, Tiina; Salanterä, Sanna; Leino-Kilpi, Helena

2008-02-01

This paper describes and compares the perceived health-related quality of life (HRQoL) of day-case surgery patients before and after their procedures and examines some associated patient-related factors. A pre/posttest survey design was employed to collect data from Finnish adult day-case surgery patients using participant-completed EuroQoL 5-Dimensional Classification Component Scores (EQ-5D) questionnaires given 2 weeks presurgery (n = 131) and 2 weeks postsurgery (n = 131) in 2004. No noticeable change after minor surgery was found using the EQ-5D. Using the EQ-5D index, patients perceived their HRQoL as high before and after surgery. Almost one fifth (17%) reported no pain or discomfort before the procedure compared with 40% after it. As measured by the EuroQol visual analogue scale (EQ(VAS)), those patients who reported chronic illness before the operation had a lower perception of their HRQoL compared with those who did not. It was also found that self-care and usual activities were more disturbed after surgery. Although there were increases and decreases within items of the EQ-5D, overall, there was no improvement on EQ-5D scores. More research is needed to explore the sensitivity and responsiveness of the EQ-5D measure in day-case surgery patients.

Context-dependent environmental quality standards of soil nitrate for terrestrial plant communities.

PubMed

van Goethem, Thomas M W J; Schipper, Aafke M; Wamelink, G W Wieger; Huijbregts, Mark A J

2016-10-01

Environmental quality standards (EQS) specify the maximum permissible concentration or level of a specific environmental stressor. Here, a procedure is proposed to derive EQS that are specific to a representative species pool and conditional on confounding environmental factors. To illustrate the procedure, a dataset was used with plant species richness observations of grasslands and forests and accompanying soil nitrate-N and pH measurements collected from 981 sampling sites in the Netherlands. Species richness was related to soil nitrate-N and pH with quantile regression allowing for interaction effects. The resulting regression models were used to derive EQS for nitrate conditional on pH, quantified as the nitrate-N concentrations at a specific pH level corresponding with a species richness equal to 95% of the species pool, for both grasslands and forest communities. The EQS varied between 1.8 mg/kg nitrate-N at pH 9-65 mg/kg nitrate-N at pH 4. EQS for forests and grasslands were similar, but EQS based on Red List species richness were considerably lower (more stringent) than those based on overall species richness, particularly at high pH levels. The results indicate that both natural background pH conditions and Red List species are important factors to consider in the derivation of EQS for soil nitrate-N for terrestrial ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Responsiveness of the EQ-5D to HADS-identified anxiety and depression.

PubMed

Whynes, David K

2009-10-01

The use of generic measures of health-related quality of life enables cost effectiveness comparisons of different health care interventions to be made. Nevertheless, there exists a concern that generic instruments may be insufficiently sensitive to detect the differences or changes in outcome identified by condition-specific instruments. This paper compares the psychometric properties of the EQ-5D generic instrument with a widely used specific measure of distress, the Hospital Anxiety and Depression Scale (HADS). The analysis was based on data obtained from a large sample of women (n = 3119) with low-grade cervical cytological abnormalities detected at routine screening. These women completed EQ-5D and HADS questionnaires at recruitment and at 12 months thereafter. We examined the strength of association between HADS-determined severity of distress and EQ-5D scores at recruitment and between changes in severity and in scores over time. A higher likelihood of HADS-identified anxiety and/or depression was associated with significantly lower EQ-5D index and visual analogue scores. Over time, the EQ-5D score rose significantly when the likelihood of an individual representing a HADS-defined anxiety and/or depression case decreased. We conclude that the EQ-5D has shown itself to be responsive to differing degrees of HADS-assessed distress, although generalization beyond the UK context requires further investigation.

A Survey on the Relationship between Emotional Intelligence and Level of Depression and Anxiety among Women with Breast Cancer

PubMed Central

Amirifard, Nasrin; Payandeh, Mehrdad; Aeinfar, Mehrnoush; Sadeghi, Masoud; Sadeghi, Edris; Ghafarpor, Somaye

2017-01-01

Background: Emotional Intelligence (EQ) is positively associated with mental health and it can have a crucial role in mental disorder therapy by suitable coping mechanisms. The present study aimed to evaluate the relationship of EQ with anxiety and depression among the women with breast cancer. Subjects and Methods: During 2013 and in a cross-sectional study, 98 breast cancer patients (14 to 21 years old) entered into the study. For data collection, the following instruments were the Bar-On EQ inventory, Beck Depression Inventory and Cattle Anxiety Inventory. Results: There was an inverse relationship between anxiety with intrapersonal (p<0.01, r=0.39) and stress management (p<0.01, r=0.37) components and also between anxiety and total scores of EQ (p<0.05, r=0.22). There was an inverse significant association between depression and intrapersonal components (p<0.05, r=0.23), general mood (p<0.01, r=0.46) and adaptation (p<0.01, r=0.38) and also between depression and a total score of EQ (p<0.01, r=0.42). Conclusion: The results of this present study confirmed the important role of EQ. Also, the results can be an inspiration for the future studies regarding the training of EQ skills in the treatment of mental disorder (anxiety and depression) among patients with breast cancer. PMID:28286616

Mixing in High Schmidt Number Turbulent Jets

DTIC Science & Technology

1991-01-01

the higher Sc jet is less well mixed. The difference is less pronounced at higher Re. Flame length estimates imply either an increase in entrainment...72 8.0 Estimation of flame lengths ....................................... 74 8.1 Estim ation m...A.4) Lf flame length N number of trials (Eq. 3.1) p exponent in fits of the variance behavior with Re p probability of a binomial event (Eq. 3.1) p

Clinical validity of a disease-specific health status questionnaire: the peripheral artery questionnaire.

PubMed

Hoeks, Sanne E; Smolderen, Kim G; Scholte Op Reimer, Wilma J M; Verhagen, Hence J M; Spertus, John A; Poldermans, Don

2009-02-01

Measuring patient-centered outcomes is becoming increasingly important in patients with peripheral arterial disease (PAD), both as a means of determining the benefits of treatment and as an aid for disease management. In order to monitor health status in a reliable and sensitive way, the disease-specific measure Peripheral Artery Questionnaire (PAQ) was developed. However, to date, its correlation with traditional clinical indices is unknown. The primary aim of this study was to better establish the clinical validity of the PAQ by examining its association with functional indices related to PAD. Furthermore, we hypothesized that the clinical validity of this disease-specific measure is better as compared with the EuroQol-5-dimensional (EQ-5D), a standardized generic instrument. Data on 711 consecutive PAD patients undergoing surgery were collected from 11 Dutch hospitals in 2004. At 3-year follow-up, questionnaires including the PAQ, EQ-5D, and EuroQol-Visual Analogue Scale (EQ VAS) were completed in 84% of survivors. The PAQ was analyzed according to three domains, as established by a factor analyses in the Dutch population, and the summary score. Baseline clinical indices included the presence and severity of claudication intermittent (CI) and the Lee Cardiac Risk Index. All three PAQ domains (Physical Function, Perceived Disability, and Treatment Satisfaction) were significantly associated with CI symptoms (P values < .001-.008). Patients with claudication had significant lower PAQ summary scores as compared with asymptomatic patients (58.6 +/- 27.8 vs 68.6 +/- 27.8, P = < .001). Furthermore, the PAQ summary score and the subscale scores for Physical Functioning and Perceived Disability demonstrated a clear dose-response relation for walking distance and the Lee Risk Index (P values < .001-.031). With respect to the generic EQ-5D, the summary EQ-5D index was associated with CI (0.81 +/- 0.20 vs 0.76 +/- 0.24, P = .031) but not with walking distance (P = .128) nor the Lee Risk Index (P = .154). The EQ VAS discriminated between the clinical indices (P values = .003-.008), although a clear dose-response relation was lacking. The clinical validity of the PAQ proved to be good as the PAQ subscales discriminated well between patients with or without symptomatic PAD and its severity as defined by walking distance. Furthermore, the PAQ subscales were directly proportional to the presence and number of risk factors relevant for PAD. For studying outcomes in PAD patients, the disease-specific PAQ is likely to be a more sensitive measure of treatment benefit as compared with the generic EQ VAS, although the latter may still be of value when comparing health status across different diseases. Regarding disease management, we advocate the use of the disease-specific PAQ as its greater sensitivity and validity will assist its translation into clinical practice.

Efficacy and Safety of Paliperidone Palmitate 3-Month Formulation for Patients with Schizophrenia: A Randomized, Multicenter, Double-Blind, Noninferiority Study

PubMed Central

Xu, Haiyan; Gopal, Srihari; Nuamah, Isaac; Ravenstijn, Paulien; Janik, Adam; Schotte, Alain; Hough, David; Fleischhacker, Wolfgang W.

2016-01-01

Background: This double-blind, parallel-group, multicenter, phase-3 study was designed to test the noninferiority of paliperidone palmitate 3-month formulation (PP3M) to the currently marketed 1-month formulation (PP1M) in patients (age 18–70 years) with schizophrenia, previously stabilized on PP1M. Methods: After screening (≤3 weeks) and a 17-week, flexible-dosed, open-label phase (PP1M: day 1 [150mg eq. deltoid], day 8 [100mg eq. deltoid.], weeks 5, 9, and 13 [50, 75, 100, or 150mg eq., deltoid/gluteal]), clinically stable patients were randomized (1:1) to PP3M (fixed-dose, 175, 263, 350, or 525mg eq. deltoid/gluteal) or PP1M (fixed-dose, 50, 75, 100, or 150mg eq. deltoid/gluteal) for a 48-week double-blind phase. Results: Overall, 1016/1429 open-label patients entered the double-blind phase (PP3M: n=504; PP1M: n=512) and 842 completed it (including patients with relapse). PP3M was noninferior to PP1M: relapse rates were similar in both groups (PP3M: n=37, 8%; PP1M: n=45, 9%; difference in relapse-free rate: 1.2% [95% CI:-2.7%; 5.1%]) based on Kaplan-Meier estimates (primary efficacy). Secondary endpoint results (changes from double-blind baseline in positive and negative symptom score total and subscale scores, Clinical Global Impression-Severity, and Personal and Social Performance scores) were consistent with primary endpoint results. No clinically relevant differences were observed in pharmacokinetic exposures between PP3M and PP1M. Both groups had similar tolerability profiles; increased weight was the most common treatment-emergent adverse event (double-blind phase; 21% each). No new safety signals were detected. Conclusion: Taken together, PP3M with its 3-month dosing interval is a unique option for relapse prevention in schizophrenia. PMID:26902950

High pressure study of viscosity and temperature effects on tetracyanobenzene EDA complexes

NASA Astrophysics Data System (ADS)

Thomas, Michele Moisio; Drickamer, H. G.

1981-12-01

High pressure fluorescence studies from 0-10 kbar have been performed on electron donor-acceptor (EDA) complexes of s-tetracyanobenzene (TCNB) with a series of aromatic hydrocarbons. Four solvents were used: 2,2,4,4,6,8,8-heptamethylnonane (HMN), methylcyclohexane (MCH), 2,6,10,14-tetramethylpentadecane (TMPD), and a mixture of MCH and HMN. A viscosity range from 0.006 to 10 000 P was covered at two temperatures: 0 and 25 °C. As pressure (viscosity) increased the fluorescence spectrum shifted from one dominated by emission from the equilibrium (EQ) excited singlet state to one dominated by Franck-Condon (FC) singlet emission. Lifetime measurements for the complexes of o-xylene and p-xylene with TCNB yielded the two radiative rates (kEQ and kFC) as well as the rate of relaxation from FC to the EQ excited state (kRE). kRE was found to correlate well with viscosity and to be independent of temperature at constant viscosity, indicating that the relaxation process is diffusion controlled.

Cross-cultural measurement equivalence of the EQ-5D-5L items for English-speaking Asians in Singapore.

PubMed

Luo, N; Wang, Y; How, C H; Wong, K Y; Shen, L; Tay, E G; Thumboo, J; Herdman, M

2015-06-01

To investigate how the response labels of the 5-level EQ-5D (EQ-5D-5L) items are interpreted and used by English-speaking Chinese and non-Chinese Singaporeans, as a means to assessing whether those items are cross-culturally equivalent health-status measures in this Asian population. In face-to-face interviews, Chinese, Malay and Indian visitors to a primary care institution in Singapore were asked to rate the relative severity conveyed by EQ-5D-5L response labels, each containing the keyword of 'no(t),' 'slight(ly),' 'moderate(ly),' 'severe(ly),' or 'unable'/'extreme(ly),' using a 0-100 numerical rating scale. Participants were also asked to describe 25 hypothetical health states using the EQ-5D-5L response labels. Differences between Chinese and Malay/Indian participants in label interpretation and selection were examined using multivariate regression analysis to adjust for participant characteristics. The differences in adjusted mean severity scores for individual EQ-5D-5L labels between Chinese (n = 148) and non-Chinese (Malay: n = 53; Indian: n = 56) participants ranged from 0.0 to 9.0. The relative severity of the labels to the participants supported the ordinality of the EQ-5D-5L response labels and was similar across ethnic groups. Chinese and non-Chinese participants selected similar response labels to describe each hypothetical health state, with the adjusted odds ratios of selecting any type of the five response labels for non-Chinese versus Chinese participants ranging from 0.92 to 1.15 (p > 0.05 for all). The EQ-5D-5L items are likely to generate equivalent health outcomes between English-speaking Chinese and non-Chinese Singaporeans.

Health-related quality of life and Chlamydia trachomatis infection in sexually experienced female inner-city students: a community-based cross-sectional study.

PubMed

Sri, Trisha; Southgate, Eleanor; Kerry, Sarah R; Nightingale, Claire; Oakeshott, Pippa

2017-03-01

This cross-sectional study was undertaken to compare health-related quality of life (EQ-5D) in women with and without undiagnosed Chlamydia trachomatis infection. We analysed data from 2401 multi-ethnic sexually active female students aged 16-27 years who were recruited to a randomised controlled trial of chlamydia screening - the prevention of pelvic infection trial in 2004-2006. At recruitment, all participants were asked to provide self-taken vaginal swabs for chlamydia testing and to complete a sexual health questionnaire including quality of life (EQ-5D). Most women (69%) had an EQ-5D of one representing 'perfect health' in the five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. We therefore compared the proportion of women with an EQ-5D score < 1 implying 'less than perfect health' in women with and without chlamydia infection, and women with symptomatic chlamydia versus the remainder. The proportion of women with EQ-5D score < 1 was similar in women with and without undiagnosed chlamydia: 34% (47/138) versus 31% (697/2263; RR 1.11, 95% CI 0.87 to 1.41). However, more women with symptomatic chlamydia had EQ-5D score < 1 than the remainder: 45% (25/55) versus 31% (714/2319; RR 1.47, CI 1.10 to 1.98). In this community-based study, EQ-5D scores were similar in women with and without undiagnosed chlamydia. However, a higher proportion of women with symptomatic chlamydia infection had 'less than perfect health'. Undiagnosed chlamydia infection may not have a major short-term effect on health-related quality of life, but EQ-5D may not be the best tool to measure it in this group.

German Value Set for the EQ-5D-5L.

PubMed

Ludwig, Kristina; Graf von der Schulenburg, J-Matthias; Greiner, Wolfgang

2018-06-01

The objective of this study was to develop a value set for EQ-5D-5L based on the societal preferences of the German population. As the first country to do so, the study design used the improved EQ-5D-5L valuation protocol 2.0 developed by the EuroQol Group, including a feedback module as internal validation and a quality control process that was missing in the first wave of EQ-5D-5L valuation studies. A representative sample of the general German population (n = 1158) was interviewed using a composite time trade-off and a discrete choice experiment under close quality control. Econometric modeling was used to estimate values for all 3125 possible health states described by EQ-5D-5L. The value set was based on a hybrid model including all available information from the composite time trade-off and discrete choice experiment valuations without any exclusions due to data issues. The final German value set was constructed from a combination of a conditional logit model for the discrete choice experiment data and a censored at -1 Tobit model for the composite time trade-off data, correcting for heteroskedasticity. The value set had logically consistent parameter estimates (p < 0.001 for all coefficients). The predicted EQ-5D-5L index values ranged from -0.661 to 1. This study provided values for the health states of the German version of EQ-5D-5L representing the preferences of the German population. The study successfully employed for the first time worldwide the improved protocol 2.0. The value set enables the use of the EQ-5D-5L instrument in economic evaluations and in clinical studies.

Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

PubMed

Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

2015-10-01

The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

Anchoring Vignettes in EQ-5D-5L Questionnaire: Validation of a New Instrument.

PubMed

Azzolina, Danila; Minto, Clara; Boschetto, Stefania; Martinato, Matteo; Bauce, Barbara; Iliceto, Sabino; Gregori, Dario

2017-01-01

Health Related Quality of Life (HRQoL) is an indicator of patient's physical, psychological and social life. HRQoL is influenced by experience, beliefs, perceptions and expectations, and measures subjective perspective of the patient himself. EQ-5D-5L and SF-12 questionnaires are validated instruments useful to measure HRQoL, increasingly administered in electronic formats. The main purpose is to evaluate the feasibility of anchoring vignettes for the EQ-5D-5L questionnaire, with the aim to improve intergroup comparability of responses among different subjects. A comparison with SF-12 questionnaire is carried out. This is a cross-sectional study conducted at the ambulatories of cardiology of the University Hospital of Padova, in Italy. Thirty-eight subjects with a diagnosis of cardiovascular disease or at risk of cardiovascular disease were enrolled. A factorial analysis has been performed to assess the convergent validity of EQ-5D-5L questionnaire compared to Sf-12. Moreover, a compound Hierarchical Ordered Probit (Chopit) model has been estimated to evaluate if the questionnaire form affects the subjective evaluation process in order to compare EQ-5D-5L with and without vignettes. Correlation and factor analysis demonstrate that EQ_5D questionnaire is coherent with SF-12 in paper format. Chopit model estimation shows that questionnaire format does not affect the subjective question interpretation. Moreover, in a parametric model including vignettes, education attainment, disease severity, and gender are predictors of HRQoL status. The EQ-5D including vignettes in electronic format seems to be a valid tool to measure HRQoL as compared to EQ-5D without vignettes in paper format and to SF-12 questionnaire.

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005–2012

PubMed Central

Leung, Cindy W.; Leak, Tashara M.; Laraia, Barbara A.

2017-01-01

Introduction Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. Methods We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005–2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Results Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce–equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). Conclusion These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group. PMID:28682743

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012.

PubMed

Tester, June M; Leung, Cindy W; Leak, Tashara M; Laraia, Barbara A

2017-07-06

Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005-2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce-equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group.

Social networks and health-related quality of life among Chinese old adults in urban areas: results from 4th National Household Health Survey.

PubMed

Lei, P; Xu, L; Nwaru, B I; Long, Q; Wu, Z

2016-02-01

To examine the associations between components of social networks and health-related quality of life (HRQoL) in community-dwelling old adults in urban areas in China. Data from the 4th National Household Health Survey (NHHS) in China, conducted in 2008, were used. HRQoL of respondents aged ≥15 years was assessed using EQ-5D in the NHHS. The sample for the current analysis included 9833 old adults aged ≥60 years. Multiple linear and logistic regression models were used to assess the associations between indicators of social network and HRQoL. Approximately 6% of the respondents saw their children once a year or less, and approximately 1% reported that they had no children. Thirteen percent of the sample seldom contacted their neighbours and seldom met with relatives or friends; approximately 62% seldom attended social gatherings. The five dimensions of HRQoL (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) were reported to be moderate or severe in 14.5%, 9.4%, 12.6%, 18.3% and 9.3% of the sample, respectively. The mean visual analogue scale (VAS) score and EQ-5D index using the time trade-off method was 70.96 [standard deviation (SD) 14.79] and 0.869 (SD 0.163), respectively. After adjusting for potential confounding variables, old adults with weaker social networks were more likely to report problems on EQ-5D dimensions, lower VAS scores and lower EQ-5D indexes. For old adults living in urban communities in China, increased social participation has a positive effect on various dimensions of HRQoL. There is a need for policy considerations that will improve integration of community-level public resources in order to encourage frequent social interaction among old adults, and promote health and social care as a whole. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Prime Contract Awards Alphabetically by Contractor, by State or Country, and Place, FY83, Part 10 (Universal Aircraft Parts Inc-Zytron Corp).

DTIC Science & Technology

1983-01-01

FIELDS & ALI 33-88 B C B 5 2 2 J070 000 A7 MAINT-REPAIR OF EQ/ADP EQUIP 3 6 4 1 1 K OCAO 0029 DAC , 33-88 B C A 5 3 2 W070 000 $1 LEASE-RENTAL OF EQ...D OCW63 0071 DAC 83-C0414 B C Z 5 3 2 S206 000 SI GUARD SERVICES 7 9 3 5 L 06 1 B J 2 D 83-C0450 B C Z 5 3 2 S206 000 Si GUARD SERVICES 7 9 7 5 L 06...C2470 J085 N62’ CONTRACTOR TOTAL 9 1,541 WALLER TODD & SADLI LA JUNTA COLORADO 040309 1520 06 1 C OCA65 0055 DAC 0-82-D4446 E C B 5 3 2 9140 000 A8A

Nonlinear Aeroelastic Study for Folding Wing Structures

DTIC Science & Technology

2010-03-29

Blm +B nl m ) ζ (14) δǫm = ( Blm +B nl m ) δζ (15) χ = Bbζ (16) δχ = Bbδζ . (17) Substitution of Eqs. 13-17 into Eq. 11 gives: δζT ( h...S ΨTFdS + ∫ S ΨTΦtrdS − h ∫ S ΨTΨρdSζ̈ − h ∫ S ΨT cΨdSζ̇ − ∫ S ( Blm ) TNdS − ∫ S (Bnlm) TNdS − ∫ S BTb MdS ) = 0 . (18) Considering the arbitrariness...of the virtual generalized displacements, Eq. 18 can be written 6 of 24 as: h ∫ S ΨTΨρdSζ̈ + h ∫ S ΨT cΨdSζ̇ + ∫ S ( Blm ) TNdS + ∫ S (Bnlm) TNdS+ ∫

Nonlinear High Fidelity Aeroelastic Analysis for Novel Configurations

DTIC Science & Technology

2010-03-29

Blm +B nl m ) ζ (14) δǫm = ( Blm +B nl m ) δζ (15) χ = Bbζ (16) δχ = Bbδζ . (17) Substitution of Eqs. 13-17 into Eq. 11 gives: δζT ( h...S ΨTFdS + ∫ S ΨTΦtrdS − h ∫ S ΨTΨρdSζ̈ − h ∫ S ΨT cΨdSζ̇ − ∫ S ( Blm ) TNdS − ∫ S (Bnlm) TNdS − ∫ S BTb MdS ) = 0 . (18) Considering the arbitrariness...of the virtual generalized displacements, Eq. 18 can be written 6 of 24 as: h ∫ S ΨTΨρdSζ̈ + h ∫ S ΨT cΨdSζ̇ + ∫ S ( Blm ) TNdS + ∫ S (Bnlm) TNdS+ ∫

Estimating quality weights for EQ-5D health states with the time trade-off method in South Korea.

PubMed

Jo, Min-Woo; Yun, Sung-Cheol; Lee, Sang-Il

2008-12-01

To estimate quality weights of EQ-5D health states with the time trade-off (TTO) method in the general population of South Korea. A total of 500 respondents valued 42 hypothetical EQ-5D health states using the TTO and visual analog scale. The quality weights for all EQ-5D health states were estimated by a random effects model and compared with those from studies in other countries. Overall estimated quality weights for all EQ-5D health states from this study were highly correlated with those from previous studies, but quality weights of individual states were substantially different from those of their corresponding states in other studies. The Korean value set differed from value sets from other countries. Special caution is needed when a value set from one country is applied to another with a different culture.

Earthquake prediction with electromagnetic phenomena

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayakawa, Masashi, E-mail: hayakawa@hi-seismo-em.jp; Advanced Wireless & Communications Research Center, UEC, Chofu Tokyo; Earthquake Analysis Laboratory, Information Systems Inc., 4-8-15, Minami-aoyama, Minato-ku, Tokyo, 107-0062

Short-term earthquake (EQ) prediction is defined as prospective prediction with the time scale of about one week, which is considered to be one of the most important and urgent topics for the human beings. If this short-term prediction is realized, casualty will be drastically reduced. Unlike the conventional seismic measurement, we proposed the use of electromagnetic phenomena as precursors to EQs in the prediction, and an extensive amount of progress has been achieved in the field of seismo-electromagnetics during the last two decades. This paper deals with the review on this short-term EQ prediction, including the impossibility myth of EQsmore » prediction by seismometers, the reason why we are interested in electromagnetics, the history of seismo-electromagnetics, the ionospheric perturbation as the most promising candidate of EQ prediction, then the future of EQ predictology from two standpoints of a practical science and a pure science, and finally a brief summary.« less

Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis.

PubMed

Lange, Johan Emil; Steen, Harald; Gunderson, Ragnhild; Brox, Jens Ivar

2011-08-31

It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%) patients had late-onset juvenile and 214 had adolescent idiopathic scoliosis. All patients had clinical and radiological examination and answered a standardised questionnaire including work status, demographics, General Function Score (GFS) (100 - worst possible) and Oswestry Disability Index (ODI) (100 - worst possible), EuroQol (EQ-5D) (1 - best possible), EQ-VAS (100 - best possible), and Scoliosis Research Society - 22 (SRS - 22) (5 - best possible). The mean age at follow-up was 40.4 (31-48) years. The prebrace major curve was in average 33.2 (20 - 57)°. At weaning and at the last follow-up the corresponding values were 28.3 (1 - 58)° and 32.5 (7 - 80)°, respectively. Curve development was similar in patients with late-onset juvenile and adolescent start. The prebrace curve increased > 5° in 31% and decreased > 5° in 26%. Twenty-five patients had surgery. Those who did not attend follow-up (n = 88) had a lower mean curve at weaning: 25.4 (6-53)°. Work status was 76% full-time and 10% part-time. Eighty-seven percent had delivered a baby, 50% had pain in pregnancy. The mean (SD) GFS was 7.4 (10.8), ODI 9.3 (11.0), EQ-5D 0.82 (0.2), EQ-VAS 77.6 (17.8), SRS-22: pain 4.1 (0.8), mental health 4.1 (0.6), self-image 3.7 (0.7), function 4.0 (0.6), satisfaction with treatment 3.7 (1.0). Surgical patients had significantly reduced scores for SRS-physical function and self-image, and patients with curves ≥ 45° had reduced self-image. Long-term results were satisfactory in most braced patients and similar in late-onset juvenile and idiopathic adolescent scoliosis.

Density functional theory-based prediction of the formation constants of complexes of ammonia in aqueous solution: indications of the role of relativistic effects in the solution chemistry of gold(I).

PubMed

Hancock, Robert D; Bartolotti, Libero J

2005-10-03

A prediction of the formation constants (log K1) for complexes of metal ions with a single NH3 ligand in aqueous solution, using quantum mechanical calculations, is reported. DeltaG values at 298 K in the gas phase for eq 1 (DeltaG(DFT)) were calculated for 34 metal ions using density functional theory (DFT), with the expectation that these would correlate with the free energy of complex formation in aqueous solution (DeltaG(aq)). [M(H2O)6]n+(g) + NH(3)(g) = [M(H2O)5NH3]n+(g) + H2O(g) (eq 1). The DeltaG(aq) values include the effects of complex changes in solvation on complex formation, which are not included in eq 1. It was anticipated that such changes in solvation would be constant or vary systematically with changes in the log K(1) value for different metal ions; therefore, simple correlations between DeltaG(DFT) and DeltaG(aq) were sought. The bulk of the log K1(NH3) values used to calculate DeltaG(aq) were not experimental, but estimated previously (Hancock 1978, 1980) from a variety of empirical correlations. Separate linear correlations between DeltaG(DFT) and DeltaG(aq) for metal ions of different charges (M2+, M3+, and M4+) were found. In plots of DeltaG(DFT) versus DeltaG(aq), the slopes ranged from 2.201 for M2+ ions down to 1.076 for M4+ ions, with intercepts increasing from M2+ to M4+ ions. Two separate correlations occurred for the M3+ ions, which appeared to correspond to small metal ions with a coordination number (CN) of 6 and to large metal ions with a higher CN in the vicinity of 7-9. The good correlation coefficients (R) in the range of 0.97-0.99 for all these separate correlations suggest that the approach used here may be the basis for future predictions of aqueous phase chemistry that would otherwise be experimentally inaccessible. Thus, the log K1(NH3) value for the transuranic Lr3+, which has a half-life of 3.6 h in its most stable isotope, is predicted to be 1.46. These calculations should also lead to a greater insight into the factors governing complex formation in aqueous solution. All of the above DFT calculations involved corrections for scalar relativistic effects (RE). Au has been described (Koltsoyannis 1997) as a "relativistic element". The chief effect of RE for group 11 ions is to favor linear coordination geometry and greatly increase covalence in the M-L bond. The correlation for M+ ions (H+, Cu+, Ag+, Au+) involved the preferred linear coordination of the [M(H2O)2]+ complexes, so that the DFT calculations of DeltaG for the gas-phase reaction in eq 2 were carried out for M = H+, Cu+, Ag+, and Au+. [M(H2O)2]+(g) + NH3(g) = [M(H2O)NH3]+(g) + H2O(g) (eq 2). Additional DFT calculations for eq 2 were carried out omitting corrections for RE. These indicated, in the absence of RE, virtually no change in the log K1(NH3) value for H+, a small decrease for Cu+, and a larger decrease for Ag+. There would, however, be a very large decrease in the log K1(NH3) value for Au(I) from 9.8 (RE included) to 1.6 (RE omitted). These results suggest that much of "soft" acid behavior in aqueous solution in the hard and soft acid-base classification of Pearson may be the result of RE in the elements close to Au in the periodic table.

Biochemical profile of coconut water from coconut palms planted in an inland region.

PubMed

Vigliar, Renata; Sdepanian, Vera L; Fagundes-Neto, Ulysses

2006-01-01

To analyze the biochemical profile of coconut water from dwarf coconut palms planted in non-coastal regions, during the maturation period (sixth to ninth month). Eight of 15 coconut palms planted in a non-coastal region were selected by lots and their coconuts sent to a laboratory for extraction and analysis of the coconut water. Coconut water from a total of 45 coconuts, from the sixth to ninth months' maturity, were analyzed to measure glucose, electrolytes, total proteins and osmolarity and to identify the sugars contained. The analysis of coconut water from the sixth to ninth month did not find any differences in the median concentrations of sodium (3 mEq/L; 2 and 3), glucose (0.6 g/L; 0.3 and 17.3) or total proteins (9 g/L; 6 and 12), but detected a reduction in the concentration of potassium (64 mEq/L; 46 and 99), calcium (6.5 mmol/L; 5 and 8.5), magnesium (8 mmol/L; 3.9 and 9.8), chloride (38.5 mEq/L; 30 and 48.7) and osmolarity (419 mOsmol/L; 354 and 472). With relation to the sugars, identified by chromatography on paper, an increase was observed from the sixth to the ninth month in the concentration of fructose (68 mg/microL; 44 and 320) and glucose (299 mg/microL; 262 and 332) and in conjunction with a concentration of sucrose (340 mg/microL; 264 and 390). The biochemical profile of coconut water varied as the coconuts matured, observing reductions in the concentration of potassium, calcium, magnesium, chloride and osmolarity. Descending paper chromatography revealed an increase in the concentration of fructose and glucose and also a reduction in the concentration of sucrose.

The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: A retrospective cohort study of adult in-hospital cardiac arrest.

PubMed

Wang, Chih-Hung; Huang, Chien-Hua; Chang, Wei-Tien; Tsai, Min-Shan; Yu, Ping-Hsun; Wu, Yen-Wen; Hung, Kuan-Yu; Chen, Wen-Jone

2016-01-01

Calcium and sodium bicarbonate (SB) are frequently used in treating patients with severe hyperkalaemia. We evaluated the efficacy of these medications for the treatment of severe hyperkalaemia during cardiopulmonary resuscitation (CPR). We also hypothesised that the effects of these medications might be associated with serum potassium level during CPR. We conducted a retrospective observational study in a single medical centre. From adult patients who had suffered an in-hospital cardiac arrest from 2006 through 2012, we included those with a serum potassium level>6.5 mEq/L measured during CPR. We used multivariable logistic regression analysis to study the association of calcium/SB with sustained return of spontaneous circulation (ROSC). Among the 109 patients included in our analysis, 40 (36.7%) patients achieved sustained ROSC, and only four (3.7%) patients survived to hospital discharge. The mean serum potassium level was 7.8 mEq/L. The analysis indicated that administration of SB was positively associated with sustained ROSC when serum potassium level was <7.9 mEq/L (odds ratio [OR]: 10.51; 95% confidence interval [CI]: 1.50-112.89; p: 0.03); administration of calcium and SB was also positively associated with sustained ROSC when serum potassium level was <9.4 mEq/L (OR: 51.11; 95% CI: 3.12-1639.16; p: 0.01). The use of calcium and SB might be effective in the treatment of severe hyperkalaemia during cardiac arrest. The efficacy of SB/calcium correlated with serum potassium level. However, because the number of patients included in the analysis was small, this conclusion should be further examined in the future. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The impact of stroke on emotional intelligence

PubMed Central

2010-01-01

Background Emotional intelligence (EI) is important for personal, social and career success and has been linked to the frontal anterior cingulate, insula and amygdala regions. Aim To ascertain which stroke lesion sites impair emotional intelligence and relation to current frontal assessment measurements. Methods One hundred consecutive, non aphasic, independently functioning patients post stroke were evaluated with the Bar-On emotional intelligence test, "known as the Emotional Quotient Inventory (EQ-i)" and frontal tests that included the Wisconsin Card Sorting Test (WCST) and Frontal Systems Behavioral Inventory (FRSBE) for correlational validity. The results of a screening, bedside frontal network syndrome test (FNS) and NIHSS to document neurological deficit were also recorded. Lesion location was determined by the Cerefy digital, coxial brain atlas. Results After exclusions (n = 8), patients tested (n = 92, mean age 50.1, CI: 52.9, 47.3 years) revealed that EQ-i scores were correlated (negatively) with all FRSBE T sub-scores (apathy, disinhibition, executive, total), with self-reported scores correlating better than family reported scores. Regression analysis revealed age and FRSBE total scores as the most influential variables. The WCST error percentage T score did not correlate with the EQ-i scores. Based on ANOVA, there were significant differences among the lesion sites with the lowest mean EQ-i scores associated with temporal (71.5) and frontal (87.3) lesions followed by subtentorial (91.7), subcortical gray (92.6) and white (95.2) matter, and the highest scores associated with parieto-occipital lesions (113.1). Conclusions 1) Stroke impairs EI and is associated with apathy, disinhibition and executive functioning. 2) EI is associated with frontal, temporal, subcortical and subtentorial stroke syndromes. PMID:21029468

Effects of Reabsorption and Spatial Trap Distributions on the Radiative Quantum Efficiencies of ZnO

DTIC Science & Technology

2010-06-06

in (a)] due to reabsorption, and the probability f reflesc of photon escape due to Fresnel reflection [derived from Eq. (1) and a Kramers- Kronig ...according to Eq. (1) using an index of refraction n(h̄ω) derived from a Kramers- Kronig transformation of the estimated absorption spectrum in Fig. 3(a

Quality of life and costs in Parkinson's disease: a cross sectional study in Hungary.

PubMed

Tamás, Gertrúd; Gulácsi, László; Bereczki, Dániel; Baji, Petra; Takáts, Annamária; Brodszky, Valentin; Péntek, Márta

2014-01-01

Patient reported outcomes and costs of illness are useful to capture some of the multiple effects of a disease and its treatments. Our aim was to assess quality of life (QoL) and costs of Parkinson's disease (PD) in Hungary, and to analyze their associations. A cross-sectional questionnaire survey was conducted in one neurology university clinic. Clinical characteristics, PD related resource utilizations and productivity loss in the past 12 months were recorded; the Hoehn&Yahr (HY) scale, PDQ-39 and EQ-5D questionnaires were applied. Cost calculation was performed from the societal perspective. 110 patients (34.5% female) were involved with mean age of 63.3 (SD=11.3) and disease duration of 8.2 (SD=5.8) years. PDQ-39 summary score was 48.1 (SD=13.4). The average EQ-5D score was 0.59 (SD=0.28), and was significantly lower than the population norm in age-groups 45-74. The correlation was significant between EQ-5D and PDQ-39 (-0.47, p=0.000), the HY scale and EQ-5D (-0.3416, p=0.0008) and PDQ-39 (0.3419, p=0.0006) scores. The total mean cost was €6030.2 (SD=6163.0)/patient/year (direct medical 35.7%, direct non-medical 29.4%, indirect cost 34.9%). A one year increase in disease duration and 0.1 decrease of the EQ-5D utility score increase the yearly costs by 8 to 10%, and 7.8%, respectively. The effect of the PDQ-39 score on total cost was not significant. Disease severity and public health importance of PD are clearly demonstrated by the magnitude of QoL loss. PD-related costs are substantial, but are much lower in Hungary than in Western European countries. Disease duration and EQ-5D score are significant proxy of costs.

Mild water restriction with or without urea for the longterm treatment of syndrome of inappropriate antidiuretic hormone secretion (SIADH): Can urine osmolality help the choice?

PubMed

Decaux, G; Gankam Kengne, F; Couturier, B; Musch, W; Soupart, A; Vandergheynst, F

2018-02-01

Treatment options for chronic SIADH include water restriction (WR) and urea. The usefulness of urine osmolality to guide the choice of the treatment option is not clearly defined. We hypothesized that urine osmolality can indicate whether treatment with mild water restriction alone could be successful. Retrospective Review of clinical and biochemical (blood and urine) data of patients with chronic SIADH treated for at least one year with mild WR (1.5-2l/day) either with or without urea. Twenty nine patients were included. Nine patients were treated by mild WR. Mean serum sodium (SNa) and mean Uosm were 129±2mEq/l and 274±78mOsm/kgH2O respectively before WR, and increased to 138.5±3mEq/l and 505±87mOsm/kgH 2 O (P<0.001). Eight patients were treated with mild WR and 15g urea daily, the SNa and Uosm before treatment were 127.5±3mEq/l and 340±100mOsm/kgH 2 O respectively and increased to 136.5±1mEq/l and 490±151mOsm/kgH 2 O (P<0.001). Four of the eight patients had a permanent low solute intake which contributed to hyponatremia. Twelve patients needed 30g urea daily combined with mild WR. The SNa and Uosm were respectively 126±2mEq/l and 595±176mOsm/kgH 2 O and increased to 136.5±2mEq/l and 698±157mOsm/kgH 2 O (P<0.05). Uosm increased in most of the treated patients. About 30% of patients could be treated by moderate WR alone. All these patients presented an initial urine osmolality lower than 400mOsm/kgH 2 O. Copyright © 2017. Published by Elsevier B.V.

Determination and validation of an aquatic Maximum Acceptable Concentration-Environmental Quality Standard (MAC-EQS) value for the agricultural fungicide azoxystrobin.

PubMed

Rodrigues, Elsa Teresa; Pardal, Miguel Ângelo; Gante, Cristiano; Loureiro, João; Lopes, Isabel

2017-02-01

The main goal of the present study was to determine and validate an aquatic Maximum Acceptable Concentration-Environmental Quality Standard (MAC-EQS) value for the agricultural fungicide azoxystrobin (AZX). Assessment factors were applied to short-term toxicity data using the lowest EC 50 and after the Species Sensitivity Distribution (SSD) method. Both ways of EQS generation were applied to a freshwater toxicity dataset for AZX based on available data, and to marine toxicity datasets for AZX and Ortiva ® (a commercial formulation of AZX) obtained by the present study. A high interspecific variability in AZX sensitivity was observed in all datasets, being the copepoda Eudiaptomus graciloides (LC 50,48h  = 38 μg L -1 ) and the gastropod Gibbula umbilicalis (LC 50,96h  = 13 μg L -1 ) the most sensitive freshwater and marine species, respectively. MAC-EQS values derived using the lowest EC 50 (≤0.38 μg L -1 ) were more protective than those derived using the SSD method (≤3.2 μg L -1 ). After comparing the MAC-EQS values estimated in the present study to the smallest AA-EQS available, which protect against the occurrence of prolonged exposure of AZX, the MAC-EQS values derived using the lowest EC 50 were considered overprotective and a MAC-EQS of 1.8 μg L -1 was validated and recommended for AZX for the water column. This value was derived from marine toxicity data, which highlights the importance of testing marine organisms. Moreover, Ortiva affects the most sensitive marine species to a greater extent than AZX, and marine species are more sensitive than freshwater species to AZX. A risk characterization ratio higher than one allowed to conclude that AZX might pose a high risk to the aquatic environment. Also, in a wider conclusion, before new pesticides are approved, we suggest to improve the Tier 1 prospective Ecological Risk Assessment by increasing the number of short-term data, and apply the SSD approach, in order to ensure the safety of aquatic organisms. Copyright © 2016 Elsevier Ltd. All rights reserved.

Semi-Cooperative Learning in Smart Grid Agents

DTIC Science & Technology

2013-12-01

2009 HOEP and its ACF/PACF diagnostic functions. . . 37 2.21 Residuals from multiplicative seasonal ARIMA model fit on 2009 HOEP. . . . . . . . . . 38...2.22 Typical forecast for the next 72 hours based on the ARIMA model of Eq. 2.14. . . . . . . 40 3.1 Consumption capacity of two small villages over...1 (the training series). . 49 3.4 ARIMA model (Eq. 3.1) forecasts based on the full village 1 time series (top subfigure) and the first 24 hours of

Association between mortality and replacement solution bicarbonate concentration in continuous renal replacement therapy: A propensity-matched cohort study.

PubMed

Kashani, Kianoush; Thongprayoon, Charat; Cheungpasitporn, Wisit; Iacovella, Gina M; Akhoundi, Abbasali; Albright, Robert C

2017-01-01

Given the known deleterious effects seen with bicarbonate supplementation for acidemia, we hypothesized that utilizing high bicarbonate concentration replacement solution in continuous venovenous hemofiltration (CVVH) would be independently associated with higher mortality. In a propensity score-matched historical cohort study conducted at a single tertiary care center from December 9, 2006, through December 31, 2009, a total of 287consecutive adult critically ill patients with Stage III acute kidney injury (AKI) requiring CVVH were enrolled. We excluded patients on maintenance dialysis, those who received other modalities of continuous renal replacement therapies, and patients that received a mixed of 22 and 32 mEq/L bicarbonate solution pre- and post-filter. The primary outcome was in-hospital and 90-day mortality rates. Among enrollees, 68 were used 32 mEq/L bicarbonate solution, and 219 received 22mEq/L bicarbonate solution for CVVH. Patients on 32 mEq/L bicarbonate solution were more often non-surgical, had lower pH and bicarbonate level but had higher blood potassium and phosphorus levels in comparison with those on 22 mEq/L bicarbonate solution. After adjustment for the baseline characteristics, the use of 32 bicarbonate solution was significantly associated with increased in-hospital (HR = 1.94; 95% CI 1.02-3.79) and 90-day mortality (HR = 1.50; 95% CI 1.03-2.14). There was a significant increase in the hospital (p = .03) and 90-day (p = .04) mortality between the 22 vs. 32 mEq/L bicarbonate solution groups following propensity matching. Our data showed there is a strong association between using high bicarbonate solution and mortality independent of severity of illness and comorbid conditions. These findings need to be evaluated further in prospective studies.

Is Serum Bicarbonate Level Associated With Negative Outcomes in Pediatric Patients?: A Retrospective Cohort Study.

PubMed

Poonai, Naveen; Mainprize, David; Travers, Carolyn; Vivas, Lilian Lee Yan; Tryphonopoulos, Peter; Sangha, Gurinder; Arbeau, Ryan; Seabrook, Jamie; Miller, Michael; Sarpal, Amrita; Lim, Rodrick

2017-11-01

Early identification of children at risk for adverse outcomes is important. Serum bicarbonate is easily collected and widely available. We described the relationship between bicarbonate and adverse outcomes in children presenting to the emergency department (ED). We conducted a retrospective cohort study of children aged 0 to 17 years from January 1, 2007, to December 31, 2011, who had a serum bicarbonate measured in the ED. Primary outcome was the predictive ability of bicarbonate for the individual components of the composite outcome that included at least one of the following: intensive care unit admission, assisted ventilation, inotropic support, cardiopulmonary resuscitation, or death. Secondary outcome was the relationship between bicarbonate level of greater and less than 13 mEq/L and the composite outcome. We reviewed 16,989 charts, of which 432 had an adverse outcome. Receiver operating characteristic curve analysis showed that a bicarbonate level of less than 18.5 mEq/L predicted inotropic support with an area under the curve of 0.69 (95% confidence interval [CI], 0.60-0.77; P < 0.001) and death with an area under the curve of 0.75 (CI, 0.66-0.85; P < 0.001). Significantly more patients with bicarbonate level of less than 13 mEq/L had at least 1 adverse outcome compared with those with bicarbonate level of greater than 13 mEq/L (4.4% vs 2.5%, P = 0.001), odds ratio 1.96 (95% CI, 1.3-2.97). Among children presenting to the ED, bicarbonate level of 18.5 mEq/L had fair specificity in predicting inotropic support and death. Negative outcomes are significantly associated with bicarbonate level of less than 13 mEq/L. Bicarbonate should routinely be measured in children at risk of clinical deterioration.

Anomalous phenomena in Schumann resonance band observed in China before the 2011 magnitude 9.0 Tohoku-Oki earthquake in Japan

NASA Astrophysics Data System (ADS)

Zhou, Hongjuan; Zhou, Zhiquan; Qiao, Xiaolin; Yu, Haiyan

2013-12-01

anomalous phenomena in the Schumann resonance (SR) band, possibly associated with the Tohoku-Oki earthquake (EQ), are studied based on the ELF observations at two stations in China. The anomaly appeared on 8 March, 3 days prior to the main shock, and was characterized by an increase in the intensity at frequencies from the first mode to the fourth mode in both magnetic field components, different from the observations in Japan before large EQs in Taiwan. The abnormal behaviors of the north-south and east-west magnetic field components primarily appeared at 0000-0900 UT and 0200-0900 UT on 8 March, respectively. The finite difference time domain numerical method is applied to model the impact of seismic process on the ELF radio propagation. A partially uniform knee model of the vertical conductivity profile suggested by V. C. Mushtak is used to model the day-night asymmetric Earth-ionosphere cavity, and a locally EQ-induced disturbance model of the atmospheric conductivity is introduced. The atmospheric conductivity is assumed to increase around the epicenter according to the localized enhancement of total electron content in the ionosphere. It is concluded that the SR anomalous phenomena before the Tohoku-Oki EQ have much to do with the excited sources located at South America and Asia and also with the localized distribution of the disturbed conductivity. This work is a further confirmation of the relationship of SR anomalies with large EQs and has further concluded that the distortions in the SR band before large EQs may be caused by the irregularities located over the shock epicenter in the Earth-ionosphere cavity by numerical method.

Dioxin-like chemicals in soil and sediment from residential and industrial areas in central South Africa.

PubMed

Nieuwoudt, Claudine; Quinn, Laura P; Pieters, Rialet; Jordaan, Ilse; Visser, Maret; Kylin, Henrik; Borgen, Anders R; Giesy, John P; Bouwman, Henk

2009-08-01

Persistent organic pollutants (POPs) are a global concern due to their ubiquitous presence and toxicity. Currently, there is a lack of information regarding POPs from South Africa. Here we report and interpret concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), -dibenzofurans (PCDFs) and co-planar-biphenyls (PCBs) in soils and sediments collected from central South Africa. High resolution gas chromatography-high resolution mass spectrometry (HRGC/HRMS) and the H4IIE-luc bio-assay were used to identify and quantify individual PCDD/F congeners and to report the total concentration of 2,3,7,8-tetrachloro dibenzo-p-dioxin equivalents (TCDD-EQ), respectively. TCDD-EQs determined by use of the bio-assay, and concentrations of WHO(2005)-TEQ (toxic equivalents) determined by chemical analysis, were similar. The limit of detection (LOD) for the bio-assay was 0.82 and 2.8 ng TCDD-EQ kg(-1), dw for sediment and soil, respectively. EQ20 concentrations determined by use of the bio-assay ranged from

Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru.

PubMed

Taype-Rondan, Alvaro; Abbs, Elizabeth Sarah; Lazo-Porras, Maria; Checkley, William; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime; Bernabe-Ortiz, Antonio

2017-12-01

To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol's EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored -13.7 points on the EQ-VAS in Lima, -7.9 in urban Puno, -11.0 in semi-urban Tumbes, and -2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations.

A comparison of direct and indirect methods for the estimation of health utilities from clinical outcomes.

PubMed

Hernández Alava, Mónica; Wailoo, Allan; Wolfe, Fred; Michaud, Kaleb

2014-10-01

Analysts frequently estimate health state utility values from other outcomes. Utility values like EQ-5D have characteristics that make standard statistical methods inappropriate. We have developed a bespoke, mixture model approach to directly estimate EQ-5D. An indirect method, "response mapping," first estimates the level on each of the 5 dimensions of the EQ-5D and then calculates the expected tariff score. These methods have never previously been compared. We use a large observational database from patients with rheumatoid arthritis (N = 100,398). Direct estimation of UK EQ-5D scores as a function of the Health Assessment Questionnaire (HAQ), pain, and age was performed with a limited dependent variable mixture model. Indirect modeling was undertaken with a set of generalized ordered probit models with expected tariff scores calculated mathematically. Linear regression was reported for comparison purposes. Impact on cost-effectiveness was demonstrated with an existing model. The linear model fits poorly, particularly at the extremes of the distribution. The bespoke mixture model and the indirect approaches improve fit over the entire range of EQ-5D. Mean average error is 10% and 5% lower compared with the linear model, respectively. Root mean squared error is 3% and 2% lower. The mixture model demonstrates superior performance to the indirect method across almost the entire range of pain and HAQ. These lead to differences in cost-effectiveness of up to 20%. There are limited data from patients in the most severe HAQ health states. Modeling of EQ-5D from clinical measures is best performed directly using the bespoke mixture model. This substantially outperforms the indirect method in this example. Linear models are inappropriate, suffer from systematic bias, and generate values outside the feasible range. © The Author(s) 2013.

76 FR 178 - Ocwen Loan Servicing, LLC; Including Workers Whose Wages Were Reported Under HomEQ Servicing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,610; TA-W-74,610A] Ocwen Loan Servicing, LLC; Including Workers Whose Wages Were Reported Under HomEQ Servicing; North Highlands, CA; Ocwen Loan Servicing, LLC; Including Workers Whose Wages Were Reported Under HomEQ Servicing; Raleigh, NC; Amended Certification Regarding...

Search for first generation leptoquark pair production in the electron + missing energy + jets final state

DOE PAGES

Abazov, Victor Mukhamedovich

2011-10-11

We present a search for the pair production of first generation scalar leptoquarks (LQ) in data corresponding to an integrated luminosity of 5.4 fb -1 collected with the D0 detector at the Fermilab Tevatron Collider in pp collisions at √s = 1.96 TeV. In the channel LQLQ → eqν eq, where q,q are u or d quarks, no significant excess of data over background is observed, and we set a 95% C.L. lower limit of 326 GeV on the leptoquark mass, assuming equal probabilities of leptoquark decays to eq and ν eq.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pletneva, Nadya V.; Pletnev, Vladimir Z.; Shemiakina, Irina I.

The wild type red fluorescent protein eqFP578 (from sea anemone Entacmaea quadricolor, {lambda}{sub ex} = 552 nm, {lambda}{sub em} = 578 nm) and its bright far-red fluorescent variant Katushka ({lambda}{sub ex} = 588 nm, {lambda}{sub em} = 635 nm) are characterized by the pronounced pH dependence of their fluorescence. The crystal structures of eqFP578f (eqFP578 with two point mutations improving the protein folding) and Katushka have been determined at the resolution ranging from 1.15 to 1.85 {angstrom} at two pH values, corresponding to low and high level of fluorescence. The observed extinguishing of fluorescence upon reducing pH in eqFP578f andmore » Katushka has been shown to be accompanied by the opposite trans-cis and cis-trans chromophore isomerization, respectively. Asn143, Ser158, His197 and Ser143, Leu174, and Arg197 have been shown to stabilize the respective trans and cis fluorescent states of the chromophores in eqFP578f and Katushka at higher pH. The cis state has been suggested as being primarily responsible for the observed far-red shift of the emission maximum of Katushka relative to that of eqFP578f.« less

Safety and efficacy of intravenous hypotonic 0.225% sodium chloride infusion for the treatment of hypernatremia in critically ill patients.

PubMed

Dickerson, Roland N; Maish, George O; Weinberg, Jordan A; Croce, Martin A; Minard, Gayle; Brown, Rex O

2013-06-01

The purpose of this study was to evaluate the safety and efficacy of central venous administration of a hypotonic 0.225% sodium chloride (one-quarter normal saline [¼ NS]) infusion for critically ill patients with hypernatremia. Critically ill, adult patients with traumatic injuries and hypernatremia (serum sodium [Na] >150 mEq/L) who were given ¼ NS were retrospectively studied. Serum sodium, fluid balance, free water intake, sodium intake, and plasma free hemoglobin concentration (fHgb) were assessed. Twenty patients (age, 50 ± 18 years; Injury Severity Score, 29 ± 12) were evaluated. The ¼ NS infusion was given at 1.5 ± 1.0 L/d for 4.6 ± 1.6 days. Serum sodium concentration decreased from 156 ± 4 to 143 ± 6 mEq/L (P < .001) over 3-7 days. Total sodium intake was decreased from 210 ± 153 to 156 ± 112 mEq/d (P < .05). Daily net fluid balance was not significantly increased. Plasma fHgb increased from 4.9 ± 5.4 mg/dL preinfusion to 8.9 ± 7.4 mg/dL after 2.6 ± 1.3 days of continuous intravenous (IV) ¼ NS in 10 patients (P = .055). An additional 10 patients had a plasma fHgb of 10.2 ± 9.0 mg/dL during the infusion. Hematocrit and hemoglobin decreased (26% ± 3% to 24% ± 2%, P < .001 and 9.1 ± 1.1 to 8.2 ± 0.8 g/dL, P < .001, respectively). Although IV ¼ NS was effective for decreasing serum sodium concentration, evidence for minor hemolysis warrants further research to establish its safety before its routine use can be recommended.

Health-related quality of life of adjuvant chemotherapy with S-1 versus gemcitabine for resected pancreatic cancer: Results from a randomised phase III trial (JASPAC 01).

PubMed

Hagiwara, Yasuhiro; Ohashi, Yasuo; Uesaka, Katsuhiko; Boku, Narikazu; Fukutomi, Akira; Okamura, Yukiyasu; Konishi, Masaru; Matsumoto, Ippei; Kaneoka, Yuji; Shimizu, Yasuhiro; Nakamori, Shoji; Sakamoto, Hirohiko; Morinaga, Soichiro; Kainuma, Osamu; Imai, Koji; Sata, Naohiro; Hishinuma, Shoichi; Ojima, Hitoshi; Yamaguchi, Ryuzo; Hirano, Satoshi; Sudo, Takeshi

2018-04-01

Adjuvant chemotherapy with S-1 for resected pancreatic cancer demonstrated survival benefits compared with gemcitabine in the JASPAC 01 trial. We investigated the effect of these agents on health-related quality of life (HRQOL) of patients in the JASPAC 01 trial. Patients with resected pancreatic cancer were randomly assigned to receive gemcitabine (1000 mg/m 2 weekly for three of four weeks for up to six cycles) or S-1 (40, 50, or 60 mg twice daily for four of six weeks for up to four cycles). HRQOL was assessed using the EuroQol-5D-3L (EQ-5D) questionnaire at baseline, months three and six, and every 6 months thereafter. HRQOL end-points included change in EQ-5D index from baseline, responses to five items in the EQ-5D, and quality-adjusted life months up to 24 months. Of randomised 385 patients, 354 patients were included in HRQOL analysis. Mean change in the EQ-5D index was similar in the S-1 and gemcitabine groups within 6 months from treatment initiation (difference, 0.024; P = 0.112), whereas corresponding mean from 12 to 24 months was better in the S-1 group than in the gemcitabine group (difference, 0.071; P < 0.001). Problems in mobility and pain/discomfort were also less frequent in the S-1 group than in the gemcitabine group in that period. Quality-adjusted life months were longer in the S-1 group than in the gemcitabine group (P < 0.001). Adjuvant chemotherapy with S-1 does not improve HRQOL within 6 months from treatment initiation but does improve HRQOL thereafter and quality-adjusted life months. UMIN000000655 at UMIN CTR. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of a Multistage Reliability-Based Design Optimization Method

DTIC Science & Technology

2014-01-01

expressed using Eq. (7), where nx is the number of design variables P a0 þ Xnx i¼1 aini þ bið Þxi 0 " # a (7) Figures 3(a)–3(c) illustrates the...constraint equation can be expressed in the gen- eral form of Eq. (16), where again nx is the number of design variables P a0;j þ Xnx i¼1 ai;jnixi

Potential Energy Surface-Based Automatic Deduction of Conformational Transition Networks and Its Application on Quantum Mechanical Landscapes of d-Glucose Conformers.

PubMed

Satoh, Hiroko; Oda, Tomohiro; Nakakoji, Kumiyo; Uno, Takeaki; Tanaka, Hiroaki; Iwata, Satoru; Ohno, Koichi

2016-11-08

This paper describes our approach that is built upon the potential energy surface (PES)-based conformational analysis. This approach automatically deduces a conformational transition network, called a conformational reaction route map (r-map), by using the Scaled Hypersphere Search of the Anharmonic Downward Distortion Following method (SHS-ADDF). The PES-based conformational search has been achieved by using large ADDF, which makes it possible to trace only low transition state (TS) barriers while restraining bond lengths and structures with high free energy. It automatically performs sampling the minima and TS structures by simply taking into account the mathematical feature of PES without requiring any a priori specification of variable internal coordinates. An obtained r-map is composed of equilibrium (EQ) conformers connected by reaction routes via TS conformers, where all of the reaction routes are already confirmed during the process of the deduction using the intrinsic reaction coordinate (IRC) method. The postcalculation analysis of the deduced r-map is interactively carried out using the RMapViewer software we have developed. This paper presents computational details of the PES-based conformational analysis and its application to d-glucose. The calculations have been performed for an isolated glucose molecule in the gas phase at the RHF/6-31G level. The obtained conformational r-map for α-d-glucose is composed of 201 EQ and 435 TS conformers and that for β-d-glucose is composed of 202 EQ and 371 TS conformers. For the postcalculation analysis of the conformational r-maps by using the RMapViewer software program we have found multiple minimum energy paths (MEPs) between global minima of 1 C 4 and 4 C 1 chair conformations. The analysis using RMapViewer allows us to confirm the thermodynamic and kinetic predominance of 4 C 1 conformations; that is, the potential energy of the global minimum of 4 C 1 is lower than that of 1 C 4 (thermodynamic predominance) and that the highest energy of those of all the TS structures along a route from 4 C 1 to 1 C 4 is lower than that of 1 C 4 to 4 C 1 (kinetic predominance).

Interpretation and use of the 5-level EQ-5D response labels varied with survey language among Asians in Singapore.

PubMed

Luo, Nan; Wang, Ye; How, Choon How; Tay, Ee Guan; Thumboo, Julian; Herdman, Michael

2015-10-01

This study aimed to investigate the comparability of the English, Chinese, and Malay versions of the 5-level EQ-5D (EQ-5D-5L) response labels in Singapore. Visitors to a primary care institution in Singapore (n = 743) were asked to complete two exercises: (1) rating the severity of the EQ-5D-5L response labels presented in English, Chinese, or Malay using a 0-100 numeric rating scale and (2) using the labels to describe various hypothetical health problems. Label ratings and choices between language versions were compared using regression analysis. Perceived severity of the English and Chinese labels was similar. Compared with their English counterparts, the Malay label "slight(ly)" was rated as more severe (adjusted mean difference: 10.5 to 14.5) and "unable"/"extreme(ly)" as less severe (adjusted mean difference: -13.3 to -11.0) (P < 0.001 for all). The Malay labels "no(t)" and "unable"/"extreme(ly)" and the less severe Chinese labels were more frequently used to describe hypothetical health problems than their English counterparts. Interpretation and use of the EQ-5D-5L response labels vary among Singaporeans using different language versions of the instrument. Future studies need to investigate ways to reduce the variations and increase the cross-cultural measurement equivalence of the instrument. Copyright © 2015 Elsevier Inc. All rights reserved.

Should pediatric parenteral nutrition be individualized?☆

PubMed Central

Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Saron, Margareth Lopes Galvão; Lima, Alexandre Esteves Souza; Hessel, Gabriel

2014-01-01

INTRODUCTION: Parenteral nutrition (PN) formulations are commonly individualized, since their standardization appears inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN, hospitalized in a tertiary hospital in Campinas, São Paulo. METHODS: This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO) (2006) and WHO (2007). The levels of the following elements in blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus, and triglycerides (TGL). Among the criteria for individualization, the following were considered undeniable: significant reduction in blood levels of potassium (<3mEq/L), sodium (<125mEq/L), magnesium (<1mEq/L), phosphorus (<1.5mEq/L), ionic calcium (<1mmol), and chloride (<90mEq/L), or any value above the references. RESULTS: Twelve pediatric patients aged 1 month to 15 years were studied (49 individualizations). Most patients were classified as malnourished. It was observed that 74/254 (29.2%) of examinations demanded individualized PN for indubitable reasons. CONCLUSION: The nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters. PMID:25510996

Predictors of health-related quality of life in 500 severely obese patients.

PubMed

Warkentin, Lindsey M; Majumdar, Sumit R; Johnson, Jeffrey A; Agborsangaya, Calypse B; Rueda-Clausen, Christian F; Sharma, Arya M; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; McCargar, Linda; Fassbender, Konrad; Padwal, Raj S

2014-05-01

To characterize health-related quality of life (HRQL) impairment in severely obese subjects, using several validated instruments. A cross-sectional analysis of 500 severely obese subjects was completed. Short-Form (SF)-12 [Physical (PCS) and Mental (MCS) component summary scores], EuroQol (EQ)-5D [Index and Visual Analog Scale (VAS)], and Impact of Weight on Quality of Life (IWQOL)-Lite were administered. Multivariable linear regression models were performed to identify independent predictors of HRQL. Increasing BMI was associated with lower PCS (-1.33 points per 5 kg/m(2) heavier; P < 0.001), EQ-index (-0.02; P < 0.001), EQ-VAS (-1.71; P = 0.003), and IWQOL-Lite (-3.72; P = 0.002), but not MCS (P = 0.69). The strongest predictors (all P < 0.005) for impairment in each instrument were: fibromyalgia for PCS (-5.84 points), depression for MCS (-7.49 points), stroke for EQ-index (-0.17 points), less than full-time employment for EQ-VAS (-7.06 points), and coronary disease for IWQOL-Lite (-10.86 points). Chronic pain, depression, and sleep apnea were associated with reduced HRQL using all instruments. The clinical impact of BMI on physical and general HRQL was small, and mental health scores were not associated with BMI. Chronic pain, depression, and sleep apnea were consistently associated with lower HRQL. Copyright © 2014 The Obesity Society.

Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression.

PubMed

Ali, Faraz Mahmood; Kay, Richard; Finlay, Andrew Y; Piguet, Vincent; Kupfer, Joerg; Dalgard, Florence; Salek, M Sam

2017-11-01

The Dermatology Life Quality Index (DLQI) and the European Quality of Life-5 Dimension (EQ-5D) are separate measures that may be used to gather health-related quality of life (HRQoL) information from patients. The EQ-5D is a generic measure from which health utility estimates can be derived, whereas the DLQI is a specialty-specific measure to assess HRQoL. To reduce the burden of multiple measures being administered and to enable a more disease-specific calculation of health utility estimates, we explored an established mathematical technique known as ordinal logistic regression (OLR) to develop an appropriate model to map DLQI data to EQ-5D-based health utility estimates. Retrospective data from 4010 patients were randomly divided five times into two groups for the derivation and testing of the mapping model. Split-half cross-validation was utilized resulting in a total of ten ordinal logistic regression models for each of the five EQ-5D dimensions against age, sex, and all ten items of the DLQI. Using Monte Carlo simulation, predicted health utility estimates were derived and compared against those observed. This method was repeated for both OLR and a previously tested mapping methodology based on linear regression. The model was shown to be highly predictive and its repeated fitting demonstrated a stable model using OLR as well as linear regression. The mean differences between OLR-predicted health utility estimates and observed health utility estimates ranged from 0.0024 to 0.0239 across the ten modeling exercises, with an average overall difference of 0.0120 (a 1.6% underestimate, not of clinical importance). This modeling framework developed in this study will enable researchers to calculate EQ-5D health utility estimates from a specialty-specific study population, reducing patient and economic burden.

The effect of dietary cation-anion difference concentration and cation source on milk production and feed efficiency in lactating dairy cows.

PubMed

Iwaniuk, M E; Weidman, A E; Erdman, R A

2015-03-01

Feed costs currently account for 55% or more of the total cost of milk production in US dairy herds, and dairy producers are looking for strategies to improve feed efficiency [FE; 3.5% fat-corrected milk (FCM) per dry matter (DM) intake]. Increasing dietary cation-anion difference [DCAD; Na+K-Cl (mEq/kg of DM)] has been shown to increase milk production, FCM, and FE. However, the optimal DCAD concentration for maximal FE has yet to be determined. The objectives of this research were to test the effects of DCAD concentration and cation source on dairy FE. Sixty Holstein dairy cows (20 cows per experiment) were used in three 4×4 Latin square design experiments with 3-wk experimental periods. In experiments 1 and 2, we tested the effect of DCAD concentration: cows were fed a basal diet containing ~250 mEq/kg of DM DCAD that was supplemented with potassium carbonate at 0, 50, 100, and 150 mEq/kg of DM or 0, 125, 250, and 375 mEq/kg of DM in experiments 1 and 2, respectively. In experiment 3, we tested the effect of cation source: sodium sesquicarbonate replaced 0, 33, 67, and 100% of the supplemental potassium carbonate (150 mEq/kg of DM DCAD). The DCAD concentration had no effect on milk production, milk protein concentration, or milk protein yield in experiments 1 and 2. Dry matter intake was not affected by DCAD concentration in experiment 1 or by cation source in experiment 3. However, DMI increased linearly with increasing DCAD in experiment 2. We detected a linear increase in milk fat concentration and yield with increasing DCAD in experiments 1 and 2 and by substituting sodium sesquicarbonate for potassium carbonate in experiment 3. Increased milk fat concentration with increasing DCAD led to increases in 3.5% FCM in experiments 1 and 2. Maximal dairy FE was achieved at a DCAD concentration of 426 mEq/kg of DM in experiments 1 and 2 and by substituting Na for K in experiment 3. The results of these experiments suggest that both DCAD concentration and the cation source used to alter DCAD concentration have effects on milk fat content and yield and dairy FE. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Learning from the experience: preliminary results of integration experiments within PRE-EARTHQUAKES EU-FP7 Project.

NASA Astrophysics Data System (ADS)

Tramutoli, V.; Inan, S.; Jakowski, N.; Pulinets, S.; Romanov, A.; Filizzola, C.; Shagimuratov, I.; Pergola, N.; Genzano, N.; Lisi, M.; Alparslan, E.; Wilken, V.; Tsybulia, K.; Romanov, A.; Paciello, R.; Balasco, M.; Zakharenkova, I.; Ouzounov, D.; Papadopoulos, G. A.; Parrot, M.

2012-04-01

PRE-EARTHQUAKES (Processing Russian and European EARTH observations for earthQUAKE precursors Studies) EU-FP7 project is devoted to demonstrate - integrating different observational data, comparing and improving different data analysis methods - how it is possible to progressively increase reliability of short term seismic risk assessment. Three main testing area were selected (Italy, Turkey and Sakhalin ) in order to concentrate observations and integration efforts starting with a learning phase on selected event in the past devoted to identify the most suitable parameters, observations technologies, data analysis algorithms. To this aim events offering major possibilities (variety) of integration were particularly considered - Abruzzo EQ (April 6th 2009 Mw 6.3) for Italy, Elazig EQ (March 8th 2010 Mw 6.1) for Turkey and Nevelsk EQ (August 2nd 2007 Mw 6.2) for Sakhalin - without excluding other significant events occurred during 2011 like the ones of Tōhoku in Japan and Van in Turkey. For these events, different ground (80 radon and 29 spring water stations in Turkey region, 2 magneto-telluric in Italy) and satellite (18 different systems) based observations, 11 data analysis methods, for 7 measured parameters, have been compared and integrated. Results achieved by applying a validation/confutation approach devoted to evaluate the presence/absence of anomalous space-time transients in single and/or integrated observation time-series will be discussed also in comparison with results independently achieved by other authors.

Comparison of mathematically-predicted toxic equivalents (TEQs) and bioassay-derived dioxin-equivalents (TCDD-EQs) in heron embryos

USGS Publications Warehouse

Rattner, B.; Hatfield, J.; Melancon, M.; Custer, T.; Tillitt, D.

1995-01-01

Pipping black-crowned night-heron (Nycticorax nycticorax) embryos were collected from an uncontaminated site (Chincoteague National Wildlife Refuge,VA) and three polluted sites (Cat Island, Green Bay, WI; Bair and West Marin Islands, San Francisco Bay, CA). Hepatic microsomal monooxygenases were induced up to 85-fold relative to the reference site, and was associated with concentrations of total PCBs and 11 PCB congeners that are presumed to concern.to express toxicity through the Ah receptor. TEQs [mathematically predicted; summed product of PCB congener concentrations using 5 different sets of toxic equivalency factors (TEFs)] were compared to TCDD-EQs [derived by bioassay; ethoxyresorufin-O-dealkylase activity of treated H411E rat hepatoma cells]. Although TEQs were up to 15-fold greater than TCDD-EQs, the pattern among sites was consistent and TEQs were highly correlated with TCDD-EQs. TEFs based on single congener mammalian studies yielded TEQs that greatly exceeded values from the H411E bioassay of field sample. TEFs generated from avian egg injection studies yielded TEQs that most closely approximated bioassay-derived TCDD-EQs. Cytochrome P450 parameters were related to TEQs and TCDD-EQs; adjusted r2 often exceeded 0.5 for the relation among mathematically predicted TEQs and cytochrome P450 measurements. These data document the general predictive value of TEQs and TCDD-EQs for P450 induction in field collected samples, but also indicate the need for development of TEFs for the species and biological end point of concern.

Very exceptional cases of VLF/LF ionospheric perturbations for deep oceanic earthquakes offshore the Japan island

NASA Astrophysics Data System (ADS)

Yamaguchi, Hiroki; Hayakawa, Masashi

2015-12-01

It is so far believed that ionospheric perturbations as detected by subionospheric VLF/LF (very low frequency/low frequency) propagation, are generated above and around the earthquake (EQ) epicenter. This paper presents very rare cases, which are in complete contrast to the above fact. We have found that in extremely rare cases when EQs happened (i) in the Pacific Ocean or (ii) offshore the Soya cape (Hokkaido) both with very large depths (300-400 km), corresponding ionospheric perturbations take place far away from the EQ epicenter and above the regions with considerable seismic intensity at the time of each EQ. Two EQs happened in the Torishima area of Izu islands (magnitude ∼7 and depth ∼400 km), and corresponding seismic intensity was observed in the Tokyo and Ibaraki districts. Our VLF data have indicated that the ionospheric perturbation takes place over such regions with high seismic intensity. Another group is two EQs (magnitude ∼5) offshore the Soya cape of Hokkaido, and the spatial distribution of seismic intensity at the time of each EQ is just around Aomori prefecture. VLF data have indicated the ionospheric perturbations taken place over the same Aomori area, which is in complete coincidence with the spatial distribution of seismic intensity. As a conclusion, these exceptional examples are, in principle, very similar to the concept of 'selectivity' (or sensitive zone) of geoelectric measurement by the Greek group, and we try to interpret these cases in the context of lithosphere-atmosphere-ionosphere coupling.

Conformational preferences for some 3-(4‧-substituted phenylsulfonyl)-1-methyl-2-piperidones through spectroscopic and theoretical studies

NASA Astrophysics Data System (ADS)

Olivato, Paulo R.; Santos, Jean M. M.; Cerqueira, Carlos R.; Vinhato, Elisângela; Zukerman-Schpector, Julio; Ng, Seik Weng; Tiekink, Edward R. T.; Colle, Maurizio Dal

2012-11-01

The analysis of the infrared (IR) carbonyl band of some 3-(4'-substituted phenylsulfonyl)-1-methyl-2-piperidones 1-5 bearing as substituents: OMe 1, Me 2, H 3, Cl 4 and NO25, supported by B3LYP/6-31G(d,p) calculations along with NBO analysis (for 1, 3 and 5) and X-ray diffraction (for 5), indicated the existence of three stable conformations i.e. quasi-axial (q-ax), syn-clinal (s-cl) and quasi-equatorial (q-eq). In the gas phase, the q-ax conformer is calculated as the most stable (ca. 88%) and the least polar, the s-cl conformer is less stable (ca. 12%) but more polar, and the q-eq conformer is the least stable (ca. 1%) and the most polar of the three conformers evaluated. The sum of the most important orbital interactions from NBO analysis and the trend of the electrostatic interactions accounts for the relative populations as well as for the νCO frequencies of the q-ax, s-cl and q-eq conformers calculated in the gas phase. The unique IR νCO band in CCl4 may be ascribed to the most stable q-ax conformer. The more intense (60%) high frequency doublet component in CHCl3 may be assigned to the summing up of the least stable q-eq and the less stable s-cl conformers, as their frequencies are almost coincident. The occurrence of only a single νCO band in both CH2Cl2 and CH3CN supports the fact that the νCO band of the two more polar conformers appear as a single band. Additional support to this rationalization is given by the single point PCM method, which showed a progressive increase of the q-eq + s-cl/q-ax population ratio going from the gas phase to CCl4, to CHCl3, to CH2Cl2 and to CH3CN. X-ray single crystal analysis of 5 indicates that this compound displays a quasi-axial geometry with respect to the [Odbnd Csbnd CHsbnd S] moiety, and that the 2-piperidone ring assumes a slightly distorted half-chair conformation. In the crystal packing, molecules of 5 are arranged into supramolecular layers linked through Csbnd H⋯O interactions along with π⋯π interactions between adjacent benzene rings.

Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms.

PubMed

Doble, Brett; Lorgelly, Paula

2016-04-01

To determine the external validity of existing mapping algorithms for predicting EQ-5D-3L utility values from EORTC QLQ-C30 responses and to establish their generalizability in different types of cancer. A main analysis (pooled) sample of 3560 observations (1727 patients) and two disease severity patient samples (496 and 93 patients) with repeated observations over time from Cancer 2015 were used to validate the existing algorithms. Errors were calculated between observed and predicted EQ-5D-3L utility values using a single pooled sample and ten pooled tumour type-specific samples. Predictive accuracy was assessed using mean absolute error (MAE) and standardized root-mean-squared error (RMSE). The association between observed and predicted EQ-5D utility values and other covariates across the distribution was tested using quantile regression. Quality-adjusted life years (QALYs) were calculated using observed and predicted values to test responsiveness. Ten 'preferred' mapping algorithms were identified. Two algorithms estimated via response mapping and ordinary least-squares regression using dummy variables performed well on number of validation criteria, including accurate prediction of the best and worst QLQ-C30 health states, predicted values within the EQ-5D tariff range, relatively small MAEs and RMSEs, and minimal differences between estimated QALYs. Comparison of predictive accuracy across ten tumour type-specific samples highlighted that algorithms are relatively insensitive to grouping by tumour type and affected more by differences in disease severity. Two of the 'preferred' mapping algorithms suggest more accurate predictions, but limitations exist. We recommend extensive scenario analyses if mapped utilities are used in cost-utility analyses.

Feeding strategies and manure management for cost-effective mitigation of greenhouse gas emissions from dairy farms in Wisconsin.

PubMed

Dutreuil, M; Wattiaux, M; Hardie, C A; Cabrera, V E

2014-09-01

Greenhouse gas (GHG) emissions from dairy farms are a major concern. Our objectives were to assess the effect of mitigation strategies on GHG emissions and net return to management on 3 distinct farm production systems of Wisconsin. A survey was conducted on 27 conventional farms, 30 grazing farms, and 69 organic farms. The data collected were used to characterize 3 feeding systems scaled to the average farm (85 cows and 127ha). The Integrated Farm System Model was used to simulate the economic and environmental impacts of altering feeding and manure management in those 3 farms. Results showed that incorporation of grazing practices for lactating cows in the conventional farm led to a 27.6% decrease in total GHG emissions [-0.16kg of CO2 equivalents (CO2eq)/kg of energy corrected milk (ECM)] and a 29.3% increase in net return to management (+$7,005/yr) when milk production was assumed constant. For the grazing and organic farms, decreasing the forage-to-concentrate ratio in the diet decreased GHG emissions when milk production was increased by 5 or 10%. The 5% increase in milk production was not sufficient to maintain the net return; however, the 10% increase in milk production increased net return in the organic farm but not on the grazing farm. A 13.7% decrease in GHG emissions (-0.08kg of CO2eq/kg of ECM) was observed on the conventional farm when incorporating manure the day of application and adding a 12-mo covered storage unit. However, those same changes led to a 6.1% (+0.04kg of CO2eq/kg of ECM) and a 6.9% (+0.06kg of CO2eq/kg of ECM) increase in GHG emissions in the grazing and the organic farms, respectively. For the 3 farms, manure management changes led to a decrease in net return to management. Simulation results suggested that the same feeding and manure management mitigation strategies led to different outcomes depending on the farm system, and furthermore, effective mitigation strategies were used to reduce GHG emissions while maintaining profitability within each farm. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A Real-Time Air Dispersion Modeling System.

DTIC Science & Technology

1984-04-01

8217 UNFORMATTED’) READ (SUNITI, REC=I) HD 5 ICNT=2 FLAGI-. FALSE. DO 20 I=2,HD,1 IF (.NOT. FLA6i) FLAG1-.TRUE. READ(SUNIT1, REC-I) HEAD, HDR ICHECK =0 DO 13 JG=1,9...lt IF (HDR(JG) NE. 0) ICHECKI1 13 CONTINUE IF ( ICHECK .EQ. 0) SOTO 28 IF (SKEY(2) .NE. ’*’) THEN IF (SKEY(2 .NE. 𔄁’) THEN DO 12 K-1,9,1 IF (HDR(K) .EQ

Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment

PubMed Central

Sarker, Abdur Razzaque; Sultana, Marufa; Chakrovorty, Sanchita; Khan, Jahangir A. M.

2018-01-01

Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D) questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002); self-care (7.1%; p = 0.000) and pain and discomfort (7.7%; p = 0.005) than uninsured. The average EQ-5D score was significantly lower among the insured (0.704) compared to the uninsured (0.749). The regression analysis showed that those who had a problem in mobility (OR = 1.65; 95% CI: 1.25–2.17); self-care (OR = 2.29; 95% CI: 1.62–3.25) and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81) were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69) were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes. PMID:29385072

Measuring health-related quality of life in women with endometriosis: comparing the clinimetric properties of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D).

PubMed

Aubry, G; Panel, P; Thiollier, G; Huchon, C; Fauconnier, A

2017-06-01

Which of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D) is the most efficient to assess quality of life in women suffering from endometriosis? Although EHP-5 and EQ-5D instruments had an excellent responsiveness, EHP-5 has a better discriminative ability than EQ-5 to measure health-related quality of life (HrQoL). Proper measurement of HrQoL is important in endometriosis. While many quality of life instruments are available, few have been completely validated in endometriosis. The EHP-5 and the EQ-5D are short and practical scales, which may be useful. Literature is lacking to determine which one is the most suitable in clinical practice or in clinical research. This prospective and observational study conducted between 1 January 2012 and 31 December 2013 included a total of 253 consecutive women with proven endometriosis, undergoing medical or surgical treatment, in 2 French tertiary care centers. Women over 18 years consulting for painful symptoms of at least 3 months' duration or for infertility, with endometriosis proven histologically or radiologically, were requested to fill in the 2 scales before (T0) and 12 months after treatment (T1). Construct validity consisted in testing presupposed relationships between the scales and the characteristics of the patients or the endometriosis. Responsiveness to change was calculated for all patients and in each treatment group. Effect sizes were used according to Cohen's d method. A total of 216 women filled in completely all the questionnaires at T0 and 133 (61.6%) at T1. EHP-5 and EQ-5D had good discriminative abilities regarding the patients' symptoms, with significant superiority of EHP-5 concerning three of the nine hypotheses. The largest difference was that calculated for the 'intensity of dysmenorrhea' using the Visual Analogic Scale, with respectively effect size from Cohen's d (ES) = 0.86 95% CI (0.54-1.17) for EHP-5 versus 0.48 95% CI (0.16-0.79) for EQ-5D. There were no differences in EHP-5 or in EQ-5D scores between subgroups according to the characteristics of endometriosis. Overall responsiveness was excellent and equivalent for EHP-5 and for EQ-5D, with, respectively, ES = 0.81 95% CI (0.56-1.56) versus ES = 0.95 95% CI (0.68-1.20). In subgroup analyses, EHP-5 was responsive in case of medical treatment with ES = 0.93 95% CI (0.07-1.70), whereas EQ-5D was not, ES = 0.73 95% CI (-0.06-1.47). Our study population included patients with symptomatic and mainly severe forms of endometriosis, which may suggest a spectrum bias. The evaluation of responsiveness in case of medical treatment was based on a small number of patients, which limits the interpretation of the difference found between the two scales in this subgroup. EHP-5 is a simple, efficient and valid tool for evaluating quality of life in daily practice and also valuable to provide a primary outcome in clinical studies evaluating treatment efficacy. This work was funded by the Direction à la Recherche Clinique et à l'Innovation of Versailles, France. The authors have no conflicts of interest. None. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Fluxes of the greenhouse gases (CO2, CH4 and N2O) above a short-rotation poplar plantation after conversion from agricultural land

NASA Astrophysics Data System (ADS)

Zona, Donatella; Ceulemans, Reinhart

2013-04-01

The increasing demand for renewable energy may lead to the conversion of millions of hectares into bioenergy plantations with a possible substantial transitory carbon (C) loss. In this study we report on the greenhouse gas fluxes (CO2, CH4, and N2O) measured using eddy covariance of a short-rotation bioenergy poplar plantation converted from agricultural fields. During the first six months after the establishment of the plantation (June-Dec 2010) there were substantial CO2, CH4, and N2O emissions (a total of 5.36 ± 0.52 Mg CO2eq ha-1 in terms of CO2 equivalents). Nitrous oxide loss mostly occurred during a week-long peak emission after an unusually large rainfall. This week-long N2O emission represented 52% of the entire N2O loss during one and an half years of measurements. As most of the N2O loss occurred in just this week-long period, accurately capturing these emission events are critical to accurate estimates of the GHG balance of bioenergy. While initial establishment (Jun-Dec 2010) of the plantation resulted in a net CO2 loss into the atmosphere (2.76 ± 0.16 Mg CO2eq ha-1), in the second year (2011) there was substantial net CO2 uptake (-3.51 ± 0.56 Mg CO2eq ha-1). During the entire measurement period, CH4 was a source to the atmosphere (0.63 ± 0.05 Mg CO2eq ha-1 in 2010, and 0.49 ± 0.05 Mg CO2eq ha-1 in 2011), and was controlled by water table depth. Importantly, over the entire measurement period, the sum of the CH4 and N2O losses was much higher (3.51 ± 0.52 Mg CO2eq ha-1) than the net CO2 uptake (-0.76 ± 0.58 Mg CO2eq ha-1). As water availability was an important control on the GHG emission of the plantation, expected climate change and altered rainfall pattern could increase the negative environmental impacts of bioenergy.

The impact of a disease management programme for type 2 diabetes on health-related quality of life: multilevel analysis of a cluster-randomised controlled trial.

PubMed

Panisch, Sigrid; Johansson, Tim; Flamm, Maria; Winkler, Henrike; Weitgasser, Raimund; Sönnichsen, Andreas C

2018-01-01

Type 2 diabetes is a chronic disease associated with poorer health outcomes and decreased health related quality of life (HRQoL). The aim of this analysis was to explore the impact of a disease management programme (DMP) in type 2 diabetes on HRQoL. A multilevel model was used to explain the variation in EQ-VAS. A cluster-randomized controlled trial-analysis of the secondary endpoint HRQoL. Our study population were general practitioners and patients in the province of Salzburg. The DMP "Therapie-Aktiv" was implemented in the intervention group, and controls received usual care. Outcome measure was a change in EQ-VAS after 12 months. For comparison of rates, we used Fisher's Exact test; for continuous variables the independent T test or Welch test were used. In the multilevel modeling, we examined various models, continuously adding variables to explain the variation in the dependent variable, starting with an empty model, including only the random intercept. We analysed random effects parameters in order to disentangle variation of the final EQ-VAS. The EQ-VAS significantly increased within the intervention group (mean difference 2.19, p = 0.005). There was no significant difference in EQ-VAS between groups (mean difference 1.00, p = 0.339). In the intervention group the improvement was more distinct in women (2.46, p = 0.036) compared to men (1.92, p = 0.063). In multilevel modeling, sex, age, family and work circumstances, any macrovascular diabetic complication, duration of diabetes, baseline body mass index and baseline EQ-VAS significantly influence final EQ-VAS, while DMP does not. The final model explains 28.9% (EQ-VAS) of the total variance. Most of the unexplained variance was found on patient-level (95%) and less on GP-level (5%). DMP "Therapie-Aktiv" has no significant impact on final EQ-VAS. The impact of DMPs in type 2 diabetes on HRQoL is still unclear and future programmes should focus on patient specific needs and predictors in order to improve HRQoL. Trial registration Current Controlled trials Ltd., ISRCTN27414162.

Including the spatial variability of metal speciation in the effect factor in life cycle impact assessment: Limits of the equilibrium partitioning method.

PubMed

Tromson, Clara; Bulle, Cécile; Deschênes, Louise

2017-03-01

In life cycle assessment (LCA), the potential terrestrial ecotoxicity effect of metals, calculated as the effect factor (EF), is usually extrapolated from aquatic ecotoxicological data using the equilibrium partitioning method (EqP) as it is more readily available than terrestrial data. However, when following the AMI recommendations (i.e. with at least enough species that represents three different phyla), there are not enough terrestrial data for which soil properties or metal speciation during ecotoxicological testing are specified to account for the influence of soil property variations on metal speciation when using this approach. Alternatively, the TBLM (Terrestrial Biotic Ligand Model) has been used to determine an EF that accounts for speciation, but is not available for metals; hence it cannot be consistently applied to metals in an LCA context. This paper proposes an approach to include metal speciation by regionalizing the EqP method for Cu, Ni and Zn with a geochemical speciation model (the Windermere Humic Aqueous Model 7.0), for 5213 soils selected from the Harmonized World Soil Database. Results obtained by this approach (EF EqP regionalized ) are compared to the EFs calculated with the conventional EqP method, to the EFs based on available terrestrial data and to the EFs calculated with the TBLM (EF TBLM regionalized ) when available. The spatial variability contribution of the EF to the overall spatial variability of the characterization factor (CF) has been analyzed. It was found that the EFs EqP regionalized show a significant spatial variability. The EFs calculated with the two non-regionalized methods (EqP and terrestrial data) fall within the range of the EFs EqP regionalized . The EFs TBLM regionalized cover a larger range of values than the EFs EqP regionalized but the two methods are not correlated. This paper highlights the importance of including speciation into the terrestrial EF and shows that using the regionalized EqP approach is not an acceptable proxy for terrestrial ecotoxicological data even if it can be applied to all metals. Copyright © 2016. Published by Elsevier B.V.

Validation and comparison of 15-D and EQ-5D-5L instruments in a Spanish Parkinson's disease population sample.

PubMed

García-Gordillo, Miguel Ángel; del Pozo-Cruz, Borja; Adsuar, José Carmelo; Sánchez-Martínez, Fernando Ignacio; Abellán-Perpiñán, José María

2014-05-01

To contribute to the ongoing discussion on the choice of a preference-based health-related quality of life (HRQoL) instrument to be used in cost-effectiveness analysis by studying and comparing the validity, sensitivity and relative efficiency of 15-D and EuroQol 5D 5L (EQ-5D-5L) in a Spanish Parkinson's disease (PD) population sample. One hundred and thirty-three volunteers were asked to complete an interview using 15-D and EQ-5D-5L. Spearman's rank correlation coefficient (r) was used to test the convergent validity of these instruments with specific PD measures. Sensitivity and efficiency were compared using receiver operating characteristic (ROC) curves and relative efficiency statistic, respectively. A strong correlation (r > 0.65; p < 0.001) was found between both 15-D and EQ-5D-5L utilities with the summary score of the PDQ-8, and a strong correlation (r > 0.50; p < 0.001) was found between 15-D and EQ-5D-5L utilities with the EQ-VAS. The areas under the ROC of both instruments all exceeded 0.5 (p < 0.001). The 15-D instrument was 4.1-29.8 % less efficient at detecting differences between patients with optimal HRQoL, while this instrument was 11 % more efficient at detecting differences between patients at mild and moderate to strong severity of the PD symptoms. 15-D and EQ-5D-5L are showed to be valid and sensitivity generic HRQoL measures in Spanish PD patients with both instruments showing similar HRQoL dimension coverage and ceiling/floor effects. The 15-D has better efficiency and greater sensitivity to detect clinical changes in PD severity of the symptoms meanwhile the EQ-5D-5L is better to detect clinical HRQoL changes. Additionally, the EQ-5D-5L questionnaire requires less time than 15-D to be administered, and it might be more appropriate for studies conducted in Spain, since a country-specific "value set" is available for this instrument and not for the 15-D.

An Analysis of the Climate Change Mitigation Potential through Soil Organic Carbon Sequestration in a Corn Belt Watershed.

PubMed

Bhattarai, Mukesh Dev; Secchi, Silvia; Schoof, Justin

2017-01-01

Land-based carbon sequestration constitutes a major low cost and immediately viable option in climate change mitigation. Using downscaled data from eight atmosphere-ocean general circulation models for a simulation period between 2015 and 2099, we examine the carbon sequestration potential of alternative agricultural land uses in an intensively farmed Corn Belt watershed and the impact of climate change on crop yields. Our results show that switching from conventional tillage continuous corn to no-till corn-soybean can sequester the equivalent of 192.1 MtCO 2 eq of soil organic carbon per hectare with a sequestration rate of 2.26 MtCO 2 eq ha -1 yr -1 . Our results also indicate that switchgrass can sequester the equivalent of 310.7 MtCO 2 eq of soil organic carbon per hectare with a sequestration rate of 3.65 MtCO 2 eq ha -1 yr -1 . Our findings suggest that, unlike for corn and soybean yields, climate change does not have a significant effect on switchgrass yields, possibly due to the carbon fertilization effect.

Correlates of health related quality of life in anorexia nervosa.

PubMed

Weigel, Angelika; König, Hans-Helmut; Gumz, Antje; Löwe, Bernd; Brettschneider, Christian

2016-06-01

We examined the association between disorder specific factors, comorbidity and health related quality of life (HRQoL) in anorexia nervosa (AN). HRQoL was assessed using the EuroQol-5D visual analog scale (EQ-VAS) in this cross-sectional study. Three regression models were estimated to determine the association between AN subtype (restrictive vs. binge/purge), duration of the eating disorder (ED), age (adolescents vs. adults), ED pathology (EDE-Q), Body Mass Index (BMI), depressive symptoms (PHQ-9), somatic complaints (PHQ-15), anxiety (GAD-7) and EQ-VAS. The sample comprised 218 female AN patients (mean age = 23.3 years [SD = 8.2]; mean EQ-VAS score = 53.4 [SD = 21.4]). A lower BMI, higher levels of depressive symptoms, and somatic complaints were significantly associated with lower EQ-VAS scores. Findings of the present study suggest that BMI and comorbidity might be more relevant to HRQoL impairments in AN than age, diagnostic subtype, duration of the ED or current psychopathology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:630-634). © 2016 Wiley Periodicals, Inc.

An Analysis of the Climate Change Mitigation Potential through Soil Organic Carbon Sequestration in a Corn Belt Watershed

NASA Astrophysics Data System (ADS)

Bhattarai, Mukesh Dev; Secchi, Silvia; Schoof, Justin

2017-01-01

Land-based carbon sequestration constitutes a major low cost and immediately viable option in climate change mitigation. Using downscaled data from eight atmosphere-ocean general circulation models for a simulation period between 2015 and 2099, we examine the carbon sequestration potential of alternative agricultural land uses in an intensively farmed Corn Belt watershed and the impact of climate change on crop yields. Our results show that switching from conventional tillage continuous corn to no-till corn-soybean can sequester the equivalent of 192.1 MtCO2 eq of soil organic carbon per hectare with a sequestration rate of 2.26 MtCO2 eq ha-1 yr-1. Our results also indicate that switchgrass can sequester the equivalent of 310.7 MtCO2 eq of soil organic carbon per hectare with a sequestration rate of 3.65 MtCO2 eq ha-1 yr-1. Our findings suggest that, unlike for corn and soybean yields, climate change does not have a significant effect on switchgrass yields, possibly due to the carbon fertilization effect.

Sensory education program development, application and its therapeutic effect in children

PubMed Central

Chung, Hae-Kyung

2014-01-01

There has recently been Increased interest in the emotional intelligence (EQ) of elementary school students, which is recognized as a more important value than IQ (intelligence quotient) for predict of their success in school or later life. However, there are few sensory education programs, available to improve the EQ of elementary school student's in Korea. This study was conducted to develop an educational program that reflects the characteristics and contents of traditional rice culture and verify the effects of those programs on the EQ of children. The program was developed based on the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and participants were elementary school students in 3rd and 4th grade (n = 120) in Cheonan, Korea. Descriptive statistics and paired t-tests were used. EQ scores pertaining to the basic sense group, culture group, and food group were significantly improved after the sensory educational program(P < 0.05), but no change was observed in the control group. These findings indicate that sensory education contributed to improving elementary school children's Emotional Intelligence (EI) and their actual understanding about Korean traditional rice culture. PMID:24611113

Dyspraxia and autistic traits in adults with and without autism spectrum conditions.

PubMed

Cassidy, Sarah; Hannant, Penelope; Tavassoli, Teresa; Allison, Carrie; Smith, Paula; Baron-Cohen, Simon

2016-01-01

Autism spectrum conditions (ASC) are frequently associated with motor coordination difficulties. However, no studies have explored the prevalence of dyspraxia in a large sample of individuals with and without ASC or associations between dyspraxia and autistic traits in these individuals. Two thousand eight hundred seventy-one adults (with ASC) and 10,706 controls (without ASC) self-reported whether they have been diagnosed with dyspraxia. A subsample of participants then completed the Autism Spectrum Quotient (AQ; 1237 ASC and 6765 controls) and the Empathy Quotient (EQ; 1147 ASC and 6129 controls) online through the Autism Research Centre website. The prevalence of dyspraxia was compared between those with and without ASC. AQ and EQ scores were compared across the four groups: (1) adults with ASC with dyspraxia, (2) adults with ASC without dyspraxia, (3) controls with dyspraxia, and (4) controls without dyspraxia. Adults with ASC were significantly more likely to report a diagnosis of dyspraxia (6.9%) than those without ASC (0.8%). In the ASC group, those with co-morbid diagnosis of dyspraxia did not have significantly different AQ or EQ scores than those without co-morbid dyspraxia. However, in the control group (without ASC), those with dyspraxia had significantly higher AQ and lower EQ scores than those without dyspraxia. Dyspraxia is significantly more prevalent in adults with ASC compared to controls, confirming reports that motor coordination difficulties are significantly more common in this group. Interestingly, in the general population, dyspraxia was associated with significantly higher autistic traits and lower empathy. These results suggest that motor coordination skills are important for effective social skills and empathy.

The Processing and Mechanical Properties of High Temperature/High Performance Composites. Book 3. Constituent Properties and Macroscopic Performance: MMCs

DTIC Science & Technology

1993-04-01

re - expressed as, v .= hCSw (C3) Combining Eqns. (C2) and C3) yields, Se = - ’. S (C4...of vi( s ) or v ’( s ). Substituting eq. (B10) into eq. (25), one finds the finite element method expression for functional Ud [ v ] which is U, d [] = v , K...Measurements 1- D 2- D S ,_DL 4 Constitutive W Constitutive Laws Laws Matrix Cracking Labor Models Models Stress Redistribution Numerical Calculations

A comparative analysis to quantify the biogeochemical and biogeophysical cooling effects on climate of a white mustard cover crop

NASA Astrophysics Data System (ADS)

Ferlicoq, Morgan; Ceschia, Eric; Brut, Aurore; Tallec, Tiphaine; Carrer, Dominique; Pique, Gaetan; Ferroni, Nicole

2017-04-01

During the COP21, agriculture was recognised as a strategic sector and an opportunity to strengthen climate mitigation. In particular, the "4 per 1000" initiative relies upon solutions that refer to agro-ecology, conservation agriculture, … that could lead to increase carbon storage. Among those agro-ecology practices, including cover crops during fallow periods is considered as a fundamental agronomic lever for storing carbon. However, if biogeochemical benefits of cover-crops (CC) have already been addressed, their biogeophysical effects on climate have never been quantified and compared to biogeochemical effects. This comparative study (CC vs. bare soil), quantified and compared biogeochemical (including carbon storage) and biophysical effects (albedo and energy partitioning effect) of CC on climate. An experimental campaign was performed in 2013 in Southwest France, during the fallow period following a winter-wheat crop (and before a maize). The experimental plot was divided in two: the northern part was maintained in bare soil (BS) while white-mustard (WM) was grown during 3-months on the southern part. On each subplot, continuous measurements of CO2, latent and sensible fluxes (by eddy covariance) and solar radiation were acquired. Also, N2O emissions were measured by means of automatic chambers on each subplots. Moreover, by using a Life-Cycle-Analysis approach, each component of the greenhouse gas budget (GHGB) was quantified for each subplot, including emissions associated to field operations (FO). To quantify the albedo induced radiative forcing (RFα) caused by the white-mustard, the bare soil subplot was used as a reference state (IPCC, 2007). Finally, the net radiative forcing for each subplot was calculated as the sum of biogeochemical and biogeophysical (albedo effect) radiative forcing. The white-mustard allowed a net CO2 fixation of 63 g C-eq.m-2, corresponding to 20% of the net annual CO2 flux that year (-332 g C-eq.m-2). Through the WM seeds, the amount of C imported to the field increased by 2 g C-eq.m-2. As the white-mustard was buried and used as green manure for the next cash crop, the amount of C exported (when harvesting winter-wheat) was unchanged. Thus, the WM improved the NECB and reinforced the sink effect by 65 g C-eq.m-2. Nevertheless, growing a CC leads to additional emissions associated to FO. They represented only 3 g C-eq.m-2 and can therefore be considered negligible. However, N2O emissions were reduced during the WM development. Finally, the GHGB of the WM subplot (-73 g C-eq.m-2) was a significant sink while the GHGB of the BS subplot was close to neutral (-12 g C-eq.m-2). By increasing surface albedo, the WM induced a biogeophysical cooling effect (-81 g C-eq.m-2) equivalent to the GHGB of the WM subplot. In other words, the white-mustard cooling effect (compared to bare soil) is doubled if both biogeochemical and RFα are considered. This cooling effect was reinforced by the 53% increase in latent heat flux during the WM development. Finally, we estimated that the albedo cooling effect could be increased by 5-fold by maintaining the WM during 6-months. We conclude that through both biogeochemical and biogeophysical effects, cover crops represent a strong mitigation potential.

Health-related quality of life in HIV/AIDS patients on antiretroviral therapy at a tertiary care facility in Zimbabwe.

PubMed

Mafirakureva, N; Dzingirai, B; Postma, M J; van Hulst, M; Khoza, S

2016-07-01

Health-related quality of life (HRQoL) is a broad concept reflecting a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of their daily life. HRQoL among patients infected with HIV has become an important indicator of impact of disease and treatment outcomes. A cross-sectional survey was carried out at Chitungwiza Central Hospital, Zimbabwe, to assess HRQoL in patients with HIV/AIDS receiving antiretroviral therapy (ART), using two validated instruments. The HIV/AIDS-targeted quality of life (HAT-QoL) and EuroQoL Five-dimensions-Three-level (EQ-5D-3L) instruments were used to assess HRQoL. Internal consistency reliability and convergent validity of the two instruments were also evaluated. For construct validity, the relationships between HRQoL scores and socio-economic and HIV/AIDS-related characteristics were explored. The median scores for the HAT-QoL dimensions ranged from 33.3 (financial worries) to 100 (HIV mastery). A considerably low HAT-QoL dimension score of 50.0 was observed for sexual function. There were ceiling effects for all HAT-QoL dimension scores except for financial worries and disclosure worries. Floor effects were observed for financial worries and sexual function. The median of the EQ-5D-3L index and visual analogue scale (VAS) was 0.81 and 79.0, respectively. There were no floor or ceiling effects for both the EQ-5D-3L index and VAS. The overall scale Cronbach's alpha was 0.83 for HAT-Qol and 0.67 for EQ-5D-3L. HAT-QoL demonstrated good convergent validity with EQ-5D index (0.58) and VAS (0.40). A higher level of HRQoL was positively and significantly related to income, education and employment. The patients' self-reported HRQoL was generally satisfactory in all the HAT-QoL dimensions as well as the two components on the EQ-5D-3L instrument. The two instruments demonstrated good measurement properties in HIV/AIDS patients receiving ART and have potential for use, alongside biomarkers, in monitoring outcomes of interventions.

Relative Impact of Multimorbid Chronic Conditions on Health-Related Quality of Life – Results from the MultiCare Cohort Study

PubMed Central

Brettschneider, Christian; Leicht, Hanna; Bickel, Horst; Dahlhaus, Anne; Fuchs, Angela; Gensichen, Jochen; Maier, Wolfgang; Riedel-Heller, Steffi; Schäfer, Ingmar; Schön, Gerhard; Weyerer, Siegfried; Wiese, Birgitt; König, Hans-Helmut; Altiner, Attila; Bickel, Horst; Blank, Wolfgang; Brettschneider, Christian; Bullinger, Monika; van den Bussche, Hendrik; Dahlhaus, Anne; Ehreke, Lena; Freitag, Michael; Fuchs, Angela; Gensichen, Jochen; Gerlach, Ferdinand; Hansen, Heike; Heinrich, Sven; Höfels, Susanne; von dem Knesebeck, Olaf; König, Hans-Helmut; Krause, Norbert; Leicht, Hanna; Luppa, Melanie; Maier, Wolfgang; Mayer, Manfred; Mellert, Christine; Nützel, Anna; Paschke, Thomas; Petersen, Juliana; Prokein, Jana; Riedel-Heller, Steffi; Romberg, Heinz-Peter; Schäfer, Ingmar; Scherer, Martin; Schön, Gerhard; Steinmann, Susanne; Schulz, Sven; Wegscheider, Karl; Weckbecker, Klaus; Werle, Jochen; Weyerer, Siegfried; Wiese, Birgitt; Zieger, Margrit

2013-01-01

Background Multimorbidity has a negative impact on health-related quality of life (HRQL). Previous studies included only a limited number of conditions. In this study, we analyse the impact of a large number of conditions on HRQL in multimorbid patients without preselecting particular diseases. We also explore the effects of these conditions on the specific dimensions of HRQL. Materials and Methods This analysis is based on a multicenter, prospective cohort study of 3189 multimorbid primary care patients aged 65 to 85. The impact of 45 conditions on HRQL was analysed. The severity of the conditions was rated. The EQ-5D, consisting of 5 dimensions and a visual-analogue-scale (EQ VAS), was employed. Data were analysed using multiple ordinary least squares and multiple logistic regressions. Multimorbidity measured by a weighted count score was significantly associated with lower overall HRQL (EQ VAS), b = −1.02 (SE: 0.06). Parkinson’s disease had the most pronounced negative effect on overall HRQL (EQ VAS), b = −12.29 (SE: 2.18), followed by rheumatism, depression, and obesity. With regard to the individual EQ-5D dimensions, depression (OR = 1.39 to 3.3) and obesity (OR = 1.44 to 1.95) affected all five dimensions of the EQ-5D negatively except for the dimension anxiety/depression. Obesity had a positive effect on this dimension, OR = 0.78 (SE: 0.07). The dimensions “self-care”, OR = 4.52 (SE: 1.37) and “usual activities”, OR = 3.59 (SE: 1.0), were most strongly affected by Parkinson’s disease. As a limitation our sample may only represent patients with at most moderate disease severity. Conclusions The overall HRQL of multimorbid patients decreases with an increasing count and severity of conditions. Parkinson’s disease, depression and obesity have the strongest impact on HRQL. Further studies should address the impact of disease combinations which require very large sample sizes as well as advanced statistical methods. PMID:23826124

Delineating a road-salt plume in lakebed sediments using electrical resistivity, piezometers, and seepage meters at Mirror Lake, New Hampshire, U.S.A

USGS Publications Warehouse

Toran, Laura; Johnson, Melanie; Nyquist, Jonathan E.; Rosenberry, Donald O.

2010-01-01

Electrical-resistivity surveys, seepage meter measurements, and drive-point piezometers have been used to characterize chloride-enriched groundwater in lakebed sediments of Mirror Lake, New Hampshire, U.S.A. A combination of bottom-cable and floating-cable electrical-resistivity surveys identified a conductive zone (<100ohm-m)">(<100ohm-m)(<100ohm-m) overlying resistive bedrock (<1000ohm-m)">(<1000ohm-m)(<1000ohm-m)beneath the lake. Shallow pore-water samples from piezometers in lakebed sediments have chloride concentrations of 200–1800μeq/liter">200–1800μeq/liter200–1800μeq/liter, and lake water has a chloride concentration of 104μeq/liter">104μeq/liter104μeq/liter. The extent of the plume was estimated and mapped using resistivity and water-sample data. The plume (20×35m">20×35m20×35m wide and at least 3m">3m3m thick) extends nearly the full length and width of a small inlet, overlying the top of a basin formed by the bedrock. It would not have been possible to mapthe plume's shape without the resistivity surveys because wells provided only limited coverage. Seepage meters were installed approximately 40m">40m40m from the mouth of a small stream discharging at the head of the inlet in an area where the resistivity data indicated lake sediments are thin. These meters recorded in-seepage of chloride-enriched groundwater at rates similar to those observed closer to shore, which was unexpected because seepage usually declines away from shore. Although the concentration of road salt in the northeast inlet stream is declining, the plume map and seepage data indicate the groundwater contribution of road salt to the lake is not declining. The findings demonstrate the benefit of combining geophysical and hydrologic data to characterize discharge of a plume beneath Mirror Lake. The extent of the plume in groundwater beneath the lake and stream indicate there will likely be a long-term source of chloride to the lake from groundwater.

[Health related quality of life and productivity of women with overactive bladder].

PubMed

Péntek, Márta; Gulácsi, László; Majoros, Attila; Piróth, Csaba; Rubliczky, Levente; Böszörményi Nagy, Géza; Törzsök, Ferenc; Timár, Petra; Baji, Petra; Brodszky, Valentin

2012-07-08

The objective of the research was to assess the health related quality of life and productivity of women with overactive bladder. A cross-sectional survey was performed in 5 outpatient centers. General health status (EQ-5D), disease-specific quality of life (King's Health Questionnaire) and productivity (Work Productivity and Activity Impairment) were assessed. Sixty-one women with mean age of 57.7 (SD = 11.6) years have had symptoms for 6.6 (SD = 6.2) years and 57 (93%) had incontinence. The EQ-5D (mean 0.668, SD = 0.314) was not significantly lower than that of the average population (p>0.05). The impact of incontinence and physical limitation (mean 70.5 and 68.9, respectively) were significant, the King's Health Questionnaire-utility was 0.932 (SD = 0.029). Productivity scores of involved patients were: absenteeism 0.04% (SD = 0.11), presenteeism 43.64% (SD = 28.54), overall work impairment 40.97% (SD = 26.91), and other activities 47.72% (SD = 27.24). Applicability of the EQ-5D and King's Health Questionnaire as utility measures in overactive bladder deserve further research. Presenteeism should be considered in the evaluation of the therapy.

Waiting for hip arthroplasty: economic costs and health outcomes.

PubMed

Fielden, Jann M; Cumming, J M; Horne, J G; Devane, P A; Slack, A; Gallagher, L M

2005-12-01

This prospective cohort study of 153 patients aimed to determine the economic and health costs of waiting for total hip arthroplasty (THA). Health-related quality of life, using self-completed WOMAC and EQ-5D questionnaires, was assessed monthly from enrolment preoperatively to 6 months postsurgery. Monthly cost diaries were used to record costs. The mean waiting time was 5.1 months and mean total cost of waiting for surgery was NZ 4305 dollars(US 2876 dollars) per person (pp) (NZ 1 dollar = US 0.668 dollar). Waiting more than 6 months was associated with a higher total mean cost (NZ 4278 dollars/US 2858 dollars pp) than waiting less than 6 months (NZ 2828 dollars/US 1889 dollars pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P < or = .01). Waiting longer led to poorer physical function preoperatively (P < or = .01). Those with poor initial health status showed greater improvement in WOMAC (P = .0001) and EQ-5D (P = .003) measures by 6 months after surgery. Longer waits for total hip arthroplasty incur greater economic costs and deterioration in physical function while waiting.

Safety, resource use, and quality of life in paramount: a phase III study of maintenance pemetrexed versus placebo after induction pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer.

PubMed

Gridelli, Cesare; de Marinis, Filippo; Pujol, Jean-Louis; Reck, Martin; Ramlau, Rodryg; Parente, Barbara; Pieters, Thierry; Middleton, Gary; Corral, Jesus; Winfree, Katherine; Melemed, Symantha; Zimmermann, Anna; John, William; Beyrer, Julie; Chouaki, Nadia; Visseren-Grul, Carla; Paz-Ares, Luis G

2012-11-01

In a phase III, randomized, double-blind study (PARAMOUNT), maintenance pemetrexed demonstrated significant benefit in advanced non-small-cell lung cancer (NSCLC). We present safety, resource use, and quality of life (QoL) results. After four 21-day cycles of pemetrexed-cisplatin (N = 939), patients with advanced nonsquamous NSCLC, whose disease had not progressed and who had a performance status of 0/1, were randomized 2:1 (N = 539) to maintenance pemetrexed 500 mg/m plus best supportive care or placebo plus best supportive care every 21 days until disease progression or unacceptable toxicity. QoL was measured using the EuroQol 5-dimensional questionnaire (EQ-5D). Frequently reported grade 3 to 4 drug-related toxicities with maintenance pemetrexed versus placebo were anemia (4.5% versus 0.6%; p = 0.016), fatigue (4.2% versus 0.6%; p = 0.016), and neutropenia (3.6% versus 0.0%; p < 0.006). No significant differences in drug-related grade 3 to 5 toxicities were observed with long-term pemetrexed exposure (>6 cycles), except grade 3 to 4 neutropenia, which did not result in increased infections. Patients on maintenance pemetrexed required more transfusions (13.4% versus 5.0%; p = 0.003), granulocyte colony- or granulocyte-macrophage colony-stimulating factors (5.3% versus 0.0%; p <0.001), anti-infectives (25.3% versus 16.7%; p = 0.028), and hospitalizations because of study drug (8.4% versus 3.3%, p = 0.028) than placebo-treated patients did. No significant treatment-by-time interactions, overall treatment differences, or clinically relevant changes from baseline were observed in EQ-5D scores during treatment. Long-term use of continuation maintenance pemetrexed was well tolerated; resource use was low, corresponding with known pemetrexed toxicities. The EQ-5D results demonstrate that patients tolerate long-term maintenance pemetrexed without worsening QoL.

Naval Postgraduate School Aircraft Synthesis Program (User’s Manual)

DTIC Science & Technology

1991-09-01

LOGICAL DVFLAG CHARACTER ANS*6, TITLE*80, PHASE*8 INTEGER EN REAL MACHI, M&CH2 DIMENSION ALTD(6), XM& CH (6) 6590 IF(DVFLAG.EQ. .FALSE.) THEN !GIVE OPTION TO...7800 7840 WRITE (6, 78 45) 7845 FORMAT(/7X,’ENTER THE HORIZONTAL TAIL/CANARD’/ &7X,’WEIGHT SLOPE: ’,$) READ(5,7826,ERR-7840) SLOPE(3) IF((SLOPE(3).LT

[Effects of superphosphate addition on NH3 and greenhouse gas emissions during vegetable waste composting].

PubMed

Yang, Yan; Sun, Qin-ping; Li, Ni; Liu, Chun-sheng; Li, Ji-jin; Liu, Ben-sheng; Zou, Guo-yuan

2015-01-01

To study the effects of superphosphate (SP) on the NH, and greenhouse gas emissions, vegetable waste composting was performed for 27 days using 6 different treatments. In addition to the controls, five vegetable waste mixtures (0.77 m3 each) were treated with different amounts of the SP additive, namely, 5%, 10%, 15%, 20% and 25%. The ammonia volatilization loss and greenhouse gas emissions were measured during composting. Results indicated that the SP additive significantly decreased the ammonia volatilization and greenhouse gas emissions during vegetable waste composting. The additive reduced the total NH3 emission by 4.0% to 16.7%. The total greenhouse gas emissions (CO2-eq) of all treatments with SP additives were decreased by 10.2% to 20.8%, as compared with the controls. The NH3 emission during vegetable waste composting had the highest contribution to the greenhouse effect caused by the four different gases. The amount of NH3 (CO2-eq) from each treatment ranged from 59.90 kg . t-1 to 81.58 kg . t-1; NH3(CO2-eq) accounted for 69% to 77% of the total emissions from the four gases. Therefore, SP is a cost-effective phosphorus-based fertilizer that can be used as an additive during vegetable waste composting to reduce the NH3 and greenhouse gas emissions as well as to improve the value of compost as a fertilizer.

Physicochemical action of potassium-magnesium citrate in nephrolithiasis

NASA Technical Reports Server (NTRS)

Pak, C. Y.; Koenig, K.; Khan, R.; Haynes, S.; Padalino, P.

1992-01-01

Effect of potassium-magnesium citrate on urinary biochemistry and crystallization of stone-forming salts was compared with that of potassium citrate at same dose of potassium in five normal subjects and five patients with calcium nephrolithiasis. Compared to the placebo phase, urinary pH rose significantly from 6.06 +/- 0.27 to 6.48 +/- 0.36 (mean +/- SD, p less than 0.0167) during treatment with potassium citrate (50 mEq/day for 7 days) and to 6.68 +/- 0.31 during therapy with potassium-magnesium citrate (containing 49 mEq K, 24.5 mEq Mg, and 73.5 mEq citrate per day). Urinary pH was significantly higher during potassium-magnesium citrate than during potassium citrate therapy. Thus, the amount of undissociated uric acid declined from 118 +/- 61 mg/day during the placebo phase to 68 +/- 54 mg/day during potassium citrate treatment and, more prominently, to 41 +/- 46 mg/day during potassium-magnesium citrate therapy. Urinary magnesium rose significantly from 102 +/- 25 to 146 +/- 37 mg/day during potassium-magnesium citrate therapy but not during potassium citrate therapy. Urinary citrate rose more prominently during potassium-magnesium citrate therapy (to 1027 +/- 478 mg/day from 638 +/- 252 mg/day) than during potassium citrate treatment (to 932 +/- 297 mg/day). Consequently, urinary saturation (activity product) of calcium oxalate declined significantly (from 1.49 x 10(-8) to 1.03 x 10(-8) M2) during potassium-magnesium citrate therapy and marginally (to 1.14 x 10(-8) M2) during potassium citrate therapy.(ABSTRACT TRUNCATED AT 250 WORDS).

Methodology and Historical Perspective of a Hall Thruster Efficiency Analysis

DTIC Science & Technology

2009-01-26

mvm ><><== ∫ θ cos vm dθ θsin θcos θv θmRπ2T ____π/2 0 2 && (2) 7 In Eq. (3), the standard definition of anode thrust efficiency is...A-5) of Appendix A. ( ) BPE d 2__ d 2 A Φη Pm θ cosvm 2 1 Pm T 2 1 η Ψ=         ><>< == & & & mvm (3) Energy efficiency in Eq

Corrigendum to ‘Evidence for shock heating and constraints on Martian surface temperatures revealed by 40Ar/ 39Ar thermochronometry of Martian meteorites’ [Geochim. Cosmochim. Acta (2010) 6900–6920

DOE PAGES

Cassata, William S.; Shuster, David L.; Renne, Paul R.; ...

2014-10-23

Here, the authors regret they have discovered errors in Eq. (3) and in a spreadsheet used to calculate cosmogenic exposure ages shown in Table 1. Eq. (3) is missing a term. The spreadsheet errors concerned an incorrect cell reference and application of Eq. (3). Correction of these errors results in ~15–20% changes to the exposure ages of all samples, minor (generally <0.2%) changes to the radioisotopic ages of some samples (those that entailed a correction for chlorine-derived 38Ar calculated based on the exposure age; see Section 3.3), and statistically insignificant changes to the inferred trapped components identified through isochron analyses.more » These modifications have no impact on the modeling, discussions, or conclusions in the paper, nor do the changes to radioisotopic ages exceed the 1 sigma uncertainties.« less

Validity and reliability of a field technique for sweat Na+ and K+ analysis during exercise in a hot‐humid environment

PubMed Central

Baker, Lindsay B.; Ungaro, Corey T.; Barnes, Kelly A.; Nuccio, Ryan P.; Reimel, Adam J.; Stofan, John R.

2014-01-01

Abstract This study compared a field versus reference laboratory technique for extracting (syringe vs. centrifuge) and analyzing sweat [Na+] and [K+] (compact Horiba B‐722 and B‐731, HORIBA vs. ion chromatography, HPLC) collected with regional absorbent patches during exercise in a hot‐humid environment. Sweat samples were collected from seven anatomical sites on 30 athletes during 1‐h cycling in a heat chamber (33°C, 67% rh). Ten minutes into exercise, skin was cleaned/dried and two sweat patches were applied per anatomical site. After removal, one patch per site was centrifuged and sweat was analyzed with HORIBA in the heat chamber (CENTRIFUGE HORIBA) versus HPLC (CENTRIFUGE HPLC). Sweat from the second patch per site was extracted using a 5‐mL syringe and analyzed with HORIBA in the heat chamber (SYRINGE HORIBA) versus HPLC (SYRINGE HPLC). CENTRIFUGE HORIBA, SYRINGE HPLC, and SYRINGE HORIBA were highly related to CENTRIFUGE HPLC ([Na+]: ICC = 0.96, 0.94, and 0.93, respectively; [K+]: ICC = 0.87, 0.92, and 0.84, respectively), while mean differences from CENTRIFUGE HPLC were small but usually significant ([Na+]: 4.7 ± 7.9 mEql/L, −2.5 ± 9.3 mEq/L, 4.0 ± 10.9 mEq/L (all P < 0.001), respectively; [K+]: 0.44 ± 0.52 mEq/L (P < 0.001), 0.01 ± 0.49 mEq/L (P = 0.77), 0.50 ± 0.48 mEq/L (P < 0.001), respectively). On the basis of typical error of the measurement results, sweat [Na+] and [K+] obtained with SYRINGE HORIBA falls within ±15.4 mEq/L and ±0.68 mEq/L, respectively, of CENTRIFUGE HPLC 95% of the time. The field (SYRINGE HORIBA) method of extracting and analyzing sweat from regional absorbent patches may be useful in obtaining sweat [Na+] when rapid estimates in a hot‐humid field setting are needed. PMID:24793982

Greenhouse gas fluxes (CO2, CH4, N2O) of a short-rotation poplar plantation after conversion from agriculture

NASA Astrophysics Data System (ADS)

Zona, D.; Janssens, I.; Aubinet, M.; Ceulemans, R.

2012-12-01

The increasing demand for renewable energy may lead to the conversion of millions of hectares into bioenergy plantations with a possible substantial transitory carbon (C) loss. Here we report on the greenhouse gas fluxes (CO2, CH4, and N2O) measured using eddy covariance of a short-rotation bioenergy poplar plantation converted from agricultural fields. The first six months after the establishment of the plantation (June-Dec 2010) presented substantial CO2, CH4, and N2O emissions (a total of 5.36 ± 0.52 Mg CO2eq ha-1 in terms of CO2 equivalents). Nitrous oxide loss mostly occurred during a week-long peak emission after an unusually large rainfall. This week-long N2O emission represented 52% of the entire N2O loss during one and an half years of measurements. As most of the N2O loss occurred in just this week-long period, accurately capturing these emission events are critical to accurate estimates of the GHG balance of bioenergy. While initial establishment (Jun-Dec 2010) of the plantation resulted in a net CO2 loss into the atmosphere (2.76 ± 0.16 Mg CO2eq ha-1), in the second year (2011) the plantation presented a substantial net CO2 uptake (-4.82 ± 0.47 Mg CO2eq ha-1). During the entire measurement period, CH4 was a source to the atmosphere (0.63 ± 0.05 Mg CO2eq ha-1 in 2010, and 0.49 ± 0.05 Mg CO2eq ha-1 in 2011), and was controlled by water table depth. Importantly, over the entire measurement period, the sum of the CH4 and N2O losses was almost double (3.51 ± 0.52 Mg CO2eq ha-1) than the magnitude of net CO2 uptake (-2.06 ± 0.50 Mg CO2eq ha-1). As water availability was an important control on the GHG emission of the plantation, expected climate change and altered rainfall pattern could increase the negative environmental impacts of bioenergy.

Higher estimates of daily dietary net endogenous acid production (NEAP) in the elderly as compared to the young in a healthy, free-living elderly population of Pakistan

PubMed Central

Alam, Iftikhar; Alam, Ibrar; Paracha, Parvez I; Pawelec, Graham

2012-01-01

Dietary intake has been shown to influence the acid–base balance in human subjects; however, this phenomenon is poorly understood and rarely reported for the least well-studied segment of older people in a developing country. The aims of the present study were to: (1) quantify estimates of daily net endogenous acid production (NEAP) (mEq/d) in a sample of otherwise healthy elderly aged 50 years and above; and (2) compare NEAP between the elderly and young to determine the effects of aging, which could contribute to changes in the acid–base balance. Analyses were carried out among 526 elderly and 131 young participants (aged 50–80 and 23–28 years, respectively), all of whom were free of discernible disease, nonsmokers, and not on any chronic medication. Selected anthropometric factors were measured and 24-hour dietary recall was recorded. We used two measures to characterize dietary acid load: (1) NEAP estimated as the dietary potential renal acid load plus organic acid excretion, the latter as a multiple of estimated body surface area; and (2) estimated NEAP based on protein and K. For the young and elderly, the ranges of NEAP were 12.1–67.8 mEq/d and 2.0–78.3 mEq/d, respectively. Regardless of the method used, the mean dietary acid–base balance (NEAP) was significantly higher for the elderly than the young (P = 0.0035 for NEAP [elderly, 44.1 mEq/d versus young 40.1 mEq/d]; and P = 0.0035 for the protein:potassium ratio [elderly, 1.4 mEq/d versus young 1.1 mEq/d]). A positive and significant correlation was found between NEAP and energy, protein, and phosphorus (P < 0.05 for all trends). The findings from this study provide evidence of the relatively higher production of NEAP in older people, possibly as an effect of higher consumption of certain acid-producing foods by the elderly. PMID:23271903

The impact of differences in EQ-5D and SF-6D utility scores on the acceptability of cost-utility ratios: results across five trial-based cost-utility studies.

PubMed

Joore, Manuela; Brunenberg, Danielle; Nelemans, Patricia; Wouters, Emiel; Kuijpers, Petra; Honig, Adriaan; Willems, Danielle; de Leeuw, Peter; Severens, Johan; Boonen, Annelies

2010-01-01

This article investigates whether differences in utility scores based on the EQ-5D and the SF-6D have impact on the incremental cost-utility ratios in five distinct patient groups. We used five empirical data sets of trial-based cost-utility studies that included patients with different disease conditions and severity (musculoskeletal disease, cardiovascular pulmonary disease, and psychological disorders) to calculate differences in quality-adjusted life-years (QALYs) based on EQ-5D and SF-6D utility scores. We compared incremental QALYs, incremental cost-utility ratios, and the probability that the incremental cost-utility ratio was acceptable within and across the data sets. We observed small differences in incremental QALYs, but large differences in the incremental cost-utility ratios and in the probability that these ratios were acceptable at a given threshold, in the majority of the presented cost-utility analyses. More specifically, in the patient groups with relatively mild health conditions the probability of acceptance of the incremental cost-utility ratio was considerably larger when using the EQ-5D to estimate utility. While in the patient groups with worse health conditions the probability of acceptance of the incremental cost-utility ratio was considerably larger when using the SF-6D to estimate utility. Much of the appeal in using QALYs as measure of effectiveness in economic evaluations is in the comparability across conditions and interventions. The incomparability of the results of cost-utility analyses using different instruments to estimate a single index value for health severely undermines this aspect and reduces the credibility of the use of incremental cost-utility ratios for decision-making.

Infrasound Signals from Ground-Motion Sources

DTIC Science & Technology

2008-09-01

signals as a basis for discriminants between underground nuclear tests ( UGT ) and earthquakes (EQ). In an earlier program, infrasound signals from... UGTs and EQs were collected at ranges of a few hundred kilometers, in the far-field. Analysis of these data revealed two parameters that had potential...well. To study the near-field signals, we are using computational techniques based on modeled ground motions from UGTs and EQs. One is the closed

Using artificial intelligence to predict the equilibrated postdialysis blood urea concentration.

PubMed

Fernández, E A; Valtuille, R; Willshaw, P; Perazzo, C A

2001-01-01

Total dialysis dose (Kt/V) is considered to be a major determinant of morbidity and mortality in hemodialyzed patients. The continuous growth of the blood urea concentration over the 30- to 60-min period following dialysis, a phenomenon known as urea rebound, is a critical factor in determining the true dose of hemodialysis. The misestimation of the equilibrated (true) postdialysis blood urea or equilibrated Kt/V results in an inadequate hemodialysis prescription, with predictably poor clinical outcomes for the patients. The estimation of the equilibrated postdialysis blood urea (eqU) is therefore crucial in order to estimate the equilibrated (true) Kt/V. In this work we propose a supervised neural network to predict the eqU at 60 min after the end of hemodialysis. The use of this model is new in this field and is shown to be better than the currently accepted methods (Smye for eqU and Daugirdas for eqKt/V). With this approach we achieve a mean difference error of 0.22 +/- 7.71 mg/ml (mean % error: 1.88 +/- 13.46) on the eqU prediction and a mean difference error for eqKt/V of -0.01 +/- 0.15 (mean % error: -0.95 +/- 14.73). The equilibrated Kt/V estimated with the eqU calculated using the Smye formula is not appropriate because it showed a great dispersion. The Daugirdas double-pool Kt/V estimation formula appeared to be accurate and in agreement with the results of the HEMO study. Copyright 2001 S. Karger AG, Basel.

Maintenance fluid therapy in a tertiary hospital: A prevalence study.

PubMed

Uña Orejón, R; Gisbert de la Cuadra, L; Garríguez Pérez, D; Díez Sebastián, J; Ureta Tolsada, M P

To assess the types of maintenance fluids used in our hospital, comparing their volume and composition to the standards recommended by the guidelines. Observational, cross-sectional study. Volume and type of fluid therapy administered during 24h to patients admitted to various hospital departments were recorded. Patients receiving fluid therapy because of water-electrolyte imbalance were excluded. Out of 198 patients registered, 74 (37.4%) were excluded because they did not meet the criteria for inclusion. Mean administered volume was 2,500cc/day. Mean daily glucose dose was 36g per 24h (SD: 31.4). The most frequent combination included normal saline solution (NSS) and glucose 5% (64.4%). Mean daily dose of sodium and chlorine was, respectively, 173mEq (SD: 74.8) and 168mEq (SD: 75), representing a surplus daily dose of +87.4mEq and +85mEq. Potassium, magnesium and calcium daily deficit was, respectively, -50mEq, -22mEq and -21mEq per day. Buffer administration was exceptional, bicarbonate (2.29%), acetate (1.29%), lactate (1.15%) and gluconate (1.10%) being the buffering agents most frequently used. NNS is the most frequently used solution. In contrast to excess doses of sodium and chlorine, there is a great deficit of other ions, buffering agents and caloric intake in the fluid therapy regimens that are usually prescribed. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Modulation of chloride secretion in the rat ileum by intracellular bicarbonate.

PubMed

Dagher, P C; Chawla, H; Michael, J; Egnor, R W; Charney, A N

1997-05-01

Increasing intracellular bicarbonate concentration ([HCO3-]i) inhibits calcium-mediated Cl- secretion in rat distal colon and T84 cells. We investigated the effect of [HCO3-]i on Cl- secretion in rat ileum. Segments of intact ileum from Sprague-Dawley rats were studied in Ussing chambers and villus and crypt intracellular pH and [HCO3-]i were determined using BCECF. A range of crypt and villus [HCO3-]i from 0 to 31 mM was obtained by varying Ringer's composition. Basal serosal-to-mucosal Cl- flux (JsmCl) averaged 8.5 +/- 0.2 mu eq.h-1.cm-2 and was unaffected by changing [HCO3-]i or serosal bumetanide. Carbachol increased JsmCl by 3.9 +/- 0.5 mu eq.h-1.cm-2 at [HCO3-]i = 0 mM but only by 1.0 +/- 0.3 mu eq.h-1.cm-2 at high crypt and villus [HCO3-]i. Dibutyryl-cAMP increased JsmCl by 2.5 +/- 0.2 mu eq.h-1.cm-2 at all [HCO3-]i. Carbachol and db-cAMP showed mutual antagonism at low [HCO3-]i and near-additivity at high [HCO3-]i. We conclude that like rat colon and T84 cells, calcium-mediated but not cAMP-mediated Cl- secretion in the ileum is inhibited by increasing [HCO3-]i. Mutual antagonism between carbachol and db-cAMP at low [HCO3-]i was present in ileum and distal colon but not in T84 cells.

An empirical comparison of the measurement properties of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U for older people in residential care.

PubMed

Easton, Tiffany; Milte, Rachel; Crotty, Maria; Ratcliffe, Julie

2018-05-01

This study aimed to empirically compare the measurement properties of self-reported and proxy-reported (in cases of severe cognitive impairment) generic (EQ-5D-5L) and condition-specific (DEMQOL-U and DEMQOL-Proxy-U) preference-based HRQoL instruments in residential care, where the population is characterised by older people with high rates of cognitive impairment, dementia and disability. Participants were recruited from seventeen residential care facilities across four Australian states. One hundred and forty-three participants self-completed the EQ-5D-5L and the DEMQOL-U while three hundred and eight-seven proxy completed (due to the presence of severe dementia) the EQ-5D-5L and DEMQOL-Proxy-U. The convergent validity of the outcome measures and known group validity relative to a series of clinical outcome measures were assessed. Results satisfy convergent validity among the outcome measures. EQ-5D-5L and DEMQOL-U utilities were found to be significantly correlated with each other (p < 0.01) as were EQ-5D-5L and DEMQOL-Proxy-U utilities (p < 0.01). Both self-reported and proxy-reported EQ-5D-5L utilities demonstrated strong known group validity in relation to clinically recognised thresholds of cognition and physical functioning, while in contrast neither DEMQOL-U nor DEMQOL-Proxy-U demonstrated this association. The findings suggest that the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U capture distinct aspects of HRQoL for this population. The measurement and valuation of HRQoL form an essential component of economic evaluation in residential care. However, high levels of cognitive impairment may preclude self-completion for a majority. Further research is needed to determine cognition thresholds beyond which an individual is unable to reliably self-report their own health-related quality of life.

Validity of the EQ-5D-5L and reference norms for the Spanish population.

PubMed

Hernandez, Gimena; Garin, Olatz; Pardo, Yolanda; Vilagut, Gemma; Pont, Àngels; Suárez, Mónica; Neira, Montse; Rajmil, Luís; Gorostiza, Inigo; Ramallo-Fariña, Yolanda; Cabases, Juan; Alonso, Jordi; Ferrer, Montse

2018-05-16

The EuroQol 5 dimensions 5 levels (EQ-5D-5L) is the new version of EQ-5D, developed to improve its discriminatory capacity. This study aims to evaluate the construct validity of the Spanish version and provide index and dimension population-based reference norms for the new EQ-5D-5L. Data were obtained from the 2011/2012 Spanish National Health Survey, with a representative sample (n = 20,587) of non-institutionalized Spanish adults (≥ 18 years). The EQ-5D-5L index was calculated by using the Spanish value set. Construct validity was evaluated by comparing known groups with estimators obtained through regression models, adjusted by age and gender. Sampling weights were applied to restore the representativeness of the sample and to calculate the norms stratified by gender and age groups. We calculated the percentages and standard errors of dimensions, and the deciles, percentiles 5 and 95, means, and 95% confidence intervals of the health index. All the hypotheses established a priori for known groups were confirmed (P < 0.001). The EQ-5D-5L index indicated worse health in groups with lower education level (from 0.94 to 0.87), higher number of chronic conditions (0.96-0.79), probable psychiatric disorder (0.94 vs 0.80), strong limitations (0.96-0.46), higher number of days of restriction (0.93-0.64) or confinement to bed (0.92-0.49), and hospitalized in the previous 12 months (0.92 vs 0.81). The EQ-5D-5L is a valid instrument to measure perceived health in the Spanish-speaking population. The representative population-based norms provided here will help improve the interpretation of results obtained with the new EQ-5D-5L.

A qualitative examination of the content validity of the EQ-5D-5L in patients with type 2 diabetes.

PubMed

Matza, Louis S; Boye, Kristina S; Stewart, Katie D; Curtis, Bradley H; Reaney, Matthew; Landrian, Amanda S

2015-12-01

The EQ-5D is frequently used to derive utilities for patients with type 2 diabetes (T2D). Despite widely available quantitative psychometric data on the EQ-5D, little is known about content validity in this population. Thus, the purpose of this qualitative study was to examine content validity of the EQ-5D in patients with T2D. Patients with T2D in the UK completed concept elicitation interviews, followed by administration of the EQ-5D-5L and cognitive interviewing focused on the instrument's relevance, clarity, and comprehensiveness. A total of 25 participants completed interviews (52.0 % male; mean age = 53.5 years). Approximately half (52 %) reported that the EQ-5D-5L was relevant to their experience with T2D. When asked if each individual item was relevant to their experience with T2D, responses varied widely (24.0 % said the self-care item was relevant; 68.0 % said the anxiety/depression item was relevant). Participants frequently said items were not relevant to themselves, but could be relevant to patients with more severe diabetes. Most participants (92.0 %) reported that T2D and/or its treatment/monitoring requirements had an impact on their quality of life that was not captured by the EQ-5D-5L. Common missing concepts included food awareness/restriction (n = 13, 52.0 %); activities (n = 11, 44.0 %); emotional functioning other than depression/anxiety (n = 8, 32.0 %); and social/relationship functioning (n = 8, 32.0 %). The results highlight strengths and potential limitations of the EQ-5D-5L, including missing content that could be important for some patients with T2D. Suggestions for addressing limitations are provided.

Estimated net acid excretion inversely correlates with urine pH in vegans, lacto-ovo vegetarians, and omnivores.

PubMed

Ausman, Lynne M; Oliver, Lauren M; Goldin, Barry R; Woods, Margo N; Gorbach, Sherwood L; Dwyer, Johanna T

2008-09-01

Diet affects urine pH and acid-base balance. Both excess acid/alkaline ash (EAA) and estimated net acid excretion (NAE) calculations have been used to estimate the effects of diet on urine pH. This study's goal was to determine if free-living vegans, lacto-ovo vegetarians, and omnivores have increasingly acidic urine, and to assess the ability of EAA and estimated NAE calculations to predict urine pH. This study used a cross-sectional design. This study assessed urine samples of 10 vegan, 16 lacto-ovo vegetarian, and 16 healthy omnivorous women in the Boston metropolitan area. Six 3-day food records from each dietary group were analyzed for EAA content and estimated NAE, and correlations with measured urine pH were calculated. The mean (+/- SD) urine pH was 6.15 +/- 0.40 for vegans, 5.90 +/- 0.36 for lacto-ovo vegetarians, and 5.74 +/- 0.21 for omnivores (analysis of variance, P = .013). Calculated EAA values were not significantly different among the three groups, whereas mean estimated NAE values were significantly different: 17.3 +/- 14.5 mEq/day for vegans, 31.3 +/- 8.5 mEq/day for lacto-ovo vegetarians, and 42.6 +/- 13.2 mEq/day for omnivores (analysis of variance, P = .01). The average deattenuated correlation between urine pH and EAA was 0.333; this value was -0.768 for estimated NAE and urine pH, with a regression equation of pH = 6.33 - 0.014 NAE (P = .02, r = -0.54). Habitual diet and estimated NAE calculations indicate the probable ranking of urine pH by dietary groups, and may be used to determine the likely acid-base status of an individual; EAA calculations were not predictive of urine pH.

Chinese time trade-off values for EQ-5D health states.

PubMed

Liu, Gordon G; Wu, Hongyan; Li, Minghui; Gao, Chen; Luo, Nan

2014-07-01

To generate a Chinese general population-based three-level EuroQol five-dimensios (EQ-5D-3L) social value set using the time trade-off method. The study sample was drawn from five cities in China: Beijing, Guangzhou, Shenyang, Chengdu, and Nanjing, using a quota sampling method. Utility values for a subset of 97 health states defined by the EQ-5D-3L descriptive system were directly elicited from the study sample using a modified Measurement and Valuation of Health protocol, with each respondent valuing 13 of the health states. The utility values for all 243 EQ-5D-3L health states were estimated on the basis of econometric models at both individual and aggregate levels. Various linear regression models using different model specifications were examined to determine the best model using predefined model selection criteria. The N3 model based on ordinary least square regression at the aggregate level yielded the best model fit, with a mean absolute error of 0.020, 7 and 0 states for which prediction errors were greater than 0.05 and 0.10, respectively, in absolute magnitude. This model passed tests for model misspecification (F = 2.7; P = 0.0509, Ramsey Regression Equation Specification Error Test), heteroskedasticity (χ(2) = 0.97; P = 0.3254, Breusch-Pagan/Cook-Weisberg test), and normality of the residuals (χ(2) = 1.285; P = 0.5259, Jarque-Bera test). The range of the predicted values (-0.149 to 0.887) was similar to those estimated in other countries. The study successfully developed Chinese utility values for EQ-5D-3L health states using the time trade-off method. It is the first attempt ever to develop a standardized instrument for quantifying quality-adjusted life-years in China. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Increased circulating cell-derived microparticle count is associated with recurrent implantation failure after IVF and embryo transfer.

PubMed

Martínez-Zamora, M Angeles; Tàssies, Dolors; Reverter, Juan Carlos; Creus, Montserrat; Casals, Gemma; Cívico, Salvadora; Carmona, Francisco; Balasch, Juan

2016-08-01

Cell-derived microparticles (cMPs) are small membrane vesicles that are released from many different cell types in response to cellular activation or apoptosis. Elevated cMP counts have been found in almost all thrombotic diseases and pregnancy wastage, such as recurrent spontaneous abortion and in a number of conditions associated with inflammation, cellular activation and angiogenesis. cMP count was investigated in patients experiencing unexplained recurrent implantation failure (RIF). The study group was composed of 30 women diagnosed with RIF (RIF group). The first control group (IVF group) (n = 30) comprised patients undergoing a first successful IVF cycle. The second control group (FER group) included 30 healthy women who had at least one child born at term and no history of infertility or obstetric complications. cMP count was significantly higher in the RIF group compared with the IVF and FER groups (P < 0.05 and P < 0.01, respectively) (RIF group: 15.8 ± 6.2 nM phosphatidylserine equivalent [PS eq]; IVF group: 10.9 ± 5.3 nM PS eq; FER group: 9.6 ± 4.0 nM PS eq). No statistical difference was found in cMP count between the IVF and FER groups. Increased cMP count is, therefore, associated with RIF after IVF and embryo transfer. Copyright © 2016. Published by Elsevier Ltd.

Emission of polycyclic aromatic hydrocarbons and lead during Chinese mid-autumn festival.

PubMed

Kuo, Chung-Yih; Lee, Hong-Shen; Lai, Jeang-Hung

2006-07-31

The emission factors of total particulate polycyclic aromatic hydrocarbons (PAHs), Benzo(a)pyrene (BaP), BaP-equivalent doses (BaP(eq)) and Pb for burning three kinds of charcoal were investigated in this study: fast-lighting charcoal, Taiwanese, and Indonesian charcoal (the latter two of which are not fast-lighting). Compared to the burning of Taiwanese and Indonesian charcoal, the burning of fast-lighting charcoal can emit much larger amounts of total PAHs, BaP(eq) and Pb into the atmosphere. The emission factors of total PAHs, BaP and BaP(eq) for broiling meat were noticeably higher than those for broiling vegetables and non-fish seafood. When using Indonesian charcoal to broil meat, the total emission factors of particulate PAHs and BaP were about 15.7 and 0.39 mg/kg, respectively. The total amounts of particulate PAHs and Pb emitted from cookouts during Mid-Autumn Festival were 2881 and 120 g, respectively. Total PAHs and BaP(eq) in PM(10) aerosols on Mid-Autumn Festival nights increased about 1.6 and 1.5 times, respectively, higher than those on non-festival nights. The mean concentration of Pb on the nights of Mid-Autumn Festival increases to about 2.8 times that of non-festival nights.

Diabetic ketoacidosis in Peruvian patients with type 2 diabetes mellitus.

PubMed

Pinto, Miguel E; Villena, Jaime E; Villena, Arturo E

2008-01-01

To describe the clinical and laboratory characteristics of diabetic ketoacidosis (DKA) in adult Peruvian patients with type 2 diabetes mellitus. In this cross-sectional analysis, we reviewed clinical charts of type 2 diabetic patients with DKA admitted to Cayetano Heredia Hospital between 2001 and 2005 for data on demographics, previous treatment, previous hospital admissions for DKA, family history of diabetes, precipitating factors, hospital course, mortality, and insulin use 3 and 6 months after the index DKA episode. Patients older than 18 years who had confirmed DKA were included. Patients with type 1 diabetes mellitus were excluded. We report on 53 patients with DKA for whom complete clinical and laboratory data were available. Of the 53 patients, 39 (74%) were men; mean age (+/- SD) was 45 +/- 12 years; and 22 (42%) had no previous diagnosis of type 2 diabetes. The following mean (+/- SD) laboratory values were obtained at DKA diagnosis: glucose, 457 +/- 170 mg/dL; pH, 7.15 +/- 0.14; bicarbonate, 7.73 +/- 6 mEq/L; and anion gap, 24.45 +/- 7.44 mEq/L. Of the 53 DKA episodes, 35 (66%) were severe (arterial pH <7.0 and/or serum bicarbonate <10 mEq/L). The following precipitating factors were discerned: discontinuation of treatment in 21 (40%), infections in 16 (30%), intercurrent illness in 3 (6%), and no identifiable cause in 13 (25%). Mortality rate was 0%. Three and 6 months after the index DKA episode, insulin was used by 65% and 56% of patients, respectively. In countries with a low incidence of type 1 diabetes, DKA is frequently reported in patients with type 2 diabetes. In this study, 42% of patients had new-onset disease. Most DKA episodes were severe and were related to infection or noncompliance with treatment.

Surface Second Harmonic Generation Studies of Stepped Ag(111) Electrode Surfaces

DTIC Science & Technology

1993-05-27

Surface Warfare Center China Lake, CA 93555-6001 Carderock Division Detachment Annapolis, MD 21402-1198 Dr. Elek Lindner (1) Naval Command, Contrl and...polarized pump beam at frequency (t. (2,W) (,( d) sin(3)p)qS’ , ,si ,p Eq. 3 with dj" =FXzf f, 10 d3 sin(3(p) Eq.4 with d = F1z)fkfk where the...electrodes at an applied potential of -0.5 V as a function of azimuthal angle for s-polarized SHG and s-polarized pump beam. Shown are measurements on

Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes.

PubMed

Cooper, Lauren B; Mentz, Robert J; Gallup, Dianne; Lala, Anuradha; DeVore, Adam D; Vader, Justin M; AbouEzzeddine, Omar F; Bart, Bradley A; Anstrom, Kevin J; Hernandez, Adrian F; Felker, G Michael

2016-09-01

Though commonly noted in clinical practice, it is unknown if decongestion in acute heart failure (AHF) results in increased serum bicarbonate. For 678 AHF patients in the DOSE-AHF, CARRESS-HF, and ROSE-AHF trials, we assessed change in bicarbonate (baseline to 72-96 hours) according to decongestion strategy, and the relationship between bicarbonate change and protocol-defined decongestion. Median baseline bicarbonate was 28 mEq/L. Patients with baseline bicarbonate ≥28 mEq/L had lower ejection fraction, worse renal function and higher N-terminal pro-B-type natriuretic peptide than those with baseline bicarbonate <28 mEq/L. There were no differences in bicarbonate change between treatment groups in DOSE-AHF or ROSE-AHF (all P > .1). In CARRESS-HF, bicarbonate increased with pharmacologic care but decreased with ultrafiltration (median +3.3 vs -0.9 mEq/L, respectively; P < .001). Bicarbonate change was not associated with successful decongestion (P > .2 for all trials). In AHF, serum bicarbonate is most commonly elevated in patients with more severe heart failure. Despite being used in clinical practice as an indicator for decongestion, change in serum bicarbonate was not associated with significant decongestion. Copyright © 2016 Elsevier Inc. All rights reserved.

[Should pediatric parenteral nutrition be individualized?].

PubMed

Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Saron, Margareth Lopes Galvão; Lima, Alexandre Esteves Souza; Hessel, Gabriel

2014-12-01

Parenteral nutrition (PN) formulations are commonly individualized, since their standardization seem inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN hospitalized in a tertiary hospital in Campinas, São Paulo. This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO) (2006) and WHO (2007). The levels of the following elements on blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus and triglycerides (TGL). Among the criteria for individualization, were considered undeniable: significant reduction in blood levels of potassium (<3 mEq/L), sodium (<125 mEq/)L, magnesium (<1 mEq/L), phosphorus (<1.5 mEq/L), ionic calcium (<1 mmol) and chloride (<90 mEq/L) or any value above the references. Twelve pediatric patients aged 1 month to 15 years were studied (49 individualizations). Most patients were classified as malnourished. It was observed that 74/254 (29.2%) of examinations demanded individualized PN by indubitable reasons. The nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

The effect of improving cow productivity, fertility, and longevity on the global warming potential of dairy systems.

PubMed

Bell, M J; Wall, E; Russell, G; Simm, G; Stott, A W

2011-07-01

This study compared the environmental impact of a range of dairy production systems in terms of their global warming potential (GWP, expressed as carbon dioxide equivalents, CO(2)-eq.) and associated land use, and explored the efficacy of reducing said impact. Models were developed using the unique data generated from a long-term genetic line × feeding system experiment. Holstein-Friesian cows were selected to represent the UK average for milk fat plus protein production (control line) or were selected for increased milk fat plus protein production (select line). In addition, cows received a low forage diet (50% forage) with no grazing or were on a high forage (75% forage) diet with summer grazing. A Markov chain approach was used to describe the herd structure and help estimate the GWP per year and land required per cow for the 4 alternative systems and the herd average using a partial life cycle assessment. The CO(2)-eq. emissions were expressed per kilogram of energy-corrected milk (ECM) and per hectare of land use, as well as land required per kilogram of ECM. The effects of a phenotypic and genetic standard deviation unit improvement on herd feed utilization efficiency, ECM yield, calving interval length, and incidence of involuntary culling were assessed. The low forage (nongrazing) feeding system with select cows produced the lowest CO(2)-eq. emissions of 1.1 kg/kg of ECM and land use of 0.65 m(2)/kg of ECM but the highest CO(2)-eq. emissions of 16.1t/ha of the production systems studied. Within the herd, an improvement of 1 standard deviation in feed utilization efficiency was the only trait of those studied that would significantly reduce the reliance of the farming system on bought-in synthetic fertilizer and concentrate feed, as well as reduce the average CO(2)-eq. emissions and land use of the herd (both by about 6.5%, of which about 4% would be achievable through selective breeding). Within production systems, reductions in CO(2)-eq. emissions per kilogram of ECM and CO(2)-eq. emissions per hectare were also achievable by an improvement in feed utilization. This study allowed development of models that harness the biological trait variation in the animal to improve the environmental impact of the farming system. Genetic selection for efficient feed use for milk production according to feeding system can bring about reductions in system nutrient requirements, CO(2)-eq. emissions, and land use per unit product. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Climate-Smart Livestock Systems: An Assessment of Carbon Stocks and GHG Emissions in Nicaragua.

PubMed

Gaitán, Lucía; Läderach, Peter; Graefe, Sophie; Rao, Idupulapati; van der Hoek, Rein

2016-01-01

Livestock systems in the tropics can contribute to mitigate climate change by reducing greenhouse gas (GHG) emissions and increasing carbon accumulation. We quantified C stocks and GHG emissions of 30 dual-purpose cattle farms in Nicaragua using farm inventories and lifecycle analysis. Trees in silvo-pastoral systems were the main C stock above-ground (16-24 Mg ha-1), compared with adjacent secondary forests (43 Mg C ha-1). We estimated that methane from enteric fermentation contributed 1.6 kg CO2-eq., and nitrous oxide from excreta 0.4 kg CO2-eq. per kg of milk produced. Seven farms that we classified as climate-smart agriculture (CSA) out of 16 farms had highest milk yields (6.2 kg cow-1day-1) and lowest emissions (1.7 kg CO2-eq. per kg milk produced). Livestock on these farms had higher-quality diets, especially during the dry season, and manure was managed better. Increasing the numbers of CSA farms and improving CSA technology will require better enabling policy and incentives such as payments for ecosystem services.

High pressure study of viscosity effects on the luminescence of tetracyanobenzene EDA complexes

NASA Astrophysics Data System (ADS)

Thomas, Michele Moisio; Drickamer, H. G.

1981-03-01

High pressure fluorescence studies fron 0-10 kbar have been performed on electron donor-acceptor (EDA) complexes of s-tetracyanobenzene (TCNB) with a series of aromatic hydrocarbons. Four solvents were used, 2,2,4,4,6,8,8 heptamethylnonane (HMN), methylcyclohexane (MCH), 2,6,10,14 tetramethylpentadecane (TMPD), and a mixture of MCH and HMN. A viscosity range from 0.006 to 10 000 poise was covered at constant temperature. As pressure (viscosity) increased the fluorescence spectrum shifted from one dominated by emission from the equilibrium (EQ) excited singlet state to one dominated by Franck-Condon (FC) singlet emission. Lifetime measurements for the complexes of o-xylene and p-xylene with TCNB as well as one mesitylene complex yielded the two radiative rates (kEQ and kFC) as well as the rate of internal conversion from FC to the EQ excited state to (kIC). The results are discussed in terms of the rate of relaxation of the solvent compared with the rate kFC. It was found that kIC correlated very well with the solvent viscosity.

Climate-Smart Livestock Systems: An Assessment of Carbon Stocks and GHG Emissions in Nicaragua

PubMed Central

Gaitán, Lucía; Läderach, Peter; Graefe, Sophie; Rao, Idupulapati; van der Hoek, Rein

2016-01-01

Livestock systems in the tropics can contribute to mitigate climate change by reducing greenhouse gas (GHG) emissions and increasing carbon accumulation. We quantified C stocks and GHG emissions of 30 dual-purpose cattle farms in Nicaragua using farm inventories and lifecycle analysis. Trees in silvo-pastoral systems were the main C stock above-ground (16–24 Mg ha-1), compared with adjacent secondary forests (43 Mg C ha-1). We estimated that methane from enteric fermentation contributed 1.6 kg CO2-eq., and nitrous oxide from excreta 0.4 kg CO2-eq. per kg of milk produced. Seven farms that we classified as climate-smart agriculture (CSA) out of 16 farms had highest milk yields (6.2 kg cow-1day-1) and lowest emissions (1.7 kg CO2-eq. per kg milk produced). Livestock on these farms had higher-quality diets, especially during the dry season, and manure was managed better. Increasing the numbers of CSA farms and improving CSA technology will require better enabling policy and incentives such as payments for ecosystem services. PMID:28030599

Cost-utility of cognitive behavioral therapy versus U.S. Food and Drug Administration recommended drugs and usual care in the treatment of patients with fibromyalgia: an economic evaluation alongside a 6-month randomized controlled trial.

PubMed

Luciano, Juan V; D'Amico, Francesco; Cerdà-Lafont, Marta; Peñarrubia-María, María T; Knapp, Martin; Cuesta-Vargas, Antonio I; Serrano-Blanco, Antoni; García-Campayo, Javier

2014-10-01

Cognitive behavioral therapy (CBT) and U.S. Food and Drug Administration (FDA)-recommended pharmacologic treatments (RPTs; pregabalin, duloxetine, and milnacipran) are effective treatment options for fibromyalgia (FM) syndrome and are currently recommended by clinical guidelines. We compared the cost-utility from the healthcare and societal perspectives of CBT versus RPT (combination of pregabalin + duloxetine) and usual care (TAU) groups in the treatment of FM. The economic evaluation was conducted alongside a 6-month, multicenter, randomized, blinded, parallel group, controlled trial. In total, 168 FM patients from 41 general practices in Zaragoza (Spain) were randomized to CBT (n = 57), RPT (n = 56), or TAU (n = 55). The main outcome measures were Quality-Adjusted Life Years (QALYs, assessed by using the EuroQoL-5D questionnaire) and improvements in health-related quality of life (HRQoL, assessed by using EuroQoL-5D visual analogue scale, EQ-VAS). The costs of healthcare use were estimated from patient self-reports (Client Service Receipt Inventory). Cost-utility was assessed by using the net-benefit approach and cost-effectiveness acceptability curves (CEACs). On average, the total costs per patient in the CBT group (1,847 €) were significantly lower than those in patients receiving RPT (3,664 €) or TAU (3,124 €). Patients receiving CBT reported a higher quality of life (QALYs and EQ-VAS scores); the differences between groups were significant only for EQ-VAS. From a complete case-analysis approach (base case), the point estimates of the cost-effectiveness ratios resulted in dominance for the CBT group in all of the comparisons performed, by using both QALYs and EQ-VAS as outcomes. These findings were confirmed by bootstrap analyses, net-benefit curves, and CEACs. Two additional sensitivity analyses (intention-to-treat analysis and per-protocol analysis) indicated that the results were robust. The comparison of RPT with TAU yielded no clear preference for either treatment when using QALYs, although RPT was determined to be more cost-effective than TAU when evaluating EQ-VAS. Because of lower costs, CBT is the most cost-effective treatment for adult FM patients. Implementation in routine medical care would require policymakers to develop more-widespread public access to trained and experienced therapists in group-based forms of CBT. Current Controlled Trials ISRCTN10804772. Registered 29 September 2008.

Hyperthermic fatigue precedes a rapid reduction in serum sodium in an ironman triathlete: a case report.

PubMed

Laursen, Paul B; Watson, Greig; Abbiss, Chris R; Wall, Bradley A; Nosaka, Kazunori

2009-12-01

To monitor the hydration, core temperature, and speed (pace) of a triathlete performing an Ironman triathlon. A 35-year-old experienced male triathlete participated in the Western Australian Ironman triathlon on December 1, 2006. The participant was monitored for blood Na(+) concentration before the race (PRE), at the transitions (T1 and T2), halfway through the run (R21), and after the race (POST; 2hPOST). Core body temperature (T(c); pill telemetry) was recorded continuously, and running speed (s3 stride sensor) was measured during the run. The participant completed the race in 11 h 38 min, in hot conditions (26.6 +/- 5.8 degrees C; 42 +/- 19% rel. humidity). His T(c) increased from 37.0 to 38.6 degrees C during the 57-min swim, and averaged 38.4 degrees C during the 335-min bike (33.5 km x h(-1)). After running at 12.4 km x h(-1) for 50 min in the heat (33.1 degrees C), T(c) increased to 39.4 degrees C, before slowing to 10.0 km x h(-1) for 20 min. T(c) decreased to 38.9 degrees C until he experienced severe leg cramps, after which speed diminished to 6 km x h(-1) and T(c) fell to 38.0 degrees C. The athlete's blood Na(+) was constant from PRE to T2 (139-140 mEq x L(-1), but fell to 131 mEq x L(-1) at R21, 133 mEq x L(-1) at POST, and 128 mEq x L(-1) at 2hPOST. The athlete consumed 9.25 L of fluid from PRE to T2, 6.25 L from T2 to POST, and lost 2% of his body mass, indicating sweat losses greater than 15.5 L. This athlete slowed during the run phase following attainment of a critically high T(c) and experienced an unusually rapid reduction in blood Na(+) that preceded cramping, despite presenting with signs of dehydration.

[Health status of the Hungarian population between 2000-2010].

PubMed

Baji, Petra; Brodszky, Valentin; Rencz, Fanni; Boncz, Imre; Gulácsi, László; Péntek, Márta

2015-12-13

So far, the latest survey which used the EQ-5D questionnaire to measure the health status of the Hungarian population was carried out in 2000. To explore the health state of the Hungarian population by socio-demographic characteristics, and to compare it with the results from 2000. As part of an international research project, a cross-sectional, online survey was carried out among the general population in 2010 using the EQ-5D-3L questionnaire. In total, 2281 respondents (female: 62.3%) completed the questionnaire with an average age of 40.8 years. The EQ-5D score ranged from 0.902 (in age-group 18-24) to 0.795 (65+). The authors found significant association between the EQ-5D score and all the socio-demographic variables (gender, age, education, income) included in the regression model (F(4,1967)=35.12, p=0.000). The results did not differ significantly from the health survey in 2000, except for the youngest population group (age 18-24), where significantly lower scores were found in the sample. While life expectance increased by 3 years between 2000 and 2010, the health status of the Hungarian population did not change significantly, and might even decreased among young adults in fact. Inequalities in health status by income and education remain significant. In international comparison, the health status of the Hungarian population remains among the worst ones.

Dark energy and fate of the Universe

NASA Astrophysics Data System (ADS)

Li, XiaoDong; Wang, Shuang; Huang, QingGuo; Zhang, Xin; Li, Miao

2012-07-01

We explore the ultimate fate of the Universe by using a divergence-free parametrization for dark energy w( z)= w 0+ w a [ln(2 + z) / (1 + z) - ln 2]. Unlike the Chevallier-Polarski-Linder parametrization, this parametrization has well behaved, bounded behavior for both high redshifts and negative redshifts, and thus can genuinely cover many theoretical dark energy models. After constraining the parameter space of this parametrization by using the current cosmological observations, we find that, at the 95.4% confidence level, our Universe can still exist at least 16.7 Gyr before it ends in a big rip. Moreover, for the phantom energy dominated Universe, we find that a gravitationally bound system will be destroyed at a time {{t ˜eq Psqrt {2| {1 + 3w( - 1)} |} } {/ {{t ˜eq Psqrt {2| {1 + 3w( - 1)} |} } {[ {6π | {1 + w( - 1)} |} ]}}} . } {[ {6π | {1 + w( - 1)} |} ]}}, where P is the period of a circular orbit around this system, before the big rip.

CH4 and N2O emissions embodied in international trade of meat

NASA Astrophysics Data System (ADS)

Caro, Dario; LoPresti, Anna; Davis, Steven J.; Bastianoni, Simone; Caldeira, Ken

2014-11-01

Although previous studies have quantified carbon dioxide emissions embodied in products traded internationally, there has been limited attention to other greenhouse gases such as methane (CH4) and nitrous oxide (N2O). Following IPCC guidelines, we estimate non-CO2 emissions from beef, pork and chicken produced in 237 countries over the period 1990-2010, and assign these emissions to the country where the meat is ultimately consumed. We find that, between 1990 and 2010, an average of 32.8 Mt CO2-eq emissions (using 100 year global warming potentials) are embodied in beef, pork and chicken traded internationally. Further, over the 20 year period, the quantity of CO2-eq emissions embodied in traded meat increased by 19%. The largest trade flows of emissions embodied in meat were from Brazil and Argentina to Russia (2.8 and 1.4 Mt of CO2-eq, respectively). Trade flows within the European region are also substantial: beef and pork exported from France embodied 3.3 Mt and 0.4 Mt of CO2-eq, respectively. Emissions factor of meat production (i.e. CO2-eq emissions per kg of meat) produced depend on ambient temperature, development level, livestock category (e.g. cattle, pork, and chicken) and livestock management practices. Thus, trade may result in an overall increase of GHG emissions when meat-consuming countries import meat from countries with a greater emissions intensity of meat production rather than producing the meat domestically. Comparing the emissions intensity of meat production of trading partners, we assess trade flows according to whether they tend to reduce or increase global emissions from meat production.

The analysis results of EEWS(Earthquake Early Warning System) about Iksan(Ml4.3) and Ulsan(Ml5.0) earthquakes in Korea

NASA Astrophysics Data System (ADS)

Park, J. H.; Chi, H. C.; Lim, I. S.; Seong, Y. J.; Pak, J.

2016-12-01

EEW(Earthquake Early Warning) service to the public has been officially operated by KMA (Korea Meteorological Administration) from 2015 in Korea. For the KMA's official EEW service, KIGAM has adopted ElarmS from UC Berkeley BSL and modified local magnitude relation, 1-D travel time curves and association procedures with real time waveforms from about 160 seismic stations of KMA and KIGAM. We have checked the performance of EEWS(Earthquake Early Warning System) reviewing two moderate size earthquakes: one is Iksan Eq.(Ml4.3) inside of networks and the other is Ulsan Eq.(Ml5.0) happened at the southern east sea of Korea outside of networks. The first trigger time at NPR station of the Iksan Eq. took 2.3 sec and BUY and JEO2 stations were associated to produce the first event version in 10.07 sec from the origin time respectively. Because the epicentral distance of JEO2 station is about 30 km and the estimated travel time is 6.2 sec, the delay time including transmission and processing is estimated as 3.87 sec with assumption that P wave velocity is 5 km/sec and the focal depth is 8 km. The first magnitude was M4.9 which was a little bigger than Ml4.3 by KIGAM. After adding 3 more triggers of stations (CHO, KMSA, PORA), the estimated magnitude became to M4.6 and the final was settled down to M4.3 with 10 stations. In the case of Ulsan the first trigger time took 11.04 sec and the first alert time with 3 stations in 14.8 sec from the origin time (OT) respectively. The first magnitude was M5.2, however, the difference between the first EEW epicenter and the manual final result was about 63 km due to the poor azimuth coverage outside of seismic network. After 16.2 sec from OT the fourth station YSB was used to update the location near to the manual results within 6 km with magnitude 5.0 and location and magnitude were stable with more stations. Ulsan Eq. was the first case announced to the public by EEWS and the process and result were successful, however, we have to make more effort to reduce the delay times and improve tools for the communication with the public in Korea.

Optical Data Processing.

DTIC Science & Technology

1988-04-01

much less for characters than for other objects, and 200 0.98 thus OCR appears to represent a worst-case guideline. 400 (10 To quantify the effect of...mm, yma = 5 mm, , = 0.6328 mn, and J = 400 mm. the effect of the positional weighting factor given b From Eq. (6), we then find a > 23 line pairs/mm...is the square radius r2 = (x2 + yN2) of each input point i required. We used n = 400 fringes in Eq. (4) for a = 40 Po. The effect of the r2 = (X2 + y2

Solar cycle variation of geosynchronous plasma mass density derived from the frequency of standing Alfvén waves

NASA Astrophysics Data System (ADS)

Takahashi, Kazue; Denton, Richard E.; Singer, Howard J.

2010-07-01

We have studied the solar cycle variation of equatorial plasma mass density ρeq in the plasma trough at geosynchronous altitude. The density was indirectly determined from the frequency, fT3, of the third harmonic of toroidal standing Alfvén waves detected over a 12 year period from 1980 to 1991 with magnetometers on five Geostationary Operational Environmental Satellites (GOES). Realistic models of the ambient magnetic field and field line mass distribution were used in numerically solving the wave equation to relate fT3 to ρeq. Scanning the magnetometer data in a 30 min time window that moved forward in 10 min steps, we obtained 228,382 fT3 samples equivalent to 1586 days of data. The detection rate of fT3 is highest (˜50%) in the prenoon sector, and fT3 and ρeq samples from this sector were used to examine their dependence on F10.7, Kp, and Dst. Overall, F10.7 exhibits the highest correlation with fT3 and ρeq, implying that the solar UV/EUV control of ion production at the ionospheric height is strongly reflected in mass density variations at geosynchronous orbit. Using 27 day medians computed excluding periods of plasmasphere expansion to geosynchronous orbit and geomagnetic storm, we obtained the empirical formula fT3 (mHz) = 38 - 0.097F10.7 and logρeq (amu cm-3) = 0.42 + 0.0039F10.7, where F10.7 is given in the solar flux units 10-22 W · m-2 · Hz-1. This last formula means that with the 27 day F10.7 in the range of 68-255 in the selected solar cycle, the mass density varied by a factor of ˜5 from ˜5 to ˜26 amu cm-3. During extremely quiet times (Kp averaged using a 3 day time scale <1), for which the plasmasphere may extend out to geosynchronous orbit, and during storm periods (Dst < -50 nT), the mass density may be enhanced beyond these values.

Synthesis and Reactivity of a New (Methylene)Phosphine.

DTIC Science & Technology

1981-01-27

the synthesis of a variety of alkyl(silylamino)- 8phosphines Similarly, if two equivalents of the silylmethyl Grignard reagent were used (eq 3), the...n-BuLi (hexane solution), and t-BuLi (pentane solution). The Grignard reagent Me 3SiCH2 MgCl was prepared in Et 0 2 2 solution from Me3SiCH 2C and Mg...trimethylsilyl)amino] (chloro)- (trimethylsilylmethyl)phosphine (1) was prepared by the "one-pot" Grignard method (eqs 1 and 2) which we have used previously for

An Experimental Characterization of Damping Properties of Thermal Barrier Coatings at Elevated Temperatures

DTIC Science & Technology

2011-03-01

zirconium. For the standard, Brayton open-cycle, gas turbine, typical of modern aircraft power plants, the thermodynamic efficiency is heavily driven by...linearize the radiation emission term around Ti,j0 from a previous the previous step, Taylor expand, and rearrange Eq. (23) in terms of Ti,j to apply as...York: Wiley. 2004. Nilsson, J. W., and Riedel, S. A. Electric Circuits. Prentice Hall. 2007. 512 Noda, N. Thermal Stresses. Taylor & Francis. 2002

Severe Hyponatremia Due to Valproic Acid Toxicity.

PubMed

Gupta, Ena; Kunjal, Ryan; Cury, James D

2015-09-01

Hyponatremia is a very commonly encountered clinical entity with potentially dangerous effects and for which many precipitating factors have been identified. We present a case of valproic acid (VPA) overdose causing profound hyponatremia, with one of the lowest serum sodium levels ever documented in literature. A 54-year-old woman with hypothyroidism, hypertension and bipolar disorder presented with somnolence after intentionally ingesting 7,500 mg VPA. She was drowsy but easily arousable with no hemodynamic compromise and an unremarkable physical exam. There was no clinical suspicion for organic neurological or pulmonary disease, adrenal insufficiency or volume depletion. She was found to have a serum sodium of 99 mEq/L, low plasma osmolality (211 mOsm/kg H2O), and high urine osmolality (115 mOsm/kg H2O). Her urine sodium was 18 mEq/L. She was euthyroid (TSH: 3.06 mIU/L) and compliant with thyroxine replacement. She was admitted to the intensive care unit for close monitoring and VPA was withheld. Over 36 hours her VPA level fell from 59.3 mg/L to 22.8 mg/L, serum sodium steadily rose to 125 mEq/L and there was concomitant improvement in her mental status. At 72 hours, she was transferred for an inpatient psychiatric evaluation and her sodium level was 135 mEq/L. She luckily did not experience any seizures or decline in neurological function. The clinical presentation in this patient is consistent with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) leading to a dramatic fall in sodium to a level of 99 mEq/L. Chronic VPA use has been associated with SIADH and chronic hyponatremia. Review of records in this patient from 1 year prior revealed that her last measured sodium level was 127 mEq/L. It is therefore most likely that our case is one of acute on chronic hyponatremia provoked by VPA overdose in the setting of chronic VPA use. Whilst our patient's course was relatively benign, this case illustrates a rare consequence of VPA toxicity, which if unnoticed in another patient may be tragic.

Parent-child discrepancy in the assessment of health- related quality of life using the EQ-5D-Y questionnaire.

PubMed

Perez Sousa, Miguel Á; Olivares Sánchez-Toledo, Pedro R; Gusi Fuerte, Narcis

2017-12-01

The assessment of health-related quality of life (HRQoL) serves to detect changes over time in patients' health status and allows to do a cost-effectiveness analysis of treatments. When children with special health features cannot perform a self-assessment, it is possible to assess their HRQoL through their parents or caregivers. To date, the discrepancy in the assessment of HRQoL using the EQ-5D-Y questionnaire among children with cerebral palsy (CP) and their parents has not been analyzed. The objective of this study was to analyze the level of agreement in the HRQoL assessment using the EQ-5D-Y questionnaire and its proxy version among children with CP and their parents or caregivers. Children and adolescents with CP, and their parents, from a special education school in the region of Extremadura (Spain) participated in the study. The EQ-5D-Y questionnaire was used for children and the EQ-5D-Y proxy version, for parents. Interviews were conducted in the first quarter of 2015. The level of agreement in the responses was analyzed using the Cohen's kappa coefficient for the five domains of the EQ-5D-Y and the intraclass correlation coefficient for the visual analogue scale. Sixty-two children with CP and mild and/or moderate functional capacity impairment, and their parents, participated in the study. The level of agreement was poor in the HRQoL assessment between children and parents in all the questionnaire domains ( <0.20) and fair or poor ( <0.60) in the visual analogue scale. A high level of parent-child disagreement was observed in the HRQoL assessment in the population with CP using the EQ-5D-Y questionnaire. Sociedad Argentina de Pediatría

Association between topiramate use and serum bicarbonate levels in a veteran population.

PubMed

Sciegienka, Anna; Argo, Tami; Cantrell, Matthew; Alexander, Bruce

2015-06-01

Topiramate has been associated with metabolic acidosis secondary to decreased serum bicarbonate. Product labeling recommends serum bicarbonate monitoring at baseline and periodically thereafter. The study objective was to assess changes in serum bicarbonate within the first year of topiramate use in an outpatient veteran population. This was a single-center, retrospective study conducted at the Iowa City Veterans Affairs Health Care System. Inclusion criteria required a minimum of 1 topiramate outpatient prescription between October 1, 1999, and August 31, 2012, and at least 1 serum bicarbonate level within 12 months prior to topiramate initiation. Patients with topiramate nonadherence, concurrent use of sodium bicarbonate or oral carbonic anhydrase inhibitors, and individual serum bicarbonate values obtained during inpatient hospitalizations were excluded. Change in bicarbonate was evaluated using a paired t test. Decreases in bicarbonate of ≥5 mEq/L, values <20 mEq/L, days to lowest value, and correlation between adverse drug reactions (ADRs) and topiramate discontinuation were evaluated. Of 546 patients reviewed, 350 were included in the analysis. There was a statistically significant decrease of 2.7 mEq/L in bicarbonate following initiation of topiramate. Only 1 patient had a bicarbonate value <17 mEq/L. There was no association between bicarbonate decrease ≥5 mEq/L and ADRs. A statistically significant reduction in bicarbonate levels occurred with topiramate, which was clinically insignificant. ADR occurrence did not correlate with bicarbonate levels <17 mEq/L or a decrease ≥5 mEq/L. Our results indicate that serum bicarbonate levels should only be monitored before topiramate initiation and in patients presenting with symptoms suggestive of acidosis. © The Author(s) 2015.

Caffeine Expectancy Questionnaire (CaffEQ): construction, psychometric properties, and associations with caffeine use, caffeine dependence, and other related variables.

PubMed

Huntley, Edward D; Juliano, Laura M

2012-09-01

Expectancies for drug effects predict drug initiation, use, cessation, and relapse, and may play a causal role in drug effects (i.e., placebo effects). Surprisingly little is known about expectancies for caffeine even though it is the most widely used psychoactive drug in the world. In a series of independent studies, the nature and scope of caffeine expectancies among caffeine consumers and nonconsumers were assessed, and a comprehensive and psychometrically sound Caffeine Expectancy Questionnaire (CaffEQ) was developed. After 2 preliminary studies, the CaffEQ was administered to 1,046 individuals from the general population along with other measures of interest (e.g., caffeine use history, anxiety). Exploratory factor analysis of the CaffEQ yielded a 7-factor solution. Subsequently, an independent sample of 665 individuals completed the CaffEQ and other measures, and a subset (n = 440) completed the CaffEQ again approximately 2 weeks later. Confirmatory factor analysis revealed good model fit, and test-retest reliability was very good. The frequency and quantity of caffeine use were associated with greater expectancies for withdrawal/dependence, energy/work enhancement, appetite suppression, social/mood enhancement, and physical performance enhancement and lower expectancies for anxiety/negative physical effects and sleep disturbance. Caffeine expectancies predicted various caffeine- associated features of substance dependence (e.g., use despite harm, withdrawal incidence and severity, perceived difficulty stopping use, tolerance). Expectancies for caffeine consumed via coffee were stronger than for caffeine consumed via soft drinks or tea. The CaffEQ should facilitate the advancement of our knowledge of caffeine and drug use in general. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Comparing UK, USA and Australian values for EQ-5D as a health utility measure of oral health.

PubMed

Brennan, D S; Teusner, D N

2015-09-01

Using generic measures to examine outcomes of oral disorders can add additional information relating to health utility. However, different algorithms are available to generate health states. The aim was to assess UK-, US- and Australian-based algorithms for the EuroQol (EQ-5D) in relation to their discriminative and convergent validity. Methods: Data were collected from adults in Australia aged 30-61 years by mailed survey in 2009-10, including the EQ-5D and a range of self-reported oral health variables, and self-rated oral and general health. Responses were collected from n=1,093 persons (response rate 39.1%). UK-based EQ-5D estimates were lower (0.85) than the USA and Australian estimates (0.91). EQ-5D was associated (p<0.01) with all seven oral health variables, with differences in utility scores ranging from 0.03 to 0.06 for the UK, from 0.04 to 0.07 for the USA, and from 0.05 to 0.08 for the Australian-based estimates. The effect sizes (ESs) of the associations with all seven oral health variables were similar for the UK (ES=0.26 to 0.49), USA (ES=0.31 to 0.48) and Australian-based (ES=0.31 to 0.46) estimates. EQ-5D was correlated with global dental health for the UK (rho=0.29), USA (rho=0.30) and Australian-based estimates (rho=0.30), and correlations with global general health were the same (rho=0.42) for the UK, USA and Australian-based estimates. EQ-5D exhibited equivalent discriminative validity and convergent validity in relation to oral health variables for the UK, USA and Australian-based estimates.

Comparing EQ-5D valuation studies: a systematic review and methodological reporting checklist.

PubMed

Xie, Feng; Gaebel, Kathryn; Perampaladas, Kuhan; Doble, Brett; Pullenayegum, Eleanor

2014-01-01

There has been a growing interest around the world in developing country-specific scoring algorithms for the EQ-5D. This study systematically reviews all existing EQ-5D valuation studies to highlight their strengths and limitations, explores heterogeneity in observed utilities using meta-regression, and proposes a methodological checklist for reporting EQ-5D valuation studies. . We searched Medline, EMBASE, the National Health Service Economic Evaluation Database (NHS EED) via Wiley's Cochrane Library, and Wiley's Health Economic Evaluation Database from inception through November 2012, as well as bibliographies of key papers and the EuroQol Plenary Meeting Proceedings from 1991 to 2012 for English-language reports of EQ-5D valuation studies. Two reviewers independently screened the titles and abstracts for relevance. Three reviewers performed data extraction and compared the characteristics and scoring algorithms developed in the included valuation studies. . Of the 31 studies included in the review, 19 used the time trade-off (TTO) technique, 10 used the visual analogue scale (VAS) technique, and 2 used both TTO and VAS. Most studies included respondents from the general population selected by random or quota sampling and used face-to-face interviews or postal surveys. Studies valued between 7 and 198 total states, with 1-23 states valued per respondent. Different model specifications have been proposed for scoring. Some sample or demographic factors, including gender, education, percentage urban population, and national health care expenditure, were associated with differences in observed utilities for moderate or severe health states. . EQ-5D valuation studies conducted to date have varied widely in their design and in the resulting scoring algorithms. Therefore, we propose the Checklist for Reporting Valuation Studies of the EQ-5D (CREATE) for those conducting valuation studies.

Assessing energy efficiencies, economy, and global warming potential (GWP) effects of major crop production systems in Iran: a case study in East Azerbaijan province.

PubMed

Mohammadzadeh, Arash; Mahdavi Damghani, Abdolmajid; Vafabakhsh, Javad; Deihimfard, Reza

2017-07-01

Efficient use of energy in farming systems is one of the most important implications for decreasing greenhouse gas (GHG) emissions and mitigating global warming (GW). This paper describes the energy use patterns, analyze the economics, and report global warming potential effects of major crop production systems in East Azerbaijan province, Iran. For this purpose, 110 farmers whose main activity was major crop production in the region, including wheat, barley, carrot, tomato, onion, potato, alfalfa, corn silage, canola, and saffron, were surveyed. Some other data was obtained from the Ministry of Agriculture Jihad of Iran. Results showed that, in terms of total energy input, onion (87,556 Mj ha -1 ) and potato (80,869 Mj ha -1 ) production systems were more energy-intensive than other crops. Among the studied crops, the highest values of net return (6563.8 $ ha -1 ) and benefit/cost ratio (1.95) were related to carrot and corn silage production systems, respectively. Studies have also shown that onion and saffron production systems emit the highest (5332.6 kg CO2eq ha -1 ) and lowest (646.24 kg CO 2 eq ha -1 ) CO 2 eq. emission, respectively. When it was averaged across crops, diesel fuel accounted for the greatest GHG contribution with 43% of the total, followed by electric power (28%) and nitrogen fertilizer (21%). In the present study, eco-efficiency was calculated as a ratio of the gross production value and global warming potential effect for the studied crops. Out of all the studied crops, the highest values of eco-efficiency were calculated to be 8.65 $ kg CO 2 eq -1 for the saffron production system followed by the carrot (3.65 $ kg CO 2 eq -1 ) production. Generally, from the aspect of energy balance and use efficiency, the alfalfa production system was the best; however, from an economical point of view, the carrot production system was better than the other crops.

Responsiveness of the EQ-5D to the effects of low vision rehabilitation.

PubMed

Malkin, Alexis G; Goldstein, Judith E; Perlmutter, Monica S; Massof, Robert W

2013-08-01

This study is an evaluation of the responsiveness of preference-based outcome measures to the effects of low vision rehabilitation (LVR). It assesses LVR-related changes in EQ-5D utilities in patients who exhibit changes in Activity Inventory (AI) measures of visual ability. Telephone interviews were conducted on 77 low-vision patients out of a total of 764 patients in the parent study of "usual care" in LVR. Activity Inventory results were filtered for each patient to include only goals and tasks that would be targeted by LVR. The EQ-5D utilities have weak correlations with all AI measures but correlate best with AI goal scores at baseline (r = 0.48). Baseline goal scores are approximately normally distributed for the AI, but EQ-5D utilities at baseline are skewed toward the ceiling (median, 0.77). Effect size for EQ-5D utility change scores from pre- to post-LVR was not significantly different from zero. The AI visual function ability change scores corresponded to a moderate effect size for all functional domains and a large effect size for visual ability measures estimated from AI goal ratings. This study found that the EQ-5D is unresponsive as an outcome measure for LVR and has poor sensitivity for discriminating low vision patients with different levels of ability.

Assessment of the Performance of Iodine-Treated Biocidal Filters and Characterization of Virus Aerosols

DTIC Science & Technology

2009-07-01

a decrease of germicidal activity due to increased iodine decomposition (Wyss and Strandskov 1945 ). Generally, iodine inactivation is effective in...wet dissemination because dehydration is an inevitable condition (Cox 1989). Songer (1967) studied the effects of RH and temperature on various... hydrolysis to form hypoiodous acid (HOI) as shown in Eq. (1-1). Hypoiodous acid then disproportionates to iodate (IO3-) as depicted in Eq. (1-2

Tailoring of Nano- and Microstructure in Biomimetically Synthesized Ceramic Films

DTIC Science & Technology

2006-11-01

Eq. 5 where the Hamaker constant (A) for a flat and infinitely large substrate (subscript 1) and a spherical particle...is determined as (Israelachvili 1985): 232 12a A RV x = − Eq. 7 where the Hamaker constant for two like spherical particle (2) in a medium...close enough to be attracted to the equilibrium separation (0.3 nm). The Hamaker constants and the minimal interaction energies for substrate-solution

Hypervolemia in men from drinking hyperhydration fluids at rest and during exercise

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Looftwilson, R.; Wisherd, P. P.; Fung, P. P.; Ertl, A. C.; Jackson, C. G. R.; Barnes, P. R.; Wong, L. G.

1994-01-01

To test the hypothesis that drink composition is more important than drink osmolality (Osm) for maintaining and increasing plasma volume (PV) at rest and during exercise, six men (22-39 yr, 76.84 +/- 16.19 kg, 2.99 +/- 0.45 L/min VO2 peak) each underwent six treatments while sitting for 90 min (VO2 = 0.39 L/min) and then performed upright ergometer exercise for 70 min (VO2 = 2.08 +/- 0.33 1/min, 70% +/- 7% VO2 peak). Drink formulations (10 ml/kg body weight, X = 768 ml) for the sitting period were: P1 (55 mEq Na(+), 365 mOsm/kg H2O), P2 (97.1 mEq Na(+), 791 mOsm/kg), P2G (113 mEqNa(+), 80 ml glycerol, 1,382 mOsm/kg, HyperAde (HA) (164 mEq Na(+), 253 mOsm/kg), and 01 and 02 (no drinking). The exercise drink (10 ml/kg, 768 ml) was P1 for all treatments except 02. Plasma volume at rest increased (p less than 0.05) by 4.7% with P1 and by 7.9% with HA. Percent change in PV during exercise was +1% to +3%0(NS) with HA; -6% to 0% (NS) with P1, P2, P2G, and 01; and -8% to -5% (p less than 0.05) with 02. HyperAde, with the lowest osmolality (253 mOsm/kg), maintained PV at rest and during exercise, whereas the other drinks with lower Na(+) and higher osmolality (365 to 1,382 mOsm/kg) did not. But Performance 1 also increased PV at rest. Thus, drink composition may be more important than drink osmolality for increasing plasma volume at rest and for maintaining it during exercise.

Analysis of emerging organic contaminants in water, fish and suspended particulate matter (SPM) in the Joint Danube Survey using solid-phase extraction followed by UHPLC-MS-MS and GC-MS analysis.

PubMed

Loos, Robert; Tavazzi, Simona; Mariani, Giulio; Suurkuusk, Gert; Paracchini, Bruno; Umlauf, Gunther

2017-12-31

In the third Joint Danube Survey (JDS3), emerging organic contaminants were analysed in the dissolved water phase of samples from the Danube River and its major tributaries. Analyses were performed using solid-phase extraction (SPE) followed by ultra-high-pressure liquid chromatography triple-quadrupole mass spectrometry (UHPLC-MS-MS) and gas chromatography-mass spectrometry (GC-MS). The polar organic compounds analysed by UHPLC-MS-MS were 1H-benzotriazole, methylbenzotriazoles, carbamazepine, 10,11-dihydro-10,11-dihydroxy-carbamazepine, diclofenac, sulfamethox-azole, 2,4-D (2,4-dichlorophenoxyacetic acid), MCPA (2-methyl-4-chlorophenoxyacetic acid), metolachlor, cybutryne (irgarol), terbutryn, DEET (N,N-diethyl-m-toluamide), and several perfluoroalkyl acids (C 6 -C 9 ; C 8 =perfluorooctanoic acid (PFOA)) and perfluorooctansulfonic acid (PFOS). In addition, several organophosphorus flame retardants were analysed by GC-MS. The most relevant compounds identified in the 71 water samples, in terms of highest median and maximum concentrations, were 1H-benzotriazole, tris(1-chloro-2-propyl)phosphate (TCPP), methylbenzotriazoles, carbama-zepine and its metabolite, DEET, sulfamethoxazole, tris(isobutyl)phosphate (TiBP), tris(2-chloroethyl)phosphate (TCEP), PFOA, PFOS and diclofenac. The concentrations of these compounds in the samples were generally below the environmental quality standard (EQS) threshold values, with the exception of PFOS, the concentration of which exceeded the annual average water EQS limit of 0.65ng/L along the whole river, and also exceeded the fish biota EQS of 9.1μg/kg. In addition, the proposed EQS for diclofenac, of 0.1μg/L, was exceeded in the Arges River in Romania (255ng/L). Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Intracerebral hemorrhage location and outcome among INTERACT2 participants.

PubMed

Delcourt, Candice; Sato, Shoichiro; Zhang, Shihong; Sandset, Else Charlotte; Zheng, Danni; Chen, Xiaoying; Hackett, Maree L; Arima, Hisatomi; Hata, Jun; Heeley, Emma; Al-Shahi Salman, Rustam; Robinson, Thompson; Davies, Leo; Lavados, Pablo M; Lindley, Richard I; Stapf, Christian; Chalmers, John; Anderson, Craig S

2017-04-11

To clarify associations between intracerebral hemorrhage (ICH) location and clinical outcomes among participants of the main phase Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Associations between ICH sites and poor outcomes (death [6] or major disability [3-5] of modified Rankin Scale) and European Quality of Life Scale (EQ-5D) utility scores at 90 days were assessed in logistic regression models. Of 2,066 patients included in the analyses, associations were identified between ICH sites and poor outcomes: involvement of posterior limb of internal capsule increased risks of death or major disability (odds ratio [OR] 2.10) and disability (OR 1.81); thalamic involvement increased risks of death or major disability (OR 2.24) and death (OR 1.97). Involvement of the posterior limb of the internal capsule, thalamus, and infratentorial sites were each associated with poor EQ-5D utility score (≤0.7 [median]; OR 1.87, 2.14, and 2.81, respectively). Posterior limb of internal capsule involvement was strongly associated with low scores across all health-related quality of life domains. ICH encompassing the thalamus and posterior limb of internal capsule were associated with death or major disability, major disability, and poor EQ-5D utility score (OR 1.72, 2.26, and 1.71, respectively). Poor clinical outcomes are related to ICH affecting the posterior limb of internal capsule, thalamus, and infratentorial sites. The highest association with death or major disability and poor EQ-5D utility score was seen in ICH encompassing the thalamus and posterior limb of internal capsule. NCT00716079. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Higher net acid excretion is associated with lower risk of kidney disease progression in patients with diabetes

PubMed Central

Scialla, Julia J.; Asplin, John; Dobre, Mirela; Chang, Alex; Lash, James; Hsu, Chi-yuan; Kallem, Radhakrishna R.; Hamm, L. Lee; Feldman, Harold I.; Chen, Jing; Appel, Lawrence; Anderson, Cheryl A. M.; Wolf, Myles

2017-01-01

Higher diet-dependent nonvolatile acid load is associated with faster chronic kidney disease (CKD) progression, but most studies have used estimated acid load or measured only components of the gold-standard, net acid excretion (NAE). Here we measured NAE as the sum of urine ammonium and titratable acidity in 24 hour urines from a random subset of 980 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. In multivariable models accounting for demographics, comorbidity and kidney function, higher NAE was significantly associated with lower serum bicarbonate (0.17 mEq/L lower serum bicarbonate per 10 mEq/day higher NAE), consistent with a larger acid load. Over a median of 6 years follow-up, higher NAE was independently associated with a significantly lower risk of the composite of end stage renal disease or halving of estimated glomerular filtration rate among diabetics (hazard ratio 0.88 per 10 mEq/day higher NAE), but not those without diabetes (hazard ratio 1.04 per 10 mEq/day higher NAE). For comparison, we estimated nonvolatile acid load as net endogenous acid production using self-reported food frequency questionnaires from 2,848 patients and dietary urine biomarkers from 3,385 patients. Higher net endogenous acid production based on biomarkers (urea nitrogen and potassium) was modestly associated with faster CKD progression consistent with prior reports, but only among those without diabetes. Results from the food frequency questionnaires were not associated with CKD progression in any group. Thus, disparate results obtained from analyses of nonvolatile acid load directly measured as NAE and estimated from diet, suggests a novel hypothesis, that the risk of CKD progression related to low NAE, or acid load, may be due to diet-independent changes in acid production in diabetes. PMID:27914710

Health Related Quality of Life in Patients with Side-Effects after Antimuscarinic Treatment for Overactive Bladder.

PubMed

Kim, Aram; Lee, Kyu-Sung; Jung, Rangrhee; Na, Selee; Kim, Joon-Chul; Kim, Hyeong Gon; Choo, Myung-Soo

2017-09-01

Drug therapy is the mainstay of treatment for overactive bladder (OAB), but antimuscarinic agents possess side-effects. These side-effects decrease the patients' quality of life. We therefore assessed the impact of side-effects on health-related quality of life (HR-QoL) through an analysis of EQ-5D questionnaire. This study was designed to investigate the patients' satisfaction by quality weight of health status as affected by the side-effects of OAB medications. Patients who had OAB symptoms lasting longer than 3 months and have experienced side-effects after any antimuscarinic treatments filled in the EQ-5D questionnaire. The enrolled patients had two EQ-5D questionnaires for two different health statuses, i.e., presence or absence of side-effects. Quality weight was calculated using the ED-5D health status score with Korean tariff. One hundred patients were enrolled and completed the HR-QoL questionnaire. The most prevalent side-effect was dry mouth (61%) and 28% patients had dry mouth and constipation concurrently. Most of the patients with side-effects tried to endure and overcome these side-effects (79%), but 10% desired a change in medication, and 6% stopped medication altogether. The quality weight of EQ-5D without side-effects was 0.863, while the quality weight with side-effects was 0.666 (P < 0.001). The VAS score was 79 in patient without side-effects and 57 in those with side-effects, supporting the results of quality weight assessment. Overactive bladder patients may enjoy a better quality of life if side-effects associated with antimuscarinic therapy are fewer. © 2016 John Wiley & Sons Australia, Ltd.

Association between mortality and replacement solution bicarbonate concentration in continuous renal replacement therapy: A propensity-matched cohort study

PubMed Central

Thongprayoon, Charat; Cheungpasitporn, Wisit; Iacovella, Gina M.; Akhoundi, Abbasali; Albright, Robert C.

2017-01-01

Background Given the known deleterious effects seen with bicarbonate supplementation for acidemia, we hypothesized that utilizing high bicarbonate concentration replacement solution in continuous venovenous hemofiltration (CVVH) would be independently associated with higher mortality. Methods In a propensity score-matched historical cohort study conducted at a single tertiary care center from December 9, 2006, through December 31, 2009, a total of 287consecutive adult critically ill patients with Stage III acute kidney injury (AKI) requiring CVVH were enrolled. We excluded patients on maintenance dialysis, those who received other modalities of continuous renal replacement therapies, and patients that received a mixed of 22 and 32 mEq/L bicarbonate solution pre- and post-filter. The primary outcome was in-hospital and 90-day mortality rates. Results Among enrollees, 68 were used 32 mEq/L bicarbonate solution, and 219 received 22mEq/L bicarbonate solution for CVVH. Patients on 32 mEq/L bicarbonate solution were more often non-surgical, had lower pH and bicarbonate level but had higher blood potassium and phosphorus levels in comparison with those on 22 mEq/L bicarbonate solution. After adjustment for the baseline characteristics, the use of 32 bicarbonate solution was significantly associated with increased in-hospital (HR = 1.94; 95% CI 1.02–3.79) and 90-day mortality (HR = 1.50; 95% CI 1.03–2.14). There was a significant increase in the hospital (p = .03) and 90-day (p = .04) mortality between the 22 vs. 32 mEq/L bicarbonate solution groups following propensity matching. Conclusion Our data showed there is a strong association between using high bicarbonate solution and mortality independent of severity of illness and comorbid conditions. These findings need to be evaluated further in prospective studies. PMID:28957333

Health-related quality of life inequalities by sexual orientation: Results from the Barcelona Health Interview Survey.

PubMed

Marti-Pastor, Marc; Perez, Gloria; German, Danielle; Pont, Angels; Garin, Olatz; Alonso, Jordi; Gotsens, Mercè; Ferrer, Montse

2018-01-01

Studies on health-related quality of life (HRQoL) inequalities according to sexual orientation are scarce. The aim of this study was to assess HRQoL inequalities between lesbian, gay, and bisexual (LGB) people and heterosexuals in the 2011 Barcelona population, to describe the extent to which sociodemographic characteristics, health-related behaviors, and chronic conditions could explain such inequalities, and to understand if they are sexual orientation inequities. In the 2011 Barcelona Health Interview Survey 3277 adults answered the EQ-5D, which measures five dimensions of HRQoL summarized into a single utility index (1 = perfect health, 0 = death). To assess HRQoL differences by sexual orientation we constructed Tobit models for the EQ-5D index, and Poisson regression models for the EQ-5D dimensions. In both cases, nested models were constructed to assess the mediator role of selected variables. After adjusting by socio-demographic variables, the LGB group presented a significantly lower EQ-5D index than heterosexuals, and higher prevalence ratios of problems in physical EQ-5D dimensions among both genders: adjusted prevalence ratio (aPR) = 1.70 for mobility (p = 0.046) and 2.11 for usual activities (p = 0.019). Differences in mental dimensions were only observed among men: aPR = 3.15 for pain/discomfort (p = 0.003) and 2.49 for anxiety/depression (p = 0.030). All these differences by sexual orientation disappeared after adding chronic conditions and health-related behaviors in the models. The LGB population presented worse HRQoL than heterosexuals in the EQ-5D index and most dimensions. Chronic conditions, health-related behaviors and gender play a major role in explaining HRQoL differences by sexual orientation. These findings support the need of including sexual orientation into the global agenda of health inequities.

Review and critical appraisal of studies mapping from quality of life or clinical measures to EQ-5D: an online database and application of the MAPS statement.

PubMed

Dakin, Helen; Abel, Lucy; Burns, Richéal; Yang, Yaling

2018-02-12

The Health Economics Research Centre (HERC) Database of Mapping Studies was established in 2013, based on a systematic review of studies developing mapping algorithms predicting EQ-5D. The Mapping onto Preference-based measures reporting Standards (MAPS) statement was published in 2015 to improve reporting of mapping studies. We aimed to update the systematic review and assess the extent to which recently-published studies mapping condition-specific quality of life or clinical measures to the EQ-5D follow the guidelines published in the MAPS Reporting Statement. A published systematic review was updated using the original inclusion criteria to include studies published by December 2016. We included studies reporting novel algorithms mapping from any clinical measure or patient-reported quality of life measure to either the EQ-5D-3L or EQ-5D-5L. Titles and abstracts of all identified studies and the full text of papers published in 2016 were assessed against the MAPS checklist. The systematic review identified 144 mapping studies reporting 190 algorithms mapping from 110 different source instruments to EQ-5D. Of the 17 studies published in 2016, nine (53%) had titles that followed the MAPS statement guidance, although only two (12%) had abstracts that fully addressed all MAPS items. When the full text of these papers was assessed against the complete MAPS checklist, only two studies (12%) were found to fulfil or partly fulfil all criteria. Of the 141 papers (across all years) that included abstracts, the items on the MAPS statement checklist that were fulfilled by the largest number of studies comprised having a structured abstract (95%) and describing target instruments (91%) and source instruments (88%). The number of published mapping studies continues to increase. Our updated database provides a convenient way to identify mapping studies for use in cost-utility analysis. Most recent studies do not fully address all items on the MAPS checklist.

VizieR Online Data Catalog: Methods for CIP and CIO localisation (Capitaine+, 2006)

NASA Astrophysics Data System (ADS)

Capitaine, N.; Wallace, P. T.

2006-04-01

Various implementations are described, their theoretical bases compared and the relationships between the expressions for the relevant parameters are provided. Semi-analytical and numerical comparisons have been made, based on the P03 precession and the IAU 2000A nutation, with slight modifications to the latter to make it consistent with P03. Methods based on the recent P03 precession model can be found in Capitaine et al. (2003A&A...412..567C, 2005A&A...432..355C). Tables 5-11 contain the coefficients in microarcseconds (uas) of the series developments (i.e. Fourier and Poisson terms) as functions of (terrestrial) time t (expressed in centuries since J2000.0) for the quantities s (Eq. (53)), s+XY/2 (Eq. (58)), s+XY/2+D (Eq. (60)), EO+Dpsi*cos(epsilonA) (where EO is given by Eq. (69)), x{CIO}, y{CIO}, z{CIO} (Eq. (70)), respectively, retaining all terms larger than 0.1 uas. The general formula is: S=Sum{on i}[Sum{j=0,5}[(S{j}i)*tj*sin(ARG)+(C{j}i*cos(ARG)]*tj

Landfill Methane

USDA-ARS?s Scientific Manuscript database

Landfill methane (CH4) accounts for approximately 1.3% (0.6 Gt) of global anthropogenic greenhouse gas emissions relative to total emissions from all sectors of about 49 Gt CO2-eq yr-1. For countries with a history of controlled landfilling, landfills can be one of the larger national sources of ant...

Historical emissions of HFC-23 (CHF3) in China and projections upon policy options by 2050.

PubMed

Fang, Xuekun; Miller, Benjamin R; Su, Shenshen; Wu, Jing; Zhang, Jianbo; Hu, Jianxin

2014-04-01

Trifluoromethane (CHF3, HFC-23) is one of the hydrofluorocarbons (HFCs) regulated under the Kyoto Protocol with a global warming potential (GWP) of 14 800 (100-year). China's past, present, and future HFC-23 emissions are of considerable interest to researchers and policymakers involved in climate change. In this study, we compiled a comprehensive historical inventory (1980-2012) and a projection (2013-2050) of HFC-23 production, abatements, and emissions in China. Results show that HFC-23 production in China increased from 0.08 ± 0.05 Gg/yr in 1980 to 15.4 ± 2.1 Gg/yr (228 ± 31 Tg/yr CO2-eq) in 2012, while actual HFC-23 emissions reached a peak of 10.5 ± 1.8 Gg/yr (155 ± 27 Tg/y CO2-eq) in 2006, and decreased to a minimum of 7.3 ± 1.3 Gg/yr (108 ± 19 Tg/yr CO2-eq) in 2008 and 2009. Under the examined business-as-usual (BAU) scenario, the cumulative emissions of HFC-23 in China over the period 2013-2050 are projected to be 609 Gg (9015 Tg CO2-eq which approximates China's 2012 CO2 emissions). Currently, China's annual HFC-23 emissions are much higher than those from the developed countries, while it is estimated that by year 2027, China's historic contribution to the global atmospheric burden of HFC-23 will have surpassed that of the developed nations under the BAU scenario.

Thermal equilibrium concentrations and effects of negatively charged Ga vacancies in n-type GaAs

NASA Astrophysics Data System (ADS)

Tan, T. Y.; You, H.-M.; Gösele, U. M.

1993-03-01

We have calculated the thermal equilibrium concentrations of the various negatively charged Ga vacancy species in GaAs. The triply-negatively-charged Ga vacancy, V {Ga/3-}, has been emphasized, since it dominates Ga self-diffusion and Ga-Al interdiffusion under intrinsic and n-doping conditions, as well as the diffusion of Si donor atoms occupying Ga sites. Under strong n-doping conditions, the thermal equilibrium V {Ga/3-}concentration, C_{V_{_{Ga} }^{3 - } }^{eq} (n), has been found to exhibit a temperature independence or a negative temperature dependence, i.e., the C_{V_{_{Ga} }^{3 - } }^{eq} (n) value is either unchanged or increases as the temperature is lowered. This is quite contrary to the normal point defect behavior for which the point defect thermal equilibrium concentration decreases as the temperature is lowered. This C_{V_{_{Ga} }^{3 - } }^{eq} (n) property provides explanations to a number of outstanding experimental results, either requiring the interpretation that V {Ga/3-}has attained its thermal equilibrium concentration at the onset of each experiment, or requiring mechanisms involving point defect non-equilibrium phenomena.

Inhaled β-agonist therapy and respiratory muscle fatigue as under-recognised causes of lactic acidosis.

PubMed

Lau, Emily; Mazer, Jeffrey; Carino, Gerardo

2013-10-14

A 49-year-old man with chronic obstructive pulmonary disease (COPD) presented with significant tachypnoea, fevers, productive cough and increased work of breathing for the previous 4 days. Laboratory data showed elevated lactate of 3.2 mEq/L. Continuous inhaled ipratropium and albuterol nebuliser treatments were administered. Lactate levels increased to 5.5 and 3.9 mEq/L, at 6 and 12 h, respectively. No infectious source was found and the lactic acidosis cleared as the patient improved. The lactic acidosis was determined to be secondary to respiratory muscle fatigue and inhaled β-agonist therapy, two under-recognised causes of lactic acidosis in patients presenting with respiratory distress. Lactic acidosis is commonly used as a clinical marker for sepsis and shock, but in the absence of tissue hypoperfusion and severe hypoxia, alternative aetiologies for elevated levels should be sought to avoid unnecessary and potentially harmful medical interventions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coughanowr, C.A.

The electrochemical machining (ECM) of a cemented titanium carbide/10% nickel composite has been investigated and compared to the ECM of the pure components, TiC and Ni. All three materials were machined in 2M KNO/sub 3/ electrolyte, under current densities ranging from 17 to 100 A/cm/sup 2/. The ECM behavior of the TiC/Ni composite was found to be intermediate to that of its components. The apparent valences of dissolution for all three materials were independent of current density in the range studied: 2.8 eq/gmol for Ni, and 6.6 and 6.5 eq/gmol for TiC and TiC/Ni, respectively. Linear cell voltage versus currentmore » density relationships were obtained for all three materials. Surface analysis of the TiC/Ni composite showed preferential dissolution of the TiC phase over the nickel phase for the entire range of operating conditions investigated. A polishing regime could not be identified for cemented TiC/Ni.« less

Size-resolved characterization of the polysaccharidic and proteinaceous components of sea spray aerosol

NASA Astrophysics Data System (ADS)

Aller, Josephine Y.; Radway, JoAnn C.; Kilthau, Wendy P.; Bothe, Dylan W.; Wilson, Theodore W.; Vaillancourt, Robert D.; Quinn, Patricia K.; Coffman, Derek J.; Murray, Benjamin J.; Knopf, Daniel A.

2017-04-01

Dissolved organic polymers released by phytoplankton and bacteria abiologically self-assemble in surface ocean waters into nano-to micro-sized gels containing polysaccharides, proteins, lipids and other components. These gels concentrate in the sea surface microlayer (SML), where they can potentially contribute to sea spray aerosol (SSA). Sea spray is a major source of atmospheric aerosol mass over much of the earth's surface, and knowledge of its properties (including the amount and nature of the organic content), size distributions and fluxes are fundamental for determining its role in atmospheric chemistry and climate. Using a cascade impactor, we collected size-fractionated aerosol particles from ambient air and from freshly generated Sea Sweep SSA in the western North Atlantic Ocean together with biological and chemical characterization of subsurface and SML waters. Spectrophotometric methods were applied to quantify the polysaccharide-containing transparent exopolymer (TEP) and protein-containing Coomassie stainable material (CSM) in these particles and waters. This study demonstrates that both TEP and CSM in surface ocean waters are aerosolized with sea spray with the greatest total TEP associated with particles <180 nm in diameter and >5 000 nm. The higher concentrations of TEP and CSM in particles >5 000 nm most likely reflects collection of microorganism cells and/or fragments. The greater concentration of CSM in larger size particles may also reflect greater stability of proteinaceous gels compared to polysaccharide-rich gels in surface waters and the SML. Both TEP and CSM were measured in the ambient marine air sample with concentrations of 2.1 ± 0.16 μg xanthan gum equivalents (XG eq.) m-3 and 14 ± 1.0 μg bovine serum albumin equivalents (BSA eq.) m-3. TEP in Sea Sweep SSA averaged 4.7 ± 3.1 μg XG eq. m-3 and CSM 8.6 ± 7.3 μg BSA eq. m-3. This work shows the transport of marine biogenic material across the air-sea interface through primary particle emission and the first demonstration of particle size discriminated TEP and CSM characterization of SSA and ambient aerosol under field conditions.

Geodetic Infrastructure, Data, Education and Community Engagement in Response to Earthquakes and Other Geophysical Events: An Overview of UNAVCO Support Resources Plus Highlights from Recent Event Response

NASA Astrophysics Data System (ADS)

Phillips, D. A.; Meertens, C. M.; Mattioli, G. S.; Miller, M. M.; Charlevoix, D. J.; Maggert, D.; Hodgkinson, K. M.; Henderson, D. B.; Puskas, C. M.; Bartel, B. A.; Baker, S.; Blume, F.; Normandeau, J.; Feaux, K.; Galetzka, J.; Williamson, H.; Pettit, J.; Crosby, C. J.; Boler, F. M.

2015-12-01

UNAVCO responds to community requests for support during and following significant geophysical events such as earthquakes, volcanic activity, landslides, glacial and ice-sheet movements, unusual uplift or subsidence, extreme meteorological events, or other hazards. UNAVCO can also respond proactively to events in anticipation of community demand for relevant data, data products or other services. Recent major events to which UNAVCO responded include the 2015 M7.8 Nepal EQ, the 2014 M6.0 American Canyon (Napa) EQ, the 2014 M8.2 Chile EQ, the 2011 M9.0 Tohoku, Japan EQ and tsunami, the 2010 M8.8 Maule, Chile EQ, and the 2010 M7.0 Haiti EQ. UNAVCO provided geophysical event response support for 15 events in 2014 alone. UNAVCO event response resources include geodetic infrastructure, data, and education and community engagement. Specific support resources include: field engineering personnel; continuous and campaign GNSS/GPS station deployment; real-time and/or high rate field GNSS/GPS station upgrades or deployment; data communications and power systems deployment; tiltmeter, strainmeter, and borehole seismometer deployments; terrestrial laser scanning (TLS a.k.a. ground-based LiDAR); InSAR data support; education and community engagement assistance or products; data processing services; generation of custom GNSS/GPS or borehole data sets and products; equipment shipping and logistics coordination; and assistance with RAPID proposal preparation, budgeting, and submission. The most critical aspect of a successful event response is effective and efficient communication. To facilitate such communication, UNAVCO creates event response web pages describing the event and the support being provided, and in the case of major events also provides an online event response forum. These resources are shared broadly with the geophysical community through multiple dissemination strategies including social media of UNAVCO and partner organizations. We will provide an overview of resources available to the community from UNAVCO in response to events. We will also highlight examples of the infrastructure, data and data products, and education and community engagement support provided by UNAVCO for major recent events.

In Vivo Effects of Free Form Astaxanthin Powder on Anti-Oxidation and Lipid Metabolism with High-Cholesterol Diet

PubMed Central

Chen, Yung-Yi; Lee, Pei-Chi; Wu, Yi-Long; Liu, Li-Yun

2015-01-01

Astaxanthin extracted from Pomacea canaliculata eggs was made into free-form astaxanthin powder (FFAP) and its effects on lipid metabolism, liver function, antioxidants activities and astaxanthin absorption rate were investigated. 45 hamsters were split into 5 groups and fed with normal diet, high-cholesterol control (0.2% cholesterol), 1.6FFAP (control+1.6% FFAP), 3.2FFAP (control+3.2% FFAP) and 8.0FFAP (control+8.0% FFAP), respectively, for 6 weeks. FFAP diets significantly decreased the liver total cholesterol, triglyceride levels and increased liver fatty acids (C20:5n3; C22:6n3) compositions. It decreased plasma alanine aminotransferase and aspartate aminotransferase. In terms of anti-oxidative activities, we found 8.0 FFAP diet significantly decreased plasma and liver malonaldehyde (4.96±1.96 μg TEP eq./mL and 1.56±0.38 μg TEP eq./g liver) and liver 8-isoprostane levels (41.48±13.69 μg 8-ISOP/g liver). On the other hand, it significantly increased liver catalase activity (149.10±10.76 μmol/min/g liver), Vitamin C (2082.97±142.23 μg/g liver), Vitamin E (411.32±81.67 μg/g liver) contents, and glutathione levels (2.13±0.42 mg GSH eq./g liver). Furthermore, 80% of astaxanthin absorption rates in all FFAP diet groups suggest FFAP is an effective form in astaxanthin absorption. Finally, astaxanthin was found to re-distribute to the liver and eyes in a dose dependent manner. Taken together, our results suggested that the appropriate addition of FFAP into high cholesterol diets increases liver anti-oxidative activity and reduces the concentration of lipid peroxidase and therefore, it may be beneficial as a material in developing healthy food. PMID:26262684

Effects of seasonality, transport pathway, and spatial structure on greenhouse gas fluxes in a restored wetland.

PubMed

McNicol, Gavin; Sturtevant, Cove S; Knox, Sara H; Dronova, Iryna; Baldocchi, Dennis D; Silver, Whendee L

2017-07-01

Wetlands can influence global climate via greenhouse gas (GHG) exchange of carbon dioxide (CO 2 ), methane (CH 4 ), and nitrous oxide (N 2 O). Few studies have quantified the full GHG budget of wetlands due to the high spatial and temporal variability of fluxes. We report annual open-water diffusion and ebullition fluxes of CO 2 , CH 4 , and N 2 O from a restored emergent marsh ecosystem. We combined these data with concurrent eddy-covariance measurements of whole-ecosystem CO 2 and CH 4 exchange to estimate GHG fluxes and associated radiative forcing effects for the whole wetland, and separately for open-water and vegetated cover types. Annual open-water CO 2 , CH 4 , and N 2 O emissions were 915 ± 95 g C-CO 2  m -2  yr -1 , 2.9 ± 0.5 g C-CH 4  m -2  yr -1 , and 62 ± 17 mg N-N 2 O m -2  yr -1 , respectively. Diffusion dominated open-water GHG transport, accounting for >99% of CO 2 and N 2 O emissions, and ~71% of CH 4 emissions. Seasonality was minor for CO 2 emissions, whereas CH 4 and N 2 O fluxes displayed strong and asynchronous seasonal dynamics. Notably, the overall radiative forcing of open-water fluxes (3.5 ± 0.3 kg CO 2 -eq m -2  yr -1 ) exceeded that of vegetated zones (1.4 ± 0.4 kg CO 2 -eq m -2  yr -1 ) due to high ecosystem respiration. After scaling results to the entire wetland using object-based cover classification of remote sensing imagery, net uptake of CO 2 (-1.4 ± 0.6 kt CO 2 -eq yr -1 ) did not offset CH 4 emission (3.7 ± 0.03 kt CO 2 -eq yr -1 ), producing an overall positive radiative forcing effect of 2.4 ± 0.3 kt CO 2 -eq yr -1 . These results demonstrate clear effects of seasonality, spatial structure, and transport pathway on the magnitude and composition of wetland GHG emissions, and the efficacy of multiscale flux measurement to overcome challenges of wetland heterogeneity. © 2017 John Wiley & Sons Ltd.

Cost-effectiveness of steroid (methylprednisolone) injections versus anaesthetic alone for the treatment of Morton's neuroma: economic evaluation alongside a randomised controlled trial (MortISE trial).

PubMed

Edwards, Rhiannon Tudor; Yeo, Seow Tien; Russell, Daphne; Thomson, Colin E; Beggs, Ian; Gibson, J N Alastair; McMillan, Diane; Martin, Denis J; Russell, Ian T

2015-01-01

Morton's neuroma is a common foot condition affecting health-related quality of life. Though its management frequently includes steroid injections, evidence of cost-effectiveness is sparse. So, we aimed to evaluate whether steroid injection is cost-effective in treating Morton's neuroma compared with anaesthetic injection alone. We undertook incremental cost-effectiveness and cost-utility analyses from the perspective of the National Health Service, alongside a patient-blinded pragmatic randomised trial in hospital-based orthopaedic outpatient clinics in Edinburgh, UK. Of the original randomised sample of 131 participants with Morton's neuroma (including 67 controls), economic analysis focused on 109 (including 55 controls). Both groups received injections guided by ultrasound. We estimated the incremental cost per point improvement in the area under the curve of the Foot Health Thermometer (FHT-AUC) until three months after injection. We also conducted cost-utility analyses using European Quality of life-5 Dimensions-3 Levels (EQ-5D-3L), enhanced by the Foot Health Thermometer (FHT), to estimate utility and thus quality-adjusted life years (QALYs). The unit cost of an ultrasound-guided steroid injection was £149. Over the three months of follow-up, the mean cost of National Health Service resources was £280 for intervention participants and £202 for control participants - a difference of £79 [bootstrapped 95% confidence interval (CI): £18 to £152]. The corresponding estimated incremental cost-effectiveness ratio was £32 per point improvement in the FHT-AUC (bootstrapped 95% CI: £7 to £100). If decision makers value improvement of one point at £100 (the upper limit of this CI), there is 97.5% probability that steroid injection is cost-effective. As EQ-5D-3L seems unresponsive to changes in foot health, we based secondary cost-utility analysis on the FHT-enhanced EQ-5D. This estimated the corresponding incremental cost-effectiveness ratio as £6,400 per QALY. Over the recommended UK threshold, ranging from £20,000 to £30,000 per QALY, there is 80%-85% probability that steroid injection is cost-effective. Steroid injections are effective and cost-effective in relieving foot pain measured by the FHT for three months. However, cost-utility analysis was initially inconclusive because the EQ-5D-3L is less responsive than the FHT to changes in foot health. By using the FHT to enhance the EQ-5D, we inferred that injections yield good value in cost per QALY. Current Controlled Trials ISRCTN13668166.

Safety Study of TCAS II for Logic Version 6.04

DTIC Science & Technology

1992-07-01

used in the fault tree of the 198 tdy. The fu given for Logic and Altimetry effects represent the site averages, and we bued upon TCAS RAs always being...comparison with the results of Monte Carlo simulations. Five million iterations were carril out for each of the four cases (eqs. 3, 4, 6 and 7

Dietary Sodium Modulation of Aldosterone Activation and Renal Function During the Progression of Experimental Heart Failure Miller: Dietary Sodium and Early Heart Failure

PubMed Central

Miller, Wayne L.; Borgeson, Daniel D.; Grantham, J. Aaron; Luchner, Andreas; Redfield, Margaret M.; Burnett, John C.

2015-01-01

Aims Aldosterone activation is central to the sodium-fluid retention that marks the progression of heart failure (HF). The actions of dietary sodium restriction, a mainstay in HF management, on cardiorenal and neuroendocrine adaptations during the progression of HF are poorly understood. The study aim was to assess the role of dietary sodium during the progression of experimental HF. Methods and Results Experimental HF was produced in a canine model by rapid right ventricular pacing which evolves from early mild HF to overt, severe HF. Dogs were fed one of three diets: 1) high sodium [250 mEq (5.8 grams) per day, n=6]; 2) standard sodium [58 mEq (1.3 grams) per day, n=6]; and 3) sodium restriction [11 mEq (0.25 grams) per day, n=6]. During the 38 day study hemodynamics, renal function, renin activity (PRA), and aldosterone were measured. Changes in hemodynamics at 38 days were similar in all three groups, as were changes in renal function. Aldosterone activation was demonstrated in all three groups, however, dietary sodium restriction, in contrast to high sodium, resulted in early (10 days) activation of PRA and aldosterone. High sodium demonstrated significant suppression of aldosterone activation over the course of HF progression. Conclusions Excessive dietary sodium restriction particularly in early stage HF results in early aldosterone activation, while normal and excess sodium intake are associated with delayed or suppressed activation. These findings warrant evaluation in humans to determine if dietary sodium manipulation, particularly during early stage HF, may have a significant impact on neuroendocrine disease progression. PMID:25823360

Fluid-inclusion data on samples from Creede, Colorado, in relation to mineral paragenesis

USGS Publications Warehouse

Woods, T.L.; Roedder, Edwin; Bethke, P.M.

1982-01-01

Published and unpublished data on 2575 fluid inclusions in ore and gangue minerals from the Creede, Colorado, Ag-Pb-Zn-Cu vein deposit collected in our laboratories from 1959 to 1981 have shown that the average salinity (wt. % NaCl equivalent, hereinafter termed wt.% eq.) and homogenization temperature (Th), and the ranges of these two parameters for fluid inclusions in sphalerite, quartz, fluorite, and rhodochrosite, respectively, are 8.1 (4.6 - 13.4), 239?C (195-274?C); 6.1 (1.1-10.0), 260?C (190->400?C); 10.7 (6.1-11.1), 217?C (213-229?C) and 260?C (247-268?C) (bimodal distribution of Th); and 9.9 (9.3 - 10.6), 214?C (185-249?C). Inclusions have been measured in minerals from four of the five stages of mineralization previously recognized at Creede. The few inclusions of fluids depositing rhodochrosite (A-stage, earliest in the paragenesis) yield Th and salinity values more similar to those of the low-temperature (average Th 217?C) fluids forming some of the much later fluorite (C-stage) than to any of the other fluids. Th measurements on A-stage quartz range from 192?C to 263?C and average 237?C. The early, fine-grained, B-stage sphalerites yielded Th of 214 to 241?C and salinities of 6.1 to 10.2 wt. % eq. D-stage sphalerite (late in the paragenesis) has been studied in detail (growth-zone by growth-zone) for several localities along the OH vein and reveals a generally positive correlation among Th, salinity and iron content of the host sphalerite. The deposition of D-stage sphalerite was characterized by repeated cycling through different regions of salinity/Th space, as Th and salinity generally decreased with time. Seventeen salinity-Th measurements were made on D-stage sphalerite from one locality on the Bulldog Mountain vein system, which, like the OH vein, is one of four major ore-producing vein systems at Creede. These data suggest a lower Th for a given salinity fluid from sphalerite on the Bulldog Mountain vein than on the OH vein. The very high values of Th for some quartz samples (mostly D-stage) are believed to be a result of the trapping of both gas and liquid from a boiling fluid in the upper levels of the vein system. Boiling of fluids depositing D-stage quartz is indicated by the presence of steam inclusions in quartz and the extreme variability of Th values measured on quartz. The pressure was low (< 125 kg/cm 2) throughout ore deposition. Three major growth zones in D-stage sphalerite are recognized throughout the OH vein. Deposition of the first major zone began from fluids having intermediate salinities and temperatures (7.8-9.2 wt. % eq., 240?C) but the characteristics of the fluids oscillated after that, ranging from 7.2 to 10.1 wt. % eq. and from 225?C to 270?C. Deposition of the second major, most Fe-rich zone began with the hottest, most saline fluids present during D-stage mineralization (. 270?C, 10.5-12.5 wt. % eq., 3 mole % FeS in sphalerite). The fluid then oscillated with respect to Th and salinity (213-274?C, 5.2-12.5 wt. % eq.) but showed a general decrease in both with time. Deposition of the youngest major zone began with a very Fe-poor sphalerite (0.25-0.75 mole % FeS), from the least saline, coolest fluids (5-6.5 wt. % eq., 200-212?C) and ended with a trend of increasing temperature at approximately constant salinity. The fluid-inclusion data can best be explained by a mixing model involving at least two fluids--one hot and saline, the other cool and fresher. Sudden changes in the mixing ratio, presumably from changes in the plumbing, punctuated long periods of remarkably uniform conditions of ore fluid flow and deposition. The effects of other processes such as convection and heat exchange with wall rocks must have been superimposed on this simple mixing model, however. In contrast to an earlier interpretation, several aspects of the inclusion data may be interpreted to suggest exceedingly slow ore deposition. Work in progress may resolve some of these ambiguities and refine

High Speed Compressor Study

DTIC Science & Technology

2011-12-21

ra tin g Fr eq...G as S pr in g Pi st on M as s (g ra m ) R es on an t F R eq ue nc y (H z) Gas Spring End Clearance (mm) Gas Spring Characteristics Resonant...0 50 100 150 200 250 20 30 40 50 60 70 80 90 R es on an t F R eq ue nc y (H z) G as S pr in g Pi st on M as s (g ra m ) Gas Spring

Life cycle Greenhouse gas emissions of current Oil Sands Technologies: surface mining and in situ applications.

PubMed

Bergerson, Joule A; Kofoworola, Oyeshola; Charpentier, Alex D; Sleep, Sylvia; Maclean, Heather L

2012-07-17

Life cycle greenhouse gas (GHG) emissions associated with two major recovery and extraction processes currently utilized in Alberta's oil sands, surface mining and in situ, are quantified. Process modules are developed and integrated into a life cycle model-GHOST (GreenHouse gas emissions of current Oil Sands Technologies) developed in prior work. Recovery and extraction of bitumen through surface mining and in situ processes result in 3-9 and 9-16 g CO(2)eq/MJ bitumen, respectively; upgrading emissions are an additional 6-17 g CO(2)eq/MJ synthetic crude oil (SCO) (all results are on a HHV basis). Although a high degree of variability exists in well-to-wheel emissions due to differences in technologies employed, operating conditions, and product characteristics, the surface mining dilbit and the in situ SCO pathways have the lowest and highest emissions, 88 and 120 g CO(2)eq/MJ reformulated gasoline. Through the use of improved data obtained from operating oil sands projects, we present ranges of emissions that overlap with emissions in literature for conventional crude oil. An increased focus is recommended in policy discussions on understanding interproject variability of emissions of both oil sands and conventional crudes, as this has not been adequately represented in previous studies.